Maternal carbohydrate intake during pregnancy is associated with child peripubertal markers of metabolic health but not adiposity.

Molly C Mulcahy,Dave Bridges,Ana Baylin,Maritsa Solano-González,Alejandra Cantoral,Wei Perng,Karen E Peterson,Martha Maria Tellez-Rojo

doi:10.1017/s1368980021004614

Abstract

To examine the associations of trimester-specific maternal prenatal carbohydrate (CHO) intake with offspring adiposity and metabolic health during peripuberty. Prospective cohort study in which maternal dietary intake was collected via validated FFQ during each trimester. Offspring adiposity and metabolic biomarkers were evaluated at age 8-14 years. We used multivariable linear regression to examine associations between total energy-adjusted maternal CHO intake and offspring BMI z-score, skinfold thickness and metabolic syndrome risk z-score calculated as the average of waist circumference, fasting glucose, fasting C-peptide, TAG:HDL and systolic blood pressure + diastolic blood pressure/2. Mexico City, Mexico. 237 mother-child pairs in the Early Life Exposure in Mexico to Environmental Toxicants cohort. We found non-linear associations of maternal CHO intake during pregnancy with offspring metabolic health during peripuberty. After adjusting for maternal age, and child age, sex and pubertal status, children whose mothers were in the fourth v. first quartile of total CHO intake during the third trimester had 0·42 (95 % CI -0·01, 0·08) ng/ml lower C-peptide and 0·10 (95 % CI -0·02, 0·22) units lower C-peptide insulin resistance (CP-IR). We found similar magnitude and direction of association with respect to net CHO intake during the first trimester and offspring C-peptide and CP-IR. Maternal CHO intake during pregnancy was not associated with offspring adiposity. In this study of mother-child pairs in Mexico City, children born to women in the highest quartile of CHO intake during pregnancy had lowest C-peptide and CP-IR during peripuberty. Additional research is warranted to replicate and identify mechanisms.

Highlights

Energy-adjusted CHO intake in pregnancy is shown in Table 1; values are shown as total CHO, net CHO and sugar intake for each trimester
Summary In this study of 237 mother–child pairs in Mexico City, we found that highest maternal intake of total and net CHO during pregnancy, during the first and third trimesters, were associated with C-peptide and C-peptide insulin resistance (CP-IR) in an inverse J-shaped manner where the highest quartile of maternal intake corresponded with lowest values of the metabolic biomarkers in offspring at 8–14 years of age
A study of 164 mother–child pairs in China demonstrated that children of women with gestational diabetes mellitus (GDM) had higher cord blood insulin levels and higher blood pressures and lower HDL at 8 years of age than those whose mothers were normoglycaemic during pregnancy[40]

Summary

Methods

Study population Participants are part of the ongoing ELEMENT cohort in Mexico City[20]. An internally derived summary risk variable (metabolic syndrome risk z-score (MetRisk z-score)) was calculated using an average of five-internally standardised z-scores for waist circumference, fasting blood glucose, fasting CP-IR (a surrogate for insulin secretion)(29), the ratio of TAG to HDL content and the average of blood pressure measures[30]. This summary risk variable has been used in prior ELEMENT studies[27,30] and validated with respect to known metabolic syndrome risk factors in children and with respect to incident type 2 diabetes and CVD in adults[31]. Data were analysed using SAS ® software version 9.4

Results

Discussion

Strengths and limitations

Conclusions