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Background: Children's energy balance‐related behaviours (EBRB), comprising diet, screen time, physical activity, and sleep, combine into "lifestyle patterns", which may exert a synergistic effect on health. To date, studies investigating this synergy have primarily focused on obesity risk, without addressing other facets of health. Objectives: To examine the prospective associations of preschoolers' lifestyle patterns with socio‐emotional, behavioural, and body mass index (BMI) outcomes at 8 years. Methods: Participants were 876 children from the EDEN mother–child cohort. Three lifestyle patterns (unhealthy, healthy, and mixed) were previously identified at age 5, separately in boys and girls. At age 8, height and weight measures generated BMI z‐scores while social–emotional and behavioural development was assessed by parents using the Strengths and Difficulties Questionnaire (SDQ). Drawing from the outcome‐wide approach, sex‐ and outcome‐specific adjusted linear regressions were fitted. Results: Boys' adherence to a healthy lifestyle pattern (combining a nutrient‐dense diet and limited screen time) at 5 years was positively associated with prosocial behaviours (β = 0.14; 95% confidence interval [CI] 0.01, 0.26) and inversely related to hyperactivity‐inattention symptoms (β = −0.12; 95% CI −0.23, −0.01) at 8 years. Girls' mixed lifestyle pattern (sugar or artificially sweetened beverages, high screen, physical activity and low sleep times) was associated with prosocial behaviours (β = 0.12; 95% CI 0.01, 0.23). There was no evidence of associations between lifestyle patterns and BMI z‐scores. Conclusions: Findings suggest synergistic benefits of engaging in a combination of optimal EBRBs, especially in boys, and support intervention efforts at preschool age to enhance some dimensions of their later socio‐emotional and behavioural development. [ABSTRACT FROM AUTHOR]

Background: The timing of introduction of complementary foods and the duration of breastfeeding (BF) have been independently associated with child overweight and obesity; however, their combined influence on body fat partitioning and cardiometabolic risk is unclear. Objective: We investigated the associations of the timing of introduction of complementary foods, the duration of BF, and their interaction with child adiposity and cardiometabolic risk markers. Methods: We analyzed data from 839 children in the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Mothers reported the age at which infants were first fed complementary foods and BF duration, classified as early (≤4 mo) versus typical (>4 mo) complementary feeding (CF) and short (≤4 mo) versus long (>4 mo) duration of any BF, respectively. We measured adiposity and cardiometabolic risk markers at the age of 6 y and examined their associations with infant feeding patterns using multiple regression, adjusting for sociodemographics, parents' body mass index (BMI), maternal factors, birth weight for gestational age, and infant weight gain. Results: Of 839 children, 18% experienced early CF, whereas 54% experienced short BF. Short (vs. long) BF and early (vs. typical) CF were independently associated with higher z-scores of BMI [β (95% confidence interval), short BF, 0.18 standard deviation score (SDS) (-0.01, 0.38); early CF, 0.34 SDS (0.11, 0.57)] and sum of skinfolds [short BF, 1.83 mm (0.05, 3.61); early CF, 2.73 mm (0.55, 4.91)]. Children who experienced both early CF and short BF (vs. typical CF-long BF) had synergistically higher diastolic blood pressure [1.41 mmHg (-0.15, 2.97), P-interaction = 0.023] and metabolic syndrome score [0.81 (0.16, 1.47), P-interaction = 0.081]. Early CF-long BF (vs. early CF-short BF) was associated with a lower systolic blood pressure [-3.74 mmHg (-7.01, -0.48)], diastolic blood pressure [-2.29 mmHg (-4.47, -0.11)], and metabolic syndrome score [-0.90 (-1.80, 0.00)]. Conclusions: A combination of early CF and short BF was associated with elevated child adiposity and cardiometabolic markers. Longer BF duration may protect against cardiometabolic risk associated with early CF. This trial was registered at clinicaltrials.gov as NCT01174875. [ABSTRACT FROM AUTHOR]

Background Diet indices are widely used in nutritional research across communities but do not "capture" the full extent of diet variability across multiple countries. Empirically-derived dietary patterns can provide additional information as they reflect combinations of foods potentially associated with health outcomes. Limited studies have evaluated preconception dietary patterns among heterogeneous populations. Objectives In the multi-site NiPPeR study, secondary aims included: (1) derive pooled and site-specific preconception dietary patterns, and (2) evaluate these patterns using anthropometric measures and metabolic biomarkers. Methods Women planning pregnancy (n = 1720) in the United Kingdom, Singapore and New Zealand completed interviewer-administered harmonized food-frequency and lifestyle questionnaires at recruitment. Across-cohort ("pooled") and site-specific dietary patterns were derived, and associations between dietary pattern scores and BMI, waist to hip ratio, plasma lipids and glycemia assessed using multivariable linear regression, expressing results as standard deviation change in outcome per standard deviation change in dietary pattern score. Results The pooled analysis identified three dietary patterns: 'Vegetables/Fruits/Nuts' ('Healthy'), 'Fried potatoes/Processed meat/Sweetened beverages' ('Less Healthy') and 'Fish/Poultry/Noodles/Rice' ('Mixed'). The 'Healthy' and 'Less Healthy' pooled pattern scores were highly correlated with their corresponding site-specific dietary pattern scores ('Healthy': ρ = 0.87–0.93, 'Less Healthy': ρ = 0.65–0.88). Women with higher scores for the 'Healthy' pooled pattern had a lower waist to hip ratio [Standardized beta (95% CI): -0.10 (-0.18, -0.01)]; those with higher scores for the 'Less Healthy' pooled pattern had a higher BMI [0.17 (0.09, 0.24)], higher LDL cholesterol [0.10 (0.01, 0.19)] and less optimal glucose profiles. However, we noted higher adherence to the 'Healthy' pooled pattern with higher BMI. Conclusions The 'Healthy' and 'Less Healthy' pooled patterns were comparable to the corresponding site-specific patterns. While the associations between these patterns and objective anthropometric/metabolic measures were largely in the expected directions, future studies are required to confirm these findings. This trial is registered at ClinicalTrials.gov (NCT02509988). [ABSTRACT FROM AUTHOR]

Context: The kynurenine pathway generates metabolites integral to energy metabolism, neurotransmission, and immune function. Circulating kynurenine metabolites positively correlate with adiposity in children and adults, yet it is not known whether this relationship is present already at birth. Objective: In this prospective longitudinal study, we investigate the relationship between cord blood kynurenine metabolites and measures of adiposity from birth to 4.5 years. Methods: Liquid chromatography-tandem mass spectrometry was used to quantify cord blood kynurenine metabolites in 812 neonates from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fat percentage was measured by air displacement plethysmography and abdominal adipose tissue compartment volumes; superficial (sSAT) and deep subcutaneous (dSAT) and internal adipose tissue were quantified by magnetic resonance imaging at early infancy in a smaller subset of neonates, and again at 4 to 4.5 years of age. Results: Cord blood kynurenine metabolites appeared to be higher in female newborns, higher in Indian newborns compared with Chinese newborns, and higher in infants born by cesarean section compared with vaginal delivery. Kynurenine, xanthurenic acid, and quinolinic acid were positively associated with birthweight, but not with subsequent weight during infancy and childhood. Quinolinic acid was positively associated with sSAT at birth. Kynurenic acid and quinolinic acid were positively associated with fat percentage at 4 years. Conclusion: Several cord blood kynurenine metabolite concentrations were positively associated with birthweight, with higher kynurenic acid and quinolinic acid correlating to higher percentage body fat in childhood, suggesting these cord blood metabolites as biomarkers of early childhood adiposity. [ABSTRACT FROM AUTHOR]