Fish oil supplementation during pregnancy and postpartum in mothers with overweight and obesity to improve body composition and metabolic health during infancy: A double-blind randomized controlled trial

Vidit V Satokar; José G B Derraik; Matire Harwood; Karaponi Okesene-Gafa; Kathryn Beck; David Cameron-Smith; Manohar L Garg; Justin M O'Sullivan; Gerhard Sundborn; Shikha Pundir; R Preston Mason; Wayne S Cutfield; Benjamin B Albert

doi:10.1016/j.ajcnut.2023.02.007

Fish oil supplementation during pregnancy and postpartum in mothers with overweight and obesity to improve body composition and metabolic health during infancy: A double-blind randomized controlled trial

Am J Clin Nutr. 2023 May;117(5):883-895. doi: 10.1016/j.ajcnut.2023.02.007. Epub 2023 Feb 11.

Affiliations

¹ Liggins Institute, University of Auckland, Auckland, New Zealand.
² Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Environmental - Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
³ Department of General Practice and Primary Care, University of Auckland, Auckland, New Zealand.
⁴ Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
⁵ School of Sport Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand.
⁶ Liggins Institute, University of Auckland, Auckland, New Zealand; College of Engineering, Science and Environment, University of Newcastle, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, New South Wales, Australia.
⁷ School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, New South Wales, Australia.
⁸ Department of Pacific Health, School of Population Health, University of Auckland, Auckland, New Zealand.
⁹ Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
¹⁰ Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, New Zealand.
¹¹ Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, New Zealand. Electronic address: b.albert@auckland.ac.nz.

PMID: 36781129
DOI: 10.1016/j.ajcnut.2023.02.007

Abstract

Background: Maternal obesity during pregnancy is associated with an increased risk of obesity and metabolic disease in the offspring. Supplementation with fish oil (FO), which is insulin sensitizing, during pregnancy in mothers with overweight or obesity may prevent the development of greater adiposity and metabolic dysfunction in their children.

Objectives: To determine the effects of FO supplementation throughout the second half of pregnancy and lactation in mothers with overweight or obesity on infant body composition and metabolism.

Methods: A double-blind randomized controlled trial of 6 g FO (3.55 g/d of n-3 PUFAs) compared with olive oil (control) from mid-pregnancy until 3 mo postpartum. Eligible women had singleton pregnancies at 12-20 wk of gestation, and BMI ≥ 25 kg/m². The primary outcome was the infant body fat percentage (DXA scans) at 2 wk of age. Secondary outcomes included maternal metabolic markers during pregnancy, infant anthropometry at 2 wk and 3 mo of age, and metabolic markers at 3 mo.

Results: A total of 129 mothers were randomized, and 98 infants had a DXA scan at 2 wk.

Primary outcome: Imputed and nonimputed analyses showed no effects of FO supplementation on infant body fat percentage at age 2 wk.

Secondary outcomes: There were no treatment effects on infant outcomes at 2 wk, but FO infants had a higher BMI z-score (P = 0.025) and ponderal index (P = 0.017) at age 3 mo. FO supplementation lowered maternal triglycerides by 17% at 30 wk of pregnancy (P = 0.0002) and infant triglycerides by 21% at 3 mo of age (P = 0.016) but did not affect maternal or infant insulin resistance. The rate of emergency cesarean section was lower with FO supplementation [aRR = 0.38 (95%CI 0.16, 0.90); P = 0.027].

Conclusions: FO supplementation of mothers with overweight or obesity during pregnancy did not impact infant body composition. There is a need to follow up the offspring to determine whether the observed metabolic effects persist.

Clinical trial registry number: This study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617001078347p). In addition, the Universal Trial Number, WHO, was obtained (U1111-1199-5860).

Keywords: fish oil supplementation; maternal overweight/obesity; n-3 polyunsaturated fatty acids; pregnancy; triglycerides.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Australia
Body Composition
Cesarean Section
Dietary Supplements
Double-Blind Method
Female
Fish Oils*
Humans
Infant
Lactation
Obesity / therapy
Overweight*
Pregnancy
Triglycerides / pharmacology

Substances

Fish Oils
Triglycerides