Eating behaviors of preschoolers may be associated with risk of cardiovascular disease in later life, suggests a study published in CMAJ (Canadian Medical Association Journal).

A study of 1076 preschool children aged 3-5 years in the TARGet Kids! practice-based research network in Toronto, Ontario, looked at the link between eating habits and serum levels of non-high-density lipoprotein (HDL) cholesterol, which is a surrogate marker of later cardiovascular risk. Parents filled out questionnaires assessing eating behaviors, such as watching television while eating, dietary intake, parental concerns about activity levels and growth, screen time and use of supplements. Researchers measured height and weight of the children and their parents and took blood samples to examine lipid profile. They assigned a risk level based on the ethnicity of the parents because some groups are more prone to heart disease than others.

"Our results show that associations between eating behaviors and cardiovascular risk appear early in life and may be a potential target for early intervention," writes Dr. Navindra Persaud, family physician and researcher at St. Michael's Hospital, Toronto, Ontario. TARGet Kids! is a collaboration between family physicians, pediatricians and researchers from The Hospital for Sick Children (SickKids) Hospital, St. Michael's Hospital and the University of Toronto.

"Eating behaviors as reported by parents via the NutriSTEP questionnaire were positively associated with serum non-HDL cholesterol levels in children aged 3-5 years," write the authors. "The association between the eating behaviors subscore and serum non-HDL cholesterol persisted after controlling for age, sex, birth weight, zBMI (z-score body mass index), parental BMI, gestational diabetes and parental ethnicity."

"Our results support previous arguments for interventions aimed at improving the eating behaviors of preschool-aged children," write the authors. "To do so, evidence suggests promoting responsive feeding, where adults provide appropriate access to healthy foods and children use internal cues (not parent-directed cues or cues from the television) to determine the timing, pace and amount they consume."