Associations of maternal macronutrient intake during pregnancy with infant BMI peak characteristics and childhood BMI

Am J Clin Nutr. 2017 Mar;105(3):705-713. doi: 10.3945/ajcn.116.148270. Epub 2017 Feb 8.


Background: Infant body mass index (BMI) peak characteristics and early childhood BMI are emerging markers of future obesity and cardiometabolic disease risk, but little is known about their maternal nutritional determinants.Objective: We investigated the associations of maternal macronutrient intake with infant BMI peak characteristics and childhood BMI in the Growing Up in Singapore Towards healthy Outcomes study.Design: With the use of infant BMI data from birth to age 18 mo, infant BMI peak characteristics [age (in months) and magnitude (BMIpeak; in kg/m2) at peak and prepeak velocities] were derived from subject-specific BMI curves that were fitted with the use of mixed-effects model with a natural cubic spline function. Associations of maternal macronutrient intake (assessed by using a 24-h recall during late gestation) with infant BMI peak characteristics (n = 910) and BMI z scores at ages 2, 3, and 4 y were examined with the use of multivariable linear regression.Results: Mean absolute maternal macronutrient intakes (percentages of energy) were 72 g protein (15.6%), 69 g fat (32.6%), and 238 g carbohydrate (51.8%). A 25-g (∼100-kcal) increase in maternal carbohydrate intake was associated with a 0.01/mo (95% CI: 0.0003, 0.01/mo) higher prepeak velocity and a 0.04 (95% CI: 0.01, 0.08) higher BMIpeak These associations were mainly driven by sugar intake, whereby a 25-g increment of maternal sugar intake was associated with a 0.02/mo (95% CI: 0.01, 0.03/mo) higher infant prepeak velocity and a 0.07 (95% CI: 0.01, 0.13) higher BMIpeak Higher maternal carbohydrate and sugar intakes were associated with a higher offspring BMI z score at ages 2-4 y. Maternal protein and fat intakes were not consistently associated with the studied outcomes.Conclusion: Higher maternal carbohydrate and sugar intakes are associated with unfavorable infancy BMI peak characteristics and higher early childhood BMI. This trial was registered at as NCT01174875.

Keywords: adiposity; carbohydrate; childhood BMI; developmental origins; growth modeling; infancy BMI peak; macronutrient; maternal diet; pregnancy diet; sugar.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index*
  • Diet*
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / adverse effects*
  • Dietary Fats / administration & dosage
  • Dietary Proteins / administration & dosage
  • Dietary Sucrose / administration & dosage
  • Dietary Sucrose / adverse effects
  • Feeding Behavior*
  • Female
  • Humans
  • Linear Models
  • Mental Recall
  • Pediatric Obesity / etiology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Prenatal Nutritional Physiological Phenomena*
  • Singapore


  • Dietary Carbohydrates
  • Dietary Fats
  • Dietary Proteins
  • Dietary Sucrose

Associated data