Diet and physical activity in pregnancy and offspring’s cardiovascular health: a systematic review

Abstract

There is increasing evidence linking maternal diet and physical activity before and during pregnancy with offspring's cardiovascular health. Although many studies examined this association, the evidence has not been reviewed systematically. We therefore undertook a systematic review to synthesize evidence examining the association of maternal diet and physical activity before and during pregnancy with offspring's blood pressure and vascular health. We systematically searched the databases MEDLINE and EMBASE from inception to June 30, 2017. Eligibility screening, data extraction and quality assessment were performed by two independent reviewers. A total of 19 articles were included comprising three randomized controlled trials and 16 observational studies. Of the studies that examined the association of interest, 60% (three out of five studies) showed that high maternal carbohydrate intake was associated with higher offspring's blood pressure. Maternal protein intake during pregnancy was negatively associated with offspring carotid intima-media thickness in two out of two studies. No consistent findings for maternal fatty acid intake were found. There were too few studies to draw conclusions on energy intake, fibre intake, protein/carbohydrate ratio, specific foods, dietary patterns and maternal physical activity. Heterogeneity in exposure and outcome assessment hampered pooling. Also, owing to the observational nature of most studies, causality cannot be established. Harmonization of valid exposure and outcome measurements, and the development of core outcome sets are needed to enable more robust conclusions.

Associations of Maternal Cardiovascular Health in Pregnancy With Offspring Cardiovascular Health in Early Adolescence

“…Fourth, gestational diet and physical activity data were unavailable. Although CVH based on 5 metrics has precedent and may be more clinically applicable, gestational diet and exercise have also been significantly associated with offspring health, and studies incorporating all 7 metrics are needed.…”

Preconception lifestyle intervention in women with obesity and echocardiographic indices of cardiovascular health in their children

“…This indicates that other factors are accountable for the positive effects of the intervention on offspring's health. Maternal diet before and during pregnancy has previously been associated with cardiometabolic health in the offspring [43][44][45], but not all research is able to demonstrate such an association [46]. Exercise during pregnancy has been associated with increased heart rate variability during fetal life and in the first month of life, indicating that it may positively influence neonatal cardiac health [47].…”

Translational challenges for the developmental origins of health and disease: time to fulfill the promises for innovative prevention strategies

“…12 As example, Vehmeijer et al and van Elten et al gave an overview of evidence on maternal stress and physical activity in pregnancy on offspring outcomes. 6,7 Tong and Giussani discuss a gestational hypoxia model for assessing the long-term maternal and offspring outcomes. 11 Life course observational studies assess the associations of exposures across the life course on later-life disease risk.…”

“…This supplemental issue of Journal of Developmental Origins of Health and Disease provides excellent examples of sessions, discussions and presentations at DOHaD 2017. [4][5][6][7][8][9][10][11] In this Editorial, I will discuss some issues of major interest for translation of DOHaD. After almost three decades of DOHaD research, it is time to fulfill the expectations for prevention of non-communicable diseases by improving growth and development during the first 1000 days.…”