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Does the impact of a plant-based diet during pregnancy on birthweight differ by ethnicity?

Published online by Cambridge University Press:  05 October 2018

M.A. Zulyniak ,
R.J. de Souza ,
M. Shaikh ,
D. Desai ,
D.L. Lefebvre ,
M. Gupta ,
J. Wilson ,
G. Wahi ,
P. Subbarao  and
A.B. Becker
...Show all authors
M.A. Zulyniak
Affiliation:
Department of Medicine, McMaster University, Canada School of Food Science and Nutrition, University of Leeds, LS17 5BL
R.J. de Souza
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
M. Shaikh
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
D. Desai
Affiliation:
Department of Medicine, McMaster University, Canada Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada
D.L. Lefebvre
Affiliation:
Department of Medicine, McMaster University, Canada
M. Gupta
Affiliation:
Department of Medicine, McMaster University, Canada Canadian Cardiovascular Research Network, Canada
J. Wilson
Affiliation:
Six Nations Health Services, Canada
G. Wahi
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada Department of Paediatrics, McMaster University, Canada
P. Subbarao
Affiliation:
Hospital for Sick Children & Department of Paediatrics, University of Toronto, Canada
A.B. Becker
Affiliation:
Department of Immunology, Faculty of Medicine, University of Manitoba, Canada
P. Mandhane
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Canada
S.E. Turvey
Affiliation:
BC Children's Hospital, Department of Paediatrics, Faculty of Medicine, University of British Columbia, Canada.
J. Beyene
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
S. Atkinson
Affiliation:
Department of Paediatrics, McMaster University, Canada
K. Morrison
Affiliation:
Department of Paediatrics, McMaster University, Canada
S. McDonald
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
K.K. Teo
Affiliation:
Department of Medicine, McMaster University, Canada Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada
M.R. Sears
Affiliation:
Department of Medicine, McMaster University, Canada
S.S. Anand
Affiliation:
Department of Medicine, McMaster University, Canada Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada
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Abstract

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Birthweight is an indicator of newborn health(Reference Mikolajczyk, Zhang and Betran1) and a strong predictor of health outcomes in later life, including cardiovascular disease, diabetes, and obesity(Reference Nordman, Voutilainen and Laitinen2). Significant variation in dietary intake during pregnancy between ethnic groups(Reference de Souza, Zulyniak and Desai3) provides an ideal opportunity to investigate the influence of maternal diet on birthweight. We aimed to investigate the impact of maternal dietary patterns on birthweight in four multi-ethnic birth cohorts in Canada.

We analyzed 3,997 full-term mother-infant pairs from diverse ethnic groups. Multivariable regression was used to test the association between 3 principal component analysis-derived diet patterns (plant-based, Western, health-conscious) and birthweight. The foods comprising significant diet patterns were investigated to identify key foods contributing to this association.

No associations were identified between the Western and health-conscious diet patterns and birthweight; however, the plant-based dietary pattern was inversely associated with birthweight (β = −67·6 g per 1-unit increase; P < 0·001) and an interaction with non-white ethnicity and birthweight was present. Ethnically stratified analyses demonstrates that among white Europeans, maternal consumption of a plant-based diet associated with lower birthweight (β= −65·9 g per 1-unit increase; P < 0·001), increased risk of small for gestational age (SGA; OR = 1·46; 95 %CI: 1·08–1·54; P = 0·005), and reduced risk of large for gestational age (LGA; OR = 0·71; 95 %CI: 0·53–0·95; P = 0·02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birthweight (β = +40·5 g per 1-unit increase; P = 0·01), partially driven by cooked vegetable consumption.

Fig. 1.

Multivariable regression between maternal adherence to a plant-based diet (higher score reflects greater adherence) and birthweight in white Europeans (dashed line; n = 2,367) and South Asians (solid line; n = 884). Dotted line is the 95 % confidence interval.

In conclusion, maternal consumption of a plant-based diet during pregnancy is associated with birthweight. Among white Europeans, a plant-based diet is associated with lower birthweight, reduced odds of an infant born LGA, and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birthweight.

References

1.Mikolajczyk, RT, Zhang, J, Betran, AP, et al. (2011) Lancet 377, 1855–1861.Google Scholar
2.Nordman, H, Voutilainen, R, Laitinen, T, et al. (2015) Horm Res Paediatr 85, 11–17.Google Scholar
3.de Souza, RJ, Zulyniak, MA, Desai, D, et al. (2016) J Nutr 146, 2343–2350.Google Scholar
Figure 0

Fig. 1. Multivariable regression between maternal adherence to a plant-based diet (higher score reflects greater adherence) and birthweight in white Europeans (dashed line; n = 2,367) and South Asians (solid line; n = 884). Dotted line is the 95 % confidence interval.