Ethnicity modifies the relationship between added sugars and fructose exposure in the first 1000 days and offspring body composition at 24 months

Abstract

Added sugars (AS) and fructose intake are linked to obesity. Hispanic populations experience high AS intake and obesity rates. It is underexplored if early sugars exposure influences offspring growth, especially across ethnic groups. This secondary analysis examined if AS and fructose intake during pregnancy, infancy, and toddlerhood influenced offspring adiposity at 24 months, and if ethnicity modified outcomes. We hypothesized that higher sugars exposure would predict increased adiposity. Mother-child pairs from a prenatal docosahexaenoic acid supplementation RCT and the offspring follow-up study were included. Dietary intake was assessed at 12 to 20 weeks gestation, and offspring intake at 2 weeks, 6 months, 12 months, and 24 months. Intake was averaged across infancy (Year 1: 2 weeks/6 months) and toddlerhood (Year 2: 12 months/24 months). Anthropometric (n = 130) and dual-energy X-ray absorptiometry (n = 42) data were collected at 24 months. Multiple hierarchical regression examined associations, with interaction terms testing ethnic differences. Higher AS intake in Year 1 predicted higher weight, fat-free mass, and total adiposity. Compared to non-Hispanic offspring, the association of Year 1 fructose intake with weight and Year 2 AS intake with fat-free mass and central fat mass, were weaker in Hispanic offspring. No other significant associations were observed. The relationships between early AS and fructose intake with body composition are dynamic over time and vary by ethnicity. Our findings highlight the potential risks of early sugars exposure on obesity and metabolic health, underscoring the need for further research to inform early-life dietary interventions and public health policies.

Keywords: 1000 days; Added sugars; Adiposity; Fructose; Hispanic; Infancy; Pregnancy; Toddlerhood.

Fig. 1 –

ADORE GAINS consort diagram. A total of 489 mother-child pairs from the ADORE trial enrolled at the KUMC site. Of those pairs, 250 enrolled in GAINS during which data on the offspring were collected at 2 weeks, 6 months, 12 months, and 24 months. For this analysis, 130 mother-child pairs had complete dietary and anthropometric data, 85 pairs had complete dietary and trunk scans, and 42 pairs had complete dietary and TBLH scans. ADORE, Assessment of DHA on Reducing Early Preterm Birth Trial; DHA, docosahexaenoic acid; GAINS, Growth and Adiposity in Newborns Study; KUMC, University of Kansas Medical Center; TBLH, total body-less head.

Fig. 2 –

A descriptive comparison of added sugars and fructose intake between ethnic groups. Blue and orange bars illustrate the relative intake of added sugars and fructose in non-Hispanic and Hispanic participants, respectively. *Indicates a significant difference in intake between groups (P < .05). Error bars represent mean standard error. Prenatal added sugars intake (%kcal) was lower in Hispanic mothers (vs non-Hispanic). Year 1 and Year 2 added sugars intake did not differ between groups. Prenatal fructose intake (%kcal) was lower in Hispanic mothers compared to non-Hispanic mothers. Offspring fructose intake in Year 1 and Year 2 did not differ between groups.