Abstract
To examine associations of healthy lifestyle during pregnancy with body mass index (BMI) and risk of overweight or obesity of grandchildren during adolescence and young adulthood. Our study population included 14,001 grandmother–mother–child triads comprised of participants of two ongoing prospective cohort studies of related individuals. We used self-reported grand-maternal gestational weight gain, diet, physical activity, and smoking during pregnancy to create a lifestyle score ranged from 0 to 12, with a higher score indicating healthier lifestyle. Grandchild BMI was self-assessed in follow-up questionnaires. Compared with individuals whose grandmothers had the least healthy lifestyle during pregnancy, individuals whose grandmothers had the most healthy lifestyle had 0.17 (95% CI 0.01, 0.33; P for trend = 0.05) kg/m2 lower BMI and 7% (95% CI 2%, 12%; P for trend = 0.001) lower risk of overweight or obesity during adolescence and young adulthood. The inverse associations between grand-maternal lifestyle and BMI in grandchildren were mainly mediated by maternal pre-pregnancy BMI (mediation effect: 64%; P value = 0.001). Overall, maternal BMI, along with maternal socioeconomic status and lifestyle factors in the second and third generations accounted for all of the inter-generational association (mediation effect: 99%; P value < 0.001). The inverse associations of grand-maternal lifestyle with BMI of offspring were not modified by grand-maternal pre-pregnancy BMI, grandchild age, or grandchild gender. Grandchildren of women who had the healthiest lifestyles during pregnancy defined by no excess gestational weight gain, no smoking, a healthy diet and being physically active, were less likely to be overweight or obese in adolescence and early adulthood.
Highlights
To examine associations of healthy lifestyle during pregnancy with body mass index (BMI) and risk of overweight or obesity of grandchildren during adolescence and young adulthood
We examined whether F2 and F3 lifestyle factors and F2 socioeconomic status singly or jointly mediated the associations between grand-maternal lifestyle factors and BMI of offspring
Compared to the individuals whose grandmothers had the least healthy lifestyle during pregnancy, individuals whose grandmothers had the most healthy lifestyle had 0.17 kg/m2 lower BMI and 7% lower risk of overweight/obesity in the offspring during adolescence and young adulthood (Table 3)
Summary
To examine associations of healthy lifestyle during pregnancy with body mass index (BMI) and risk of overweight or obesity of grandchildren during adolescence and young adulthood. Prospective cohort studies have shown that maternal lifestyle factors such as weight gain and smoking during pregnancy were associated with higher risk of obesity in the offspring[6,7,8,9,10,11]. By combining individual lifestyle factors, maternal adherence to a healthier pre-pregnancy lifestyle including high-quality diet, adequate physical activity, normal body mass index (BMI), and no smoking was associated with lower risk of obesity in the o ffspring[14,15]. We examined the association of grand-maternal lifestyle during pregnancy with BMI and risk of overweight or obesity of offspring by adopting a three-generation study design This unique design included 14,001 grandmother–mother–child triads comprised of participants in the Nurses’ Mother Cohort (F1), the Nurses’ Health Study II (NHS II, F2), and the Growing Up Today Study (GUTS, F3)
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