Close Adherence to a Mediterranean Diet during Pregnancy Decreases Childhood Overweight/Obesity: A Prospective Study

Abstract

The study of dietary patterns during pregnancy may be of great importance for determining the potential risk of obesity in childhood. We assessed the prospective association between maternal adherence to the Mediterranean diet (MedDiet) during pregnancy and risk of childhood overweight/obesity at 4 years. This prospective analysis involved 272 mother–child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated 45-item food-frequency questionnaire and a relative whole-pregnancy MedDiet score (rMedDiet) was calculated. The children’s weight and height were measured at the age of 4. Primary outcome was childhood overweight/obesity based on age- and-sex-specific BMI z-score > 85th percentile using the WHO child growth standards. Mean maternal rMedDiet score in pregnancy was 9.8 (±standard deviation 2.3) and 25.7% of the children were overweight/obese. Significant differences in anthropometric measurements (weight, height, and BMI) were found according to sex, with higher scores for boys. After controlling for potential confounders, greater maternal adherence to rMedDiet during pregnancy was associated with a lower risk of childhood overweight/obesity, highest vs. lowest quartile (OR = 0.34, 95% CI: 0.12–0.90; p-trend 0.037). Similar trends regarding this association (per 1-point increase rMedDiet score) were observed after stratification by advanced maternal age, maternal early pregnancy BMI, education, socioeconomic status, smoking, and gestational weight gain. Our findings suggest that closer adherence to the MedDiet during pregnancy may protect against the risk of offspring overweight/obesity at 4 years. Further research is needed to explore whether associations persist across the life course.

Exploring Maternal Diet-Epigenetic-Gut Microbiome Crosstalk as an Intervention Strategy to Counter Early Obesity Programming

“…Maternal over or under nutrition during pregnancy may lastingly alter gene expression through epigenetic mechanisms, leading to metabolic alterations and obesity programming in prenatal life [30]. It has been demonstrated that the tight adherence to the Mediterranean diet during pregnancy reduces the risk of overweight/obesity in offspring at 4 years [31], although other studies did not find any association between a maternal diet and fetal and childhood adiposity [32,33]. Moreover, specific nutrients, such as Docoexhaenoic acid (DHA), in obese women or in women with GDM administered in late pregnancy have been positively associated with lower adiposity in infants under exclusive breastfeeding [34].…”