Maternal prenatal nut and seafood consumption and child neuropsychological function from 4 to 15 years of age: a population-based cohort study

Pinar-Martí, Ariadna; Ayala-Aldana, Nicolas; Ruiz-Rivera, Marina; Lertxundi, Nerea; Subiza-Pérez, Mikel; González-Safont, Llúcia; Vioque, Jesus; Riaño Galán, Isolina; Rodríguez Dehli, Cristina; Iglesias-Vázquez, Lucía; Arija, Victoria; Fernández-Barrés, Sílvia; Romaguera Bosch, Dora; Pascual-Rubio, Vicenç; Fabregat-Sanjuan, Albert; Healy, Darren; Basagaña Flores, Xavier; Vrijheid, Martine; Guxens Junyent, Mònica; Foraster Pulido, Maria, 1984-; Júlvez Calvo, Jordi

doi:http://dx.doi.org/10.1016/j.ajcnut.2025.04.032

Maternal prenatal nut and seafood consumption and child neuropsychological function from 4 to 15 years of age: a population-based cohort study

Citation

Pinar-Martí A, Ayala-Aldana N, Ruiz-Rivera M, Lertxundi N, Subiza-Pérez M, González-Safont L, et al. Maternal prenatal nut and seafood consumption and child neuropsychological function from 4 to 15 years of age: a population-based cohort study. Am J Clin Nutr. 2025 Jul;122(1):274-84. DOI: 10.1016/j.ajcnut.2025.04.032

Abstract

Background: Understanding the role of maternal diet in early brain development is critical, as pregnancy represents a period of significant vulnerability and growth for the developing brain. Objectives: This study aims to assess the association between maternal nuts, total seafood, and large fatty fish consumption during pregnancy and offspring neuropsychological function ≤15 y, considering the potential mediation of omega-3 fatty acids. Methods: This study was part of The Spanish Childhood and Environment birth cohort, following 1737 mother-child pairs from pregnancy to age 15. Maternal diet was evaluated using a semiquantitative food frequency questionnaire, whereas children's neuropsychological function was measured through standardized computer-based tests. Attention (hit reaction time and its variability, HRT and HRT-SE) was measured with the Conners' Kiddie Continuous Performance Test and the Attention Network Test. Working memory (detectability in 2-back, d2', and 3-back tasks, d3') was evaluated using the N-back task. Fluid intelligence was assessed with Raven's Progressive Matrices and the Test of Primary Mental Abilities. Linear mixed-effects regression models assessed the association of nuts, seafood and large fatty fish with neuropsychological outcomes, whereas generalized structural equation modeling was used for mediation analyses. Results: Higher maternal nut consumption was significantly linked to improved attention [HRT-SE β = -0.05, 95% confidence interval (CI): -0.09, -0.00] and working memory (d2' β = 0.05, 95% CI: 0.00, 0.09, and d3' β = 0.06, 95% CI: 0.02, 0.11) in offspring. Greater consumption of large fatty fish was associated with better attention (HRT-SE β = -0.06, 95% CI: -0.10, -0.02; and HRT β = -0.04, 95% CI: -0.08, -0.00), and fluid intelligence (β = 0.08, 95% CI: 0.02, 0.13). Omega-3 fatty acids mediated 8%-14% of these effects on attention. Conclusions: Maternal diet at pregnancy and omega-3 intake may support long-term cognitive development in children and adolescents.