Added sugar intake during pregnancy: Fetal behavior, birth outcomes, and placental DNA methylation

Abstract

Pregnancy is a critical time for the effects of environmental factors on children's development. The effect of added sugar intake on fetal development and pregnancy outcomes remains understudied despite increasing dietary intake in the United States. This study investigated the effect of added sugar on fetal programming by examining the association between maternal added sugar consumption, fetal movement, birth outcomes, and placental DNA methylation. Further, primary human fibroblasts were cultured under normal or high glucose conditions to assess the effect of high glucose exposure on cells' DNA methylation. We found that higher added sugar intake across pregnancy was associated with reduced 3rd‐trimester fetal movement (p < .05) and shorter gestation (p < .01). Our sample size was not powered to detect the alteration of individual placental CpG with genome‐wide significance. However, a secondary analysis suggested that added sugar consumption was associated with differential methylation of functionally related gene families across pregnancy. Consistent with this, high glucose exposure in primary cultured human fibroblasts altered the methylation of 17% of all CpGs, providing converging evidence for an effect of sugar on DNA methylation. Our results suggest that diets high in added sugar during pregnancy may have implications for offspring health via prenatal programming effects measurable before birth.

The Impact of Lifestyle, Diet and Physical Activity on Epigenetic Changes in the Offspring—A Systematic Review

“…Among the 16 studies included, 5 studies were RCTs [ 17 , 18 , 19 , 20 , 21 , 26 ] and 11 studies were cohort studies [ 3 , 4 , 6 , 12 , 13 , 14 , 16 , 22 , 23 , 24 , 25 ]. In total, 3617 mother–offspring pairs were included.…”

“…Some of the included studies investigated a lifestyle with a combination of diet and physical activity, while others investigated either a specific diet or dietary components. Four studies investigated physical activity as the exposure variable [ 4 , 6 , 17 , 21 ], four studies investigated carbohydrate intake [ 12 , 14 , 16 , 22 ], four studies investigated glycemic index [ 17 , 18 , 19 , 24 ], two studies investigated sugar intake [ 12 , 23 ], two studies investigated Mediterranean diet [ 21 , 25 ], four studies investigated fat intake [ 12 , 17 , 22 , 27 ] and three studied other exposures (olive oil [ 20 ], unbalanced diet [ 13 ] and pro-inflammatory diet [ 3 ]). Most studies investigated epigenetic changes in the offspring at birth.…”

“…We identified no studies that investigated histone changes and only one that study investigated miRNA changes [ 20 ]. The remaining 15 studies investigated DNA methylation, of which 7 of the included studies used a genome-wide approach [ 17 , 18 , 19 , 21 , 22 , 23 , 24 ] measuring methylation at CpG sites or differentially methylated regions (DMRs), while eight studies investigated DNA methylation at specific genes [ 3 , 4 , 6 , 12 , 13 , 14 , 16 , 25 ]. Seven studies used cord blood [ 3 , 6 , 14 , 17 , 19 , 21 , 25 ], five studies used placenta samples [ 12 , 20 , 22 , 23 , 24 ] and the rest of the studies used material from either saliva [ 18 ], umbilical cord (UC) tissue [ 16 ], blood spots [ 4 ] or peripheral blood [ 13 ].…”

“…Five RCTs [ 17 , 18 , 19 , 20 , 21 ] and three cohort studies [ 22 , 23 , 24 ] examined genome-wide methylation levels. Antoun et al [ 17 ] and Jönsson et al [ 21 ] both investigated an intervention of a combination of diet and physical activity on DNA methylation in cord blood.…”

“…However, no maternal diet predictor variable was significantly associated with placental DNA methylation when adjusting for multiple testing. Trumpff et al [ 23 ] focused on one specific type of carbohydrates, namely, added sugar. They observed DNA methylation levels in placenta in 453,144 CpG sites, but no individual CpG achieved significance for altered methylation.…”