Kaiser Permanente analysis finds infants of mothers whose diets aligned with guidelines were more likely to have healthy growth through age two
Mothers whose diets aligned with federal nutrition guidelines during pregnancy were more likely to have babies whose birth weight and growth in early childhood also aligned with recommendations, according to new research from Kaiser Permanente investigators published in JAMA Network Open.
The results highlight the role of nutrition in pregnancy, said lead author Monique Hedderson, PhD, a research scientist with the Kaiser Permanente Division of Research. “The findings suggest that following the current guidelines for a healthy diet during pregnancy may have long-term benefits for the infant,” Hedderson said. “This suggests the need for programs to help improve pregnant people’s access to healthy food and interventions to support healthy eating during pregnancy.”
The analysis used data from 2,854 mothers and their children from 8 studies participating in the Environmental Influences on Child Health Outcomes (ECHO) program between 2007 and 2021. ECHO, which is supported by the National Institutes of Health, includes participating mothers and children across the United States, including Northern California.
The pregnant patients were assessed for how their diets during pregnancy aligned with the Healthy Eating Index — a measure of healthy diet based on adherence to the U.S. Department of Agriculture Dietary Guidelines for Americans — and the Empirical Dietary Inflammatory Pattern, which estimates the inflammatory potential of a diet. Inflammation has been associated with multiple health risks.
The researchers then looked at the children’s birthweights and growth patterns in the first 2 years of life. Being large for gestational age is associated with later-life obesity, while being born small for gestational age is associated with adverse later-life cardiometabolic outcomes — for example, diabetes and heart disease. Both slow and rapid weight gain during the first year of life are associated with later-life obesity risk.
The study found prenatal diet quality, as measured by the Healthy Eating Index, was associated with reduced odds of infants being born large for gestational age and greater odds of having healthy growth trajectories during the first 2 years of life.
Findings on outcomes related to the inflammatory diet showed complex associations with birth size and infant growth, requiring further study to understand the implications.
“This study adds to our understanding of how pregnancy can be an important time when we can influence future risk of obesity, cardiovascular disease, and metabolic disorders in children,” said senior author Assiamira Ferrara, MD, PhD, a research scientist with the Division of Research who directs its Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM).
The mothers and children in this study were racially and ethnically diverse, making the findings more widely applicable, the authors said.
Future research could explore the findings on the inflammatory prenatal dietary patterns, as well as how an infant’s appetite and feeding habits might influence the connection between a mother’s diet during pregnancy and the baby’s long-term growth.
The study was funded by ECHO, which is supported by the National Institutes of Health.
Additional co-authors were Lyndsay Avalos, PhD, MPH, and Yeyi Zhu, PhD, of the Division of Research; Holly B. Shuh, PhD, MPH, and Emily A. Knapp, PhD, MHS, of Johns Hopkins Bloomberg School of Public Health; Traci A. Bekelman, PhD, MPH, and Dana Dabelea, MD, PhD, of the University of Colorado; Diane J. Catellier, DrPH, and Matt Westlake, MS, of RTI International; Kristen Lyall, PhD, of Drexel University; Rebecca J. Schmidt, PhD, of the University of California, Davis; Anne L. Dunlop, MD, MPH, of Emory University; Sarah S. Comstock, PhD, of Michigan State University; Leda Chatzi, PhD, of the University of Southern California; Katherine A. Sauder, PhD, of Wake Forest University; and Karen M. Switkowski, PhD, MPH, and Debby Lin, ScD, of Harvard Medical School.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow us @KPDOR.
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