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Int J Obes (Lond). 2016 Jul;40(7):1056-62. doi: 10.1038/ijo.2016.79. Epub 2016 May 2.

Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study.

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Department of Epidemiology, Colorado School of Public Health (CSPH), Aurora, CO, USA.
Division of Pediatric Nutrition, University of Colorado School of Medicine, Aurora, CO, USA.
Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Biostatistics and Informatics, CSPH, Aurora, CO, USA.
Division of Endocrinology, Metabolism and Diabetes, Department of Medicine University of Colorado, Denver, CO, USA.
Departments of Pediatrics and Biochemistry and Molecular Genetics, School of Medicine, University of Colorado, Denver, CO, USA.



Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass (%FM)) at birth by increasing the fat mass (FM) component of neonatal body composition.


Our analysis was conducted using a prebirth observational cohort of 1079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of ⩽57 and >57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age.


Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, s.d.: 13.6). An HEI-2010 score of ⩽57 was significantly associated with higher neonatal %FM (β=0.58, 95% confidence interval (CI) 0.07-1.1, P<0.05) and FM (β=20.74; 95% CI 1.49-40.0; P<0.05) but no difference in FFM.


Poor diet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

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