Date Published: March 8, 2019
Publisher: Public Library of Science
Author(s): Sofus C. Larsen, Jeanett F. Rohde, Nanna J. Olsen, Mina N. Händel, Maria Stougaard, Jan Fahrenkrug, Berit L. Heitmann, Maciej S. Buchowski.
The association between chronically elevated cortisol, as measured by hair cortisol concentration (HCC), and dietary intake among children has generally not been explored. Moreover, it is unknown whether there is an association between parental HCC and dietary intake among their children.
To examine associations between HCC and dietary intake among children, and to explore the association between parental HCC and dietary intake among their children.
We conducted a cross-sectional study based on 296 children predisposed to overweight and obesity who participated in the Healthy Start study. Multiple Linear regression analyses were conducted to assess the association between HCC and total energy intake, macronutrients, fruit and vegetables, added sugar, sugar-sweetened beverages (SSB), and a diet quality index (DQI).
Among the children, we found that higher HCC was associated with a lower consumption of dietary fat (β: -0.7 g/day [95% CI: -1.3, -0.0] per 100 pg/mg HCC). We found no statistically significant association between HCC and intake of total energy, protein, carbohydrate, fruit and vegetables, added sugar, SSB or DQI. We found no association between parental HCC and intake of total energy, added sugar, selected food groups or DQI among their children. However, stratified analyses showed that paternal HCC was associated with a borderline significant lower total energy intake and significantly lower protein intake, but only among daughters (adjusted β: -42 kcal/day [95% CI: -85, 0] and -2.6 g/day [95% CI: -4.4, -0.8] per 100 pg/mg HCC, respectively).
Among children, chronic stress as measured by HCC may be associated with a lower fat consumption, and paternal HCC may be associated with a lower intake of energy and protein among their daughters. However, the associations observed were weak, and any clinical relevance of these findings remains questionable.
Several studies have shown a relationship between stress and obesity among children and adults [1–4], and that parental stress is associated with obesity in their children . The underlying causes of these associations are not fully understood, but it is well known that both psychosocial stress and obesity are linked to an unhealthy lifestyle . In this regard, a number of studies have suggested that psychosocial stress, as measured by questionnaire, is associated with a less healthy diet and higher intake of fatty and sweet foods [7–10]. Moreover, as parents have a high degree of influence on what their children eat, a relationship between parental stress levels and their children’s eating habits is also likely, and a direct association between parental perceived stress and higher fast food consumption among their children has been reported . Hence, both child and parental stress level may be a barrier for making healthy dietary choices necessary for long term weight control. However, the relationships may not be straight forward, as it has also been suggested that while some individuals have a propensity to increase their caloric intake during periods of stress, others tend to reduce their caloric intake .
Information on HCC, dietary intake and covariates are shown in Table 1. The median HCC was 92 pg/mg (5–95 percentiles: 23–416) among the children, 122 pg/mg (5–95 percentiles 47–329) among the mothers, and 148 pg/mg (5–95 percentiles: 52–404) among the fathers.
In this cross-sectional study of primarily normal-weight preschool children predisposed to overweight and obesity, we found that higher HCC was associated with a lower consumption of dietary fat, while no statistically significant associations were found between HCC and intake of total energy, protein, carbohydrate, fruit and vegetables, added sugar, SSB or DQI was found. Moreover, we found no evidence of association between parental HCC and intake of total energy, added sugar, selected food groups or DQI among their children. However, stratified analyses showed that paternal HCC was associated with a borderline significant lower total energy intake and a significantly lower protein intake among their daughters but not among their sons.