Cristina Jardí

Purpose To investigate the associations between maternal consumption of fresh fruits, vegetables, and fruit juices during pregnancy and neonatal anthropometric outcomes, including birth weight, birth length and head circumference. Methods A prospective cohort study was conducted, including 614 mother–child pairs. Maternal diet was assessed as the average intake across the three trimesters using a validated food frequency questionnaire. Neonatal outcomes were assessed using INTERGROWTH-21st standards as continuous (z-scores) and categorical (below the 10th percentile [< P10]) measures of birth weight, birth length, and head circumference. Associations were estimated using multivariable linear and logistic regression models adjusted for relevant covariates. Results Each 100 g/day increase in combined consumption of fresh fruits and vegetables during pregnancy was associated with higher birth weight z-score (β = 0.14 [0.01, 0.27]) and lower odds of birth weight < P10 (OR = 0.62 [0.41, 0.96]) and birth length < P10 (OR = 0.64 [0.42, 0.98]). Separately, each 100 g/day increase in vegetable consumption was associated with lower odds of birth weight < P10, whereas higher fresh fruit consumption was associated with lower odds of birth length < P10. No significant associations were observed for fruit juice consumption, and none of the dietary exposures were associated with head circumference outcomes. Conclusion This study provides new evidence on maternal fresh fruit and vegetable consumption in relation to neonatal anthropometric outcomes by evaluating their overall combined intake alongside their separate consumption. These findings may help strengthen the evidence base for maternal nutritional guidance.

Background/Objectives: Maternal diet plays a crucial role in fetal development and may influence offspring weight development. Although fruits and vegetables provide nutritional and metabolic benefits during pregnancy, evidence regarding their specific role on childhood overweight/obesity remains limited. This study aimed to examine the association between maternal intake of fruits, vegetables, and fruit juices during pregnancy and the risk of overweight/obesity in children at 4 years of age. Methods: We analyzed 252 mother–child pairs from the Mediterranean ECLIPSES cohort in a prospective observational study. Maternal dietary intake was assessed at 12, 24 and 36 weeks of gestation using a semiquantitative food frequency questionnaire previously validated in a Spanish population. Childhood overweight/obesity was defined as a BMI z-score above the 85th percentile for age and sex at age 4. Multivariable-adjusted logistic regression models estimated ORs and 95% CIs. Results: Higher maternal consumption of fruits and vegetables was inversely associated with overweight/obesity in children (OR: 0.31 [0.13–0.74]). No associations were observed for total or natural fruit juice, whereas higher consumption of commercial fruit juice was associated with increased odds of overweight/obesity (OR: 2.48 [1.06–5.78]). Conclusions: Higher maternal combined consumption of fruits and vegetables during pregnancy was associated with lower odds of overweight or obesity in offspring at 4 years of age, whereas the opposite association was observed for commercial, but not natural, fruit juice. These associations may involve both prenatal biological and postnatal behavioral and family dietary pathways; however, the commercial fruit juice finding should be considered exploratory and requires confirmation in larger prospective studies.

Vitamin B12 is an essential micronutrient required for DNA synthesis, red blood cell formation, and neurological function, and its adequate status is particularly important during pregnancy to supp...

Evidence on prenatal ultra-processed food (UPF) consumption and offspring psychopathological problems remains limited. Therefore, this study assessed the associations between UPF consumption during pregnancy and offspring emotional and behavioral problems. The potential impact of theoretically replacing UPFs with unprocessed or minimally processed foods was also examined using simulation models. The analyses included 201 mother-child pairs from the ECLIPSES study. Dietary intake was assessed using a validated food frequency questionnaire at 12, 24, and 36 weeks of gestation. UPF consumption (%grams/day) was estimated using the NOVA classification system. Children’s behavior was assessed at age 4 using the parent-reported Child Behaviour Checklist (1.5 to 5 years), with outcomes defined as borderline/clinical scores. Multivariable-adjusted logistic regression models were fitted. Every 10% grams/day increase in prenatal UPF consumption was associated with higher odds of having children with borderline/clinical scores on several syndrome and broad-band scales: emotionally reactive (Odd ratios [OR]: 1.67; 95% Confidence interval [CI]: 1.06–2.63), aggressive behavior (OR 2.13; 95% CI: 1.18–3.84), internalizing problems (OR: 1.56 95%CI: 1.06–2.31), externalizing problems (OR: 2.00; 95% CI: 1.31–3.07) and total problems (OR: 1.68; 95%CI: 1.12–2.51). Associations were also observed with DSM-oriented scales, including depressive (OR: 2.08; 95%CI: 1.25–3.45), attention deficit/hyperactivity (OR: 1.71; 95%CI: 1.08–2.68) and oppositional defiant problems (OR: 1.85; 95%CI: 1.09–3.13). Replacing 10%grams/day of UPF with equal amounts of unprocessed or minimally processed foods was associated with lower likelihood of children presenting the aforementioned borderline/clinical scores. The findings suggest that prenatal UPF consumption might be associated with adverse emotional and behavioral outcomes in the offspring.

Aim: The prevalence of type 2 diabetes (T2D) is rising, posing serious public health challenges. While evidence from experimental settings shows that combined aerobic and resistance training improves cardiometabolic health in T2D, data from real‐world primary care—especially Mediterranean populations—remain limited. This trial assessed the effects of two 9‐month supervised exercise interventions on cardiometabolic outcomes in T2D primary care patients in the Mediterranean region of Catalonia, Spain. Methods: In this community‐based, parallel‐group trial within the “Pas a Pas” project, 273 primary care patients with T2D (mean age 68 ± 8.5 years) were randomized to 9‐month exercise programs: aerobic training ( n = 69), combined aerobic and resistance training ( n = 77), or control ( n = 127). Exercise groups attended two weekly 60‐min supervised outdoor sessions using public parks. Primary outcomes were 9‐month changes in fasting glucose and HbA1c; secondary outcomes included adiposity measures, lipid profile, and blood pressure. Multivariable‐adjusted regression models were applied. Results: After 9 months, combined training significantly reduced fasting glucose and HbA1c, while aerobic training showed no meaningful change. Combined training was more effective than controls and aerobic training in maintaining or improving glycemic levels. Fasting glucose worsened in the aerobic group versus controls. Both exercise groups reduced body weight and BMI, but only the combined group exceeded controls. Additionally, combined training improved LDL cholesterol and both systolic/diastolic blood pressure. Conclusions: While both interventions improved weight‐related outcomes, combined aerobic and resistance training showed superior benefits in glycemic control and cardiometabolic risk. These findings support integrating structured, multicomponent exercise programs within primary care for T2D management. Trial Registration: ClinicalTrials.gov identifier: NCT02767739

The impact of prenatal exposure to trace metal mixtures on children’s neurodevelopment remains debated. Many studies treat all trace metals as a single entity, overlooking the distinct biological roles of essential and toxic metals. This approach may highlight overall exposure but fails to capture their differential effects on neurodevelopment. This study aims to examine the associations between prenatal exposure to essential and toxic metals and children’s cognitive development, focusing on their independent effects. A cohort of 201 mother–infant pairs was analyzed. Maternal urinary metal levels were measured at 12 weeks of gestation, and children’s neurodevelopment was assessed at 4 years using the Wechsler Preschool and Primary Scale of Intelligence and the Developmental Neuropsychological Assessment. Generalized Additive Models (GAM), Restricted Cubic Spline (RCS), and Weighted Quantile Sum (WQS) regression were applied. GAM identified non-linear associations between essential metals (manganese and molybdenum) and cognitive outcomes, including verbal comprehension index (VCI), working memory index, full-scale IQ, and general ability index, which were confirmed by RCS. No non-linear relationships were observed for toxic metals. WQS showed negative associations between toxic metals and VCI (b = −1.07), processing speed index (b = −0.98), vocabulary acquisition index (b = −1.25), and verbal fluency (b = −0.23), mainly driven by cadmium (Cd) and antimony (Sb). Essential metal mixtures were not associated with cognitive outcomes. Prenatal exposure to toxic metals negatively affects children’s cognitive and neuropsychological development. Reducing maternal exposure during pregnancy is essential for protecting offspring development.

Background/Objectives: Dietary patterns rich in plant-based foods during pregnancy have been associated with neurodevelopmental outcomes in offspring. However, not all components of these diets are healthy, and the impact of their quality on behavioral outcomes remains unexplored. Therefore, this study aimed to examine the association between healthy and unhealthy plant-based diets and offspring behavioral problems at the age of four. Methods: This research involved 201 mother–child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated food frequency questionnaire, from which the healthy plant-based diet index (hPDI) was calculated, emphasizing the consumption of fruits, vegetables, legumes and nuts, along with the unhealthy plant-based diet index (uPDI), highlighting the intake of sugary drinks and refined grains. Children’s behavior was evaluated using the Child Behavior Checklist 1.5-5. Multivariable logistic regression analyses were conducted to estimated odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Greater adherence to the uPDI during pregnancy was associated with higher odds for externalizing problems, including attention-deficit/hyperactivity problems (OR = 1.08; 95%CI from 1.01 to 1.16) and oppositional defiant behavior (OR = 1.09; 95%CI from 1.00 to 1.19) in offspring, particularly girls. Higher adherence to the hPDI was not associated with children’s behavior. Conclusions: The consumption of unhealthy components of a plant-based dietary pattern during gestation has been associated with adverse behavioral outcomes in children at age four. These findings underscore the importance of discerning between the healthy and unhealthy components of plant-based diets when assessing their impact on child development.

Background: The balance of omega-6/omega-3 (n-6/n-3) is crucial for proper brain function as they have opposite physiological roles. Objectives: To analyze the association between maternal serum ratios of n-6/n-3 in the first and third trimesters of pregnancy and the neurodevelopment of their children in the early days after birth in the population of Northern Spain’s Mediterranean region. Methods: Longitudinal study in which 336 mother–child pairs participated. Mother serum concentrations of long-chain polyunsaturated fatty acids (LCPUFAs), docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA) were determined. Sociodemographic, clinical, lifestyle habits, and obstetrical variables were collected. The Bayley Scales of Infant and Toddler Development (BSID-III) was used to assess infant neurodevelopment. Multiple linear regression models adjusting for confounding factors were performed. Results: In the third trimester, a higher maternal n-6/n-3 ratio was negatively associated with infant motor development (β = −0.124, p = 0.023). Similarly, higher ARA/DHA ratios were negatively associated with total motor (β = −2.005, p = 0.002) and fine motor development (β = −0.389, p = 0.001). No significant associations were observed in the first trimester nor for the ARA/EPA ratio in the third trimester. Conclusions: Our findings indicate that an elevated n-6/n-3 ratio and ARA/DHA ratio in the third trimester of pregnancy are associated with poorer motor development outcomes in infants. These results highlight the importance of optimizing maternal fatty acid balance during pregnancy to support fetal neurodevelopment, suggesting a need for further research to verify these associations and elucidate underlying mechanisms.

Prenatal exposure to dietary toxicants is linked to neurocognitive issues, but its effect on early emotional and behavioral development in children is less clear. To explore the relationship between prenatal intake of As, iAs, Cd, MeHg, Pb, PCDD/Fs, DL-PCBs, and NDL-PCBs and emotional and behavioral issues in four-year-old children. This study included 192 mother–child pairs from the ECLIPSES study, assessing prenatal dietary toxicant exposure through a food-frequency questionnaire and Catalan Food Safety Agency data. Children’s emotional and behavioral scores were evaluated using the Child Behavior Checklist for ages 1.5–5 years. Multivariable regression and logistic models were used, focusing on iAs after finding significant preliminary associations. Increased prenatal dietary intake of iAs was associated with internalizing, externalizing, and attention-deficit/hyperactivity problems. Higher iAs levels (>4.16 μg/day) significantly increased the risk of total problems (OR = 2.94) and specific issues like anxious/depressed (OR = 4.88), anxiety (OR = 3.27), and oppositional defiant problems (OR = 4.30). High iAs consumption correlated with the intake of meat, eggs, cereals, tubers, fruits, and pulses Prenatal dietary iAs exposure is associated with various emotional and behavioral problems in children. Monitoring and reducing iAs levels in food are crucial for public health.