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Pregnancy Diet May Affect Child's Future Weight, Study Shows

Pregnancy nutrition
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Key Takeaways:

  • A new study looked at whether the maternal diet during pregnancy has an impact on the future weight of the children.
  • The researchers found that a healthier diet during pregnancy was associated with lower odds of obesity in late childhood, but not in early or mid-childhood.
  • Obesity alone is not a measure of a child’s health, and weight stigma can be damaging for a child’s self-esteem.

A balanced diet during pregnancy is important for both mom and baby. An adequate supply of nutrients helps with the baby’s normal growth and development. Mom needs more protein, iron, and folic acid when pregnant to meet the demands of the growing baby.??

Certain nutrients also play a role in reducing the risk of the baby developing spina bifida, cleft palate, or other conditions.???? Researchers often explore how the mom’s diet can affect a child’s health later on, and have examined conditions such as allergies, obesity, and diabetes.??

To date, research has shown that malnutrition during pregnancy is associated with a higher risk of childhood obesity and Type 2 diabetes later in life.???? However, these are generally weak correlations.

In a new study published in the journal BMC Medicine, researchers looked at the dietary patterns of pregnant women, then followed up to assess the weight and fat mass of their offspring. They found that following a DASH diet during pregnancy may be associated with lower rates of obesity in late childhood.??

What Did the Study Find?

This cohort study focused on 16,296 mother-child pairs across Europe.??

For this study, researchers rated the maternal diets using the Dietary Inflammatory Index (E-DII), and the principles of the Dietary Approaches to Stop Hypertension (DASH) diet.

They compared different dietary patterns with future childhood obesity, which was measured using age-specific body mass index (BMI) scores.

Secondary outcomes that were examined included:

  • Skinfold thickness (SST)—the amount of subcutaneous fat
  • Fat mass index (FMI)—a calculation of height and waist circumference to estimate body fat percentage
  • Fat-free mass index (FFMI)—similar to body mass index, but accounts for muscle mass

The researchers found that a higher DASH diet score during pregnancy was associated with lower odds of obesity in late childhood (10.6 years). They found no statistically significant association for pregnancy E-DII score.

In general, no consistent associations were observed between maternal E-DII and DASH scores for early (2.8 years) and mid-childhood (6.1 years) obesity.

Associations between maternal diet and secondary adiposity measures for SST, FMI and FFMI were only observed during late-childhood. Specifically:

  • A higher pregnancy E-DII score was associated with a lower late-childhood FFMI.
  • A higher pregnancy DASH score was associated with a lower late-childhood FMI.
  • No apparent associations were observed for E-DII, DASH scores and childhood SST.

Dr. Ling-Wei Chen, PhD, was one of the researchers on the study, and was a postdoctoral research fellow with University College Dublin, Republic of Ireland, when he conducted this work. 

Verywell Fit reached out to Dr. Chen to see what nutrition advice should be offered to pregnant women based on the results of the study.

Dr. Ling-Wei Chen, PhD

Pregnant women should consume an overall healthy diet, high in fruit and vegetables and low in refined carbohydrates and red and processed meats, throughout pregnancy. 

— Dr. Ling-Wei Chen, PhD

He said the findings suggest that pregnant women should consume an overall healthy diet, high in fruit and vegetables and low in refined carbohydrates and red and processed meats, throughout pregnancy. 

Jay Baum, a dietitian and Certified Diabetes Educator with Pommetta Nutrition in Toronto, Ontario, says the nutrition advice she gives to pregnant clients is rooted in basic self-care behaviors that help them nourish themselves regularly and adequately.

She recommends that pregnant clients take prenatal vitamins, stay hydrated, have a consistent meal and snack schedule, and include high-fiber carbohydrates consistently throughout the day, paired with protein and healthy fats.

There’s no doubt that diet plays an important role in pregnancy. From folic acid for prevention of spina bifida, to omega-3 fats for baby's brain health, a well-balanced diet has certain benefits from the pregnant mother and child.

The Trouble With BMI

While it is important to eat a nutrient-rich diet during pregnancy, not every health professional believes that BMI or obesity are good indicators of a child's health.

Many researchers have called BMI “flawed” because it doesn’t differentiate fat from fat-free mass such as muscle and bone.?? The current research took that into account by looking at both BMI and FFMI, which is a newer calculation that accounts for muscle mass.

Still, Chen says that BMI is a useful but somewhat imperfect measure of health, since weight and BMI can be affected by many factors, including genetics, diet, and physical activity.

Is Obesity a Measure of Health?

The bigger question may be why studies examine BMI in children, since not all health professionals agree that weight is an accurate measure of health.

Some health professionals argue that weight status is a very narrow view of health, and a non-weight-centric approach may be a more beneficial approach.??

Baum says focusing primarily on decreasing body fat to improve health outcomes is flawed.

“In my work, I find that poor health is rarely due to a lack of knowledge about diet, exercise, and health behaviors," she says. "People experience systemic barriers that make it difficult for them to take care of themselves and to access health services.”

She points to social determinants of health such as low income, food insecurity, inadequate support, unsafe environments, minimal education opportunities, genetics, disability, and racism, and how they all play a role in health.

“Weight is one very small piece of the puzzle,” says Baum. 

If a child grows up and has a high BMI, what mom ate during pregnancy is never the sole cause.

Raising Healthy Eaters

The current study looked ahead 10 years to measure obesity in childhood. Chen says that the biological mechanism linking maternal diet and childhood outcomes is not well-studied, and should be investigated in future research.

“More detailed health outcomes of the children should be examined, alongside with other determinants of child health such as childhood diet and physical activity,” says Chen.

Pediatric dietitians who counsel families about raising healthy eaters do focus on nutrition and physical activity as important factors for optimal growth and development.

But weight takes a backseat to overall health.

“Weight loss is not something I ever recommend for children,” says Baum. “Dieting and restricting a child’s food intake puts them at higher risk for developing an eating disorder, and can negatively impact growth and development.”

Baum says that normalizing body diversity and providing children with skills to navigate fat phobia in the real world may do more for their child’s long-term health than dietary changes.

According to Ellyn Satter’s Division of Responsibility in Feeding, it’s a parent’s role to offer a variety of nutritious foods at regular intervals and make mealtimes pleasant, and it’s a child’s role to decide how much and which foods to eat based on what’s provided.

With this balance, children will grow into the body that’s right for them.

“I tell parents that weight alone doesn’t tell us much about a child’s health,” says Baum.

She says that if a child is following a consistent curve on their growth chart, it indicates they are growing at the rate they are meant to grow.

“If there is rapid acceleration of growth, that might indicate a medical, social, or developmental concern where weight gain is merely a symptom,” says Baum. 

Jay Baum, RD, CDE

In my work, I find that poor health is rarely due to a lack of knowledge about diet, exercise, and health behaviours. People experience systemic barriers that make it difficult for them to take care of themselves and to access health services.

— Jay Baum, RD, CDE

What’s Next?

In addition to more studies about the optimal eating plan during pregnancy, there need to be more studies on whether weight is a determinant of a child's overall health, as well as research into the consequences of weight stigma in the medical community. 

Well beyond weight or BMI, healthcare settings need to get better at offering optimal care without weight bias for pregnant women and children.

What This Means For You

A healthy diet during pregnancy is important for maternal health, and for the normal development of the growing baby. But good health is about so much more than focusing on weight.

The hope is that a balanced diet in pregnancy will stay lifelong, so parents can be role models for healthy eating, which is smart for the whole family. 

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