Objectives:Prenatal and early life factors such as Gestational Diabetes Mellitus (GDM), exclusive breastfeeding (EBF), and early exposure to sugar-sweetened beverages (SSBs) may contribute to obesity in children. The relationship of EBF and SSBs with obesity prevalence in children exposed to GDM has rarely been evaluated. This study examined the association of EBF and early SSBs consumption with obesity prevalence in children (1-5y) born to mothers with and without GDM.

Methods:This study used data from the 2014 Los Angeles County Women, Infants, and Children(WIC) Survey, which included 3,707 mothers and their children (1-5y). Infants (1-2y) with weight-for-height ≥ 97.7percentile were classified as subjects with high weight-for-length and children (2-5y) were classified as subjects with obesity if their BMI-for-age was ≥ 95percentile.

Results:The individual and combination interaction effects of GDM, SSBs intake, and EBF on obesity prevalence were all significant ( < 0.05). Compared to GDM offspring, with low SSBs intake, and who were EBF (referent), those who were GDM, with high SSBs intake and who were EBF had approximately a five-fold increase in odds of obesity (OR = 4.77, 95%CI 1.55-8.60, = 0.03). Compared to the GDM referent group, GDM offspring who were not EBF with low and high SSBs intake had 4.3- and 4.4-times higher odds of obesity, respectively (OR = 4.33, 95%CI 1.42- 8.07, = 0.01; OR = 4.38, 95%CI 1.39- 8.16, = 0.01). Using non-GDM, EBF and low SSBs as referent, those who were not EBF, with either high or low SSBs had approximately a 4-fold increase in odds of obesity (OR = 3.62, 95%CI: 2.16-6.05, < 0.0001; OR = 3.83, 95%CI: 2.26-6.48, < 0.0001).Compared to the non-GDM referent group, those who were EBF and had high SSBs intake had 77% higher odds of obesity (OR = 1.77, 95%CI 0.93-3.37, = 0.001).

Conclusions:In non-GDM offspring, EBF was protective against odds of obesity in both high and low SSBs consumers. In GDM offspring, EBF was only protective against obesity when SSBs intake was low. Surprisingly, GDM offspring who were EBF and had high SSBs consumption had a 4- to 5-fold increase in odds of obesity compared to those not EBF with either low or high SSBs intake. These results suggest that interventions should focus on the combined protective effects of EBF and low SSBs intake, particularly in GDM offspring.

Funding Sources:First 5 LA.

BACKGROUND:This study assessed whether aerobic exercise would attenuate microvascular endothelial dysfunction induced by commercial sugar-sweetened beverage (SSB) consumption.

METHODS:Eleven healthy males participated in this randomized, single-blind crossover study. Cutaneous microvascular endothelial function was assessed using laser speckle contrast imaging coupled with post-occlusive reactive hyperemia before and after a) consumption of water; b) consumption of a commercial SSB; c) 30min of aerobic exercise followed by water consumption; and d) 30 minutes of aerobic exercise followed by SSB consumption. Blood glucose and arterial pressure responses were also monitored. Volumes of water and SSB consumed (637.39±29.15 mL) were individualized for each participant, ensuring SSB consumption delivered 1 g of sucrose per kg of body weight. Exercise was performed at 75% of the maximal oxygen uptake heart rate.

RESULTS:Compared to water consumption, the commercial SSB elevated blood glucose concentrations in both sedentary (4.69±0.11 vs. 7.47±0.28 mmol/L, P<0.05) and exercised states (4.95±0.13 vs. 7.93±0.15 mmol/L, P<0.05). However, the decrease in microvascular endothelial function observed following sedentary SSB consumption, expressed as the percentage increase from baseline (208.60±22.40 vs. 179.83±15.80%, P=0.01) and the change in peak hyperemic blood flux from basal to post-intervention assessments (-0.04±0.03 vs. -0.12±0.02 ΔCVC, P=0.01), was attenuated following 30min of aerobic exercise.

CONCLUSIONS:To our knowledge, this is the first study to provide evidence that a single bout of aerobic exercise may prevent transient SSB-mediated microvascular endothelial dysfunction.