Maternal dietary quality, inflammatory potential and childhood adiposity: an individual participant data pooled analysis of seven European cohorts in the ALPHABET consortium

BMC Medicine

Nitin Shivappa¹  James R. Hébert¹  Catherine M. Phillips²  John Mehegan²  Cecily C. Kelleher²  Ling-Wei Chen²  Matthew Suderman³  Caroline L. Relton³  Sarah R. Crozier⁴  Keith M. Godfrey⁵  Cyrus Cooper⁵  Nicholas C. Harvey⁵  Mark Hanson⁶  Agnieszka Jankowska⁷  Wojciech Hanke⁷  Kinga Polanska⁷  Sara M. Mensink-Bout⁸  Liesbeth Duijts⁹  Romy Gaillard^1,10  Fionnuala M. McAuliffe^1,11  Aisling A. Geraghty^1,11  Barbara Heude^1,12  Adrien M. Aubert^1,12  Jonathan Y. Bernard^1,13 

[1] Arnold School of Public Health, University of South Carolina, 29208, Columbia, SC, USA;Connecting Health Innovations, LLC, 29201, Columbia, SC, USA;HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland;MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK;MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK;MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK;NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK;NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK;Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK;Nofer Institute of Occupational Medicine, Lodz, Poland;The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland;Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France;Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France;Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore, Singapore;

关键词: Childhood obesity;    Maternal;    Pregnancy;    Diet;    Quality;    Inflammation;    Dietary inflammatory index;    Dietary approaches to stop hypertension;    Developmental origin of health and diseases;   

DOI  :  10.1186/s12916-021-01908-7

来源: Springer

【 摘 要 】

BackgroundMounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity.MethodsWe harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity (OWOB) (age-and-sex-specific BMI z-score > 85th percentile). Secondary outcomes were sum of skinfold thickness (SST), fat mass index (FMI) and fat-free mass index (FFMI). We used multivariable regression analyses (adjusting for maternal lifestyle and sociodemographic factors) to assess the associations of maternal DASH and E-DII scores with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effect meta-analyses.ResultsThe study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m2. Higher early-pregnancy E-DII scores (more pro-inflammatory diet) tended to be associated with a higher odds of late-childhood [10.6 (1.2) years] OWOB [OR (95% CI) 1.09 (1.00, 1.19) per 1-SD E-DII score increase], whereas an inverse association was observed for late-pregnancy E-DII score and early-childhood [2.8 (0.3) years] OWOB [0.91 (0.83, 1.00)]. Higher maternal whole pregnancy DASH score (higher dietary quality) was associated with a lower odds of late-childhood OWOB [OR (95% CI) 0.92 (0.87, 0.98) per 1-SD DASH score increase]; associations were of similar magnitude for early and late-pregnancy [0.86 (0.72, 1.04) and 0.91 (0.85, 0.98), respectively]. These associations were robust in several sensitivity analyses and further adjustment for birth weight and childhood diet did not meaningfully alter the associations and conclusions. In two cohorts with available data, a higher whole pregnancy E-DII and lower DASH scores were associated with a lower late-childhood FFMI in males and a higher mid-childhood FMI in females (P interactions < 0.10).ConclusionsA pro-inflammatory, low-quality maternal antenatal diet may adversely influence offspring body composition and OWOB risk, especially during late-childhood. Promoting an overall healthy and anti-inflammatory maternal dietary pattern may contribute to the prevention of childhood obesity, a complex health issue requiring multifaceted strategy.

【 授权许可】

CC BY