title: Effects of nutritional supplementation during pregnancy on early adult disease risk: follow up of offspring of participants in a randomised controlled trial investigating effects of supplementation on infant birth weight.
abstract: BACKGROUND
  Observational evidence suggests that improving fetal growth may improve adult health. Experimental evidence from nutritional supplementation trials undertaken amongst pregnant women in the less developed world does not show strong or consistent effects on adult disease risk and no trials from the more developed world have previously been reported.
  
  
  OBJECTIVE
  To test the hypothesis that nutritional supplementation during pregnancy influences offspring disease risk in adulthood.
  
  
  METHODS
  Clinical assessment of a range of established diseases risk markers in young adult offspring of 283 South Asian mothers who participated in two trials of nutritional supplementation during pregnancy (protein/energy/vitamins; energy/vitamins or vitamins only) at Sorrento Maternity Hospital in Birmingham UK either unselected or selected on the basis of nutritional status.
  
  
  RESULTS
  236 (83%) offspring were traced and 118 (50%) of these were assessed in clinic. Protein/energy/vitamins supplementation amongst undernourished mothers was associated with increased infant birthweight. Nutritional supplementation showed no strong association with any one of a comprehensive range of markers of adult disease risk and no consistent pattern of association with risk across markers in offspring of either unselected or undernourished mothers.
  
  
  CONCLUSIONS
  We found no evidence that nutritional supplements given to pregnant women are an important influence on adult disease risk however our study lacked power to estimate small effects. Our findings do not provide support for a policy of nutritional supplementation for pregnant women as an effective means to improve adult health in more developed societies.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom ; Department of Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Macleod
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Lie
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: F D Richard
authors.initials: FD
authors.lastname: Hobbs
authors.affiliation: Institutes of Child Health, University of London and University of Birmingham, London and Birmingham, United Kingdom.
authors.forename: Brian
authors.initials: B
authors.lastname: Wharton
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Roger
authors.initials: R
authors.lastname: Holder
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Shakir
authors.initials: S
authors.lastname: Hussain
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Nichols
authors.affiliation: Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Stewart
authors.affiliation: Department of Clinical Biochemistry, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Penny
authors.initials: P
authors.lastname: Clark
authors.affiliation: College of Medicine, Swansea University, Swansea, United Kingdom.
authors.forename: Steve
authors.initials: S
authors.lastname: Luzio
authors.affiliation: School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.
authors.forename: Jeff
authors.initials: J
authors.lastname: Holly
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: George Davey
authors.initials: GD
authors.lastname: Smith
mesh_terms: D000328:Adult; D044466:Asian People; D004044:Dietary Proteins / Q000008:administration & dosage*; D004435:Eating; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D004044:Dietary Proteins; D014815:Vitamins