Prenatal Diet Associated with Symptoms of Hyperactivity-Inattention in Offspring

by | Sep 16, 2019 | 2018, Attention Deficit Hyperactivity Disorder (ADHD), Brain Health, Infant and Children's Health, Pregnancy and Lactation

Written by Angeline A. De Leon, Staff Writer. Maternal diet during pregnancy was independently associated with children’s hyperactivity–inattention symptoms but not with conduct problems, validating the importance of diet in pregnant women.

Over the last several decades, the relationship between diet and mental health has become clearer 1,2. In adults and adolescents, an unhealthy Western-style diet (processed foods, high carbohydrate intake, and high saturated fat) has been recognized for its association with anxiety, depression, and other common mental disorders 1,3,4. More recently now, the long-term effects of diet are being examined in the context of the developing brain, with birth cohort studies suggesting that prenatal diet may be related to later development of behavioral problems, such as externalizing behaviors (generally conceptualized as a global aggregate of symptoms from attention deficit disorder (ADHD) and conduct disorder) 5,6. While the relationship between prenatal diet and a more specific phenotype of externalizing behavior (early onset persistent conduct problems) is supported 7, the distinctive influence of maternal diet on ADHD and conduct problems as separate and independent conditions 8 (as opposed to a generalized index of externalizing behavior) is relatively unknown. Thus, in a research study 9 published in The Journal of Child Psychology and Psychiatry (2018), researchers examined the effects of prenatal diet on children’s trajectories of hyperactivity-inattention and conduct problems.

Data was obtained from a total of 1,242 mother-child pairs enrolled as participants in the EDEN mother-child study in France. Data tracking started from the time of pregnancy with follow-up assessments conducted intermittently until children reached 8 years of age. Children’s externalizing symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ, including separate scales for hyperactivity-inattention and conduct problems), which was administered when children were 3, 5, and 8 years-old. Maternal diet during the last trimester of pregnancy was assessed retrospectively using a food frequency questionnaire (FFQ), which was administered shortly after delivery. Two main dietary patterns (DP) were identified, either “healthy” (high intake of fruit, vegetables, fish, and whole grains) or “Western” (high intake of processed and snacking foods), and a mean score calculated for each DP at the individual-level.

Statistical analyses showed that children of mothers who scored in the lowest quartile of the Healthy DP, compared to children of mothers in the other quartiles, had a higher likelihood of displaying high levels of both hyperactivity-inattention (21.4% vs. 12.9%, p = 0.0003) and conduct problems (19.4% vs. 14.7%, p = 0.0484) from 3 to 8 years. Relative to children of mothers in the other quartiles, children of mothers in the highest quartile of the Western DP were more likely to show high levels of hyperactivity-inattention (21.6% vs. 12.8%, p = 0.0002) from 3 to 8 years (p < 0.05). After controlling for maternal stress and depression, socioeconomic status, gestational diabetes, and DP of children at age 2, significant associations were found between later development of high levels of hyperactivity-inattention in children and low Healthy DP (adjusted Odds Ratio = 1.61, 95% Confidence Interval: 1.09 to 2.37) and high Western DP (adjusted OR = 1.67, 95% CI: 1.13 to 2.47) during pregnancy.

Findings confirm an independent association between maternal diet and subsequent symptoms of hyperactivity-inattention, but not conduct problems, in offspring. Through pathways involving dietary patterns characterized as low in healthfulness and highly Western, researchers conclude that exposure to certain nutrients during pregnancy may influence the probability of developing symptoms of externalizing behavior. The present study is particularly valuable for its ability to disentangle the effects of prenatal diet on symptoms of ADHD vs. conduct problems. Additional studies are necessary, however, to examine the epigenetic mechanisms involved in maternal diet, fetal programming, and mental health in both conditions. Potential shortcomings of the current study involve the use of self-report measures for dietary intake and the selective response of women with higher socioeconomic status. The use of biological assessments, to measure immunological variables, for example, would also be highly beneficial for future studies to add.

Source: Galera C, Heude B, Forhan A, et al. Prenatal diet and children’s trajectories of hyperactivity-inattention and conduct problems from 3 to 8 years: the EDEN mother-child cohort. The Journal of Child Psychology and Psychiatry. 2018; 59(9): 1003-1011. DOI: 10.1111/jcpp.12898.

© 2018 Association for Child and Adolescent Mental Health.

Posted September 16, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Jacka FN, Sacks G, Berk M, Allender S. Food policies for physical and mental health. BMC psychiatry. 2014;14(1):132.
  2. O’Neil A, Itsiopoulos C, Skouteris H, et al. Preventing mental health problems in offspring by targeting dietary intake of pregnant women. BMC medicine. 2014;12(1):208.
  3. Martínez-González MA, Sánchez-Villegas A. Food patterns and the prevention of depression. Proceedings of the Nutrition Society. 2016;75(2):139-146.
  4. Logan AC, Jacka FN. Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch. Journal of physiological anthropology. 2014;33(1):22.
  5. Jacka FN, Ystrom E, Brantsaeter AL, et al. Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(10):1038-1047.
  6. Steenweg-de Graaff J, Tiemeier H, Steegers-Theunissen RP, et al. Maternal dietary patterns during pregnancy and child internalising and externalising problems. The Generation R Study. Clinical nutrition. 2014;33(1):115-121.
  7. Mesirow MS, Cecil C, Maughan B, Barker ED. Associations between prenatal and early childhood fish and processed food intake, conduct problems, and co-occurring difficulties. Journal of abnormal child psychology. 2017;45(5):1039-1049.
  8. Scott S. Oppositional and conduct disorders. Rutter’s child and adolescent psychiatry. 2015;6:966-980.
  9. Galera C, Heude B, Forhan A, et al. Prenatal diet and children’s trajectories of hyperactivity–inattention and conduct problems from 3 to 8 years: the EDEN mother–child cohort. Journal of Child Psychology and Psychiatry. 2018;59(9):1003-1011.