title: Maternal Protein Intake during Pregnancy Is Not Associated with Offspring Birth Weight in a Multiethnic Asian Population.
abstract: BACKGROUND
  Maternal diet during pregnancy can influence fetal growth. However, the relation between maternal macronutrient intake and birth size outcomes is less clear.
  
  
  OBJECTIVE
  We examined the associations between maternal macronutrient intake during pregnancy and infant birth size.
  
  
  METHODS
  Pregnant women (n = 835) from the Singapore GUSTO (Growing Up in Singapore Towards healthy Outcomes) mother-offspring cohort were studied. At 26-28 wk of gestation, the macronutrient intake of women was ascertained with the use of 24 h dietary recalls and 3 d food diaries. Weight, length, and ponderal index of their offspring were measured at birth. Associations were assessed by substitution models with the use of multiple linear regressions.
  
  
  RESULTS
  Mean ± SD maternal energy intake and percentage energy from protein, fat, and carbohydrates per day were 1903 ± 576 kcal, 15.6% ± 3.9%, 32.7% ± 7.5%, and 51.6% ± 8.7% respectively. With the use of adjusted models, no associations were observed for maternal macronutrient intake and birth weight. In male offspring, higher carbohydrate or fat intake with lower protein intake was associated with longer birth length (β = 0.08 cm per percentage increment in carbohydrate; 95% CI: 0.04, 0.13; β = 0.08 cm per percentage increment in fat; 95% CI: 0.02, 0.13) and lower ponderal index (β = -0.12 kg/m(3) per percentage increment in carbohydrate; 95% CI: -0.19, -0.05; β = -0.08 kg/m(3) per percentage increment in fat; 95% CI: -0.16, -0.003), but this was not observed in female offspring (P-interaction < 0.01).
  
  
  CONCLUSIONS
  Maternal macronutrient intake during pregnancy was not associated with infant birth weight. Lower maternal protein intake was significantly associated with longer birth length and lower ponderal index in male but not female offspring. However, this finding warrants further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.
authors.affiliation: Clinical Nutrition Research Centre, and Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Paediatrics, and mary_chong@sics.a-star.edu.sg.
authors.forename: Mary Foong-Fong
authors.identifier: http://orcid.org/0000-0003-0587-2505
authors.initials: MF
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;
authors.forename: Ai-Ru
authors.initials: AR
authors.lastname: Chia
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;
authors.forename: Marjorelee
authors.initials: M
authors.lastname: Colega
authors.affiliation: Department of Obstetrics and Gynaecology.
authors.forename: Mya-Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Department of Paediatrics, and.
authors.forename: Izzuddin M
authors.initials: IM
authors.lastname: Aris
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Obstetrics and Gynaecology.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand;
authors.forename: Peter
authors.initials: P
authors.lastname: Gluckman
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom;
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Department of Maternal Fetal Medicine and.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Paediatric Endocrinology, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Lee Kong Chian School of Medicine, Singapore; and.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, and Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Paediatrics, and Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001724:Birth Weight; D004032:Diet; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D039382:Maternal Nutritional Physiological Phenomena; D011939:Mental Recall; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011247:Pregnancy; D011446:Prospective Studies; D012846:Singapore; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins
keywords: birth length; birth weight; macronutrients; ponderal index; pregnancy diet; protein