Abstract
Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC) during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (<16 year) (n = 53,922). In multivariable Cox regression models, offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk (Hazard ratio, 95% confidence interval: 1.11, 1.01–1.23) of fractures, and there was a borderline significant positive trend (p = 0.06). The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02). In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research.
Highlights
It is well known that low bone mass in old age, which constitutes a major public health concern, can be prevented by optimal accumulation of bone mass during childhood and adolescence
53,922 mother and child-pairs were available for analysis (Figure 1) of which 4222 offspring were diagnosed with a first time forearm fracture during follow up
We found no associations between single nutrients and offspring forearm fractures, which indicated that the modest association for maternal Western diet with offspring forearm fracture risk might be due to factors other than the total maternal intake of nutrients during pregnancy
Summary
It is well known that low bone mass in old age, which constitutes a major public health concern, can be prevented by optimal accumulation of bone mass during childhood and adolescence. The peak bone mass is influenced by lifestyle factors, such as diet and physical activity, during childhood and adolescence [2]. The hypothesis of fetal programming of bone health has mainly been studied by analyzing the association between maternal Vitamin D status during pregnancy and offspring bone mineral content (BMC) and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) at a single time point during childhood, but the results are conflicting [4,5,6,7,8]. Few studies have explored the relation between maternal diet during pregnancy and offspring accumulation of bone mass measured by DXA during childhood [9,10,11,12,13,14,15,16]. There seems to be some evidence for a negative association with respect to dietary fat intake, but a positive association with respect to calcium, magnesium and folate with offspring BMD
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