Prenatal Diet in Relation to Sleep Health of Offspring During Adolescence: Evidence From the ELEMENT Study

Abstract

Objectives Maternal diet during gestation has been linked to sex-specific differences in infant sleep; however, the impact on sleep into adolescence is unknown. We sought to examine the relationship between maternal diet patterns and sex-stratified offspring sleep health during adolescence among a Mexico City cohort. Methods Data from 309 mother-adolescent dyads were analyzed. Prenatal diet patterns were formed by principal component analysis derived from a food frequency questionnaire collected over the third trimester. Sleep variables were derived from 7-day actigraphy data from adolescents aged 9–17 years. Linear regression was employed to examine sex-stratified associations between tertiles of the diet patterns with adolescent sleep, adjusting for confounding factors. Results Three diet patterns included: the Prudent Diet (PD), high in lean proteins and vegetables; the Transitioning Mexican Diet (TMD) high in Mexican and “Westernized” foods; and the High Meat & Fat Diet (HMFD), high in meats and high-fat dairy products. The mean (SD) offspring age was 15.1 (1.9) years, and 52.4% of the sample was female. The mean (SD) sleep duration was 8.4 (1.4) h/night. Adjusted analyses showed an association between PD adherence and earlier sleep midpoint among female offspring, the offspring of mothers in the highest tertile of PD had a 0.70 h (95% CI: −1.2, −0.20; p = 0.01) earlier sleep midpoint (p, trend = 0.01). Additional associations were detected between TMD prenatal adherence with shorter sleep duration and earlier sleep midpoint among both sexes. For example, female and male offspring of mothers in the highest tertile of TMD had 0.80 h (95% CI: −85.0, −10.6; p = 0.01) (p, trend = 0.0043) and 0.54 h (95% CI: −66.1, 1.3) (p, trend = 0.03) shorter sleep duration, respectively. HMFD prenatal adherence was associated with less fragmented sleep in a non-linear manner among females and was non-linearly associated with an earlier sleep midpoint among males. Conclusions Sex-stratified analyses demonstrated that findings were more robust between multiple diet patterns and shorter sleep, earlier sleep timing, and less fragmented sleep among female offspring, thus indicating that maternal diet during pregnancy may impact female offspring's sleep health in adolescence. Funding Sources US EPA, NIEHS, NHLBI, and the National Institute of Public Health/Ministry of Health of Mexico.