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

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

Background: Mounting 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. Methods: We 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. Results: The study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m 2. 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). Conclusions: A 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.

Childhood obesity, Developmental origin of health and diseases, Diet, Dietary approaches to stop hypertension, Dietary inflammatory index, Inflammation, Maternal, Pregnancy, Quality
1741-7015
Chen, Ling-Wei
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Aubert, Adrien M.
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Shivappa, Nitin
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Bernard, Jonathan Y.
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Mensink-Bout, Sara M.
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Geraghty, Aisling A.
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Mehegan, John
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Suderman, Matthew
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Polanska, Kinga
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Hanke, Wojciech
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Jankowska, Agnieszka
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Relton, Caroline L.
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Crozier, Sarah
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Harvey, Nicholas
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Cooper, Cyrus
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Hanson, Mark
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Godfrey, Keith
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Gaillard, Romy
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Duijts, Liesbeth
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Heude, Barbara
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Hebert, James R.
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McAuliffe, Fionnuala M.
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Kelleher, Cecily C.
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Phillips, Catherine M.
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Chen, Ling-Wei
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Aubert, Adrien M.
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Shivappa, Nitin
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Bernard, Jonathan Y.
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Mensink-Bout, Sara M.
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Geraghty, Aisling A.
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Mehegan, John
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Suderman, Matthew
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Polanska, Kinga
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Hanke, Wojciech
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Jankowska, Agnieszka
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Relton, Caroline L.
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Crozier, Sarah
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Harvey, Nicholas
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Cooper, Cyrus
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Hanson, Mark
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Godfrey, Keith
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Gaillard, Romy
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Duijts, Liesbeth
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Heude, Barbara
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Hebert, James R.
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McAuliffe, Fionnuala M.
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Kelleher, Cecily C.
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Phillips, Catherine M.
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Chen, Ling-Wei, Aubert, Adrien M., Shivappa, Nitin, Bernard, Jonathan Y., Mensink-Bout, Sara M., Geraghty, Aisling A., Mehegan, John, Suderman, Matthew, Polanska, Kinga, Hanke, Wojciech, Jankowska, Agnieszka, Relton, Caroline L., Crozier, Sarah, Harvey, Nicholas, Cooper, Cyrus, Hanson, Mark, Godfrey, Keith, Gaillard, Romy, Duijts, Liesbeth, Heude, Barbara, Hebert, James R., McAuliffe, Fionnuala M., Kelleher, Cecily C. and Phillips, Catherine M. (2021) Maternal dietary quality, inflammatory potential and childhood adiposity: an individual participant data pooled analysis of seven European cohorts in the ALPHABET consortium. BMC Medicine, 19 (1), [33]. (doi:10.1186/s12916-021-01908-7).

Record type: Article

Abstract

Background: Mounting 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. Methods: We 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. Results: The study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m 2. 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). Conclusions: A 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.

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Accepted/In Press date: 12 January 2021
e-pub ahead of print date: 22 February 2021
Published date: December 2021
Additional Information: Funding Information: Whole consortium : the authors acknowledge all investigators working on the ERA-HDHL ALPHABET project and are grateful to all the families in the participating cohorts. ALSPAC: we are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. Please note that the ALSPAC study website contains details of all available data is available through a fully searchable data dictionary and variable search tool (http://www.bristol.ac.uk/alspac/researchers/our-data/). EDEN: the authors thank the EDEN mother-child cohort study group, whose members are I. Annesi-Maesano, J. Y. Bernard, J. Botton, M.A. Charles, P. Dargent-Molina, B. de Lauzon-Guillain, P. Ducimeti?re, M. de Agostini, B. Foliguet, A. Forhan, X. Fritel, A. Germa, V. Goua, R. Hankard, B. Heude, M. Kaminski, B. Larroque, N. Lelong, J. Lepeule, G. Magnin, L. Marchand, C. Nabet, F Pierre, R. Slama, M.J. Saurel-Cubizolles, M. Schweitzer, and O. Thiebaugeorges. Generation R: The Generation R Study is conducted by the Erasmus Medical Centre in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam, the Municipal Health Service, Rotterdam area, and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. We gratefully acknowledge the contribution of children and their parents, general practitioners, hospitals, midwives and pharmacies in Rotterdam. Lifeways: We would like to thank all members of the Lifeways cohort for their valuable contribution to the study. The participation of families is much appreciated. REPRO_PL: We gratefully acknowledge the contribution of children and their parents, hospitals, physicians, and midwives. ROLO: We are grateful to the participating mothers, children, and to the research and clinical staff who enabled us recruit this pregnancy and birth cohort. SWS: We are grateful to the women of Southampton and their children, who gave their time to take part in this study, and to the research nurses and other staff who collected and processed the data This work was supported by an award from the European Union?s Horizon 2020 research and innovation programme under the ERA-Net Cofund of the Joint Programming Initiative Healthy Diet for Healthy Life (JPI-HDHL) (http://www.healthydietforhealthylife.eu). The funder was not involved in study?s design, conduct and reporting. Funding Information: This work was supported by an award from the European Union’s Horizon 2020 research and innovation programme under the ERA-Net Cofund of the Joint Programming Initiative Healthy Diet for Healthy Life (JPI-HDHL) ( http://www.healthydietforhealthylife.eu ) action number 696295 (Biomarkers for Nutrition and Health). Co-funding was provided by Science Foundation Ireland, Ireland (Grant Number SFI/16/ERA-HDHL/3360), the UK Biotechnology and Biological Sciences Research Council (ERA-HDHL Biomarkers: BBSRC: BB/P028179/1 and BB/P028187/1), National Centre for Research and Development (ERA-HDHL/01/ALPHABET/1/2017), the ZonMW The Netherlands (no 529051014; 2017)) ALPHABET project (no 696295; 2017) and the French National Agency of Research (reference AnrR16227KK). ALSPAC: The UK Medical Research Council and Wellcome (Grant ref.: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and Matthew Suderman will serve as guarantor for the contents of this paper. EDEN: The EDEN study was supported by Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A), and Human Nutrition National Research Programs, Paris-Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007–2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l’Education Nationale a complementary health insurance (MGEN), French national agency for food security, French-speaking association for the study of diabetes and metabolism (ALFEDIAM). Generation R: The Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam, the Erasmus University Rotterdam and The Netherlands Organization for Health Research and Development. The project received funding from the European Union’s Horizon 2020 research and innovation programme (LIFECYCLE project, grant agreement no 733206; 2016). RG received funding from the Dutch Heart Foundation (grant number 2017 T013), the Dutch Diabetes Foundation (grant number 2017.81.002) and the Netherlands Organization for Health Research and Development (ZonMW, grant number 543003109). The study sponsors had no role in the study design, data analysis, interpretation of data, or writing of this report. Lifeways: The Lifeways Cross-Generation Cohort Study is funded by the Irish Health Research Board (reference HRC/2007/13) and is overseen by an inter-disciplinary steering group. REPRO_PL: The REPRO_PL cohort was mainly supported by the Ministry of Science and Higher Education, Poland (PBZ-MEiN-/8/2/2006; contract no. K140/P01/2007/1.3.1.1); by the grant PNRF-218-AI-1/07 from Norway through the Norwegian Financial Mechanism within the Polish- Norwegian Research Fund and National Science Centre, Poland (DEC-2014/15/B/NZ7/00998). ROLO: ROLO study is supported by Health Research Board Health Research Centre for Diet and Health Research Ireland and The National Maternity Hospital Medical Fund, and The European Union’s Seventh Framework Programme (FP7/2007–2013). SWS: This work was supported by grants from the Medical Research Council, British Heart Foundation, Arthritis Research UK, Food Standards Agency, and the European Union’s Seventh Framework (FP7/2007–2013), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and the NIHR Southampton Biomedical Research Centre) and the European Union (Erasmus+ Programme Early Nutrition eAcademy Southeast Asia-573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP). Publisher Copyright: © 2021, The Author(s).
Keywords: Childhood obesity, Developmental origin of health and diseases, Diet, Dietary approaches to stop hypertension, Dietary inflammatory index, Inflammation, Maternal, Pregnancy, Quality

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Local EPrints ID: 446589
URI: http://eprints.soton.ac.uk/id/eprint/446589
ISSN: 1741-7015
PURE UUID: e0a4908a-f571-4d2c-9222-be3b964b689b
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Mark Hanson: ORCID iD orcid.org/0000-0002-6907-613X
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 15 Feb 2021 17:32
Last modified: 06 Jun 2024 01:42

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Contributors

Author: Ling-Wei Chen
Author: Adrien M. Aubert
Author: Nitin Shivappa
Author: Jonathan Y. Bernard
Author: Sara M. Mensink-Bout
Author: Aisling A. Geraghty
Author: John Mehegan
Author: Matthew Suderman
Author: Kinga Polanska
Author: Wojciech Hanke
Author: Agnieszka Jankowska
Author: Caroline L. Relton
Author: Sarah Crozier ORCID iD
Author: Nicholas Harvey ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Mark Hanson ORCID iD
Author: Keith Godfrey ORCID iD
Author: Romy Gaillard
Author: Liesbeth Duijts
Author: Barbara Heude
Author: James R. Hebert
Author: Fionnuala M. McAuliffe
Author: Cecily C. Kelleher
Author: Catherine M. Phillips

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