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. Effect modification by childhood factors including breastfeeding duration and child's physical activity and intake of sugar sweetened beverages at 7 years was assessed. Results Intake of refined grain during pregnancy was significantly and positively associated with offspring growth at 7 years. The adjusted β coefficient (95% CI) for a one‐serving per‐day increment of refined grains associated with offspring BMIZ at 7 years was 0.09 (0.02, 0.16). At 7 years, offspring born to women who consumed refined grains in the highest quartile during pregnancy (≥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 10 th 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, which were 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 one serving/day of refined grains with an equal serving of whole grains during pregnancy was associated with an 11% (95% CI: 0.82, 0.98) reduced risk of offspring overweight/obesity at 7 years. No associations were observed between grain intake and offspring growth at earlier ages. 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. Support or Funding Information The study is funded by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract # HHSN275201000020C). The Danish National Birth Cohort is supported by grants from The Danish Research Council # 09‐067124 (Center for Fetal Programming) and 09‐075611.