Inflammatory potential of diet and health outcomes in pregnancy, infancy, and childhood

Diet-associated inflammation affects health outcomes in pregnancy and throughout childhood. Pregnancy is a sophisticated physiological process during which significant transformations occur in the maternal immune system to ensure a successful pregnancy and birth. Excessive systemic and chronic inflammation and immune activation in pregnancy have been linked to adverse maternal pregnancy outcomes that are associated with higher morbidity and mortality during childhood, higher risk of noncommunicable diseases in the child's adult life, and related socioeconomic and healthcare costs. Therefore, identifying potential modifiable determinants of adverse pregnancy, birth, and childhood outcomes is of paramount importance to improving maternal and child health. Maternal diet is an important modifiable behavior, which not only plays an important role in maternal health but also influences neonatal and child health outcomes. We describe the relationship between maternal dietary inflammatory index (DII) and pregnancy outcomes, including gestational weight gain, hypertensive disorders of pregnancy, mode of delivery, gestational diabetes mellitus, breastfeeding outcomes, breast milk composition, and spontaneous abortion. Next, we address the intergenerational influence of maternal DII in pregnancy on offspring health outcomes. We examine the evidence regarding maternal DII associations with offspring birth outcomes, focusing on gestational length, preterm birth, birthweight, and related measures. Further, we examine the long-term associations between maternal DII and a range of offspring health outcomes during childhood. Finally, we turn our attention to childhood dietary inflammation, as determined by the C-DII, and its associations with childhood growth, adiposity, respiratory health, and neurodevelopment. We conclude with some thoughts regarding the current state of the art and look to the future regarding new research avenues.