How prenatal psychosocial stress impacts proinflammatory diet and child adiposity

Exposure to poor prenatal diet may lead to worse adiposity outcomes in children when psychosocial stress is present during pregnancy, according to a recent study.

Childhood adiposity has been linked to insulin resistance during childhood and risk of metabolic syndrome in adulthood. Knowledge on early-life determinants of body composition may support strategies for improving cardiometabolic health outcomes.

Cardiometabolic health is often affected by prenatal factors, with exposure to a proinflammatory diet associated with higher child body mass index (BMI) and obesity risk. However, little data has been gathered on long-term adiposity outcomes.

The effects of poor nutrition in pregnancy have been shown to be exacerbated by psychosocial stress. However, few studies have evaluated the correlation between psychosocial stress and outcomes associated with poor diet.

To determine the effects psychosocial stress has on the association between poor prenatal diet and adiposity outcomes in children, investigators conducted a study with participants from Project Viva, a cohort study of influences on maternal and child health.

The association between dietary inflammation and adiposity outcomes was evaluated, with offspring adiposity indices being the primary outcome. Dietary Inflammatory Index (DII) scores were used to measure dietary inflammation. 

Adiposity outcomes were calculated through measurements of weight, length or height, subscapular and triceps skinfold thickness, and waist circumference. These measurements were taken in early childhood, midchildhood, and early adolescence. Body composition was also measured at midchildhood and early adolescence.

Using the Edinburgh Postpartum Depression Scale (EPDS), mothers reported depressive symptoms they were experiencing. Mothers with an EPDS score of 13 or higher were indicated as positive for depression, though this was not a clinical diagnosis.

Social vulnerability index (SVI) was calculated using residential address data. The 4 themes of SVI include socioeconomic status, household composition and disability, racial and ethnic and language status, and housing and transportation type.

There were 1060 participants, with an average maternal age of 32.6 years and prepregnancy BMI of 24.4. Non-Hispanic White mothers made up 77% of the study population.

The average DII score among participants was -2.7 units, while mean SVI was 38th percentile. Depressive symptoms were recorded in 8% of mothers. Lower pregnancy BMI, college education, and non-Hispanic White status were factors more often seen in the lowest DII quartile compared to the highest.

BMI scores decreased at a slower rate from childhood to early adolescence in children born to mothers in the highest prenatal DII quartile compared to the lowest. Children in this group also saw faster adiposity gain over time.

A positive EPDS screen was reported in 88 mothers. Offspring of these mothers had a stronger association between prenatal DII levels and adiposity outcomes. SVI status moderated associations between DII and direct adiposity measures, but not proxy measures.

These results indicate a direct impact from prenatal psychosocial stress on the association between prenatal diet and adiposity outcomes. Investigators recommended that interventions for preventing childhood adiposity examine both prenatal diet and psychosocial stress in women.

Reference

Monthé-Drèze C, Aris IM, Rifas-Shiman SL, Shivappa N, Hebert JR, Oken E, et al. The role of prenatal psychosocial stress in the associations of a proinflammatory diet in pregnancy with child adiposity and growth trajectories. JAMA Netw Open. 2023;6(1):e2251367. doi:10.1001/jamanetworkopen.2022.51367