Diet quality during pregnancy, adolescent brain morphology, and cognitive performance in a population-based cohort

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BackgroundDiet quality during pregnancy may affect offspring’s neurobiology and cognitive performance in childhood. However, little is known about underlying mechanisms and potential long-term effects. ObjectivesTo examine associations of diet quality during pregnancy with offspring pre- and early-adolescent brain morphology and to investigate whether brain morphology mediates associations of diet quality during pregnancy with full-scale intelligence quotient (IQ) in early adolescence. MethodsWe studied 2223 and 1582 mother–child dyads with brain scans collected using magnetic resonance imaging at ages 10 and 14 y in the population-based Generation R Study in The Netherlands. We assessed dietary intake during pregnancy with 293-item food-frequency questionnaires and calculated predefined diet quality scores (total score 0–15), reflecting adherence to dietary guidelines. Cognitive performance was assessed using Wechsler Intelligence Scale for Children-V at age 14 y. We examined associations using multiple regression models, corrected for multiple testing. ResultsAfter adjustment for child age, sex, socioeconomic factors, maternal age, smoking, and psychopathological symptoms during pregnancy, we found that higher diet quality during pregnancy was associated with a larger total brain (B: 4.54, 95% confidence interval [CI]: 1.80, 7.28), cerebral white matter (1.83, 95% CI: 0.56, 3.10), cerebral gray matter (1.99, 95% CI: 0.63, 3.35), and subcortical volumes (0.16, 95% CI: 0.04, 0.28) of children at age 10 y. Similar results were found for age 14 y. Widespread differences in cortical thickness, gyrification, and surface area in both hemispheres were also observed. Better diet quality during pregnancy was associated with higher full-scale IQ scores of adolescents, particularly on verbal comprehension and matrix reasoning. The associations between diet quality during pregnancy and full-scale IQ in early adolescence were partially mediated by brain volumetric markers in pre-adolescence. ConclusionsDiet quality during pregnancy was associated with structural brain alterations in the offspring, which partly explained the relation between prenatal dietary patterns and cognitive outcomes in children.