Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

Ekaterina Maslova; Susanne Hansen; Louise Groth Grunnet; Marin Strøm; Anne Ahrendt Bjerregaard; Line Hjort; Freja Bach Kampmann; Camilla Møller Madsen; A C Baun Thuesen; Bodil Hammer Bech; Thorhallur I. Halldorsson; Allan A. Vaag; Sjurdur F. Olsen

doi:10.3945/ajcn.115.128637

Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

Ekaterina Maslova^*, Susanne Hansen, Louise Groth Grunnet, Marin Strøm, Anne Ahrendt Bjerregaard, Line Hjort, Freja Bach Kampmann, Camilla Møller Madsen, A C Baun Thuesen, Bodil Hammer Bech, Thorhallur I. Halldorsson, Allan A. Vaag, Sjurdur F. Olsen

^*Corresponding author for this work

12 Citations (Scopus)

Abstract

Background: Recent years have seen strong tendencies toward high-protein diets. However, the implications of higher protein intake, especially during developmentally sensitive periods, are poorly understood. Conversely, evidence on the long-term developmental consequences of low protein intake in free-living populations remains limited. Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM). Design: Six hundred eight women with an index pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a foodfrequency questionnaire in gestational week 25. The offspring underwent a clinical examination including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1:1 substitution of carbohydrates for protein. Results: The mean ± SD protein intake in pregnancy was 93 ± 15 g/d (16% ± 3% of energy) in GDM-exposed women and 90 ± 14 g/d (16% ± 2% of energy) in control women. There were overall no associations between maternal protein intake and offspring fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We found that maternal total protein intake was associated with a tendency for a higher abdominal fat mass percentage (quartile 4 compared with quartile 1: 0.40 SD; 95% CI: -0.03, 0.83 SD; P = 0.07) in GDM-exposed offspring and a tendency for a higher total fat mass percentage among male offspring (quartile 4 compared with quartile 1: 0.33 SD; 95% CI: -0.01, 0.66 SD; P = 0.06), but a small sample size may have compromised the precision of the effect estimates. GDMexposed offspring of mothers with a protein intake in the lowest decile (≤12.5% of energy compared with >12.5% of energy) had lower fasting insulin (ratio of geometric means: 0.82; 95% CI: 0.68, 0.99; P = 0.04) and a tendency toward lower HOMA-IR (ratio of geometric means: 0.82; 95% CI: 0.66, 1.02; P = 0.07), but there was no evidence of associations with body composition. Male offspring seemed to derive a similar benefit from a maternal low protein intake as did GDM-exposed offspring. Conclusions: Overall, our results provide little support for an association of maternal protein intake in pregnancy with measures of offspring metabolic health. Further studies in larger cohorts are needed to determine whether low maternal protein intake in pregnancy may improve glucose homeostasis in GDM-exposed and male offspring.

Original language	English
Journal	American Journal of Clinical Nutrition
Volume	106
Issue number	2
Pages (from-to)	623-636
Number of pages	14
ISSN	0002-9165
DOIs	https://doi.org/10.3945/ajcn.115.128637
Publication status	Published - 1 Aug 2017
Externally published	Yes

Keywords

Body composition
Gestational diabetes mellitus
Insulin
Pregnancy
Protein

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Maslova, E., Hansen, S., Grunnet, L. G., Strøm, M., Bjerregaard, A. A., Hjort, L., Kampmann, F. B., Madsen, C. M., Thuesen, A. C. B., Bech, B. H., Halldorsson, T. I., Vaag, A. A., & Olsen, S. F. (2017). Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls. American Journal of Clinical Nutrition, 106(2), 623-636. https://doi.org/10.3945/ajcn.115.128637

Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls. / Maslova, Ekaterina; Hansen, Susanne; Grunnet, Louise Groth et al.
In: American Journal of Clinical Nutrition, Vol. 106, No. 2, 01.08.2017, p. 623-636.

Research output: Contribution to journal › Journal article › Research › peer-review

Maslova, E, Hansen, S, Grunnet, LG, Strøm, M, Bjerregaard, AA, Hjort, L, Kampmann, FB, Madsen, CM, Thuesen, ACB, Bech, BH, Halldorsson, TI, Vaag, AA & Olsen, SF 2017, 'Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls', American Journal of Clinical Nutrition, vol. 106, no. 2, pp. 623-636. https://doi.org/10.3945/ajcn.115.128637

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title = "Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls",

abstract = "Background: Recent years have seen strong tendencies toward high-protein diets. However, the implications of higher protein intake, especially during developmentally sensitive periods, are poorly understood. Conversely, evidence on the long-term developmental consequences of low protein intake in free-living populations remains limited. Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM). Design: Six hundred eight women with an index pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a foodfrequency questionnaire in gestational week 25. The offspring underwent a clinical examination including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1:1 substitution of carbohydrates for protein. Results: The mean ± SD protein intake in pregnancy was 93 ± 15 g/d (16% ± 3% of energy) in GDM-exposed women and 90 ± 14 g/d (16% ± 2% of energy) in control women. There were overall no associations between maternal protein intake and offspring fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We found that maternal total protein intake was associated with a tendency for a higher abdominal fat mass percentage (quartile 4 compared with quartile 1: 0.40 SD; 95% CI: -0.03, 0.83 SD; P = 0.07) in GDM-exposed offspring and a tendency for a higher total fat mass percentage among male offspring (quartile 4 compared with quartile 1: 0.33 SD; 95% CI: -0.01, 0.66 SD; P = 0.06), but a small sample size may have compromised the precision of the effect estimates. GDMexposed offspring of mothers with a protein intake in the lowest decile (≤12.5% of energy compared with >12.5% of energy) had lower fasting insulin (ratio of geometric means: 0.82; 95% CI: 0.68, 0.99; P = 0.04) and a tendency toward lower HOMA-IR (ratio of geometric means: 0.82; 95% CI: 0.66, 1.02; P = 0.07), but there was no evidence of associations with body composition. Male offspring seemed to derive a similar benefit from a maternal low protein intake as did GDM-exposed offspring. Conclusions: Overall, our results provide little support for an association of maternal protein intake in pregnancy with measures of offspring metabolic health. Further studies in larger cohorts are needed to determine whether low maternal protein intake in pregnancy may improve glucose homeostasis in GDM-exposed and male offspring.",

keywords = "Body composition, Gestational diabetes mellitus, Insulin, Pregnancy, Protein",

author = "Ekaterina Maslova and Susanne Hansen and Grunnet, {Louise Groth} and Marin Str{\o}m and Bjerregaard, {Anne Ahrendt} and Line Hjort and Kampmann, {Freja Bach} and Madsen, {Camilla M{\o}ller} and Thuesen, {A C Baun} and Bech, {Bodil Hammer} and Halldorsson, {Thorhallur I.} and Vaag, {Allan A.} and Olsen, {Sjurdur F.}",

year = "2017",

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day = "1",

doi = "10.3945/ajcn.115.128637",

language = "English",

volume = "106",

pages = "623--636",

journal = "American Journal of Clinical Nutrition",

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TY - JOUR

T1 - Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y

T2 - results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

AU - Maslova, Ekaterina

AU - Hansen, Susanne

AU - Grunnet, Louise Groth

AU - Strøm, Marin

AU - Bjerregaard, Anne Ahrendt

AU - Hjort, Line

AU - Kampmann, Freja Bach

AU - Madsen, Camilla Møller

AU - Thuesen, A C Baun

AU - Bech, Bodil Hammer

AU - Halldorsson, Thorhallur I.

AU - Vaag, Allan A.

AU - Olsen, Sjurdur F.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background: Recent years have seen strong tendencies toward high-protein diets. However, the implications of higher protein intake, especially during developmentally sensitive periods, are poorly understood. Conversely, evidence on the long-term developmental consequences of low protein intake in free-living populations remains limited. Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM). Design: Six hundred eight women with an index pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a foodfrequency questionnaire in gestational week 25. The offspring underwent a clinical examination including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1:1 substitution of carbohydrates for protein. Results: The mean ± SD protein intake in pregnancy was 93 ± 15 g/d (16% ± 3% of energy) in GDM-exposed women and 90 ± 14 g/d (16% ± 2% of energy) in control women. There were overall no associations between maternal protein intake and offspring fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We found that maternal total protein intake was associated with a tendency for a higher abdominal fat mass percentage (quartile 4 compared with quartile 1: 0.40 SD; 95% CI: -0.03, 0.83 SD; P = 0.07) in GDM-exposed offspring and a tendency for a higher total fat mass percentage among male offspring (quartile 4 compared with quartile 1: 0.33 SD; 95% CI: -0.01, 0.66 SD; P = 0.06), but a small sample size may have compromised the precision of the effect estimates. GDMexposed offspring of mothers with a protein intake in the lowest decile (≤12.5% of energy compared with >12.5% of energy) had lower fasting insulin (ratio of geometric means: 0.82; 95% CI: 0.68, 0.99; P = 0.04) and a tendency toward lower HOMA-IR (ratio of geometric means: 0.82; 95% CI: 0.66, 1.02; P = 0.07), but there was no evidence of associations with body composition. Male offspring seemed to derive a similar benefit from a maternal low protein intake as did GDM-exposed offspring. Conclusions: Overall, our results provide little support for an association of maternal protein intake in pregnancy with measures of offspring metabolic health. Further studies in larger cohorts are needed to determine whether low maternal protein intake in pregnancy may improve glucose homeostasis in GDM-exposed and male offspring.

AB - Background: Recent years have seen strong tendencies toward high-protein diets. However, the implications of higher protein intake, especially during developmentally sensitive periods, are poorly understood. Conversely, evidence on the long-term developmental consequences of low protein intake in free-living populations remains limited. Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM). Design: Six hundred eight women with an index pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a foodfrequency questionnaire in gestational week 25. The offspring underwent a clinical examination including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1:1 substitution of carbohydrates for protein. Results: The mean ± SD protein intake in pregnancy was 93 ± 15 g/d (16% ± 3% of energy) in GDM-exposed women and 90 ± 14 g/d (16% ± 2% of energy) in control women. There were overall no associations between maternal protein intake and offspring fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We found that maternal total protein intake was associated with a tendency for a higher abdominal fat mass percentage (quartile 4 compared with quartile 1: 0.40 SD; 95% CI: -0.03, 0.83 SD; P = 0.07) in GDM-exposed offspring and a tendency for a higher total fat mass percentage among male offspring (quartile 4 compared with quartile 1: 0.33 SD; 95% CI: -0.01, 0.66 SD; P = 0.06), but a small sample size may have compromised the precision of the effect estimates. GDMexposed offspring of mothers with a protein intake in the lowest decile (≤12.5% of energy compared with >12.5% of energy) had lower fasting insulin (ratio of geometric means: 0.82; 95% CI: 0.68, 0.99; P = 0.04) and a tendency toward lower HOMA-IR (ratio of geometric means: 0.82; 95% CI: 0.66, 1.02; P = 0.07), but there was no evidence of associations with body composition. Male offspring seemed to derive a similar benefit from a maternal low protein intake as did GDM-exposed offspring. Conclusions: Overall, our results provide little support for an association of maternal protein intake in pregnancy with measures of offspring metabolic health. Further studies in larger cohorts are needed to determine whether low maternal protein intake in pregnancy may improve glucose homeostasis in GDM-exposed and male offspring.

KW - Body composition

KW - Gestational diabetes mellitus

KW - Insulin

KW - Pregnancy

KW - Protein

U2 - 10.3945/ajcn.115.128637

DO - 10.3945/ajcn.115.128637

M3 - Journal article

C2 - 28679553

AN - SCOPUS:85026663236

SN - 0002-9165

VL - 106

SP - 623

EP - 636

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 2

ER -

Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

Abstract

Keywords

UN SDGs

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