title: Dietary patterns in early childhood and child cognitive and psychomotor development: the Rhea mother-child cohort study in Crete.
abstract: Early-life nutrition is critical for optimal brain development; however, few studies have evaluated the impact of diet as a whole in early childhood on neurological development with inconsistent results. The present analysis is a cross-sectional study nested within an ongoing prospective birth cohort, the Rhea study, and aims to examine the association of dietary patterns with cognitive and psychomotor development in 804 preschool (mean age 4·2 years) children. Parents completed a validated FFQ, and dietary patterns were identified using principal component analysis. Child cognitive and psychomotor development was assessed by the McCarthy Scales of Children's Abilities (MSCA). Multivariable linear regression models were used to investigate the associations of dietary patterns with the MSCA scales. After adjustment for a large number of confounding factors, the 'Snacky' pattern (potatoes and other starchy roots, salty snacks, sugar products and eggs) was negatively associated with the scales of verbal ability (β=-1·31; 95 % CI -2·47, -0·16), general cognitive ability (β=-1·13; 95 % CI -2·25, -0·02) and cognitive functions of the posterior cortex (β=-1·20; 95 % CI -2·34, -0·07). Further adjustment for maternal intelligence, folic acid supplementation and alcohol use during pregnancy attenuated the observed associations, but effect estimates remained at the same direction. The 'Western' and the 'Mediterranean' patterns were not associated with child neurodevelopmental scales. The present findings suggest that poorer food choices at preschool age characterised by foods high in fat, salt and sugar are associated with reduced scores in verbal and cognitive ability.
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Leventakou
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Sarri
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Koutra
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Mariza
authors.initials: M
authors.lastname: Kampouri
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Andriani
authors.initials: A
authors.lastname: Kyriklaki
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Vassilaki
authors.affiliation: 2Centre for Research in Environmental Epidemiology (CREAL),Barcelona,E-08003,Spain.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: 1Department of Social Medicine, Faculty of Medicine,University of Crete,Heraklion, 71003,Crete,Greece.
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
mesh_terms: D000328:Adult; D001921:Brain / Q000254:growth & development*; D002657:Child Development / Q000502:physiology*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D015930:Diet Records; D038441:Diet, Mediterranean; D066273:Diet, Western; D004522:Educational Status; D005260:Female; D006115:Greece; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers; D011247:Pregnancy; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology*; D062410:Snacks; D011795:Surveys and Questionnaires
keywords: Birth cohort studies; Cognition; Dietary patterns; IQ intelligence quotient; MSCA McCarthy Scales of Children’s Abilities; Neurodevelopment; PCA principal component analysis; Preschool children