title: Maternal Macronutrient Intake during Pregnancy Is Associated with Neonatal Abdominal Adiposity: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study.
abstract: Infant body composition has been associated with later metabolic disease risk, but few studies have examined the association between maternal macronutrient intake and neonatal body composition. Furthermore, most of those studies have used proxy measures of body composition that may not reflect body fat distribution, particularly abdominal internal adiposity.
  
  
  
  We investigated the relation between maternal macronutrient intake and neonatal abdominal adiposity measured by using MRI in a multiethnic Asian mother-offspring cohort.
  
  
  
  The macronutrient intake of mothers was ascertained by using a 24-h dietary recall at 26-28 wk gestation. Neonatal abdominal adiposity was assessed by using MRI in week 2 of life. Mother-offspring dyads with complete macronutrient intake and adiposity information (n = 320) were included in the analysis. Associations were assessed by both substitution and addition models with the use of multivariable linear regressions.
  
  
  
  Mothers (mean age: 30 y) consumed (mean ± SD) 15.5% ± 4.3% of their energy from protein, 32.4% ± 7.7% from fat, and 52.1% ± 9.0% from carbohydrate. A higher-protein, lower-carbohydrate or -fat diet during pregnancy was associated with lower abdominal internal adipose tissue (IAT) in the neonates [β (95% CI): -0.18 mL (-0.35, -0.001 mL) per 1% protein-to-carbohydrate substitution and -0.25 mL (-0.46, -0.04 mL) per 1% protein-to-fat substitution]. These associations were stronger in boys than in girls (P-interaction < 0.05). Higher maternal intake of animal protein, but not plant protein, was associated with lower offspring IAT. In contrast, maternal macronutrient intake was not associated consistently with infant anthropometric measurements, including abdominal circumference and subscapular skinfold thickness.
  
  
  
  Higher maternal protein intake at the expense of carbohydrate or fat intake at 26-28 wk gestation was associated with lower abdominal internal adiposity in neonates. Optimizing maternal dietary balance might be a new approach to improve offspring body composition. This trial was registered at clinicaltrials.gov as NCT01174875.
authors.affiliation: Department of Paediatrics, paeclw@nus.edu.sg paeleeys@nus.edu.sg.
authors.forename: Ling-Wei
authors.identifier: 0000-0002-2661-8752
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynaecology, and.
authors.forename: Mya-Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Department of Diagnostic and Interventional Imaging and.
authors.forename: Marielle V
authors.initials: MV
authors.lastname: Fortier
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;
authors.forename: Izzuddin M
authors.initials: IM
authors.lastname: Aris
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Bernard
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: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand;
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore;
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Obstetrics and Gynaecology, and Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore; Duke-NUS Graduate Medical School, Lee Kong Chian School of Medicine, Singapore;
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom;
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Department of Obstetrics and Gynaecology, and Departments of Pediatrics and Epidemiology, Biostatistics, and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada;
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, and Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Department of Nutrition, Harvard School of Public Health, Boston, MA;
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; and.
authors.forename: Mary Foong-Fong
authors.initials: MF
authors.lastname: Chong
authors.affiliation: Department of Paediatrics, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore paeclw@nus.edu.sg paeleeys@nus.edu.sg.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D004032:Diet; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000494:pharmacology; D004041:Dietary Fats / Q000008:administration & dosage / Q000494:pharmacology; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D011939:Mental Recall; D056128:Obesity, Abdominal / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D011446:Prospective Studies; D012737:Sex Factors; D012846:Singapore; D012885:Skinfold Thickness; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins
keywords: abdominal adiposity; adiposity distribution; carbohydrate; developmental origins; fat; infant; internal fat; macronutrient; pregnancy; protein