THE IMPORTANCE OF DIETARY PATTERNS AND APPETITE FOR THE ASSOCIATION BETWEEN IN UTERO EXPOSURE TO MALARIA AND FASTING PLASMA GLUCOSE AMONG ADOLESCENTS IN RURAL GHANA.

OBJECTIVE: In rural Ghana, in utero exposure to malaria is associated with 0.20 mmol/L higher fasting plasma glucose (FPG) in adolescence. We aimed to determine whether appetite and food intake mediate this association. METHODS: We used data of 155 mother-child pairs who were recruited at delivery in 2000 with data on in utero exposure to malaria. In 2015, we assessed appetite, food intake, and cardio-metabolic traits of the teenaged children. Mediation analysis was used to determine the contributions of increased appetite and dietary patterns to the observed infection-FPG-association. RESULTS: 45% of participants had in utero exposure to malaria, and 72% presented with increased appetite. Four dietary patterns were identified: i) manufactured foods, ii) vegetables, iii) roots and tubers, iv) soup and fufu-based. In utero exposure to malaria was positively associated with increased appetite (odds ratio: 2.38, 95% confidence interval (CI): 1.05, 5.60) and the roots & tubers pattern (beta: 2.23, 95% CI: 0.94, 3.54). This pattern tended to increase FPG (beta: 0.02, 95% CI: -0.01, 0.04 mmol/L), and mediated 60% of the infection-FPG-association. CONCLUSION: In utero exposure to malaria appears to increase appetite and promote adherence to carbohydrate-dense diets in adolescence. This pattern may contribute to altered glucose metabolism in adolescence.