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PEDIATRICS

Added sugars mediate the relation between pre-pregnancy BMI and infant rapid weight gain: a preliminary study

International Journal of Obesity volume 45, pages 2570–2576 (2021)Cite this article

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Abstract

Background

Parental obesity is linked to offspring obesity, though little research has explored factors that might influence this relationship during the complementary feeding period. This study investigated whether infant intakes of added sugars mediate the relationship between a mother’s pre-pregnancy body mass index (BMI) and infant rapid weight gain (defined as upward weight-for-age percentile crossing).

Methods

This study was of a cross-sectional design. Anthropometrics for 141 mother-infant dyads (mean age [standard deviation]: 32.6 [4.4] year for mothers, 11.9 [1.9] months for infants) were obtained. Data from three 24-h recalls pertaining to the infants’ diets were collected and analyzed. Pearson product-moment correlations and multivariable regressions assessed bivariate relationships between pre-pregnancy BMI, infant added sugar intakes and upward weight-for-age percentile crossing. Mediation models evaluated the effects of added sugars and breastfeeding duration.

Results

Pre-pregnancy BMI correlated positively with infants’ added sugar intakes (r = 0.230, p = 0.006). Added sugar intakes mediated the impact of pre-pregnancy BMI on upward weight-for-age percentile crossing (indirect effect = 0.007, 95% CI = 0.0001, 0.0197, indirect/total effect ratio = 0.280). Breastfeeding duration also moderated the relationship, with infants who were breastfed for a shorter duration experiencing a greater mediating effect (indirect effect = 0.010, 95% CI = 0.0014, 0.0277, indirect/direct effect ratio = 0.7368).

Conclusions

Mothers who were overweight or obese prior to pregnancy were significantly more likely to give their infants foods and beverages with added sugars, and this practice was found to mediate the relationship between maternal and infant obesity. Breastfeeding duration moderated the mediating effect of added sugars between pre-pregnancy BMI and infant rapid weight gain.

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Fig. 1: The relationship between pre-pregnancy BMI and infant rapid weight gain was mediated by infant added sugar intakes.
Fig. 2: Breastfeeding duration moderated the mediating effect of added sugar intakes on infant rapid weight gain linked to pre-pregnancy BMI.

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Acknowledgements

All authors thank the families who participated in this study and the research staff responsible for the data collection and nutritional analyses.

Funding

This work was funded by the National Institute on Child Health and Human Development of the National Institutes of Health, grant number R01 HD087082-01 (awarded to Kai Ling Kong). The sponsor had no role in the study design, data collection, analysis and interpretation, writing of the report, or decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA

    Brenda Burgess, Katherine S. Morris & Rocco A. Paluch

  2. Department of Counseling, School, and Educational Psychology, Graduate School of Education, State University of New York at Buffalo, Buffalo, NY, USA

    Myles S. Faith

  3. Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO, USA

    Kai Ling Kong

  4. Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA

    Kai Ling Kong

  5. Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA

    Kai Ling Kong

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  1. Brenda Burgess
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  5. Kai Ling Kong
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Contributions

BB initiated the research question, assisted with the results’ interpretation, drafted the manuscript, and approved the final manuscript as submitted; KM assisted with all aspects of the data collection, conducted training for all the research staff members and dietetic interns, quality-controlled all dietary recalls and nutritional analyses, and revised and approved the final manuscript as submitted; MF assisted with the research question, interpreted the results, revised the manuscript, and approved the final manuscript as submitted; RP contributed to the data analyses, interpreted the results, and revised and approved the final manuscript as submitted; KK initiated and developed the research question and study design, led the analytic plan, drafted the manuscript, and approved the final manuscript as submitted.

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Correspondence to Kai Ling Kong.

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Burgess, B., Morris, K.S., Faith, M.S. et al. Added sugars mediate the relation between pre-pregnancy BMI and infant rapid weight gain: a preliminary study. Int J Obes 45, 2570–2576 (2021). https://doi.org/10.1038/s41366-021-00936-w

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