Predictors of maternal dietary quality and dietary inflammation during pregnancy: An individual participant data meta-analysis of seven European cohorts from the ALPHABET consortium

Adrien M. Aubert, Ling Wei Chen, Nitin Shivappa, Cyrus Cooper, Sarah R. Crozier, Liesbeth Duijts, Anne Forhan, Wojciech Hanke, Nicholas C. Harvey, Agnieszka Jankowska, Cecily C. Kelleher, Blandine de Lauzon-Guillain, Fionnuala M. McAuliffe, Sara M. Mensink-Bout, Kinga Polanska, Caroline L. Relton, Matthew Suderman, James R. Hebert, Catherine M. Phillips, Jonathan Y. Bernard*Barbara Heude

*Corresponding author for this work

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Abstract

Background & aims: Maternal diet during pregnancy is a modifiable behaviour which plays an important role in maternal, neonatal and child health outcomes. Thus, knowledge of predictors of dietary quality and dietary inflammatory potential in European countries may contribute to developing maternal diet-related public health policies that target specific at-risk populations in Europe. Methods: We used harmonised data from >26,000 pregnant women enrolled in the ALSPAC, EDEN, Generation R, Lifeways, REPRO_PL, ROLO and SWS cohorts, as part of the ALPHABET consortium. Maternal dietary quality and inflammatory potential were assessed using the Dietary Approaches to Stop Hypertension (DASH) and the energy-adjusted Dietary Inflammatory Index (E-DII). We conducted an individual participant data meta-analysis to investigate the maternal sociodemographic, health and behavioural predictors of maternal diet before and during pregnancy. Results: DASH and E-DII scores were moderately correlated: from −0.63 (95% CI: −0.66, −0.59) to −0.48 (95% CI: −0.49, −0.47) across cohorts. Higher maternal age, education, household income, and physical activity during pregnancy were associated with a better dietary quality and a more anti-inflammatory diet. Conversely, multiparity and smoking during pregnancy were associated with a poorer dietary quality and a more proinflammatory diet. Women with obesity had a poorer pregnancy dietary quality than women with a normal body mass index range. Conclusions: The results will help identify population subgroups who may benefit from targeted public health strategies and interventions aimed at improving women's dietary quality during pregnancy.

Original languageEnglish
Pages (from-to)1991-2002
Number of pages12
JournalClinical Nutrition
Volume41
Issue number9
Early online date7 Jul 2022
DOIs
Publication statusPublished - 1 Sep 2022

Bibliographical note

Funding Information:
ALPHABET: This research was supported by an award from the European Union’s Horizon 2020 research and innovation programme under the ERA-Net Cofund of the Joint Programming Initiative A healthy diet for a healthy life ( http://www.healthydietforhealthylife.eu ) action number 696295 (Biomarkers for Nutrition and Health). Co-funding was provided by Science Foundation Ireland , Ireland (Grant Number SFI/16/ERA-HDHL/3360 ), the UK Biotechnology and Biological Sciences Research Council (ERA-HDHL Biomarkers: BBSRC: BB/P028179/1 and BB/P028187/1 ), the National Center for Research and Development ( ERA-HDHL/01/ALPHABET/1/2017 ), the ZonMw The Netherlands (no 529051014 ; 2017)) ALPHABET project (no 696295 ; 2017), and the French National Agency of Research (reference AnrR16227KK ). The APC was funded by the French National Agency of Research (reference AnrR16227KK ). ALSPAC: The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z ) and the University of Bristol provide core support for ALSPAC . This publication is the work of the authors, and Matthew Suderman will serve as guarantor for the contents of this paper. EDEN: The EDEN study was supported by Foundation for Medical Research , National Agency for Research (ANR) , National Institute for Research in Public health (IRESP : TGIR cohorte santé 2008 program), French Ministry of Health (DGS) , French Ministry of Research , INSERM Bone and Joint Diseases National Research (PRO-A) , and Human Nutrition National Research Programs , Paris-Sud University , Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES) , the European Union FP7 programmes ( FP7/2007–2013 , HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l’Education Nationale a complementary health insurance (MGEN), French national agency for food security, French-speaking association for the study of diabetes and metabolism (ALFEDIAM). Generation R: The Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam , the Erasmus University Rotterdam , and The Netherlands Organization for Health Research and Development . Dr Liesbeth Duijts received funding from the European Union's Horizon 2020 co-funded programme ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL) (ALPHABET project (no 696295 ; 2017), ZonMw The Netherlands (no 529051014 ; 2017)). The project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE project, grant agreement no 733206 ; 2016). The study sponsors had no role in the study design, data analysis, interpretation of data, or writing of this report. The Generation R Study is conducted by the Erasmus Medical Centre in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam, the Municipal Health Service, Rotterdam area, and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. Lifeways: The Lifeways Cross-Generation Cohort Study is funded by the Irish Health Research Board (reference HRC/2007/13 ) and is overseen by an inter-disciplinary steering group . REPRO_PL: The REPRO_PL cohort was mainly supported by the Ministry of Science and Higher Education , Poland ( PBZ-MEiN-/8/2/2006 ; contract no. K140/P01/2007/1.3.1.1 ); by the grant PNRF-218-AI-1/07 from Norway through the Norwegian Financial Mechanism within the Polish-Norwegian Research Fund and the National Science Centre under the call JPI HDHL Nutrition and Cognitive Function ( 2015/17/Z/NZ7/04273 ). ROLO: ROLO study is supported by Health Research Board Health Research Centre for Diet and Health Research Ireland and The National Maternity Hospital Medical Fund , and The European Union’s Seventh Framework Programme ( FP7/2007–2013 ). SWS: This work was supported by grants from the Medical Research Council, British Heart Foundation , Arthritis Research UK , Food Standards Agency , and the European Union’s Seventh Framework ( FP7/2007–2013 ), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977 .

Funding Information:
ALPHABET: This research was supported by an award from the European Union's Horizon 2020 research and innovation programme under the ERA-Net Cofund of the Joint Programming Initiative A healthy diet for a healthy life (http://www.healthydietforhealthylife.eu) action number 696295 (Biomarkers for Nutrition and Health). Co-funding was provided by Science Foundation Ireland, Ireland (Grant Number SFI/16/ERA-HDHL/3360), the UK Biotechnology and Biological Sciences Research Council (ERA-HDHL Biomarkers: BBSRC: BB/P028179/1 and BB/P028187/1), the National Center for Research and Development (ERA-HDHL/01/ALPHABET/1/2017), the ZonMw The Netherlands (no 529051014; 2017)) ALPHABET project (no 696295; 2017), and the French National Agency of Research (reference AnrR16227KK). The APC was funded by the French National Agency of Research (reference AnrR16227KK). ALSPAC: The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and Matthew Suderman will serve as guarantor for the contents of this paper. EDEN: The EDEN study was supported by Foundation for Medical Research, National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A), and Human Nutrition National Research Programs, Paris-Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007–2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l'Education Nationale a complementary health insurance (MGEN), French national agency for food security, French-speaking association for the study of diabetes and metabolism (ALFEDIAM). Generation R: The Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam, the Erasmus University Rotterdam, and The Netherlands Organization for Health Research and Development. Dr Liesbeth Duijts received funding from the European Union's Horizon 2020 co-funded programme ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL) (ALPHABET project (no 696295; 2017), ZonMw The Netherlands (no 529051014; 2017)). The project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE project, grant agreement no 733206; 2016). The study sponsors had no role in the study design, data analysis, interpretation of data, or writing of this report. The Generation R Study is conducted by the Erasmus Medical Centre in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam, the Municipal Health Service, Rotterdam area, and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. Lifeways: The Lifeways Cross-Generation Cohort Study is funded by the Irish Health Research Board (reference HRC/2007/13) and is overseen by an inter-disciplinary steering group. REPRO_PL: The REPRO_PL cohort was mainly supported by the Ministry of Science and Higher Education, Poland (PBZ-MEiN-/8/2/2006; contract no. K140/P01/2007/1.3.1.1); by the grant PNRF-218-AI-1/07 from Norway through the Norwegian Financial Mechanism within the Polish-Norwegian Research Fund and the National Science Centre under the call JPI HDHL Nutrition and Cognitive Function (2015/17/Z/NZ7/04273). ROLO: ROLO study is supported by Health Research Board Health Research Centre for Diet and Health Research Ireland and The National Maternity Hospital Medical Fund, and The European Union's Seventh Framework Programme (FP7/2007–2013). SWS: This work was supported by grants from the Medical Research Council, British Heart Foundation, Arthritis Research UK, Food Standards Agency, and the European Union's Seventh Framework (FP7/2007–2013), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977.

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