孕期母体饮食质量与儿童早期肝内脂肪：健康开端研究。
Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study.
机构信息
Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
出版信息
J Nutr. 2023 Apr;153(4):1122-1132. doi: 10.1016/j.tjnut.2023.01.039. Epub 2023 Feb 14.
BACKGROUND
Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans.
OBJECTIVES
This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4-8 y old).
METHODS
Data were from 278 mother-child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1-8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake.
RESULTS
Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of "empty calories" were associated with higher offspring hepatic fat in early childhood.
CONCLUSIONS
Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.
背景
宫内营养过剩可能会增加后代非酒精性脂肪肝（NAFLD）的风险，但在人类中，妊娠期间母体饮食质量对这种关联的具体贡献仍研究不足。
目的
本研究旨在探讨妊娠期间母体饮食质量与后代幼儿期肝内脂肪（中位数：5 岁，范围：4-8 岁）的相关性。
方法
数据来自科罗拉多州纵向健康启动研究中的 278 对母婴。在妊娠期间，母亲每月接受多次 24 小时回顾性饮食调查（中位数：3 次回忆，范围：1-8 次回忆，从入组后开始），并用于估计母体的一般营养素摄入量和饮食模式评分[健康饮食指数-2010（HEI-2010）、饮食炎症指数（DII）和相对地中海饮食评分（rMED）]。通过 MRI 测量幼儿期后代的肝内脂肪。在校正后代人口统计学、产妇/围产期混杂因素和母体总能量摄入后，使用线性回归模型评估妊娠期间母体饮食预测因素与后代对数转换肝内脂肪的相关性。
结果
在完全调整模型中，较高的母体纤维摄入量和 rMED 评分与幼儿期后代肝内脂肪较低相关[逆转换β（95%可信区间）：5 g/1000 kcal 纤维增加 0.82（0.72，0.94）；rMED 增加 0.93（0.88，0.99）]。相比之下，较高的母体总糖和添加糖摄入量以及 DII 评分与后代肝内脂肪较高相关[逆转换β（95%可信区间）：每 5% kcal/d 添加糖增加 1.18（1.05，1.32）；DII 增加 1.08（0.99，1.18）]。饮食模式亚成分分析也表明，母体绿叶蔬菜和豆类摄入量较低，“空卡路里”摄入量较高与幼儿期后代肝内脂肪较高有关。
结论
妊娠期间母体饮食质量较差与后代幼儿期肝内脂肪增加有关。我们的研究结果为小儿非酒精性脂肪肝的原始预防提供了潜在的围产期目标。
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