Maternal total energy, macronutrient and vitamin intakes during pregnancy associated with the offspring’s birth size in the Japan Environment and Children’s Study

Abstract

Maternal diet during pregnancy can influence fetal growth; however, the available evidence is controversial. We aimed to assess whether maternal diet of Japanese women in mid-pregnancy can affect their offspring’s birth size via collection of questionnaire and medical record data. The studied sample was a large cohort of paired mothers and their singleton offspring (n 78 793) from fifteen areas all over Japan who participated in the Japan Environment and Children’s Study. The mid-pregnancy intakes of total energy, macronutrients and vitamins were lower than the recommended intakes for pregnant Japanese women. Maternal total energy intake was positively associated with the offspring’s birth weight; there was a 10-g mean difference in the offspring’s birth weight of mothers in the lowest (3026 g) v. highest (3036 g) quartiles of energy intake. Carbohydrate intake was positively associated with the offspring’s birth length (mean difference of 0·7 cm) and inversely associated with the ponderal index (mean difference of 0·8 g/cm3). Offspring of mothers in the highest v. lowest quartiles of total dietary fibre intake were on average 9 g heavier and had 0·3 cm longer birth length and 0·2 cm longer head circumference. The highest in reference to lowest intake quartile of vitamin C was associated with 13 g and 0·7 cm mean differences in the offspring’s birth weight and length, respectively. Several other associations were evident for maternal intakes of vitamins and the offspring’s birth size. In conclusion, maternal dietary intakes of energy, dietary fibre, carbohydrate and vitamins during pregnancy were associated with the offspring’s birth size.

The Carbohydrate Threshold in Pregnancy and Gestational Diabetes: How Low Can We Go?

“…Several studies suggest that birth size varies by carbohydrate intake. In a Japanese cohort of 78,793 ( Table 1 ) [ 30 ], women were categorized into quartiles of carbohydrate intake (45.1% to 64.9% of EI) and total EI. BW was lowest in the lowest quartile for both dietary factors.…”

“…Folate, vitamins B6 and D intakes significantly changed through pregnancy, but were explained by supplement use rather than carbohydrate intake. In Japan ( n = 78,793), median carbohydrate intake was 55% of EI, with most women consuming less than the Japanese recommendation (57.5% EI) [ 30 ]. Micronutrient intakes below recommendations were also reported ( Table 3 ), suggesting micronutrient deficiencies may exist even with higher carbohydrate intake.…”

“…After elimination of duplicates, and studies that did not meet inclusion criteria, 11 reports met inclusion criteria ( Table 1 , Table 2 , Table 3 and Table 4 ). Of these, 9 reported data from observational cohort or cross-sectional studies [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], 1 from an original RCT [ 39 ], and 1 from a secondary analysis of an RCT [ 40 ]. Figure 1 shows the distribution of carbohydrate intakes reported across these studies.…”

Vitamin A, D, and E Levels and Reference Ranges for Pregnant Women: A Cross-Sectional Study 2017–2019

“…Maternal vitamin levels during pregnancy are closely linked to the health and survival of mothers and their offspring (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). From 1995 to 2005, ∼19 million pregnant women had vitamin A deficiency and ∼9.8 million pregnant women had night blindness worldwide, mostly from Southeast Asia and Africa (11).…”

Diet Quality Is Associated with a High Newborn Size and Reduction in the Risk of Low Birth Weight and Small for Gestational Age in a Group of Mexican Pregnant Women: An Observational Study

“…Similarly, vitamins A and D intakes have been associated with a higher head circumference in a Japanese cohort [33]. Iron supplementation appears to increase birth weight through an increase in maternal hemoglobin concentrations in the third trimester [34]. Finally, folate, vitamin A, C, and D, magnesium, selenium, and zinc have fetal programming implications that, in turn, are closely related with nutrition status at birth [2].…”