The Journal of nutrition · 2026
Early-pregnancy calcium and protein intake are associated with newborn bone mineral density in women with obesity.
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Ammundsen Anna A, Krak Emma, Schmidt Pernille, Halldórsson Thórhallur I, Mølgaard Christian, Vaag Allan A, Nørgaard Kirsten, Carlsen Emma M, Brøns Charlotte, Renault Kristina M
Аннотация
BACKGROUND: Maternal vitamin D status, calcium and protein intake during pregnancy may influence offspring bone health. However, these associations are poorly understood in women with obesity, who are often advised to restrict dietary intake.
OBJECTIVE: To examine associations between maternal vitamin D status, calcium and protein intake in early and late pregnancy and newborn areal bone mineral density (aBMD) among women with obesity.
METHODS: In the Treatment of Obese Pregnant Women (TOP) study, 231 offspring underwent dual-energy X-ray absorptiometry scans within 48 hours after birth to assess aBMD. Analyses included 218 and 208 mother-newborn dyads with dietary data and 175 and 171 dyads with maternal vitamin D data in early and late pregnancy, respectively. Maternal calcium and protein intake were assessed by validated food frequency questionnaires (FFQ) at gestational weeks 11-14 and 36-37, and maternal serum 25-hydroxyvitamin D concentrations were measured at weeks 18-20 and 28-30.
RESULTS: Offspring of mothers in the lowest calcium intake quartile in early pregnancy had 4.1% lower BMD than those in the highest intake quartile (P = 0.028). Moderate protein intake (15.1-17.1% of total energy intake (E%)) was associated with 6.2% higher newborn BMD compared with intake <15 E% (P = 0.001). No associations were observed for late-pregnancy intake or maternal vitamin D status.
CONCLUSIONS: Lower maternal calcium intake and moderate protein intake during early pregnancy were associated with differences in newborn BMD, with lower BMD at low calcium intake and higher BMD at moderate protein intake levels in women with obesity.
OBJECTIVE: To examine associations between maternal vitamin D status, calcium and protein intake in early and late pregnancy and newborn areal bone mineral density (aBMD) among women with obesity.
METHODS: In the Treatment of Obese Pregnant Women (TOP) study, 231 offspring underwent dual-energy X-ray absorptiometry scans within 48 hours after birth to assess aBMD. Analyses included 218 and 208 mother-newborn dyads with dietary data and 175 and 171 dyads with maternal vitamin D data in early and late pregnancy, respectively. Maternal calcium and protein intake were assessed by validated food frequency questionnaires (FFQ) at gestational weeks 11-14 and 36-37, and maternal serum 25-hydroxyvitamin D concentrations were measured at weeks 18-20 and 28-30.
RESULTS: Offspring of mothers in the lowest calcium intake quartile in early pregnancy had 4.1% lower BMD than those in the highest intake quartile (P = 0.028). Moderate protein intake (15.1-17.1% of total energy intake (E%)) was associated with 6.2% higher newborn BMD compared with intake <15 E% (P = 0.001). No associations were observed for late-pregnancy intake or maternal vitamin D status.
CONCLUSIONS: Lower maternal calcium intake and moderate protein intake during early pregnancy were associated with differences in newborn BMD, with lower BMD at low calcium intake and higher BMD at moderate protein intake levels in women with obesity.