Ford ND, et al. - Whether better protein-energy nutrition from conception to age 2 years can reduce cardiometabolic disease risk was investigated in this analysis. Researchers reported that improved protein-energy nutrition from conception to the second birthday decreased the odds of diabetes at ages 37–54 years. The risk of obesity and several obesity-related conditions, including diastolic blood pressure and dyslipidemia, was also increased by this protein-energy supplementation. The findings suggested a mixed ability of protein-energy nutritional supplementation to prevent adult cardiometabolic disease incidence in contexts of chronic childhood undernutrition and an obesogenic adult environment.

Methods

• For this investigation, researchers followed up a cohort of 2,392 people born between January 1, 1962, and February 28, 1977 in four villages in Guatemala who had taken an interest in a cluster-randomized protein-energy nutritional supplementation (Atole) trial.
• Out of 1,661 members available for follow-up from February 26, 2015 to April 29, 2017, 684 women and 455 men were studied.
• Using anthropometry, fasting and post-challenge glucose, fasting lipid concentrations, and blood pressure, they evaluated cardiometabolic disease risk at ages 37–54 years.
• Generalized linear and logistic regression modelling were used to assess the impact of Atole from conception to age 2 years (the first 1,000 days) on cardiometabolic disease risk.

Results

• The study results showed that exposure to Atole from conception to age 2 years was correlated with increased fatness (body-mass index [1.29 kg/m², 95% CI 0.08 to 2.50], body fat [1.73%, 0.20 to 3.26], and obesity [odds ratio 1.94, 1.11 to 3.40]), diastolic blood pressure (1.59 mm Hg, -0.74 to 3.92), and blood lipids (total cholesterol [10.10 mg/dL, 0.80 to 19.40] and non-HDL cholesterol [10.41 mg/dL, 1.51 to 19.31]), reduced post-challenge glucose (–5.84 mg/dL, -12.51 to 0.83), and reduced odds of diabetes (odds ratio 0.46, 0.21 to 0.97).
• They discovered stratum heterogeneity by sex in pooled models for non-HDL cholesterol (4.34 mg/dL, 95% CI -6.86 to 15.55 for women vs 19.84 mg/dL, 5.86 to 33.82 for men) and post-challenge glucose (–0.19 mg/dL, -8.63 to 8.24 for women vs -13.10 mg/dL, -23.64 to -2.56 for men).
• Findings revealed that p values for interaction of sex and exposure to Atole from conception to age 2 years were 0.09 and 0.04, respectively.