Socio-economic differences in cardiometabolic risk markers are mediated by diet and body fatness in 8- to 11-year-old Danish children: a cross-sectional study.

Objective: To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. Design: Cross-sectional study including measurements of fasting blood lipids, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure and heart rate. Potential mediators examined were fat mass index (FMI); intakes of fruit, vegetables, dietary fibre and added sugar; whole-blood n-3 longchain PUFA (LCPUFA) as a biomarker of fish intake; and physical activity and sedentary time. Setting: Nine primary schools in Denmark. Subjects: Children aged 8-11 years (n 715). Results: Children of parents with the shortest compared with longest education had higher TAG by 0·12 (95% CI 0·04, 0·21) mmol/l and HOMA-IR by 0·36 (0·10, 0·62), whereas children of parents with a vocational education had higher total cholesterol by 0·14 (0·02, 0·27) mmol/l and LDL cholesterol by 0·14 (0·03, 0·25) mmol/l compared with children of parents with the longest education; all P <0·05. FMI explained 25% of the difference in TAG, 64% of the difference in HOMA-IR and 21-29% of the differences in cholesterols. FMI and whole-blood n-3 LCPUFA combined explained 42% of the difference in TAG, whereas FMI, whole-blood n-3 LCPUFA and dietary fibre explained 89% of the difference in HOMA-IR. Conclusions: Socio-economic differences were present in blood lipids and insulin resistance among 8- to 11-year-olds and were mediated by body fatness, wholeblood n-3 LCPUFA and dietary fibre. These lifestyle factors may be targets in public initiatives to reduce socio-economic differences. Confirmation in longitudinal studies and trials is warranted. [ABSTRACT FROM AUTHOR]