Data from several cohort studies suggest that a Western dietary pattern during pregnancy is associated with an increase in risk for neurodevelopmental disorders, including both autism and attention-deficit/hyperactivity disorder (ADHD), with the analysis published in Nature Metabolism. The initial prospective cohort was comprised of approximately 600 children (age 10) who were participants in the Copenhagen Prospective Study on Neuro-Psychiatric Development study (COPSYCH), a subset of a larger mother-child cohort that included 14 clinical visits within the first 10 years of life. Results were validated in 3 independent mother-child cohorts, including the Danish National Birth Cohort which had nearly 60,000 mother-child pairs.
Dietary patterns during pregnancy were established by one 30-day food frequency questionnaire (FFQ) given at 24 weeks gestation in COPYSCH. The Western diet was characterized as rich in saturated fats, animal fats, refined grains, and high-energy drinks, with low intakes of fruit, fish, and vegetables. Given the obvious limitations of a single FFQ, they also performed a metabolomic analysis at 24 weeks, used to develop a Western dietary pattern metabolite score (WEP-MS).
Using FFQ data, COPSYCH found a Western diet to be associated with a 53% increase in risk for any neurodevelopmental disorder (and also symptom loads), including a 66% increase in risk for ADHD and a 122% increase in autism risk (after multivariate adjustment). The WEP-MS was associated with approximately a 40% higher risk both for any neurodevelopmental disorder and ADHD (but not autism). A closer analysis found that 15 metabolites mediated 80% of the portion of risk due to diet, with plant-based compounds (e.g., ergothioneine, carotene diol) offering a protective effect and lipid metabolites (e.g., caprate and caprylate) associated with greater risk. It’s important to note there were limitations of this study, but overall it suggests there may be a diet-sensitive period of neurodevelopment that interacts with genetic risk.