In a recent study published in the journal Current Developments in Nutrition, The researchers used a range of biochemical and body composition analyzes to investigate associations between maternal docosahexaenoic acid (DHA) supplementation and offspring obesity outcomes. Specifically, they evaluated the effects of prenatal DHA supplementation on gestational weight gain (GWG) and adipose tissue distribution in the offspring. Their study, titled the Growth and Adiposity in Newborns Study (GAINS; NCT 03310983), included 250 participants from the Assessment of DHA on Reducing Early Preterm Birth (ADORE; NCT 02626299) randomized controlled trial followed up to 24 months after birth .
Study findings reveal that prenatal DHA consumption significantly increases infant total and central fat mass (FM), but does not alter GWG status. These results were unaffected by the observed gender of the offspring and persisted at 24 months of age, making this the third study to highlight the (beneficial) effects of prenatal supplementation on offspring health. However, additional research and follow-up are needed to ascertain whether these benefits persist throughout childhood.
Study: The effect of prenatal DHA supplementation on offspring fat mass and distribution at 24 months of age. Image credit: Nemer-T / Shutterstock
The risk of childhood obesity
Childhood obesity is often a serious medical condition characterized by significantly higher than normal weights (body mass index [BMI] > 95u percentile for age) in children and adolescents. Alarmingly, the prevalence of the condition is increasing, especially in developed countries such as the United States of America (USA), necessitating research into the mechanistic underpinnings of the disease and ideal windows where clinical interventions could best combat the condition.
Recent research has suggested that the first 1,000 days post-gestation represent one of these critical windows—here, a rapid expansion in the abundance and size of adipocytes in infants is observed, substantially altering measurements of adipose tissue at birth and during early life. Zoe. Since infant fat-free mass is generally constant between individuals, this observed variation in adipose tissue underlies the measured weight results. Parallel research has further highlighted the profound effects of neonatal excess gestational weight (GWG) on the subsequent development of offspring obesity and its comorbidities (cardiovascular disease [CVD] and diabetes).
Prenatal supplementation has significantly improved offspring outcomes in unrelated medical research, suggesting its use in combating childhood obesity. Polyunsaturated fatty acids (PUFAs) represent a key area for potential investigation since prenatal maternal intake of some PUFAs (particularly the n-3 PUFA-like docosahexaenoic acid [DHA]) has been observed to reduce progeny fat mass (FM) by preventing stem cells from maturing into adipocytes. So far, two randomized clinical trials have investigated this association – the DHA to Optimize Maternal Infant Outcome (DOMINO) trial and the Copenhagen Prospective Studies of Asthma in Childhood (COPSAC). Unfortunately, the former focused on an older age group (3 to 7 years), while the latter lacked the experimental design needed to elucidate the mechanisms of this interaction.
About the study
In the present study, researchers conducted a randomized, controlled, double-blind study to investigate whether prenatal DNA supplementation reduces the risk of excess fat accumulation in offspring due to increased GWG. Specifically, this study aims to clarify whether different prenatal doses of DHA (1000 mg/day vs. 200 mg/day) induce changes in GWG that, in turn, alter offspring FM at 24 months of age. In addition, the researchers investigate any sex-specific patterns observed during the analyses.
The study cohort was drawn from the Evaluation of DHA in the Reduction of Premature Preterm Birth (ADORE) randomized controlled trial. Of the 448 initial enrollees, 250 had completed medical and demographic records and demonstrated high compliance during the 24-month follow-up period and were thus included in the analyses. In addition to collected demographic and medical history records, anthropometry (weight and height) was measured at study initiation (baseline) and maternal blood was routinely collected for red blood cell fatty acid phospholipid (RCB) determinations. Chromatography was additionally used to identify the relative abundance of various PUFAs in maternal blood.
GWG was measured by comparing the mother’s self-reported body weight before pregnancy with the final body weight measured immediately before delivery. The National Cancer Institute (NCI) Diet History Questionnaire II (DHQ-II) was used to record participants’ dietary compliance and was analyzed using Diet Calc Analysis software to reveal trends in macronutrient and micronutrient intake. A modified version of the DHQ-II questionnaire was used to document the infant’s dietary intake. Finally, dual-energy X-ray absorptiometry was used to measure regional adipose tissue distribution and total body composition.
Conclusions and conclusions of the study
Of the 250 mothers-to-be enrolled in the study, 124 received the low-dose DHA regimen (200 mg/day), while the remainder were administered the high-dose DHA regimen (1000 mg/day cohort). Encouragingly, 90.9% of participants depicted high adherence to their respective treatments. Study findings reveal that the high-dose cohort experienced higher overall infant FM than their low-dose counterparts, regardless of GWG status. In addition, the high-dose cohort significantly increased central FM, with other FM measures relatively stable across cohorts.
Sex-specific assessments failed to differentiate between males and females, highlighting that these results are valid regardless of the sex of the developing infant. These results persisted over the course of the 24-month study, validating previous research suggesting the benefits of prenatal supplementation on offspring health. Unfortunately, these results need additional follow-up before their effects in children and adolescents can be verified.
