Maternal environmental exposure and early-life health risks: The modulating role of nutritional status-A scoping review.

Emerging evidence suggests that maternal food intake and nutritional status may modify the relationship between environmental toxicants and early-life health risks, potentially mitigating their adverse effects. However, the interplay between nutritional status, environmental exposures, and health outcomes remains poorly characterized in the literature. Notably, foods can serve as the dual source of toxins (e.g., methylmercury in fish) and protective nutrients (e.g., omega-3 fatty acids), which complicate their role in risk reduction. This scoping review aims to evaluate the extent of research on how maternal nutrition (from both dietary intake and supplements) modify the risk of adverse early-life outcomes associated with environmental exposures. We also identified critical research gaps to guide future investigations. Our search included identified English-language, free full-text articles from PubMed and Google Scholar published up to November 2025. Among the 60 included studies (55 observational and 5 interventional), most were conducted in the USA (42%), with toxic metals (33%) and endocrine disrupting chemicals (EDCs) (20%) as the primary exposures. Folate (28%) and fish/fatty acids (15%) were the most frequently studied nutrients/food sources. Neurodevelopmental/behavioral disorders (42%) and adverse birth outcomes (32%) were the predominant endpoints. Maternal nutrition, particularly folate, fish, vitamins, and minerals, may mitigate environmental exposure-related risks. The findings suggest that folate may modify health risks from air pollution, toxic metals, and smoking, whereas fish intake, fatty acids, selenium, and vitamins A, B, C, D, and E may modify the effects of air pollution, EDCs, toxic metals, and smoking. Future research should prioritize mechanistic studies, optimal dosages, and longitudinal designs in diverse populations.