The risk of autism diagnosis among offspring is reduced by adherence to healthy prenatal dietary patterns (HPDPs), according to a recent study published in JAMA Network Open.
Takeaways
- Adherence to healthy prenatal dietary patterns is associated with a reduced risk of autism diagnosis in offspring.
- Data from the Norwegian Mother, Father, and Child Cohort Study and the Avon Longitudinal Study of Parents and Children were analyzed, involving over 96,000 pregnancies.
- High adherence to HPDPs was linked to lower odds of autism diagnosis and reduced autism-associated traits, such as social communication difficulties and restrictive behaviors.
- Plant-based and fish-based dietary patterns specifically showed significant associations with reduced autism-associated traits in children at age 8 years.
- While results are promising, investigators recommend additional research to further substantiate the findings on the impact of prenatal dietary patterns on autism.
Autism spectrum disorder diagnoses are estimated in approximately 1% to 2% of individuals, with autism diagnosis encompassing a spectrum of neurodevelopmental conditions. As social communication difficulties and restrictive behaviors have a phenotypically and genetically dissociable relationship, measuring autism-associated traits may be advantageous.
Prenatal dietary patterns have been proposed as a potential factor influencing autism etiology. Previous studies have linked autism-associated traits with prenatal multivitamin and folic acid supplement use, but general data about the link between prenatal diet and autism diagnosis remains limited.
Investigators conducted a study to determine the impact of prenatal dietary patterns on autism diagnosis and autism-associated traits. Data was obtained from the Norwegian Mother, Father, and Child Cohort Study (MoBa). MoBa participants were recruited from Norway between 1999 and 2008.
Additional data was obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC), which included pregnant individuals in the Southwest of England delivering at any point from April 1, 1991, to December 31, 1992. Data was restricted to singleton pregnancies with food frequency questionnaire (FFQ) responses.
MoBa children were linked to the Norwegian Patient Registry, allowing all autism diagnoses between 2008 to 2018 in those aged up to 16 years at diagnosis to be identified. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision criteria was used to diagnose autism.
Autism-associated traits were reported using the Social Communication Questionnaire (SCQ) about autism associated social communication difficulties (SCQ-SOC) and restrictive and repetitive behaviors (SCQ-RRB). Mothers completed the questionnaire when their child was aged 3 and 8 years.
Secondary outcomes included the restrictive and repetitive behaviors and social communication subdomains. ALSPAC patients completed the Social and Communication Disorders Checklist (SCDC) at the child age of approximately 7.6 years to measure challenges with social and communication skills.
The FFQ was used to detail dietary patterns, with both MoBa and ALSPAC participants reporting information about commonly consumed foods and beverages, as well as dietary supplement use. Food and beverage items reported were matched to a healthy dietary pattern through exploratory factor analysis.
There were 84,548 pregnancies with a mean age of 30.2 years in the MoBa cohort and 11,760 with a mean age of 27.9 years in the ALSPAC cohort. MoBa participants were often older, had higher educational levels, and were more likely to plan their pregnancy than ALSPAC participants.
Patients with high HPDP adherence were often older, with higher educational attainment, and more likely to use prenatal multivitamin supplements. Only the lowest level of HPDP had a higher event rate for each outcome compared to medium or high adherence. SCQ-RRB at age 3 years had an especially low prevalence of children with recurrent high scores.
HDPD was associated with a decreased risk of each outcome in crude models, with an odds ratio (OR) of 0.68 for autism diagnosis, 0.86 for SCQ at 3 years, 0.80 for SCQ at 8 years, and 0.59 for SCDC at 8 years. Higher adherence was also linked reduced odds of autism diagnosis in MoBa and reduced SCDC at 8 years in ALSPAC.
The clearest HDPD association were found when evaluating food subgroups. A plant-based dietary pattern was associated with reduced odds of a high SCQ and SCQ-SOQ score at 8 years, with ORs of 0.92 and 0.89, respectively. Additionally, a fish-based dietary pattern had a reduced risk of a high SCQ-RRB score at 8 years, with an OR of 0.93.
These results indicated reduced risks of autism diagnosis and certain autism-associated traits from high adherence to HPDP. Investigators recommended further research to substantiate these findings.
Reference
Friel C, Leyland AH, Anderson JL, Havdahl A, Lise Brantsaeter A, Dundas R. Healthy prenatal dietary pattern and offspring autism. JAMA Netw Open. 2024;7(7):e2422815. doi:10.1001/jamanetworkopen.2024.22815
