The relationship of eating behavior with biochemical blood parameters in children and adolescents born preterm

BACKGROUND: Prematurity is a risk for the formation of adverse metabolic disorders, the components of which can progress and lead to obesity. However, at the moment, the presence and nature of interrelations of metabolic parameters with the type of nutrition have not been established, there is also no clear idea of the age and structure of the initial manifestations of metabolic shifts, the prevalence of eating disorders in children born prematurely.

AIMS: To determine the frequency and structure of the initial manifestations of the metabolic syndrome (abdominal obesity, impaired glucose tolerance, dyslipidemia, hypertension); to establish associations of types of eating behavior with biochemical parameters characterizing the adverse metabolic phenotype in children and adolescents born prematurely.

MATERIALS AND METHODS: The study involved 123 children: in the main group (group 1) there were children and adolescents aged 10-17 years 11 months who were born prematurely (less than 37 weeks at birth and less than 2500 grams at birth), in the control group (group 2) included full-term children (more than 37 weeks and more than 2500 grams at birth). The study included clinical anthropometry with measurement of body weight, height, waist circumference (WC) and hips (HC), followed by calculation of body mass index (BMI) and ratio of WC/HC, measurement of blood pressure (BP). Eating behavior (EB) was assessed using a modified validated Dutch Eating Behavior Questionnaire (DEBQ).

RESULTS: WC equal to or above the 90th percentile were only in children from the main group (4 children (9.7%).There were not observed such parameters in the control group (χ²=4.63, p=0.047). BP higher than the 95th percentile was observed mainly in children born prematurely: 19 children (46.3%) against one (3.3%) of the control group (χ²=21.94, p <0.001). Eating disorders are often found in both groups (59 of 123 (47.9%)): the control group had 35 of 65 (53.8%) children against 24 of 58 (41.4%) of the main group (p>0.05).

CONCLUSIONS: The components of metabolic syndrome are registered more often in children born prematurely. Eating disorders are often found in both groups.

eating behavior, preterm infants, metabolic syndrome

1. Salvatori P, Andrei F, Neri E, et al. Pattern of mother-child feeding interactions in preterm and term dyads at 18 and 24 months. Front Psychol. 2015;6:1245. DOI:10.3389/fpsyg.2015.01245

2. Krug I, Taborelli E, Sallis H, et al. A systematic review of obstetric complications as risk factors for eating disorder and a meta-analysis of delivery method and prematurity. Physiol Behav. 2013;109:51-62. DOI:10.1016/j.physbeh.2012.11.003

3. Ammaniti M, Lucarelli L, Cimino S, et al. Feeding disorders of infancy: a longitudinal study to middle childhood. Int J Eat Disord. 2012;45(2):272-280. DOI:10.1002/eat.20925

4. Tinnion R, Gillone J, Cheetham T, Embleton N. Preterm birth and subsequent insulin sensitivity: a systematic review. Arch Dis Child. 2014;99(4):362-368. DOI:10.1136/archdischild-2013-304615

5. Kerkhof GF, Breukhoven PE, Leunissen RW, et al. Does preterm birth influence cardiovascular risk in early adulthood? J Pediatr. 2012;161(3):390-396. DOI:10.1016/j.jpeds.2012.03.048

6. Hales CN, Barker DJ. The thrifty phenotype hypothesis. Br Med Bull. 2001;60:5-20. DOI:10.1093/bmb/60.1.5

7. Langley-Evans SC. Nutritional programming of disease: unravelling the mechanism. J Anat. 2009;215(1):36-51. DOI:10.1111/j.1469-7580.2008.00977.x

8. Van Strien T, Frijters JE, Bergers GP, et al. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord. 1986;5(2):295-315.DOI:10.1002/1098-108X(198602)5:23.0.CO;2-T

9. International Diabetes Federation. The IDF consensus definition of the metabolic syndrome in children and adolescents.Brussels: IDF; 2007.

10. Hack M, Cartar L, Schluchter M, et al. Self-perceived health, functioning and well-being of very low birth weight infants at age 20 years. J Pediatr. 2007;151(6):635-641, 641 e631-632. DOI:10.1016/j.jpeds.2007.04.063

11. Mathai S, Derraik JG, Cutfield WS, et al. Increased adiposity in adults born preterm and their children. PLoS One. 2013;8(11):e81840. DOI:10.1371/journal.pone.0081840

12. Ruppar TM, Conn VS, Chase JA, Phillips LJ. Lipid outcomes from supervised exercise interventions in healthy adults. Am J Health Behav. 2014;38(6):823-830. DOI:10.5993/AJHB.38.6.4

13. Ye J. Mechanisms of insulin resistance in obesity. Front Med. 2013;7(1):14-24. DOI:10.1007/s11684-013-0262-6

14. Lee DY, Lee ES, Kim JH, et al. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study. PLoS One. 2016;11(9):e0163465. DOI:10.1371/journal.pone.0163465

15. Gesteiro E, Bastida S, Barrios L, Sanchez-Muniz FJ. The triglyceride-glucose index, an insulin resistance marker in newborns? Eur J Pediatr. 2018;177(4):513-520. DOI:10.1007/s00431-018-3088-z

16. Angoorani P, Heshmat R, Ejtahed HS, et al. Validity of triglyceride-glucose index as an indicator for metabolic syndrome in children and adolescents: the CASPIAN-V study. Eat Weight Disord. 2018;23(6):877-883. DOI:10.1007/s40519-018-0488-z

17. Ghaemi S, Najafi R, Kelishadi R. Cord blood lipoprotein profile in term, preterm, and late preterm newborns.J Res Med Sci. 2014;19(11):1038-1040.

18. Parkinson JR, Hyde MJ, Gale C, et al. Preterm birth and the metabolic syndrome in adult life: a systematic review and meta-analysis. Pediatrics. 2013;131(4):e1240-1263. DOI:10.1542/peds.2012-2177

19. Victor S, Dickinson H, Turner MA. Plasma aminotransferase concentrations in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2011;96(2):F144-145. DOI:10.1136/adc.2008.152454

20. Braet C, Claus L, Goossens L, et al. Differences in eating style between overweight and normal-weight youngsters. J Health Psychol. 2008;13(6):733-743. DOI:10.1177/1359105308093850

21. Юдицкая Т.А. Роль и место нарушений пищевого поведения в комплексной характеристике ожирения у детей: Автореф. дис. … канд. мед. наук. — Томск; 2016. [Yuditskaya TA. Rol’ i mesto narusheniy pishchevogo povedeniya v kompleksnoy kharakteristike ozhireniya u detey. [dissertation] Tomsk; 2016. (In Russ).]

22. Potijk MR, de Winter AF, Bos AF, et al. Higher rates of behavioural and emotional problems at preschool age in children born moderately preterm. Arch Dis Child. 2012;97(2):112-117. DOI:10.1136/adc.2011.300131

23. Александров А.А., Петеркова В.А., Васюкова О.В., и др. Рекомендации по диагностике, лечению и профилактике ожирения у детей и подростков. — М.: Практика; 2015. [Aleksandrov AA, Peterkova VA, Vasjukova OV, et al. Recommendations for diagnosis, treatment and prevention of obesity in children and adolescents. Moscow: Praktika; 2015. (In Russ).] DOI:10.13140/RG.2.1.1842.0084