Maternal obesity influences the relationship between location of neonate fat mass and total fat mass

The Effect of Prenatal Docosahexaenoic Acid Supplementation on Offspring Fat Mass and Distribution at 24 Months Old

Background

Excessive gestational weight gain (GWG) is related to increased offspring fat accrual, and increased fat mass (FM) is related to obesity development. Prenatal DHA supplementation has been linked to lower levels of offspring FM; however, conflicting data exist.

Objectives

This study aimed to determine if there is a protective effect of prenatal DHA supplementation on offspring fat accrual and adipose tissue deposition at 24 mo in offspring born to females who gain excessive weight compared with nonexcessive weight during pregnancy. We also explored if the effect of DHA dose on FM differed by offspring sex.

Methods

Infants born to females who participated in the Assessment of DHA on Reducing Early Preterm Birth randomized controlled trial (ADORE) were recruited. In ADORE, females were randomly assigned to either a high or low prenatal DHA supplement. Offspring body composition and adipose tissue distribution were measured using dual-energy x-ray absorptiometry (DXA). GWG was categorized as excessive or not excessive based on clinical guidelines.

Results

For total FM, there was a significant main effect for the DHA dose (P = 0.03); however, the dose by GWG status was nonsignificant (P = 0.44). Therefore, a higher prenatal DHA dose was related to greater offspring FM (622.9 g greater) and unrelated to GWG status. When investigating a DHA dose by sex effect, a significant main effect for DHA dose (P = 0.01) was detected for central FM. However, no interaction was detected (P = 0.98), meaning that both boys and girls had greater central FM if their mother was assigned to the higher DHA dose.

Conclusions

Greater prenatal DHA supplementation was associated with greater offspring FM and adipose tissue distribution at 24 mo. It will be important to understand if these effects persist into childhood.This trial was registered at clinicaltrials.gov as NCT03310983.

Growth and adiposity in newborns study (GAINS): The influence of prenatal DHA supplementation protocol

BACKGROUND

Obesity and central fat mass (FM) accrual drive disease development and are related to greater morbidity and mortality. Excessive gestational weight gain (GWG) increases fetal fat accretion resulting in greater offspring FM across the lifespan. Studies associate greater maternal docosahexaenoic acid (DHA) levels with lower offspring FM and lower visceral adipose tissue during childhood, however, most U.S. pregnant women do not consume an adequate amount of DHA. We will determine if prenatal DHA supplementation is protective for body composition changes during infancy and toddlerhood in offspring exposed to excessive GWG.

METHODS AND DESIGN

Infants born to women who participated in the Assessment of DHA on Reducing Early Preterm Birth randomized controlled trial (ADORE; NCT02626299) will be invited to participate. Women were randomized to either a high 1000 mg or low 200 mg daily prenatal DHA supplement starting in the first trimester of pregnancy. Offspring body composition and adipose tissue distribution will be measured at 2 weeks, 6 months, 12 months, and 24 months using dual energy x-ray absorptiometry. Maternal GWG will be categorized as excessive or not excessive based on clinical guidelines.

DISCUSSION

Effective strategies to prevent obesity development are lacking. Exposures during the prenatal period are important in the establishment of the offspring phenotype. However, it is largely unknown which exposures can be successfully targeted to have a meaningful impact. This study will determine if prenatal DHA supplementation modifies the relationship between maternal weight gain and offspring FM and FM distribution at 24 months of age.

ETHICS AND DISSEMINATION

The University of Kansas Medical Center Institutional Review Board (IRB) approved the study protocol (STUDY00140895). The results of the trial will be disseminated at conferences and in peer reviewed publications.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT03310983.

Association of Prepregnancy BMI, Gestational Weight Gain, and Child Birth Weight with Metabolic Dysfunction in Children and Adolescents with Obesity

OBJECTIVES

Previous studies have reported that maternal prepregnancy body mass index (BMI), gestational weight gain (GWG), and child birth weight are positively associated with metabolic dysfunction (a broader term than metabolic syndrome) in children and adolescents. Physical activity habits may play a role in reducing these risk factors. The objectives of this study were to investigate the association of prepregnancy BMI, GWG, child birth weight, physical activity, and sedentary time with metabolic dysfunction in a cohort of children and adolescents with obesity.

METHODS

Participants (N = 117; 53% Hispanic) were children and adolescents, aged 8 to 17 years, with obesity. Fasting serum glucose, insulin, and a complete lipid profile were obtained. Body weight, height, waist circumference, and blood pressure were measured. A self-reported survey assessed prepregnancy BMI, GWG, child birth weight, physical activity, and sedentary time. The χ² test and the Mantel-Haenzel test statistic were used to examine the differences in proportions for the outcome of metabolic dysfunction.

RESULTS

In this sample, 76.9% of children and adolescents had metabolic dysfunction. Prepregnancy BMI and GWG were not associated with metabolic dysfunction. Child birth weight and sedentary behavior were positively correlated (P = 0.033 and P = 0.015, respectively) with a diagnosis of metabolic dysfunction. Physical activity levels were not associated with metabolic dysfunction. Hispanic and non-Hispanic youth were similar for all risk factors.

CONCLUSIONS

Contrary to previous studies, prepregnancy BMI and GWG were not correlated with metabolic dysfunction. These findings support the need for lifestyle interventions, particularly in reducing sedentary behaviors, in obese children and adolescents.

Effect of maternal nutrient intake during 31-37 weeks gestation on offspring body composition in Samoa

BACKGROUND

Pregnancy dietary intake may be associated with newborn body composition, a predictor of future obesity. In Samoa, an energy-dense diet contributes to an alarming prevalence of adult obesity. Identifying associations between pregnancy nutrition and infant body composition in this setting may guide strategies to mitigate intergenerational transmission of obesity risk.

AIM

To examine dietary macro- and micronutrient intake of Samoan women during the third trimester of pregnancy and associations with infant body composition.

SUBJECTS AND METHODS

At 34-41 weeks of gestation, we measured dietary intake from the prior month using a Food Frequency Questionnaire (FFQ). Dual-energy X-ray absorptiometry (DXA) measured infant body composition at 1-14 days. We used multivariable linear regression models accounting for confounders to identify independent effects of nutrient intake on infant body composition.

RESULTS

After adjusting for maternal body mass index, age, gravidity, infant age, and sex, a respective 0.2 g increase and 0.2 g decrease in infant bone mass was associated with fibre and saturated fat intake. Increased protein intake was associated with 0.02 g decrease in bone mass.

CONCLUSIONS

While maternal dietary intake was not associated with infant adiposity or lean mass, we observed an effect on bone mass whose role in regulating metabolic health is overlooked.

Maternal weight prior and during pregnancy and offspring's BMI and adiposity at 5-6 years in the EDEN mother-child cohort

BACKGROUND

Beyond pre-pregnancy BMI, maternal weight change before and during pregnancy may also affect offspring adiposity.

OBJECTIVE

To investigate the relationship between maternal weight history before and during pregnancy with children's adiposity at 5-6 years.

METHODS

In 1069 mother-child dyads from the EDEN Cohort, we examined by linear regression the associations of children's BMI, fat mass and abdominal adiposity at 5-6 years with maternal pre-pregnancy BMI, pre-pregnancy average yearly weight change from age 20 and gestational weight gain. The shapes of relationships were investigated using splines and polynomial functions were tested.

RESULTS

Children's BMI and adiposity parameters were positively associated with maternal pre-pregnancy BMI, but these relationships were mainly seen in thin mothers, with no substantial variation for maternal BMI ranging from 22 to 35 kg/m² . Gestational weight gain was positively associated with children's BMI Z-score, but again more so in thin mothers. We found no association with pre-pregnancy weight change.

CONCLUSIONS

Before the adiposity rebound, maternal pre-pregnancy thinness explains most of the relationship with children's BMI. The relationship may emerge at older ages in children of overweight and obese mothers, and this latency may be an obstacle to early prevention.

Validity of anthropometric equations to estimate infant fat mass at birth and in early infancy

BACKGROUND

In newborns and children, body fat estimation equations are often used at different ages than the age used to develop the equations. Limited validation studies exist for newborn body fat estimation equations at birth or later in infancy. The study purpose was to validate 4 newborn fat mass (FM) estimation equations in comparison to FM measured by air displacement plethysmography (ADP; the Pea Pod) at birth and 3 months.

METHODS

Ninety-five newborns (1-3 days) had their body composition measured by ADP and anthropometrics assessed by skinfolds. Sixty-three infants had repeat measures taken (3 months). FM measured by ADP was compared to FM from the skinfold estimation equations (Deierlein, Catalano, Lingwood, and Aris). Paired t-tests assessed mean differences, linear regression assessed accuracy, precision was assessed by R² and standard error of the estimate (SEE), and bias was assessed by Bland-Altman plots.

RESULTS

At birth, FM measured by ADP differed from FM estimated by Deierlein, Lingwood and Aris equations, but did not differ from the Catalano equation. At 3 months, FM measured by ADP was different from all equations. At both time points, poor precision and accuracy was detected. Bias was detected in most all equations.

CONCLUSIONS

Poor agreement, precision, and accuracy were found between prediction equations and the criterion at birth and 3 months.