Maternal Consumption of Ultra-processed Foods Linked to Weight Gain in Offspring
Key findings
- This cohort study of 19,958 mother–child pairs with long-term follow-up examined relationships between maternal ultra-processed food intake during peripregnancy and childrearing and offspring's body weight in childhood and adolescence
- Maternal consumption of ultra-processed food when children were seven to 18 years old was associated with an increased risk of overweight or obesity in offspring, with a 26% higher risk in the 5th quintile (with the highest consumption) compared with the 1st quintile (with the lowest consumption)
- The association of maternal ultra-processed food intake and offspring adiposity did not substantially differ by offspring age, sex, pregnancy complications, birth weight, gestational age, gestational weight gain, or maternal body mass index
- Peripregnancy consumption of ultra-processed foods was not significantly associated with an increased risk of overweight or obesity in offspring
- Mothers of reproductive age who limit their consumption of ultra-processed food may reduce the risk of adiposity in their children, but these data should not be used to stigmatize food choices, which are often influenced by socioeconomic factors
Research has consistently associated the intake of ultra-processed foods with excess body fat, overweight, and obesity in adults and children.
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Researchers at Massachusetts General Hospital have now tied maternal consumption of ultra-processed foods during the childrearing period to increased risk of overweight and obesity in offspring. Andrew T. Chan, MD, MPH, chief of the Clinical and Translational Epidemiology Unit at Mass General, vice chief for clinical research in the Division of Gastroenterology, director of Cancer Epidemiology at the Mass General Cancer Center, and Daniel K. Podolsky professor of Medicine at Harvard Medical School, Yiqing Wang, PhD, a research fellow in the Department of Medicine at Mass General and Harvard Medical School, and colleagues detail the findings in BMJ.
Methods
The research team analyzed data from three prospective cohort studies:
- Nurses' Health Study II (NHS II)—enrolled 116,429 female registered nurses in 1989, ages 25–42 years, with questionnaires mailed biennially and a food frequency questionnaire mailed every four years starting in 1991
- Growing Up Today Study (GUTS I)—enrolled 16,882 children of NHS II participants, ages 8–15 years, in 1996; children were followed up every year between 1997 and 2001, and biennially after that
- GUTS II—enrolled an additional 10,918 children of NHS II participants, ages 7–17 years, in 2004; children were followed up in 2006, 2008, 2011, and biennially after that
The final analytic cohort included 19,958 children (55% girls, ages 7 to 17 years at enrollment) born to 14,553 mothers.
The researchers examined maternal food frequency questionnaires to calculate the number of servings per day of ultra-processed foods. They also categorized ultra-processed foods into nine subgroups: ultra-processed bread and breakfast foods; sauces, cheeses, spreads, and gravies; beverages; packaged sweets and desserts; dairy-based desserts; frozen and ready-to-eat meals; packaged savory snacks; bacon, certain other meats, and meat substitute products; and others (e.g., liquor, non-dairy creamers).
Overall Sample
The median follow-up period for the 19,958 mother–child pairs was four years. Maternal consumption of ultra-processed food was associated with an increased risk of overweight or obesity in offspring during childhood and adolescence (ages 7–18).
Specifically, the risk was 26% higher in the group of offspring whose mothers reported the highest consumption of ultra-processed food (5th quintile: mean 12 servings/day) compared with the group whose mothers reported the lowest consumption (1st quintile: mean three servings/day; RR, 1.26; P for trend <0.001).
Ultra-processed bread and breakfast foods is the only subtype independently associated with childhood risk of overweight or obesity (RR per one standard deviation increase, 1.10, 95% CI, 1.06–1.15).
The association of maternal ultra-processed food intake with offspring adiposity was not significantly influenced by offspring age, offspring sex, pregnancy complications, birth weight, gestational age, gestational weight gain, or maternal body mass index.
Peripregnancy Subsample
To assess maternal consumption of ultra-processed food during peripregnancy, the researchers restricted the analytic cohort to 2,790 mothers and 2,925 offspring from GUTS II. They examined food frequency data from one year that covered at least part of pregnancy.
Peripregnancy consumption of ultra-processed foods was not significantly associated with an increased risk of overweight or obesity in offspring when comparing the groups with the highest and lowest intakes of ultra-processed food.
Patient Counseling
Mothers of reproductive age who limit their consumption of ultra-processed food may reduce the risk of adiposity in their children. It's important to remember, though, that social determinants of health can impede women from reducing their intake of such food:
- Inadequate time to prepare unprocessed food
- The additional cost of a more healthful diet
- Limited access to healthy food options due to geographic location
Many women already feel shamed for weight-related health behaviors during pregnancy and childrearing, and these data should not be used to stigmatize their food choices further.
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