AJ Drexel Autism Institute, Drexel University, 3020 Market St., Philadelphia, PA, 19104, USA.
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Curr Environ Health Rep. 2022 Jun;9(2):324-338. doi: 10.1007/s40572-022-00347-7. Epub 2022 Mar 19.
Environmental chemicals and toxins have been associated with increased risk of impaired neurodevelopment and specific conditions like autism spectrum disorder (ASD). Prenatal diet is an individually modifiable factor that may alter associations with such environmental factors. The purpose of this review is to summarize studies examining prenatal dietary factors as potential modifiers of the relationship between environmental exposures and ASD or related neurodevelopmental outcomes.
Twelve studies were identified; five examined ASD diagnosis or ASD-related traits as the outcome (age at assessment range: 2-5 years) while the remainder addressed associations with neurodevelopmental scores (age at assessment range: 6 months to 6 years). Most studies focused on folic acid, prenatal vitamins, or omega-3 fatty acids as potentially beneficial effect modifiers. Environmental risk factors examined included air pollutants, endocrine disrupting chemicals, pesticides, and heavy metals. Most studies took place in North America. In 10/12 studies, the prenatal dietary factor under study was identified as a significant modifier, generally attenuating the association between the environmental exposure and ASD or neurodevelopment. Prenatal diet may be a promising target to mitigate adverse effects of environmental exposures on neurodevelopmental outcomes. Further research focused on joint effects is needed that encompasses a broader variety of dietary factors, guided by our understanding of mechanisms linking environmental exposures with neurodevelopment. Future studies should also aim to include diverse populations, utilize advanced methods to optimize detection of novel joint effects, incorporate consideration of timing, and consider both synergistic and antagonistic potential of diet.
环境化学物质和毒素与神经发育受损风险增加以及自闭症谱系障碍（ASD）等特定疾病有关。产前饮食是一种个体可改变的因素，可能会改变与这些环境因素的关联。本综述的目的是总结研究，这些研究检查了产前饮食因素作为环境暴露与 ASD 或相关神经发育结果之间关系的潜在调节剂。
确定了 12 项研究；其中 5 项研究将 ASD 诊断或与 ASD 相关的特征作为结果（评估年龄范围：2-5 岁），而其余研究则探讨了与神经发育评分的关联（评估年龄范围：6 个月至 6 岁）。大多数研究都集中在叶酸、产前维生素或欧米伽-3 脂肪酸作为潜在的有益效应调节剂。研究的环境风险因素包括空气污染物、内分泌干扰化学物质、杀虫剂和重金属。大多数研究都在美国进行。在 12 项研究中的 10 项中，所研究的产前饮食因素被确定为一个重要的调节剂，通常会减弱环境暴露与 ASD 或神经发育之间的关联。产前饮食可能是减轻环境暴露对神经发育结果的不良影响的一个有希望的目标。需要进一步研究，重点是联合作用，包括更广泛的饮食因素，这需要我们了解环境暴露与神经发育之间的联系机制。未来的研究还应旨在纳入不同人群，利用先进的方法优化检测新的联合作用，考虑时间因素，并考虑饮食的协同和拮抗潜力。
