Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
Biol Psychiatry. 2021 Mar 15;89(6):550-559. doi: 10.1016/j.biopsych.2020.10.008. Epub 2020 Oct 24.
The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age.
Individual participant data for 11,870 mother-child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression and anxiety, aggressive behavior, and attention-deficit/hyperactivity disorder in children were assessed using mother-reported tests and classified within the normal or borderline/clinical ranges using validated cutoffs. Adjusted odds ratios were determined by multivariable logistic regression models and aggregated by the two-level individual participant data meta-analysis method.
Higher maternal DASH scores (indicating better dietary quality) were associated with lower risk of depressive and anxiety symptoms, aggressive behavior symptoms, and attention-deficit/hyperactivity disorder symptoms within the borderline/clinical ranges: odds ratio [OR] 0.97, 95% confidence interval [CI], 0.95-0.99; OR 0.97, 95% CI, 0.94-0.99; OR 0.97, 95% CI, 0.95-0.98, per one-unit DASH score increase, respectively. For depression and anxiety, aggressive behavior, and attention-deficit/hyperactivity disorder symptoms, a one-unit increase in E-DII scores (a more proinflammatory diet) was associated with a 7% increased risk of all three analyzed emotional and behavioral symptoms: OR 1.07, 95% CI, 1.03-1.11; OR 1.07, 95% CI, 1.02-1.13; OR 1.07, 95% CI, 1.01-1.13, respectively.
Our findings suggest that a maternal low-quality and proinflammatory diet may increase the risk of emotional and behavioral symptoms in children.
母亲在怀孕期间的饮食对儿童神经发育有重要影响，具有公共卫生和临床意义。我们评估了基于饮食方法来停止高血压（DASH）评分的饮食质量，以及基于能量调整的饮食炎症指数（E-DII）评分的饮食炎症潜能与 7 至 10 岁儿童情绪和行为症状之间的关联。
分析了来自参与 ALPHABET 项目的四个欧洲队列的 11870 对母婴的个体参与者数据。母亲在产前时的 DASH 和 E-DII 评分是通过自我完成的食物频率问卷生成的。使用母亲报告的测试评估儿童的抑郁和焦虑症状、攻击行为和注意缺陷多动障碍，并使用验证过的截止值将其分类为正常或边界/临床范围内。通过多变量逻辑回归模型确定调整后的优势比，并通过两级个体参与者数据荟萃分析方法进行汇总。
较高的母体 DASH 评分（表示饮食质量更好）与边界/临床范围内的抑郁和焦虑症状、攻击行为症状和注意缺陷多动障碍症状的风险降低相关：比值比（OR）0.97，95%置信区间（CI）0.95-0.99；OR 0.97，95% CI，0.94-0.99；OR 0.97，95% CI，0.95-0.98，每增加一个单位的 DASH 评分。对于抑郁和焦虑、攻击行为和注意缺陷多动障碍症状，E-DII 评分每增加一个单位（更具促炎作用的饮食），所有三种分析的情绪和行为症状的风险增加 7%：OR 1.07，95% CI，1.03-1.11；OR 1.07，95% CI，1.02-1.13；OR 1.07，95% CI，1.01-1.13。
我们的研究结果表明，母体低质量和促炎饮食可能会增加儿童出现情绪和行为症状的风险。
