Abstract
Aims: This systematic review examines the association between maternal lifestyle, diet and physical activity, and epigenetic changes in the offspring. Methods: A literature search was conducted using multiple science databases: PubMed, Embase and Cochrane Library, on 10 March 2021. RCT and Cohort studies in English or Scandinavian languages were included. Exposure variables included diet, lifestyle, meal patterns or physical activity. Studies using dietary supplements as exposure variables were excluded. Outcome variables included were DNA methylation, microRNA or histone changes in placenta, cord blood or offspring. Two independent authors screened, read and extracted data from the included papers. The Cochrane risk-of-bias tool for randomized trials (RoB2) and The Critical Appraisal Skills Program (CASP) Cohort Study Checklist were used to assess risk of bias in the included studies. A qualitative approach was employed due to heterogeneity of exposures and results of the studies. Results: 16 studies and 3617 participants were included in the final analysis. The exposure variables included physical activity, carbohydrate, low glycemic index diet, added sugar, fat, Mediterranean diet and pro-inflammatory diet. The outcome variables identified were differences in DNA methylation and microRNA. Most studies described epigenetic changes in either placenta or cord blood. Genes reported to be methylated were GR, HSD2, IGF-2, PLAG1, MEG-3, H19 and RXRA. However, not all studies found epigenetic changes strong enough to pass multiple testing, and the study quality varied. Conclusion: Despite the variable quality of the included studies, the results in this review suggest that there may be an association between the mother’s lifestyle, diet and level of physical activity during pregnancy and epigenetic changes in the offspring.
Highlights
The prenatal development process is a critical period where variation, overload or deficiency of nutrients can affect the fetus through fetal programming that may have persistent effects on the health of the offspring and induce the risk of disease later in life [1,2]
Eligibility was assessed for all studies that reported paternal or maternal lifestyle prior to and/or during pregnancy associated with epigenetic modifications in placental or offspring tissues and fluids
The studies included in this review suggest that diet and physical activity during pregnancy can influence offspring DNA methylation at several differentially methylated regions (DMRs) and CpG sites related to cell proliferation, cancer development, obesity, type 2 diabetes and immune and inflammatory responses
Summary
The prenatal development process is a critical period where variation, overload or deficiency of nutrients can affect the fetus through fetal programming that may have persistent effects on the health of the offspring and induce the risk of disease later in life [1,2]. Epigenetic changes can alter gene expression without changing the DNA-sequence and include DNA methylation, histone modification and micro-RNA (miRNA) changes [7]. With increased DNA methylation, the activity of the gene will be downregulated [4]. Whether it is advantageous in terms of programming for a gene to be methylated to a greater or lesser degree depends on the specific gene [4]. Whether it is advantageous in terms of programming for a gene to be methylated to a greater or lesser degree depends on the specific gene [4]. miRNA are small RNA molecules that can bind to specific transcribed mRNA sequences, and thereby lower their expression [7]
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