A healthy and potentially sustainable Nordic diet in early life and aspects of child growth and development

Neha Agnihotri will defend the thesis for A healthy and potentially sustainable Nordic diet in early life and aspects of child growth and development for the PhD degree, 23 August 2023.

Agnihotri has followed the Ph.D. programme at The Faculty of Health and Sport Sciences.

Summary of the thesis:

What we eat directly impacts public health, food systems, the environment and the future. The New Nordic Diet (NND) has been proposed as a regionally appropriate and sustainable diet to the Nordic countries and the potential health benefits of the NND have been increasingly investigated in different samples and populations. However, there is limited knowledge on the effects of adherence to the NND from fetal life through maternal diet and into childhood. Healthy child growth and development resulting from a nutritionally adequate maternal and child diet during this phase and beyond, has the potential to impact both present and future health.

In this thesis, we therefore wanted to investigate whether a dietary pattern in line with the NND could be beneficial for aspects of growth and development in children, while also being healthy and potentially sustainable. Three research aims were put forth to investigate this overarching purpose, which correspond to the three research papers included in this thesis. The data material was obtained from the Norwegian Mother, Father and Child Cohort Study (MoBa). In the first study, we developed child diet scores reflecting adherence to the NND, based on a maternal pregnancy NND-score which has been developed in an earlier project. Dietary data was available from parent-completed questionnaires at four time-points, resulting in child NND-scores operationalizing adherence to a healthy and potentially sustainable child diet at age 6 months (n=89,715), 18 months (n=76,432), 3 years (n=58,884), and 7 years (n=35,978). In the second paper, we aimed to assess potential associations with maternal and child adherence to the NND and weight status at eight years of age (n=14, 989). In the last paper, we wanted to investigate potential associations with the NND-scores and measures of language and motor development up to five years of age (n=83,800). A quantitative approach was applied with logistic regression analyses in both latter studies, in addition to linear regression in the last study.

The main results from this thesis show that although the developed child NND-scores could not fully resemble the maternal pregnancy NND-score, aspects of diet quality and features of a healthy and potentially sustainable diet in children could still be captured to some degree. There was no association with NND adherence and weight status at 8 years in adjusted analyses, which could be a true nullfinding, or it could partly be explained by the complexity of this relationship and that the MoBa-sample was healthier than the general population. On the other hand, we did find a positive association between maternal and child NND-adherence with communication and motor skills, and with low and medium adherence indicating higher odds for developmental delay at almost all measured timepoints in crude and adjusted analyses.

Therefore, a diet based on the NND during pregnancy and childhood, with key foods such as whole grains, fruits, vegetables, cabbages, potatoes, milk, oatmeal, fish, water, and being breast-fed and receiving homemade food as a toddler, can be beneficial for immediate and future child development, while also having an environmental-friendly potential. Although the developed scores may have shortcomings regarding validity, the findings in the current thesis contribute to the field with its prospective and longitudinal nature. The findings are relevant in terms of expanding the knowledge on the positive health effects of regional and sustainable diets starting from early life through maternal diet and onwards. Further research on sustainable diets is encouraged as an investment for future healthy generations on a healthy planet.

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