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Optimal diet, physical activity lower obesity risk in children exposed to gestational diabetes
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An optimal diet or daily physical activity in childhood or adolescence can reduce or even eliminate the adverse effects of maternal gestational diabetes on pediatric adiposity, according to findings published in Pediatric Obesity.
“There is consistent evidence that fetal exposure to gestational diabetes increases offspring risk for obesity,” Katherine A. Sauder, PhD, a professor of pediatric nutrition and assistant director for translation research in the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center at the University of Colorado in Aurora, told Endocrine Today. “Our study showed that being breastfed, eating a healthy diet, or regularly engaging in vigorous physical activity may be able to counter this adverse effect on child obesity risk. This means there is hope for families — rather than obesity and diabetes being passed down from generation to generation, parents may be able to break the vicious cycle by helping children engage in healthy behaviors from birth onward.”
Sauder and colleagues analyzed data from children enrolled in the Exploring Perinatal Outcomes among Children (EPOCH) study, a cohort of children born to Colorado women with (n = 84; 48% girls) and without (n = 480; 52% girls) gestational diabetes. Researchers assessed breastfeeding (via maternal recall), dietary intake (via food frequency questionnaire), physical activity (via 3day recall) and adiposity (via measurements of BMI, waisttoheight ratio, visceral and subcutaneous adipose tissue, and subscapulartotriceps skinfold ratio) during two visits (mean age at visit one, 10.4 years; mean age ay visit two, 16.7 years). Optimal behaviors were defined as breastfeeding for at least 6 months, a Healthy Eating Index score of at least 60 and at least 1 hour per day of vigorous activity. Researchers used linear mixed models to assess the association between gestational diabetes exposure and adiposity among children with optimal vs. suboptimal health behaviors.
Researchers found that gestational diabetes exposure was associated with increased skinfold ratio (P = .01) and visceral (P = .05) and subcutaneous adipose tissue (P = .03) among children breastfed for less than 6 months. However, among children breastfed for at least 6 months, only the association between gestational diabetes exposure and skinfold ratio persisted (P = .01).
Gestational diabetes exposure was also associated with increases in all adiposity measures among children with Healthy Eating Index scores less than 60 (P < .01); however, these associations did not persist among children with scores of at least 60 (P > .1).
Among offspring with less than 1 hour per day of vigorous physical activity, researchers found that gestational diabetes exposure was associated with increases in BMI (P = .03) and subcutaneous adipose tissue (P = .001), as well as increases that did not rise to significance for waist-to-height ratio, visceral adipose tissue and skinfold ratio. For children with at least 1 hour per day of vigorous activity, only an increase in skinfold ratio was associated with gestational diabetes exposure (P = .001), according to researchers.
“While prevention of the initial [gestational diabetes] exposure is ideal for reducing offspring adiposity risks, studies of lifestyle interventions during pregnancy have shown that this is extremely difficult to accomplish,” the researchers wrote. “For the 18 million offspring worldwide that are born to women with [gestational diabetes] each year, our study provides promising evidence that diet and activity behaviors in early life have potential to shift one’s health trajectory away from excess adiposity even in the presence of adverse intrauterine exposures.” – by Regina Schaffer
For more information:
Katherine A. Sauder, PhD, can be reached at the LEAD Center, University of Colorado, Mail Stop F426, 12474 E 19th Ave., Aurora, CO 80045; email: katherine.sauder@ucdenver.edu.
Disclosures: The authors report no relevant financial disclosures.
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