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Maternal consumption of ultra-processed foods and subsequent risk of offspring overweight or obesity: Results from three prospective cohort studies

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Wang, Yiqing, Wang, Kai, Du, Mengxi, Khandpur, Neha, Rossato, Sinara Laurini, Lo, Chun-Han, VanEvery, Hannah, Kim, Daniel Y +7 more·2022·BMJ
DOI 10.1136/bmj-2022-071767PMC PMC9533299
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Abstract

Objective: To assess whether maternal ultra-processed food intake during peripregnancy and during the child rearing period is associated with offspring risk of overweight or obesity during childhood and adolescence. Design: Population based prospective cohort study. Setting: The Nurses’ Health Study II (NHSII) and the Growing Up Today Study (GUTS I and II) in the United States. Participants: 19 958 mother-child (45% boys, aged 7-17 years at study enrollment) pairs with a median follow-up of 4 years (interquartile range 2-5 years) until age 18 or the onset of overweight or obesity, including a subsample of 2925 mother-child pairs with information on peripregnancy diet. Main outcome measures: Multivariable adjusted, log binomial models with generalized estimating equations and an exchangeable correlation structure were used to account for correlations between siblings and to estimate the relative risk of offspring overweight or obesity defined by the International Obesity Task Force. Results: 2471 (12.4%) offspring developed overweight or obesity in the full analytic cohort. After adjusting for established maternal risk factors and offspring’s ultra-processed food intake, physical activity, and sedentary time, maternal consumption of ultra-processed foods during the child rearing period was associated with overweight or obesity in offspring, with a 26% higher risk in the group with the highest maternal ultra-processed food consumption (group 5) versus the lowest consumption group (group 1; relative risk 1.26, 95% confidence interval 1.08 to 1.47, P for trend<0.001). In the subsample with information on peripregnancy diet, while rates were higher, peripregnancy ultra-processed food intake was not significantly associated with an increased risk of offspring overweight or obesity (n=845 (28.9%); group 5 v group 1: relative risk 1.17, 95% confidence interval 0.89 to 1.53, P for trend=0.07). These associations were not modified by age, sex, birth weight, and gestational age of offspring or maternal body weight. Conclusions: Maternal consumption of ultra-processed food during the child rearing period was associated with an increased risk of overweight or obesity in offspring, independent of maternal and offspring lifestyle risk factors. Further study is needed to confirm these findings and to understand the underlying biological mechanisms and environmental determinants. These data support the importance of refining dietary recommendations and the development of programs to improve nutrition for women of reproductive age to promote offspring health.

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  • Higher maternal consumption of ultra-processed foods is associated with higher risk of offspring overweight or obesity through adolescence in three US prospective cohorts.

    “Across three US prospective cohorts, the Nurses’ Health Study II (NHSII) and the Growing Up Today Study (GUTS I and II) in the United States, higher maternal consumption of ultra-processed foods was associated with higher risk of offspring overweight or obesity through adolescence.”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [95]

  • Because the exposure period in the ultra-processed food analysis was not limited to pregnancy and peripregnancy analyses were limited, the findings are better viewed as reflecting broader family dietary patterns and the link between pregnancy diet and the child's later food environment.

    “However, because the exposure period was not limited to pregnancy and analyses around the peripregnancy period were limited, these findings are better viewed as reflecting broader family dietary patterns and the link between pregnancy diet and the child’s later food environment [95].”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [95]

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Authors
Wang, Y., Wang, K., Du, M., Khandpur, N., Rossato, S. L., Lo, C.-H., VanEvery, H., Kim, D. Y., Zhang, F. F., Chavarro, J. E., Sun, Q., Huttenhower, C., Song, M., Nguyen, L. H., & Chan, A. T.
Affiliations
  • Harvard University (US)
  • Tufts University (US)
  • Brigham and Women's Hospital (US)
  • Broad Institute (US)
Corresponding author
Chan, Andrew T
ORCID
Venue
BMJ
Publisher
BMJ
Published
2022-10-05
Volume
379
Pages
e071767
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj-2022-071767
PMC
PMC9533299
OpenAlex
W4302028034
Cited by
55
References
3
Citations by year
2026: 10 · 2025: 22 · 2024: 16 · 2023: 7
FWCI
9.93
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • American Gastroenterological Association
  • American Cancer Society
  • Massachusetts General Hospital
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
ultra-processed foods, maternal diet, childhood obesity, adolescent obesity, parenting, maternal obesity, maternal weight, maternal physical activity, sedentary time, Nurses' Health Study II, Growing Up Today Study, mother-child pairs, sibling correlation, dietary exposure assessment
MeSH terms
Adolescent, Diet, Female, Humans, Male, Obesity, Prospective Studies, Cohort Studies, Body Mass Index, Overweight, Fast Foods, Pediatric Obesity

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