Pro-inflammatory diet in pregnancy tied to diabetes in offspring

Pro-inflammatory diet in pregnancy tied to diabetes in offspring | Image Credit: © vaaseenaa - stock.adobe.com.Pro-inflammatory diet in pregnancy tied to diabetes in offspring | Image Credit: © vaaseenaa - stock.adobe.com.

A maternal diet characterized by high intake of pro-inflammatory foods during pregnancy may increase the risk of type 1 diabetes in offspring, according to findings from a large prospective cohort study in Denmark published in the Journal of Epidemiology & Community Health.^1,2

Researchers evaluated data from 67,701 mother-child pairs enrolled in the Danish National Birth Cohort (DNBC) between 1996 and 2002. The study excluded mothers with pre-existing diabetes or implausible dietary reports. Maternal diet was assessed at approximately 25 weeks of gestation using a comprehensive 360-item food frequency questionnaire. An empirical dietary inflammatory index (EDII) score was calculated to quantify the inflammatory potential of each participant’s diet, with higher scores indicating a more pro-inflammatory dietary pattern.

Over an average follow-up period of 17.6 years, 281 children (0.42%) were diagnosed with type 1 diabetes. The investigators observed a statistically significant association between maternal EDII score and the risk of type 1 diabetes in offspring. Each 1 standard deviation increase in the EDII score was associated with a 16% increased hazard (adjusted HR, 1.16; 95% CI, 1.02–1.32) of type 1 diabetes diagnosis during childhood or adolescence.

“A low-grade inflammatory state secondary to an altered immune cell profile, which triggers pro-inflammatory pathways, is increasingly acknowledged as a critical early-life factor influencing offspring health,” the authors wrote.

The EDII score was derived using reduced rank regression and weighted based on associations between specific food group intake and circulating C-reactive protein (CRP) concentrations, using data from a similar Nordic cohort. Diets high in red or processed meats, low-fat dairy, pizza, French fries, margarine, and savory snacks were associated with higher EDII scores. Conversely, higher intake of alliums, tomatoes, whole grains, fruits, vegetables, tea, and dark meat fish contributed to lower (anti-inflammatory) EDII scores.

Higher EDII scores were also associated with other maternal characteristics such as younger age, higher body mass index (BMI), smoking beyond 12 weeks of pregnancy, lower alcohol consumption, shorter breastfeeding duration, and lower socioeconomic status. However, total energy intake did not significantly differ across EDII quintiles.

Importantly, the observed association between a pro-inflammatory diet and type 1 diabetes remained robust after adjusting for multiple potential confounders, including maternal age, BMI, smoking status, socioeconomic status, breastfeeding duration, and energy intake. Additional analyses indicated that gluten intake during pregnancy was also independently associated with elevated type 1 diabetes risk in offspring (HR per 10 g/day increase, 1.36; 95% CI, 1.09–1.71). In contrast, continued smoking during pregnancy was associated with a reduced risk (HR, 0.47; 95% CI, 0.31–0.72).

“Of particular note is the fact that three factors during mid-pregnancy, a pro-inflammatory dietary pattern, gluten, and smoking, seemed to independently predict the child’s risk of type 1 diabetes,” the authors stated. “This suggests that mid-pregnancy may be a critical period during which the fetus is particularly susceptible to maternal lifestyle influences in relation to the individual’s later risk for developing type 1 diabetes during childhood or adolescence.”

While the findings support the role of fetal programming in the development of autoimmune disease, the authors acknowledge limitations. As an observational study, causality cannot be established. Additionally, the child’s own diet postnatally was not assessed, and residual confounding from unmeasured factors remains possible.

Nevertheless, the study adds to a growing body of evidence linking maternal dietary exposures during pregnancy to long-term metabolic and immune outcomes in children. The authors concluded that further studies are warranted to replicate these findings and elucidate underlying biological mechanisms.

References:

1. BMJ Group. ‘Inflammatory’ diet during pregnancy may raise child’s diabetes type 1 risk. Eurekalert. July 1, 2025. Accesed July 9, 2025. https://www.eurekalert.org/news-releases/1089224?

2. Rohina Noorzae, Bjerregaard AA, Thorhallur Ingi Halldorsson, et al. Association between a pro-inflammatory dietary pattern during pregnancy and type 1 diabetes risk in offspring: prospective cohort study. Journal of Epidemiology & Community Health. Published online July 1, 2025:jech-223320. doi:https://doi.org/10.1136/jech-2024-223320