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Maternal and Early Postnatal Nutrition and Mental Health of Offspring by Age 5 Years: A Prospective Cohort Study

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Objective

Diet quality is related to the risk for depression and anxiety in adults and adolescents; however, the possible impact of maternal and early postnatal nutritional exposures on children’s subsequent mental health is unexplored.

Method

The large prospective Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and 2008. Data were collected from mothers during pregnancy and when children were 6 months and 1.5, 3, and 5 years of age. Latent growth curve models were used to model linear development in children’s internalizing and externalizing problems from 1.5 to 5 years of age as a function of diet quality during pregnancy and at 1.5 and 3 years. Diet quality was evaluated by dietary pattern extraction and characterized as “healthy” or “unhealthy.” The sample comprised 23,020 eligible women and their children. Adjustments were made for variables including sex of the child, maternal depression, maternal and paternal age, maternal educational attainment, household income, maternal smoking before and during pregnancy, mothers’ parental locus of control, and marital status.

Results

Higher intakes of unhealthy foods during pregnancy predicted externalizing problems among children, independently of other potential confounding factors and childhood diet. Children with a high level of unhealthy diet postnatally had higher levels of both internalizing and externalizing problems. Moreover, children with a low level of postnatal healthy diet also had higher levels of both internalizing and externalizing problems.

Conclusion

Among this large cohort of mothers and children, early nutritional exposures were independently related to the risk for behavioral and emotional problems in children.

Section snippets

Method

The large, ongoing Norwegian Mother and Child Cohort Study (MoBa) is conducted by the Norwegian Institute of Public Health.24 Between 1999 and 2008, invitations were sent by mail to pregnant women across Norway concurrent with the routine ultrasound examination offered to all pregnant women at their local hospital around week 17 of pregnancy. The participation rate was 38.5%, with more than 108,000 births enrolled during the recruitment period. When pregnant mothers consented to participate,

Results

Figure 1 provides a graphical depiction of the children’s externalizing and internalizing behaviors as a function of both maternal and child dietary patterns. The intercept describes the level of internalizing or externalizing behaviors at 18 months, whereas the slopes describe the trajectory of such behaviors over the ensuing assessment periods to age 5. The lines in Figure 1 depict both “healthy” dietary patterns (in green) and “unhealthy” dietary patterns (in red), as well as the mean of the

Discussion

In this study, we report highly novel data suggesting that maternal and early postnatal dietary factors play a role in the subsequent risk for behavioral and emotional problems in children. Both an increased intake of unhealthy foods and a decreased intake of nutrient-rich foods in early childhood were independently related to higher internalizing and externalizing behaviors in young children. These behaviors are established early markers for later mental health problems.37 In addition,

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    The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, the National Institutes of Health (NIH)/National Institute of Environmental Health Sciences (NIEHS) (contract no NO1-ES-75558), NIH/National Institute of Neurological Disorders and Stroke (NINDS) (grants UO1 NS 047537-01 and UO1 NS047537-06A1), and the Norwegian Research Council/Functional Genomics in Norway (FUGE) (grant 151918/S10).

    This study was funded by the Brain and Behaviour Research Institute (formerly NARSAD). Dr. Jacka also gratefully acknowledges current and previous grant/research support from the National Health and Medical Research Council (NHMRC); Australian Rotary Health; the Geelong Medical Research Foundation; the Ian Potter Foundation; and the University of Melbourne. Dr. Jacka is currently supported by an NHMRC fellowship (#628912).

    Dr. Ystrom served as the statistical expert for this research.

    The authors are grateful to all of the participating families in Norway who take part in this ongoing cohort study.

    Disclosure: Drs. Jacka, Ystrom, Brantsaeter, Karevold, Haugen, Meltzer, and Berk, and Ms. Roth and Ms. Schjolberg report no biomedical financial interests or potential conflicts of interest.

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