Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study

Abstract

Background and Objective Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass, %FM) at birth by increasing the fat mass (FM) component of neonatal body composition. Methods Our analysis was conducted using a pre-birth observational cohort of 1,079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-hour dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores ≤ 57 and scores > 57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 hours after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for pre-pregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex, and gestational age. Results Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, SD: 13.6). An HEI-2010 score ≤ 57 was significantly associated with higher neonatal %FM (β = 0.58, 95% CI 0.07, 1.1, p<0.05) and FM (β=20.74; 95% CI 1.49, 40.0; p<0.05) but no difference in FFM. Conclusions Poor diet quality during pregnancy increases neonatal adiposity independent of maternal pre-pregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

Maternal obesity and increased neonatal adiposity correspond with altered infant mesenchymal stem cell metabolism

“…However, our P values were generally robust, and patterns of analyte and gene expression were consistent within themselves such that interpretation of results was based on multiple analytes and/or genes within any given pathway. Findings in our cohort vs. the larger Healthy Start Cohort, especially in relationships of maternal BMI and FFA to infant adiposity, may reflect the intentional selection bias of choosing an equal number of OB and NW mothers vs. the ~20% of OB mothers in the larger Healthy Start Study (53). This does not negate the possible biological relevance but warrants caution when applying findings to a larger, more general population.…”

Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

“…For birth size, a better-quality diet during pregnancy has generally been associated with higher birth weight (10,14,17) and a lower risk of fetal growth restriction (10,14,20), but other studies have reported no association (9,(11)(12)(13)(14). To our knowledge, only one study has explored infant body composition; this study observed a lower HEI score (i.e., poorer diet quality) to be associated with increased infant adiposity (9).…”

“…There has been growing interest in examining overall maternal diet quality (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) by using index scores such as the Healthy Eating Index (HEI) (7)(8)(9)(10), the Mediterranean diet score (10)(11)(12)(13)(14)(15)(16), the New Nordic diet score (17,18), and the Dietary Approaches to Stop Hypertension (DASH) score (19). This is because these take into account the multiplex interactions among nutrients and foods (22), an approach congruent with recommendations of the 2015 Dietary Guidelines Advisory Committee (23).…”

“…This is because these take into account the multiplex interactions among nutrients and foods (22), an approach congruent with recommendations of the 2015 Dietary Guidelines Advisory Committee (23). Although each dietary index captures adherence to slightly different dietary guidelines, in general, these indexes indicate a good-quality diet as one that is high in vegetables, fruit, fish, and unsaturated fats and low in red and processed meat and saturated fats (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Unraveling Mechanisms of Insulin Resistance in Type 2 Diabetes in Human Aidpocytes : Role of extracelluar signal kinase 1/2 (ERK1/2) and farkhead box protein 01 (FOX01)

“…Also, changes in maternal body composition before or during pregnancy seem to be related to adiposity of the offspring (74). Furthermore, maternal diet during pregnancy has been suggested to influence neonatal adiposity (75) and has also been shown to induce epigenetic modifications that can be reverted by diet intervention during pregnancy (76).…”