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. 2022 Apr;46(4):758-766.
doi: 10.1038/s41366-021-01047-2. Epub 2021 Dec 16.

Longitudinal dietary trajectories from preconception to mid-childhood in women and children in the Southampton Women's Survey and their relation to offspring adiposity: a group-based trajectory modelling approach

Kathryn V Dalrymple  1   2 , Christina Vogel  1   3   4 , Keith M Godfrey  1   3 , Janis Baird  1   3   4 , Nicholas C Harvey  1   3 , Mark A Hanson  3   5 , Cyrus Cooper  1   3   6 , Hazel M Inskip  1   3 , Sarah R Crozier  7   8
Affiliations

Longitudinal dietary trajectories from preconception to mid-childhood in women and children in the Southampton Women's Survey and their relation to offspring adiposity: a group-based trajectory modelling approach

Kathryn V Dalrymple et al. Int J Obes (Lond). 2022 Apr.

Abstract

Background: Rates of childhood obesity are increasing globally, with poor dietary quality an important contributory factor. Evaluation of longitudinal diet quality across early life could identify timepoints and subgroups for nutritional interventions as part of effective public health strategies.

Objective: This research aimed to: (1) define latent classes of mother-offspring diet quality trajectories from pre-pregnancy to child age 8-9 years, (2) identify early life factors associated with these trajectories, and (3) describe the association between the trajectories and childhood adiposity outcomes.

Design: Dietary data from 2963 UK Southampton Women's Survey mother-offspring dyads were analysed using group-based trajectory modelling of a diet quality index (DQI). Maternal diet was assessed pre-pregnancy and at 11- and 34-weeks' gestation, and offspring diet at ages 6 and 12 months, 3, 6-7- and 8-9-years using interviewer-administered food frequency questionnaires. At each timepoint, a standardised DQI was derived using principal component analysis. Adiposity age 8-9 years was assessed using dual-energy X-ray absorptiometry (DXA) and BMI z-scores.

Results: A five-trajectory group model was identified as optimal. The diet quality trajectories were characterised as stable, horizontal lines and were categorised as poor (n = 142), poor-medium (n = 667), medium (n = 1146), medium-better (n = 818) and best (n = 163). A poorer dietary trajectory was associated with higher maternal pre-pregnancy BMI, smoking, multiparity, lower maternal age and lower educational attainment. Using linear regression adjusted for confounders, a 1-category decrease in the dietary trajectory was associated with higher DXA percentage body fat (0.08 SD (95% confidence interval 0.01, 0.15) and BMI z-score (0.08 SD (0.00, 0.16) in the 1216 children followed up at age 8-9 years.

Conclusion: Mother-offspring dietary trajectories are stable across early life, with poorer diet quality associated with maternal socio-demographic and other factors and childhood adiposity. The preconception period may be an important window to promote positive maternal dietary changes in order to improve childhood outcomes.

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Conflict of interest statement

In relation to the current work, none of the authors report any competing interests. KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products, and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec, BenevolentAI Bio Ltd. and Danone. JB has received grants from Danone Nutricia Early Life Nutrition and is part of a collaboration with Iceland Foods Ltd.

Figures

Fig. 1
Fig. 1
Flow diagram.
Fig. 2
Fig. 2
Diet quality trajectories, using group-based trajectory modelling, from preconception to 8–9 years of age.
Fig. 3
Fig. 3. Adjusted means (and 95% CI) for offspring outcomes at 8–9 years of age.
All outcomes were adjusted for maternal BMI, parity, highest maternal education attainment and maternal age. Percentage body fat and lean mass were also adjusted for offspring sex and age. Trajectory categories: 1 = poor, 2 = poor-medium, 3 = medium, 4 = medium-better, 5 = best.
See this image and copyright information in PMC

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