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Background: Offspring of obese rodents develop a metabolic phenotype that favors fat deposition. Data regarding the impact of maternal obesity programing of offspring fuel usage in humans is scarce.

Objective: The objective of this study was to explore the association between maternal weight status and dietary palmitate oxidation (DPO) in 2-y-old offspring, taking into consideration potential confounders and modifiers.

Methods: Women (n = 56) were enrolled by the first trimester of gestation. Maternal physical activity (PA; measured with accelerometers) at enrollment and gestational weight gain (GWG) were measured. Offspring sex, race, and breastfeeding (BF) duration were self-reported. Human milk (HM) composition was determined at 6 mo postpartum. At age 2 y, dietary quality [healthy eating index (HEI)] and parental feeding practices [Child Feeding Questionnaire (CFQ)] were assessed. DPO in 2-y-olds (2-yo-DPO) was measured using deuterated palmitic acid. Generalized linear regression analysis was used to model the associations of 2-yo-DPO with maternal weight status [normal weight (NW), BMI <25 (in kg/m2) compared with excessive weight (EW), BMI >=25].

Results: DPO was higher in offspring of women with EW compared with NW (2.1 /- 1.2%/h compared with 1.4 /- 0.7%/h, P = 0.03). Maternal weight status interacted with BF duration in association with 2-yo-DPO (log [beta]: 0.05, P = 0.04). Specifically, 2-yo-DPO was higher in the EW compared with NW group if BF duration was >=9 mo. HM insulin (log [beta]: 0.35, P = 0.002) and HM leptin (log [beta]: 0.81, P = 0.001) concentrations directly associated with 2-yo-DPO. PA (log [beta]: 0.06, P = 0.013), parental feeding restriction (log [beta]: 0.05, P < 0.0001), and male sex (log [beta]: 0.54, P < 0.001) were positively associated with 2-yo-DPO. HEI was negatively associated with 2-yo-DPO (log [beta]:-0.03, P < 0.0001).

Conclusions: Higher 2-yo-DPO in offspring of women with EW compared with NW were driven by BF duration. Higher HM insulin and leptin concentrations in women with EW may explain these finding. More studies are needed to confirm these results. This trial was registered at clinicaltrials.gov as NCT03281850.

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