Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study

Int J Obes (Lond). 2016 Jul;40(7):1056-62. doi: 10.1038/ijo.2016.79. Epub 2016 May 2.


Background/objectives: Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass (%FM)) at birth by increasing the fat mass (FM) component of neonatal body composition.

Methods: Our analysis was conducted using a prebirth observational cohort of 1079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of ⩽57 and >57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age.

Results: Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, s.d.: 13.6). An HEI-2010 score of ⩽57 was significantly associated with higher neonatal %FM (β=0.58, 95% confidence interval (CI) 0.07-1.1, P<0.05) and FM (β=20.74; 95% CI 1.49-40.0; P<0.05) but no difference in FFM.

Conclusions: Poor diet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity / physiology*
  • Adult
  • Birth Weight / physiology
  • Blood Glucose
  • Body Mass Index
  • Diet
  • Diet Surveys
  • Energy Intake
  • Feeding Behavior
  • Female
  • Fetal Development / physiology
  • Humans
  • Infant, Newborn
  • Longitudinal Studies
  • Maternal Nutritional Physiological Phenomena*
  • Mothers*
  • Pregnancy
  • Prenatal Nutritional Physiological Phenomena
  • United States / epidemiology


  • Blood Glucose