Background

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in the US accounting for nearly 1 in 3 adult deaths. Risk factors for CVD can begin early in childhood and may extend into adulthood. The study objective was to explore potential associations between intake of whole grain (WG) or dietary fiber with cardiometabolic risk factors including Metabolic Syndrome (MetS) using NHANES 2003-2014 survey data from children 2-18 years old (n=21,867).

Methods

Continuous MetS scores (cMetS) were computed by aggregating age/sex regressed standardized individual residuals (z-scores) of waist circumference (WC), mean arterial pressure (MAP = {(systolic blood pressure (SBP)-diastolic blood pressure (DBP))/3} + DBP), high density lipoprotein-cholesterol (HDL-C) multiplied by -1, fasting triglycerides (TG), and fasting blood glucose (FBG). Odds ratios (OR) with 99% confidence intervals (CI) for adjusted (age, gender, race/ethnicity, poverty income ratio, physical activity level and caloric intake) risk variables were developed for tertiles of fiber and WG intake with comparisons to the tertile 1 as reference group.

Results

Risk of elevated DBP (n=5,507) decreased by 23% (OR 0.77, Plinear trend = 0.0210) with increasing fiber density and by 10% (OR 0.90, Plinear trend = 0.0307) with increasing fiber intake but was not associated with WG intake. Risk of elevated TG (n=2,482) decreased by 52% (OR 0.48, Plinear trend = 0.0116) with increasing WG density but was not associated with fiber intake. Risk of elevated cMetS score (>85th percentile) (n=5,629) decreased by 3% (OR 0.97, Plinear trend = 0.0269) with increasing fiber intake but was not associated with WG intake.

Conclusions

These results suggest that increased fiber intake in children is associated with decreased risk of elevated cMetS while increased WG intake is associated with lower TG levels. This study also provides a novel methodology for examining MetS in pediatric populations using nationally representative data.