Wibrand Camilla, Gaml-Sørensen Anne, Bjerregaard Anne Ahrendt, Olsen Sjurdur Frodi, Ramlau-Hansen Cecilia
Department of Public Health, Research Unit for Epidemiology, Bartholins Allé 2, Aarhus University, 8000 Aarhus C, Denmark.
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Clin Nutr ESPEN. 2025 Sep 9;70:18-28. doi: 10.1016/j.clnesp.2025.09.006.
Animal studies have suggested that nutrition received in utero may impact pubertal timing. However, the potential association between maternal dietary quality during pregnancy and pubertal timing remains unevaluated in humans. We examined if a measure reflecting dietary quality in mid-pregnancy is related to pubertal timing.
We utilized data from the Danish National Birth Cohort and its sub-cohort, the Puberty Cohort with children born in 2000-2003. Data on diet, the primary exposure, was collected in mid-pregnancy using a Food Frequency Questionnaire and condensed into eight domains based on Danish National Food-based Dietary Guidelines. Based on guideline compliance, a maternal healthy eating index (mHEI) ranging from 0 to 80 was constructed. Self-reported data on pubertal development, the primary outcome, was collected half-yearly from age 11 years and throughout puberty. Main outcome was age difference in months at reaching individual pubertal milestones as well as reaching all pubertal milestones in a combined estimate, which was analyzed according to mHEI in quartiles, continuous and as restricted cubic splines using multi-variable interval-censored regression models. The analyses were stratified by sex.
The study population consisted of 12,979 mother-offspring pairs. The mHEI ranged from 4.5 to 54.7 with a median of 22.3. In girls, we found an indication of an association between mHEI and slightly earlier pubertal timing, as both high and low mHEI were associated with an earlier combined pubertal estimate compared to the median mHEI as restricted cubic splines. Not meeting fruit and vegetable recommendations was associated with later pubertal onset in girls. We found no association between mHEI and pubertal timing in boys.
There might be an association between mHEI and puberty timing in girls, but results should be interpreted cautiously due to the study's lack of consistent results, possible unmeasured residual confounding, a risk of misclassification and few participants meeting the dietary recommendations.
动物研究表明，子宫内所摄取的营养可能会影响青春期的时间。然而，孕期母亲饮食质量与青春期时间之间的潜在关联在人类中仍未得到评估。我们研究了反映孕中期饮食质量的一项指标是否与青春期时间相关。
我们利用了丹麦国家出生队列及其子队列——2000年至2003年出生儿童的青春期队列的数据。饮食数据作为主要暴露因素，在孕中期使用食物频率问卷进行收集，并根据丹麦国家基于食物的膳食指南浓缩为八个领域。基于指南依从性，构建了一个范围从0到80的母亲健康饮食指数（mHEI）。关于青春期发育的自我报告数据作为主要结局，从11岁起每半年收集一次，贯穿整个青春期。主要结局是达到各个青春期里程碑的月龄差异，以及综合估计中达到所有青春期里程碑的情况，使用多变量区间删失回归模型，根据四分位数、连续变量以及受限立方样条的mHEI进行分析。分析按性别分层。
研究人群包括12979对母婴。mHEI范围为4.5至54.7，中位数为22.3。在女孩中，我们发现mHEI与青春期时间稍早之间存在关联迹象，因为与作为受限立方样条的中位数mHEI相比，高mHEI和低mHEI均与综合青春期估计较早有关。未达到水果和蔬菜推荐量与女孩青春期开始较晚有关。我们在男孩中未发现mHEI与青春期时间之间存在关联。
mHEI与女孩青春期时间之间可能存在关联，但由于该研究结果缺乏一致性、可能存在未测量的残余混杂因素、存在错误分类风险且很少有参与者达到膳食推荐标准，因此结果应谨慎解读。
