Background and aims
Maternal diet and chronic inflammation may influence early-life offspring health. No comparative data regarding parental or intergenerational associations between dietary inflammation and offspring growth exist. We investigated potential associations between maternal, paternal and grandparental dietary inflammatory index (DII®) with offspring birth outcomes and childhood adiposity.

Methods
This analysis of the Lifeways Cross-Generation Cohort Study includes 1082 mother-child pairs, 333 index-child’s fathers and 707 grandparents. Energy-adjusted DII (E-DII) scores were derived from a validated FFQ for expectant mothers, fathers and up to four grandparents. Birth outcomes were abstracted from hospital records. Childhood BMI was determined at age 5 and 9 years. Logistic regression and mediation analyses were performed.

Results 
After adjustment for confounders, higher maternal E-DII scores, reflecting a more pro-inflammatory diet, were associated with increased risk of low birth weight (LBW) (OR:1.20; 95% CI:1.02-1.47; P=0.03).  Higher maternal grandmothers’ (MGM) E-DII scores were associated with increased risk of macrosomia (OR 1.35, 95% CI 1.02-1.79, P=0.03). Higher paternal and paternal grandmothers’ (PGM) E-DII scores were associated with greater risk of childhood overweight/obesity at 5 years (OR: 1.03; 95% CI:1.01-1.19; P=0.04 and OR: 1.07; 95% CI:1.05-1.09; P=0.01, respectively). The association with the PGMs’ E-DII persisted at age 9 (OR:1.13; 95%CI:1.01-1.90; P=0.04). Mediation analysis results were inconclusive; a significant total effect was found only between MGM E-DII scores and grandchild’s BW

Conclusions
Dietary inflammation is associated with adverse offspring birth outcomes and childhood adiposity. A more pro-inflammatory maternal line diet appears to influence early-life growth whereas the paternal line influences childhood weight status.

ASSOCIATIONS OF DIETARY INFLAMMATORY INDEX WITH BIRTH OUTCOMES AND WEIGHT STATUS AT AGE 5 AND 9: RESULTS FROM THE LIFEWAYS CROSS-GENERATION COHORT STUDY