Macronutrient intake during pregnancy in women with a history of obesity or gestational diabetes and offspring adiposity at 5 years of age

• Published in: International Journal of Obesity Vol. 45; no. 5; pp. 1030 - 1043
• Main Authors: Meinilä, Jelena, Klemetti, Miira M, Huvinen, Emilia, Engberg, Elina, Andersson, Sture, Stach-Lempinen, Beata, Koivusalo, Saila
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.05.2021; Nature Publishing Group UK
• Subjects: Adipose tissue; Adiposity; Adult; Body fat; Breast feeding; Carbohydrates; Child, Preschool; Children; Complications and side effects; Diabetes in pregnancy; Diabetes mellitus; Diabetes, Gestational - epidemiology; Disease control; Eating; Fatty Acids, Omega-3 - administration & dosage; Female; Finland; Follow-Up Studies; Food and nutrition; Gestation; Gestational diabetes; Health aspects; Humans; Male; Maternal Nutritional Physiological Phenomena; Obesity; Obesity - epidemiology; Obesity in children; Offspring; Pregnancy; Pregnant women; Prenatal Exposure Delayed Effects; Prenatal influences; Randomized Controlled Trials as Topic; Risk factors; Statistical analysis; Finland
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-021-00762-0

The impact of maternal macronutrient intake during pregnancy on offspring childhood adiposity is unclear. We assessed the associations between maternal macronutrient intake during and after pregnancy with offspring adiposity at 5 years of age. Additionally, we investigated whether gestational diabetes (GDM), BMI, or breastfeeding modified these associations. Altogether, 301 mother-child dyads with maternal prepregnancy BMI ≥ 30 and/or previous GDM participated in the Finnish Gestational Diabetes Prevention Study (RADIEL) and its 5 years follow-up. Macronutrient intakes (E%) were calculated from 3-day food records collected at 5-18 weeks' gestation, in the third trimester, and at 12 months and 5 years after pregnancy. Offspring body fat mass (BFM) and fat percentage (BF%) at 5 years were measured by bioimpedance. Statistical analyses were multivariate linear regression. Mean (SD) prepregnancy BMI was 33(4) kg/m . GDM was diagnosed in 47%. In normoglycemic women, higher first half of pregnancy n-3 PUFA intake was associated with lower offspring BFM (g) (ß -0.90; 95% CI -1.62, -0.18) and BF% (ß -3.45; 95% CI -6.17, -0.72). In women with GDM, higher first half of pregnancy n-3 PUFA intake was associated with higher offspring BFM (ß 0.94; 95% CI 0.14, 1.75) and BF% (ß 3.21; 95% CI 0.43, 5.99). Higher SFA intake in the third trimester and cumulative intake across pregnancy (mean of the first half and late pregnancy) was associated with higher BFM and BF% (across pregnancy: ß 0.12; 95% CI 0.03, 0.20 and ß 0.44; 95% CI 0.15, 0.73, respectively). Higher carbohydrate intake across pregnancy was associated with lower BFM (ß -0.044; 95% CI -0.086, -0.003), and borderline associated with BF% (ß -0.15; 95% CI -0.31, 0.00). The macronutrient composition of maternal diet during pregnancy is associated with offspring BFM and BF% at 5 years. GDM modifies the association between prenatal n-3 PUFA intake and offspring anthropometrics.