Cheese consumption during pregnancy is associated with improved neurological development in children

A recent study published in the journal PLoS ONE examined the association between maternal consumption of fermented foods during pregnancy and children's development at age 3.

Fermented food consumption regulates the gut microbiota and helps prevent diseases such as diabetes, allergies, depression, obesity and constipation. Research suggests a link between autism, depressive symptoms, gut-brain interactions and fermented food consumption. Although diet alters gut microbiota, fetal microbiota development begins in the womb and is inherited from the mother. This means that maternal consumption of fermented foods may influence fetal development by improving the gut environment. Fermented foods also provide nutrients that are beneficial for the child’s development. Further research is needed to comprehensively assess the factors that influence the relationship between maternal diet and child development.

The Japan Environment and Children's Study (JECS) is a national cohort study examining the effects of the environment on children's health and development. This study used data from the JECS collected from 103,060 pregnancies. After excluding cases of multiple registration, multiple pregnancies, miscarriage or stillbirth, and incomplete data, 60,910 mother-child pairs were analyzed.

Maternal consumption of fermented foods (miso, natto, yogurt, and cheese) during pregnancy was assessed using a self-administered food frequency questionnaire. All participants provided written informed consent. The primary outcome, children's neurodevelopment at age 3, was assessed using the Ages and Stages Questionnaires (ASQ-3). This instrument assesses development in five domains: communication, problem solving, gross motor skills, fine motor skills, and social skills.

Participants' responses were assessed, taking into account partially completed questionnaires. Data were analyzed using multivariable logistic regression to estimate the risk of neurodevelopmental delays based on maternal fermented food intake, divided into quartiles. Factors included maternal age, body mass index, parity, smoking, passive smoking, alcohol intake, physical activity, folate intake, energy intake, marital status, educational level, partner's educational level, employment, household income, and antibiotic use. Potential mediators were excluded as covariates.

Consumption levels of four fermented foods during pregnancy were categorized into quartiles:

• Miso: 0–24 g, 25–74 g, 75–145 g, 147–2.063 g
• Natto: 0–1.7 g, 3.3–5.4 g, 10.7–12.5 g, 16.1–600.0 g
• Yogurt: 0-8 g, 12-26 g, 30-90 g, 94-1.440 g
• Cheese: 0–0.7 g, 1.3–2.0 g, 2.1–4.3 g, 5.0–240.0 g

Mothers who consumed more yogurt during pregnancy tended to have higher levels of education, higher annual income, and a higher percentage of first-time mothers. Their partners were also more likely to have higher levels of education and a lower percentage of smokers or passive smokers. All groups with high fermented food consumption had higher energy and folate intakes compared to the low-consumption group.

Multivariable logistic regression analysis showed that cheese consumption during pregnancy significantly reduced the risk of neurodevelopmental delays in children across all five domains at age 3 years.

Mothers in the highest quartile of cheese consumption had children with significantly lower risk of delays in communication, gross motor, fine motor, problem solving, and social skills compared with mothers in the lowest quartile. Similarly, higher yogurt consumption was associated with a reduced risk of developmental delays, particularly in communication, among mothers in the highest quartile of consumption.

Interestingly, higher levels of miso and natto consumption also showed some beneficial effects, but they were less pronounced compared to yogurt and cheese. For example, mothers in the highest quartile of miso consumption had children with a modest reduction in the risk of delays in communication skills. However, natto consumption did not show a significant correlation with reduced developmental delays across the domains assessed.

Overall, when mothers consumed ≥1.3 g of cheese daily during pregnancy, their children had a significantly reduced risk of motor and neurodevelopmental delays at age 3 years. Fermented foods increase nutritional value through microbial fermentation, promoting health and influencing neurodevelopment through gut-brain interactions. Previous studies have linked maternal intake of fish, fruit, and vitamins to better child development. This study extends previous findings by highlighting the unique benefits of cheese. Cheese contains important nutrients such as protein, zinc, and tryptophan that support neurodevelopment. Improving maternal gut health through fermented food consumption may positively impact fetal development, highlighting the importance of maternal diet during pregnancy.