Emotion regulation in the two-year-old offspring of pregnant persons in a diet-and-exercise intervention: A randomized controlled trial

This study examined whether a high protein/energy-controlled diet and exercise pregnancy intervention influences putative emotional regulation (ER) neural activity in two-year-old offspring. Participants were recruited from the Be Healthy in Pregnancy randomized controlled trial. Pregnant individuals (n = 24; >18 years, singleton pregnancy, 12-17 weeks gestation) were randomized to either an intervention (high-protein, energy-controlled diet, nutrition counseling, walking program plus usual pregnancy care [UPC]) or control (UPC only) group. Offspring (n = 12 intervention, n = 12 control) completed resting-state EEG using a 128-channel EEG and a delayed gratification task at age two. Delta-Beta Coupling, an EEG-derived index of ER-related neural function, was measured via correlation between delta (2-4 Hz) and beta (13-30 Hz) power. Children of intervention group participants exhibited a significantly lower delta-beta correlation in frontal (Z = -2.20, p = 0.03), central (Z = -2.34, p = 0.02), and parietal (Z = -2.32, p = 0.02) regions, as well as superior performance on the delayed gratification task (p = 0.04, Hedges' g = 0.89). Prenatal diet and exercise interventions may promote more efficient ER-related neural functioning and behavioral self-regulation in early childhood. These findings suggest modifiable prenatal factors can shape offspring neurodevelopment, supporting early interventions to enhance emotional and cognitive outcomes.