Maternal pre-pregnancy dietary patterns were selectively associated with body composition in preschool children: the processed meat-dairy pattern was associated with higher fat mass, while the grain-vegetable-fruit and vegetable-legume patterns were associated with lower muscle indices.
Key Findings
Methods
Five distinct maternal pre-pregnancy dietary patterns were identified via principal component analysis from food frequency questionnaire data.
The five patterns were: animal-based food, grain-vegetable-fruit, processed meat-dairy, vegetable-legume, and cured vegetable.
Dietary intake was assessed for the month before pregnancy using a food frequency questionnaire.
The study comprised 582 mother-child pairs from the Taicang and Wuqiang Mother-Child Cohort Study (TAWS).
Standardized pattern scores (mean = 0, SD = 1) were analyzed both as continuous variables (per 1-SD increase) and categorized into quartiles (Q1-Q4).
Results
The processed meat-dairy dietary pattern was positively associated with fat mass index (FMI) in preschool children.
In multivariable-adjusted models, Q4 vs. Q1 of the processed meat-dairy pattern was associated with higher FMI (β = 0.262, 95% CI: 0.036 to 0.488).
Body composition was measured by bioelectrical impedance analysis in children aged 3-6 years.
The association remained significant after adjustment for child characteristics, maternal sociodemographic and gestational factors, family factors, feeding mode, and other dietary patterns.
No significant association was found between the processed meat-dairy pattern and other body composition indicators after adjustment.
Results
The grain-vegetable-fruit dietary pattern was inversely associated with fat-free mass index (FFMI) and skeletal muscle index (SMI) in preschool children.
Q4 of the grain-vegetable-fruit pattern was associated with lower FFMI (β = -0.265, 95% CI: -0.510 to -0.020).
Q4 of the grain-vegetable-fruit pattern was also associated with lower SMI (β = -0.256, 95% CI: -0.564 to -0.113).
These associations were observed in multivariable-adjusted models.
No significant association was observed for percent body fat (PBF) or FMI with this pattern after adjustment.
Results
The vegetable-legume dietary pattern was associated with higher percent body fat (PBF) and lower skeletal muscle index (SMI) in preschool children.
Q3 of the vegetable-legume pattern was associated with higher PBF (β = 0.234, 95% CI: 0.007 to 0.461).
Q4 of the vegetable-legume pattern was associated with lower SMI (β = -0.338, 95% CI: -0.564 to -0.113).
The authors noted that these associations should be interpreted with caution and 'should not be regarded as negative effects of plant-based diets.'
These associations were observed in multivariable-adjusted models.
Results
No significant associations were found for the animal-based food or cured vegetable dietary patterns with body composition outcomes after multivariable adjustment.
Both the animal-based food pattern and the cured vegetable pattern showed no significant associations with any body composition indicator (PBF, FMI, FFMI, or SMI) in fully adjusted models.
This indicates that adjustment for confounders attenuated any crude associations observed for these patterns.
Multiple linear regression was used under two models: an unadjusted model and a multivariable-adjusted model.
Results
Child sex significantly modified the association between the animal-based food pattern and both FFMI and SMI, with associations in opposite directions for boys and girls.
The p-value for interaction between child sex and the animal-based food pattern was 0.048 for FFMI and 0.013 for SMI.
Sex-stratified analyses revealed that the direction of association differed between boys and girls.
Interaction terms were introduced to test for potential effect modification by child sex and maternal pre-pregnancy BMI.
Results
Maternal pre-pregnancy BMI significantly modified the association between the processed meat-dairy pattern and skeletal muscle index (SMI).
The p-value for interaction between maternal pre-pregnancy BMI and the processed meat-dairy pattern for SMI was 0.032.
Maternal pre-pregnancy BMI did not significantly modify associations between any other dietary pattern and body composition outcomes.
This was the only significant effect modification by maternal pre-pregnancy BMI identified across all dietary pattern-body composition associations.
What This Means
This research suggests that what mothers eat in the month before becoming pregnant may be linked to their children's body composition during the preschool years (ages 3-6). Using data from 582 mother-child pairs in China, researchers found that mothers who ate more processed meats and dairy products before pregnancy tended to have children with higher fat mass. Mothers who ate diets rich in grains, vegetables, and fruits, or diets high in vegetables and legumes, tended to have children with lower muscle mass measurements, though the researchers caution that this does not mean plant-based diets are harmful to children's muscle development.
The study also found that a child's sex mattered: the relationship between the mother's animal-based food consumption and the child's muscle-related body composition measures went in opposite directions for boys versus girls. Additionally, the mother's own pre-pregnancy weight status (BMI) influenced how her processed meat and dairy intake related to her child's muscle index. These findings suggest the relationship between maternal diet and child body composition is complex and may vary by both the child's sex and the mother's starting weight.
This research suggests that the nutritional environment before conception may have lasting effects on how children's bodies develop, a concept sometimes called 'developmental programming.' However, the study is observational, meaning it cannot prove that maternal diet directly caused the differences in children's body composition — other unmeasured factors could be involved. The findings highlight the potential importance of preconception nutrition as a period that may influence offspring health, though further research is needed to confirm these associations and understand the underlying mechanisms.
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Zhang Q, Zhao Y, Duan Y, Luo G, Duan J, Liu C. (2026). Associations Between Maternal Pre-Pregnancy Dietary Patterns and Body Composition in Preschool Children: A Prospective Cohort Study.. Nutrients. https://doi.org/10.3390/nu18172895