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The role of maternal diet on offspring hyperinsulinaemia and adiposity after birth: a systematic review of randomised controlled trials

Published online by Cambridge University Press:  02 November 2021

Sylvia North Open the ORCID record for Sylvia North [Opens in a new window] ,
Catherine Crofts Open the ORCID record for Catherine Crofts [Opens in a new window] ,
Christian Thoma Open the ORCID record for Christian Thoma [Opens in a new window]  and
Caryn Zinn Open the ORCID record for Caryn Zinn [Opens in a new window]
Sylvia North*
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
Catherine Crofts
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand Department of Interdisciplinary Studies, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand AUT BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
Christian Thoma
Affiliation:
Department of Interdisciplinary Studies, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand AUT BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
Caryn Zinn
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
*
Address for correspondence: Sylvia North, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand. Email: sylvia.north@aut.ac.nz
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Abstract

In utero diet may be directly related to the risk of fetal hyperinsulinaemia and offspring metabolic health. This review examines the relationship between maternal dietary exposures and sub-clinical fetal hyperinsulinaemia and neonatal adiposity. Articles were identified in MEDLINE, Web of Science, Cochrane Controlled Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, SCOPUS, and SPORTDiscus (September 2019–March 2021) using the preferred reporting items for systematic reviews and meta-analyses guidelines. PROSPERO registration ID CRD42020146453. Studies were selected by two independent reviewers. Randomised controlled trials (RCT) involving a dietary intervention with pregnant women (healthy pregnancy, gestational diabetes mellitus and obesity) and reporting fetal cord-blood insulin, c-peptide, glucose or adiposity estimates were included. One author extracted all information on main study characteristics and outcomes. Risk of bias was assessed using the Cochrane Collaboration’s bias risk assessment tool. A total of 733 articles were identified. Fourteen articles from 11 RCTs (3614 participants) were included. Studies reviewed showed no specific effect of maternal diet on neonatal cord blood insulin, c-peptide or glucose levels. Infants born to mothers who followed a low glycaemic load (GL) had lower skin fold thickness compared to controls. Interventions that provided individualised nutrition counselling to women with obesity or previous infant born > 4 kg were also associated with lower adiposity. The studies reviewed suggest that lifestyle-based dietary interventions to improve glycaemia (low GL) have a protective effect against excess adiposity. Future studies should incorporate multi-modal interventions with dietary counselling to support lifestyle changes throughout gestation and include assessments of maternal insulin resistance at recruitment.

Keywords

Maternal nutritionprenataloffspring body sizefetal hyperinsulinaemia
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 5 , October 2022 , pp. 527 - 540
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Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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