孕前女性生活方式与儿童期至成年早期后代肥胖风险的关系。
Lifestyle of women before pregnancy and the risk of offspring obesity during childhood through early adulthood.
机构信息
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
出版信息
Int J Obes (Lond). 2018 Jul;42(7):1275-1284. doi: 10.1038/s41366-018-0052-y. Epub 2018 Mar 3.
BACKGROUND
In women, adhering to an overall healthy lifestyle is associated with a dramatically reduced risk of cardio-metabolic disorders. Whether such a healthy lifestyle exerts an intergenerational effects on child health deserves examination.
METHODS
We included 5701 children (9-14 years old at baseline) of the Growing Up Today Study 2, and their mothers, who are participants in the Nurses' Health Study II. Pre-pregnancy healthy lifestyle was defined as a normal body mass index, no smoking, physical activity ≥150 min/week, and diet in the top 40% of the Alternative Healthy Eating Index-2010. Obesity during childhood and adolescence was defined using the International Obesity Task Force age- and sex-specific cutoffs. Multivariable log-binominal regression models with generalized estimating equations were used to evaluate the association of pre-pregnancy healthy lifestyle and offspring obesity.
RESULTS
We identified 520 (9.1%) offspring who became obese during follow-up. A healthy body weight of mothers and no smoking before pregnancy was significantly associated with a lower risk of obesity among offspring: the relative risks [RRs; 95% confidence intervals (CIs)] were 0.37 (0.31-0.43) and 0.64 (0.49-0.84), respectively. Eating a healthy diet and regular moderate-to-vigorous physical activities were inversely related to offspring obesity risk, but these relations were not statistically significant. Compared to children of mothers who did not meet any low-risk lifestyle factors, offspring of women who adhered to all four healthy lifestyle factors had 75% lower risk of obesity (RR: 0.25, 95% CI: 0.14-0.43).
CONCLUSION
Adherence to an overall healthy lifestyle before pregnancy is strongly associated with a low risk of offspring obesity in childhood, adolescence, and early adulthood. These findings highlight the importance of an overall healthy lifestyle before pregnancy as a potential strategy to prevent obesity in future generations.
背景
在女性中，坚持整体健康的生活方式与心血管代谢疾病风险的显著降低密切相关。这种健康的生活方式是否对儿童健康产生代际影响值得研究。
方法
我们纳入了 5701 名来自“今日成长研究 2 期”的儿童（基线时 9-14 岁）及其母亲，这些母亲是“护士健康研究 II”的参与者。孕前健康生活方式定义为正常体重指数、不吸烟、每周体力活动≥150 分钟和饮食处于“替代健康饮食指数-2010”的前 40%。儿童和青少年期肥胖采用国际肥胖特别工作组特定年龄和性别的标准进行定义。使用广义估计方程的多变量对数二项式回归模型来评估孕前健康生活方式与后代肥胖的关系。
结果
我们发现 520 名（9.1%）儿童在随访期间肥胖。母亲健康的体重和怀孕前不吸烟与后代肥胖风险降低显著相关：相对风险[RR；95%置信区间（CI）]分别为 0.37（0.31-0.43）和 0.64（0.49-0.84）。健康饮食和有规律的中等至剧烈体力活动与后代肥胖风险呈负相关，但这些关系没有统计学意义。与母亲没有任何低风险生活方式因素的儿童相比，坚持所有四项健康生活方式因素的女性的后代肥胖风险降低 75%（RR：0.25，95%CI：0.14-0.43）。
结论
怀孕前坚持整体健康的生活方式与儿童、青少年和成年早期后代肥胖风险低密切相关。这些发现强调了怀孕前整体健康生活方式作为预防后代肥胖的潜在策略的重要性。
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