Association of Maternal Dietary Patterns With Birth Weight and the Mediation of Gestational Weight Gain: A Prospective Birth Cohort

Abstract

The associations among maternal diet, birth weight, and gestational weight gain are still inconclusive. This study aimed to investigate the associations between maternal dietary patterns and birth weight, and further explore whether GWG mediates these associations. A total of 3,334 pregnant women who completed a validated semi-quantitative food frequency questionnaire from the Tongji Maternal and Child Health Cohort were included. Dietary patterns were extracted by using principal component analysis. Regression models and mediation analyses were performed to explore the associations between dietary patterns and birth weight and the effects of GWG on these associations. Five dietary patterns were identified: “Beans-vegetables,” “Fish-meat-eggs,” “Nuts-whole grains,” “Organ-poultry-seafood” and “Rice-wheat-fruits.” Only women following the “Beans-vegetables” pattern had heavier newborns (β = 47.39; 95% CI: 12.25, 82.54). Women following the “Beans-vegetables” pattern had significantly lower GWG (β = −0.7; 95% CI: −1.15, −0.25) and had a 16% lower risk of excessive GWG and 11% higher odd of adequate GWG. The association between the “Beans-vegetables” pattern and birth weight was negatively mediated by GWG. A dietary pattern enriched in beans and vegetables is beneficial for effectively controlling GWG and increasing birth weight. GWG serves.Clinical Trial Registry: This trial was registered at ClinicalTrials.gov (NCT03099837).

The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

“…Our findings are in line with the findings of previous studies [9,[12][13][14]18,19,28] that indicated prenatal dietary patterns have important roles in GWG status. We reported that women who adhered to a traditional pattern consisting of high intakes were at a higher risk of EGWG.…”

“…Even though fried foods are known as risk markers for the development of obesity, fried foods also contain an abundance of high-protein foods, such as fried chicken and fish. Previous studies have reported that dietary patterns containing protein-rich foods, such as beans [13,19], dairy [9,28], and fish [28], are associated with a lower risk of EGWG. Potential mechanisms could be that most of these high-protein foods, such as milk, bean products, and fish, are relatively low-energy dense foods compared to high-carbohydrate or -fat foods [29].…”

“…Possible mechanisms underlying the association between dietary pattern and EGWG could be that the over-consumption of high glycemic index foods, such as tubers, rice, and fruits and high energy dense foods, such as red meat, may influence maternal blood glucose levels and lead to excess fat storage among pregnant women. Even though the traditional pattern also contains food items, such as vegetables, they have been reported to have a beneficial effect on women's health [13,19]. This common Chinese dietary pattern has an adverse influence on EGWG prevention.…”

“…Maternal dietary patterns represent a broader picture of food consumption during pregnancy and are more relevant and practical for the prevention of EGWG, especially among Asian Chinese populations, who have a complex food composition and diet culture [16,17]. However, only two studies were based on Chinese populations and have reported conflicting results [18,19]. Yang et al [17] reported that pregnant women following a beans-vegetables dietary pattern had significantly lower gestational weight gain (GWG); however, the bean-vegetable pattern was not associated with GWG in another cohort study in China [18].…”

“…Yang et al [17] reported that pregnant women following a beans-vegetables dietary pattern had significantly lower gestational weight gain (GWG); however, the bean-vegetable pattern was not associated with GWG in another cohort study in China [18]. Furthermore, both studies [18,19] were conducted in southern China, which may not be representative of the northern food environment in China. Additional studies, therefore, are warranted.…”