title: Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease.
abstract: Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary behaviors contribute to elevated CVD risk among young adults who are born prematurely.
authors.affiliation: Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Mastaneh
authors.initials: M
authors.lastname: Sharafi
authors.affiliation: Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA. Electronic address: valerie.duffy@uconn.edu.
authors.forename: Valerie B
authors.initials: VB
authors.lastname: Duffy
authors.affiliation: School of Nursing, University of Connecticut, Storrs, CT, USA.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Miller
authors.affiliation: Brown Center for Study of Children at Risk Women & Infants Hospital, Providence, RI, USA; College of Nursing, University of Rhode Island, Kingston, RI, USA.
authors.forename: Suzy B
authors.initials: SB
authors.lastname: Winchester
authors.affiliation: Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Tania B
authors.initials: TB
authors.lastname: Huedo-Medina
authors.affiliation: College of Nursing, University of Rhode Island, Kingston, RI, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Sullivan
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D000072001:Diet, Healthy; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D063427:Food Quality; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D008137:Longitudinal Studies; D008297:Male; D009511:New England; D015596:Nutrition Assessment; D047928:Premature Birth / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cardiovascular disease; Dietary quality; Food neophobia; Food preference; Preterm; Restraint; Structural equation modeling