A supply-demand model of fetal energy sufficiency predicts lipid profiles in male but not female Filipino adolescents

Objective: To test the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply during pregnancy will predict lipid profiles in offspring measured in adolescence. Subjects and methods: A total of 296 male and 307 female Filipino offspring (aged 14-16 y) and mothers enrolled in a longitudinal birth cohort study (begun in 1983-84) had lipid profiles measured. Data on maternal height (as a proxy for offspring growth potential and thus fetal nutritional demand) and third trimester maternal arm fat area (as a proxy for maternal supply) were used to create four groups hypothesized to reflect a gradient of fetal energy sufficiency. Results: As fetal energy sufficiency increased among males, there was a decrease in total cholesterol (TC) (P<0.05 for trend), low-density lipoprotein cholesterol (LDL-C), and the ratios of TC/HDL-C cholesterol and LDL-C/HDL-C (all P<0.001), while HDL-C increased (P<0.05). Similar associations were identified when lipid levels were modeled as dichotomous 'high-risk' cut-points used in cardiovascular disease prevention in adolescents. These relationships were stronger, or only present, among offspring of mothers in the lower half of the third trimester energy intake distribution, and were independent of the child's current adiposity, dietary energy and fat intake, maturity, household income, and birth weight. In females, the supply-demand model did not predict any lipid outcome or clinical risk criteria. Conclusions: Our findings in males support the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply has implications for future lipid profiles. The lack of significant associations in females adds to mounting evidence for sex differences in lipid metabolism programming, and may reflect sex differences in fetal nutritional demand. Sponsorship: The National Science Foundation, the Mellon Foundation, the Nestle Foundation, and the Emory University Internationalization Program.