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Maternal diet, coupled with gestational diabetes, may increase child’s risk for obesity

When compared with women who ate low amounts of refined grains, women with gestational diabetes who consumed high proportions of refined grains gave birth to children who had a higher risk for obesity by age 7, according to research recently published in the American Journal of Clinical Nutrition.

“It is ... of great public health importance to identify modifiable early-life factors that may inform effective intervention strategies to mitigate childhood obesity in this high-risk group,” Yeyi Zhu, PhD, MS, postdoctoral fellow, division of intramural population health research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues wrote. “However, epidemiologic studies on the intergenerational association of maternal diet, in particular, the intake of refined grains, during pregnancy with offspring growth and risk of overweight or obesity during infancy and childhood are lacking.”

Researchers noted that gestational diabetes affects about 5% of all U.S. pregnancies and that previous studies have linked diets high in refined grains to heart disease, obesity, and type 2 diabetes.

In the present study, Zhu and colleagues studied 918 mother–singleton child dyads from the Danish National Birth Cohort. The offspring’s BMI z score was determined by weight and length or height at birth, and again at 5 months, 1 year and 7 years. Overweight or obesity was defined by WHO cutoffs. Poisson and linear regressions were used, with adjustment for maternal dietary, demographic and lifestyle factors. White bread, rice, pasta, bread rolls, crisp bread, crackers and cookies were considered refined grains; rye bread, rye flour, whole-wheat bread, whole-wheat flour, barley grouts, wheat kernels, wheat bran and brown rice were considered whole grains.

Researchers found that refined-grain intake during pregnancy was positively associated with offspring BMI z score (adjusted beta per serving increase per day = 0.09; 95% CI, 0.02-0.15) and overweight and obesity at age 7 (adjusted RR comparing the highest with the lowest quartile: 1.8; 95% CI, 1.09-2.98) The association appeared to be more pronounced among children who were breastfed for less than 6 months. In addition, the substitution of one serving refined grains per day with an equal serving of whole grains during pregnancy was related to a 10% reduced risk (adjusted RR = 0.9; 95% CI, 0.82-0.98) for being overweight or obese at 7 years of age. Also, no associations were observed between refined-grain intake and infant growth.

“Our findings are biologically plausible, although the underlying mechanisms remain largely unknown,” Zhu and colleagues wrote. “Our study adds to the emerging, yet limited, data on the possible intergenerational association of refined-grain intake during pregnancy with adverse offspring cardiometabolic outcomes and suggests that these associations may become more apparent after infancy. It also underlines the need for future prospective studies with longer follow-up through later childhood, adolescence, and adulthood to evaluate whether our findings persist in later life.” – by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.