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Background <p>Neonatal obesity has profound effects across the entire life. Although maternal diet and environmental exposures such as high altitude are potential influencing factors, the modulating effects of the unique high-altitude environment and distinct ethnic dietary patterns prevalent on the Tibetan Plateau remain unexplored. To investigate this association, we utilized Compositional Data Analysis (CoDA) to model dietary patterns.</p> Aim <p>This study aims to investigate the associations between maternal dietary patterns during pregnancy and neonatal obesity, examining the potential modification effect by altitude and ethnicity. Furthermore, we apply the CoDA approach to quantify the impact of dietary redistribution on obesity risk. The findings are expected to inform targeted dietary interventions and public health strategies for high-risk populations.</p> Method <p>A birth cohort study encompassed 1173 pregnant women from the Tibetan Plateau. Dietary intake frequency during pregnancy was assessed using the food frequency questionnaire. Principal component analysis was used to identify the dietary patterns. Linear and logistic regression was used to examine the associations between dietary patterns and neonatal obesity. CoDA was employed to assess the association between redistribution of diet servings during pregnancy and altered risk of high ponderal index (HPI).</p> Results <p>Of the total 1173 mother-neonate pairs, 40.3% were Tibetans, 22.7% resided in ultra-high altitude areas, and 4.9% of neonates had obesity. Four dietary patterns were identified. A higher protein-fruit pattern score was significantly associated with a lower risk of HPI (OR = 0.66, 95% CI 0.47–0.93). We also observed a modification effect by altitude (<i>P</i><sub>interaction</sub> = 0.026). Stratified by living altitude, this association was statistically significant only in Tibetans who lived in ultra-high altitude areas (OR = 0.39, 95% CI 0.20–0.69, <i>P</i> = 0.003). Composition of data analysis showed that when fruit consumption increased, estimated Δβ of HPI and z-score of ponderal index (PI) decreased.</p> Conclusion <p>Higher adherence to protein-fruit dietary patterns during pregnancy was negatively associated with neonatal obesity in the Tibetans living in ultra-high altitude areas. Encouraging healthy diets during pregnancy, particularly through initiatives such as increasing fruit intake, may help to prevent neonatal obesity.</p>

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Associations of maternal dietary patterns during pregnancy with neonatal obesity among Han and Tibetan maternal-child pairs: results from a prospective birth cohort in Tibetan area

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Xiao Tang,
  • Bin Zhang,
  • Wenxiu Jian,
  • Keting Zhou,
  • Pinhua Wang,
  • Jiangcuo Zhaxi,
  • Xuejun Wang,
  • Liehong Wang,
  • Xiaozhong Wen,
  • Lei Zhao,
  • Wen Peng

摘要

Background

Neonatal obesity has profound effects across the entire life. Although maternal diet and environmental exposures such as high altitude are potential influencing factors, the modulating effects of the unique high-altitude environment and distinct ethnic dietary patterns prevalent on the Tibetan Plateau remain unexplored. To investigate this association, we utilized Compositional Data Analysis (CoDA) to model dietary patterns.

Aim

This study aims to investigate the associations between maternal dietary patterns during pregnancy and neonatal obesity, examining the potential modification effect by altitude and ethnicity. Furthermore, we apply the CoDA approach to quantify the impact of dietary redistribution on obesity risk. The findings are expected to inform targeted dietary interventions and public health strategies for high-risk populations.

Method

A birth cohort study encompassed 1173 pregnant women from the Tibetan Plateau. Dietary intake frequency during pregnancy was assessed using the food frequency questionnaire. Principal component analysis was used to identify the dietary patterns. Linear and logistic regression was used to examine the associations between dietary patterns and neonatal obesity. CoDA was employed to assess the association between redistribution of diet servings during pregnancy and altered risk of high ponderal index (HPI).

Results

Of the total 1173 mother-neonate pairs, 40.3% were Tibetans, 22.7% resided in ultra-high altitude areas, and 4.9% of neonates had obesity. Four dietary patterns were identified. A higher protein-fruit pattern score was significantly associated with a lower risk of HPI (OR = 0.66, 95% CI 0.47–0.93). We also observed a modification effect by altitude (Pinteraction = 0.026). Stratified by living altitude, this association was statistically significant only in Tibetans who lived in ultra-high altitude areas (OR = 0.39, 95% CI 0.20–0.69, P = 0.003). Composition of data analysis showed that when fruit consumption increased, estimated Δβ of HPI and z-score of ponderal index (PI) decreased.

Conclusion

Higher adherence to protein-fruit dietary patterns during pregnancy was negatively associated with neonatal obesity in the Tibetans living in ultra-high altitude areas. Encouraging healthy diets during pregnancy, particularly through initiatives such as increasing fruit intake, may help to prevent neonatal obesity.