(PTFS17-05-24) Maternal Periconceptional Adherence to a Mediterranean Diet Pattern and Child Body Mass Index Between Ages 3–10 Years by Sex, Age, and Race

Objectives: To assess the extent to which the associations between maternal periconceptional Mediterranean diet (MD) pattern adherence and child BMI between ages 3-10 years vary by age, sex, and race/ethnicity in a diverse cohort of mother-child dyads.

Methods: We conducted secondary data analysis of n=537 mother-child dyads from the Newborn Epigenetics Study (NEST), a multi-ethnic longitudinal birth cohort from North Carolina. Maternal diet information was collected through a food frequency questionnaire reflecting the periconceptional period and assessed with the Mediterranean Diet Score. Height and weight were measured annually between ages 3-10 years and body mass index (BMI) was calculated. Multiple linear mixed effects regression models with exponential correlation structure and multiple logistic regression models were used to assess the associations between maternal MD adherence and 1) BMI between 3-10 years and 2) the likelihood of BMI < 85^th percentile between 3-10 years. Models were adjusted for sex at birth, birth weight, breastfeeding, race/ethnicity, pre-pregnancy BMI, maternal smoking during pregnancy. Given statistically significant interaction terms, stratified models by race/ethnicity, age, and sex were explored.

Results: Among mother-child dyads, 44% identified as Black/African American, 38% as White, and 18% as Hispanic/Latinx. A greater maternal periconceptional adherence to a MD was associated with a lower BMI between ages 3-10 years among non-Hispanic Black children (p=0.03), but not among those identifying as Hispanic or White. There was also a consistent association between maternal MD adherence and greater likelihood of BMI < 85th percentile at age 3 (p=0.005), 4 (p < 0.001), 5 (p=0.02), and 6 years (p < 0.001) among boys of all races/ethnicities. Associations were not statistically significant after age 6 years.

Conclusions: Greater maternal periconceptional adherence to a Mediterranean dietary pattern is associated with a lower likelihood of child overweight/obesity between ages 3-6 years among boys, and a lower BMI across ages 3-10 years among non-Hispanic Black children. The Mediterranean diet shows promise as a potential periconceptional intervention for reducing the likelihood of future overweight in children. The role of sex, age, and race warrant further exploration.

Funding Sources: NIH: NIEHS, NIMHD