Abstract P274: Trans-generational Impact of Diet in Pregnancy: Maternal Dietary Intake of Grains During Pregnancy and Offspring Growth and Obesity From Birth Through Age of 7 Years

Introduction: Emerging data from animal studies suggest that diet during pregnancy may affect fetal growth and metabolic programming of the offspring with long-term consequences. Epidemiologic data on transgenerational effects of maternal diet are sparse. Objective: We prospectively investigated the association of maternal diet, in particular, intake of grains during pregnancy with offspring growth and risk of obesity from birth through age 7 years among high risk populations, women complicated by gestational diabetes (GDM) and their children born from the index pregnancy. Methods: In the Danish National Birth Cohort (1996-2002), 918 women complicated by GDM and their singleton children were included in the study. Diet during pregnancy was measured by a validated food frequency questionnaire. Offspring body mass index z-scores (BMIZ) by WHO references were calculated using clinically measured weight and length/height at birth, 5 months, 12 months, and 7 years. Overweight/obese was defined by WHO cutoffs. Linear and Poisson regression with robust standard errors were applied, adjusting for maternal pre-pregnancy BMI and other demographic, lifestyle, and dietary factors. Results: Refined grain intake during pregnancy was significantly and positively associated with offspring growth at 7 years: adjusted β coefficient (95% CI) for a 1-serving per-day increment of refined grains associated with BMIZ at 7 years was 0.09 (0.02, 0.16). At 7 years, offspring born from women who consumed refined grains in the highest quartile (≥4.7 servings/day) experienced more than 1.7-fold increased risk of overweight/obesity as compared to those in the lowest quartile (<2.2 servings/day) [adjusted relative risk (RR) (95% CI) = 1.74 (1.03, 2.93)]. Corresponding RR (95% CI) comparing the extremely high amount of refined grains (the highest 10th percentile, ≥5.9 servings/day) to the lowest quartile was 2.59 (1.28, 5.23). The associations appeared being modified by offspring diet and lifestyle factors during childhood: being more pronounced among children with less favorable lifestyle (i.e., who were breastfed <6 months, physically inactive, or consumed more sugar sweetened beverages). Moreover, substitution of 1 serving/day of refined grains with an equal serving of whole grains among women was associated with an 11% (95% CI: 0.82, 0.98) reduced risk of overweight/obesity at 7 years among the offspring. Conclusions: Our findings suggest that higher intake of refined grains during pregnancy was significantly associated with greater offspring BMIZ and increased risk of overweight/obesity at 7 years. Such associations could be potentially modified by offspring diet and lifestyle factors during childhood.