Diet and exercise interventions before and during pregnancy could lower cardiovascular risk in children, researchers have suggested.
Scientists at King’s College London (KCL) reviewed previous studies to examine the effectiveness of health interventions in obese women such as antenatal and postnatal exercise programmes and healthy diets for unborn children and the development of cardiovascular health.
Over half of women attending antenatal clinics in England and Wales are either obese or overweight, putting their unborn children at risk of heart issues in both childhood and later life.
The findings, published in the International Journal of Obesity, could help inform public health strategies and improve the heart health of future generations, the authors said.
The researchers reviewed existing data from sources such as PubMed, Embase, and previous reviews, to determine whether lifestyle interventions in pregnant women with obesity could reduce the chance of abnormal cardiac development in their offspring. In particular, they examined how the intervention could impact changes in the shape, size, structure and function of the heart, known as cardiac remodelling, and related cardiovascular parameters.
After screening over 3,000 articles, eight studies from five randomised controlled trials were included in the review. Diet and exercise interventions introduced during these trials included antenatal exercise (n = 2), diet and physical activity (n = 2), and preconception diet and physical activity (n = 1). The children in the studies were under two months old or between the ages of three and seven.
The researchers found that lifestyle interventions in obese women could benefit the heart health of children. Interventions led to lower rates of heart wall thickening, normal heart weight and a reduced risk of high heart rates.
In all the reviewed studies, reduced cardiac remodelling and reduced interventricular septal wall thickness were reported as a result of diet and exercise interventions. In some of the studies, the interventions in diet and exercise led to improved systolic and diastolic function and a reduced resting heart rate.
Dr Samuel Burden, research associate in the Department of Women and Children’s Health at KCL, said: ‘Maternal obesity is linked with markers of unhealthy heart development in children. We reviewed the existing literature on whether diet and exercise interventions in women with obesity either before or during pregnancy can reduce the impact of this and found evidence that these interventions indeed protect against the degree of unhealthy heart development in their children.’
The researchers suggested that longitudinal studies with larger sample sizes and in older children are required to confirm these observations and to determine whether these changes persist to adulthood.
Dr Burden added: ‘If these findings persist until adulthood, then these interventions could incur protection against the adverse cardiovascular outcomes experienced by adult offspring of women with obesity and inform public health strategies to improve the cardiovascular health of the next generation.’
Evidence from The Academy of Medical Sciences earlier this year highlighted that early years health, which starts in pre-conception and goes through pregnancy and the first five years of life, is often overlooked in current policy but is crucial for laying the foundations for lifelong mental and physical health.
A version of this article was originally published by our sister publication Nursing in Practice.
