1. Ultra-processed food consumption by mothers during child rearing period was found to be associated with an increased risk of obesity/overweight in offspring, independent of maternal and offspring lifestyle risk factors

Evidence Rating Level: 2 (Good)

Childhood obesity is a common and rising concern in the United States, with an increase from 10.2%, 5.2% and 1.0% from the 1970s to 16.1%, 19.3% and 6.1% in 2017/18 in the prevalence of overweight, obesity and severe obesity respectively in those aged 2-19. Current evidence has shown that ultra-processed food is linked to excess body fat in overweight, excess body fat, and obesity in children and adults. This study examined the effects of maternal ultra-processed food consumption during the peri-pregnancy period and child rearing period (age 7-18 years) and the effect on offspring obesity. The final cohort in this study included 19 958 mother-child pairs (with 2925 pairs having both peri-pregnancy and child rearing data) who participated in the Nurses’ Health Study II (NHS II), a study enrolling female registered nurses aged 25-42 at the time of establishment in 1989, and the Growing Up Today Study (GUTS I and II), a study which was established in 1996 in which children of NHS II participants were enrolled. Food items were classified by the NOVA food criteria, and body mass index was calculated for each of the children using self-reported weight and height measurements, with specific instructions to obtain these measurements. Covariates in this study included maternal risk factors such as race, body mass index, total energy intake, chronic diseases, gestation age and pregnancy complications. Offspring covariates were age, sex, ultra-processed food intake, physical activity and sedentary time. Offspring were followed until the onset of overweight/obesity, loss to follow-up or the age of 18 years, depending on which occurred first. A subsample analysis of peri-pregnancy consumption of ultra-processed food was also conducted. As maternal ultra-processed food consumption increased, consumption of ultra-processed food in offspring also increased, with a decrease in the overall quality of offspring diet. A 26% higher risk of overweight or obesity in offspring was seen in the group with highest maternal ultra-processed food consumption, compared to the group with lowest consumption (relative risk 1.26, 95% confidence interval 1.08 to 1.47, P for trend<0.001) even after controlling for established risk factors for obesity (maternal body mass index, physical activity, smoking, offspring ultra-processed food consumption and activity levels). Peri-pregnancy consumption of ultra-processed food was not significantly associated with increased risk of overweight or obesity in offspring. Both these associations were similar across various risk profiles. A large cohort was used in this study, with long term follow-up, though there were still some limitations to this study. Specifically, not all risk factors could be adjusted for and self-reported weight and height are subject to misreporting. Additionally, some offspring were lost to follow-up. Mothers were also predominantly white, with similar personal backgrounds, making it difficult to generalize these results. Previous studies have shown that maternal diet during child rearing periods has an impact on offspring’s diet and lifestyle. This study however showed a positive correlation between maternal ultra-processed foods and offspring obesity independent of offspring lifestyle factors, suggesting there may be other mechanisms impacting offspring weight. Further studies are needed to understand these specific mechanisms as well as the effect of various interventions to further quantify the relationship between maternal ultra-processed food consumption and health of their children, perhaps helping to guide dietary recommendations.

Click to read the study in BMJ

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