Maternal Preconception Body Mass Index and Early Childhood Nutritional Risk

Kate E Braddon; Charles Dg Keown-Stoneman; Cindy-Lee Dennis; Xuedi Li; Jonathon L Maguire; Deborah L O'Connor; Jessica A Omand; Janis Randall Simpson; Catherine S Birken

doi:10.1016/j.tjnut.2023.06.022

Maternal Preconception Body Mass Index and Early Childhood Nutritional Risk

J Nutr. 2023 Aug;153(8):2421-2431. doi: 10.1016/j.tjnut.2023.06.022. Epub 2023 Jun 24.

Authors

Kate E Braddon¹, Charles Dg Keown-Stoneman², Cindy-Lee Dennis³, Xuedi Li⁴, Jonathon L Maguire⁵, Deborah L O'Connor⁶, Jessica A Omand⁷, Janis Randall Simpson⁸, Catherine S Birken⁹

Affiliations

¹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: kate.braddon@mail.utoronto.ca.
² Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
³ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
⁴ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.
⁶ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Translational Medicine, SickKids Research Institute, Toronto, Ontario, Canada; Department of Paediatrics, Mount Sinai Health, Toronto, Ontario, Canada.
⁷ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; School of Nutrition, Toronto Metropolitan University, Toronto, Ontario, Canada.
⁸ Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
⁹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: catherine.birken@sickkids.ca.

PMID: 37356500
DOI: 10.1016/j.tjnut.2023.06.022

Abstract

Background: Risk factors for problematic child eating behaviors and food preferences are thought to begin during the preconception period. It is unknown if maternal preconception body mass index (BMI) is associated with child nutritional risk factors (eg, poor dietary intake and eating behaviors).

Objectives: We aimed to determine whether maternal preconception BMI was associated with child nutritional risk.

Methods: In this longitudinal cohort study, a secondary data analysis of children ages 18 mo to 5 y were recruited from The Applied Research Group for Kids (TARGet Kids!), a primary care practice-based research network in Canada. The primary exposure was maternal preconception BMI. The primary outcome was parent-reported child nutritional risk score, measured using the Nutrition Screening for Every Preschooler/Toddler (NutriSTEP), an age-appropriate validated questionnaire. Fitted linear mixed effects models analyzed associations between maternal preconception BMI and child nutritional risk after adjusting for covariates.

Results: This study included 4733 children with 8611 repeated NutriSTEP observations obtained between ages 18 mo to 5 y. The mean (standard deviation [SD]) maternal preconception BMI was 23.6 (4.4), where 73.1% of mothers had a BMI ≤24.9 kg/m², and 26.9% had a BMI ≥25 kg/m². The mean (SD) NutriSTEP total score was 13.5 (6.2), with 86.6% at low risk (score <21) and 13.4% at high risk (score ≥21). Each 1 unit increase in maternal preconception BMI was associated with a 0.09 increase in NutriSTEP total score (95% confidence interval [CI]: 0.05, 0.12; P ≤ 0.001). After stratification, each 1 unit increase in maternal BMI was associated with a 0.06 increase in mean NutriSTEP total score (95% CI: 0.007, 0.11; P = 0.025) in toddlers and 0.11 increase in mean NutriSTEP total score (95% CI: 0.07, 0.15; P < 0.001) in preschoolers.

Conclusion: Higher maternal preconception BMI is associated with slightly higher NutriSTEP total scores. This provides evidence that the preconception period may be an important time to focus on for improving childhood nutrition. This study was registered at clinicaltrials.gov as NCT01869530.

Keywords: child eating behaviors; child nutrition; child nutritional risk; maternal body mass index; preconception health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
Child, Preschool
Feeding Behavior*
Female
Humans
Longitudinal Studies
Nutritional Status*
Risk Factors

Associated data

ClinicalTrials.gov/NCT01869530

Grants and funding

CIHR/Canada