Abstract
The ‘Developmental Origins of Health and Diseases’ hypothesis posits that prenatal maternal diet influences offspring growth and later life health outcomes. Dietary assessment has focused on selected nutrients. However, this approach does not consider the complex interactions between foods and nutrients. To provide a more comprehensive approach to public health, dietary indices have been developed to assess dietary quality, dietary inflammation and risk factors for non-communicable diseases. Thus far, their use in the context of placental development is limited and associations with offspring outcomes have been inconsistent. Although epidemiological studies have focused on the role of maternal diet on foetal programming, the underlying mechanisms are still poorly understood. Some evidence suggests these associations may be driven by placental and epigenetic changes. In this narrative review, we examine the current literature regarding relationships between key validated diet quality scores (Dietary Inflammatory Index [DII], Mediterranean diet [MD], Healthy Eating Index [HEI], Alternative Healthy Eating Index [AHEI], Dietary Approaches to Stop Hypertension [DASH], Glycaemic Index [GI] and Glycaemic Load [GL]) in pregnancy and birth and long-term offspring outcomes. We summarise findings, discuss potential underlying placental and epigenetic mechanisms, in particular DNA methylation, and highlight the need for further research and public health strategies that incorporate diet quality and epigenetics.
Highlights
The importance of adequate nutrition during foetal life for long-term health is well documented [1]
More recent observational research based on the Lifeways cohort of generally healthy pregnant women found no clear associations between maternal glycaemic index (GI) and glycaemic load (GL) with childhood body mass index (BMI), waist circumference z-scores and general or central obesity at 5 years [38]
Birth Cohort, higher maternal GI and GL were associated with an increase in 7-year BMI
Summary
The importance of adequate nutrition during foetal life for long-term health is well documented [1]. The ‘Developmental Origins of Health and Diseases’ (DOHaD) hypothesis postulates that maternal nutritional status in the preconception period and during pregnancy may influence offspring development and the occurrence of disease, from childhood to later life [2,3,4,5]. Smaller size or relative thinness at birth or during infancy has been related to increased rates of cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) in adulthood [5,6,7,8]. Much attention has focused on the conditions of nutritional deprivation, but there is new evidence that maternal obesity during pregnancy is associated with long-term health consequences for the offspring, such as increased body mass index (BMI) during infancy, childhood and later life and increased risk of T2DM in adulthood [9,10]
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