We aimed to investigate the effects of a high protein content and a low glycemic index (HPLGI) diet during pregnancy on offspring body composition and metabolic health at 9 years of age. We conducted a randomized controlled trial in pregnant women with a pre-pregnancy BMI of 28–45 kg/m2 who were randomly assigned to either an HPLGI diet or a moderate-protein, moderate-glycemic-index (MPMGI) diet. Of the 208 live-born offspring, 114 were followed up at 9 years of age. Offspring blood samples were collected following an overnight fast, and continuous glucose monitoring data were obtained for up to 14 days. Body composition was assessed using dual-energy X-ray absorptiometry and magnetic resonance imaging. Offspring in the HPLGI group exhibited 0.30 mmol/L (P = 0.033) higher total cholesterol, 0.24 mmol/L (P = 0.031) higher LDL-cholesterol, and 0.03 g/cm2 (P = 0.017) higher bone mineral density than those in the MPMGI group. LDL-cholesterol trajectories from birth to 9 years of age indicated that group differences in LDL-cholesterol increased with age and manifested later in life. Glucose homeostasis and adipose tissue mass did not differ significantly between groups. An HPLGI diet during pregnancy may negatively affect offspring total cholesterol and LDL-cholesterol. This underscores the need to investigate the long-term consequences of high-protein diets and the underlying mechanisms.

ABSTRACT Gastroenteritis is an important cause of ailment among infants in high-income countries, including Denmark. There are many cases of diarrhea among Danish children for which no etiological agent is detected. This study investigated the associations between gastroenteritis-related morbidities (diarrhea, fever, and vomiting) and gut microbial community in well-nourished, breastfeeding Danish infants. Infant stool samples, morbidity questionnaires, and diet/breastfeeding questionnaires were collected at three time points during the first 8.5 months of life. The V4-V5 region of the 16S rRNA gene was amplified from stool DNA extracts, sequenced with Illumina MiSeq, and analyzed using QIIME2. PERMANOVA, linear mixed-effects modeling, and ANCOM-BC2 were used to identify associations between infant gut microbiome and gastroenteritis-related morbidities across all visits. Logistic regression and random forest models were employed to determine whether early gut microbial alpha diversity or abundance, respectively, could predict morbidity later in infancy. Alpha diversity was negatively associated with diarrhea. Granulicatella abundance was positively associated with diarrhea. From 3.5 to 6 months of age, Bacteroidales abundance was negatively associated with fever. Faith’s phylogenetic diversity, Staphylococcales abundance, and Haemophilus abundance during 3.5 months of life were positively associated with future diarrhea during ages 3.5–8.5 months. Pielou’s evenness and Actinobacteriota abundance within 3.5 months of life had negative and positive associations, respectively, with fever during ages 3.5–8.5 months. This study reveals diarrhea is associated with stool Granulicatella in well-nourished, breastfeeding Danish infants, as it is in children from low-income countries, and that the early gut microbiome may contribute to risks of diarrhea and fever morbidities later in infancy.CLINICAL TRIALSThis trial was registered at ClinicalTrials.gov as NCT03254329.IMPORTANCEGastroenteritis continues to cause much morbidity among infants in high-income countries, and the relationship with the gut microbiome is not fully understood, especially for well-nourished and breastfeeding infants. In the study presented here, infant stool Staphylococcales abundance (comprised of Staphylococcus and Gemella) and Haemophilus abundance during the first few months of life were positively associated with later diarrhea in well-nourished and breastfeeding Danish infants. Meanwhile, the abundance of Granulicatella (a facultative anaerobe with pathogenic potential) was greater in stool from infants who had recent diarrhea, suggesting further research is needed to determine its possible role in diarrhea and recovery from diarrhea. Fever usually did not co-occur with diarrhea or vomiting. Early life Actinobacteriota abundance was positively associated with later fever. This phylum was represented here by both pathobionts (Actinomyces) and mutualists (bifidobacteria), which may have contributed to fever differently—pathobionts through infection and mutualists through promotion of effective immune response to infection.

Diet in childhood is important for growth, brain development, and long-term health. Thus, assessing children’s adherence to dietary recommendations and identifying sociodemographic groups with low adherence is of great public health relevance. We investigated dietary intake, adherence to recommendations, and sociodemographic differences in a large cohort of Danish children. We analyzed baseline data from 1094 children aged 6–9 years from 23 schools across Denmark participating in the Generation Healthy Kids study. Diet was assessed by three-day dietary records and food frequency questionnaires for fish and supplements, focusing on key food groups, macronutrients, and iron. Fasting blood samples were collected from n = 347 and analyzed for nutritional biomarkers of fish, wholegrains, and iron for validation. Overall adherence to dietary recommendations showed a mean ± SD score of 4.6 ± 1.0 out of 7.0. However, < 15

BACKGROUND:Stunting is widespread in low-income settings because of inferior quality diets and infections, which downregulate serum concentration of insulin-like growth factor-1 (serum IGF-1). Associations among plasma concentrations of amino acids (plasma AA), serum IGF-1, and growth remain underexplored in humans. OBJECTIVES:The aim of this study was to assess the role of plasma AA as a correlate of serum IGF-1, linear growth, and fat-free mass (FFM) among stunted children. METHODS:In a cross-sectional study nested in a nutrition intervention trial among 750 Ugandan children, aged 12-59 mo, with stunting, we assessed anthropometry, recent intake of animal-source foods (ASFs), fasting time, and body composition. Serum IGF-1, serum concentrations of the inflammatory markers C-reactive protein and α1-acid glycoprotein, and 21 plasma AA were measured. RESULTS:Mean (standard deviation) age and height-for-age z-score (HAZ) were 32.0 (11.7) mo and -3.02 (0.74). Plasma AA data were available for 711-730 (95%-97%) children. For 18 AA, plasma concentrations were lower among children with elevated inflammatory markers. ASF intake within 24 h was associated with few AA; meat intake was associated with higher plasma methionine, whereas cow milk and egg intake were not associated with plasma concentration of any essential AA (EAA). Nearly all plasma AA, including all EAA, were positively associated with serum IGF-1, after adjusting for fasting and markers of inflammation. Only a few plasma AA, including methionine, threonine, and valine, were associated with FFM or FFM index. Only plasma tyrosine and taurine were associated with HAZ. CONCLUSIONS:Among stunted children, most plasma AA were positive correlates of serum IGF-1, but few correlated with HAZ or FFM. Further research is needed to clarify the role of plasma AA in the complex mechanisms underlying growth faltering in malnourished children.

BACKGROUND:Human milk (HM) contains essential components that support infant growth and development; however, evidence linking HM macronutrient intake to infant growth remains minimal. OBJECTIVES:This study aimed to evaluate the longitudinal association between HM macronutrient intake and infant growth. METHODS:This study includes 833 mother-infant pairs from the 4-site Mothers, Infants and Lactation Quality study (Bangladesh, Brazil, Denmark, and The Gambia) who were followed at 1-3.49 mo (M1), 3.5-5.99 mo (M2), and 6-8.5 mo (M3). HM macronutrients were measured by near-infrared spectroscopy at M1. HM volume intake was assessed at M1 on a subset of 533 participants using the stable isotope "dose-to-mother" method, except in Denmark, where test-weighing was used. HM macronutrient intake was estimated as the product of each macronutrient concentration and HM intake. Weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and BMI-for-age (BAZ) z-scores were calculated at M1, M2, and M3, and analyzed according to WHO Growth Standards. Statistical analyses included linear mixed-effects models adjusted for site, maternal age, and BMI, infant birth weight, and sex. Interaction terms for site and Benjamini-Hochberg multiple testing comparisons were included. RESULTS:Positive longitudinal associations were observed between HM protein intake (g/d) at M1 and WAZ (β = 0.084), LAZ (β = 0.044), WLZ (β = 0.082), and BAZ (β = 0.092) between 1 and 8.5 mo. HM carbohydrate intake (g/d) at M1 was associated with higher WAZ (β = 0.034), LAZ (β = 0.016), WLZ (β = 0.036), and BAZ (β = 0.039) between 1 and 8.5 mo. Positive associations were also observed between HM lipid intake (g/d) and WAZ (β = 0.014), WLZ (β = 0.017), and BAZ (β = 0.018). Significant interactions with study site were observed for the associations between HM protein intake and LAZ in Brazil (β = 0.115) and between HM carbohydrate intake and WAZ in Bangladesh (β = 0.018), compared with The Gambia. CONCLUSIONS:These results reveal that HM macronutrient intake is positively associated with infant growth, and some associations may also be modified by site. This study was registered at clinicaltrials.gov as NCT03254329.

Undernutrition and reduced health-related quality of life (HRQoL) are common in severe chronic obstructive pulmonary disease (COPD) and may exacerbate functional decline. This study evaluated whether individualized nutritional care with adherence support improves HRQoL in individuals with severe COPD at risk of undernutrition. Secondary outcomes included physical function, anthropometry, body composition, and dietary intake. In this 3-month, single-center, open-label randomized controlled trial, 87 adults with severe COPD were randomized 1:1 to individualized nutritional care or standard care. The intervention comprised tailored dietary plans, adherence support (phone calls, reminders), optional oral nutritional supplements and weight diary. The primary outcome was HRQoL (EQ-5D-5 L). Secondary outcomes were disease-specific HRQoL (CAT), chair stand test, grip strength, anthropometry, body composition, and protein and energy intake. Analyses followed an intention-to-treat approach using linear mixed-effects models. Of 674 individuals screened, 91 were enrolled; of whom 87 completed the baseline visit; 44 received the intervention and 43 standard care, with 78 (90

BACKGROUND & AIMS:Although nutritional therapy is crucial for children undergoing allogeneic hematopoietic stem cell transplantation (HSCT) standard equations used for calculating energy requirements in healthy children may be misleading in these heavily treated patients. High-dose chemotherapy, total body irradiation, and acute graft-versus-host disease may increase energy needs, while immobilization may reduce it. This study aimed to assess energy requirements during HSCT in children and compare resting energy expenditure (REE) measured by indirect calorimetry (IC) with REE calculated using standard equations for healthy children. METHODS:We included 12 children (9 males) undergoing myeloablative HSCT for benign diseases (n = 6) or malignant disorders (n = 6). REE was measured by IC before conditioning, at day of transplant, and between days +7-14, +21-28 and beyond day +90 post transplantation, under generally standardized conditions. A planned fasting interval could not always be achieved due to clinical needs, and in 16/53 cases, measurements were performed approximately 2 h after the last meal. REE was further calculated using The Oxford Equation for REE in healthy children, based on the patients' weight at referral to transplant. Energy intake, enteral and parenteral nutrition (PN) including intravenous fluids, were recorded. RESULTS:Measured REE decreased during the early phase of transplantation, reaching a nadir at day +7-14 post-transplant (1408 vs 1154 kcal, p = 0.007), corresponding to 89.9 % of the calculated REE (75.8-93.4 %, P = 0.007), indicating a risk of overestimation of energy expenditure by the standard equation during the most toxic phase of the treatment. Dietary intake was generally reduced during the study period, with the most significant reduction observed at day 0, prior to initiation of parenteral nutrition (PN). At this time point, median intake covered 35 % of measured REE (26-52 %) and was given primarily through glucose-containing IV fluids. On day +7-14, where 92 % (11/12) of the patients received PN, measured REE requirements were covered by the diet in 50 % of patients. On day 21-28, where 50 % of patients remained on PN, 19 % of REE was met, while on day 90, when none of the patients received PN, sufficient coverage by enteral intake was observed in 7/9 patients (77 %). CONCLUSION:Our findings suggest that the standard equation for calculating REE may overestimate energy needs during the early toxic phase of pediatric HSCT. However, even with these conservative estimates based on IC measurements, energy needs are not sufficiently met in a significant proportion of the patients. Overall, this study emphasizes the importance of increased focus on individualized dietary support based on measured energy demands.

Pre-pregnancy obesity is linked to an increased risk of adverse maternal and neonatal outcomes, and an increased likelihood of offspring obesity later in life. Accumulation of visceral adipose tissue (VAT) has been reported to be more detrimental to health outcomes than generalized obesity. Therefore, we investigated the association between maternal VAT and the metabolic health of offspring at birth. This study was a secondary analysis of a dietary randomized controlled trial. Magnetic resonance imaging was performed in gestational weeks (GW) 15, 32, and at birth in a cohort of 119 pregnant women with a pre-pregnancy body mass index ranging from 28–45 kg/m2. Offspring anthropometric measurements and cord blood samples were collected at birth. Linear regression models were applied to evaluate the association between maternal VAT and offspring outcomes. Analysis of covariance was utilized to compare offspring outcomes among mothers who exhibited either an increase or a decrease in VAT volume from GW 15 to birth. Absolute maternal VAT during pregnancy was not associated with birthweight; however, women who experienced a reduction in VAT volume during pregnancy entered pregnancy with a higher VAT volume and gave birth to heavier infants by 161 grams (95

Introduction Concurrent with infants’ progression in dietary complexity and gut microbiome diversity, infants gradually change their defecation patterns during the first year of life. However, the links between bowel habits, the gut microbiota and early life nutrition remain unclear. The primary outcome is to characterise the gut microbiome development from birth to 1 year of age. Second, to investigate how bowel habits and nutrition in early life relate to the gut microbiome and metabolome during this period of life, and to explore how the development of the gut microbiome associates with host development.Methods and analysis The MOTILITY Mother-Child Cohort (MOTILITY) is a Danish prospective longitudinal cohort study enrolling up to 125 mother–infant dyads. Assessments occur at 36 weeks gestation (visit 1), birth (screening of infant) and 3, 6, 9 and 12 months (±2 weeks) post partum (visits 2–5). At visit 1, maternal anthropometrics, self-collected faecal and urine samples, and questionnaires on bowel habits and lifestyle are obtained. Between visits, infant faecal (biweekly), urine (monthly) and maternal breast milk (monthly until 6 months of age) samples are collected at home, and bowel habits and dietary intake are assessed biweekly by self-reported questionnaires. At visits 2–5, infant blood and saliva samples are collected, and anthropometric measurements are obtained. In addition, dietary intake is recorded thrice throughout the study period for mother and infant, respectively, and infant whole-gut transit time is estimated by sweet corn tests at 9 and 12 months of age. Birth, growth, motor development, sleep patterns, tooth development, overall health and well-being are assessed using questionnaires. Univariate and multivariate statistics will be applied to identify associations between the gut microbiome, early life nutrition and host physiology including bowel habits during the first year of life.Ethics and dissemination The MOTILITY study has been approved by the Research Ethics Committee for the Capital Region of Denmark (reference number: H-21063016). Selected results will be made available to the participants in the form of a summary document. Results will be published in peer-review journals and by means of national and international conferences.Trial registration number NCT05491161.

OBJECTIVES:To examine the effects of lipid-based nutrient supplements (LNS) containing milk protein (MP) and/or whey permeate (WP) on markers of intestinal inflammation and enterocyte mass among stunted children. Furthermore, to explore whether gut status modifies effects of LNS on growth and micronutrient status. METHODS:In a 2 × 2 factorial trial 12-59 months-old Ugandan children with stunting were randomized to four LNS formulations (100 g/day for 12 weeks) containing MP or soy protein and WP or maltodextrin, or to no supplementation. Linear mixed-effects models were used to explore faecal myeloperoxidase (f-MPO) and plasma citrulline (p-cit) as outcomes and modifiers of the intervention effects (ISRCTN13093195). RESULTS:Of 750 children, mean ± SD age was 32.0 ± 11.7 months and height-for-age Z-score was -3.02 ± 0.74. Neither MP nor WP had effects on p-cit or f-MPO. f-MPO decreased over time among controls (ratio of change 0.54, 95% confidence interval [CI]: 0.35, 0.84), but not among those given LNS (0.99, 95% CI: 0.79, 1.23) (p = 0.016). In contrast, LNS had no effect on p-cit (p = 0.27). The effect of LNS on cobalamin (B12) status was reduced in children with p-cit <20 µmol/L; whereby there was 20% (95% CI: 2, 35) lower increase in plasma cobalamin and 59% (95% CI: 13, 125) smaller decrease in plasma methylmalonic acid. p-cit or f-MPO did not modify the effects of LNS on growth or other micronutrient markers. CONCLUSION:LNS had no effect on enterocyte mass and possibly increased intestinal inflammation. The effect of LNS on cobalamin status was reduced in those with low enterocyte mass.

Children with stunting are at risk of infections. We assessed the effect of lipid-based nutrient supplement (LNS) on morbidity in children with stunting. This was a secondary analysis of a randomized, 2×2 factorial trial among 12–59 months-old, stunted children in Uganda. Children were randomized to LNS containing milk or soy protein and whey permeate or maltodextrin, or no supplementation, for 12 weeks. The outcomes were caregiver-reported morbidity after 2, 4, 8 and 12 weeks, serum C-reactive protein (S-CRP), α1-acid glycoprotein (S-AGP), and phase-angle (PhA) by bioimpedance. Of 750 children, mean (SD) age was 32.0 (11.7) months, 55% (n = 412) were male. LNS increased diarrhoea prevalence (18.1% vs 7.3%, P = 0.001) during the first two weeks, but not thereafter. There was no effect of LNS on cough or fever. LNS resulted in greater decline in S-AGP (−0.10 g/L, 95% CI: −0.17, −0.03, P = 0.003) but not S-CRP (25%, 95% CI: −11, 74, P = 0.193), and greater increase in PhA (0.10 degrees, 95% CI: 0.01, 0.18, P = 0.030), explained by greater fat-free mass. Milk compared to soy protein in LNS resulted in higher PhA (0.10 degrees, 95% CI: 0.02, 0.17, P = 0.013), not explained by fat-free mass. LNS supplementation in children with stunting had no effect on morbidity but resulted in a small reduction in sub-acute systemic inflammation. The possible effect of LNS supplementation on inflammation in stunted children requires further evaluation. ( www.isrctn.com : ISRCTN13093195).

OBJECTIVE:The study objective was to evaluate changes in abdominal adipose tissue and ectopic fat during pregnancy and their associations with gestational weight gain (GWG) in women with overweight/obesity. METHODS:This study was a secondary analysis of a randomized controlled trial. Magnetic resonance scans were performed during gestational week (GW) 15, GW 32, and around birth to measure abdominal subcutaneous (SAT) and visceral (VAT) adipose tissues, liver fat, and muscle fat. Linear mixed models and multivariable linear regression analyses were utilized, adjusting for prepregnancy BMI, parity, and randomization. RESULTS:Among 119 women, VAT and SAT decreased from GW 15 to GW 32 but rebounded at birth; final levels were lower than at GW 15. Liver fat and muscle fat did not change significantly. GWG was positively associated with changes in SAT but not with those in VAT, liver fat, or muscle fat. CONCLUSIONS:This study demonstrates dynamic changes in abdominal fat depots during pregnancy in women with overweight/obesity. The observed reduction in VAT and SAT during pregnancy and the association of GWG with SAT suggest that weight gain during pregnancy may be less metabolically harmful than outside pregnancy. Future research should investigate the mechanisms and long-term effects on maternal and child health.

Pregnancy and lactation change women’s body composition (BC), but few longitudinal studies have investigated postpartum BC trajectories. We aimed to investigate maternal and infant predictors of maternal body fat (BF), fat mass (FM), fat-free mass (FFM) and BMI trajectories during lactation. Longitudinal study with 234 Brazilian mother–infant dyads followed at 1·0–3·49, 3·5–5·99 and 6·0–8·5 months postpartum. Maternal BC was estimated using bioelectrical impedance at all follow-up points. Longitudinal mixed–effects models with interaction terms with time (weeks postpartum) were employed. FFM declined significantly over weeks postpartum ( β = −0·02 kg; 95 % CI –0·03, −0·01). Pre-pregnancy overweight women experienced an increase in all body components (BF: β = 4·91 %, 95 % CI 3·79, 6·04; FM: β = 6·46 kg, 95 % CI 5·26, 7·67; FFM: β = 3·72 kg, 95 % CI 2·80, 4·65) and BMI ( β = 4·51 kg/m 2 , 95 % CI 3·91, 5·12). Multiparous women showed BMI increases ( β = 0·76 kg/m 2 , 95 % CI 0·11, 1·41), and those who delivered by caesarean had FFM ( β = 1·87 kg, 95 % CI 0·67, 3·07) and BMI ( β = 1·39 kg/m 2 , 95 % CI 0·61, 2·18) increases. Women who birthed girls had reductions in FM ( β = −1·24 kg, 95 % CI –2·41, −0·07) and FFM ( β = −0·93 kg, 95 % CI –1·84, −0·01). Interactions occurred between maternal age ≥ 30 years, higher family income, multiparity and infant sex for BC and BMI trajectories. Maternal age, pre-pregnancy BMI, parity, family income, mode of delivery and infant sex predict maternal BC and BMI trajectories.

Pregnancy and lactation change women's body composition (BC), but few longitudinal studies have investigated postpartum BC trajectories. We aimed to investigate maternal and infant predictors of maternal body fat (BF), fat mass (FM), fat-free mass (FFM) and BMI trajectories during lactation. Longitudinal study with 234 Brazilian mother-infant dyads followed at 10-349, 35-599 and 60-85 months postpartum. Maternal BC was estimated using bioelectrical impedance at all follow-up points. Longitudinal mixed-effects models with interaction terms with time (weeks postpartum) were employed. FFM declined significantly over weeks postpartum (beta = -002 kg; 95 % CI -003, -001). Pre-pregnancy overweight women experienced an increase in all body components (BF: beta = 491 %, 95 % CI 379, 604; FM: beta = 646 kg, 95 % CI 526, 767; FFM: beta = 372 kg, 95 % CI 280, 465) and BMI (beta = 451 kg/m2, 95 % CI 391, 512). Multiparous women showed BMI increases (beta = 076 kg/m2, 95 % CI 011, 141), and those who delivered by caesarean had FFM (beta = 187 kg, 95 % CI 067, 307) and BMI (beta = 139 kg/m2, 95 % CI 061, 218) increases. Women who birthed girls had reductions in FM (beta = -124 kg, 95 % CI -241, -007) and FFM (beta = -093 kg, 95 % CI -184, -001). Interactions occurred between maternal age >= 30 years, higher family income, multiparity and infant sex for BC and BMI trajectories. Maternal age, pre-pregnancy BMI, parity, family income, mode of delivery and infant sex predict maternal BC and BMI trajectories.

Background:A deficient vitamin D status is linked to increased risk of community-acquired pneumonia (CAP) and both short- and long-term mortality. Given small sizes of previous studies and lack of adjustment for key confounders, we aimed to investigate the association between vitamin D status (sufficient, insufficiency, or deficiency) and mortality risk in adults hospitalized with CAP. Methods:This study, nested within the Surviving Pneumonia Study at Copenhagen University Hospital-North Zealand, Denmark, included adults hospitalized with CAP between 2019 and 2022. Vitamin D status was assessed using serum 25(OH)D concentrations, categorizing participants as sufficient (≥50 nmol/L), insufficient (25-<50 nmol/L), or deficient (<25 nmol/L). Logistic regression was used to assess mortality risk. Covariates included age, sex, Charlson comorbidity index, CURB-65, smoking history, and BMI. Results:Among 514 participants, 29 (5.6%) and 130 (25.3%) had deficient and insufficient vitamin D status, respectively. Participants with deficient vitamin D status were younger, and more than 50% were current smokers. Vitamin D deficiency was associated with higher 90-day (OR: 3.50, 95% CI 1.01; 12.21) and 180-day (OR: 3.27, 95% CI 1.04; 10.25) mortality risk compared with participants with sufficient vitamin D status, while no difference was observed between the sufficient and insufficient group. No differences were observed for in-hospital or 30-day mortality. Conclusions:Participants with deficient vitamin D status were younger and faced higher mortality risk despite milder disease at admission. Given that vitamin D deficiency may relate to poorer health habits and low levels of other micronutrients, trials on tailored micronutrient supplementation during acute conditions like CAP could be considered.

Maternal pre-pregnancy BMI and excessive gestational weight gain (GWG) are associated with offspring obesity. Moreover, maternal dietary patterns, particularly protein intake and glycemic index, influence GWG and fetal development. This study aimed to investigate the association of a high-protein, low-glycemic-index (HPLGI) diet during pregnancy with offspring growth and obesity. Using observational data from the Danish National Birth Cohort, a target trial emulation was conducted to investigate the association of an HPLGI diet during pregnancy on offspring growth up to 18 years of age. A cohort of 17,551 women who met the inclusion criteria was categorized into exposure groups based on their protein intake and glycemic index to emulate the groups in the APPROACH trial. Maternal characteristics varied between the exposure groups, with the HPLGI women exhibiting 1.67 kg higher pre-pregnancy weight and 0.49 kg/m2 BMI, with no differences in GWG. Offspring outcomes were assessed at various ages, and a linear mixed model was used, including potential confounders. Offspring born to women following an HPLGI diet during pregnancy had 2.59 kg higher body weight and 0.72 kg/m2 higher BMI at 18 years compared to those from the moderate-protein, moderate-glycemic-index (MPMGI) group. An HPLGI diet during pregnancy was associated with higher offspring body weight and BMI at 18 years of age compared to an MPMGI diet. These findings suggest that maternal dietary composition during pregnancy may have long-term implications for offspring growth and obesity risk, underscoring the importance of evaluating dietary recommendations during pregnancy.