Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Am J Clin Nutr. 2021 Apr 6;113(4):895-904. doi: 10.1093/ajcn/nqaa398.
Nutrition in pregnancy and accelerated childhood growth are important predictors of obesity risk. Yet, it is unknown which dietary patterns in pregnancy are associated with accelerated growth and whether there are specific periods from birth to adolescence that are most sensitive to these associations.
To examine the extent to which 3 dietary indices in pregnancy [Dietary Inflammatory Index (DII), Alternate Healthy Eating Index for Pregnancy (AHEI-P), and Mediterranean Diet Score (MDS)] are associated with child BMI z-score (BMI-z) trajectories from birth to adolescence.
We examined 1459 mother-child dyads from Project Viva that had FFQ data in pregnancy and ≥3 child BMI-z measurements between birth and adolescence. We used linear spline mixed-effects models to examine whether BMI-z growth rates and BMI z-scores differed by quartile of each dietary index from birth to 1 mo, 1-6 mo, 6 mo to 3 y, 3-10 y, and >10 y.
The means ± SDs for DII (range, -9 to +8 units), AHEI-P (range, 0-90 points), and MDS (range, 0-9 points) were -2.6 ± 1.4 units, 61 ± 10 points, and 4.6 ± 2.0 points, respectively. In adjusted models, children of women in the highest (vs. lowest) DII quartile had higher BMI-z growth rates between 3-10 y (β, 0.03 SD units/y; 95% CI: 0.00-0.06) and higher BMI z-scores from 7 y through 10 y. Children of women with low adherence to a Mediterranean diet had higher BMI z-scores from 3 y through 15 y. Associations of AHEI-P with growth rates and BMI z-scores from birth through adolescence were null.
A higher DII and a lower MDS in pregnancy, but not AHEI-P results, are associated with higher BMI-z trajectories during distinct growth periods from birth through adolescence. Identifying the specific dietary patterns in pregnancy associated with rapid weight gain in children could inform strategies to reduce child obesity.
孕期营养和儿童加速生长是肥胖风险的重要预测因素。然而，目前尚不清楚孕期哪种饮食模式与生长加速有关，以及从出生到青春期是否存在对这些关联最敏感的特定时期。
研究孕期的 3 种饮食指数[饮食炎症指数（DII）、孕期替代健康饮食指数（AHEI-P）和地中海饮食评分（MDS）]与儿童从出生到青春期 BMI-z 轨迹的关联程度。
我们对来自 Viva 项目的 1459 对母婴对进行了研究，这些母婴对在孕期有 FFQ 数据，并且在出生到青春期之间有≥3 次儿童 BMI-z 测量值。我们使用线性样条混合效应模型来研究从出生到 1 个月、1-6 个月、6 个月至 3 岁、3-10 岁和>10 岁期间，每个饮食指数的四分位数是否会影响 BMI-z 增长率和 BMI z 评分。
DII（范围，-9 至+8 单位）、AHEI-P（范围，0-90 分）和 MDS（范围，0-9 分）的平均值±标准差分别为-2.6±1.4 单位、61±10 分和 4.6±2.0 分。在调整后的模型中，与最低四分位数相比，DII 最高四分位数的女性的孩子在 3-10 岁期间 BMI-z 增长率更高（β，0.03 SD 单位/y；95%CI：0.00-0.06），在 7 岁至 10 岁期间 BMI z 评分更高。饮食中遵循地中海饮食模式较低的女性的孩子从 3 岁到 15 岁 BMI z 评分更高。AHEI-P 与出生至青春期的生长率和 BMI z 评分之间的关联是无效的。
孕期 DII 升高和 MDS 降低，但 AHEI-P 结果没有，与从出生到青春期的不同生长阶段的 BMI-z 轨迹升高有关。确定与儿童体重快速增加相关的孕期特定饮食模式，可以为减少儿童肥胖提供策略。
