A western dietary pattern during pregnancy is associated with neurodevelopmental disorders in childhood and adolescence

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Pregnancy Diet and Neurodevelopmental Disorders: Hold the Fries, Pass the Fruit?

This large prospective study suggests that a "Western" diet high in processed foods, sugar, and unhealthy fats during pregnancy is associated with increased risk of ADHD and possibly autism in children. The findings were supported by blood metabolite analyses and replicated for ADHD in three additional cohorts. The association was stronger in children with a higher genetic risk and those born to mothers with a higher BMI, especially in males.

Possible Conflicts of Interest

B.E. disclosed consulting or advisory board roles for several pharmaceutical companies (Eli Lilly, Janssen, Lundbeck, Takeda, Bristol-Myers Squibb, Boehringer Ingelheim, and Otsuka). B.Y.G. led a research center partially funded by Lundbeck. J.L-S. disclosed roles as a scientific advisor and consultant for two companies. All other authors declared no competing interests.

Identified Weaknesses

Confounding factors

While the study tries to account for these, it's hard to completely rule out other things that could be affecting the results, like genetics or the child's diet after birth.

Measurement limitations

The study relies on food questionnaires and blood tests, which aren't perfect measures of what people actually eat or the exact effects on the body.

Correlation vs. causation

While there's a link between diet and these disorders, this study doesn't prove that one causes the other.

Inconsistent replication for autism

The findings about autism weren't as strong when tested in another large group, so more research is needed to be sure about this link.

Limited generalizability

The study mostly involved people of European descent, so the findings might not apply to everyone.

Rating Explanation

Strong methodology with longitudinal data, large sample size, objective metabolomics data, and external validation efforts. However, the observational design limits causal inference, and replication for autism was inconsistent, hence not a 5. Also, the disclosed conflicts of interest, while noted as not influencing the research, merit transparency and slight caution.

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