title: Maternal first-trimester diet and childhood bone mass: the Generation R Study.
abstract: BACKGROUND
  Maternal diet during pregnancy has been suggested to influence bone health in later life.
  
  
  OBJECTIVE
  We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass.
  
  
  METHODS
  In a prospective cohort study in 2819 mothers and their children, we measured first-trimester daily energy, protein, fat, carbohydrate, calcium, phosphorus, and magnesium intakes by using a food-frequency questionnaire and homocysteine, folate, and vitamin B-12 concentrations in venous blood. We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y.
  
  
  RESULTS
  Higher first-trimester maternal protein, calcium, and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass, whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass (all P-trend < 0.01). Maternal fat, magnesium intake, and folate concentrations were not associated with childhood bone mass. In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass, maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content (BMC) [β = 2.8 (95% CI: 1.1, 4.5) and β = -1.8 (95% CI: -3.6, 0.1) g per SD increase, respectively], whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [β = 2.1 (95% CI: 0.7, 3.5) and β = 1.8 (95% CI: 0.4, 3.2) g per SD increase, respectively].
  
  
  CONCLUSIONS
  Maternal first-trimester dietary factors are associated with childhood bone mass, suggesting that fetal nutritional exposures may permanently influence bone development.
authors.affiliation: Generation R Study Group and the Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Denise H M
authors.initials: DH
authors.lastname: Heppe
authors.forename: Carolina
authors.initials: C
authors.lastname: Medina-Gomez
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivadeneira
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000097:blood; D002648:Child; D004032:Diet; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood; D006710:Homocysteine / Q000008:administration & dosage / Q000097:blood; D006801:Humans; D008019:Life Style; D008274:Magnesium / Q000008:administration & dosage / Q000097:blood; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D016226:Phosphorus, Dietary / Q000008:administration & dosage / Q000097:blood; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D016226:Phosphorus, Dietary; D006710:Homocysteine; D005492:Folic Acid; D008274:Magnesium; D014805:Vitamin B 12