Childhood obesity has become a public health crisis in recent years. Studies suggest that early life influences (both during and after pregnancy) affect a child's risk of becoming obese. Obesity puts children at higher risk for developing chronic disease later in life such as Diabetes, Cardiovascular Disease, and high blood pressure.  The Healthy Start Study aims to investigate how the decisions that women make while pregnant (e.g. diet, physical activity, smoking) and their environment during pregnancy affect their children's fatness (adiposity), and therefore risk of other chronic disease later in life.  1,410 ethnically diverse pregnant women were recruited from obstetrics clinics at the University of Colorado Hospital to participate in the Healthy Start Study. 

Collecting observational data about moms during pregnancy and their children throughout the first 3 years of life has allowed Healthy Start investigators to publish the following papers:


The purpose of this report is to estimate the associations between women with and without obesity before pregnancy and the weight these women gained during pregnancy with infant fatness (adiposity). It was found that women with obesity before pregnancy and women who gained more weight than suggested (relative to recommendations by the Institute of Medicine) after the first trimester are both associated with fatter babies.

What does this mean for you and public health?

These findings suggest that women who gain more weight than suggested by the IOM during pregnancy may subject their children to overnutrition in utero. This overnutrition may put infants at higher risk of having obesity through their early years of life. Long-term follow-up of participants of the Healthy Start Study is needed to confirm this.   


The purpose of this report is to evaluate the associations between maternal fuels (blood sugar and free fatty acids) and insulin resistance (decreased ability to regulate blood sugar), both during the first half and second half of pregnancy, with infant fatness. The results demonstrate that in the first half of pregnancy, a higher insulin resistance is associated with fatter infants. During the second half of pregnancy, higher blood glucose and free fatty acids levels are associated with infant fatness as well.   


In this report, it is hypothesized that greater maternal exposure to multivitamin supplementation will be associated with greater infant size at birth and an increased rate of growth in the first 5 months of life for both total weight and percent body fat (adiposity). However, the results demonstrated no association between prenatal multivitamin supplementation with increased infant size (fat-free mass) at birth or within the first months of life.

What does this mean for you and public health?

The results also showed that increased prenatal multivitamin supplementation is associated with a slower relative growth in percent fat in infants. From these results, we can infer that in a population similar to ours (Western USA), increased prenatal multivitamin supplementation during pregnancy may have no effect on infant body size and composition.  


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The hypothesis for this analysis is that pregnant women who meet certain standards for diet quality, physical activity levels, and mental health status during early to midpregnancy are at a decreased risk of abnormal blood glucose levels. After analysis, it was found that physical activity level was associated with reduced risk of abnormal blood glucose, while diet quality and mental health status were not associated with a decreased risk. When all 3 modifiable factors were examined together, pregnant women who met these standards were at a 73% reduced risk of abnormal blood glucose levels. 

What does this mean for you and public health?

These results suggest that pregnant women who maintain moderate physical activity, diet quality, and healthy mental health status all during early to midpregnancy are at a lower risk of abnormal blood glucose levels, which in turn may reduce the risk of developing gestational diabetes. 


The goal of this report is to test the hypothesis that infants born to women with a low quality diet (based on the Healthy Eating Index) have increased fatness (adiposity). It also aims to assess whether or not a high diet quality prevents infant fatness regardless of maternal obesity before pregnancy. The results of this analysis revealed the association between a mother's poor diet quality during pregnancy and higher infant fatness, regardless of whether or not a woman has obesity before becoming pregnant.

What does this mean for you and public health?

The results of this analysis highlights the importance of healthy dietary interventions during pregnancy on infant body composition and health. 


The aim of this report is to estimate the associations between second and third trimester maternal blood pressure changes (in women who do not have chronic high blood pressure) with infant birth weight and body composition. Results of this analysis found that greater increases in blood pressure (systolic and diastolic) are associated with increased risk of infants being born small for gestational weight. Furthermore, infant fat mass and fat free mass were lower among infants whose mothers had an increased blood pressure between the second and third trimester of pregnancy.

What does this mean for you and public health?

Research has shown that infants born small for gestational age are at an increased risk for future chronic disease. Increases in maternal blood pressure from the second to the third trimester of pregnancy may put infants at higher risk to be born small for gestational age, although long-term follow-up studies are needed to confirm this. 

 


The hypothesis for this report is that increased intake of Niacin (a form of vitamin B), along with a high fat diet during pregnancy, will increase infant fatness at birth. Results of this analysis found that there was no significant relationship between Niacin intake during pregnancy and infant fatness at birth, whether or not paired with a high fat diet. It was found, however, that a high fat diet during pregnancy was significantly associated with infant fatness at birth.

What does this mean for you and public health?

The findings of this analysis demonstrate that maternal diet during pregnancy, especially with regards to high fat foods, may need to be regulated to prevent infants from being born with high percent body fat. 

The aim of this analysis is to test the hypothesis that infants who are exposed to smoking in utero will exhibit "catch-up growth" (compensation for the growth restriction associated with smoking during pregnancy) with higher fast mass and fat free mass compared to infants not exposed to smoke in utero when measured at birth and at 3-9 months after birth. The results of this analysis showed that exposure to smoke in utero was associated with smaller fat mass and fat free mass at birth. However, at the 3-9 month follow-up, babies exposed to smoke in utero had significantly greater fat free mass than babies who were unexposed to smoke, suggesting there is rapid postnatal growth for exposed babies.

What does this mean for you and public health?

Findings in previous studies suggest that "catch-up growth" is associated with a risk of early-life developmental changes that predispose infants to obesity later in life. The results of this analysis may indicate that maternal smoking while pregnant may increase the risk of "catch-up growth," and therefore risk of obesity later in life.