Plasma ω-3 fatty acids in pregnancy are inversely associated with postpartum weight retention in a multiethnic Asian cohort1,2

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Abstract

Background: Studies have demonstrated associations between polyunsaturated fatty acids (PUFAs) and adiposity. It is unclear whether PUFAs in pregnancy have an effect on maternal weight retention after childbirth, which can contribute to long-term obesity.

Objective: We examined the association of maternal plasma PUFAs in pregnancy with 18-mo postpartum weight retention (PPWR) in a multiethnic Asian cohort.

Design: We studied pregnant women (n = 653) recruited between June 2009 and September 2010 from a prospective cohort. At 26–28 wk of gestation, plasma phosphatidylcholine PUFA concentrations were measured and determined as percentages of total fatty acids (FAs). PPWR was calculated based on the difference between measured weight at the first antenatal clinic visit and at 18 mo postpartum.

Results: The median retained weight of women was 0.90 kg (IQR: −1.40, 3.25) at 18 mo postpartum. Of 653 women, 544 women (83.3%) had PPWR of <5 kg and 109 (16.7%) had PPWR of ≥5 kg. In adjusted linear regression models, higher plasma eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total ω-3 (n–3) PUFA concentrations were associated with lower PPWR [EPA: β = −0.62 kg/1% increase of total FAs (95% CI: −1.18, −0.05); DHA: β = −0.24 kg/1% increase (95% CI: −0.45, −0.02); total ω-3 PUFAs: β = −0.20 kg/1% increase (95% CI: −0.36, −0.03)], whereas a higher ratio of plasma ω-6-to-ω-3 PUFAs was associated with a higher PPWR [β = 0.21 kg/unit increase (95% CI: 0.05, 0.36)].

Conclusions: Higher plasma percentages of ω-3 PUFAs and a lower ratio of ω-6-to-ω-3 PUFAs in the late-second trimester of pregnancy are associated with less weight retention at 18 mo postpartum. This may offer an alternative strategy to assist postpartum weight reduction by increasing EPA and DHA status together with a decreased ratio of ω-6-to-ω-3 PUFA through diet or fish-oil supplementation during pregnancy. This study was registered at clinicaltrials.gov as NCT01174875.

Keywords

adiposity
obesity
polyunsaturated fatty acids
postpartum weight
pregnancy

ABBREVIATIONS

AA
arachidonic acid
ALA
α-linolenic acid
GDM
gestational diabetes mellitus
GUSTO
Growing Up in Singapore Towards healthy Outcomes
GWG
gestational weight gain
LA
linoleic acid
PPWR
postpartum weight retention.

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Supported by the Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council, Singapore (NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014). Additional funding was provided by the Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore. YBC is supported by the National Research Foundation, Singapore, under its Clinician Scientist Award (NMRC/CSA/0039/2012) administered by the Singapore Ministry of Health’s National Medical Research Council. KMG and PCC are supported by the National Institute for Health Research through the National Institute for Health Research Southampton Biomedical Research Centre. KMG is supported by the European Union’s Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition under grant agreement 289346. JKYC received salary support from the Ministry of Health’s National Medical Research Council, Singapore (NMRC/CSA/043/2012).

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Supplemental Tables 1 and 2 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.