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. Study data can be made available upon request to the corresponding author under usual cohort procedures (). Cohort consent specifically precludes deposition of this data into public repositories as NHS II and GUTS participants agreed to participate only if data were made available to cohort investigators and external researchers after vetting.

中文翻译：

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母亲食用超加工食品以及随后的后代超重或肥胖的风险：三项前瞻性队列研究的结果

目的 评估母亲在围孕期和育儿期摄入超加工食品是否与后代儿童期和青春期超重或肥胖的风险相关。设计基于人群的前瞻性队列研究。在美国开展护士健康研究 II (NHSII) 和今日成长研究 (GUTS I 和 II)。参与者 19 958 名母子（45% 是男孩，研究登记时年龄为 7-17 岁），中位随访时间为 4 年（四分位数间距 2-5 年），直至 18 岁或出现超重或肥胖，包括2925 对母子的子样本，包含围孕期饮食信息。主要结果测量 使用具有广义估计方程和可交换相关结构的多变量调整对数二项式模型来解释兄弟姐妹之间的相关性，并估计国际肥胖工作组定义的后代超重或肥胖的相对风险。结果 在完整的分析队列中，有 2471 名 (12.4%) 后代出现超重或肥胖。在调整已确定的母亲危险因素和后代的超加工食品摄入量、体力活动和久坐时间后，母亲在育儿期间食用超加工食品与后代超重或肥胖相关，其中后代的风险增加 26%。产妇超加工食品消费量最高的组（第 5 组）与消费量最低的组（第 1 组；相对风险 1.26，95% 置信区间 1.08 至 1.47，趋势 P<0.001）。在包含围孕期饮食信息的子样本中，虽然比率较高，但围孕期超加工食品摄入量与后代超重或肥胖风险增加并无显着相关性（n=845 (28.9%)；第 5 组与第 1 组：相对风险1.17，95% 置信区间 0.89 至 1.53，趋势 P=0.07）。这些关联不会因年龄、性别、出生体重、后代孕龄或母亲体重而改变。结论 母亲在育儿期间食用超加工食品与后代超重或肥胖的风险增加相关，与母亲和后代生活方式危险因素无关。需要进一步的研究来证实这些发现并了解潜在的生物机制和环境决定因素。这些数据支持完善膳食建议和制定改善育龄妇女营养以促进后代健康的计划的重要性。根据通常的队列程序，可以根据通讯作者的要求提供研究数据（）。队列同意明确禁止将这些数据存储到公共存储库中，因为 NHS II 和 GUTS 参与者只有在审查后向队列研究人员和外部研究人员提供数据的情况下才同意参与。