Maternal healthful dietary patterns during peripregnancy and long-term overweight risk in their offspring

Abstract

Adherence to healthful dietary patterns is associated with lower body mass index (BMI) in adults; however, whether maternal diet quality during peripregnancy is related to a lower overweight risk in the offspring remains to be elucidated. We investigated the associations between the Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (aMED) and Dietary Approach to Stop Hypertension (DASH) during peripregnancy and offspring weight outcomes in a study including 2729 mother-child pairs from the Nurses' Health Study II and offspring cohort Growing Up Today Study II. Children, 12-14 years at baseline were 21-23 years at the last follow-up. Overweight or obesity was defined according to International Obesity Task Force (< 18 years) and World-Health-Organization guidelines (18 + years). Maternal dietary patterns were calculated from food frequency questionnaires. Log-binomial models were used to estimate relative risks (RR) and 95% confidence intervals. In models adjusted for sex, gestational age at delivery and maternal total energy intake, greater maternal adherence to aMED and DASH, but not AHEI, was associated with lower overweight risk in the offspring (RR Q5 vs Q1 = 0.82 [0.70-0.97] for aMED and 0.86 [0.72-1.04] for DASH, P for trend < 0.05 for both). After additional adjustment for maternal pre-pregnancy lifestyle factors and socio-demographic characteristic, none of the diet quality scores were significantly associated with offspring overweight risk. Maternal pre-pregnancy BMI did not modify any of these associations. In this population of generally well-nourished women, maternal healthful dietary patterns during the period surrounding pregnancy were not independently associated with offspring overweight risk at ages 12-23 years.

Pre-Pregnancy Diet Quality Is Associated with Lowering the Risk of Offspring Obesity and Underweight: Finding from a Prospective Cohort Study

“…To our knowledge, this is the first evidence conducted on the association between preconception diet quality and offspring BMI outcomes in Australia. Our finding is contrary to that of Strohmaier et al (2020) who found no relationship between healthful dietary intake during peri-conception and offspring obesity aged 12–23 years [ 19 ]. This inconsistency might be due to the difference in quality and quantity of maternal diets, the timing of the intake, offspring age, and the assessment techniques used.…”

“…A considerable amount of literature has been published on the relationship between maternal diet in pregnancy and childhood body compositions or BMI outcomes, including overweight and obesity; however, the findings have been inconsistent [ 15 , 16 , 17 , 18 ]. A prospective cohort study conducted by Strohmaier et al reported no association between peri-conception healthy dietary patterns and obesity risk in their offspring [ 19 ]. No study, to our knowledge, has conducted the relationship between pre-pregnancy diet quality and a child’s BMI outcomes in offspring.…”

Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation

“…The analysis of results from the Growing Up Today Study II across follow-up ages of 12–23 years indicate that greater maternal adherence to the Alternate Mediterranean Diet (aMED) score (adapted to the US population) showed similar findings with a lower risk of offspring overweight or obesity [ 116 ]. However, the results were not significant following adjustment for potential confounders including maternal pre-pregnancy BMI and lifestyle factors.…”

“…However, the results were not significant following adjustment for potential confounders including maternal pre-pregnancy BMI and lifestyle factors. It should be noted that childhood weight measures were self-reported in the study, which may lead to underreporting amongst adolescents with obesity [ 116 ]. In a Spanish study predicting long-term health outcome risks, the importance of tracking childhood adiposity rather than crude weight alone is underscored, because cardiometabolic risk factors are more prevalent in children and adolescents with abdominal obesity than those with general overweight/obesity [ 121 , 124 , 125 ].…”

“…However, another study by Gonzalez-Nahm et al in an American cohort found no association between AHEI-2010 scores in mid to late pregnancy and infant adiposity at birth, 6 or 12 months after adjustment for confounders such as maternal smoking, pre-pregnancy BMI, maternal ethnicity and maternal education [ 118 ]. Similarly, retrospective analysis by Strohmaier et al found no associations between peripregnancy maternal adherence to the AHEI-2010 and offspring risk for obesity 12–23 years after adjustment for pre-pregnancy BMI and lifestyle factors [ 116 ]. Long-term studies using the modified AHEI-P are not yet available.…”