Association of a high-protein and low-glycemic-index diet during pregnancy with offspring growth and obesity until the age of 18 years – a target trial emulation

作者：Christina Sonne Mogensen, Christian Mølgaard, Faidon Magkos, Nina Rica Wium Geiker, Anne Ahrendt Bjerregaard, Charlotta Granström, Thorhallur Ingi Halldorsson, Sjúrđur F. Olsen · 发表于：European Journal of Clinical Nutrition · 年份：2025 · DOI：10.1038/s41430-025-01666-2 · 被引用次数：3 · 研究领域：Gestational Diabetes Research and Management、Birth, Development, and Health、Nutritional Studies and Diet

Abstract Background Maternal pre-pregnancy BMI and excessive gestational weight gain (GWG) are associated with offspring obesity. Moreover, maternal dietary patterns, particularly protein intake and glycemic index, influence GWG and fetal development. This study aimed to investigate the association of a high-protein, low-glycemic-index (HPLGI) diet during pregnancy with offspring growth and obesity. Methods Using observational data from the Danish National Birth Cohort, a target trial emulation was conducted to investigate the association of an HPLGI diet during pregnancy on offspring growth up to 18 years of age. A cohort of 17,551 women who met the inclusion criteria was categorized into exposure groups based on their protein intake and glycemic index to emulate the groups in the APPROACH trial. Results Maternal characteristics varied between the exposure groups, with the HPLGI women exhibiting 1.67 kg higher pre-pregnancy weight and 0.49 kg/m 2 BMI, with no differences in GWG. Offspring outcomes were assessed at various ages, and a linear mixed model was used, including potential confounders. Offspring born to women following an HPLGI diet during pregnancy had 2.59 kg higher body weight and 0.72 kg/m 2 higher BMI at 18 years compared to those from the moderate-protein, moderate-glycemic-index (MPMGI) group. Conclusion An HPLGI diet during pregnancy was associated with higher offspring body weight and BMI at 18 years of age compared to an MPMGI diet. These findings suggest ...