Maternal Diet and Child Development

Maternal metabolic abnormalities and nutrition may influence long-term infantile neurodevelopment. In this study by Saros et al. (2023), the authors looked into how food, obesity, and gestational diabetes mellitus (GDM) in mothers may impact the neurodevelopment of 2-year-old kids. Tools like the third edition of the Bayley Scale of Infant and Toddler Development (BSID) and the Hammersmith Infant Neurological Examination were used to evaluate the neurodevelopment of 243 children born to mothers who were overweight or obese. Air displacement plethysmography was used to measure maternal adiposity, and an oral glucose tolerance test was used to measure GDM. Dietary evaluation methods comprised three-day food diaries from which dietary inflammatory index (DII®) scores, diet quality, and fish intake questionnaires were calculated. Analysis of the results revealed that GDM was linked to poorer expressive language abilities and higher maternal obesity was linked to children's poorer cognitive, language, and motor skills. Better expressive language abilities were associated with elevated maternal dietary quality and greater fish intake. On the other hand, children's neurodevelopment and DII scores were unrelated. Findings imply that, although neurodevelopmental skills in this cohort of children were still within the mean normal range, GDM and more significant maternal obesity may contribute to lower skills. The authors conclude that a child's language development may be aided by a healthy diet and increased fish consumption during pregnancy. [NPID: Gestational diabetes, obesity, diet, neurodevelopment, pregnancy, language, motor skills]

The aim of this 2018 study was to find out whether expecting mothers’ adherence to the Mediterranean diet can influence the child’s behavioral outcomes in the future. To attain Mediterranean diet scores, the study used the answers to the food frequency questionnaires completed by the participants. In addition, toddlers were examined on social and emotional skills at 1-2 years old using the Infant Toddler Social and Emotional Assessment (ITSEA) questionnaire. The results indicated an inverse relationship between child depression and maternal adherence to the Mediterranean diet. Compared to the offspring of women in the lowest tertile for Mediterranean diet adherence (MDA) scores, those of women in the medium and high tertile for MDA scores had lower risk of atypical behaviors, maladaptive behaviors, and an index of autism spectrum disorder behaviors. Furthermore, these children of mothers in the highest MDA category were less likely to show depressive and anxiety behaviors, and more likely to exhibit social relatedness, when compared with children of mothers in the low MDA score category. With regards to the methylated DNA regions, perinatal MDA score was found to be linked with methylation differences for imprinted control regions of PEG10/SGCE, MEG3, and IGF2 in males. To summarize these findings, maternal adherence to a Mediterranean diet in early pregnancy was associated with favorable neurobehavioral outcomes in early childhood. [NPID: maternal diet, pregnancy, childbirth, behaviors, children, toddlers, diet, Mediterranean diet, dietary pattern, autism spectrum disorder, anxiety, depression]

This 2016 review investigates whether a mother’s nutritional status before and during pregnancy has influence over the cognitive ability of the child. Since the mother is in fact the only source of nutrition for the offspring before childbirth, the hypothesis is that the mothers’ height, weight, and diet can potentially predict the cognitive function of the baby. This review considered maternal BMI, height, weight, micronutrient status (vitamins D, B12, folate and iron), and macronutrient intakes (carbohydrate, protein, and fat). Any measure of cognitive function in children under the age of 18 constituted as an outcome. After a systematic search for observational studies and trials, two reviewers independently extracted data from relevant articles, finding 38 studies that met the inclusion criteria. While there were a few randomized controlled trials, most of the studies were observational and from high-income settings. Maternal obesity was consistently linked with lower cognitive capacity in children. Two of the three studies investigating maternal vitamin D status showed lower cognitive function in children of deficient mothers. Articles on folic acid supplementation had mixed results, with one demonstrating no difference in child cognitive performance between deficient and non-deficient mothers. Most studies analyzing maternal vitamin B12 status also showed no association, although there were two suggesting that low vitamin B12 levels may have an effect. Four out of six observational studies and two trials discovered no correlation between maternal iron status and offspring cognitive function. Lastly, no cognitive effect was found in one trial exploring maternal carbohydrate/protein supplementation. Based on the current evidence, it could not be concluded whether maternal nutritional status during pregnancy (BMI, single micronutrient or macronutrient consumption) influences child cognitive function. Further investigation is encouraged, particularly in areas where maternal malnutrition is prevalent. [NPID: malnutrition, nutrition, vitamins, supplements, micronutrients, macronutrients, nutrients, pregnancy, pregnant, mother, obesity, diet, cognition, cognitive, brain]

Pang et al. (2020) investigated whether types of milk feeding and mode of breastmilk feeding influences child cognition. This study collected the data from the GUSTO (Growing Up in Singapore Toward Healthy Outcomes) cohort, which repeatedly assessed the healthy children on their neurodevelopment at 6 to 54 months. Results showed that compared to infants that were fed only formula, those bottle-fed on breast milk scored better on both the Bayley Scales of Infant and Toddler Development at 2 years old and on the Kaufman Brief Intelligence Test at 4.5 years old. Moreover, these kids that received bottled breast milk demonstrated better gross motor skills at 2 years than those fed formula. But among the infants that were fully fed breast milk, those fed directly at the breast scored higher on several memory tasks compared to children bottle-fed breast milk (in the deferred imitation task at 6 months and relational binding tasks at both 6 and 54 months). The data suggests that nutrients obtained through breast milk may enhance the children’s general cognition, while nursing infants directly at the breast may also positively affect memory. [NPID: maternal diet, child development, postpartum depression, breastmilk, child cognition, Singapore, neurodevelopment, toddlers, toddler development, memory]

The purpose of this 2018 study was to evaluate whether the maternal diet during pregnancy can influence the child’s mental health outcomes such as hyperactivity-inattention symptoms and conduct problems at 3 to 8 years old. Using a French cohort study called EDEN, Galera et al. analyzed the data of 1,242 mother-child pairs that were followed up from pregnancy until the children were 8 years of age. The kids were assessed at 3, 5, and 8 years old on the externalizing behavior using the Strength and Difficulties Questionnaire. These answers were then used to indicate any hyperactivity-inattention symptoms and conduct problems experienced by the children. The results demonstrated that the maternal 'low Healthy diet' and 'high Western diet' during pregnancy correlated with increased symptoms of hyperactivity-inattention in the children. While expecting mothers consuming these aforementioned diets were independently associated with children's hyperactivity-inattention symptoms, there were no marked links with conduct problems. [NPID: maternal diet, child development, postpartum depression, pregnancy, hyperactivity, ADHD, Western-style diet, WS diet, behavioral problems, conduct problems]

Emmett et al. (2015) reviewed all publications concerning diet during pregnancy that were based on the Avon Longitudinal Study of Parents and Children. Diet differences, namely in dietary patterns and intakes of certain foods and nutrients, were linked to maternal educational attainment, smoking habits, and financial difficulty. According to the dietary data from the food frequency questionnaires, the pregnant participants barely obtained key nutrients such as iron, magnesium, potassium, and folate from their meals. Maternal diet during pregnancy was also predictive of the offspring’s diet at childhood. There were additional benefits of consuming fish during pregnancy, which lowered the frequency of intrauterine growth retardation, and maternal depressive and anxiety symptoms. In addition to this, maternal fish consumption correlated with better neurocognitive development of the child. These positive effects were attributed to the n-3 polyunsaturated fatty acids and iodine components of the fish. In conclusion, the Avon Longitudinal Study of Parents and Children data alludes to the benefits of eating fish during pregnancy. [NPID: maternal diet, child development, postpartum depression, pregnancy, obesity, brain development, fetal brain development, dietary patterns, fish consumption, fish, anxiety, depression, fatty acids, neurocognitive development, iodine, fish]

Since obesity and high-fat diets are interlinked with higher systemic levels of inflammatory mediators, Bolton & Bilbo (2014) reviewed the evidence that the brain and behaviors are programmed by perinatal (immediately before or after birth) diet via inflammatory mechanisms. It is believed that maternal obesity and the consumption of a high-fat diet during gestation/lactation may result in increased risk of the child being obese and developing mood disorders. If inflammation is present early in life, this can permanently change the course of fetal brain development. This is explained by the disruption of the delicate balance between growth factors or neurotransmitters and the immune molecules, which have roles in placental function and brain development. The review hypothesizes that external influences on inflammatory pathways (the perinatal environment) are likely to cause further alterations in metabolic and brain function. [NPID: maternal diet, child development, postpartum depression, pregnancy, obesity, inflammatory mediators, inflammation, perinatal, maternal obesity, mood disorders, fetal brain development, brain development]

Amati et al. (2019) performed a systematic review to analyze whether consuming a Mediterranean diet during pregnancy can positively influence the mother and child. After inspecting the available literature, this review found that eating a Mediterranean diet when pregnant is associated with favourable outcomes for both maternal and offspring health. The mothers were at less risk of experiencing gestational diabetes, while the baby was less likely to have any congenital defects. It was therefore recommended for expecting mothers to follow a Mediterranean Diet to potentially decrease chances of developing gestational diabetes and of the offspring being born with atopy (tendency to develop allergic diseases such as allergic rhinitis, asthma and eczema). [NPID: maternal diet, child development, postpartum depression, Med diet, Mediterranean diet, pregnancy, diabetes, allergic rhinitis, asthma, eczema]

This 2019 systematic review was conducted on studies that assessed the effect of eating a Mediterranean diet during pregnancy on the fetal growth, and this diet’s role in fetal prematurity, neural tube defects and other congenital pathologies, asthma and allergy, body weight and metabolic markers. The traditional Mediterranean diet is known to be a healthy eating pattern that protects against the development of many diseases in adults and children, while fetal development may be significantly influenced by environmental factors including maternal nutrition. Biagi et al. expose the limited data in this area of research, calling for more randomized controlled trials. Nevertheless, the current studies suggested that the intake of the Mediterranean diet during pregnancy positively affects the health of the child. [NPID: maternal diet, child development, postpartum depression, Mediterranean diet, Med diet, fetal growth, fetal prematurity, asthma, allergies, maternal nutrition]

This 2017 systematic review aims to provide a summary of the current evidence on the relationship between maternal diet quality during pregnancy and child cognitive and affective outcomes. Borge et al. looked for studies that recruited children of elementary school age or younger, while assessing maternal diet quality and child cognitive and affective measures. The analysis of the 18 included studies revealed that higher diet quality during pregnancy correlated with slightly better cognitive functioning. Publication bias and significant heterogeneity between studies were discovered. Around 30% of this heterogeneity was accounted for by type of diet classification, publication year and outcome domain. The results indicated that higher diet quality during pregnancy has a small positive impact on child neurodevelopment, while the most reliable data was on cognitive development. [NPID: maternal diet, child development, postpartum depression, neonatal, post-partum depression, pregnancy, child cognition, diet quality, neurodevelopment]

This 2020 study analyzed the relationship between maternal intake of vegetables, fruit, and antioxidants during pregnancy, and the prevalence of behavioral problems in the children at 5 years old. The sample included 1199 Japanese mother-child pairs. The children were less likely to show low prosocial behavior if the mother had eaten more green and yellow vegetables, and more vegetables in total. Increased maternal intake of other vegetables was also linked with less risk of the child having hyperactivity issues and low prosocial behavior. Increased fruit and apple consumption during pregnancy was independently associated with fewer childhood hyperactivity problems. The more citrus fruits the mother ate during pregnancy, the lower the chances of the child experiencing emotional, conduct, and hyperactivity problems. Miyake et al. in fact found that maternal vitamin C consumption during pregnancy was inversely connected with fewer childhood conduct and hyperactivity problems, and low prosocial behavior. To summarize these results, the maternal intake of vegetables, fruit, and vitamin C during pregnancy may help prevent one or more behavioral problems in Japanese children. [NPID: maternal diet, child development, postpartum depression, neonatal, post-partum depression, antioxidants, prosocial behavior, childhood hyperactivity, citrus, emotional problems, vitamin C, Japanese, Japan]

The objective of this 2018 study was to determine the relationship between sugar consumption (of the mother during pregnancy and of the offspring after conceiving) and the child’s cognitive performance. As well as sucrose and fructose intake, Cohen et al. analyzed the association between intakes of sugar-sweetened beverages (SSBs), diet soda, juice, and fruit with the child’s cognition. This present study utilized the data of Project Viva, a cohort assessing diet during pregnancy and early childhood, in addition to cognitive outcomes in early and mid-childhood. There was a correlation found between increased maternal sugar consumption with the child’s lower non-verbal scores (at mid-childhood) in the Kaufman Brief Intelligence Test. Higher maternal sugar-sweetened beverage consumption was also linked with lower mid-childhood cognition, while diet soda consumption was negatively associated with early and mid-childhood cognition scores. Furthermore, there was a connection between increased sugar-sweetened beverage intake at early childhood, and lower mid-childhood KBIT-II verbal scores. Conversely, greater fruit consumption correlated with better cognitive scores in early and mid-childhood. Maternal/child fructose and juice consumption were not related with cognition. To conclude, sugar intake (especially those obtained from sugar-sweetened beverages) during pregnancy and childhood, as well as maternal diet soda consumption may negatively affect child cognition, while fruits eaten during childhood may lead to better cognitive outcomes. [NPID: maternal diet, child development, postpartum depression, neonatal, post-partum depression, well-being, sugar, sucrose, fructose, sugar sweetened beverages, diet soda, child cognition]