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J Pediatr. 2018 Nov 12. pii: S0022-3476(18)31417-3. doi: 10.1016/j.jpeds.2018.10.005. [Epub ahead of print]

The Association of Mediterranean Diet during Pregnancy with Longitudinal Body Mass Index Trajectories and Cardiometabolic Risk in Early Childhood.

Author information

1
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), Reus, Spain. Electronic address: silvia.fernandez@isglobal.org.
2
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
3
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
4
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.
5
BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain.
6
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Pediatric Unit, Hospital San Agustin, Aviles, Spain.
7
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Public Health, History of Medicine and Gynecology, Universidad Miguel Hernández, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
8
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain.
9
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IUOPA and University of Oviedo, Asturias, Spain.
10
Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), Reus, Spain.
11
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain.
12
ISGlobal, Barcelona, Spain; Instituto de Investigación Sanitaria Illes Balears, Hospital Universitari Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.

Abstract

OBJECTIVE:

To evaluate the associations between maternal adherence to the Mediterranean diet during pregnancy and their offspring's longitudinal body mass index (BMI) trajectories and cardiometabolic risk in early childhood.

STUDY DESIGN:

We included mother-child pairs from the Infancia y Medio Ambiente (INMA) longitudinal cohort study in Spain. We measured dietary intake during pregnancy using a validated food frequency questionnaire and calculated the relative Mediterranean diet score (rMED). We estimated offspring's BMI z score trajectories from birth to age 4 years using latent class growth analyses (n = 2195 mother-child pairs). We measured blood pressure, waist circumference, and cardiometabolic biomarkers to construct a cardiometabolic risk score at 4 years (n = 697 mother-child pairs). We used multivariable adjusted linear and multinomial regression models.

RESULTS:

A higher maternal rMED in pregnancy was associated with a lower risk in offspring of larger birth size, followed by accelerated BMI gain (reference trajectory group: children with average birth size and subsequent slower BMI gain) (relative risk of high vs low rMED score, 0.68; 95% CI, 0.47-0.99). rMED score during pregnancy was not associated with the cardiometabolic risk score, its components, or related biomarkers.

CONCLUSIONS:

Higher adherence to the Mediterranean diet in pregnancy was associated with lower risk of having offspring with an accelerated growth pattern. This dietary pattern was not associated with the offspring's cardiometabolic risk at 4 years.

KEYWORDS:

Mediterranean diet; cardiometabolic risk; childhood; cohort; growth

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