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.
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DOI：
10.1186/s12916-021-01908-7
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发表时间：
2021-02-22
期刊：
影响因子：
9.3
通讯作者：
Phillips CM
中科院分区：
文献类型：
--
作者：
Chen LW;Aubert AM;Shivappa N;Bernard JY;Mensink-Bout SM;Geraghty AA;Mehegan J;Suderman M;Polanska K;Hanke W;Jankowska A;Relton CL;Crozier SR;Harvey NC;Cooper C;Hanson M;Godfrey KM;Gaillard R;Duijts L;Heude B;Hébert JR;McAuliffe FM;Kelleher CC;Phillips CM
越来越多的证据表明，母亲的饮食影响怀孕和分娩的结果，但其对全球流行的儿童肥胖症的贡献尚未得到明确的表征。我们调查了母亲的整体饮食质量和炎症潜力是否会影响儿童肥胖。我们协调和汇总了来自7个欧洲出生队列的16，295对母婴的个体参与者数据。分别采用饮食方法终止高血压（DASH）评分和能量调整饮食炎症指数（E-DII™）评分评估母体妊娠前、妊娠早期、妊娠晚期和整个妊娠期（妊娠期间的任何时间）的饮食质量和炎症潜力。主要结局为儿童期超重和肥胖（OWOB）（年龄和性别特异性BMI z评分>第85百分位数）。次要结局是皮褶厚度（SST）、脂肪质量指数（FMI）和无脂肪质量指数（FFMI）的总和。我们使用多变量回归分析（调整母亲的生活方式和社会人口学因素）来评估母亲DASH和E-DII评分与队列特异性分析中后代肥胖结局的相关性，随后进行随机效应荟萃分析。研究母亲的平均（SD）年龄为30.2（4.6）岁，平均BMI为23.4（4.2）kg/m2。早期妊娠E-DII评分较高（更多的促炎饮食）倾向于与儿童晚期的更高几率相关[10.6（1.2）年] OWOB [OR（95% CI）1.09（1.00，1.19）/1-SD E-DII评分增加]，而妊娠晚期E-DII评分与儿童早期[2.8（0.3）岁] OWOB [0.91（0.83，1.00）]呈负相关。孕产妇整个妊娠期DASH评分较高（饮食质量较高）与儿童晚期OWOB的几率较低相关[OR（95%CI）0.92（0.87，0.98）每增加1 SD DASH评分];妊娠早期和晚期的相关性程度相似[分别为0.86（0.72，1.04）和0.91（0.85，0.98）]。在几项敏感性分析中，这些关联是强有力的，进一步调整出生体重和儿童饮食并没有有意义地改变关联和结论。在两个有可用数据的队列中，较高的整个妊娠E-DII和较低的DASH评分与男性较低的儿童晚期FFMI和女性较高的儿童中期FMI相关（P相互作用< 0.10）。促炎、低质量的母亲产前饮食可能会对后代的身体组成和OWOB风险产生不利影响，特别是在儿童后期。促进整体健康和抗炎的母亲饮食模式可能有助于预防儿童肥胖，这是一个复杂的健康问题，需要多方面的战略。在线版本包含补充材料，可通过10.1186/s12916-021-01908-7获得。
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. 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. The study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m2. 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). 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. The online version contains supplementary material available at 10.1186/s12916-021-01908-7.
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DOI：
10.3945/jn.109.109579
发表时间：
2009-10
期刊：
The Journal of nutrition
影响因子：
--
作者：
Crozier SR;Robinson SM;Godfrey KM;Cooper C;Inskip HM
通讯作者：
Inskip HM
影响因子：
3.6
作者：
BAUM, D;BECK, RQ;GREENWOOD, MRC
通讯作者：
GREENWOOD, MRC
影响因子：
8
作者：
Barlow, Sarah E.
通讯作者：
Barlow, Sarah E.
影响因子：
4.9
作者：
Freedman, DS;Wang, J;Horlick, M
通讯作者：
Horlick, M
DOI：
10.1080/14767058.2018.1517315
发表时间：
2020-04-02
影响因子：
1.8
作者：
Donnelly, Jean M.;Lindsay, Karen;McAuliffe, Fionnuala M.
通讯作者：
McAuliffe, Fionnuala M.