The role of lifestyle and non-modifiable risk factors in the development of metabolic disturbances from childhood to adolescence

Background: The study aimed to identify the effects of lifestyle, C-reactive protein (CRP) and non-modifiable risk factors on metabolic disturbances in the transition from childhood to adolescence. Methods: In 3889 children of the IDEFICS/I.Family cohort, latent transition analysis estimated probabilities of metabolic disturbances based on waist circumference, blood pressure, blood glucose, and lipids at baseline and at 2- and 6-year follow-ups. Multivariate mixed-effects models assessed age-dependent associations of lifestyle, non-modifiable risk factors and CRP with the transformed probabilities of abdominal obesity, hypertension, dyslipidemia, or several metabolic disturbances (reference: metabolically healthy). Results: Higher maternal BMI, familial hypertension and higher CRP z-score increased risk for all four outcomes; low/medium parental education increased risk of abdominal obesity and of showing several metabolic disturbances. Among lifestyle factors, the number of media in the bedroom, membership in a sports club, and well-being were associated with some outcomes. Having ≥1 media in the bedroom increased the risk for several metabolic disturbances with odds ratio (OR) increasing with age (1.30 [95% CI 1.18; 1.43] at age 8; interaction with age 1.18 [1.14; 1.23]). Early puberty strongly associated with abdominal obesity (2.43 [1.60; 3.69] at age 8; interaction 0.75 [0.69; 0.81]) and with several metabolic disturbances (2.46 [1.53; 3.96] at age 8; interaction 0.71 [0.65; 0.77]). Conclusions: Multiple factors influence children’s metabolic risk, indicating the need for multifactorial interventions. Removal of media from children’s bedrooms and promoting sports club membership are promising prevention targets.