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Nutrients for Cognitive Development in School-aged Children
Abstract
This review considers the research to date on the role of nutrition in cognitive development in children, with a particular emphasis on the relatively neglected post-infancy period. Undernutrition and deficiencies of iodine, iron, and folate are all important for the development of the brain and the emergent cognitive functions, and there is some evidence to suggest that zinc, vitamin B12, and omega-3 polyunsaturated fatty acids may also be important. Considerations for future research include a focus on the interactions between micronutrients and macronutrients that might be influential in the optimization of cognitive development; investigation of the impact of nutritional factors in children after infancy, with particular emphasis on effects on the developing executive functions; and selection of populations that might benefit from nutritional interventions, for example, children with nutrient deficiencies or those suffering from attention deficit-hyperactivity disorder and dyslexia.
... Vitamin B12 de ciency is a common nutritional de ciency and has been associated with a variety of neuropsychiatric disorders, including deterioration in memory, irritability, depression, dementia, and, rarely psychosis. In school-age children with B12 de ciency, however, the primary ndings are seen as attention de cits, decreases in academic success, neglecting routine tasks, and increases in delinquent behaviors (12)(13)(14). In addition, vitamin B12 is a cofactor of the enzymes required for the metabolism of monoaminergic neurotransmitters, playing an important role in the etiology of ADHD. ...
... In many studies conducted in recent years, it has been revealed that vitamin B12 has impacts on the development and functions of the central nervous system, and vitamin B12 de ciency is a common nutritional de ciency playing a key role in the development of various psychopathologies. It has also been stated in those studies that B12 de ciency is related to cognitive de cits, and even borderline vitamin B12 de ciency also leads to the deterioration in cognitive functions in adolescents; low levels of vitamin B12 have been reported in children and adolescents with neurodevelopmental disorders such as ADHD and autism spectrum disorder (12,13,(22)(23)(24)(25). In addition, while a micronutrient supplement containing vitamin B12 has been shown to improve the symptoms of ADHD in children and adolescents, such a situation has not been emphasized in adults (22,26,27). ...
... Although no studies have examined the relationship between SCT and B12 levels to date, there are numerous studies investigating whether individuals with ADHD have low levels of vitamin B12 (17,24,25). B12 de ciency is associated with the symptoms of attention de cits in ADHD and the clinical symptoms similar to those of SCT, such as lack of energy, sluggishness, and mental confusion (13,17). Although SCT and ADHD have been reported to have similarities in terms of their symptoms, these two conditions are known to display different clinical pictures (2,29). ...
Background
Slow cognitive tempo (SCT) is a disorder characterized by two symptomatic dimensions: motor symptoms such as sluggishness and slow movement, and such cognitive problems as daydreaming, appearing sleepy, slowed behavior/thinking, and confusion. Albeit its unclear etiology, SCT is considered multifactorial, as in attention deficit hyperactivity disorder (ADHD). Here, we aimed to investigate the relationship between vitamin B12 deficiency, one of the conditions causing neurodevelopmental retardation, and SCT.
Methods
Diagnosed with vitamin B12 deficiency, 52 patients without additional vitamin deficiency and psychiatric diseases, and 52 controls without vitamin deficiency and any diseases were included in the study. While the Conners' Parent Rating Scale-Revised Long (CPRS-R:L) and the Barkley Child Attention Scale (BCAS) were performed with cases’ parents, their teachers underwent the Conners' Teacher Rating Scale-Revised Long (CTRS-R:L) and BCAS. The scores were also evaluated statistically.
Results
Among B12 deficiency patients, parental education was found lower, and the number of siblings was higher than controls. The risk of patients’ daydreaming scores with vitamin B12 deficiency was 1.4 times higher than that of the controls. Given the investigation of SCT concerning sluggishness and daydreaming scores, a significant difference was detected in terms of sex difference (p = 0.008), and girls were seen to have a higher total score.
Conclusion
In families with a higher number of siblings and a lower level of parental education, vitamin B12 deficiency is more commonly witnessed, and the symptoms of SCT should be considered to develop in those with B12 deficiency, without severe neurological and hematological findings.
... Salah satu faktor lingkungan yang digunakan program genetik untuk memengaruhi perkembangan otak adalah asupan zat gizi yang cukup (Bryan et al., 2004;Toga, Thompson and Sowell, 2006;Giedd et al., 2010). Melalui mekanisme epigenetik, lingkungan dapat memengaruhi ekspresi gen. ...
... Otak telah mencapai 80% massa otak orang dewasa pada usia dua tahun. Tubuh dan otak sangat sensitif terhadap kekurangan makanan dan zat gizi pada periode tersebut (Bryan et al., 2004;Lenroot and Giedd, 2006). ...
... Zink menjadi kofaktor lebih dari 200 enzim yang mengatur berbagai aktivitas metabolisme dalam tubuh, termasuk sintesis protein, DNA, dan RNA. Zink berperan dalam neurogenesis, pematangan, migrasi neuron, serta pembentukan sinaps (Bhatnagar and Taneja, 2001;Black, 2003aBlack, , 2003bBryan et al., 2004;Shah and Sachdev, 2006;Georgieff, 2007). ...
Tujuan dari penulisan buku ini tidak lain adalah untuk membantu dalam memahami konsep serta komponen yang terkait kesehatan anak usia dini.
Buku ini juga akan memberikan informasi secara lengkap mengenai:
Bab 1 Pengertian dan Hakikat Kesehatan Pada Anak Usia Dini
Bab 2 Konsep Sehat dan Gangguan Kesehatan Pada AUD
Bab 3 Konsep Dasar Ilmu Gizi dan Sejarah Perkembangannya
Bab 4 Peran Gizi Dalam Tumbuh Kembang Anak
Bab 5 Gizi dan Nutrisi Untuk Tumbuh Kembang Anak
Bab 6 Jenis dan Fungsi Gizi Dalam Tubuh
Bab 7 Gizi Seimbang Pada Anak Usia Dini
Bab 8 Kebutuhan Zat Gizi Anak Usia Dini (AUD)
Bab 9 Dasar-Dasar Penilaian Status Gizi
Bab 10 Masalah-Masalah Kekurangan Gizi
Bab 11 Kecukupan Gizi dan Syarat Makanan Anak Usia Dini
Bab 12 Syarat Pemberian Zat Gizi Anak Usia Dini
Bab 13 Pendidikan Gizi Bagi Anak Usia Dini (AUD)
... polyunsaturated fatty acids, vitamin B12, zinc, iron, and iodine during pregnancy and/or early infancy, have shown to be associated with impaired neurocognitive development in children [2,3]. In addition to providing specific nutrients, healthy dietary patterns have been suggested to promote a healthy neurocognitive development through changes in cellular processes, neuroplasticity, or epigenetic mechanisms [4,5]. ...
... In addition to providing specific nutrients, healthy dietary patterns have been suggested to promote a healthy neurocognitive development through changes in cellular processes, neuroplasticity, or epigenetic mechanisms [4,5]. There are also indications that an unhealthy diet could limit or delay typical development [3,6]. The current literature increasingly focuses on the first 1000 days of life as a critical developmental period [1]. ...
... A small, but positive association between a healthy dietary pattern during infancy and early childhood and subsequent child developmental outcomes and/or a negative association between "unhealthy" patterns and cognitive measures has been shown in a systematic review from 2016 [4]. However, as some parts of the brain continue to develop throughout childhood and adolescence [3], a deeper understanding of the overall role and impact of longer-term exposure of potentially healthy dietary patterns on child development is needed. ...
Background
The rapid neurodevelopment that occurs during the first years of life hinges on adequate nutrition throughout fetal life and early childhood. Therefore, adhering to a dietary pattern based on healthy foods during pregnancy and the first years of life may be beneficial for future development. The aim of this paper was to investigate the relationship between adherence to a healthy and potentially sustainable Nordic diet during pregnancy and in early childhood and child development.
Methods
This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). In 83,800 mother-child pairs, maternal pregnancy diet and child diet at 6 months, 18 months and 3 years were scored according to adherence to the New Nordic Diet (NND). NND scores were calculated both as a total score and categorized into low, medium, or high adherence. Child communication and motor development skills were reported by parents at 6 months, 18 months, 3 and 5 years, using short forms of the Ages and Stages Questionnaire and the Child Development Inventory. Associations of NND adherence with child development were estimated with linear and logistic regression in crude and adjusted models.
Results
When examining the NND and child developmental scores as percentages of the total scores, we found positive associations between the NND scores (both maternal pregnancy diet and child diet) and higher scoring on child development (adjusted $$\hat{\beta}$$ β ^ s [95% confidence intervals] ranging from 0.007 [0.004, 0.009] to 0.045 [0.040, 0.050]). We further found that low and medium adherence to NND were associated with higher odds of later emerging developmental skills compared to high NND adherence at nearly all measured timepoints (odds ratios [95% CI] ranging from significant values 1.15 [1.03–1.29] to 1.79 [1.55, 2.06] in adjusted analyses).
Conclusions
Our findings support that adherence to a healthy and potentially sustainable diet early in life is important for child development every step of the way from pregnancy until age 5 years.
... Overall, micronutrient deficiencies are linked to different cognitive impairments, especially iodine and iron, as well as to potential long-term behavioral changes. 2 Generally, a lack of iron in the neonatal period and early childhood is considered as a key to the development of disturbances in cognitive development. 3 At the same time, there is little consensus about the effectiveness of possible preventive programs. Cognitive disturbances in general and vasomotor development have been related to iron deficiency (ID), and more recently, a possible link between dieting, ID, and the possible presentation of cognitive alterations has been studied. ...
... Specifically, nutrients such as iron and omega-3 polyunsaturated fatty acids, in particular, might have specific effects on frontal lobe functioning. 3 There are works in which it is possible to obtain a clear idea about the effects of ID and IDA on behavior and development. Generally, in non-IDA, there seems to be lower performance in cognitive functions, so a question arises as to whether ID, IDA, and anemia (other than IDA) may cause the same cognitive deficits. ...
Micronutrient deficiencies, especially those related to iodine and iron, are linked to different cognitive impairments, as well as to potential long-term behavioral changes. Among the cognitive impairments caused by iron deficiency, those referring to attention span, intelligence, and sensory perception functions are mainly cited, as well as those associated with emotions and behavior, often directly related to the presence of iron deficiency anemia. In addition, iron deficiency without anemia may cause cognitive disturbances. At present, the prevalence of iron deficiency and iron deficiency anemia is 2%–6% among European children. Given the importance of iron deficiency relative to proper cognitive development and the alterations that can persist through adulthood as a result of this deficiency, the objective of this study was to review the current state of knowledge about this health problem. The relevance of iron deficiency and iron-deficiency anemia, the distinction between the cognitive consequences of iron deficiency and those affecting specifically cognitive development, and the debate about the utility of iron supplements are the most relevant and controversial topics. Despite there being methodological differences among studies, there is some evidence that iron supplementation improves cognitive functions. Nevertheless, this must be confirmed through adequate follow-up studies among different groups. TAJ 2021; 34: No-1: 115-122
... The overall well-being and nutritional development of children are established during childhood, and are of special importance in the first 8 years of life [180]. It has been suggested that there is rapid growth and development of the brain from gestation to the first two years of life, which can be affected by a poor diet [181]. However, the relationship between nutrition and mental development is equally important both in early life and in later life [182]. ...
... In this sense, it has been reported that a deficiency in the intake of vitamin B12 can have negative implications on cognitive development in children [185]. However, it is difficult to establish the importance of the deficit of this type of nutrient on cognitive development since very few RCTs have been carried out in children [181]. ...
In order to better understand the implications of physical activity and nutrition in child development, we conducted the present narrative with the aim to analyze the physical activity and nutritional patterns related to maturation and development. To reach our study objective, a consensus and critical review were conducted by analyzing primary sources such as academic research and secondary sources such as databases, web pages, and bibliographic indexes following procedures of previous critical narrative reviews. We employed the MedLine (Pubmed), Cochrane (Wiley), PsychINFO, Embase, and CinAhl databases to search the MeSH-compliant keywords of exercise, physical activity, nutrition, maturation, development, child, neonatal, infantry, and cognitive development. We used manuscripts published from 1 January 2012 to 1 September 2022, although previous studies were included to explain some information in several points of the review. We found that physical activity and nutrition are basic pillars for the correct development and maturation of the child. Factors associated with development as a species such as breastfeeding, the correct intake of micro and macronutrients, and the performance of both passive and active physical activity will modulate the correct motor and cognitive development in preschool age, childhood, and adolescence.
... We can speculate that our lower mean PSI score depends on the simultaneous presence of high loadings on cholesterol and SFA and low loadings on PUFAs. While PUFAs have been proven to support neural membrane functionality and neurotransmitter action in the frontal lobes (e.g., [71]), a brain area that subsides processing speed [72], they are materially absent in our DP; on the other hand, high intakes of cholesterol and SFA might lead to reduced executing functioning from frontal lobes, thus providing the global detrimental effect of this DP. Similarly, the lack of association of our "Fats" DP with cognitive performance might be due to the simultaneous presence of cholesterol and SFA-showing negative effects-and PUFAs-showing positive effects-on neurodevelopment. ...
... The current analysis has strengths and limitations. Among the strengths, our study shed light on a possible link between higher cognitive functions subsumed by frontal lobe development at 7 years of age [75] and dietary exposure [71]. It also assessed dietary habits through a 3-dDR, which should have provided a more precise quantification of daily, although not necessarily habitual, food intake [76]. ...
Research from different sources supports a link between nutrition and neurodevelopment, but evidence is still sparse regarding the relationship between a posteriori dietary patterns (DPs) and cognitive performance in school-aged children. Within the Northern Adriatic Cohort II, Friuli Venezia Giulia, Italy, 379 7-year-old children were cross-sectionally evaluated. Dietary patterns were identified through a principal component factor analysis based on 37 nutrients from children’s 3-day dietary records. The Wechsler Intelligence Scale of Children (WISC-IV) test provided measures of cognitive performance, including the full-scale intelligence quotient (FSIQ) and single index scores. Each DP was related to FSIQ or single index scores through multiple robust linear regression models. We identified five DPs named “Dairy Products”, “Plant-based Foods”, “Fats”, “Meat and Potatoes”, and “Seafood” (63% of variance explained). After adjustment, no significant relationship was observed with the FSIQ score; positive associations were found between the “Seafood” DP and Verbal Comprehension Index or Perceptual Reasoning Index. The “Meat and Potatoes” and “Dairy Products” DPs were inversely associated with the Verbal Comprehension Index and Processing Speed Index scores, respectively. In the absence of a relation with the overall FSIQ score, single DPs might influence specific cognitive functions, including verbal and reasoning abilities, as targeted by single indexes, in the expected direction.
... First, they can affect an individual's childhood BMI which could then persist into adulthood. Second, they may affect an individual's brain development (Bellisle 2004, Bryan et al. 2004, and thus affect the resources available to the individual later in life, and hence potential later self-investments. income quartile. ...
... The cognition process of the child is analogous, and thus also depends on diet quality. In doing so, the model can capture the effects of diet on brain development in children documented by Bellisle (2004), Bryan et al. (2004). ...
Why do individuals who grew up in low income families tend to have lower income themselves? Why do they also tend to be unhealthier than those who grew up in richer families? This thesis studies how inequalities in income and health develop from childhood to adulthood. The first chapter quantifies the effect of various channels - education, cognitive skills, parental investments and family background - on intergenerational earnings persistence in Great Britain. We find that earnings persistence is largely driven by differences in parental investments during childhood, which encourage greater cognitive development and lifetime earnings. The second chapter jointly studies different channels through which parents invest in their children - by spending time with them to foster cognitive skills, by paying for their education, and by making monetary transfers. We find that 28% of the variance of lifetime wages can already be explained by characteristics of the parents before individuals are born and 62% of the variance can be explained by age 23 characteristics of the individual. In terms of investments, we find evidence of dynamic complementarity between time and educational investments – the returns to education are higher for high ability individuals. This is a potentially important mechanism in perpetuating intergenerational outcomes, as borrowing constraints prevent low-income families from investing in education, thus simultaneously reducing the incentive to invest in time. The final chapter studies health inequality. I find that 34% of the differences in obesity rates between those coming from rich versus poor families is driven by differences in investments over the lifecycle. Differences in health investments received from the parents during childhood matter more than differences in investments in adulthood. A policy counterfactual in which the government directly invests in low income children’s health reduces obesity rates and has substantial welfare effects.
... Iodine is critical to the developing brain as a component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) [41,42]. The importance of adequate consumption of this micronutrient is especially important during neurological development [43][44][45][46]. Iodine deficiency can cause a decrease in brain mass and a greater cell mass in the cortex, and a lower cell mass in the baby's cerebellum. ...
... Iodine is a good solution for the proper functioning of the body (i.e., brain function and target hormones) and can improve cognitive functions at every stage of life [43][44][45][46][47][48]. Iodine deficiency may also correlate with a lower IQ index in children and adolescents [49], as well as cognitive declines among school-age children [50,51]. ...
Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players' eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.
... Either in a direct or in an indirect way, the iron status can shows an effect on the capacity of a cell to produce adenosine triphosphate (ATP) and on the glucose and other carbohydrates oxidation process (Griffith, 1995). Bryan (2004), have determined that deficient iron levels result in deterioration of cognitive functioning, mainly among school going children (Sungthong, 2002). Verbal performance may directly get affected by deficient iron status. ...
Background: Aegle marmelos also known as Bael has been familiarly known as a constituent of traditional medication for treating several human ailments. Even though every part of the plant is beneficial leading to their significant use in vital medicines, the leaves and fruits are commonly useful as essential drugs from the ancient times of medicinal system to treat most of the general illnesses of humans. Its fruit consists of vast medicine related benefits which are useful in diarrhea, dysentery and gastrointestinal disorders. The medicinal properties of Bael work as chief components for discovering and designing of drugs. Purpose: The present study was evaluated for the nutritional and phytochemical compositions of Aegel marmelos dry leaves. Basic Procedure: AOAC standard method was used. For experiments, mineral compositions were determined by atomic absorption spectrophotometry for Ca, Na, Mg, Zn, Cu and Fe. Flame photometer was used to determine K. The qualitative phytochemical examination was done to determine tannins, flavonoids, alkaloids, saponins, phenols and steroids. Results: Aegle marmelos fruit pulp powder depicted the existence of tannins, flavonoids and alkaloids as main bioactive components and presence of Vitamin C in higher concentration. Micronutrients like potassium, magnesium and sodium were present in adequate amount. Conclusion: It was examined that Bael fruit pulp powder consists of protein, minerals, crude fiber and energy in good amount. It is richer source of carbohydrates and dietary fiber. It provides various nutrients and phytochemicals which are not provided by allopathic medicine having no side effects.
... Either in a direct or in an indirect way, the iron status can shows an effect on the capacity of a cell to produce adenosine triphosphate (ATP) and on the glucose and other carbohydrates oxidation process [23] . [24] have determined that deficient iron levels result in deterioration of cognitive functioning, mainly among school going children [25] . Verbal performance may directly get affected by deficient iron status. ...
Pomegranate (Punica granatum) has been used for thousands of years to cure a wide range of diseases like diabetes, cancer, osteoarthritis, cardiovascular diseases and other myriad ailments across different cultures and civilizations. This is because pomegranates have the potential to thin the blood, increases blood flow to the heart, reduce blood pressure, plaque in the arteries, bad cholesterol parallel increasing good cholesterol. For experiments, proximate composition (moisture, ash, protein, fat, crude fiber, carbohydrate and vitamin C) were done by using Association of Analytical Communities (AOAC) standard methods. Mineral compositions (Na, Ca, Mg, K, P, Fe and Zn) were determined by atomic absorption spectrophotometry. UV spectrophotometer was used to determine phosphorous. Solvent free extract filtrate was used with various alkaloidal reagents to determine phytoconstituents. The result of the analysis shows that the peel, seed and whole fruit powder contains moisture content, ash, protein, crude fiber and fat. It also contains sodium, calcium, magnesium, potassium, phosphorus and iron. The three different extracts from peel, seed and whole fruit powder were found to contain alkaloids, flavonoids, phenolic compounds, glycosides, saponins, carbohydrates and protein. All of these findings implied that minerals and phytochemicals and vitamin C from pomegranate peels, seeds and whole fruit might be potential resources for the development of antioxidant function dietary foods and are useful in preventive healthcare.
... As the brain consists of more than 60% lipids, the maintenance of the lipid composition of neuronal membranes is essential for optimal brain functioning [21]. The essential omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), play an important role as components of the phospholipids that form the structures of cell membranes. ...
Little information is available on the nutritional and health status of pre-school children attending informal crèches. The study aimed to determine the status of blood carotenoid, vitamin E, inflammatory markers and omega-3 fatty acids in children attending crèches in the Eastern Cape, South Africa. Baseline measurements were followed by an intervention to determine the effect of a biscuit baked with red palm oil (RPO) shortening on these parameters. Forty-seven (n=47) children were randomly assigned to a RPO (Group A) (n=25) and non-RPO (Group B) (n=22) group. Group A received biscuits providing carotenoids, tocotrienols and α-tocopherol while Group B biscuits provided only tocotrienols and α-tocopherol. Biscuits were distributed daily during the school week. Blood samples were obtained at baseline, 3 months and 6 months during intervention as well as 6 months post intervention. At baseline, children showed a mild (10%) vitamin A deficiency, severe vitamin E deficiency (69%) while 98% presented with omega-3 fatty acid indexes below 8%. For vitamin E data was pooled as both groups received similar amounts of vitamin E while no significant differences were observed between the groups during the intervention. Significant increases (p ≤ 0.05) in α-tocopherol levels were observed in both groups at 3-, 6- and 6- months post intervention. Deficiency levels declined to 10% and 0% at 6- and 6-months post, respectively. In group A, plasma α-carotene levels (p ≤ 0.05) increased significantly from baseline (0.04 μmol/L; 95% CI: 0.03 – 0.06) at 3 (0.36 μmol/L; 95% CI: 0.29 – 0.45) and 6 months (0.48 μmol/L; 95% CI: 0.39 – 0.60). Similar significant (p ≤ 0.05) results were observed for plasma β-carotene levels (3 months (0.31 μmol/L; 95% CI: 0.27 – 0.40) and 6 months (0.33 μmol/L; 95% CI: 0.28 – 0.40). Consumption of a biscuit baked with RPO can play a significant role in alleviating vitamin E deficiency and can significantly increase plasma α- and β-carotene levels in pre-school children. Key words: Vitamin A, carotenoids, vitamin E, CRP, IL-6, fortification, omega-3 fatty acids
... One critical developmental period is the first 1000 days of life, from conception until age 2 years, when brain growth is rapid and plastic. This renders the brain vulnerable and highly sensitive to influences from environmental factors such as nutrition [2][3][4]. ...
Purpose
To examine the associations between infants’ dietary nutrient trajectories and subsequent neurodevelopment during childhood in the Growing Up in Singapore Towards healthy Outcomes study.
Methods
One-day food records were collected at ages 6, 9 and 12 months, whilst Bayley Scales of Infant and Toddler Development-III and Kaufman Brief Intelligence Test-2 were conducted at ages 24 and 54 months respectively. Nutrient trajectories were constructed using multi-level mixed modelling and associations with neurodevelopment (24 months: n = 484; 54 months: n = 444) were examined using adjusted multivariable linear regression.
Results
At age 24 months, higher protein intake (at 6 months) and increasing rate of intake (from 6 to 12 months) were associated with higher fine motor score [β = 0.17 SD (95% CI 0.03, 0.31) and 0.62 SD (0.10, 1.14) respectively]. Higher fat intake was associated with higher receptive language score [0.04 SD (0.003, 0.07)], but increasing rate of intake was associated with lower expressive language [− 0.20 SD (− 0.39, − 0.01)] and fine motor [− 0.29 SD (− 0.48, − 0.10)] scores. Higher carbohydrate intake was associated with lower gross motor score [− 0.07 SD (− 0.14, − 0.005)], but increasing rate of intake was associated with higher receptive language [0.44 SD (0.08, 0.81)] and fine motor [0.56 SD (0.18, 0.93)] scores. Increasing rate of dietary fibre intake was associated with higher fine motor scores [0.63 SD (0.16, 1.10)]. No significant associations were observed with neurodevelopment at 54 months.
Conclusion
Our findings provide greater understanding of how nutrition over time could have varying effects on child neurodevelopment.
... The time and the type of nutritional deficiency are important determinants of cognitive deficit (Nyaradi et al., 2013;Roberts et al., 2022). Evidence suggests that the first two years of life are the most vulnerable period for nutritional deficiencies in diet (Bryan et al., 2004). Adolescence is another critical period during which poor nutrition may interfere with cognitive maturation (Luna and Sweeney, 2001). ...
Access to a nutritious diet can be one of the foremost challenges for most
Sri Lankans today. In such a resource limited setting, an approach to a low-input
poultry production system (LIPPS) is reviewed as a sustainable option to ensure
nutritional security and economic resilience in vulnerable groups in the community.
A shift in poultry production to a low-input system, targeting small- and mediumscale producers, can be encouraged to provide access to a nutritionally balanced
diet and a source of income. Indigenous poultry genetic resource, diverse
management system and feed resource base, short supply chain and low
productivity are typical characteristics of a LIPPS. These characteristics have made
the LIPPS instrumental in achieving food and nutritional security, economic
resilience, women empowerment, sustainability and climatic adaptability especially
among vulnerable groups in society in the face of crisis.
... I am unaware of any scientist who argues that genes have no role in determining ability, nor of any who posit that genes are exclusively responsible for cognitive ability. Environmental factors such as nutrition, cognitive stimuli, and stress have proven effect on human ability (see e.g., Beilharz et al. 2015;Farah et al. 2008;Martin et al. 2019;Osendarp et al. 2004;Sandi 2013;Yehuda et al. 2006). ...
The meritocratic principle of educational justice maintains that it is unfair that individuals with similar ability who invest equal effort, have unequal educational prospects. In this paper I argue that the conception of ability that meritocracy assumes, namely as an innate trait, is critically flawed. Absent a coherent conception of ability, meritocracy loses its ability to morally evaluate educational practices and policies, rendering it an unworkable principle of educational justice. Replacing innate ability with an alternative conception of ability is, therefore, crucial for meritocratic educational justice. I propose incorporating an alternative conception of ability into meritocracy—as the ″current limits of student ability″. The account of meritocracy that follows entails that unequal educational prospects are fair only when they result from the constraints of individual potential (or from differential effort). I argue that this potential-based account of meritocracy, though demanding, is a plausible and attractive account of educational justice.
... The time and the type of nutritional deficiency are important determinants of cognitive deficit (Nyaradi et al., 2013;Roberts et al., 2022). Evidence suggests that the first two years of life are the most vulnerable period for nutritional deficiencies in diet (Bryan et al., 2004). Adolescence is another critical period during which poor nutrition may interfere with cognitive maturation (Luna and Sweeney, 2001). ...
... In terms of dietary copper, which is mainly from nuts and seafood [30], a previous study found that a higher copper intake, particularly when combined with a diet high in saturated fat, was associated with a higher risk of dementia and cognitive impairment [31], while another study reported the opposite [28]. In addition, most previous population studies on the associations of dietary zinc and manganese with cognitive function were conducted among children [32,33], while evidence for age-related cognitive function among older adults remained scarce [28,34]. ...
Previous studies have related circulating levels of trace metal elements, of which dietary intake is the major source, to cognitive outcomes. However, there are still relatively few studies evaluating the associations of dietary intake levels of iron, copper, zinc, and manganese with cognitive function (CF). Methods: We leveraged the data of 6863 participants (mean [standard deviation] age = 66.7 [10.5] years) in the Health and Retirement Study (2013/2014). Dietary intake levels of iron, copper, zinc, and manganese were calculated from a semi-quantitative food frequency questionnaire. CF was assessed using the 27-point modified Telephone Interview for Cognitive Status (TICS). We used linear regression models to calculate the mean differences in global CF scores by quintiles of dietary intake levels of trace metal elements. Results: Among the study participants, the mean (SD) values of daily dietary intake were 13.3 (6.3) mg for iron, 1.4 (0.7) mg for copper, 10.7 (4.6) mg for zinc, and 3.3 (1.6) mg for manganese. Compared with the lowest quintile of dietary iron intake (<8.1 mg), the highest quintile (≥17.7 mg) was associated with a lower cognitive score (−0.50, −0.94 to −0.06, P-trend = 0.007). Higher dietary copper was significantly associated with poorer CF (P-trend = 0.002), and the mean difference in cognitive score between extreme quintiles (≥1.8 vs. <0.8 mg) was −0.52 (95% confidence interval: −0.94 to −0.10) points. We did not observe significant associations for dietary intake of zinc (P-trend = 0.785) and manganese (P-trend = 0.368). Conclusion: In this cross-sectional study, higher dietary intake of iron and copper was related to worse CF, but zinc and manganese intake levels were not significantly associated with CF.
... School age children ranging between 6-12 years has been found to be a critical period of physical, cognitive, and social development of children [5,6]. However, in case of a problem such as nutrition [7], these vital parameters would not be achieved and may result in chronic malnutrition, intellectual development delay, school failures, and delayed transition to safe adolescent and adulthood [8,9]. Although, there is lack of comprehensive evidence about the magnitude of malnutrition among school age children, small scale surveys in developing countries indicate that a high burden of chronic malnutrition such as stunting in school age children is observed to be prevalent amongst 40% India [10], 39% in Indonesia [11], and 26% in Bangladesh [12,13], and 22.5% in Nigeria [14]. ...
Prior research identified malnutrition as one of the most common causes of morbidity and mortality among children globally. Furthermore, research revealed that over two thirds of deaths associated with inappropriate feeding practices occurred during the early years of life. Improper feeding practices impact a child’s health in many different ways. However, research on the possible factors driving underweight, wasting, and stunting among school aged children in developing countries is limited, hence warrant further attention. Against this backdrop, this research strives to identify and assess the determinants of underweight, wasting and stunting among school aged children of a developing country-Ethiopia. A community based cross-sectional study was conducted from April 1, 2018 to June 15, 2018 in Merawi town, Ethiopia. An interviewer-administered questionnaire was used to collect data from a sample of 422 children. Binary logistic regression technique was performed to examine the effect of each selected variable on the outcome measure. The prevalence of being underweight, wasting and stunting was found to be 5.7%, 9.8%, 10.4%, respectively. The age of the child [adjusted odds ratio (AOR) = 12.930 (2.350, 71.157)] and the number of children [AOR = 8.155 (1.312, 50.677)] were emerged as the key determinants for underweight, and the gender of the child was significantly associated with wasting [AOR = 0.455 (0.224, 0.927)]. Finally, the age of the child [AOR = 12.369 (2.522, 60.656)] was found to predict the risk of stunting. This study revealed the age, number of children and gender of the child to have a significant association with malnutrition. The findings of this research suggest that in improving the feeding practices of young school-aged children, special attention should be paid to female children and those coming from relatively large families.
... The development phase of children is packed with learning and cognitive growth 20,21 . Mental health is another critical aspect of children's health, which can signi cantly in uence their later success in school and at work. ...
Children’s brains dynamically adapt to the stimuli from the internal state and the external environment, allowing for changes in the cognitive and mental behavior of individuals. In this work, we performed a large-scale analysis of dynamic functional connectivity (DFC) in children aged 9 ~ 11 years, investigating how brain dynamics relate to cognitive performance and mental health during an early age. An adaptive independent component analysis framework was applied to the Adolescent Brain Cognitive Development (ABCD) data containing 10,988 children. We combined a sliding-window approach with k-means clustering to identify five reoccurring brain states with distinct DFC patterns. Interestingly, the occurrence of a strongly connected state was negatively correlated with cognitive performance and positively correlated with dimensional psychopathology in children. Meanwhile, the opposite relationships were observed for a sparsely connected state. The composite scores, the attention score, and the Attention-Deficit/Hyperactivity Disorder score were the most significantly correlated with the DFC states. The cognitive and psychiatric relevance of DFC states were highly reproducible across scans and between longitudinal sessions. Finally, the mediation analysis showed that the attention problems mediate the effect of DFC states on cognitive performance. This investigation unveils the neurological underpinnings of DFC by highlighting their robust associations with behavioral development in childhood. Tracking the patterns of maturation in DFC states may capture delays in development and guide people to provide early intervention to buffer adverse influences in children’s development.
... 63 El suministro continuo de nutrientes se hace imprescindible para sostener todos estos procesos de acreción tisular, crecimiento, desarrollo y transformación. 64 Figura 2. Estado de la desnutrición energético-nutrimental en los niños y niñas atendidos en la Escuela "San José del Buen Pastor". Izquierda: Estado de la Talla para el sexo y la edad del escolar. ...
RESUMEN Justificación: Son escasos los reportes sobre el estado nutricional de niños ecuatorianos atendidos en hogares para huérfanos. Objetivo: Describir el estado nutricional de los niños atendidos en un orfanato de la ciudad de Guayaquil. Diseño del estudio: Descriptivo, transversal. Serie de estudio: Ciento dieciocho niños (Huérfanos: 44.0%; Hembras: 59.9%; Edad promedio: 8.0 ± 2.8 años) atendidos en la Escuela "San José del Buen Pastor", ciudad de Guayaquil (Ecuador), entre Septiembre del 2014 y Junio del 2015. Material y método: El estado nutricional del escolar se estableció tanto de la Talla para la Edad (Talla disminuida para la Edad: <-2.0 desviaciones estándar para el sexo y la edad) como del Índice de Masa Corporal (IMC): Peso disminuido para la Edad: IMC <-2.0 desviaciones estándar para el sexo y la edad vs. Peso excesivo para la Edad: IMC > +2.0 desviaciones estándar para el sexo y la edad. Adicionalmente, se estimó el tamaño de la grasa corporal (GC) mediante bioimpedancia eléctrica. Resultados: La frecuencia de la Talla disminuida para la Edad fue del 6.8% (No huérfanos: 3.0% vs. Huérfanos: 11.5% ( =-8.5%; p < 0.05). El Peso disminuido para la Edad se presentó en menos del 1.0% de la serie de estudio. Por su parte, el Peso excesivo para la Edad afectó al 2.5% de los niños y niñas. Los niños no huérfanos reunieron los valores mayores del peso corporal. La condición de orfandad no influyó en el tamaño de la GC: No huérfanos: 25.2 ± 6.6% vs. Huérfanos: 19.8 ± 7.5% (p > 0.05). Conclusiones: Las formas de la desnutrición infantil, así como el exceso de peso, fueron poco frecuentes en los niños y niñas examinados. Álvarez Córdova LR, Rojas Criollo M, Escobar Valdivieso G, Sierra Nieto VH, Espinoza Caicedo J, Fonseca Pérez DM. Estado nutricional de los escolares atendidos en un hogar ecuatoriano para huérfanos. RCAN Rev Cubana Aliment Nutr 2017;27(1):68-80. RNPS: 2221. ISSN: 1561-2929. Palabras claves: Estado nutricional / Niñez / Orfandad / Antropometría / Bioimpedancia eléctrica / Evaluación nutricional.
... The brain growth is a continuous process during infancy, childhood and early adolescent, diet might have a significant influence on cognitive and behavior abilities (Bryan et al., 2004;Huo et al., 2012;Prado & Dewey, 2014). Iron being one of the most crucial micronutrients, and satisfying its demanding requirement is likely to have a beneficial influence on cognitive development in children (Sachdev et al., 2005). ...
... Overweight and obesity, micronutrient deficiency, stunting and wasting during childhood increase the risk of other health complications and can compromise cognitive and social development in later life (9)(10)(11) . It is also recognised that the eating habits that children learn during an early age are likely to be carried into adulthood (12,13) . ...
Objective
The school setting can provide an environment that supports healthy behaviours, including the provision of food. School food activities, i.e. school feeding, are commonplace globally, but not well understood in the Pacific Islands region. The aim of this research is to explore learnings associated within existing school food programs (SFP), and adoption resistors in those Pacific Island Countries and Territories (PICT) without SFP, with the intent of improving current and future SFP interventions.
Design
This observational cross-sectional study utilised four facilitated workshop sessions to explore SFP within an existing framework.
Setting
Pacific Islands region
Participants
Fourteen participants representing the education and health sectors from 11 PICT, and two participants representing regional organisations.
Results
Most countries reported some form of related policy, but key critical constraints to the use of SFP included: local food environments; strategic alignment to organisational priorities; advocacy and organisational leadership; community and cultural connections and collaboration. There are opportunities for integration of SFP into existing frameworks (i.e. Health Promoting Schools), increased collaboration, greater professional development and awareness activities, improved monitoring and evaluation, improved awareness of SFP and promotion of healthy eating for the wider school community.
Conclusions
Given the current health, social and economic challenges faced by countries and territories in the Pacific Islands region, SFP should be considered as an opportunity for food provision and associated nutrition education for students and their wider community. Further research is needed to understand the critical constraints of SFP in this region, and how to support stakeholders to advocate for, develop and sustain SFP that are contextually and culturally appropriate.
... Other factors affecting children's cognitive development include society [17], culture [18][19][20][21][22][23][24], religion [25], family [26,27], marital conflict, history of parental problems [28], malnutrition [29], food [30], maternal depression [31], air pollution [32], and maternal epilepsy during pregnancy [33]. Although Piaget's theory had a profound effect on the theory of psychology, it was not immune to criticism. ...
Background: Cognitions and attitudes, especially anthropological attitudes, are influential in human behavior. Objectives: The present study was conducted to investigate the cognitive evolution of the human concept in elementary school female students and its adaptation to Piaget’s theory of cognitive development. Materials & Methods: The present research method is qualitative of deductive-inductive type. Participants were first (n=12), second (n=13), and third-grade (n=12) elementary female students selected through the available sampling method. Semi-structured interviews were conducted with them to the point of theoretical saturation. Consistent with the research method, the findings were analyzed by theme analysis. Results: The findings showed that regarding human nature, students of all three grades have concrete thinking. Regarding the distinction between humans and animals, first and second grade students have concrete thinking, and third-grade students have concrete-abstract thinking. Regarding the purpose of life, students of all three grades have concrete thinking. Regarding the end of life, students of all three grades have abstract thinking. Regarding the beginning of human life, first-grade students have abstract thinking, and second- and third-grade students have concreteabstract thinking. Conclusion: Research findings consistent with some studies have shown that students can achieve abstract cognitive growth at younger ages than what Piaget stated, which can be a function of cultural, religious, and social factors.
... Nutrition is a key factor in the physical and cognitive development of children and may impact their educational performance [1][2][3][4][5]. Children need optimal access to food to enhance their development regardless of race, religion, and ethnicity. ...
Background: There is a high estimated prevalence of obesity and poor eating habits among children with disabilities. Unfortunately, the extent of parental and teachers’ awareness of the dietary needs and nutritional requirements of children with disabilities has been understudied. This study aims to explore the predictors and mediators of nutritional knowledge and practices among parents and teachers of children with disabilities in the United Arab Emirates (UAE) using Nutbeam’s hierarchical health literacy model as a framework to test three hypotheses.
Methods: A total of 149 parents and teachers were recruited from rehabilitation centres in two of the seven Emirates in the UAE. The revised Food and Nutritional Literacy Scale (FNLIT) was used for data collection. The revised scale was validated and its reliability was assessed using SPSS and AMOS version 28 to compute exploratory factor analysis and structural equation modelling (confrmatory factor analysis and path analysis), respectively.
Results: The results confrmed a four-factor structure for FNLIT, and all three hypotheses were supported by the study fndings. We confrmed a relationship between understanding and practical nutritional skills (Hypothesis I), and found that two practical nutritional skills, functional and interactive, combined to predict the understanding of nutritional needs of children with disabilities (Hypothesis II). Hypothesis III was partially supported in that participant type mediated the relationship between functional, interactive, and understanding factors. The convergent and discriminant validities of the scale were confirmed, and path analysis showed the ability of practical skills to predict
knowledge.
Conclusion: The study concludes on the need for public education on nutritional needs as well as developing the capacity of teachers and parents to implement appropriate eating programmes for children with disabilities.
... Research has shown that the maturation of certain areas of the brain during childhood is associated with the development of specific cognitive functions, such as language, reading, and memory [31,32]. Rapid brain growth occurs during the first 2 years of life (at age 2, the brain reaches 80% of an adult's weight), so this period of life may be particularly sensitive to nutritional deficiencies [33]. ...
Down syndrome (DS) is one of the most common genetic disorders associated with a number of difficulties that are visible through the motor and cognitive development. Some theories claim that intake of supplements in very high doses could upgrade the physical and intellectual status of individuals with DS. Numerous papers have been published to support these theories, but at the same time, a great number of papers have warned of the risks of uncontrolled, excessive use of dietary supplements and asked for the proof of such claims by independent scientific studies. In this chapter, we will provide a review of the most commonly used supplements and major findings on this matter. Open access to information about the positive and negative sides of such supplementation is primarily important for guardians of people with DS in order to make the decision whether to use such preparations. It could also be an incentive for scientists to focus on the development of beneficial and safe therapies.
... Lee et al. [47] showed an inverse association between postnatal exposure to DEHP and cognitive function. Indeed, cognitive functions together with several brain areas continue to develop during Toxics 2022, 10, 538 3 of 20 childhood [48]. Sex-specific associations were reported between BBzP and decreased motor abilities in females [49]. ...
Information about the effects of phthalates and non-phthalate substitute cyclohexane-1,2-dicarboxylic acid diisononyl ester (HEXAMOLL® DINCH) on children’s neurodevelopment is limited. The aim of the present research is to evaluate the association between phthalate/HEXAMOLL® DINCH exposure and child neurodevelopment in three European cohorts involved in HBM4EU Aligned Studies. Participating subjects were school-aged children belonging to the Northern Adriatic cohort II (NAC-II), Italy, Odense Child Cohort (OCC), Denmark, and PCB cohort, Slovakia. In each cohort, children’s neurodevelopment was assessed through the Full-Scale Intelligence Quotient score (FSIQ) of the Wechsler Intelligence Scale of Children test using three different editions. The children’s urine samples, collected for one point in time concurrently with the neurodevelopmental evaluation, were analyzed for several phthalates/HEXAMOLL® DINCH biomarkers. The relation between phthalates/HEXAMOLL® DINCH and FSIQ was explored by applying separate multiple linear regressions in each cohort. The means and standard deviations of FSIQ were 109 ± 11 (NAC-II), 98 ± 12 (OCC), and 81 ± 15 (PCB cohort). In NAC-II, direct associations between FSIQ and DEHP’s biomarkers were found: 5OH-MEHP+5oxo-MEHP (β = 2.56; 95% CI 0.58–4.55; N = 270), 5OH-MEHP+5cx-MEPP (β = 2.48; 95% CI 0.47–4.49; N = 270) and 5OH-MEHP (β = 2.58; 95% CI 0.65–4.51; N = 270). On the contrary, in the OCC the relation between DEHP’s biomarkers and FSIQ tended to be inverse but imprecise (p-value ≥ 0.10). No associations were found in the PCB cohort. FSIQ was not associated with HEXAMOLL® DINCH in any cohort. In conclusion, these results do not provide evidence of an association between concurrent phthalate/DINCHHEXAMOLLR DINCH exposure and IQ in children.
... Such low levels of hemoglobin concentration will affect the oxygen-carrying capacity of the blood, resulting in impaired memory and learning capacities, as well as general growth and development, which in some cases may be caused by a cerebral infarct 19,20 . Iron deficiency has been linked to a reduction in dopamine neurotransmission, which can be reflected in cognitive functions associated with motor activity, problem-solving ability, and academic performance 21,22,23 . In addition to fatigue and poor memory, attention deficit related to mitochondrial damage in brain neurogenic cells 24 and low academic accomplishment is possible consequences of reduced cognitive function 25,26 . ...
Background and objective: The importance of exercise and knowledge of emotional intelligence (EI) is gaining pace in academia, which is a positive development. Only a few single-blind research studies on the benefits of exercise and Emotional intelligence have indicated their effects on educational attainment among primary school children, but there are very few reports from young adult students. This longitudinal study aims to develop an intervention protocol to investigate the differential association between induced moderate physical exercise combined with emotional intelligence awareness on academic performance among 18-24-year-old private medical university students. Methods: Students are voluntarily enrolled in two groups: TEST (n = 180) and CONTROL (n = 180) based on inclusion criteria along with applicable consent’s and ethical clearance. The groups' baseline data mapping was completed in three phases. For the TEST group, baseline data was obtained in three stages during Phase-1; -, which is the pre-intervention phase: Anthropometric data, haemoglobin concentration, and cardiorespiratory measurements were all measured in Stage 1. (Lab-based data). Stage 2: two questionnaires were used, one to measure EI awareness and the other to assess learning styles (VARK). Stage 3 entailed the simultaneous recording of pre-intervention academic grades, of a said end block examination for both TEST and CONTROL groups. Phase 2: This is the intervention phase, which included only two components for the TEST group: the first was a moderate exercise regime (BRISK WALKING) of 2-3 sessions per week for about 30 minutes per session, and the second was addressing EI awareness. Which refers to knowing the current status of EI level, and fostering EI knowledge through various teaching-learning methods. Following the end of Phase -1 baseline data mapping, the two intervention components for the TEST group run concurrently for about 6months/24weeks, for the TEST group. Phase-3: is the post-intervention phase which included repeating of Phase-1; Stages 1, 2, and 3 for the TEST group, as well as a concurrent record and analysis of post-intervention academic grades, of the final professional examination for both TEST and CONTROL groups was done after Phase-2. The outcomes of Phase-1 and Phase-3 differential association compared. Results: The Statistical Package for Social Science (SPSS) Version 21.0 software was used to analyse all data from phases 1 and 3. A statistically significant correlation was found between the TEST group (p = 0.0001) and the CONTROL group (p = 0.406) when the pre-intervention period of multifactorial components subjected to intervention was compared to the post-intervention period. Conclusion: Intervention protocol with combined effect of emotional intelligence awareness and induced moderate physical exercise (BRISK WALKING) has shown significant improvement in academic grades.
... Children are at risk for trace element (TE) deficits due to rapid growth and high metabolic demands [1][2][3][4]. A dysregulated TE metabolism can severely impair brain development and neurocognitive functions, eventually manifesting as a neurodevelopmental disease [5,6]. Among the different TE, selenium (Se) is of particular importance as it is essentially needed for the biosynthesis of several selenoproteins with key functions in metabolism, endocrine signalling, and antioxidative defence systems [7][8][9][10]. ...
Neurodevelopmental diseases are often associated with other comorbidities, especially inflammatory processes. The disease may affect the trace element (TE) status, which in turn may affect disease severity and progression. Selenium (Se) is an essential TE required for the biosynthesis of selenoproteins including the transporter selenoprotein P (SELENOP) and extracellular glutathione peroxidase (GPX3). SELENOP deficiency in transgenic mice resulted in a Se status-dependent phenotype characterized by impaired growth and disturbed neuronal development, with epileptic seizures on a Se-deficient diet. Therefore, we hypothesized that Se and SELENOP deficiencies may be prevalent in paediatric patients with a neurodevelopmental disease. In an exploratory cross-sectional study, serum samples from children with neurodevelopmental diseases (n = 147) were analysed for total serum Se, copper (Cu), and zinc (Zn) concentrations as well as for the TE biomarkers SELENOP, ceruloplasmin (CP), and GPX3 activity. Children with epilepsy displayed elevated Cu and Zn concentrations but no dysregulation of serum Se status. Significantly reduced SELENOP concentrations were found in association with intellectual disability (mean ± SD (standard deviation); 3.9 ± 0.9 mg/L vs. 4.4 ± 1.2 mg/L, p = 0.015). A particularly low GPX3 activity (mean ± SD; 172.4 ± 36.5 vs. 192.6 ± 46.8 U/L, p = 0.012) was observed in phacomatoses. Autoantibodies to SELENOP, known to impair Se transport, were not detected in any of the children. In conclusion, there was no general association between Se deficiency and epilepsy in this observational analysis, which does not exclude its relevance to individual cases. Sufficiently high SELENOP concentrations seem to be of relevance to the support of normal mental development. Decreased GPX3 activity in phacomatoses may be relevant to the characteristic skin lesions and merits further analysis. Longitudinal studies are needed to determine whether the observed differences are relevant to disease progression and whether correcting a diagnosed TE deficiency may confer health benefits to affected children.
... Copper (Cu) is an important microelement for enzyme catalysis crucial for balanced metabolism (Harris 2001). Fe is another trace element of interest, which is required for hemoglobin synthesis, red blood cell formation, and regulation of oxidative reactions (Bryan et al. 2004). Iron, which is essential for the synthesis of hemoglobin and new tissues, contributes to the functioning of the immune system and the health of the nervous system. ...
Breast milk represents the best food for growth and healthy development of new-borns and infants. Exclusive breast feeding is recommended for the first 6 months of life. The composition of human milk changes throughout the lactation period. The aim of this preliminary study was to evaluate the variations in fatty acid composition and elemental concentrations of breast milk during the first 6 months of lactation. Fatty acid methyl esters were prepared by standard methods, separated, and quantified by gas chromatography with flame ionization detection (GC-FID). An inductively coupled plasma mass spectrometry (ICP-MS) method was used to determine 16 elements in breast milk after acid microwave digestion. The mean concentrations of essential elements and potentially toxic elements were as follows: 410.3 mg/L (Na), 53.5 mg/L (Mg), 118.4 mg/L (P), 516 mg/L (K), 326.4 mg/L (Ca), 0.5 mg/L (Fe), 0.4 mg/L (Cu), 1.5 mg/L (Zn), 0.2 mg/L (Cr), 0.02 mg/L (Ni), 3.5 µg/L (Li), 5.0 µg/L (Mn), 0.6 µg/L (Co), 7.7 µg/L (As), and 1.5 µg/L (Pb). Analysis of variance (ANOVA), linear discriminant analysis (LDA) and Pearson’s correlation analysis was applied to evaluate correlations among the lactation stages as a function of fatty acid and elemental contents and to identify the best discriminant markers.
... Studies have shown that the maturation of specific brain areas during childhood is associated with development of specific cognitive functions such as language, reading and memory (Nagy et al., 2004;Giedd et al., 2010). Since rapid brain growth occurs during the first 2 years of life (by the age of 2 the brain reaches 80 % of its adult weight), this period of life may be particularly sensitive to deficiencies in diet (Bryan et al., 2004). ...
Coffee is one of the most popular beverages around the world. There is a long tradition of consuming black coffee in our area (western Balkan). Coffee like any other consuming product is valued by the sensory properties (color, scent, taste, consistency). The good evaluator can discover the beginning of degradation or poorly performed technological process. A precise description of the aroma, taste, and color of the black coffee, as the most important sensory properties, can be given by applying descriptive sensory analysis. The aim of the final work was to examine the sensory quality and acceptability of black coffee. Two types of coffee were used to prepare the black coffee beverage Arabica (Coffea arabica, sorts Rio Minas and Santos) and Robusta (Coffea robusta, syn. Coffea canephora, sorts Scheery and Camerun) in different rations. Participants in the sensor evaluation of coffee samples were mainly influenced by the type and ratio of coffee that is used. Mixing Arabica and Robusta coffee has significantly improved the sensory properties of the product, especially the scent and taste. The results of instrumental color measurements show that the examined coffee samples were dark and medium roasted. The acceptability test showed good acceptance of samples of different black coffee beverages by potential consumers.
... Nutrition is the cornerstone for the growth of the brain, language, and cognitive development [9] . Therefore, studying the effect of ID and IDA on NV-IQ as a mirror to cognitive brain function is the concern of this study. ...
Objective: Determine the effect of iron deficiency anemia (IDA) & iron deficiency (ID), on the cognitive functions in children and its consequences. Patients and Methods: Three groups of children were enrolled in this case-control study with an age range of 3-8 years. They were selected from pediatric and phoniatric clinics in Egypt. Control group (CG): thirty normal children. Case groups were divided into GroupI: Nineteen Delayed language development children had ID only, Group II: Thirty Delayed language development children had iron deficiency anemia (IDA). Groups were subjected to (1) Full history taking (focusing on nutritional history). (2) CBC by automatic cell counters. (3) Iron status through estimation of serum ferritin level by ELISA. (4) Assessment of cognitive functions by assessment of Non-verbal Intelligent Quotient (NV-IQ) using Stanford Binet 5 th Edition measuring (fluid reasoning, knowledge, quantitative reasoning, visual-spatial processing, and working memory). (5) Assessment of language-by-language test to confirm diagnosis of delayed language development. Results: Under the umbrella of faulty eating habits, there was a direct correlation between the NV-IQ and the deterioration of iron status with their consequence on delaying language development. Conclusion: There is a necessary to assess NV-IQ and iron status in any child with delayed language development with poor attention span, intelligence, sensory perception functions, emotions, and behavior, especially with the condition of faulty eating habits.
... Children must meet their nutritional requirements through the inclusion of healthy food in their diet for various reasons, amongst others cognitive and behavioural development. 5,6 Children with a better nutrient intake have been reported to experience fewer psychosocial problems and feelings of hunger. 7 Unfortunately, parents (especially mothers) with a lower level of education have a lower 'health-attitude', 8 which may influence health messages to their children. ...
Objective
A study was undertaken to determine the sociodemographic variables (SDV) and caregivers’ attitudes that impact on healthy eating and the provision of healthy breakfast and school lunchboxes.
Design
This was a cross-sectional, descriptive study using self-administered questionnaires.
Setting
Participating Quintile 5 primary schools in Bloemfontein, South Africa (SA).
Participants
Caregivers of learners, aged 6–12 years (N = 1 286).
Main outcome measures
To determine associations between sociodemographic variables (SDV) and attitudes towards the provision of healthy breakfast and lunchbox foods.
Analysis
Wilcoxon two-sample test for unpaired data or the chi-square test to compare groups. A p-value of <0.05 indicated statistical significance.
Results
Caregivers with higher income and those living with a life partner were more likely to perceive healthy food as being more expensive than less healthy food (p < 0.01 and p < 0.01, respectively) and were of the opinion that preparing lunchboxes increased their workload (p < 0.01 and p < 0.01, respectively). Caregivers with lower income had a less positive attitude towards healthy eating habits (p < 0.01).
Conclusions
Caregivers mostly had a positive attitude towards providing healthy breakfast and lunchbox foods. Discrepancies between caregivers’ perception of preparation time and cost of healthy food, and the provision of healthy food to learners, were observed.
... Cereals, millets and legumes also form a good source of macro and micronutrients, phytochemicals and to prepare nutritionally balanced composites of high biological value [10]. Nutrition can be redesigned to improve cognitive development, and micronutrient supplementation can help those at risk of cognitive impairment avoid deficiencies [11]. Vitamins B1, B2, B3, B6, B12, Vit C, folic acid, and minerals like iron, iodine, and zinc are the micronutrients most closely linked to cognitive function [12,13]. ...
... The first 1000 days of life are a crucial brain development period in which adequate nutrition is vital for optimal growth and cognitive development [39][40][41]. This has been identified as a sensitive time in which children are most vulnerable to behavioral and cognitive deficits [39]. ...
The developing human brain requires all essential nutrients to form and to maintain its structure. Infant and child cognitive development is dependent on adequate nutrition. Children who do not receive sufficient nutrition are at high risk of exhibiting impaired cognitive skills. This systematic review aimed to examine the effects of nutritional interventions on cognitive outcomes of preschool-age children. PubMed, PsycInfo, Academic Search Complete, and Cochrane Library electronic databases were searched to identify Randomized Controlled Trials (RCTs) published after the year 2000. Studies assessing the effects of food-based, single, and multiple micronutrient interventions on the cognition of nourished and undernourished children aged 2–6 years were deemed eligible. A total of 12 trials were identified. Eight out of the twelve studies found significant positive effects on cognitive outcomes. Iron and multiple-micronutrients supplementation yield improvements in the cognitive abilities of undernourished preschool-age children. Increased fish consumption was found to have a beneficial effect in the cognitive outcomes of nourished children. On the other hand, B-vitamin, iodized salt, and guava powder interventions failed to display significant results. Findings of this review highlight the importance of adequate nutrition during preschool years, and the crucial role sufficient nutrition plays in cognitive development.
... The Italian DRVs include RI range, SDT, or AI, as applicable [38]. (12)(13)(14)(15)(16)(17)(18). Furthermore, the median %En from total PUFAs, PUFAs ω-6, and PUFAs ω-3 were below the lower limit of the RI range. ...
Few Italian and European studies have assessed adherence to dietary recommendations in primary school children using dietary records. No Italian studies have provided an index-based nutritional adequacy assessment. We provided a comprehensive overview of dietary intake in 381 7-year-old children from NAC-II cohort study, Friuli Venezia Giulia (Italy). Energy, macro-, and micronutrient intakes were derived from 3-day dietary records. Standard (median and percentage) and index-based (Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR)) approaches were used to evaluate adequacy to Italian dietary reference values at nutrient- and overall-diet-level. Percentage contribution of macronutrients to energy intake (%En) was unbalanced towards total fats and protein. In 25% of children, total fats intake exceeded the reference intake upper limit. In ~63% of children, protein intake was at least doubled in their child-specific population reference intake. Median intakes of sodium (1.7 g/day), saturated fatty acids (12.2 %En), and soluble carbohydrates (19.4 %En) exceeded the suggested dietary target in most (65–84%) children. Inadequacy was also observed for micronutrients, with median NARs ranging from 0.11 (vitamin D) to 0.90 (zinc). The median MAR was 0.75 (0.69–0.79), with 1 indicating optimal overall dietary intake. In conclusion, the enrolled children showed suboptimal intakes of several macro- and micronutrients, in line with Italian and European studies on primary school children. Based on the current findings, public health interventions may be targeted to specific nutrients or subpopulations.
... Any effects of BMI (conceived of as a measure of health) were inconclusive, though we suggest it may have had a stronger association with self-regulation with a larger sample, given the extensive evidence for the impact of nutrition on cognitive development (Bryan et al., 2004;Freeman et al. 1980;Nyaradi et al., 2013). While we were unable to assess SES, we acknowledge its importance as a variable in cognitive assessment and that cross-cultural samples represent communities with diverse demographics in geographic location, political and educational systems, and socioeconomic conditions. ...
Self-regulation is a widely studied construct, generally assumed to be cognitively supported by executive functions (EFs). There is a lack of clarity and consensus over the roles of specific components of EFs in self-regulation. The current study examines the relations between performance on a) a self-regulation task (Heads, Toes, Knees Shoulders Task) and b) two EF tasks (Knox Cube and Beads Tasks) that measure different components of updating: working memory and short-term memory, respectively. We compared 107 8- to 13-year-old children (64 females) across demographically-diverse populations in four low and middle-income countries, including: Tanna, Vanuatu; Keningau, Malaysia; Saltpond, Ghana; and Natal, Brazil. The communities we studied vary in market integration/urbanicity as well as level of access, structure, and quality of schooling. We found that performance on the visuospatial working memory task (Knox Cube) and the visuospatial short-term memory task (Beads) are each independently associated with performance on the self-regulation task, even when controlling for schooling and location effects. These effects were robust across demographically-diverse populations of children in low-and middle-income countries. We conclude that this study found evidence supporting visuospatial working memory and visuospatial short-term memory as distinct cognitive processes which each support the development of self-regulation.
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... Esta tendencia guarda relación con el tema alimentario si consideramos que cuando existe desnutrición, y en específico cuando ocurre durante la niñez, las capacidades cerebrales de los niños son afectadas de forma severa, ocasionando un déficit en las funciones cognitivas (Bellisle, 2004;Walker et al., 2007). No obstante, Janet Bryan considera que los daños ocasionados por la desnutrición pueden ser temporales, esto es, sólo se presentan cuando la situación nutricional prevalece (Bryan et al., 2004). Sin embargo, y pese a la implementación del programa de desayunos escolares, el porcentaje de alumnos con resultados deficientes se mantiene considerablemente alto y no se observa un incremento en el número de alumnos en el nivel sobresaliente. ...
p>La crisis sanitaria provocada por el covid-19 ha tenido un efecto significativo en el sector de la educación, en términos pedagógicos y de apropiación del conocimiento. Asimismo, uno de los aspectos que más ha impactado en los colectivos en condiciones de muy alta y alta marginación es el que refiere a la crisis alimentaria derivada de la suspensión del programa de desayunos escolares que se implementa en escuelas de Educación Básica, lo que conlleva un incremento en la violencia estructural. En este contexto se analizan las condiciones de los alumnos que habitan en comunidades rurales y de alta marginación del estado de Tamaulipas, México, entidad con altos índices de violencia, enfatizando la afectación que en términos individuales, colectivos y sociales genera el déficit alimentario de al menos 32,010 menores durante la pandemia.</p
Background
Stunting is a condition of toddlers who experience growth failure due to chronic nutrient deficiencies that must be addressed immediately, if children lack nutrients continuously, it can affect their nutritional status and will cause children to be shorter than their age. The purpose of this study was to determine the differences in macronutrient intake in stunted and non-stunted toddlers in Jember, Indonesia.
Design and methods
Type of analytical observational research with case control design, sampling technique using simple random sampling. The number of subjects needed in each group is 66 stunting toddlers and 66 non-stunting toddlers with total subjects used are 132 toddlers.
Results
There are differences in macronutrient intake: energy, protein, fat, and carbohydrates between stunted and non-stunted toddlers with a higher average value of food intake per day for non-stunted toddlers than for stunted toddlers.
Conclusions
There are differences in macronutrient intake between stunted and non-stunted toddlers in Jember, Indonesia with a p-value = 0.000 < 0.05.
The general objective of this grounded theory multiple-case study was to further apprehend how independent K-12 schools within America foster a connection between children and adolescent students and the natural world through examining the relationship between this connection and (a) the school community (“community connectedness”) and (b) personal sense/belief about spirituality. This study utilized a grounded theory multiple-case study approach to perform secondary data analysis on pre-existing data collected during the original parent study. From this parent study, two schools from the initial cohort of 20 were selected and their data were examined for this grounded theory multiple-case study. Data were primarily collected through school site visits that were one to two days in duration.
Background
School feeding programs (SFP) in low-income countries are designed to provide food to vulnerable school children to create optimal educational and health conditions for learners. Ethiopia scaled up the implementation of SFP in Addis Ababa. Yet, the utility of this program in terms of school absenteeism has not been monitored thus far. Hence, we aimed at evaluating the effect of the SFP on school performance of primary school adolescents in Addis Ababa, Central Ethiopia.
Methods
A prospective cohort study was carried out from 2020 to 2021 on SFP-beneficiary (n = 322) and non-SFP beneficiary (n = 322). Logistic regression models were done using SPSS version 24.
Results
In logistic regression, unadjusted model (model 1), the school absenteeism of non-school-fed adolescents was higher by 1.84 (adjusted odds ratio [aOR] 0.36, 95% confidence interval [CI] 1.28-2.64) as compared to school-fed adolescents. The odds ratio remained positive after adjusting for age and sex (model 2: aOR 1.84, 95% CI 1.27-2.65), and sociodemographic (model 3: aOR 1.84, 95% CI 1.27-2.67). In the final model, adjusted model 4, health and lifestyle, there was a significant increase in absenteeism of non-school-fed adolescents (model 4: aOR 2.37, 95% CI 1.54-3.64). The likelihood of absenteeism in female increase by 2.03 (aOR 2.03, 95% CI 1.35-3.05), whereas being in a low tertile wealth index family decreases absenteeism by (aOR 0.51, 95% CI 0.32-0.82). School feeding was negatively associated with school absenteeism.
Conclusions
The findings imply the need for strengthening school feeding programs.
Objectives:
Low cognitive performance is a major concern among fishermen's children in Malaysia. Thus, this study was aimed at assessing dietary intake, nutritional status, physical activity, and socio-economic status, and their associations with cognitive performance among fishermen's children in Terengganu, Malaysia. We also investigated the risk associated with low cognitive performance.
Methods:
This cross-sectional study included 94 children 7-11 years of age in Terengganu. Dietary adequacy was assessed with two 24-h dietary recall surveys. Anthropometric measurements were assessed by calculation of the body mass index (BMI)-for-age Z-score and height-for-age Z-score. In addition, median urinary iodine tests were conducted to determine iodine concentrations. Physical activity was measured with the Physical Activity Questionnaire for Children (PAQ-C). Raven's coloured progressive matrices were used to determine cognitive performance. Binominal logistic regressions were performed on factors associated with cognitive performance, to identify the risk factors with the strongest association with cognitive performance.
Results:
The children of fishermen had adequate intake of all necessary nutrients except for fat, dietary fibre, thiamine, folate, vitamin C, vitamin E, calcium, zinc, and potassium. Most of the children had normal BMI-for-age [median = -0.86 (2.11)] and height-for-age (mean = -1.01 ± 1.03). However, more than half had iodine deficiency [median = 83.9 (102)]. In addition, 16% had low physical activity levels, and their cognitive performance was classified with a low average score [median = 80.0 (21.0)]. The mother's education level (p = 0.037), children's BMI-for-age (p = 0.012), protein (p = 0.020), and niacin (p = 0.032), exhibited significant relationships with cognitive performance (p < 0.05). Of these variables, BMI-for-age (OR = 0.290, p = 0.036) and fourth quartile protein intake (≥52.69 g) (OR = 7.565, p = 0.015) were significant risk factors for low cognitive performance among fishermen's children in Terengganu.
Conclusion:
A balanced diet and healthy lifestyle are crucial for children's cognitive development. Thus, interventions emphasising the promotion of healthy lifestyles, particularly focusing on BMI-for-age and protein intake, are advised.
Over the preceding several decades, significant improvements have been made in our understanding of the processes and mechanisms of mammalian brain development. The cognitive, social, and emotional components of the brain remain to develop throughout the lifespan. The trajectories of the growth and development of the nervous system are non-homogenous across time. There is expanding evidence suggesting that nutrition especially during early life influences the development of an individual. Iron, a ubiquitous metal, plays an essential role in several neurodevelopmental processes. Due to the high requirement of iron for several cellular functions, mammals during developmental stages are more vulnerable to iron deficiency, hence leading to abnormalities in the structure and function of organs which predominantly dependent on iron stores such as the nervous system. Furthermore, iron insufficiency is the most common dietary problem worldwide, with numerous cognitive and neurological consequences. Not only iron deficiency, but also iron overload poses significant high risks to the development and function of the nervous system. Studies of completely developed infants that have been exposed to iron deficiency during development show the long-lasting and irreversible deficit of cognition, memory, and motor skills, indicating the profound influence on the human brain. The most commonly considered neurodevelopmental disorders in childhood are attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), which can be lifelong conditions. As a result, understanding the mechanisms by which iron influences the brain and its development as well as how those processes are regulated addresses major public health concerns. This chapter is intended to provide an overview of some basics of the role of iron in brain development and neurodevelopmental disorders, that may be useful for investigators from a wide range of disciplines.
Approximately 1 in 6 children in New Zealand are living in households facing poverty and 14% of the population is food insecure. The Ka Ora, Ka Ako|Healthy School Lunches program aims to reduce food insecurity by providing access to a nutritious lunch every school day. This study analyzed the nutritional content of Ka Ora, Ka Ako meals and compared them to national and international standards. Meals were selected at random from approved menus. The suppliers covered by the 302 meals analyzed provide 161,699 students with a lunch (74.9% of students on the program). The meals were analyzed using Foodworks 10 nutrient analysis software. The nutrient content was compared against the New Zealand/Australia Nutrient Reference Values (NRVs) and to nutrient-level standards for international school lunch programs. A total of 77.5% of nutrients analyzed exceeded 30% of the recommended daily intakes. Protein, vitamin A and folate met the NRV targets and a majority of the international standards (55/57). Energy, calcium, and iron were low compared to NRVs and international standards (meeting 2/76 standards). Carbohydrates were low compared to international standards. The findings have been used to inform the development of revised nutrition standards for the program, which will be released in 2022.
Children’s brains dynamically adapt to the stimuli from the internal state and the external environment, allowing for changes in the cognitive and mental behavior of individuals. In this work, we performed a large-scale analysis of dynamic functional connectivity (DFC) in children aged 9~11 years, investigating how brain dynamics relate to cognitive performance and mental health during an early age. An adaptive independent component analysis framework was applied to the Adolescent Brain Cognitive Development (ABCD) data containing 10,988 children. We combined a sliding-window approach with k-means clustering to identify five reoccurring brain states with distinct DFC patterns. Interestingly, the occurrence of a strongly connected state was negatively correlated with cognitive performance and positively correlated with dimensional psychopathology in children. Meanwhile, the opposite relationships were observed for a sparsely connected state. The composite scores, the attention score, and the Attention-Deficit/Hyperactivity Disorder score were the most significantly correlated with the DFC states. The cognitive and psychiatric relevance of DFC states were highly reproducible across scans and between longitudinal sessions. Finally, the mediation analysis showed that the attention problems mediate the effect of DFC states on cognitive performance. This investigation unveils the neurological underpinnings of DFC by highlighting their robust associations with behavioral development in childhood. Tracking the patterns of maturation in DFC states may capture delays in development and guide people to provide early intervention to buffer adverse influences in children’s development.
Background:
Since 2016, the School Food Program in the Buenos Aires Province, Argentina, implemented a nutritional regulatory framework (NRF) and varying administration systems (AS). Here, we examined the association between the interventions (only NRF and NRF + AS) and breakfast nutritional and food indicators between 2016 and 2019.
Methods:
Data collected from the Survey of the School Food Program, 2016-2019, were analyzed. The dependent variables were the energy, macro-and micronutrients, milk/yogurt, and fruit quantities in school breakfasts. The independent variables were the school's status: (a) control group, (b) Intervention 1 (only NRF), and (c) Intervention 2 (NRF + AS). We preformed crude and adjusted linear regressions with robust variances.
Results:
We evaluated 4,060 schools (control group: 24%; Intervention 1: 39%; Intervention 2: 37%). Only vitamin A levels increased after Intervention 1, and almost all indicators (80%) showed better values when applying Intervention 2.
School health policy implications:
Nutritional and food indicator improvements were associated with the implementation of the NRF and AS, emphasizing the significance of design and management of school food public policies, along with the amount of investment/territorial coverage.
Conclusions:
Our findings highlight the importance of school food and nutrition policies with a potential impact on improving the nutritional status of children.
Background
The COVID-19 pandemic required a shift in the landscape of practice patterns regarding management of pediatric feeding disorders. The challenging limitations impacted routine service delivery models and deemed it necessary for abrupt transition to optimize professional care to best meet the needs of clients and families. Telepractice platforms were explored across practice settings and often integrated new technology, telehealth practices, and family support systems.
Purpose
The purpose of this clinical focus article was to consider the impact of COVID-19 on modifications in clinical practice related to pediatric feeding disorders and dysphagia.
Conclusions
The COVID-19 pandemic demanded modification of clinical service delivery to pediatric clients having feeding disorders and dysphagia. The service challenges prior to the pandemic were further complicated by challenging limitations in service delivery, client accessibility, and family support resources. Telehealth offered a hybrid model for quality care when access to traditional in-person sessions was limited. Future research on this dynamic framework will guide us in evaluating the benefits and limitations in clinical practices. Ongoing research and development of resources are needed to ensure equitable and accessible services across settings.
The majority of studies of developmental zinc deficiency and behavior were conducted in laboratory animals, primarily rats and rhesus monkeys. Effects on food intake complicate interpretation of experiments using severe zinc deficiency. Severe zinc deficiency in rats during the period of rapid brain growth has similar effects to protein calorie malnourishment during this period, including altered emotionality and food motivation. When behavior is tested during a period of zinc deprivation in immature animals, lethargy (reduced activity and responsiveness) is a prominent characteristic, but learning, attention and memory are also affected. The few supplement studies available in children did not report effects on behavior. Although zinc has multiple roles in brain function, considerable brain sparing occurs in zinc deficiency, and peripheral mechanisms of altered behavior also need to be considered.
Although endemic goitre is no longer a major public health problem in Malaysia, iodine deficiency still remains a significant problem in a few remote settlements. The aim of this study was to determine the effectiveness of iodized oil intervention in the prevention of endemic goitre among the indigenous people in Malaysia. A pretest and post-test controlled trial was conducted among primary schoolchildren and pregnant mothers in Lasah, Sungai Siput and Perak. Legap Post and Yum Post were selected as the intervention areas, while Perwor Post and Poi Post were taken as controls. The variables studied included thyroid hormone concentrations, thyroid volume, urinary iodine excretions and mental performance. A baseline and two follow-up visits were conducted in both intervention and control areas. Intervention subjects were given iodized oil in the form of capsules which were taken orally (Laboratoire Guerbet, Paris, France). There was a significant increase in serum thyroxine hormone (T4) concentrations (p<0.0001) and a significant decrease in thyroid stimulating hormone (TSH) concentrations (p<0.05) in the schoolchildren following the intervention, however, pregnant mothers did not show any significant changes in T4 and TSH concentrations. Thyroid size was significantly reduced in both groups (p<0.05). Urinary iodine excretions showed a significant increase in both groups following the intervention (p<0.01). However, mental performance in schoolchildren was not affected. In conclusion, iodized oil (oral) is effective in reducing thyroid size, as well as improving the supply of iodine among schoolchildren and pregnant mothers in endemic goitre areas; however, its long-term effects need to be monitored closely. This method can be considered as an alternative while awaiting national coverage for the salt iodization program.
This study evaluates the effects of vitamin B-6 supplementation (20 mg pyridoxine HCL daily for 3 months) on mood and performance in 38 self-supporting healthy men, aged between 70-79 years. Effects were compared with 38 controls who received placebo and were matched for age, plasma pyridoxal-5'-phosphate (PLP) concentration and intelligence score. Before and after drug intervention vitamin B-6 status was determined, and mood and performance were measured by means of a computerized testing system. In addition, the phasic pupil response was measured in order to assess mental effort. Positive effects of vitamin B-6 supplementation were only found with respect to memory, especially concerning long-term memory. In view of the finding that mental performance improvement and delta PLP values were most strongly correlated within an intermediate range of delta PLP, it is suggested that cognitive effects are primarily associated with a certain range of vitamin B-6 status increment. The general conclusion is that vitamin B-6 supplementation improves storage of information modestly but significantly.
Iron-deficiency anemia has been associated with lowered scores on tests of mental and motor development in infancy. However, the long-term developmental outcome of infants with iron deficiency is unknown, because developmental tests in infancy do not predict later intellectual functioning.
This study is a follow-up evaluation of a group of Costa Rican children whose iron status and treatment were documented in infancy. Eighty-five percent (163) of the 191 children in the original group underwent comprehensive clinical, nutritional, and psychoeducational assessments at five years of age. The developmental test battery consisted of the Wechsler Preschool and Primary Scale of Intelligence, the Spanish version of the Woodcock-Johnson Psycho-Educational Battery, the Beery Developmental Test of Visual-Motor Integration, the Goodenough-Harris Draw-a-Man Test, and the Bruininks-Oseretsky Test of Motor Proficiency.
All the children had excellent hematologic status and growth at five years of age. However, children who had moderately severe iron-deficiency anemia as infants, with hemoglobin levels less than or equal to 100 g per liter, had lower scores on tests of mental and motor functioning at school entry than the rest of the children. Although these children also came from less socioeconomically advantaged homes, their test scores remained significantly lower than those of the other children after we controlled for a comprehensive set of background factors. For example, the mean (+/- SD) adjusted Woodcock-Johnson preschool cluster score for the children who had moderate anemia in infancy (n = 30) was 448.6 +/- 9.7, as compared with 452.9 +/- 9.2 for the rest of the children (n = 133) (P less than 0.01); the adjusted visual-motor integration score was 5.9 +/- 2.1, as compared with 6.7 +/- 2.3 (P less than 0.05).
Children who have iron-deficiency anemia in infancy are at risk for long-lasting developmental disadvantage as compared with their peers with better iron status.
The behavioral effects of iron deficiency and its treatment were evaluated in a double-blind randomized controlled community-based study of 191 Costa Rican infants, 12 to 23 months of age, with various degrees of iron deficiency. The Bayley Scales of Infant Development were administered before and both 1 week and 3 months after IM or oral administration of iron. Appropriate placebo-treated control infants were also tested. Infants with iron deficiency anemia showed significantly lower mental and motor test scores, even after considering factors relating to birth, nutrition, family background, parental IQ, and the home environment. After 1 week, neither IM nor oral iron treatments differed from placebo treatment in effects on scores. After 3 months, lower mental and motor test scores were no longer observed among iron-deficient anemic infants whose anemia and iron deficiency were both corrected (36%). However, significantly lower mental and motor test scores persisted among the majority of initially anemic infants (64%) who had more severe or chronic iron deficiency. Although no longer anemic, they still showed biochemical evidence of iron deficiency after 3 months of treatment. These persistent lower scores suggest either that iron therapy adequate for correcting anemia is insufficient to reverse behavioral and developmental disturbances in many infants or that certain ill effects are long-lasting, depending on the timing, severity, or chronicity of iron deficiency anemia in infancy.
This double-blind clinical trial was conducted in Thailand to assess the impact of iron treatment on the IQ and educational attainment of 1358 9–11-y-old children. The children were classified into one of three groups: iron replete, iron depleted, and iron-deficient anemic. The Raven Progressive Matrices was used to measure IQ. A Thai language and a math test were administered to assess school attainment. A 50-mg/d tablet of ferrous sulphate was given for 2 wk and a 100 mg/d tablet, for 14 wk. An anthelminthic drug was given on the day of the blood test before treatment and 3 mo after the intervention started. There is evidence of a positive association between iron status and IQ and a language school achievement test but there is no support for the internal validity of the hypothesis that this association is causal.
The brain is 60% structural lipid, which universally uses arachidonic acid (AA; 20:4n−6) and docosahexaenoic acid (DHA; 22:6n−3) for growth, function, and integrity. Both acids are consistent components of human milk. Experimental evidence in animals has demonstrated that the effect of essential fatty acid deficiency during early brain development is deleterious and permanent. The risk of neurodevelopmental disorder is highest in the very-low-birth-weight babies. Babies born of low birth weight or prematurely are most likely to have been born to mothers who were inadequately nourished, and the babies tend to be born with AA and DHA deficits. Because disorders of brain development can be permanent, proper provision should be made to protect the AA and DHA status of both term and preterm infants to ensure optimum conditions for the development of membrane-rich systems such as the brain, nervous, and vascular systems.
In a study of periurban Guatemalan schoolchildren (89 males, 73 females) aged 81.5 ± 7.0 mo (x̄ ± SD), height, weight, arm circumference, and triceps-skinfold-thickness (TSF) measurements were examined in relation to plasma and hair zinc concentrations, plasma and red blood cell alkaline phosphatase activities, recognition thresholds for salt (RTS), de-layed-cutaneous hypersensitivity response to seven recall skin-test antigens, and cognitive measures. Children were stunted [median height-for-age (HA) Z score −1.49] but not wasted [median weight-for-height (WH) Z score 0.20], with median midarm muscle area (MAMA) and midarm-fat area (MAFA) Z scores of −0.57 and −0.35, respectively. Of the children, 63.5% of males and 44.1% of females had hair zinc < 1.68 µmol/g (P < 0.05); 12.3% of males and 1.5% of females had plasma zinc < 10.71 µmol/L(P < 0.05). Children with hair zinc < 1.68 µmol/ g had higher (P < 0.05) medians for WA Z and WH Z scores, RTS, and phytic acid intake than did those with hair zinc ≥ 1.68 µmol/g. Zinc status explained some of the variance in growth (HA, WA, and WH Z scores), body composition (MAFA Z scores), and taste acuity. Suboptimal zinc status arose partly from diets low in readily available zinc.
A supplement containing 20 mg/d zinc (Zn), Zn plus micronutrients (Zn+M; 50% RDA or mean ESSADI, excluding Zn, Ca, Mg, P; folate at 25% RDA), or micronutrients alone (M) was provided in a double-blind fashion for 10 weeks to 540 children (aged 6-9 years) from poor rural regions located near the cities of Chongqing, Qingdao, and Shanghai in the Peoples Republic of China. Cognitive and psychomotor function were assessed at baseline and 10 weeks by measuring performance on a battery of computer-administrated tasks designed specifically to emphasize attention, perception, memory and concept formation (reasoning), and the motor and spatial skills necessary for successful performance. Plasma lead was also measured and included as a covariate in the analysis of treatment effects. Compared to either M or Zn alone, Zn+M resulted in greater improvement in finger tapping (manual dexterity), object search (perception), and performance on an oddity task (reasoning). Compared to M alone, Zn alone resulted in greater improvement in memory for both objects and complex shapes. There were no treatment effects on continuous performance (attention). Results will be compared to those from an earlier study with children living in nearby urban areas. These findings indicate that cognitive and psychomotor function may be suboptimal in the estimated 30% of Chinese children who are zinc deficient.
Although endemic goitre is no longer a major public health problem in Malaysia, iodine deficiency still remains a significant problem in a few remote settlements. The aim of this study was to determine the effectiveness of iodized oil intervention in the prevention of endemic goitre among the indigenous people in Malaysia. A pretest and post-test controlled trial was conducted among primary schoolchildren and pregnant mothers in Lasah, Sungai Siput and Perak. Legap Post and Yum Post were selected as the intervention areas, while Perwor Post and Poi Post were taken as controls. The variables studied included thyroid hormone concentrations, thyroid volume, urinary iodine excretions and mental performance. A baseline and two follow-up visits were conducted in both intervention and control areas. Intervention subjects were given iodized oil in the form of capsules which were taken orally (Laboratoire Guerbet, Paris, France). There was a significant increase in serum thyroxine hormone (T4) concentrations (P < 0.0001) and a significant decrease in thyroid stimulating hormone (TSH) concentrations (p < 0.05) in the schoolchildren following the intervention, however, pregnant mothers did not show any significant changes in T4 and TSH concentrations. Thyroid size was significantly reduced in both groups (P < 0.05). Urinary iodine excretions showed a significant increase in both groups following the intervention (P < 0.01). However, mental performance in schoolchildren was not affected. In conclusion, iodized oil (oral) is effective in reducing thyroid size, as well as improving the supply of iodine among schoolchildren and pregnant mothers in endemic goitre areas; however, its long-term effects need to be monitored closely. This method can be considered as an alternative while awaiting national coverage for the salt iodization program.
This review critically summarizes the literature on the spectrum of health effects of zinc status, ranging from symptoms of zinc deficiency to excess exposure. Studies on zinc intake are reviewed in relation to optimum requirements as a function of age and sex. Current knowledge on the biochemical properties of zinc which are critical to the essential role of this metal in biological systems is summarized. Dietary and physiological factors influencing the bioavailability and utilization of zinc are considered with special attention to interactions with iron and copper status. The effects of zinc deficiency and toxicity are reviewed with respect to specific organs, immunological and reproductive function, and genotoxicity and carcinogenicity. Finally, key questions are identified where research is needed, such as the risks to human health of altered environmental distribution of zinc, assessment of zinc status in humans, effects of zinc status in relation to other essential metals on immune function, reproduction, neurological function, and the cardiovascular system, and mechanistic studies to further elucidate the biological effects of zinc at the molecular level.
Despite a high incidence level the study of relations between nutritional deficits and children's behavioural development is a topic that has been relatively neglected by developmental researchers. Such neglect has implications for the generalisability of developmental theories, especially to less developed countries where the majority of the world's children live and where nutritional deficits are more likely to occur. This paper reviews evidence on the role played by nutritional deficits in children's development and the mechanisms underlying nutrition → development links. Future directions for collaborative research between clinical, developmental, and nutritional scientists are proposed. © 2000 The International Society for the Study of Behavioural Development.
We evaluated the association between nutritional status and cognitive functioning in 260 noninstitutionalized men and women older than 60 years who had no known physical illnesses and were receiving no medications. Nutritional status was evaluated by three-day food records and also by biochemical determination of blood levels of specific nutrients. Cognitive status was evaluated by the Halstead-Reitan Categories Test (a nonverbal test of abstract thinking ability) and by the Wechsler Memory Test. Subjects with low blood levels of vitamins C or B12 scored worse on both tests. Subjects with low levels of riboflavin or folic acid scored worse on the categories test. These differences remained significant after controlling for age, gender, level of income, and amount of education. "Subclinical" malnutrition may play a small role in the depression of cognitive function detectable in some elderly individuals, or depressed cognitive function may result in reduced nutrient intake.
(JAMA 1983;249:2917-2921)
This paper summarizes recent research on the importance of zinc for human health, and reviews available methods of evaluating zinc status in individuals and populations. The lack of generally accepted biomarkers of zinc status has impeded estimation of the global prevalence of zinc deficiency. Although measurement of zinc consumption and/or plasma zinc concentration can be used to assess population zinc status, few countries have collected adequate data to permit estimation of the prevalence of zinc deficiency. An alternative method, described herein, is to estimate the zinc content of national food supplies, using FAO food balance sheets; the assumed bioavailability of that zinc based on phytate:zinc molar ratios; and the relation between absorbable zinc and theoretical requirements according to country-specific demographics. The results of these analyses indicate that nearly half of the world's population is at risk for inadequate zinc intake, suggesting that public health programs are urgently needed to control zinc deficiency.
The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.
The fatty acid composition of the total phospholipid fraction of serum obtained from 11 controls and 10 protein-energy malnourished (PEM) children in Benin City, Nigeria were determined by gas-liquid chromatography. Comparisons of the fatty acid patterns revealed that the severely malnourished children were not deficient in arachidonic acid or the essential fatty acids, linoleic [C18:2n-6] and α-linolenic [C18:3n-3]. However, the serum phospholipids of the PEM children contained twice as much oleic acid [C18:1n-9] (p < 0.01) and C20:1n-9 (p < 0.03) as those of the controls. The proportions of C20:3n-6 (dihomo-γ-linolenic acid) and C20:5n-3(eicosapentaenoic acid) were significantly lower in the serum phospholipids of the malnourished children compared to the controls (p <0.01 and p = 0.03, respectively). The data show that while profoundly protein-energy malnourished children may not necessarily be deficient in the essential fatty acids, they can still manifest marked and pathophysiologically significant derangements in the pathways that interconvert long chain fatty acids.
Despite a high incidence level the study of relations between nutritional deficits and children’s behavioural development is a topic that has been relatively neglected by developmental researchers. Such neglect has implications for the generalisability of developmental theories, especially to less developed countries where the majority of the world’s children live and where nutritional deficits are more likely to occur. This paper reviews evidence on the role played by nutritional deficits in children’s development and the mechanisms underlying nutrition → development links. Future directions for collaborative research between clinical, developmental, and nutritional scientists are proposed.
New evidence indicates that choline, a small vitamin, is essential for optimal brain development. In his Perspective, Blusztajn summarizes recent work that points to choline's newly recognized importance, which has resulted in its reclassification as an essential nutrient by the Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences.
Few studies have examined the biologic impact of iron and zinc when given at a ratio of 2:1 during pregnancy. We examined the change in serum zinc after 3 weeks among night blind Nepali pregnant women who were randomly assigned to receive zinc (25 mg) or placebo, stratified by whether they received iron (60 mg) - folate (400 μg) or not. Further, we looked at change in hemoglobin (Hb) and serum ferritin concentrations by whether women had received iron or not, stratified by supplementation group (zinc or placebo). Women who received iron were anemic (Hb < 110 g/L) at baseline. The treatment groups were comparable on serum zinc and ferritin and Hb concentration at baseline. There was a mean increase of ∼1.6 μmol/L (p < 0.05) in the serum zinc concentration in women receiving zinc relative to a decline of ∼0.5 μmol/L in the placebo group, which was similar both in women who received iron or not. Similarly, treatment with iron resulted in significant increases in Hb of 4.8 g/L and 7.8 g/L, and in serum ferritin of 12.2 μg/L and 13.6 μg/L among those in the zinc and placebo groups, respectively. However, there was some evidence that zinc supplementation may adversely effect iron status among women with initial Hb of
The issue of continuous versus discontinuous cognitive development was evaluated in terms of the nonlinear dynamics of human cerebral maturation. Convergent evidence from studies of the development of cerebral architecture, the development of EEG relative power, and the development of EEG coherence demonstrate oscillations and equilibrium processes that underlay cerebral maturation. Life‐span development was shown to be a “wave” process with spectral characteristics determined by anatomy. The frontal regions exhibited different wave characteristics than posterior regions, similarly, the left and right hemispheres exhibited differential developmental features. The establishment of corticocortical connections with different regions of the frontal lobes were shown to sequentially occur and to dominate postnatal cerebral development from birth to age 16.
A relationship between folate and neuropsychiatric disorders has been inferred from clinical observation and from the enhanced understanding of the role of folate in critical brain metabolic pathways. Depressive symptoms are the most common neuropsychiatric manifestation of folate deficiency. Conversely, borderline low or deficient serum or red blood cell folate levels have been detected in 15–38% of adults diagnosed with depressive disorders. Recently, low folate levels have been linked to poorer antidepressant response to selective serotonin reuptake inhibitors. Factors contributing to low serum folate levels among depressed patients as well as the circumstances under which folate and its derivatives may have a role in antidepressant pharmacotherapy must be further clarified.
The effects of dietary docosahexaenoic acid (DHA) supply during infancy on later cognitive development of healthy term infants were evaluated in a randomized clinical trial of infant formula milk supplemented with 0.35% DHA or with 0.36% DHA and 0.72% arachidonic acid (AA), or control formula which provided no DHA or AA. Fifty-six 18-month-old children (26 male, 30 female) who were enrolled in the trial within the first 5 days of life and fed the assigned diet to 17 weeks of age were tested using the Bayley Scales of Infant Development, 2nd edition (BSID-II) (Bayley 1993) at the Retina Foundation of the Southwest, Dallas, TX. These children had also been assessed at 4 months and 12 months of age for blood fatty-acid composition, sweep visual evoked potential (VEP) acuity, and forced-choice preferential looking (FPL) acuity (Birch et al. 1998). Supplementation of infant formula with DHA+AA was associated with a mean increase of 7 points on the Mental Development Index (MDI) of the BSID-II. Both the cognitive and motor subscales of the MDI showed a significant developmental age advantage for DHA- and DHA+AA-supplemented groups over the control group. While a similar trend was found for the language subscale, it did not reach statistical significance. Neither the Psychomotor Development Index nor the Behavior Rating Scale of the BSID-II showed significant differences among diet groups, consistent with a specific advantage of DHA supplementation on mental development. Significant correlations between plasma and RBC-DHA at 4 months of age but not at 12 months of age and MDI at 18 months of age suggest that early dietary supply of DHA was a major dietary determinant of improved performance on the MDI.
This study tested the hypothesis that infants with iron-deficiency anemia show behaviors, such as increased proximity to caregivers, increased wariness or hesitance, and decreased activity, that could contribute to “functional isolation.” The behavior of 52 Costa Rican 12- to 23-month-old infants with iron-deficiency anemia was contrasted with that of 139 comparison group infants with better iron status during free play and mental and motor testing and in the home. Infants with iron-deficiency anemia maintained closer contact with caregivers; showed less pleasure and delight; were more wary, hesitant, and easily tired; made fewer attempts at test items; were less attentive to instructions and demonstrations; and were less playful. Adult behavior also differed. The results indicate that iron-deficiency anemia in infancy is associated with alterations in affect and activity, suggesting that functional isolation is a useful framework for understanding poorer developmental outcome in iron-deficiency anemia, the world's most common single nutrient deficiency.
The rationale for randomized trials designed to measure the effects of variable docosahexaenoic acid (DHA) status on neurodevelopment
in human infants came from earlier studies of neurodevelopment in animals that were deficient in DHA owing to diets low in
α-linolenic acid. The session on neurodevelopment looked at the results of these animal studies and discussed outcomes that
appear to be analogous in human infants with variable DHA status. Presentations focused mainly on measures of development
that may be attributed to more specific developmental domains (e.g., visual attention, recognition memory, problem-solving),
some of which have been shown to be affected by long-chain polyunsaturated fatty acid (LCPUFA) status. This paper derives
from discussions that took place during the session and reviews subsequent developments in this area. Although more difficult
to interpret, global measures of infant development (e.g., the Bayley Scales of Infant Development, and Brunet-Lezine) can
only suggest a relationship to specific developmental domains, but they have been applied in some randomized trials of LCPUFA
and infant development. Those results are also summarized here.
The present study was carried out on 120 (9–12.5 and 15–17.5 years), rural, male, school children of Kashi Vidyapeeth Block of Varanasi District. Out of these 60 children 30 wellnourished and 30 in grade II or III undernutrition (height for age < 90%) were in both the age groups. These children were examined for anthropometry, and soft neurological signs. It was found that soft neurological deficits observed in undernourished children persisted with increase in age i.e. during adolescence. The performance of wellnourished children was significantly better on all the six timed coordination motor tasks as compared with that of the undernourished children in both the age groups. However, significant difference was observed for foot tap (p < 0.01) and finger tap (p < 0.01) in 9–12.5 years and for foot tap, hand pat and finger tap (p < (1.01 for all) in 15–17.5 years respectively. Age and nutrition taken together showed that with age there was an improvement in performance of wellnourished and undernourished children on all the tasks. However, nutrition showed significant independent influence on all the tasks excepting hand pronation supination indicating that the effect of nutrition persisted with the increase in age. Further analysis revealed that undernutrition affects repetitive speed movements more. There was significantly higher percentage of overflow and dysrythmia on all the time coordination motor tasks among undernourished as compared to wellnourished children in both the age groups.
Objectives: This study assessed the effects of zinc supplementation in the prevention of diarrhea and pneumonia with the use of a pooled analysis of randomized controlled trials in children in developing countries. Study design: Trials included were those that provided oral supplements containing at least one half of the United States Recommended Daily Allowance (RDA) of zinc in children <5 years old and evaluated the prevention of serious infectious morbidity through household visits. Analysis included 7 “continuous” trials providing 1 to 2 RDA of elemental zinc 5 to 7 times per week throughout the period of morbidity surveillance and 3 “short-course” trials providing 2 to 4 RDA daily for 2 weeks followed by 2 to 3 months of morbidity surveillance. The effects on diarrhea and pneumonia were analyzed overall and in subgroups defined by age, baseline plasma zinc concentration, nutritional status, and sex. The analysis used random effects hierarchical models to calculate odds ratios (OR) and 95% CIs. Results: For the zinc-supplemented children compared with the control group in the continuous trials, the pooled ORs for diarrheal incidence and prevalence were 0.82 (95% CI 0.72 to 0.93) and 0.75 (95% CI 0.63 to 0.88), respectively. Zinc-supplemented children had an OR of 0.59 (95% CI 0.41 to 0.83) for pneumonia. No significant differences were seen in the effects of the zinc supplement between the subgroups examined for either diarrhea or pneumonia. In the short-course trials the OR for the effects of zinc on diarrheal incidence (OR 0.89, 95% CI 0.62 to 1.28) and prevalence (OR 0.66, 95% CI 0.52 to 0.83) and pneumonia incidence (OR 0.74, 95% CI 0.40 to 1.37) were similar to those in the continuous trials. Conclusions: Zinc supplementation in children in developing countries is associated with substantial reductions in the rates of diarrhea and pneumonia, the 2 leading causes of death in these settings. (J Pediatr 1999;135:689-97)
To examine possible effects of iron supplementation on the intelligence of young adolescents, iron supplements and placebos were given daily for 16 weeks to two matched groups of 208 and 205 12–15-year-olds. Iron status before the trial began was assessed by the measurement of serum ferritin and haemoglobin levels. In the sample considered as a whole, the iron supplementation had a small but nonsignificant effect on IQ, but those who were iron deficient, with serum ferritin levels of 12 ng/ml and below, showed a statistically significant IQ gain of 5.8 IQ points, as compared with a matched control group given placebos.
The relevance of low folate levels as determinants of cognitive deficits and the usefulness of folate supplementation in the treatment of cognitive deficits was reviewed from the literature. Over 40 papers and book chapters published in English, French, German, Italian and Spanish were examined. This represents those papers published in the international literature in the last 10 years which were identified by various key words including folate, cognition and aging (or ageing). Among these papers, only 13 articles specifically addressed issues relevant to the criteria adopted for this review. The remaining papers were principally concerned with depression and or with other pathologies of the aged associated with folate deficiency. Although the specific role of low folate levels in the physiopathology of dementia is still under debate, a growing consensus is emerging in the literature where low folate as well as cobalamin levels in aged patients with cognitive deficits are being considered as a sign of functional problems in the absorption and utilization of vitamins, and not merely as a sign of bad eating habits. In studies where folate compounds were evaluated for treatment effects, the results of a majority of investigations indicated that folate treatment was effective in lessening cognitive deficits. Treatment efficacy, however, has not yet been sufficiently demonstrated by these results because there were no controlled studies and the methodology was heterogeneous for the evaluation of cognitive characteristics. An ad hoc double-blind, controlled versus placebo pilot study was undertaken to evaluate the efficacy of folic acid in 30 aged patients with abnormal cognitive decline and folate level below 3 ng/ml to better understand the value of this type of intervention. Our results from this preliminary study demonstrated that patients treated with folic acid for 60 days showed a significant improvement on both memory and attention efficiency when compared with a placebo group. The intensity of memory improvement was positively correlated with initial severity of folate deficiency. On the contrary, the severity of initial cognitive decline was unrelated to the degree of folate deficiency.
To test whether zinc supplementation reduces the deficits in mental development and behaviour that are found in term infants of low birth weight in the study population.
A prospective double-blind, part-randomised efficacy trial.
A low-income population in Pernambuco, northeast Brazil, where the economy is largely dependent on sugar-cane production, and where over 90% of deliveries occur in health facilities.
During a 20-month period, all singleton, term infants weighing 1500-2499 g born to families of low income ( < US $280/month) were enrolled at birth (n = 205). At 6 and 12-months, the numbers tested were 163 and 138 respectively.
Infants born from January 1993-January 1994 were randomly assigned to receive daily, except Sundays, a placebo (n = 66) or 1 mg zinc (n = 68). Those born February-August 1994 were given 5 mg zinc (n = 71). Supplementation was for eight weeks, starting at birth. Field workers visited each infant at home to administer the supplement.
At 6 and 12-months, mental and psychomotor development was assessed with the Bayley Scales of Infant Development and no significant differences in the scores of the three groups were found. At 12-months, behaviour was also assessed on 5 ratings. Ratings were highest in infants given 5 mg zinc (P = 0.042).
Zinc supplementation (5 mg/d) for eight weeks may reverse some of the poor behaviours, particularly responsiveness, exhibited by low birth weight infants. No amelioration of their mental and psychomotor deficits was found.
Primary school children (n = 424) from the Ntcheu District, Malawi, aged 6 - 8 years, were selected for a double-blind placebo-controlled study to evaluate the effect of iodine and iron supplementation on physical, psychomotor and mental development. After the baseline measurements were carried out, children were given a single dose of iodized oil (1 mL Lipiodol®; 490 mg I) or placebo and daily doses of iron (ferrous sulphate, 60 mg of Fe) or placebo on weekdays (February-July and October- November 1991).The anthropometric measurements included height, weight, mid-upper arm cicumference (MUAC), and four skinfolds while indicators of physical stamina included lung function, hand grip and sitting and standing ability. The psychomotor development tests were pegboard, ball throwing, tapping and reaction time tasks. The mental development tests included fluency and exclusion as a measure of fluid intelligence; quantity and verbal meaning to evaluate crystallized intelligence and visual memory and closure tests to measure perceptual skills. Baseline data were collected from October 1990 to January 1991 and the final tests and measurements were carried out in October-November 1991.The initial iodine and iron status was established by measuring the concentration of iodine in urine and of hemoglobin in blood. About 86% of children had urinary iodine concentrations below 0.4 μmol/L indicating moderate iodine deficiency while 18% of children had hemoglobin levels below 110 g/L which is the cut-off point for indicating anemia. Measurement of iodine in urine three months after supplementation showed a normal level of urinary iodine. After one year, the level had dropped to the baseline value. The change in haemoglobin could not be measured due to objections from the parents in obtaining further blood samples. About 27% of children were stunted while 2% were wasted when measured at both time points.One year after supplementation, the four treatment groups did not grow differentially indicating no effect of iodine or iron supplementation on physical growth. The iodinetreated group scored higher in tests of physical stamina as measured by sitting-standing and hand grip. The iodine treated group also significantly improved scores on the ball throwing exercise indicating an improvement in eye-hand coordination. No changes were noticed on reaction time, movement time and tapping indicating no effect of iodine on speed, dexterity and manual-motor coordination. The iron-treated group showed improvement only in eyehand coordination tests. No improvements were seen in other psychomotor tests.Subjects in all four groups improved their scores on all mental development tests. The analysis of the placebo group indicated a considerable learning effect especially in fluency. Detailed analysis were conducted based upon the differential improvement when compared with the placebo group during the final test. The iodine-treated groups showed a large improvement in fluid intelligence measured by the fluency and exclusion tests. This component of intelligence measures reasoning, classification and fluency. Perceptual skills, as measured by visual memory and closure, also improved considerably in the iodine-treated group. Crystallized intelligence, as measured by quantity and verbal meaning, was also improved in the iodine-treated group but to a lesser extent than fluid intelligence. Crystallized intelligence is associated with word meaning, factual knowledge, short termmemory and decision making. These skills are closely associated with the classroom environment.In the iron-treated group, a significant improvement was noted only in fluid intelligence and in the quantity test, a component of crystallized intelligence. No significant interaction of iodine and iron was noted. However, combined supplementation with iodine and iron sometimes resulted in an additive effect.It has been shown in several studies in which iodine has been administered to mothers prior to pregnancy or during gestation that iodine supplementation reduces spontaneous abortion and stillbirths and improves the birth weight, and the mental and psychomotor performance of children. Previous studies in which children have been supplemented with iodine have not been able to demonstrate unequivocally that such supplementation affects mental or psychomotor development. In the present study we were able to demonstrate that iodine supplementation to children as old as 6-8 yr could improve mental and psychomotor development. The present study also demonstrates that iodine supplementation was more effective than iron supplementation in the population studied but the low prevalence of iron-deficiency anemia in children could have been responsible for such an outcome.Concerning supplementation with iron, several previous studies have indicated that correction of iron deficiency early in infancy tends to improve psychomotor and mental development more than when the correction takes place in later life. In the present study, supplementation with iron was found to improve eye-hand coordination and fluid intelligence which justify prevention and control of iron-deficiency anemia in infants and children as soon as such a problem is detected.An important finding from the perspective of planners is that 490 mg oral iodine may be inadequate to provide sufficient iodine for one year as indicated by the measurement of urinary iodine excretion. In iodine-deficient areas where provision of iodized salt is not available, the provision of iodized oil capsules could be an attractive alternative provided that the dosing schedule is adequate.