European Journal of Clinical Nutrition https://doi.org/10.1038/s41430-018-0161-7 ARTICLE Maternal and pediatric nutrition Early first trimester maternal ‘high fish and olive oil and low meat’ dietary pattern is associated with accelerated human embryonic development Francesca Parisi 1 ● Melek Rousian 1 ● Régine P. M. Steegers-Theunissen 1,2 ● Anton H. J. Koning 3 ● Sten P. Willemsen 1,4 ● Jeanne H. M. de Vries 5 ● Irene Cetin 6 ● Eric A. P. Steegers 1 Received: 27 November 2017 / Revised: 23 January 2018 / Accepted: 4 March 2018 © Macmillan Publishers Limited, part of Springer Nature 2018 Abstract Background/objectives Maternal dietary patterns were associated with embryonic growth and congenital anomalies. We aim to evaluate associations between early first trimester maternal dietary patterns and embryonic morphological development among pregnancies with non-malformed outcome. Subjects/methods A total of 228 strictly dated, singleton pregnancies without congenital malformations were enrolled in a periconceptional hospital-based cohort. Principal component analysis was performed to extract early first trimester maternal dietary patterns from food frequency questionnaires. Serial transvaginal three-dimensional ultrasound (3D US) scans were performed between 6 +0 and 10 +2 gestational weeks and internal and external morphological criteria were used to define Carnegie stages in a virtual reality system. Associations between dietary patterns and Carnegie stages were investigated using linear mixed models. Results A total of 726 3D US scans were included (median: three scans per pregnancy). The ‘high fish and olive oil and low meat’ dietary pattern was associated with accelerated embryonic development in the study population (β = 0.12 (95%CI: 0.00; 0.24), p < 0.05). Weak adherence to this dietary pattern delayed embryonic development by 2.1 days (95%CI: 1.6; 2.6) compared to strong adherence. The ‘high vegetables, fruit and grain’ dietary pattern accelerated embryonic development in the strictly dated spontaneous pregnancy subgroup without adjustment for energy intake. Conclusions Early first trimester maternal dietary patterns impacts human embryonic morphological development among pregnancies without congenital malformations. The clinical meaning of delayed embryonic development needs further investigation. Introduction Human health is critically dependent on maternal exposures and especially nutrition during pregnancy. Several animal models considered the effect of maternal nutrition during pregnancy, showing interactions with hormonal signaling, placental functioning, fetal growth, and metabolism, which further program the foundation for later disease in adult life [1, 2]. More recently, even gametes and early embryos have been recognized to show lasting responses to nutritional programming due to the unique metabolic, epigenetic and developmental events occurring in the periconceptional period [3, 4]. Finally, first trimester human embryonic size and growth have been strongly associated with peri- conceptional maternal dietary patterns and one-carbon biomarkers, supporting the evidence that embryonic * Régine P. M. Steegers-Theunissen r.steegers@erasmusmc.nl 1 Department of Obstetrics and Gynecology, Erasmus MC University Medical Centre PO Box 2040, 3000 CA Rotterdam, Netherlands 2 Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Centre 3015 GD Rotterdam, Netherlands 3 Department of Bioinformatics, Erasmus MC University Medical Centre Dr. Molewaterplein 50-60, 3015 GE Rotterdam, Netherlands 4 Department of Biostatistics, Erasmus MC University Medical Centre PO Box 2040, 3000 CA Rotterdam, Netherlands 5 Human Nutrition Wageningen University Bomenweg 2, 6700 EV Wageningen, Netherlands 6 Department of Biomedical and Clinical Sciences, Hospital Luigi Sacco, Università degli Studi di Milano, Milan, Italy 1234567890();,: 1234567890();,: