The Association of Prenatal Dietary Factors with Child Autism Diagnosis and Autism-Related Traits Using a Mixtures Approach: Results from the Environmental Influences on Child Health Outcomes Cohort
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Previous research on the role of maternal diet in relation to autism has focused on examining individual nutrient associations. Few studies have examined associations with multiple nutrients using mixtures approaches, which may better reflect true exposure scenarios. OBJECTIVES: This study aims to examine associations of nutrient mixtures with children's autism diagnosis and trait scores within a large, diverse population. METHODS: Participants were drawn from the United States Environmental influences on Child Health Outcomes (ECHO) consortium. Maternal prenatal diet was reported via validated food frequency questionnaires. Children's autism-related traits were measured using the Social Responsiveness Scale (SRS) and autism diagnoses were from parent reports of physician diagnosis. Bayesian kernel machine regression was used to examine the overall mixture effect and interactions between a set of 5 primary nutrients (folate, vitamin D, omega 3 and omega 6 fatty acids, and iron), adjusted for potential confounders, in relationship to child outcomes. Secondary analyses were conducted in a subset of cohorts with an expanded set of 14 nutrients. Traditional linear and logistic regression models were also analyzed for comparison of results to mixture models. RESULTS: A total of 2614 participants drawn from 7 ECHO cohorts were included in primary analysis. Mixture analyses suggested that increasing the overall 5-nutrient mixture was associated with lower SRS scores. Individual U-shaped associations and bivariate interactions between folate and omega 3 fatty acids were suggested. In the subset included in the secondary analyses of the 14-nutrient mixture, a modest inverse trend remained, but individual nutrient associations were altered, with vitamin D demonstrating higher relative importance than other nutrients. Strong associations with autism diagnosis were not observed. CONCLUSIONS: In this large sample, we found evidence for combined nutrient effects with broader autism-related traits. Because results for individual nutrients were sensitive to mixture components, replication of combined associations between nutrients and autism-related outcomes is needed.
Source: Journal of Nutrition
Authors: Megan G Bragg, Juliette Rando, Kecia N Carroll, Stephanie M Eick, Margaret R Karagas, Pi-I Lin, Rebecca J Schmidt, Kristen Lyall, P Brian Smith, L Kristin Newby, Linda Adair, Lisa P Jacobson, Diane Catellier, Monica McGrath, Christian Douglas, Priya Duggal, Emily Knapp, Amii Kress, Courtney K Blackwell, Maxwell A Mansolf, Jin-Shei Lai, Emily Ho, David Cella, Richard Gershon, Michelle L Macy, Suman R Das, Jane E Freedman, Simon A Mallal, John A McLean, Ravi V Shah, Meghan H Shilts, Akram N Alshawabkeh, Jose F Cordero, John Meeker, Leonardo Trasande, Carlos A Camargo, Zhaozhong Zhu, Ashley F Sullivan, Dana Dabelea, Wei Perng, Traci A Bekelman, Greta Wilkening, Sheryl Magzamen, Brianna F Moore, Anne P Starling, Deborah J Rinehart, Daphne Koinis Mitchell, Viren D'Sa, Sean CL Deoni, Hans-Georg Mueller, Cristiane S Duarte, Catherine Monk, Glorisa Canino, Jonathan Posner, Tenneill Murray, Claudia Lugo-Candelas, Anne L Dunlop, Patricia A Brennan, Christine Hockett, Amy Elliott, Assiamira Ferrara, Lisa A Croen, Monique M Hedderson, John Ainsworth, Leonard B Bacharier, Casper G Bendixsen, James E Gern, Diane R Gold, Tina V Hartert, Daniel J Jackson, Christine C Johnson, Christine LM Joseph, Meyer Kattan, Gurjit K Khurana Hershey, Robert F Lemanske, Susan V Lynch, Rachel L Miller, George T O’Connor, Carole Ober, Dennis Ownby, Katherine Rivera-Spoljaric, Patrick H Ryan, Christine M Seroogy, Anne Marie Singh, Robert A Wood, Edward M Zoratti, Rima Habre, Shohreh Farzan, Frank D Gilliland, Irva Hertz-Picciotto, Deborah H Bennett, Julie B Schweitzer, Rebecca J Schmidt, Janine M LaSalle, Alison E Hipwell, Kate E Keenan, Catherine J Karr, Nicole R Bush, Kaja Z LeWinn, Sheela Sathyanarayana, Qi Zhao, Frances Tylavsky, Kecia N Carroll, Christine T Loftus, Leslie D Leve, Jody M Ganiban, Jenae M Neiderhiser, Scott T Weiss, Augusto A Litonjua, Cindy T McEvoy, Eliot R Spindel, Robert S Tepper, Craig J Newschaffer, Kristen Lyall, Heather E Volk, Rebecca Landa, Sally Ozonoff, Joseph Piven, Heather Hazlett, Juhi Pandey, Robert Schultz, Steven Dager, Kelly Botteron, Daniel Messinger, Wendy Stone, Jennifer Ames, Thomas G O'Connor, Richard K Miller, Emily Oken, Michele R Hacker, Tamarra James-Todd, T Michael O'Shea, Rebecca C Fry, Jean A Frazier, Rachana Singh, Caitlin Rollins, Angela Montgomery, Ruben Vaidya, Robert M Joseph, Lisa K Washburn, Semsa Gogcu, Kelly Bear, Julie V Rollins, Stephen R Hooper, Genevieve Taylor, Wesley Jackson, Amanda Thompson, Julie Daniels, Michelle Hernandez, Kun Lu, Michael Msall, Madeleine Lenski, Rawad Obeid, Steven L Pastyrnak, Elizabeth Jensen, Christina Sakai, Hudson Santos, Jean M Kerver, Nigel Paneth, Charles J Barone, Michael R Elliott, Douglas M Ruden, Chris Fussman, Julie B Herbstman, Amy Margolis, Susan L Schantz, Sarah Dee Geiger, Andrea Aguiar, Karen Tabb, Rita Strakovsky, Tracey Woodruff, Rachel Morello-Frosch, Amy Padula, Joseph B Stanford, Christina A Porucznik, Angelo P Giardino, Rosalind J Wright, Robert O Wright, Brent Collett, Nicole Baumann-Blackmore, Ronald Gangnon, Daniel J Jackson, Chris G McKennan, Jo Wilson, Matt Altman, Judy L Aschner, Annemarie Stroustrup, Stephanie L Merhar, Paul E Moore, Gloria S Pryhuber, Mark Hudak, Ann Marie Reynolds Lyndaker, Andrea L Lampland, Burton Rochelson, Sophia Jan, Matthew J Blitz, Michelle W Katzow, Zenobia Brown, Codruta Chiuzan, Timothy Rafael, Dawnette Lewis, Natalie Meirowitz, Brenda Poindexter, Tebeb Gebretsadik, Sarah Osmundson, Jennifer K Straughen, Amy Eapen, Andrea Cassidy-Bushrow, Ganesa Wegienka, Alex Sitarik, Kim Woodcroft, Audrey Urquhart, Albert Levin, Tisa Johnson-Hooper, Brent Davidson, Tengfei Ma, Emily S Barrett, Martin J Blaser, Maria Gloria Dominguez-Bello, Daniel B Horton, Manuel Jimenez, Todd Rosen, Kristy Palomares, Lyndsay A Avalos, Yeyi Zhu, Kelly J Hunt, Roger B Newman, Michael S Bloom, Mallory H Alkis, James R Roberts, Sunni L Mumford, Heather H Burris, Sara B DeMauro, Lynn M Yee, Aaron Hamvas, Antonia F Olidipo, Andrew S Haddad, Lisa R Eiland, Nicole T Spillane, Kirin N Suri, Stephanie A Fisher, Jeffrey A Goldstein, Leena B Mithal, Raye-Ann O DeRegnier, Nathalie L Maitre, Ruby HN Nguyen, Meghan M JaKa, Abbey C Sidebottom, Michael J Paidas, JoNell E Potter, Natale Ruby, Lunthita Duthely, Arumugam Jayakumar, Karen Young, Isabel Maldonado, Meghan Miller, Jonathan L Slaughter, Sarah A Keim, Courtney D Lynch, Kartik K Venkatesh, Kristina W Whitworth, Elaine Symanski, Thomas F Northrup, Hector Mendez-Figueroa, Ricardo A Mosquera, Margaret R Karagas, Juliette C Madan, Debra M MacKenzie, Johnnye L Lewis, Brandon J Rennie, Bennett L Leventhal, Young Shin Kim, Somer Bishop, Sara S Nozadi, Li Luo, Barry M Lester, Carmen J Marsit, Todd Everson, Cynthia M Loncar, Elisabeth C McGowan, Stephen J Sheinkopf, Brian S Carter, Jennifer Check, Jennifer B Helderman, Charles R Neal, Lynne M Smith
Institutions: Drexel University, Icahn School of Medicine at Mount Sinai, Emory University, Dartmouth College, Harvard University, Harvard Pilgrim Health Care, University of California, Davis, Duke University, Duke Medical Center, University of North Carolina at Chapel Hill, Johns Hopkins University, RTI International, Northwestern University
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $5,200
Awards: Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-Up, G1869699344, G1974852530, G1988135985, G2190254635, Resilience to prenatal stress: Implications for offspring health and neurodevelopment, G2516051815, G2766169687, Early Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO), Columbia Center for Children's Environmental Health in ECHO II: Impact of environmental exposures on children's health and the co-morbidity of asthma and ADHD., ECHO in Agricultural Washington and Rural Environments (ECHO AWARE), ASSESSING THE EVOLVING IMPACT OF EARLY LIFE EXPOSURES ON CHILD PHYSICAL HEALTH AND NEURODEVELOPMENT, G457819564, Mount Sinai ECHO site for Perinatal Environment and Development Studies, ECHO Renewal for the INSPIRE Study Cohort, Early Life Determinants of Child Health: A New Denver-Based Cohort, G5869702591, Prenatal Exposures and Child Health Outcomes 2: Increasing ECHO Urban and Rural Diversity, G7908395992, G796731216, Autism: Social and Communication Predictors in Siblings, G833303656, Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2, Preconception and Prenatal Health Impacting Factors and Child Health, G9000001270, G9000003391, G9000010796, G9000021191, G9000025637, G9000027450, G9000027494, G9000027636, G9000027973, G9000030369, G9000031755, G9000032645, G9000035545, G9000038244, G9000043298, G9000045817, G9000047767, G9000052929, G9000054878, G9000056855, G9000059539, G9000061677, G9000063312, G9000065193, G9000071661, G9000072616, G9000076072, G9000082517, G9000084979, G9000085602, G9000085698, G9000086074, G9000089160, G9000094357, G9000095024, G9000097450, G9000102029, G9000105771, G9000106765, G9000107045, G9000122439, G9000122753, G9000123098, G9000134580, G9000144879, G9000145361, G9000153013, G9000175423, G9000175822, G9000182430, G9000190789, G9000202421, G9000202576, G9000205763, G9000206263, G9000213019, G9000217686, G9000217873, G9000230525, G9000237105, G9000247545, G9000251564, G9000267474, G9000277210, G9000280754, G9000289244, G9000321463, G9000326798, Utah Children's Project, Prenatal Exposures and Child Health Outcomes 2: A Statewide Study of Michigan Families, Atlanta ECHO Pediatric Cohort, Continued follow-up of the Vitamin C and Smoking in Pregnancy (VCSIP) cohorts through the ECHO consortium, focus on Echo-wide protocols, respiratory outcomes, airway function, and epigenetic changes, Environmental influences on Child Health Outcomes (ECHO) Coordinating Center, Human Health Exposure Analysis Resource Core: Untargeted Analysis, ECHO DAC (Environmental Influences on Child Health Outcomes Data Analysis Center), University of Washington Interdisciplinary Center for Exposures, Diseases, Genomics & Environment, Environmental Influences on Child Health Outcomes (ECHO) and Pregnancy in Ohio, Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2, Duke Environmental Analysis Laboratory
OpenAlex ID: W4408514864