The association between dietary patterns and cardio vascular disease risk indicators in healthy youngsters: results covering fifteen years of longitudinal development

OBJECTIVE: To examine longitudinal relationships between nutrition and risk indicators for cardio vascular diseases (CVD) during adolescence and young adulthood.

DESIGN: A longitudinal study over fifteen years.

SUBJECTS: 98 females and 84 males, from 13 to 27 years.

METHODS: By means of six interviews dietary patterns were determined. Blood samples were analyzed for serum concentration of total cholesterol (TC), and high-density-lipoprotein (HDL), blood pressure, body fat and maximal aerobic power (VO2max) were determined. The longitudinal relations were analyzed with generalized estimation equations (GEE), a statistical technique in which relations at different time-points are tested simultaneously.

RESULTS: Compared to Dutch recommendations six out of seven macro nutrients appear to be unfavorable with respect to CVD. Borderline or high CVD risk values are apparent at 27 y in more than 25% of the subjects with respect to percentage body fat and serum total cholesterol in both sexes. In males 40% or more show borderline hypertension. The 'univariate' longitudinal analyses showed significantly positive relations: (1) between the intake of animal protein, saturated fat (SFA), cholesterol (Cho1) and TC, and HDL; (2) between total energy intake (EN) and systolic blood pressure, and VO2max. Significantly negative associations were found: (1) between EN, poly-unsaturated fat (PUFA) and TC concentrations; (2) between EN and sum of four skinfolds (SSF).

CONCLUSIONS: With increasing age, over a period of 15 y in both sexes the SFA and Cho1 intake relate significantly to the development of a negative CVD risk profile. The intake of PUFA relates positive to a CVD risk profile. The significantly negative relation between EN intake and body fat (SSF) is partly explained by the relation between EN and VO2max.