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Randomized Controlled Trial
. 2025 Apr;21(4):361-371.
doi: 10.1007/s12519-025-00900-y. Epub 2025 May 14.

Infant body composition in a randomised trial of a maternal nutritional supplement during preconception and pregnancy

Jaz Lyons-Reid  1 , José G B Derraik  2   3   4 , Leigh C Ward  5 , Timothy Kenealy  1   6 , Benjamin B Albert  1 , Jose M Ramos Nieves  7 , Cathriona R Monnard  7 , Mya Thway-Tint  8   9 , Heidi Nield  10 , Sheila J Barton  10 , Sarah El-Heis  10   11 , Elizabeth H Tham  8   9   12 , Keith M Godfrey  10   11 , Shiao-Yng Chan  8   9   12 , Wayne S Cutfield  13   14 ; NiPPeR Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Infant body composition in a randomised trial of a maternal nutritional supplement during preconception and pregnancy

Jaz Lyons-Reid et al. World J Pediatr. 2025 Apr.

Abstract

Background: In a multinational randomized controlled trial, we previously showed that maternal supplementation with myo-inositol, probiotics, and micronutrients was associated with reduced incidence of rapid infant weight gain and high body mass index (BMI) at two years among offspring. It was unclear whether these differences in weight gain and body mass were due to reduced adiposity. Therefore, we aimed to determine whether there were any differences in body composition.

Methods: Body composition was measured using bioelectrical impedance spectroscopy at six weeks, six months, one year, and two years among offspring born to mothers who received a nutritional intervention (n = 268) or control (n = 264) supplement preconception and during pregnancy.

Results: There were no group-level differences in body composition, except at two years, when fat-free mass was greater among control offspring [adjusted mean difference (aMD) 0.14 kg, 95% confidence interval (CI) 0.03, 0.25, P = 0.012]. However, there were no differences in mean percentage fat mass (%FM) at any time. In both groups, rapid weight gain [Δ weight > 0.67 standard deviation (SD) from birth to one year] was associated with greater %FM (aMD 2.0% at six months, 2.0% at one year, 1.4% at two years) compared with those who did not have rapid weight gain. Likewise, high BMI (≥ 95 percentile) at two years was associated with greater %FM (aMD 2.5%).

Conclusions: A maternal nutritional intervention did not lead to differences in average offspring body composition in the first two years of life. However, fewer offspring from the supplemented group experienced rapid weight gain and high BMI, characterized by greater %FM.

Keywords: Adiposity; Bioelectrical impedance; Body weight; Randomized controlled trial.

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Conflict of interest statement

Delarations. Conflict of interest: LCW provides consultancy services to ImpediMed Ltd. (a manufacturer of devices for bioelectrical impedance analysis). ImpediMed Ltd. was not involved in the inception and conduct of this research, or in the writing of this manuscript. MCR and RNJM are employees of Société des Produits Nestlé S.A. LRJ, RNJM, GKM, CSY and CWS are co-inventors on patent filings by Nestlé S.A. relating to the NiPPeR intervention or its components. GKM, CSY and CWS are part of an academic consortium that has received grants from Abbott Nutrition, Nestlé S.A., Danone and Benevolent AI Bio Ltd. outside the submitted work. CSY has received reimbursement and honoraria into her research funds from Nestlé S.A. for speaking at a conference. KM has received reimbursement for speaking at conferences sponsored by companies selling nutritional products. All other authors declare no competing interests. JGBD is a member of the International Editorial Board for the World Journal of Pediatrics; however, this manuscript was managed by the Editors-in-Chief, underwent rigorous peer review, and JGBD had no involvement in the journal’s review process or any decisions regarding this manuscript. Ethical approval: Ethics approval was granted by the UK Health Research Authority National Research Ethics Service South Central Research Ethics Committee (15/SC/0142), the National Healthcare Group Domain Specific Review Board Singapore (2015/00205), and the Northern A Health and Disability Ethics Committee New Zealand (15/NTA/21). Written informed consent to participate in the study was obtained from the mothers of the study participants.

Figures

Fig. 1
Fig. 1
Body composition in the first two years of life in the intervention (red) and control (black) offspring. Data are the least squares means (i.e., adjusted means) and 95% confidence intervals for a fat-free mass (kg), b fat mass (kg), and c fat mass (%), derived from linear mixed models based on repeated measures. *P < 0.05 for a difference between groups at a given age
Fig. 2
Fig. 2
Fat mass percentage in the offspring in the first two years of life. Panels represent: a children who experienced rapid weight gain in the first year of life (> 0.67 SD; light blue) and those who did not (≤ 0.67 SD; green); and b children who experienced sustained rapid weight gain in the first two years of life (> 1.34 SD; dark blue) and those who did not (≤ 1.34 SD; green). Data are the least squares means (i.e., adjusted means) and 95% confidence intervals at each visit derived from linear mixed models based on repeated measures. *P < 0.05 and †P < 0.001 for a difference between the two groups at a given age. SD standard deviation
Fig. 3
Fig. 3
Indices of body composition in the first two years of life in the intervention (red) and control (black) offspring. Data are the least squares means (i.e., adjusted means) and 95% confidence intervals for a fat-free mass index (kg/m2) and b fat mass index (kg/m2), derived from linear mixed models based on repeated measures. *P < 0.05 for a difference between groups at a given age
See this image and copyright information in PMC

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