Maternal Obesity, Gestational Weight Gain, and Offspring Adiposity: The Exploring Perinatal Outcomes among Children Study

Abstract

Objective To determine if adequate versus excessive gestational weight gain (GWG) attenuated the association between maternal obesity and offspring outcomes. Study design Data from 313 mother-child pairs participating in the Exploring Perinatal Outcomes in Children (EPOCH) study were used to test this hypothesis. Maternal pre-pregnancy body mass index (BMI) and weight measures throughout pregnancy were abstracted from electronic medical records. GWG was categorized according to the 2009 Institute of Medicine (IOM) criteria as adequate or excessive. Offspring outcomes were obtained at a research visit (average age 10.4 years) and included body mass index (BMI), waist circumference (WC), subcutaneous (SAT) and visceral adipose tissue (VAT), HDL-cholesterol (HDL-c) and triglyceride (TG) levels. Results More overweight/obese mothers exceeded the IOM GWG recommendations (68%) compared with normal weight women (50%) (p<0.01). Maternal pre-pregnancy BMI was associated with worse childhood outcomes, particularly among offspring of mothers with excessive GWG [increased BMI (20.34 vs 17.80 kg/m2, WC (69.23 vs 62.83 cm), SAT (149.30 vs 90.47 cm2), VAT (24.11 vs 17.55 cm2), and HOMA-IR (52.52 vs 36.69), all p< 0.001]. The effect of maternal pre-pregnancy BMI on several childhood outcomes was attenuated for offspring of mothers with adequate vs excessive GWG (p<0.05 for the interaction between maternal BMI and GWG status on childhood BMI, WC, SAT, and HDL-c). Conclusion Our findings lend support for pregnancy interventions aiming at controlling GWG to prevent childhood obesity.

Dietary micronutrient intake during pregnancy is a function of carbohydrate quality

“…This is conceivable because healthy pregnant women may compensate for much of the assumed increased energy needs by selecting less demanding physical activities (5). Recommending additional energy intake may therefore contribute to the increasing prevalence of excessive weight gain in pregnancy, a risk factor for gestational diabetes and offspring obesity (6)(7)(8)(9).…”

“…Carbohydratecontaining foods can be assessed for nutritional quality according to various measures, including whole-grain content, added sugar, and high or low glycemic index (GI). 7 The GI [a ranking of carbohydrate foods by their glycemic potency (18)] and glycemic load (GL, the mathematical product of the GI and carbohydrate per serving) capture the postprandial glycemic response to a food (19). In a previous study in women with gestational diabetes mellitus, lower dietary GL was associated with improved dietary quality, whereas intake of grain and cereal products was 1 Supported by Illawarra Shoalhaven Local Health District, National Health and Medical Research Council, and the University of Sydney 2 Supplemental Table 1 is available from the "Supplemental data" link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.…”

Preconception and Prenatal Factors and Metabolic Risk

“…In a retrospective cohort study, excessive maternal GWG had an adverse impact on the risk of childhood overweight and abdominal adiposity (Ensenauer et al 2013). Kaar et al further reported that maternal prepregnancy BMI was not only associated with increased general adiposity (BMI) and abdominal adiposity (waist circumference) in offspring but visceral adipose tissue at age 10 years (Kaar et al 2014). A recent study points to an association between maternal excess weight in pregnancy and offspring BMI increase from adolescence to adulthood (Lawrence et al 2014).…”

“…Early pregnancy obesity has also been associated with an increased risk of premature death in adult offspring (Reynolds et al 2013a). To further the negative impact, maternal prepregnancy BMI was also associated with increased offspring insulin resistance at age 10 years (Kaar et al 2014) and an increased risk of developing T2DM (Dabelea et al 2008). …”

Role of Breastfeeding in Preventing Long-Term Metabolic Disorders: Review

“…Указывается, что своевременная коррекция диеты беременной и кормящей женщины способствует профи-лактике детского ожирения [33,38].…”