Maternal diet during pregnancy can induce developmental adaptations that permanently alter offspring physiology and metabolism. Fetal programming is an important risk factor for obesity- and adiposity-related noncommunicable diseases in adult life. The influence of maternal dietary protein during pregnancy on offspring phenotype and health is generating research interest. Both low-protein (LP)⁴ and higher-protein (HP) diets during pregnancy have been associated with detrimental effects on offspring, suggesting a quadratic (U-shaped) relation and that macronutrient ratio may influence offspring health and disease. Research evaluating the optimal macronutrient ratio is required. In this issue of the Journal, Maslova et al present observations from a prospective Danish birth cohort of pregnant women recruited in 1988–1989 with offspring follow-up at age 19–21 y. This study is novel because it examines the long-term impact of maternal protein intake and protein quality during pregnancy on offspring anthropometric measures and biomarkers of adiposity and glucose metabolism. The study observed associations between higher maternal intakes of animal protein when substituted for carbohydrate [ie, higher animal protein-to-carbohydrate (P:C) ratio] with higher offspring BMI, primarily among females.This relation strengthened when models were adjusted for maternal age, education, parity, prepregnancy BMI, smoking, and sibling overweight. However, no associations were found between maternal protein intake and waist circumference or biomarkers of adiposity. Mean maternal protein intake [16% of energy (%E)] was comparable to that reported by pregnant women in developed countries. However, large variations in protein intake (9.5–40%E) during pregnancy have been recorded.
American Journal of Clinical Nutrition Vol. 100, Issue 4, p. 993-995