Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?

Rodrigo Antunes Lima; Gernot Desoye; on behalf of the DALI Core Investigator Group; David Simmons; Mireille Nicoline Maria van Poppel; Roland Devlieger; Sander Galjaard; Rosa Corcoy; Juan M. Adelantado; Fidelma Dunne; Jürgen Harreiter; Alexandra Kautzky-Willer; Peter Damm; Elisabeth R. Mathiesen; Dorte M. Jensen; Lise Lotte Andersen; Mette Tanvig; Annunziata Lapolla; Maria Grazia Dalfra; Alessandra Bertolotto; Ewa Wender-Ozegowska; Agnieszka Zawiejska; David J. Hill; Frank J. Snoek; Judith G.M. Jelsma

doi:10.1038/s41390-021-01450-5

Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?

Rodrigo Antunes Lima^*, Gernot Desoye, on behalf of the DALI Core Investigator Group, David Simmons, Mireille Nicoline Maria van Poppel, Roland Devlieger, Sander Galjaard, Rosa Corcoy, Juan M. Adelantado, Fidelma Dunne, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R. Mathiesen, Dorte M. Jensen, Lise Lotte Andersen, Mette Tanvig, Annunziata Lapolla, Maria Grazia Dalfra, Alessandra BertolottoEwa Wender-Ozegowska, Agnieszka Zawiejska, David J. Hill, Frank J. Snoek, Judith G.M. Jelsma

^*Corresponding author for this work

Obstetrics & Gynecology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m² were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24–28 and 35–37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: −0.217 to 0.253 and an indirect effect on leptin of −0.143 (μg/l), 95% CI: −0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.

Original language	English
Pages (from-to)	522-525
Number of pages	4
Journal	Pediatric Research
Volume	91
Issue number	3
DOIs	https://doi.org/10.1038/s41390-021-01450-5
Publication status	Published - Feb 2022

Bibliographical note

Acknowledgements
This work was supported by European Union 7th framework (FP7/ 2007–2013) under Grant Agreement no. 242187. In the Netherlands, additional funding was provided by the Netherlands Organisation for Health Research and Development (ZonMw) (grant 200310013). In Poland, additional funding was obtained from Polish Ministry of Science (grants 2203/7, PR/2011/2). In Denmark, additional funding was provided by Odense University Free Research Fund. In Spain, additional funding was provided by CAIBER (1527-B-226). The funders had no role in any aspect of the study beyond funding.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

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Lima, R. A., Desoye, G., on behalf of the DALI Core Investigator Group, Simmons, D., van Poppel, M. N. M., Devlieger, R., Galjaard, S., Corcoy, R., Adelantado, J. M., Dunne, F., Harreiter, J., Kautzky-Willer, A., Damm, P., Mathiesen, E. R., Jensen, D. M., Andersen, L. L., Tanvig, M., Lapolla, A., Dalfra, M. G., ... Jelsma, J. G. M. (2022). Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle? Pediatric Research, 91(3), 522-525. https://doi.org/10.1038/s41390-021-01450-5

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title = "Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?",

abstract = "We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m2 were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24–28 and 35–37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: −0.217 to 0.253 and an indirect effect on leptin of −0.143 (μg/l), 95% CI: −0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.",

author = "Lima, {Rodrigo Antunes} and Gernot Desoye and {on behalf of the DALI Core Investigator Group} and David Simmons and {van Poppel}, {Mireille Nicoline Maria} and Roland Devlieger and Sander Galjaard and Rosa Corcoy and Adelantado, {Juan M.} and Fidelma Dunne and J{\"u}rgen Harreiter and Alexandra Kautzky-Willer and Peter Damm and Mathiesen, {Elisabeth R.} and Jensen, {Dorte M.} and Andersen, {Lise Lotte} and Mette Tanvig and Annunziata Lapolla and Dalfra, {Maria Grazia} and Alessandra Bertolotto and Ewa Wender-Ozegowska and Agnieszka Zawiejska and Hill, {David J.} and Snoek, {Frank J.} and Jelsma, {Judith G.M.}",

note = "Acknowledgements This work was supported by European Union 7th framework (FP7/ 2007–2013) under Grant Agreement no. 242187. In the Netherlands, additional funding was provided by the Netherlands Organisation for Health Research and Development (ZonMw) (grant 200310013). In Poland, additional funding was obtained from Polish Ministry of Science (grants 2203/7, PR/2011/2). In Denmark, additional funding was provided by Odense University Free Research Fund. In Spain, additional funding was provided by CAIBER (1527-B-226). The funders had no role in any aspect of the study beyond funding. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.",

year = "2022",

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doi = "10.1038/s41390-021-01450-5",

language = "English",

volume = "91",

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journal = "Pediatric Research",

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Lima, RA, Desoye, G, on behalf of the DALI Core Investigator Group, Simmons, D, van Poppel, MNM, Devlieger, R, Galjaard, S, Corcoy, R, Adelantado, JM, Dunne, F, Harreiter, J, Kautzky-Willer, A, Damm, P, Mathiesen, ER, Jensen, DM, Andersen, LL, Tanvig, M, Lapolla, A, Dalfra, MG, Bertolotto, A, Wender-Ozegowska, E, Zawiejska, A, Hill, DJ, Snoek, FJ & Jelsma, JGM 2022, 'Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?', Pediatric Research, vol. 91, no. 3, pp. 522-525. https://doi.org/10.1038/s41390-021-01450-5

TY - JOUR

T1 - Mediators of lifestyle intervention effects on neonatal adiposity

T2 - are we missing a piece of the puzzle?

AU - Lima, Rodrigo Antunes

AU - Desoye, Gernot

AU - on behalf of the DALI Core Investigator Group

AU - Simmons, David

AU - van Poppel, Mireille Nicoline Maria

AU - Devlieger, Roland

AU - Galjaard, Sander

AU - Corcoy, Rosa

AU - Adelantado, Juan M.

AU - Dunne, Fidelma

AU - Harreiter, Jürgen

AU - Kautzky-Willer, Alexandra

AU - Damm, Peter

AU - Mathiesen, Elisabeth R.

AU - Jensen, Dorte M.

AU - Andersen, Lise Lotte

AU - Tanvig, Mette

AU - Lapolla, Annunziata

AU - Dalfra, Maria Grazia

AU - Bertolotto, Alessandra

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David J.

AU - Snoek, Frank J.

AU - Jelsma, Judith G.M.

N1 - Acknowledgements This work was supported by European Union 7th framework (FP7/ 2007–2013) under Grant Agreement no. 242187. In the Netherlands, additional funding was provided by the Netherlands Organisation for Health Research and Development (ZonMw) (grant 200310013). In Poland, additional funding was obtained from Polish Ministry of Science (grants 2203/7, PR/2011/2). In Denmark, additional funding was provided by Odense University Free Research Fund. In Spain, additional funding was provided by CAIBER (1527-B-226). The funders had no role in any aspect of the study beyond funding. Publisher Copyright: © 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

PY - 2022/2

Y1 - 2022/2

N2 - We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m2 were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24–28 and 35–37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: −0.217 to 0.253 and an indirect effect on leptin of −0.143 (μg/l), 95% CI: −0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.

AB - We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m2 were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24–28 and 35–37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: −0.217 to 0.253 and an indirect effect on leptin of −0.143 (μg/l), 95% CI: −0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.

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U2 - 10.1038/s41390-021-01450-5

DO - 10.1038/s41390-021-01450-5

M3 - Article

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AN - SCOPUS:85102886687

SN - 0031-3998

VL - 91

SP - 522

EP - 525

JO - Pediatric Research

JF - Pediatric Research

IS - 3

ER -

Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?

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