title: Maternal dietary intake during pregnancy and offspring body composition: The Healthy Start Study.
abstract: BACKGROUND
  Consistent evidence of an influence of maternal dietary intake during pregnancy on infant body size and composition in human populations is lacking, despite robust evidence in animal models.
  
  
  OBJECTIVE
  We sought to evaluate the influence of maternal macronutrient intake and balance during pregnancy on neonatal body size and composition, including fat mass and fat-free mass.
  
  
  METHODS
  The analysis was conducted among 1040 mother-offspring pairs enrolled in the prospective prebirth observational cohort: the Healthy Start Study. Diet during pregnancy was collected using repeated 24-hour dietary recalls (up to 8). Direct measures of body composition were obtained using air displacement plethysmography. The National Cancer Institute measurement error model was used to estimate usual dietary intake during pregnancy. Multivariable partition (nonisocaloric) and nutrient density (isocaloric) linear regression models were used to test the associations between maternal dietary intake and neonatal body composition.
  
  
  RESULTS
  The median macronutrient composition during pregnancy was 32.2% from fat, 15.0% from protein, and 47.8% from carbohydrates. In the partition multivariate regression model, individual macronutrient intake values were not associated with birthweight or fat-free mass, but were associated with fat mass. Respectively, 418 kJ increases in total fat, saturated fat, unsaturated fat, and total carbohydrates were associated with 4.2-g (P = .03), 11.1-g (P = .003), 5.9-g (P = .04), and 2.9-g (P = .02) increases in neonatal fat mass, independent of prepregnancy body mass index. In the nutrient density multivariate regression model, macronutrient balance was not associated with fat mass, fat-free mass, or birthweight after adjustment for prepregnancy body mass index.
  
  
  CONCLUSIONS
  Neonatal adiposity, but not birthweight, is independently associated with increased maternal intake of total fat, saturated fat, unsaturated fat, and total carbohydrates, but not protein, suggesting that most forms of increased caloric intake contribute to fetal fat accretion.
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO. Electronic address: Tessa.Crume@ucdenver.edu.
authors.forename: Tessa L
authors.initials: TL
authors.lastname: Crume
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO.
authors.forename: John T
authors.initials: JT
authors.lastname: Brinton
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO.
authors.forename: Allison
authors.initials: A
authors.lastname: Shapiro
authors.affiliation: Department of Pediatrics and Nutrition, School of Medicine, University of Colorado-Denver Anschutz Medical Center, Denver, CO.
authors.forename: Jill
authors.initials: J
authors.lastname: Kaar
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO.
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Glueck
authors.affiliation: Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
mesh_terms: D000328:Adult; D001724:Birth Weight; D001823:Body Composition; D004032:Diet; D004034:Diet Surveys; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D039401:Prenatal Nutritional Physiological Phenomena; D011446:Prospective Studies
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins
keywords: birthweight; dietary intake; fetal growth; fetal programming; neonatal body composition; nutrition during pregnancy; saturated fat