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  • Original Article
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Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study

Abstract

Background/Objectives:

Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass (%FM)) at birth by increasing the fat mass (FM) component of neonatal body composition.

Methods:

Our analysis was conducted using a prebirth observational cohort of 1079 mother–offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of 57 and >57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age.

Results:

Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, s.d.: 13.6). An HEI-2010 score of 57 was significantly associated with higher neonatal %FM (β=0.58, 95% confidence interval (CI) 0.07–1.1, P<0.05) and FM (β=20.74; 95% CI 1.49–40.0; P<0.05) but no difference in FFM.

Conclusions:

Poor diet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

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Acknowledgements

We thank all women and children who have taken part in the Healthy Start study. We also thank Mrs Mercedes Martinez, the Healthy Start Study Project Coordinator, Colorado School of Public Health, University of Colorado Denver and the Healthy Start team for their hard work and dedication. The Healthy Start study is supported by the R01 Grant from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) (R01 #DK076648; Principal Investigator: Dana Dabelea).

Author contributions

ALBS conducted the research, analyzed data and wrote the full draft of the manuscript as well as made revisions on subsequent drafts. BMR and DHG analyzed data and consulted on interpretation of statistical findings. JLK, TLC, APS, AMS-R and JMN made substantial contributions for the revision of manuscript drafts. LAB and JEF reviewed all manuscript drafts and made substantial contributions to the clinical and mechanistic interpretation of the study findings. DD designed the Healthy Start study, reviewed each manuscript draft and has primary responsibility for the final content of this manuscript. The Healthy Start research team collected all data, including diet data.

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Correspondence to D Dabelea.

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Shapiro, A., Kaar, J., Crume, T. et al. Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study. Int J Obes 40, 1056–1062 (2016). https://doi.org/10.1038/ijo.2016.79

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