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.

Claudia Börnhorst, Paola Russo, Toomas Veidebaum, Michael Tornaritis, Dénes Molnár, Lauren Lissner, Staffan Märild, Stefaan De Henauw, Luis A. Moreno, Anna Floegel, Wolfgang Ahrens, Maike Wolters