title: Association between serum cholesterol and eating behaviours during early childhood: a cross-sectional study.
abstract: BACKGROUND
  Modifiable behaviours during early childhood may provide opportunities to prevent disease processes before adverse outcomes occur. Our objective was to determine whether young children's eating behaviours were associated with increased risk of cardiovascular disease in later life.
  
  
  METHODS
  In this cross-sectional study involving children aged 3-5 years recruited from 7 primary care practices in Toronto, Ontario, we assessed the relation between eating behaviours as assessed by the NutriSTEP (Nutritional Screening Tool for Every Preschooler) questionnaire (completed by parents) and serum levels of non-high-density lipoprotein (HDL) cholesterol, a surrogate marker of cardiovascular risk. We also assessed the relation between dietary intake and serum non-HDL cholesterol, and between eating behaviours and other laboratory indices of cardiovascular risk (low-density lipoprotein [LDL] cholesterol, apolipoprotein B, HDL cholesterol and apoliprotein A1).
  
  
  RESULTS
  A total of 1856 children were recruited from primary care practices in Toronto. Of these children, we included 1076 in our study for whom complete data and blood samples were available for analysis. The eating behaviours subscore of the NutriSTEP tool was significantly associated with serum non-HDL cholesterol (p = 0.03); for each unit increase in the eating behaviours subscore suggesting greater nutritional risk, we saw an increase of 0.02 mmol/L (95% confidence interval [CI] 0.002 to 0.05) in serum non-HDL cholesterol. The eating behaviours subscore was also associated with LDL cholesterol and apolipoprotein B, but not with HDL cholesterol or apolipoprotein A1. The dietary intake subscore was not associated with non-HDL cholesterol.
  
  
  CONCLUSIONS
  Eating behaviours in preschool-aged children are important potentially modifiable determinants of cardiovascular risk and should be a focus for future studies of screening and behavioural interventions.
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, Toronto, Ont. nav.persaud @utoronto.ca
authors.forename: Navindra
authors.initials: N
authors.lastname: Persaud
authors.forename: Jonathon L
authors.initials: JL
authors.lastname: Maguire
authors.forename: Gerald
authors.initials: G
authors.lastname: Lebovic
authors.forename: Sarah
authors.initials: S
authors.lastname: Carsley
authors.forename: Marina
authors.initials: M
authors.lastname: Khovratovich
authors.forename: Janis A
authors.initials: JA
authors.lastname: Randall Simpson
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Parkin
authors.forename: Catherine
authors.initials: C
authors.lastname: Birken
mesh_terms: D002170:Canada; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002669:Child Welfare; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D061345:Early Medical Intervention; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000175:diagnosis; D008297:Male; D011320:Primary Health Care; D018570:Risk Assessment
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol