The Association between Maternal Folate Status and Childhood Obesity-Systematic Review and Meta-Analysis

The Association between Maternal Folate Status and Childhood Obesity-Systematic Review and Meta-AnalysiPURPOSE: Maternal nutrition plays a crucial role in fetal growth and lifelong health outcomes. Folate is an essential methyl donor in the epigenetic programming of offspring. This review and meta-analysis was conducted to compile the evidence reported thus far to identify associations between maternal folate status and childhood obesity.METHODS: A keyword/reference search was performed in EBSCOhost and Web of Science databases. A CMA program was used for a meta-analysis to estimate the pooled effect of maternal folate status on childhood obesity in offspring and to examine the influence of moderating variables on the overall effect.RESULTS: Better maternal folate intake was associated with a lower risk of childhood obesity: the overall effect size (ES; Hedges’ g) was 0.168 (95% CI=0.075 to 0.260, p<.001; small effects; cf., Cohen’s criteria). Moderator analysis revealed that the ≥Q statistic for the age group was statistically significant (Qb=4.730, df=1. p=.030; heterogeneity of ES). In offspring <7 years and >7 years, the ES was 0.277 (95% CI=0.151, 0.404) and 0.089 (95% CI=-0.025, 0.202), respectively. The study design was a statistically significant variable (Qb=4.310, df=1. p=.038; heterogeneity of ES). In cohort studies, ES was 0.251 (95% CI=0.135, 0.367), whereas in randomized controlled trial group, ES was 0.062 (95% CI=-0.073, 0.197).CONCLUSIONS: Maternal folate intake significantly affects childhood obesity, and the effect of maternal folate status is stronger inchildren younger than 7 years.