The Association between Maternal Folate Status and Childhood Obesity-Systematic Review and Meta-Analysis

Abstract

The Association between Maternal Folate Status and Childhood Obesity-Systematic Review and Meta-AnalysiPURPOSE: Maternal nutrition plays a crucial role in fetal growth and lifelong health outcomes. Folate is an essential methyl donor in the epigenetic programming of offspring. This review and meta-analysis was conducted to compile the evidence reported thus far to identify associations between maternal folate status and childhood obesity.METHODS: A keyword/reference search was performed in EBSCOhost and Web of Science databases. A CMA program was used for a meta-analysis to estimate the pooled effect of maternal folate status on childhood obesity in offspring and to examine the influence of moderating variables on the overall effect.RESULTS: Better maternal folate intake was associated with a lower risk of childhood obesity: the overall effect size (ES; Hedges’ g) was 0.168 (95% CI=0.075 to 0.260, <i>p</i><.001; small effects; cf., Cohen’s criteria). Moderator analysis revealed that the ≥Q statistic for the age group was statistically significant (Q<sub>b</sub>=4.730, df=1. <i>p</i>=.030; heterogeneity of ES). In offspring <7 years and >7 years, the ES was 0.277 (95% CI=0.151, 0.404) and 0.089 (95% CI=-0.025, 0.202), respectively. The study design was a statistically significant variable (Q<sub>b</sub>=4.310, df=1. <i>p</i>=.038; heterogeneity of ES). In cohort studies, ES was 0.251 (95% CI=0.135, 0.367), whereas in randomized controlled trial group, ES was 0.062 (95% CI=-0.073, 0.197).CONCLUSIONS: Maternal folate intake significantly affects childhood obesity, and the effect of maternal folate status is stronger inchildren younger than 7 years.

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

“…These factors are believed to reduce susceptibility to childhood weight gain by positively influencing fetal glucose metabolism and fetal metabolic function [ 46 , 47 ] while also supporting a favorable neonatal microbiome [ 48 ]. Other studies indicate that maternal deficiency in micronutrients such as vitamin D [ 49 ], folate [ 50 ], and ω-3 polyunsaturated fatty acids [ 51 ] during pregnancy, which is extremely prevalent, has the potential to indirectly impact offspring metabolic programming through epigenetic changes and to ultimately contribute to childhood obesity [ 35 ]. Conversely, maternal high-fat (especially saturated fat) diets also result in increased offspring adiposity by modifying DNA methylation and the gene expression of fetal hypothalamic appetite-related neurons and central reward system molecules, thus leading to alterations in appetite and energy metabolism in offspring [ 51 ].…”

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“…The conclusions drawn should be sup-ported by the data. Out of the above four suggestions, the study design was well-documented in some articles [3]. The interpretation is reasonable and logical in all manuscripts.…”