1. Myrte J. Tielemans1,2 m.tielemans@erasmusmc.nl
Protein intake during pregnancy and offspring body composition at the age of six years: the Generation R Study
Myrte J. Tielemans1,2
Eric A.P. Steegers*2,3, Trudy Voortman*1,2, Vincent W.V. Jaddoe1,2,4, Fernando Rivadeneira5, Oscar H. Franco1, Jessica C. Kiefte-de Jong1,6
Research questions
Is maternal protein intake during pregnancy associated with children’s body composition at the age of 6 years?
Are associations different for animal-based versus vegetable-based protein?
Conclusions
Higher maternal protein intake during pregnancy is associated with higher fat-free mass, but not with fat mass in the children at the age of 6 years
Associations are comparable for animal-based and vegetable- based protein
Background
Prevalence of childhood overweight is increasing worldwide
Intra-uterine exposures, including maternal diet, might affect offspring’s body composition via foetal programming
Results from previous studies have been inconsistent
Methods
2,694 Dutch mother-child pairs
Embedded in the Generation R Study:
A population-based cohort study in Rotterdam, the Netherlands
Enrolment 2002 – 2006
First trimester protein intake was measured using a food-frequency questionnaire:
Total protein
Animal-based versus vegetable-based protein
Offspring body composition was measured at the age of 6 years by:
Age- and sex-specific standard deviations scores (SDS) were calculated for BMI, FFMI and FMI
Energy-adjusted protein intake was evaluated in quartiles
Table 1. Participant characteristics (n = 2,694)
Results
Higher maternal protein intake during pregnancy was associated with higher children’s BMI and fat-free mass (Figures A and B)
Maternal protein intake during pregnancy was not associated with children’s fat mass (Figure C)
Comparable associations were found for animal-based and vegetable-based protein A. B. C.
Figures. Mean difference (95%CI) in regression coefficients reflect the difference in SDS of childhood BMI, FMI and FFMI relative to the first quartile of protein intake. Adjusted for maternal age, education, smoking behaviour and alcohol use during pregnancy, folic acid supplementation, maternal energy and carbohydrate intake, gestational age at birth, breastfeeding practice 2 months postpartum and screen- time of the children at 6 years of age.
Anthropometry
Fat-free mass
Anthropometry
dual-energy X-ray absorptiometry
Body mass index
Fat-free mass index
Fat mass index
weight
BMI
Fat mass
Maternal characteristics
Mean ± SD
Age (y)
31.7 ± 4.2
BMI at enrolment (kg/m2)†
23.4 (21.6 – 26.0)
Energy intake (kcal/day)
2,153 ± 503
Protein intake (E%)
15 ± 2
Animal-based (E%)
9 ± 2
Vegetable-based (E%)
6 ± 2
Child characteristics
Mean ± SD
Age (y)
6.1 ± 0.4
BMI at follow-up (kg/m2)†
15.7 (15.0 – 16.6)
FFMI (kg/m2)
11.9 ± 0.8
FMI (kg/m2)†
3.6 (3.1 – 4.2)
Author affiliations
Funding
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
The general design of the Generation R Study was made possible by financial support from the Erasmus Medical Center, Rotterdam; the Erasmus University, Rotterdam; the Dutch Ministry of Health, Welfare and Sport; and the Netherlands Organization for Health Research and Development (ZonMw). VWVJ received an additional grant from the Netherlands Organization for Health Research and Development (ZonMW VIDI: ). MJT, TV, OHF, and JCKJ work in ErasmusAGE, a centre for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA. Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA had no role in design or conduct of the study; collection, management, analysis, or interpretation of the data; and preparation, review or approval of the manuscript.
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Leiden University College, The Hague, the Netherlands
* These authors contributed equally to this work; † Median (interquartile range)