The Importance of Nutrition in Early Childhood Development

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Nutrition and Early Brain Development
October 12, at 2: Both prenatal and postnatal fatty acid deficiency in rodents reduces the amount and alters the composition of myelin. The Bacon Chow study: Of all the cells that are produced in the brain, about half die through a variety of mechanisms. Jamaica 49 , , — Thus nutritional deficiencies during pregnancy and infancy are likely to affect cognition, behaviour and productivity throughout the school years and adulthood. Zinc supplementation during infancy may positively affect motor development and activity levels, but it does not seem to affect early cognitive ability.

Introduction

Nutrition and brain development in early life

Three randomized trials in Ghana, China, and South Africa demonstrated positive effects on motor development in children between the ages of 12 and 18 months , , and one trial also showed an effect on the overall developmental quotient. When a child is adequately nourished from conception through infancy, the essential energy, protein, fatty acids, and micronutrients necessary for brain development are available during this foundational period, establishing the basis for lifetime brain function.

The well-nourished child is also better able to interact with his or her caregivers and environment in a way that provides the experiences necessary for optimal brain development. Children who are not adequately nourished are at risk for failing to reach their developmental potential in cognitive, motor, and socioemotional abilities.

These abilities are strongly linked to academic achievement and economic productivity. Therefore, preventing or reversing developmental losses in early childhood is crucial for fostering economic development in low- and middle-income countries as well as reducing economic disparities in high-income countries. The evidence is clear that the following conditions are key risk factors for poor motor, cognitive, and socioemotional development: Preventing these conditions should be a global health priority.

The following interventions are examples of strategies that have been found to be effective in preventing or improving these conditions: Strategies to promote exclusive breastfeeding during the first 6 months of life and continued breastfeeding thereafter, along with adequate complementary feeding, are also likely to improve cognitive development, though additional evidence for the effectiveness of these strategies is also needed. The following interventions are promising for preventing developmental loss: However, additional robust research in low- and middle-income countries that evaluates the long-term effects of these interventions is needed.

The design and interpretation of further research should take into account the factors discussed above: Interventions to improve the home environment and the quality of caregiver-infant interaction are also recommended to complement and enhance the effect of improved nutrition.

These types of interventions are crucial to offset the negative effects of adverse environmental conditions for example, poverty and low maternal education that often coexist in populations in which undernutrition is common. Integrated strategies targeting multiple risk factors, including nutrition, are necessary to reduce inequality and promote cognitive, motor, and socioemotional development in disadvantaged children worldwide, ensuring that all children have the opportunity to fulfill their developmental potential.

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Close mobile search navigation Article navigation. Role of Nutrients in Brain Development. Factors Influencing the Impact of Undernutrition. Brief Review of Human Studies. Nutrition and brain development in early life Elizabeth L Prado.

Abstract Presented here is an overview of the pathway from early nutrient deficiency to long-term brain function, cognition, and productivity, focusing on research from low- and middle-income countries. This begins in week 7 of gestation and continues to at least 4. This process begins during gestation and continues through at least 2 years after birth. In some brain areas, axons reach their final destinations at 15 weeks gestation, in others at 32 weeks gestation. Dendrite growth begins at 15 weeks gestation and continues through the second year after birth in some brain areas.

Synapse formation begins during gestation around week 23 and continues throughout the lifespan. Synaptic density reaches a peak at different times in different brain areas for example, in the visual cortex between 4 and 12 months postpartum, and in the prefrontal cortex after 15 months postpartum. Synapse overproduction is completed in the second year after birth, while synaptic pruning begins in the first year after birth and continues through adolescence.

Myelination begins as early as 12—14 weeks of gestation in the spinal cord and continues until adulthood. The most significant period of myelination occurs from mid-gestation to age 2 years. After birth, the rate of myelination of areas involved in vision and hearing reaches a peak before myelination of areas underlying language, coinciding with the emergence of these abilities.

Of all the cells that are produced in the brain, about half die through a variety of mechanisms. When levels of neurotrophic factors are below a certain threshold, molecules within the cell trigger degeneration. Neuron apoptosis coincides with the period of synaptogenesis, beginning during gestation and continuing through adolescence.

Reduced neuron proliferation has been shown in animals with gestational DHA deficiency. Both prenatal and postnatal fatty acid deficiency in rodents reduces the amount and alters the composition of myelin.

In animal models, even marginal iron deficiency during prenatal and early postnatal development decreases myelin synthesis and alters myelin composition, which is not corrected with iron repletion. Gestational iodine deficiency in sheep and marmosets resulted in reduced brain weight and cell number, which was not corrected with iodine repletion. No effect on brain weight or cell number was found in rodents with gestational iodine deficiency, but cell migration was impaired.

Gestational zinc deficiency in rodents results in decreased number of cells, as reflected by total brain DNA 29 and reduced regional brain mass in the cerebellum, limbic system, and cerebral cortex.

Gestational choline deficiency in rodents has long-term effects on cholinergic neurotransmission despite repletion. View large Download slide. Positive effects on vocabulary and reading achievement were found only in children who received supplementation before 2 years of age. An effect of the high protein and energy milk was found on one of several measures of cognitive development.

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Perinatal iron deficiency alters apical dendritic growth in hippocampal CA1 pyramidal neurons. Fetal iron deficiency disrupts the maturation of synaptic function and efficacy in area CA1 of the developing rat hippocampus. Recent evidence from human and animal studies regarding iron status and infant development.

Chronic marginal iron intakes during early development in mice result in persistent changes in dopamine metabolism and myelin composition. Morphologic study on cerebral cortex development in therapeutically aborted fetuses in an endemic goiter region in Guizhou.

The impaired growth induced by zinc deficiency in rats is associated with decreased expression of the hepatic insulin-like growth factor I and growth hormone receptor genes.

Imprinting of hippocampal metabolism of choline by its availability during gestation: Maternal vitamin B 12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic acid fortification.

Effects of vitamin B 6 deficiency on morphological changes in dendritic trees in Purkinje cells in developing cerebellum in rats.

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Differential rearing affects corpus callosum size and cognitive function of rhesus monkeys. Modeling transformations of neurodevelopmental sequences across mammalian species. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: Nutritional supplementation, maternal education, and cognitive development of infants at risk of malnutrition.

Double burden of iron deficiency in infancy and low socioeconomic status: The effect of birthweight on childhood cognitive development in a middle-income country. Early childhood development interventions and cognitive development of young children in rural Vietnam. Home intervention improves cognitive and social-emotional scores in iron-deficient anemic infants. Zinc supplementation and psychosocial stimulation: Prenatal choline availability modulates hippocampal neurogenesis and neurogenic responses to enriching experiences in adult female rats.

Nutrition and environmental interactions in the behavioural development of the rat: Activity and behavioral development in stunted and nonstunted children and response to nutritional supplemenation. Time course of axonal myelination in the human brainstem auditory pathway.

Model-based analysis and quantification of age trends in auditory evoked potentials. Nutritional effects on auditory brainstem maturation in healthy term infants. Issues in the timing of integrated early interventions: Sheep models of intrauterine growth restriction: Maternal iron status influences iron transfer to the fetus during the third trimester of pregnancy.

Effects of prenatal food and micronutrient supplementation on infant development: Maternal multiple micronutrient supplements and child cognition: Iron-fortified vs low-iron infant formula: Neurodevelopmental disorders after prenatal famine: Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood.

Children who recover from early stunting and children who are not stunted demonstrate similar levels of cognition.

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The crucial role of thiamine in the development of syntax and lexical retrieval: A review of studies of the effect of severe malnutrition on mental development. Infant malnutrition is associated with persisting attention deficits in middle adulthood. Socioeconomic outcomes in adults malnourished in the first year of life: Effects of being born small for gestational age on long-term intellectual performance.

Inequality in early childhood: Low birth weight, prematurity, and paternal social status: The effect of psychosocial stimulation on cognition and behaviour at 6 years in a cohort of term, low-birthweight Jamaican children. Development and behaviour of low-birthweight term infants at 8 years in northeast Brazil: Low birthweight and subsequent emotional and behavioural outcomes in year-old children in Soweto, South Africa: Growth and development of term children born with low birth weight: Neurodevelopmental outcome in children with intrauterine growth retardation: Effects of early childhood supplementation on the educational achievement of women.

Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. The behavioral consequences of protein-energy deprivation and supplementation in early life: The Bacon Chow study: Developmental effects of short-term supplementary feeding in nutritionally at-risk Indonesian infants.

Three-month nutritional supplementation in Indonesian infants and toddlers benefits memory function 8 y later. Effects of an energy and micronutrient supplement on mental development and behavior under natural conditions in undernourished children in Indonesia. Effects of an energy and micronutrient supplement on growth and activity, correcting for non-supplemental sources of energy input in undernourished children in Indonesia. Effects of early childhood supplementation with and without stimulation on later development in stunted Jamaican children.

Effects of stunting in early childhood on growth, IQ and cognition at age 11—12 years and the benefits of nutritional supplementation and psychological stimulation. Effects of early childhood psychosocial stimulation and nutritional supplementation on cognition and education in growth-stunted Jamaican children: Early childhood stunting is associated with poor psychological functioning in late adolescence and effects are reduced by psychosocial stimulation.

Oligosaccharides in human milk: A critical evaluation of the evidence on the association between type of infant feeding and cognitive development. Breast milk and cognitive development — the role of confounders: Effect of breast feeding on intelligence in children: Breastfeeding and maternal and infant health outcomes in developed countries. What are the causal effects of breastfeeding on IQ, obesity and blood pressure?

Evidence from comparing high-income with middle-income cohorts. Breastfeeding and child cognitive development: Impact of fatty acid status on growth and neurobehavioural development in humans. Meta-analysis of long-chain polyunsaturated fatty acid supplementation of formula and infant cognition. Developmental profiles of polyunsaturated fatty acids in the brain of normal infants and patients with peroxisomal diseases: Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: Effects of nutrient fortified complementary food supplements on development of infants and young children in poor rural area of Gansu Province.

Developmental outcomes among month-old Malawians after a year of complementary feeding with lipid-based nutrient supplements or corn-soy flour. The effect of maternal omega-3 n-3 LCPUFA supplementation during pregnancy on early childhood cognitive and visual development: Assessment of the risk of zinc deficiency in populations and options for its control.

Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. Effects of maternal micronutrient supplementation on the mental development of infants in rural western China: Effect of iron supplementation during pregnancy on the intelligence quotient and behavior of children at 4 y of age: Effects of iron supplementation of LBW infants on cognition and behavior at 3 years.

Preschool iron-folic acid and zinc supplementation in children exposed to iron-folic acid in utero confers no added cognitive benefit in early school-age. Preschool micronutrient supplementation effects on intellectual and motor function in school-aged Nepalese children. Iron deficiency and iron-deficiency anemia in the first two years of life: Neurological damage to the fetus resulting from severe iodine deficiency during pregnancy. A metaanalysis of research on iodine and its relationship to cognitive development.

The effects of iodine on intelligence in children: Iodine deficiency in pregnancy, infancy and childhood and its consequences for brain development. Effects of iodine supplementation during pregnancy on child growth and development at school age. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: Iodine and mental development of children 5 years old and under: Folate status of mothers during pregnancy and mental and psychomotor development of their children at five years of age.

Zinc supplementation during pregnancy and effects on mental development and behavior of infants: A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: Iron and zinc supplementation promote motor development and exploratory behavior among Bangladesh infants. Daily supplementation with iron plus folic acid, zinc, and their combination is not associated with younger age at first walking unassisted in malnourished preschool children from a deficient population in rural Nepal.

Randomized controlled trial of the effect of zinc supplementation on the mental development of Bangladeshi infants. Effect of zinc supplementation on development and growth of Chilean infants. Effect of zinc supplementation on observed activity in low socioeconomic Indian preschool children. Zinc supplementation affects the activity patterns of rural Guatemalan infants.

Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Relation of maternal zinc nutriture to pregnancy outcome and infant development in an Egyptian village. Diet during lactation associated with infant behavior and caregiver-infant interaction in a semirural Egyptian village. Effect of maternal multivitamin supplementation on the mental and psychomotor development of children who are born to HIVinfected mothers in Tanzania.

Effect of a fortified maize-meal porridge on anemia, micronutrient status, and motor development of infants. The effect of nutritional supplementation on physical activity and exploratory behavior of Mexican infants aged 8—12 months. Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt. Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries.

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Neuron proliferation is the creation of new cells through cell division. Axons and dendrites are branching projections that grow out from cell bodies to make connections with other cells. Synapses are connections between axons, dendrites, and cell bodies. Myelin is white, fatty matter that covers axons and accelerates the speed of nerve impulses traveling from one cell to another. Apoptosis is programmed cell death. Human autopsy studies and magnetic resonance imaging studies have shown that infants with IUGR had fewer brain cells and cerebral cortical grey matter volume than normal-birth-weight infants.

A human autopsy study showed that 3—4-month-old infants with moderate malnutrition low weight for age had decreased dendritic span and arborization complexity of branching projections compared to well-nourished infants. Both prenatal and postnatal undernutrition in rodents results in fewer synapses as well as synaptic structural changes.

Human autopsy studies have also shown that infants with severe acute malnutrition have fewer brain cells than well-nourished infants. Neurogenesis requires the synthesis of large amounts of membrane phospholipid from fatty acids. Arachidonic acid and docosahexaenoic acid DHA in membranes at synaptic sites play a role in the maturation of synapses and in neurotransmission.

Fatty acids are structural components of myelin. Iron is required for the enzyme ribonucleotide reductase that regulates central nervous system cell division. Gestational and neonatal iron deficiency in rodents results in truncated dendritic branching in the hippocampus, which persists into adulthood despite iron repletion.

Gestational and early postnatal iron deficiency in rodents results in decreased synaptic maturity and efficacy in the hippocampus, which persists despite iron repletion. Iron plays a role in myelin synthesis. In adult rodents, iron deficiency decreases the number of dopamine D2 receptors and the density of dopamine transporter in the striatum and nucleus accumbens.

In both animal models and cell culture experiments, dopamine and norepinephrine metabolism are altered by iron deficiency. Some fetuses aborted in months 6 and 8 of gestation in an iodine-deficient area of China had lower brain weight than fetuses in an iodine-sufficient area, while some showed increased cell density.

Gestational iodine deficiency results in reduced dendritic branching in the cerebral cortex in rodents 26 and in the cerebellum in sheep and marmosets. Gestational iodine deficiency in sheep resulted in decreased synaptic density, which was not corrected with iodine repletion. Gestational and early postnatal hypothyroidism in rodents decreases the number and density of synapses in the cerebellum, and alters neurotransmitter levels.

No myelination was detected in the cerebral cortex of fetuses aborted at month 8 of gestation in an iodine-deficient area of China. Early postnatal hypothyroidism in rodents results in decreased dendritic branching in the visual and auditory cortex and cerebellum. Gestational and early postnatal hypothyroidism in rodents leads to reduced myelination.

Zinc is necessary for cell division due to its role in DNA synthesis. Gestational zinc deficiency in rodents results in reduced dendritic arborization. Zinc released into synapses in the hippocampus and cerebral cortex modulates synapse function. In rodent pups, zinc deficiency decreased expression of IGF-1 and growth hormone receptor genes. Choline is essential for stem cell proliferation and is involved in transmembrane signaling during neurogenesis.

The neurotransmitter acetylcholine is synthesized from choline. Gestational choline deficiency increases the rate of apoptosis in the hippocampus in rodents. Gestational and early postnatal vitamin B 6 deficiency in rodents results in reduced dendritic branching in the neocortex and cerebellum.

Gestational and early postnatal vitamin B 6 deficiency in rodents results in decreased synaptic density in the neocortex, 35 reduced synaptic efficiency, particularly in NMDA receptors, 36 and lowered dopamine levels and dopamine D2 receptor binding in the striatum.

Gestational and early postnatal vitamin B 6 deficiency in rodents results in reduced myelination. Rodents raised in enriched environments large enclosures with objects that allow visual and tactile stimulation show greater brain weight and cortical thickness than rodents raised in impoverished environments standard lab cages.

A human autopsy study showed that individuals with higher levels of education had more dendritic branching than those with lower education in Wernicke's area, a brain area underlying language processing. Rodents raised in enriched environments large enclosures with objects that allow visual and tactile stimulation show more synapses per neuron in visual and motor cortices than rodents raised in impoverished environments standard lab cages.

It is likely that nutrition deficiency during pregnancy and early childhood affects individual cognition, behaviour, long term productivity and also negatively impacts economic development.

What this article adds: Severe acute malnutrition, chronic undernutrition intrauterine growth retardation and stunting , iron deficiency anaemia and iodine deficiency are key risk factors for poor motor, cognitive, and socio-emotional development and should be a global priority. Effective strategies to address these forms of undernutrition exist; the evidence for impact of other forms of undernutrition on brain development is lacking.

Robust research to evaluate interventions in low and middle income countries is needed. Adequate nutrition is necessary for normal brain development. Nutrition is especially important during pregnancy and infancy, which are crucial periods for the formation of the brain, laying the foundation for the development of cognitive, motor, and socio-emotional skills throughout childhood and adulthood. Thus nutritional deficiencies during pregnancy and infancy are likely to affect cognition, behaviour and productivity throughout the school years and adulthood.

Focusing on this early period for the prevention of nutrient deficiencies may have long-term and widespread benefits for individuals and societies.

A recently published article presents an overview of the pathway from early nutritional deprivation to long-term brain function, cognition, behaviour, and productivity. The article focuses on nutrition during pregnancy and the first few years after birth, which is the period of most rapid brain development. Children who are not adequately nourished are at risk of failing to reach their developmental potential in cognitive, motor and socio-emotional abilities.

These abilities are strongly linked to academic achievement and economic productivity. Therefore, preventing or reversing developmental losses in early childhood is crucial for fostering economic development in low-and middle-income countries, as well as reducing economic disparities in high-income countries.

The evidence is clear that the following conditions are key risk factors for poor motor, cognitive, and socio-emotional development: Preventing these conditions needs to be a global health priority. Effective strategies to prevent or improve these conditions include salt iodisation to prevent iodine deficiency, provision of iron via home fortification e.

With the exception of a few studies on food supplementation, direct evidence of the impact of these strategies on brain development is scarce. Strategies to promote exclusive breastfeeding during the first six months of life and continued breastfeeding thereafter along with adequate complementary feeding are also likely to improve cognitive development, though additional evidence for the effectiveness of these strategies is also needed.

The following interventions are promising for preventing developmental loss: However, additional robust research in low-and middle-income countries that evaluates the long-term effects of these interventions is needed. Interventions to improve the home environment and the quality of caregiver-infant interaction are also recommended to complement and enhance the effect of improved nutrition.

These types of interventions are crucial to offset the negative effects of adverse environmental conditions for example, poverty and low maternal education that often coexist in populations in which undernutrition is common. Nutrition and brain development in early life. Nutrition Reviews, vol 72 4 , pp The following provides a short summary of each of these important research studies. A fuller summary of each can be found online at www.

What are the current issues regarding nutrition and cognitive abilities of children in especially in Africa, as it seems this continent has not seen much of Global What we know already: Early child development ECD is a key predictor of future social capital and national productivity.

Below are short summaries of the recently launched Lancet series of papers on Maternal and Child Undernutrition1. This high profile series focuses on the disease burden A life cycle approach would be preferable that can break the inter-generation of malnutrition. Summary of research1 Location:

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