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Eating a Mediterranean diet and reducing stress during pregnancy improve infant brain development

13 October 2023
IMPACT study team - BCNatal (SJD Barcelona Children's Hospital - Hospital Clinic)

The IMPACT-BCN clinical trial, which studied the benefits of different lifestyle changes during pregnancy, found that both eating a Mediterranean diet and reducing stress significantly improve infant brain development in the first two years of life.

Lifestyle changes such as eating a Mediterranean diet or embracing mindfulness to reduce stress during pregnancy improve brain development of children in their first two years of life. This was demonstrated in the IMPACT-BCN clinical trial published in the JAMA Network Open journal.

The clinical trial was coordinated by: Eduard Gratacós, director of BCNatal at the SJD Barcelona Children's Hospital and Hospital Clinic Barcelona (IRSJD and FRCB-IDIBAPS); Francesca Crovetto (SJD Barcelona Children's Hospital and IRSJD) and Fàtima Crispi(Hospital Clinic and FRCB-IDIBAPS); doctorand Ayako Nakaki (doctoral INPhINIT fellowship from the ‘Caixa’ Foundation); with the collaboration of Ramón Estruch from the Internal Medicine Department at Clinic, Head of the Cardiovascular Risk, Nutrition and Aging Group at FRCB-IDIBAPS and researcher at CIBEROBN; and Eduard Vieta, Head of the Psychiatry Department at Hospital Clinic, Head of the Bipolar and Depressive Disorders group at FRCB-IDIBAPS and Scientific Director of CIBERSAM.

The IMPACT-BCN clinical trial has been the first to assess active lifestyle changes, such as eating a Mediterranean diet or embracing mindfulness, among pregnant women. A clinical trial published in 2021 in the JAMA journal demonstrated for the first time that eating a Mediterranean diet or reducing stress during pregnancy reduced the likelihood of low birth weight by more than 30%.

Now investigators want to also examine the effects of maternal lifestyle changes during pregnancy on infant brain development. Thanks to the support from The ‘la Caixa’ Foundation and CEREBRA, the trial analysed data from the two first years of life of 626 children using the Bayley scale: a standardised test used for measuring infant brain development.  

Results show that children of mothers who ate a Mediterranean diet during pregnancy scored better in testing, particularly on a cognitive level (sensory and motor development, object interaction and concept formation) and also a social-emotional level (with regard to relationships and interaction). Moreover, children of mothers who followed a stress-reduction programme during pregnancy scored better in social-emotional tests. 

‘These results send a clear positive message that empowers mothers and families. It is possible to have a positive impact on the future child during pregnancy with relatively easy-to-apply measures’, declare the authors.

Study methodology

In the last ten years, several studies have shown that unhealthy diets or maternal stress were linked to poorer infant brain development. However, this is the first study that examined active changes to lifestyle among pregnant women.

The IMPACT-BCN study used the Mediterranean diet, which has shown very clear benefits in preventing cardiovascular diseases, neurodegenerative diseases, metabolic disorders and cancer. The Mediterranean diet is based on high-intake of vegetables, legumes, fish, white meat, dairy, wholegrains and healthy fats, such as extra virgin olive oil and nuts. Likewise, reducing stress during the study was done through a structured stress-reduction programme rooted in mindfulness, with complementary relaxation activities. 

All scores on the Bayley scale were corrected according to the mother's socio-economic level and the child’s gender, which are well-known areas of confusion.

Participating sites in the clinical trial 

The IMPACT-BCN trial (2017-2020) was carried out at BCNatal, a leading mother-and-child healthcare facility at the SJD Barcelona Children's Hospital and Hospital Clinic, a pioneer in clinical research and investigation. It is one of the largest mother-and-child and neonatal facilities in Europe, with a longstanding involvement in high-impact clinical trials. Furthermore, the trial was done in close collaboration with researchers from the IMIM-Hospital del Mar and from the Instituto esMindfulness.