Maternal dietary intake during pregnancy and offspring body composition: The Healthy Start Study

Abstract

Background Consistent evidence of an influence of maternal dietary intake during pregnancy on infant body size and composition in human populations is lacking, despite robust evidence in animal models. Objective To evaluate the influence of maternal macronutrient intake and balance during pregnancy on neonatal body size and composition, including fat mass and fat free mass. Study Design The analysis was conducted among 1040 mother-offspring pairs enrolled in the prospective pre-birth observational cohort: The Healthy Start Study. Diet during pregnancy was collected using repeated 24 hour dietary recalls (up to 8). Direct measures of body composition were obtained using air displacement plethysmography. The National Cancer Institute measurement error model was used to estimate usual dietary intake during pregnancy. Multivariable partition (non-isocaloric) and nutrient density (isocaloric) linear regression models were used to test the associations between maternal dietary intake and neonatal body composition. Results The median macronutrient composition during pregnancy was 32.2% from fat, 15.0% from protein and 47.8% from carbohydrates. In the partition multivariate regression model, individual macronutrient intake values were not associated with birth weight or fat free mass, but were associated with fat mass. Respectively, 100 kilocalorie increases in total fat, saturated fat, unsaturated fat and total carbohydrates were associated with 4.2 gram (p=0.03), 11.1 gram (p=0.003), 5.9 gram (p=0.04) and 2.9 gram (p=0.02) increases in neonatal fat mass, independent of pre-pregnancy BMI. In the nutrient density multivariate regression model, macronutrient balance was not associated with fat mass, fat free mass or birth weight after adjustment for pre-pregnancy BMI. Conclusions Neonatal adiposity, but not birth weight, is independently associated with increased maternal intake of total fat, saturated fat, unsaturated fat, and total carbohydrates, but not protein, suggesting that most forms of increased caloric intake contribute to fetal fat accretion.

Resting Energy Expenditure Relationship with Macronutrients and Gestational Weight Gain: A Pilot Study

“…Baseline intakes of total fat (69 g/day) for the entire study population were comparable to findings from other studies [26][27][28][34][35][36][37]. Despite percent fat (35.7%) being slightly above the Acceptable Macronutrient Distribution Range, the mean total energy consumption (1690 kcal/day) among our cohort was much lower than other studies (1970-2480 kcal/day) [27,28,35,36]. Likewise, energy from carbohydrates (48%) was slightly lower (31-62 g/day less) than previous reports which ranged from 238 to 269 g/day [26][27][28]35,36].…”

“…The current study also assessed maternal diet composition during pregnancy. Baseline intakes of total fat (69 g/day) for the entire study population were comparable to findings from other studies [26][27][28][34][35][36][37]. Despite percent fat (35.7%) being slightly above the Acceptable Macronutrient Distribution Range, the mean total energy consumption (1690 kcal/day) among our cohort was much lower than other studies (1970-2480 kcal/day) [27,28,35,36].…”

“…A recent meta-analysis of 90 studies found that the mean reported intake for total energy, protein, fat, and carbohydrate increased by 184 ± 86 kcal/day, 5.9 g/day, 10.1 g/day, and 17.8 g/day, respectively, from the first to the third trimesters [27]. Although self-reported macronutrient compositions vary among pregnant women [24][25][26]28], an estimated 51% of pregnant women have total energy intakes that exceed daily recommendations, with 19% not meeting carbohydrate and 38% exceeding fat recommendations [29]. It is well known that a high-quality diet during pregnancy is related to better pregnancy outcomes [30,31]; however, there is a paucity of research investigating not only changes in REE during pregnancy but also how REE is influenced by maternal diet and its impact on rate of weight gain.…”

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child

“…Broadly, these studies point to a model whereby dietary changes or exposure to one or more obesity associated metabolites or hormones during critical stages of development can alter developmental pathways in the offspring and lead to greater accrual of fat mass. [118][119][120][121][122] Studies in experimental models and limited human data suggest that the earliest stages of development (both preconception and periconception) are crucial. [123][124][125] Although, developmental programming associated with obesity probably occurs throughout gestation and neonatal life, understanding the crucial periods during which the major changes are initiated is key to devising effective interventions.…”

“…[118][119][120][121][122][123][124][125][126][127][128][129][130][131][132][133] Overall, although poor quality diets seem to have detrimental effects in the offspring, they are unlikely to be mediators of changes associated with maternal obesity but probably represent an independent risk factor. Studies have also evaluated the association between type of dietary fat and child health outcomes.…”