Maternal nutrition and offspring CVD risk later in life - Nutrition During Infancy - cardiovascular diseases - Author Abstract

Nutrition Research Newsletter, May, 2003

Cholesterol profiles are one of the myriad of conditions that contribute to the inverse relationship between birth weight and cardiovascular disease mortality in humans. It is widely believed that low birth weight (LBW) indicates fetal growth restriction and underlying nutritional deficiency, which is then viewed as the stimulus that fuels fetal adaptations that have effects on cholesterol metabolism into adulthood. As fetal nutritional sufficiency is a product of the maternal capacity to supply the energy and nutrients needed for growth, maternal nutritional status during pregnancy may be an important factor influencing patterns of CVD risk in offspring. There has been little research in the area of maternal nutrition during pregnancy and later offspring CVD risk.

Investigators used the data collected prospectively over a 17-year period in the Philippines to test the hypothesis that poor maternal energy status during pregnancy and LBW predict elevated CVD risk in offspring during adolescence, as indexed by cholesterol profiles. A community-based cohort study of infants based in the metropolitan Cebu area was performed. The current analysis used the data collected from mothers during the third trimester of pregnancy (1983-1984) and from their offspring at birth (1983-1984) and at 14 to 16 years of age (1998-1999).

Maternal arm fat area (MAFA) was calculated from triceps skinfold thickness and midupper arm circumference measured during the baseline survey. Maternal height was measured. Infant length and birth weight were measured. Gestational age was estimated.

From the entire original cohort, a subsample of 307 females and 296 males were selected at random within 2 birth weight strata for blood sample collection during their teen years. Subjects of this part of the analysis were limited to term infants. For measurement of lipid profiles, subjects were asked to fast overnight for 12 hr. Body weight, height, waist circumference, midupper arm circumference, and triceps skinfold thickness were measured in the adolescents.

MAFA was positively associated with HDL cholesterol (0.12 log mg/dL; P < 0.01) and inversely associated with total cholesterol (-10.0 mg/dL; P < 0.10), LDL cholesterol (-13.1 mg/dL; P < 0.01), and the ratios of total to HDL cholesterol and LDL to HDL cholesterol (both P < 0.001) in males. These relations were found to be independent of birth weight, present adiposity, energy and fat intakes, maturity, and income. Birth weight d" 2.6 kg was associated with elevated LDL cholesterol (9.9 mg/dL; P < 0.01) and an elevated ratio of LDL to HDL cholesterol (0.22; P < 0.10) only in males. In females, MAFA related positively total (15.5 mg/dL; P < 0.05) and LDL (11.9 mg/dL; P < 0.05) cholesterol.

In this particular Filipino population, mothers with poor/low energy status during pregnancy did give birth to male offspring who had a high CVD risk during adolescents, as measured by lipid profiles. The findings in females were less consistent. Researchers suggest that sex differences in the relation between fetal nutrition and postnatal lipid metabolism likely come in to play.

C. Kuzawa, L. Adair. Lipid profiles in adolescent Filipinos: relation to birth weight and maternal energy status during pregnancy. Am J Clin Nutr;77:960-966 (April 2003). [Correspondence: CW Kuzawa, Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208. E-mail: kuzawa@northwestern.edu].