Impact of Dietary Macronutrient Intake during Early and Late Gestation on Offspring Body Composition at Birth, 1, 3, and 5 Years of Age

Abstract

Dietary intake during pregnancy as a possible modifiable risk factor for childhood obesity is poorly explored. In a prospective observational study, two multivariable regression models were therefore used to associate maternal diet at 15 and 32 weeks’ gestation with offsprings’ body composition and fat distribution at birth, 1, 3, and 5 years. Mean energy intake was 2157 ± 375 kcal (n = 186) in early and 2208 ± 460 kcal (n = 167) in late gestation. The partition model showed mostly no significant associations between maternal diet in early pregnancy and offspring body composition. In late pregnancy, higher fat intake was negatively associated with clinical outcomes at birth, 1, and 5 years. Protein intake was negatively associated with BMI z score (zBMI) at 3 and 5 years. A 10 g increase in fiber was associated with an increase of 3.50 mm2 abdominal subcutaneous fat at 1, 172.49 g fat mass at 3, and 0.23 zBMI at 5 years. Results were largely comparable in the substitution model. An incremental increase in fat and protein at the expense of carbohydrates in late but not early pregnancy may be associated with lower fat mass up to 5 years. Findings require confirmation by additional prospective studies.

In Overweight or Obese Pregnant Women, Maternal Dietary Factors are not Associated with Fetal Growth and Adiposity

“…The majority of the literature relates to neonatal and infant body composition [ 15 , 21 , 24 ], birthweight [ 18 , 19 , 20 ] with variable methodology and inconsistent findings [ 21 , 43 ]. An explanation for the lack of association seen in our study and inconsistent findings within the literature may relate to the timing of the dietary assessment.…”

“…An explanation for the lack of association seen in our study and inconsistent findings within the literature may relate to the timing of the dietary assessment. Early 2nd trimester maternal dietary analysis has been assessed in the literature [ 15 , 44 ] with no consistent findings [ 15 , 20 , 24 , 44 ]. One study assessed dietary intake between 8 and 12 weeks and found carbohydrate consumption was associated with increase in birthweight, whereas fat intake was associated with lower birthweight [ 19 ].…”

“…There is growing interest in the programming of fetal growth, the critical time points and the influence of maternal diet as a potentially modifiable factor. The current literature is inconsistent, largely due to the heterogeneity and variability relating to the timing and types of dietary assessments, reporting and methodology along with body composition outcome measurements [ 15 ]. In relation to maternal carbohydrate intake for example, some studies have shown a positive effective of high carbohydrates on childhood BMI [ 16 ] and others have shown a low carbohydrate diet was associated with increased fetal abdominal fat [ 17 ].…”

“…In relation to maternal carbohydrate intake for example, some studies have shown a positive effective of high carbohydrates on childhood BMI [ 16 ] and others have shown a low carbohydrate diet was associated with increased fetal abdominal fat [ 17 ]. The majority have shown a negative effect [ 18 , 19 , 20 ] and one study has shown no effect [ 15 ]. Protein and carbohydrate ratios or combination diets have also been reported, where high protein associated with low carbohydrate and fat diet was associated with a reduction in neonatal abdominal adiposity [ 21 ], whereas another study showed low protein: carbohydrate ratio was associated with increased abdominal fat in the fetus.…”

Maternal Adiposity is Associated with Fat Mass Accretion in Female but not Male Offspring During the First 2 Years of Life

“…A novel finding of this study is that maternal dietary fiber intake during gestation is negatively associated with female offspring adiposity. Very few studies have specifically looked at dietary fiber intake and its contribution to offspring whole-body adiposity, and none have evaluated its effect in a sexual dimorphic manner (26,27). In agreement with our findings, a study by Hallam et al (28) found that female offspring of rats exposed to a high fiber diet in utero had lower birth weight and body fat at 22 weeks of age (adolescence equivalent in humans) and lower levels of hepatic triacylglycerol, indicating an effect on hepatic lipid storage.…”