Adherence to the Mediterranean diet during pregnancy and behavioural problems at 4 years of age

There is an increasing prevalence of psychological issues in childhood. Lifestyle factors during pregnancy, including maternal nutrition, have been linked to children's behavioural development. This study aims to assess the impact of adherence to the Mediterranean diet during pregnancy on the behavioural problems of children at the age of 4. A total of 231 mother-child pairs were assessed. Maternal adherence to the Mediterranean diet during pregnancy was estimated using a relative Mediterranean Diet Score (rMED). Behavioural outcomes were evaluated through the Child Behaviour Checklist 1 1/2--5, Teacher's Report Form 1 1/2 -5, and Behaviour Rating Inventory of Executive Function-Preschool Version questionnaires. The results indicated that a higher rMED score during pregnancy was associated with a reduced probability of obtaining a clinical score for total problems (OR = 0.42; 95% IC from 0.21 to 0.85), including externalising (OR = 0.29; 95% IC from 0.14 to 0.62), attention problems (OR = 0.32; 95%IC from 0.15 to 0.70), attention-deficit/hyperactivity problems (OR = 0.36; 95% IC from 0.15 to 0.87), oppositional defiant problems (OR = 0.06; 95% IC from 0.06 to 0.75), and depressive problems (OR = 0.38; 95% IC from 0.15 to 0.96). This study highlights the importance of maternal diet, especially Mediterranean diet, during gestation for proper child development. A high adherence to a Mediterranean diet during pregnancy has been associated with a reduction in behavioural problems in children at the age of 4, particularly in externalising problems such as attention-deficit/hyperactivity problems and depressive symptoms. These results highlight the critical role of prenatal nutrition for optimal child development. image Maternal nutrition during pregnancy has a significant impact on children's development. Previous studies showed that prenatal adherence to the Mediterranean diet is associated with beneficial outcomes for both mother and foetus and in children's development outcomes. Adhering to a Mediterranean diet during pregnancy is related to lower behavioural problems, especially externalising and attention-deficit hyperactivity disorder, and psychological problems such as depression, in children at 4 years of age. Attention should be directed towards maternal nutrition during the prenatal period to ensure proper child neurodevelopment, encouraging mothers to follow healthy nutritional habits.