A recent study involving over 2,800 mother-child pairs across eight sites in the Environmental Influences on Child Health Outcomes (ECHO) program has found that adhering to USDA dietary guidelines during pregnancy is associated with healthier growth patterns in infants, potentially reducing obesity risks later in life.
Published in JAMA Network Open, the research investigates the impact of prenatal dietary patterns on infant size at birth and growth trajectories up to 24 months. The study utilized dietary quality indices, including the Healthy Eating Index (HEI) and the Empirical Dietary Inflammatory Pattern (EDIP), to assess their relationship with infant growth rates and obesity risk.
Childhood obesity has become a significant public health concern, particularly in Western nations, where early life factors are critical in determining long-term health outcomes. Infants born either small or large for their gestational age are at greater risk for adverse health effects, and rapid weight gain in the first year of life further increases the likelihood of obesity. While nutrition during pregnancy is crucial for fetal development, much of the existing research has focused on individual food items rather than overall dietary patterns.
The cohort study analyzed data from 2,854 birthing parent-child pairs who provided dietary information during pregnancy and infant growth measurements at birth and at least one follow-up at 6, 12, or 24 months. The HEI assesses adherence to US dietary guidelines, while the EDIP reflects the inflammatory potential of a diet.
Participants completed food frequency questionnaires or 24-hour dietary recalls, with HEI scores categorized as high or low based on a threshold of 80. EDIP scores were classified as less inflammatory (≤63.6) or more inflammatory (>63.6). Infant growth was measured using weight-for-length z-scores, categorizing growth trajectories as rapid, slow, or within reference ranges.
The researchers employed multinomial logistic regression models to analyze the data, adjusting for variables such as maternal education, age, pre-pregnancy body mass index (BMI), tobacco use, and dietary assessment methods. The analysis, conducted from March 2021 to August 2024, utilized harmonized data from a diverse US population.
The study revealed that the quality of a mother’s prenatal diet significantly influences infant growth patterns. Higher HEI scores, indicating healthier dietary choices, were associated with lower odds of infants being large for gestational age and reduced instances of both rapid and slow growth during the first two years of life.
Specifically, infants born to mothers with high HEI scores had a 12% lower likelihood of being large for gestational age and experienced a 20% reduction in the risk of rapid growth in the first six months, with an 18% reduction over the first two years. Additionally, high HEI scores correlated with a 35% decrease in the risk of slow growth at six months, 26% at 12 months, and 35% at 24 months.
In contrast, a less inflammatory diet, as indicated by lower EDIP scores, showed mixed results. While it was associated with a 24% increase in the odds of being large for gestational age, it also reduced the risk of rapid growth at six months by 23%. However, it was linked to a 50% higher likelihood of slow growth at 24 months. These findings suggest that while healthier maternal diets are linked to more favorable growth patterns, the relationship between EDIP scores and infant growth is less straightforward.
Conclusions
The study underscores the importance of prenatal diet quality in shaping infant growth trajectories and mitigating risks associated with childhood obesity. Adherence to dietary guidelines during pregnancy is linked to positive growth outcomes, while the effects of less inflammatory diets remain complex and warrant further investigation.
These findings highlight the necessity for targeted nutritional interventions during pregnancy to foster healthy early-life growth and suggest that future research should continue to explore the impact of maternal dietary patterns on long-term health outcomes for infants.
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