Maternal dietary intake of fish and PUFAs and child neurodevelopment at 6 months and 1 year of age: a nationwide birth cohort—the Japan Environment and Children's Study (JECS)

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ABSTRACT

Background

Although emerging evidence indicates a relation between maternal intake of fish and improved child neurodevelopment, the results are inconsistent.

Objectives

This study investigated whether dietary consumption of fish during pregnancy is associated with offspring neurodevelopment at age 6 mo and 1 y. As exploratory research, we also examined the association between consumption of PUFAs and neurodevelopment at the same time points.

Methods

After exclusion and multiple imputation from a dataset comprising 104,065 records from the Japan Environment and Children's Study, we evaluated 81,697 and 77,751 mother-child pairs at age 6 mo and 1 y, respectively.

Results

Maternal fish intake during pregnancy was independently associated with reduced risk of delay in problem-solving at age 6 mo (lowest compared with highest quintile OR = 0.88; 95% CI: 0.79, 0.99; P-trend = 0.01) and in fine motor skills (highest quintile OR = 0.90; 95% CI: 0.81, 0.99; P-trend = 0.02) and problem-solving (fourth quintile OR = 0.89; 95% CI: 0.81, 0.98; and highest quintile OR = 0.90; 95% CI: 0.81, 0.99; P-trend = 0.005) at age 1 y. Dietary intake of total n–3 PUFAs was associated with reduced risk of delay in fine motor skills at 6 mo, and in fine motor skills and problem-solving at 1 y. Dietary intake of total n–6 PUFAs was associated with reduced risk of delay in communication and fine motor skills at 6 mo, and in gross motor skills, fine motor skills, and problem-solving at 1 y. In contrast, the dietary n–6/n–3 ratio was positively associated with increased risk of delay in problem-solving at 1 y.

Conclusions

The results of this study suggest there might be beneficial effects of fish intake during pregnancy on some domains of child psychomotor development and this effect might be partially explained by PUFA intake from fish. Trial registration: UMIN000030786.

Related collections

Most cited references 46

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CORA L. CRAIG, ALISON L. MARSHALL, MICHAEL SJ??STR??M … (2003)

Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

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Adjustment for total energy intake in epidemiologic studies

W Willett, G R Howe, L H Kushi (1997)

In epidemiologic studies, total energy intake is often related to disease risk because of associations between physical activity or body size and the probability of disease. In theory, differences in disease incidence may also be related to metabolic efficiency and therefore to total energy intake. Because intakes of most specific nutrients, particularly macronutrients, are correlated with total energy intake, they may be noncausally associated with disease as a result of confounding by total energy intake. In addition, extraneous variation in nutrient intake resulting from variation in total energy intake that is unrelated to disease risk may weaken associations. Furthermore, individuals or populations must alter their intake of specific nutrients primarily by altering the composition of their diets rather than by changing their total energy intake, unless physical activity or body weight are changed substantially. Thus, adjustment for total energy intake is usually appropriate in epidemiologic studies to control for confounding, reduce extraneous variation, and predict the effect of dietary interventions. Failure to account for total energy intake can obscure associations between nutrient intakes and disease risk or even reverse the direction of association. Several disease-risk models and formulations of these models are available to account for energy intake in epidemiologic analyses, including adjustment of nutrient intakes for total energy intake by regression analysis and addition of total energy to a model with the nutrient density (nutrient divided by energy).

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Multiple imputation of discrete and continuous data by fully conditional specification.

Stef van Buuren (2007)

The goal of multiple imputation is to provide valid inferences for statistical estimates from incomplete data. To achieve that goal, imputed values should preserve the structure in the data, as well as the uncertainty about this structure, and include any knowledge about the process that generated the missing data. Two approaches for imputing multivariate data exist: joint modeling (JM) and fully conditional specification (FCS). JM is based on parametric statistical theory, and leads to imputation procedures whose statistical properties are known. JM is theoretically sound, but the joint model may lack flexibility needed to represent typical data features, potentially leading to bias. FCS is a semi-parametric and flexible alternative that specifies the multivariate model by a series of conditional models, one for each incomplete variable. FCS provides tremendous flexibility and is easy to apply, but its statistical properties are difficult to establish. Simulation work shows that FCS behaves very well in the cases studied. The present paper reviews and compares the approaches. JM and FCS were applied to pubertal development data of 3801 Dutch girls that had missing data on menarche (two categories), breast development (five categories) and pubic hair development (six stages). Imputations for these data were created under two models: a multivariate normal model with rounding and a conditionally specified discrete model. The JM approach introduced biases in the reference curves, whereas FCS did not. The paper concludes that FCS is a useful and easily applied flexible alternative to JM when no convenient and realistic joint distribution can be specified.

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Author and article information

Contributors

Kei Hamazaki

Kenta Matsumura

Akiko Tsuchida

Haruka Kasamatsu

Tomomi Tanaka

Mika Ito

Hidekuni Inadera

Journal

Journal ID (nlm-ta): Am J Clin Nutr

Journal ID (iso-abbrev): Am J Clin Nutr

Journal ID (publisher-id): ajcn

Title: The American Journal of Clinical Nutrition

Publisher: Oxford University Press

ISSN (Print): 0002-9165

ISSN (Electronic): 1938-3207

Publication date Collection: November 2020

Publication date (Electronic): 07 August 2020

Publication date PMC-release: 07 August 2020

Volume: 112

Issue: 5

Pages: 1295-1303

Affiliations

Department of Public Health, Faculty of Medicine, University of Toyama , Toyama, Japan

Toyama Regional Center for JECS, University of Toyama , Toyama, Japan

Department of Public Health, Faculty of Medicine, University of Toyama , Toyama, Japan

Toyama Regional Center for JECS, University of Toyama , Toyama, Japan

Department of Pediatrics, Faculty of Medicine, University of Toyama , Toyama, Japan

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama , Toyama, Japan

Department of Public Health, Faculty of Medicine, University of Toyama , Toyama, Japan

Toyama Regional Center for JECS, University of Toyama , Toyama, Japan

Nagoya City University , Nagoya, Japan

National Institute for Environmental Studies , Tsukuba, Japan

National Center for Child Health and Development , Tokyo, Japan

Hokkaido University , Sapporo, Japan

Tohoku University , Sendai, Japan

Fukushima Medical University , Fukushima, Japan

Chiba University , Chiba, Japan

Yokohama City University , Yokohama, Japan

University of Yamanashi , Chuo, Japan

University of Toyama , Toyama, Japan

Kyoto University , Kyoto, Japan

Osaka University , Suita, Japan

Hyogo College of Medicine , Nishinomiya, Japan

Tottori University , Yonago, Japan

Kochi University , Nankoku, Japan

University of Occupational and Environmental Health , Kitakyushu, Japan

Kumamoto University , Kumamoto, Japan

Author notes

Address correspondence to KH (e-mail: keihama@ 123456med.u-toyama.ac.jp ).

Article

Publisher ID: nqaa190

DOI: 10.1093/ajcn/nqaa190

PMC ID: 7657336

PubMed ID: 32766751

SO-VID: 6f66bbf2-d028-43c7-acba-aa011e01e020

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 23 January 2020

Date accepted : 17 June 2020

Page count

Pages: 9

Funding

Funded by: Ministry of the Environment, DOI 10.13039/501100006120;

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Maternal dietary intake of fish and PUFAs and child neurodevelopment at 6 months and 1 year of age: a nationwide birth cohort—the Japan Environment and Children's Study (JECS)

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ABSTRACT

Background

Objectives

Methods

Results

Conclusions

Related collections

Karger: Nutrition and Dietetics

Most cited references 46

International physical activity questionnaire: 12-country reliability and validity.

Adjustment for total energy intake in epidemiologic studies

Multiple imputation of discrete and continuous data by fully conditional specification.

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Cited by 12

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