The Impact of Lifestyle, Diet and Physical Activity on Epigenetic Changes in the Offspring—A Systematic Review

Nutrients
Q1
Aug 2021
Citations:32
Influential Citations:0
Systematic Reviews / Meta-Analyses
81
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Methods
Systematic review of randomized controlled trials and cohort studies (English or Scandinavian languages). Included 16 studies with 3,617 participants; pregnant women and their offspring. Study designs included 5 RCTs and 11 cohorts. Exposures encompassed lifestyle, diet and physical activity during pregnancy. Tissues studied included placenta, cord blood, saliva, and other neonatal samples. Paternal exposures were not identified. Offspring follow-up included birth and later ages up to 40 years in some studies. Risk of bias varied; RoB2 used for RCTs and CASP for cohorts.
Intervention
Extra virgin olive oil; 3 tablespoons per day; during pregnancy; added to regular diet.
Results
Sixteen studies (5 RCTs, 11 cohorts) with 3,617 participants show that maternal lifestyle, diet and physical activity during pregnancy can be associated with offspring epigenetic changes, primarily DNA methylation and, less commonly, miRNA in placenta and cord blood. Genome-wide methylation changes occurred in cord blood in some interventions; gene-specific methylation changes were observed for genes such as GR, HSD2, IGF-2, MEG3, H19, RXRA and PLAG1. Diets such as low glycemic index, Mediterranean diet, and higher carbohydrate intake were linked to methylation changes at multiple CpG sites. One low GI diet trial reported widespread methylation changes; an olive oil supplement trial showed changes in placental methylation signatures. Several findings did not remain significant after adjusting for multiple tests, and study quality varied. Overall, there may be an association between maternal lifestyle during pregnancy and offspring epigenetic marks, with potential implications for obesity, diabetes and inflammatory conditions later in life; however, evidence is heterogeneous and not yet sufficient to guide clinical recommendations. Paternal exposures were not studied; larger, well-designed studies including preconception and paternal factors are needed to clarify causality and health relevance.
Limitations
Heterogeneous exposures and outcomes across studies; small-to-moderate sample sizes and variable methodological quality; inconsistent control for confounders; reliance on self-reported dietary data; diverse tissues analyzed; limited preconception/periconception exposure data; no paternal exposure data; observational designs predominate; no meta-analysis due to heterogeneity.

Abstract

Aims: This systematic review examines the association between maternal lifestyle, diet and physical activity, and epigenetic changes in the offspring. Methods: A literature search was conducted using multiple science databases: PubMed, Embase and Coc...