Intake of carbohydrates during pregnancy in obese women is associated with fat mass in the newborn offspring

• Published in: The American journal of clinical nutrition 2015-12, Vol.102 (6), p.1475-1481
• Main Authors: Renault, Kristina M, Carlsen, Emma M, Nørgaard, Kirsten, Nilas, Lisbeth, Pryds, Ole, Secher, Niels J, Cortes, Dina, Jensen, Jens-Erik Beck, Olsen, Sjurdur F, Halldorsson, Thorhallur I
• Format: Article
• Language: English
• Subjects: Adipogenesis; Adiposity; Adult; Birth Weight; Body Mass Index; Carbohydrates; Denmark - epidemiology; Diet, Carbohydrate-Restricted; Diet, Mediterranean; Dietary Carbohydrates - adverse effects; Female; Fetal Development; Glucose Intolerance - complications; Glucose Intolerance - diet therapy; Glucose Intolerance - physiopathology; Humans; Infant, Newborn; Maternal Nutritional Physiological Phenomena; Newborn babies; Obesity; Obesity - complications; Obesity - diet therapy; Obesity - physiopathology; Pediatric Obesity - epidemiology; Pediatric Obesity - etiology; Pediatric Obesity - prevention & control; Pregnancy; Pregnancy Complications - diet therapy; Pregnancy Complications - physiopathology; Risk Factors; Self Report; Young Adult
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.115.110551

Transmission of obesity across generations is of concern. Offspring of obese women have short- and long-term increased morbidities. A high intake of carbohydrate during pregnancy combined with impaired glucose tolerance is postulated to result in high birth weight, which is linked to subsequent metabolic disease. The objective was to examine the association between carbohydrate intake in obese pregnant women and their offspring's body composition. Secondary analyses were performed in an observational setting of 222 pregnant women with a pregestational BMI (in kg/m(2)) ≥30 participating in a randomized controlled trial. Diet was assessed at gestational weeks 11-14 and 36-37 by using a semiquantitative food-frequency questionnaire. Body composition in the offspring was assessed at birth by dual-energy X-ray absorptiometry. Relative fat mass (%) was the primary outcome. Absolute measures (total fat, abdominal fat, and lean body mass) were secondary outcomes. Mean ± SD weight and absolute and relative fat mass in the offspring at birth were 3769 ± 542 g, 436 ± 214 g, and 11% ± 4%, respectively. Maternal intake of digestible carbohydrates was associated with the offspring's relative fat mass in late (P-trend = 0.006) but not early (P-trend = 0.15) pregnancy. A comparison of mothers in the highest (median: 238 g/d) compared with the lowest (median: 188 g/d) quartile of digestible carbohydrate intake showed a mean adjusted higher value in the offspring's relative fat mass of 2.1% (95% CI: 0.6%, 3.7%), which corresponded in absolute terms to a 103-g (95% CI: 27, 179-g) higher fat mass. Abdominal fat mass was also higher. In a strata of women with well-controlled glucose (2-h glucose values ≤6.6 mmol/L), no association between carbohydrate intake and offspring fat mass was observed, but the associations became significant and increased in strength with higher intolerance (strata with 2-h glucose values between 6.7-7.7 and ≥7.8 mmol/L). In obese women, even those without gestational diabetes but with impaired glucose tolerance, a lower carbohydrate intake at moderate levels in late gestation is associated with a lower fat mass in their offspring at birth. The TOP study was registered at clinicaltrials.gov as NCT01345149.