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Maternal and pediatric nutrition

Polyunsaturated fatty acid status at birth, childhood growth, and cardiometabolic risk: a pooled analysis of the MEFAB and RHEA cohorts

European Journal of Clinical Nutrition (2018) | Download Citation



Polyunsaturated fatty acid (PUFA) status during pregnancy has been suggested to influence offspring obesity and cardiometabolic health. We assessed whether prenatal PUFA exposure is associated with rapid infant growth, childhood BMI, and cardiometabolic profile.


In the Dutch MEFAB (n = 266) and Greek RHEA (n = 263) cohorts, we measured n-3 and n-6 PUFA concentrations in cord blood phospholipids, which reflect fetal exposure in late pregnancy. We defined rapid infant growth from birth to 6 months of age as an increase in weight z-score >0.67. We analyzed body mass index (BMI) as continuous and in categories of overweight/obesity at 4 and 6 years. We computed a cardiometabolic risk score at 6–7 years as the sum of waist circumference, non-high-density lipoprotein cholesterol and blood pressure z-scores. Associations of PUFAs with child health outcomes were assessed using generalized linear models for binary outcomes and linear regression models for continuous ones after adjusting for important covariates, and for the pooled estimates, a cohort indicator.


In pooled analyses, we found no association of PUFA levels with rapid infant growth, childhood BMI (β per SD increase in the total n-3:n-6 PUFA ratio = −0.04 SD; 99% CI: −0.15, 0.06; P = 0.65 at 4 years, and −0.05 SD; 99% CI: −0.18, 0.08; P = 0.78 at 6 years), and overweight/obesity. We also found no associations for clustered cardiometabolic risk and its individual components. The results were similar across cohorts.


Our findings suggest that PUFA concentrations at birth are not associated with later obesity development and cardiometabolic risk in childhood.

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These authors contributed equally: Maurice P. Zeegers, Leda Chatzi.


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We would like to thank Professor Emeritus Gerard Hornstra, who made the MEFAB study possible. We are also extremely grateful to the MEFAB and RHEA study participants for their time and commitment.


The MEFAB cohort was financially supported by the University Hospital of Maastricht (Profilerings Fonds), and the Dutch Organization for Scientific Research (NWO, Grant number 904 62 186). The RHEA Mother Child Cohort in Crete project was financially supported by European projects [EU FP6-003-Food-3-NewGeneris-contract no. 16320, EU FP6 STREP Hiwate-contract no. 36224, EU FP7 ENV.2007. Project No. 211250 Escape, EU FP7-2008-ENV- Envirogenomarkers contract no. 226756, EU FP7-HEALTH-2009-single stage CHICOS contract no. 241604, EU FP7 ENV.2008. proposal no. 226285 ENRIECO, EU-FP7, proposal no. 264357 MeDALL, EU- FP7- HEALTH-2012 proposal no. 308333 HELIX], and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011-2014; “Rhea Plus”: Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-2015).

Author contributions

The authors’ responsibilities were as follows: NS, MG, LC, and MPZ designed the research; MA and EGS carried out the fatty acid analysis for the RHEA cohort; all authors contributed to the acquisition of data; NS and KM analyzed the data and performed statistical analysis; NS, MG, and LC wrote the paper; MG, LC, RHMdG, and MPZ contributed to study supervision. All authors read and approved the final manuscript.

Author information

Author notes


    1. Section of Complex Genetics and Epidemiology, Departments of Genetics and Cell Biology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

      • Nikos Stratakis
      • , Marij Gielen
      • , Renate H. M. de Groot
      • , Maurice P. Zeegers
      •  & Leda Chatzi
    2. Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece

      • Nikos Stratakis
      • , Katerina Margetaki
      • , Georgia Chalkiadaki
      • , Marina Vafeiadi
      • , Vasiliki Leventakou
      • , Marianna Karachaliou
      •  & Leda Chatzi
    3. Welten Institute-Research Centre for Learning, Teaching and Technology, Open University of the Netherlands, Heerlen, The Netherlands

      • Renate H. M. de Groot
    4. Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece

      • Maria Apostolaki
      •  & Euripides G. Stephanou
    5. Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

      • Roger W. Godschalk
    6. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain

      • Manolis Kogevinas
    7. IMIM Hospital del Mar Medicine Research Institute, Barcelona, Spain

      • Manolis Kogevinas
    8. Spanish Consortium for Research in epidemiology and Public Health (CIBERESP), Madrid, Spain

      • Manolis Kogevinas
    9. The Cyprus Institute, Nicosia, Cyprus

      • Euripides G. Stephanou
    10. School CAPHRI: Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands

      • Maurice P. Zeegers
    11. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA

      • Leda Chatzi


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    The authors declare that they have no conflict of interest.

    Corresponding author

    Correspondence to Nikos Stratakis.

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