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Eberhardt N, Roedig T, Schmidt L, Bartmann P, Holterhus PM, Kulle AE, Schulte S, Gohlke B. Behavior and circadian glucocorticoids in prepubertal monozygotic twins with birthweight differences: A prospective longitudinal cohort study on twin-to-twin transfusion syndrome patients. Psychoneuroendocrinology 2024; 167:107082. [PMID: 38810374 DOI: 10.1016/j.psyneuen.2024.107082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/28/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND/OBJECTIVE Low birthweight may have adverse sequelae in later life. Therefore, we analyzed behavioral difficulties and salivary glucocorticoid profiles in monozygotic twins with intra-twin birthweight differences due to twin-to-twin transfusion syndrome (TTTS). METHODS 46 monozygotic TTTS twin pairs with birthweight differences of <1SDS (concordant; n=29) and ≥1SDS (discordant; n=17) were recruited at a mean age of 6.9 years for a prospective longitudinal cohort study. For glucocorticoid analysis, saliva samples were collected (at 7 h, 13 h, 18 h and 21 h) and analyzed with liquid chromatography-tandem mass spectrometry. Parents completed the Strengths and Difficulties Questionnaire. RESULTS From the parents' perspective, the formerly smaller twins had statistically higher scores regarding hyperactivity (mean 4.63 vs 3.48, p=0.003) and emotional problems (mean 2.67 vs 2.02, p=0.042). Less catch-up growth (Δintra-twin height SDS 4 years of age - Δintra-twin birth length SDS) of the smaller twins was associated with higher scores for hyperactivity (Adj. R²=0.261, p<0.001, β=-1.88, F(1.44)=16.86, n=46, f²=0.35), while smaller birthweight (Adj. R²=0.135, p=0.007, β=-0,87, F(1.44)=8.03, n=46, f²=0.16) and birth length (Adj. R²=0.085, p=0.028, β=-0,78, F(1.44)=5.19, n=46, f²=0.09) were associated with higher scores for peer problems. Greater Δintra-twin for cortisol (7 h: rho=0.337, p=0.029; cumulative: rho=0.458; p=0.024) and cortisone (7 h: rho=0.329, p=0.029; 13 h: rho=0.436, p=0.005) correlated with a greater Δintra-twin for conduct problems. In the discordant group, circa 1 SDS in head circumference persisted from birth (mean SDS: smaller twin -1.18, larger twin -0.08, p<0.001) to present (mean SDS: smaller twin -1.16, larger twin -0.14, p<0.001). CONCLUSION Higher cortisol and cortisone concentrations in smaller twins were associated with higher scores for conduct problems. Lower birthweight and absent catch-up growth affected the parents' perspective on the smaller twins' behavior. They saw those children as more hyperactive, with more peer problems and emotional problems. Thus, it seems important to introduce regular check-ups where behavioral difficulties can be assessed, and assistance and advice can be given to the families. Due to the persisting smaller head circumference in the smaller discordant twins, this should be measured regularly.
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Affiliation(s)
- Nora Eberhardt
- Children's University Hospital Bonn, Dept. of Pediatric Endocrinology and Diabetology, Venusberg-Campus 1, Building 30, Bonn 53127, Germany
| | - Thea Roedig
- Children's University Hospital Bonn, Dept. of Pediatric Endocrinology and Diabetology, Venusberg-Campus 1, Building 30, Bonn 53127, Germany
| | - Lisa Schmidt
- Children's University Hospital Bonn, Dept. of Neonatology and Pediatric Intensive Care, Venusberg-Campus 1, Building 30, Bonn 53127, Germany
| | - Peter Bartmann
- Children's University Hospital Bonn, Dept. of Neonatology and Pediatric Intensive Care, Venusberg-Campus 1, Building 30, Bonn 53127, Germany
| | - Paul-Martin Holterhus
- University Hospital of Schleswig-Holstein, Campus Kiel / Christian-Albrechts University of Kiel, Building C, Department of Pediatrics and Adolescent Medicine I, Pediatric Endocrinology and Diabetes, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Alexandra E Kulle
- University Hospital of Schleswig-Holstein, Campus Kiel / Christian-Albrechts University of Kiel, Building C, Department of Pediatrics and Adolescent Medicine I, Pediatric Endocrinology and Diabetes, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Sandra Schulte
- Children's University Hospital Bonn, Dept. of Pediatric Endocrinology and Diabetology, Venusberg-Campus 1, Building 30, Bonn 53127, Germany
| | - Bettina Gohlke
- Children's University Hospital Bonn, Dept. of Pediatric Endocrinology and Diabetology, Venusberg-Campus 1, Building 30, Bonn 53127, Germany.
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Li J, Su X, Zhou Y, Ji H, Xie Z, Sun S, Wang Z, Yuan W, Miao M, Liang H. Association between prenatal exposure to per- and polyfluoroalkyl substances and infant anthropometry: A prospective cohort study. Int J Hyg Environ Health 2024; 257:114339. [PMID: 38401404 DOI: 10.1016/j.ijheh.2024.114339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/19/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are a group of synthetic organic chemicals with potential endocrine-disrupting effects, and have been found to impair the physical growth of offspring in both experimental and epidemiological studies. We aimed to investigate the effects of prenatal PFAS exposure on repeated measurements of multiple anthropometric indicators in infants. METHOD PFAS were measured in serum samples collected from pregnant women at 12-16 gestational weeks. We calculated z-scores for the weight-for-age (WAZ), weight-for-length (WLZ), head circumference-for-age (HCZ), arm circumference-for-age (ACZ), triceps skinfold-for-age (TSZ), and subscapular skinfold-for-age (SSZ) at birth, 6 months, and 12 months of age according to the child growth standards of the World Health Organization (WHO) for anthropometric indicators. A total of 964 mother-infant pairs were included. A multivariate linear regression was performed to examine the associations between prenatal PFAS concentrations and anthropometric indicators at each time point. A generalized estimating equation (GEE) model was used to examine the longitudinal effects of PFAS exposure on repeated measurements of anthropometric indicators. Ultimately, a Bayesian kernel machine regression (BKMR) model was used to assess the joint effects of the PFAS mixture on anthropometric indicators. RESULTS In GEE models, perfluorododecanoic acid (PFDoA) in the high tertile group was associated with increased WAZ/WLZ, with β values (95% confidence intervals (CI)) of 0.12 (0.00, 0.23) and 0.18 (0.03, 0.32), respectively. Perfluorononanoic acid (PFNA) was associated with increased ACZ in the middle and high tertile groups. The BKMR models also presented the associations of the PFAS mixture with increased WAZ/WLZ throughout infancy, with more profound effects in females. Meanwhile, a pattern of inverse associations was observed between the perfluorooctanoic acid (PFOA) concentrations in the high tertile group and decreased WAZ, WLZ, and HCZ in males. In addition, the associations between PFAS and increased TSZ/SSZ at birth were identified by both linear regression and BKMR models. CONCLUSION Prenatal PFAS exposure (PFNA and PFDoA) was associated with increased infant anthropometry, especially in female infants, while prenatal PFOA exposure was associated with decreased weight, and head and arm circumference in male infants. The findings indicate that prenatal PFAS exposure may impair the growth trajectory of offspring.
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Affiliation(s)
- Jincan Li
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Department of Public Health, Fudan University, Shanghai, 200237, China
| | - Xiujuan Su
- Clinical Research Centre, Shanghai Key Laboratory of Maternal Foetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Yan Zhou
- National Reference Laboratory of Dioxin, Institute of Health Inspection and Detection, Hubei Provincial Academy of Preventive Medicine, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Honglei Ji
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Zhenzhen Xie
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Department of Public Health, Fudan University, Shanghai, 200237, China
| | - Songlin Sun
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Department of Public Health, Fudan University, Shanghai, 200237, China
| | - Ziliang Wang
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Wei Yuan
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Maohua Miao
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Hong Liang
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
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Gimbel BA, Roediger DJ, Ernst AM, Anthony ME, Mueller BA, de Water E, Rockhold MN, Wozniak JR. Normative Magnetic Resonance Imaging Data Increase the Sensitivity to Brain Volume Abnormalities in the Classification of Fetal Alcohol Spectrum Disorder. J Pediatr 2024; 266:113868. [PMID: 38065282 PMCID: PMC10922916 DOI: 10.1016/j.jpeds.2023.113868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/27/2023] [Accepted: 12/04/2023] [Indexed: 12/31/2023]
Abstract
OBJECTIVE To evaluate the use of a large magnetic resonance imaging (MRI) normative dataset to quantify structural brain anomalies that may improve diagnostic sensitivity for atypical brain volume in youth with fetal alcohol spectrum disorder (FASD). STUDY DESIGN Participants included 48 children with prenatal alcohol exposure (PAE) and 43 controls, ages 8-17 years, from the longitudinal Collaborative Initiative on FASD s. Recently published lifespan brain charts were used to quantify participants' (per)centile for brain volumes (cortical and subcortical gray matter and cortical white matter), providing an index of (dis)similarity to typically developing individuals of the same age and sex. RESULTS Participants with PAE demonstrated lower mean centile scores compared with controls. Participants with PAE and scores ≤ 10th centile on at least 1 brain volume metric demonstrated significantly lower performance on measures of intellectual function and aspects of executive functioning compared with participants with PAE and "typical" volumes (>10th centile). Brain volume centiles explained a greater amount of variance in IQ and improved sensitivity to brain volume anomalies in FASD compared with the most commonly used diagnostic criterion of occipitofrontal circumference (OFC) ≤ 10th. CONCLUSION Age- and sex-adjusted brain volumes based on a large normative dataset may be useful predictors of functional outcomes and may identify a greater number of individuals with FASD than the currently used criterion of OFC.
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Affiliation(s)
- Blake A Gimbel
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN
| | - Donovan J Roediger
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN
| | - Abigail M Ernst
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN
| | - Mary E Anthony
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN
| | | | | | - Jeffrey R Wozniak
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN.
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Abdel-Alim T, Tio P, Kurniawan M, Mathijssen I, Dirven C, Niessen W, Roshchupkin G, van Veelen ML. Reliability and Agreement of Automated Head Measurements From 3-Dimensional Photogrammetry in Young Children. J Craniofac Surg 2023; 34:1629-1634. [PMID: 37307495 PMCID: PMC10445626 DOI: 10.1097/scs.0000000000009448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/25/2023] [Indexed: 06/14/2023] Open
Abstract
This study aimed to assess the reliability and agreement of automated head measurements using 3-dimensional (3D) photogrammetry in young children. Specifically, the study evaluated the agreement between manual and automated occipitofrontal circumference (OFC) measurements (n = 264) obtained from 3D images of 188 patients diagnosed with sagittal synostosis using a novel automated method proposed in this study. In addition, the study aimed to determine the interrater and intrarater reliability of the automatically extracted OFC, cephalic index, and volume. The results of the study showed that the automated OFC measurements had an excellent agreement with manual measurements, with a very strong regression score ( R2 = 0.969) and a small mean difference of -0.1 cm (-0.2%). The limits of agreement ranged from -0.93 to 0.74 cm, falling within the reported limits of agreement for manual OFC measurements. High interrater and intrarater reliability of OFC, cephalic index, and volume measurements were also demonstrated. The proposed method for automated OFC measurements was found to be a reliable alternative to manual measurements, which may be particularly beneficial in young children who undergo 3D imaging in craniofacial centers as part of their treatment protocol and in research settings that require a reproducible and transparent pipeline for anthropometric measurements. The method has been incorporated into CraniumPy, an open-source tool for 3D image visualization, registration, and optimization, which is publicly available on GitHub ( https://github.com/T-AbdelAlim/CraniumPy ).
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Affiliation(s)
- Tareq Abdel-Alim
- Department of Neurosurgery, Erasmus University Medical Center
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center
| | - Pauline Tio
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam
| | - Melissa Kurniawan
- Department of Neurosurgery, Erasmus University Medical Center
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam
| | - Irene Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam
| | - Clemens Dirven
- Department of Neurosurgery, Erasmus University Medical Center
| | - Wiro Niessen
- Faculty of Medical Sciences, University Groningen, Groningen, The Netherlands
| | - Gennady Roshchupkin
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center
- Department of Epidemiology, Erasmus University Medical Center
| | - Marie-Lise van Veelen
- Department of Neurosurgery, Erasmus University Medical Center
- Child Brain Center, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
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Connery A, Colbert A, Lamb M. Head circumference may be the best proxy for neurodevelopmental risk in children in low-resource settings. Arch Dis Child 2023; 108:287-288. [PMID: 35074831 DOI: 10.1136/archdischild-2021-323216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/24/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Amy Connery
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Alison Colbert
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Molly Lamb
- Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
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Anthropometric proxies for child neurodevelopment in low-resource settings: length- or height-for-age, head circumference or both? J Dev Orig Health Dis 2023; 14:61-69. [PMID: 35844103 PMCID: PMC9845425 DOI: 10.1017/s2040174422000423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Stunting (<-2 SD of length- or height-for-age on WHO growth curves) is the most used predictor of child neurodevelopmental (ND) risk. Occipitofrontal head circumference (OFC) may be an equally feasible, but more direct and robust predictor. We explored association of the two measurements with ND outcome, separately and combined, and examined if cutoffs are more efficacious than continuous measures in predicting ND risk. Infants and young children in rural Guatemala (n = 642; age range = 0.1-35.9 months) were enrolled in a prospective natural history study, and their ND was tested using the Mullen Scales of Early Learning (MSEL) longitudinally. Length- or height-for-age and OFC-for-age were calculated. We performed age-adjusted multivariable regression analyses to explore the association between 1) length or height and ND, 2) OFC and ND, and 3) both length or height and OFC combined, with ND; concurrently, predictively, and longitudinally, as continuous variables and using WHO z-score cutoffs. Continuous length- or height-for-age and OFC z-scores were more strongly associated with MSEL than the traditional -2 SD WHO cutoff. The combination of height-for-age z-score and OFC z-score was consistently, strongly associated with the MSEL Early Learning Composite concurrently (p-values 0.0004-0.11), predictively (p-value 0.001-0.07), with the exception of the 18-24 months age group which had very few records, and in the longitudinal model (p-value <0.0001-0.004). The combination of continuous length- or height-for-age and OFC shows additional utility in estimating ND risk in infants and young children. Measurement of OFC may improve precision of prediction of ND risk in infants and young children.
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Pokharel A, Webb P, Miller LC, Zaharia S, Shrestha R, Davis D, Trevino JA, Baral KP, Paudel K, Ghosh S. Relationship between Animal Sourced Food Consumption and Early Childhood Development Outcomes. Nutrients 2023; 15:nu15020315. [PMID: 36678186 PMCID: PMC9861056 DOI: 10.3390/nu15020315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Early-childhood development (ECD) is an important determinant of a child’s cognitive ability, learning, productivity, and lifetime earnings. Animal-sourced food (ASF), which is a rich source of high-quality protein and micronutrients, has been linked with ECD outcomes. This study investigates the relationship between the number, frequency, and cumulative consumption of ASF at 6, 9, 12, and 18 months of age and ECD outcomes at 24 months of age, controlling for physical growth. The study uses data collected from 701 mother−child pairs from an observational birth cohort study carried out in Banke, Nepal. ECD outcomes were assessed through a standardized ages and stages questionnaire (ASQ-3) tool. Separate multivariable ordinary least squares regression models were used to test for associations. Significant positive association was seen between total ASQ-3 score at 24 months of age and any ASF consumption at 18 months (β = 8.98, p-value < 0.01), controlling for growth outcomes. The study findings highlight the positive contribution and the accumulating benefit of consistent ASF consumption on ECD outcomes. This study recommends support and promotion of ASF intake among young children in Nepal through policy and programming actions relevant to female education; nutrition knowledge; quality ASF production; improved market access; cold storage; and poverty reduction.
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Affiliation(s)
- Ashish Pokharel
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Correspondence:
| | - Patrick Webb
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Laurie C. Miller
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Sonia Zaharia
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Robin Shrestha
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Dale Davis
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
| | - Johanna Andrews Trevino
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Kedar Prasad Baral
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- School of Public Health, Patan Academy of Health Sciences, Lalitpur 44600, Nepal
| | | | - Shibani Ghosh
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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McKune SL, Mechlowitz K, Miller LC. Dietary animal source food across the lifespan in LMIC. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ivanovic D, Zamorano F, Soto-Icaza P, Rojas T, Larraín C, Silva C, Almagià A, Bustamante C, Arancibia V, Villagrán F, Valenzuela R, Barrera C, Billeke P. Brain structural parameters correlate with University Selection Test outcomes in Chilean high school graduates. Sci Rep 2022; 12:20562. [PMID: 36446926 PMCID: PMC9709063 DOI: 10.1038/s41598-022-24958-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
How well students learn and perform in academic contexts is a focus of interest for the students, their families, and the entire educational system. Although evidence has shown that several neurobiological factors are involved in scholastic achievement (SA), specific brain measures associated with academic outcomes and whether such associations are independent of other factors remain unclear. This study attempts to identify the relationship between brain structural parameters, and the Chilean national University Selection Test (PSU) results in high school graduates within a multidimensional approach that considers socio-economic, intellectual, nutritional, and demographic variables. To this end, the brain morphology of a sample of 102 students who took the PSU test was estimated using Magnetic Resonance Imaging. Anthropometric parameters, intellectual ability (IA), and socioeconomic status (SES) were also measured. The results revealed that, independently of sex, IA, gray matter volume, right inferior frontal gyrus thickness, and SES were significantly associated with SA. These findings highlight the role of nutrition, health, and socioeconomic variables in academic success.
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Affiliation(s)
- Daniza Ivanovic
- grid.443909.30000 0004 0385 4466Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile ,grid.412187.90000 0000 9631 4901Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Francisco Zamorano
- grid.412187.90000 0000 9631 4901Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Patricia Soto-Icaza
- grid.412187.90000 0000 9631 4901Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Tatiana Rojas
- grid.443909.30000 0004 0385 4466Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Cristián Larraín
- grid.412187.90000 0000 9631 4901Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Claudio Silva
- grid.412187.90000 0000 9631 4901Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Atilio Almagià
- grid.8170.e0000 0001 1537 5962Laboratory of Physical Anthropology and Human Anatomy, Institute of Biology, Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Claudia Bustamante
- grid.443909.30000 0004 0385 4466Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Violeta Arancibia
- grid.431778.e0000 0004 0482 9086Department of Global Partnership for Education (GPE) World Bank, Washington, USA
| | - Francisca Villagrán
- grid.443909.30000 0004 0385 4466Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Rodrigo Valenzuela
- grid.443909.30000 0004 0385 4466Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Cynthia Barrera
- grid.443909.30000 0004 0385 4466Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Pablo Billeke
- grid.412187.90000 0000 9631 4901Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
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Miele MJ, Souza RT, Calderon IM, Feitosa FE, Leite DF, Rocha Filho EA, Vettorazzi J, Mayrink J, Fernandes KG, Vieira MC, Pacagnella RC, Cecatti JG. Head circumference as an epigenetic risk factor for maternal nutrition. Front Nutr 2022; 9:867727. [PMID: 35923204 PMCID: PMC9340063 DOI: 10.3389/fnut.2022.867727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Nutrition indicators for malnutrition can be screened by many signs such as stunting, underweight or obesity, muscle wasting, and low caloric and nutrients intake. Those deficiencies are also associated with low socioeconomic status. Anthropometry can assess nutritional status by maternal weight measurements during pregnancy. However, most studies have focused primarily on identifying changes in weight or Body Mass Index (BMI), and their effects on neonatal measures at present time. Whereas head circumference (HC) has been associated with nutrition in the past. When the mother was exposed to poor nutrition and unfavorable social conditions during fetal life, it was hypothesized that the intergenerational cycle was potentially mediated by epigenetic mechanisms. To investigate this theory, maternal head circumference (MHC) was associated with neonatal head circumference (NHC) in pregnant women without preexisting chronic conditions, differentiated by sociodemographic characteristics. A multiple linear regression model showed that each 1 cm-increase in MHC correlated with a 0.11 cm increase in NHC (β95% CI 0.07 to 0.15). Notwithstanding, associations between maternal and neonatal anthropometrics according to gestational age at birth have been extensively explained. Path analysis showed the influence of social status and the latent variable was socioeconomic status. A model of maternal height and head circumference was tested with effects on neonatal HC. The social variable lacked significance to predict neonatal HC in the total sample (p = 0.212) and in the South/Southeast (p = 0.095), in contrast to the Northeast (p = 0.047). This study highlights the potential intergenerational influence of maternal nutrition on HC, suggesting that maternal nutrition may be more relevant in families with major social vulnerability.
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Affiliation(s)
- Maria J. Miele
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
| | - Renato T. Souza
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
| | - Iracema M. Calderon
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | | | - Debora F. Leite
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
- Department of Gynaecology and Obstetrics, Federal University of Pernambuco, Recife, PE, Brazil
| | | | - Janete Vettorazzi
- Department of Obstetrics and Gynaecology, Maternity Hospital, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jussara Mayrink
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
| | - Karayna G. Fernandes
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
- Department of Obstetrics and Gynaecology, Jundiaí School of Medicine, Jundiaí, SP, Brazil
| | - Matias C. Vieira
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
- Division of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, United Kingdom
| | - Rodolfo C. Pacagnella
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
| | - Jose G. Cecatti
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP) School of Medicine, Campinas, SP, Brazil
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Pietschnig J, Gerdesmann D, Zeiler M, Voracek M. Of differing methods, disputed estimates and discordant interpretations: the meta-analytical multiverse of brain volume and IQ associations. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211621. [PMID: 35573038 PMCID: PMC9096623 DOI: 10.1098/rsos.211621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/19/2022] [Indexed: 05/03/2023]
Abstract
Brain size and IQ are positively correlated. However, multiple meta-analyses have led to considerable differences in summary effect estimations, thus failing to provide a plausible effect estimate. Here we aim at resolving this issue by providing the largest meta-analysis and systematic review so far of the brain volume and IQ association (86 studies; 454 effect sizes from k = 194 independent samples; N = 26 000+) in three cognitive ability domains (full-scale, verbal, performance IQ). By means of competing meta-analytical approaches as well as combinatorial and specification curve analyses, we show that most reasonable estimates for the brain size and IQ link yield r-values in the mid-0.20s, with the most extreme specifications yielding rs of 0.10 and 0.37. Summary effects appeared to be somewhat inflated due to selective reporting, and cross-temporally decreasing effect sizes indicated a confounding decline effect, with three quarters of the summary effect estimations according to any reasonable specification not exceeding r = 0.26, thus contrasting effect sizes were observed in some prior related, but individual, meta-analytical specifications. Brain size and IQ associations yielded r = 0.24, with the strongest effects observed for more g-loaded tests and in healthy samples that generalize across participant sex and age bands.
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Affiliation(s)
- Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Daniel Gerdesmann
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Austria
- Department of Physics Education, Faculty of Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| | - Michael Zeiler
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Austria
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A prospective cohort study of head circumference and its association with neurodevelopmental outcomes in infants and young children in rural Guatemala. J Dev Orig Health Dis 2022; 13:779-786. [PMID: 35450541 DOI: 10.1017/s204017442200023x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Microcephaly, an anthropometric marker of reduced brain volume and predictor of developmental disability, is rare in high-income countries. Recent reports show the prevalence of microcephaly to be much higher in lower resource settings. We calculated the prevalence of microcephaly in infants and young children (n = 642; age range = 0.1-35.9 months), examined trends in occipitofrontal circumference (OFC) growth in the year after birth and evaluated the relationship between OFC and performance on the Mullen Scales of Early Learning (MSEL) in rural Guatemala. Multivariable regression analyses adjusted for age were performed: (1) a model comparing concurrent MSEL performance and OFC at all visits per child, (2) concurrent OFC and MSEL performance by age group, and (3) OFC at enrollment and MSEL at final visit by age group. Prevalence of microcephaly ranged from 10.1% to 25.0%. OFC z-score decreased for most infants throughout the first year after birth. A significant positive association between continuous OFC measurement and MSEL score suggested that children with smaller OFC may do worse on ND tests conducted both concurrently and ∼1 year later. Results were variable when analyzed by OFC cutoff scores and stratified by 6-month age groups. OFC should be considered for inclusion in developmental screening assessments at the individual and population level, especially when performance-based testing is not feasible.
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Bogolepova I, Agapov P. Creative thinking and structural organization of cortical formations of the brain of outstanding scientists. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:111-114. [DOI: 10.17116/jnevro2022122071111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Turesky TK, Shama T, Kakon SH, Haque R, Islam N, Someshwar A, Gagoski B, Petri WA, Nelson CA, Gaab N. Brain morphometry and diminished physical growth in Bangladeshi children growing up in extreme poverty: A longitudinal study. Dev Cogn Neurosci 2021; 52:101029. [PMID: 34801857 PMCID: PMC8605388 DOI: 10.1016/j.dcn.2021.101029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
Diminished physical growth is a common marker of malnutrition and it affects approximately 200 million children worldwide. Despite its importance and prevalence, it is not clear whether diminished growth relates to brain development and general cognitive ability. Further, diminished growth is more common in areas of extreme poverty, raising the possibility that it may mediate previously shown links between socioeconomic status (SES) and brain structure. To address these gaps, 79 children growing up in an extremely poor, urban area of Bangladesh underwent MRI at age six years. Structural brain images were submitted to Mindboggle software, a Docker-compliant and high-reproducibility tool for tissue segmentation and regional estimations of volume, surface area, cortical thickness, sulcal depth, and mean curvature. Diminished growth predicted brain morphometry and mediated the link between SES and brain morphometry most consistently for subcortical and white matter subcortical volumes. Meanwhile, brain volume in left pallidum and right ventral diencephalon mediated the relationship between diminished growth and full-scale IQ. These findings offer malnutrition as one possible pathway through which SES affects brain development and general cognitive ability in areas of extreme poverty.
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Affiliation(s)
- Ted K Turesky
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Talat Shama
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Rashidul Haque
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nazrul Islam
- National Institute of Neuroscience and Hospital, Dhaka, Bangladesh
| | - Amala Someshwar
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Borjan Gagoski
- Harvard Graduate School of Education, Cambridge, MA, United States; Fetal-Neonatal Neuroimaging and Development Science Center, Boston Children's Hospital, Boston, MA, United States
| | - William A Petri
- Division of Infectious Diseases and International Health, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nadine Gaab
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
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Bergerat M, Heude B, Taine M, Nguyen The Tich S, Werner A, Frandji B, Blauwblomme T, Sumanaru D, Charles MA, Chalumeau M, Scherdel P. Head circumference from birth to five years in France: New national reference charts and comparison to WHO standards. LANCET REGIONAL HEALTH-EUROPE 2021; 5:100114. [PMID: 34557823 PMCID: PMC8454714 DOI: 10.1016/j.lanepe.2021.100114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The monitoring of head circumference (HC) is essential to early detect any conditions affecting its growth in early childhood. A positive secular trend and regional specificities in HC suggested the need to provide updated national HC reference growth charts. Methods We extracted all growth data collected from 42 primary-care physicians from across the French metropolitan territory who used the same electronic medical-records software. We selected HC measurements up to age five years for all children who were born after 1990 with birth weight > 2500 g. We derived new HC growth charts by using Generalized Additive Models for Location, Scale and Shape, then externally validated them until 30 months of age by comparison with the national population-based Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort and compared them to previous French and WHO growth charts. Findings With 973,869 HC measurements from 157,762 children, new calibrated HC growth charts from birth to age five years were generated. The new HC growth charts showed good external fit by comparison with the ELFE birth cohort. As compared with the new HC growth charts, the previous French and WHO growth charts mean HC z-scores were, respectively, -0.4 and -0.6 SD for girls and -0.2 and -0.6 SD for boys. Interpretation We produced and validated national calibrated HC growth charts by using a novel big-data approach applied to data routinely collected in clinical practice. Comparison with previous French and WHO growth charts confirmed a positive secular trend since the 1960s and regional specificities. Funding The French Ministry of Health; Laboratoires Guigoz—General Pediatrics section of the French Society of Pediatrics—Paediatric Epidemiological Research Group; the French Association of Ambulatory Pediatrics; and educational grant from the Regional Health Agency of Ile-de-France.
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Affiliation(s)
- Manon Bergerat
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Corresponding author at: Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, 16 avenue Paul Vaillant Couturier, Villejuif, F-94807, France
| | - Marion Taine
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
| | - Sylvie Nguyen The Tich
- Department of Pediatric Neurology, University Hospital Salengro, F-59037 Lille, France
- Société Française de Neurologie Pédiatrique, France
| | - Andreas Werner
- Association Française de Pédiatrie Ambulatoire, Commission Recherche, Pediatric office, Villeneuve-lès-Avignon, France
| | | | - Thomas Blauwblomme
- Université de Paris, Institut Imagine, INSERM U1163, F-75015 Paris, France
- Department of Pediatric Neurosurgery, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Dorin Sumanaru
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Institut national d'études démographiques (INED), INSERM, Joint Unit Elfe, Paris, France
| | - Martin Chalumeau
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Pauline Scherdel
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
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Kalloo G, Wellenius GA, McCandless L, Calafat AM, Sjodin A, Sullivan AJ, Romano ME, Karagas MR, Chen A, Yolton K, Lanphear BP, Braun JM. Chemical mixture exposures during pregnancy and cognitive abilities in school-aged children. ENVIRONMENTAL RESEARCH 2021; 197:111027. [PMID: 33744271 PMCID: PMC9022783 DOI: 10.1016/j.envres.2021.111027] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Gestational exposure to chemical mixtures, which is prevalent among pregnant women, may be associated with adverse childhood neurodevelopment. However, few studies have examined relations between gestational chemical mixture exposure and children's cognitive abilities. METHODS In a cohort of 253 pregnant women and their children from Cincinnati, OH (enrolled 2003-2006), we quantified biomarker concentrations of 43 metals, phthalates, phenols, polybrominated diphenyl ethers, organophosphate and organochlorine pesticides, polychlorinated biphenyls, perfluoroalkyl substances, and environmental tobacco smoke in blood or urine. Using k-means clustering and principal component (PC) analysis, we characterized chemical mixtures among pregnant women. We assessed children's cognitive abilities using the Wechsler Preschool and Primary Scale of Intelligence-III and Wechsler Intelligence Scale for Children-IV at ages 5 and 8 years, respectively. We estimated covariate-adjusted differences in children's cognitive ability scores ]=cross clusters, and with increasing PC scores and individual biomarker concentrations. RESULTS Geometric mean biomarker concentrations were generally highest, intermediate, and lowest among women in clusters 1, 2, and 3, respectively. Children born to women in clusters 1 and 2 had 5.1 (95% CI: 9.4,-0.8) and 2.0 (95% CI: 5.5, 1,4) lower performance IQ scores compared to children in cluster 3, respectively. PC scores and individual chemical biomarker concentrations were not associated with cognitive abilities. CONCLUSIONS In this cohort, combined prenatal exposure to phenols, certain phthalates, pesticides, and perfluoroalkyl substances was inversely associated with children's cognition, but some individual chemical biomarker concentrations were not. Additional studies should determine if the aggregate impact of these chemicals on cognition is different from their individual effects.
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Affiliation(s)
- Geetika Kalloo
- Department of Epidemiology, Brown University, Providence, RI, USA.
| | | | | | | | - Andreas Sjodin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adam J Sullivan
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Megan E Romano
- Department of Epidemiology, Dartmouth College, Hanover, NH, USA
| | | | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; Child and Family Research Institute, BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
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Koshy B, Srinivasan M, Murugan TP, Bose A, Christudoss P, Mohan VR, John S, Roshan R, Kang G. Association between head circumference at two years and second and fifth year cognition. BMC Pediatr 2021; 21:74. [PMID: 33573614 PMCID: PMC7876785 DOI: 10.1186/s12887-021-02543-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background Head circumference (HC) measurement is routinely not performed in early childhood and there is conflicting information about its utility in literature. The current study analyses the association between HC at two years of age and cognition at two and five years of age. Methods A community based birth-cohort recruited between 2010 and 2012 was followed up till five years of age in an urban slum in Vellore, India. Children were recruited at birth after informed parental consent by consecutive sampling using eligibility criteria of healthy new-born, singleton pregnancy and family’s availability in the study area during follow-up. HC measured at two years of age was used as the exposure variable to calculate association with cognition at both two and five years of age. Cognitive domain of Bayley scale of infant development was used at two years of age and Wechsler Preschool Primary Scales of Intelligence at five years. Results Of the 251 enrolled children, 138 (55%) were girls and 71 (30%) belonged to lower socioeconomic status. At 2 years, 8.81% of children had HC < − 3SD. Compared to children with HC z-scores ≥ − 2 SD, those with measurements < − 3 SD had a lower cognition scores by − 2.21 [95% CI: − 3.87 - -0.56] at 2 years. Also, children with HC < − 3 SD at two years scored significantly lower scores in cognitive domains of verbal, − 7.35 [95% CI: − 11.78 - -2.92] and performance, − 7.07 [95% CI: − 11.77 - -2.36] intelligence at five years. Conclusions This study showed that smaller HC at 2 years of age was negatively associated with cognition at both 2 and 5 years of age. Early childhood HC measurements can be utilised as a cheaper screening tool to identify children at risk in LMIC settings. Further studies can confirm these findings in diverse settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02543-0.
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Affiliation(s)
- Beena Koshy
- Developmental Paediatrics Unit, Christian Medical College, Vellore, 632004, India.
| | | | | | - Anuradha Bose
- Community Health, Christian Medical College, Vellore, 632004, India
| | - Pamela Christudoss
- Clinical Biochemistry, Christian Medical College, Vellore, 632004, India
| | | | - Sushil John
- Low Cost Effective Care Unit, Christian Medical College, Vellore, 632004, India
| | - Reeba Roshan
- Developmental Paediatrics Unit, Christian Medical College, Vellore, 632004, India
| | - Gagandeep Kang
- Wellcome research Unit, Christian Medical College, Vellore, 632004, India
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Dipasquale V, Cucinotta U, Romano C. Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment. Nutrients 2020; 12:nu12082413. [PMID: 32806622 PMCID: PMC7469063 DOI: 10.3390/nu12082413] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/31/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually due to an underlying disease causing abnormal nutrient loss, increased energy expenditure, or decreased food intake. Acute malnutrition leads to biochemical changes based on metabolic, hormonal, and glucoregulatory mechanisms. Most children with primary acute malnutrition can be managed at home with nutrition-specific interventions (i.e., counseling of parents, ensuring household food security, etc.). In case of severe acute malnutrition and complications, inpatient treatment is recommended. Secondary acute malnutrition should be managed by treating the underlying cause.
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Miller LC, Neupane S, Joshi N, Shrestha M, Neupane S, Lohani M, Thorne-Lyman AL. Diet quality over time is associated with better development in rural Nepali children. MATERNAL AND CHILD NUTRITION 2020; 16:e12964. [PMID: 32048475 PMCID: PMC7296824 DOI: 10.1111/mcn.12964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
Abstract
Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p = .04) or dairy products (aOR 0.95, p = .05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality.
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Affiliation(s)
- Laurie C Miller
- Department of Pediatrics, Friedman School of Nutrition Science and Policy, and Eliot-Pearson Department of Child Study and Human Development, Tufts University, Boston, Massachusetts
| | - Sumanta Neupane
- International Food Policy Research Institute, New Delhi, India
| | | | - Merina Shrestha
- Institute of Medicine, Tribhuvhan University, Kathmandu, Nepal
| | | | | | - Andrew L Thorne-Lyman
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Anindya IG, Salimo H, Retno Dewi YL. Hubungan Pemberian Asi Eksklusif Dan Status Gizi Ibu Dengan Pertumbuhan Lingkar Kepala Bayi Usia 6 Bulan. AMERTA NUTRITION 2019. [DOI: 10.20473/amnt.v3i4.2019.263-268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Measurement of head circumference is highly crucial during the early years of life which considered as an anthropometric parameter substantially correlated with brain size. The emergence of head circumference aberration functions to warn of abnormal brain development. Breast milk is the ideal nutritional provider that babies need for optimal healthy growth. Nursing mothers with good nutrition will affect their nutritional status. The nutritional status will determine the quantity and quality of dairy products that indirectly play a role in determining children’s nutritional status.Objective: Analyzing the relationship between exclusive breastfeeding and maternal nutritional status with the growth of the head circumference of 6 months old infants.Method: Using a cross-sectional design in the Kaliwates, Jember. Subjects were 6 months old infants in which 128 babies were selected by purposive sampling. Data on maternal nutritional status were based on Body Mass Index (BMI). Data on exclusive breastfeeding were based on interviews and KMS data. The baby’s head circumference data were based on direct measurements and those were interpreted using WHO growth charts. Then, the data were analyzed using Chi-Square test.Results: The results showed that there was a significant relationship between exclusive breastfeeding (p<0.001) and maternal nutritional status (p=0.028) with the growth of the baby’s head circumference.Conclusion: Exclusive breastfeeding and maternal nutritional status are associated with the growth of the baby’s head circumference. ABSTRAKLatar Belakang : Pengukuran lingkar kepala sangat penting selama tahun awal kehidupan, hal ini merupakan parameter antropometri yang sangat berkorelasi dengan ukuran otak. Terjadi penyimpangan pada lingkar kepala, maka memperingatkan perkembangan otak yang tidak normal. Air susu ibu merupakan penyedia nutrisi ideal yang dibutuhkan bayi untuk pertumbuhan yang sehat secara optimal. Ibu menyusui dengan pemenuhan gizi yang baik akan mempengaruhi status gizinya. Status gizi tersebut akan menentukan kuantitas dan kualitas produk susu yang secara tidak langsung berperan dalam menentukan status gizi anak.Tujuan : Menganalisis hubungan pemberian ASI eksklusif dan status gizi ibu dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Metode : Menggunakan desain cross-sectional di wilayah Kecamatan Kaliwates, Kabupaten Jember. Subjek penelitian adalah bayi usia 6 bulan, 128 bayi dipilih dengan purposive sampling. Data status gizi ibu berdasarkan IMT. Data pemberian ASI eksklusif berdasarkan wawancara dan data KMS. Data lingkar kepala bayi berdasarkan pengukuran langsung dan diinterprestasikan menggunakan grafik pertumbuhan WHO. Analisis data menggunakan uji Chi-Square.Hasil : Hasil penelitian menunjukkan bahwa ada hubungan yang bermakna antara pemberian ASI eksklusif (ρ = <0,001 dan OR 9,58) dan status gizi ibu (ρ = 0,028 dan OR 0,28) dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Kesimpulan : Pemberian ASI eksklusif pada bayi akan memberikan pertumbuhan lingkar kepala yang normal dibandingkan bayi yang tidak diberikan ASI eksklusif dan pada ibu yang memiliki status gizi baik juga akan memberikan pertumbuhan lingkar kepala bayi yang normal dibandingkan dengan ibu berstatus gizi kurang dan gemuk. Kata kunci : status gizi, ASI eksklusif, lingkar kepala
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Yang XL, Zhang SY, Zhang H, Wei XT, Feng GJ, Pei YF, Zhang L. Three Novel Loci for Infant Head Circumference Identified by a Joint Association Analysis. Front Genet 2019; 10:947. [PMID: 31681408 PMCID: PMC6798153 DOI: 10.3389/fgene.2019.00947] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/05/2019] [Indexed: 01/02/2023] Open
Abstract
As an important trait at birth, infant head circumference (HC) is associated with a variety of intelligence- and mental-related conditions. Despite being dominated by genetics, the mechanism underlying the variation of HC is poorly understood. Aiming to uncover the genetic basis of HC, we performed a genome-wide joint association analysis by integrating the genome-wide association summary statistics of HC with that of its two related traits, birth length and birth weight, using a recently developed integrative method, multitrait analysis of genome-wide association (MTAG), and performed in silico replication in an independent sample of intracranial volume (N = 26,577). We then conducted a series of bioinformatic investigations on the identified loci. Combining the evidence from both the MTAG analysis and the in silico replication, we identified three novel loci at the genome-wide significance level (α = 5.0 × 10-8): 3q23 [lead single nucleotide polymorphism (SNP) rs9846396, p MTAG = 3.35 × 10-8, p replication = 0.01], 7p15.3 (rs12534093, p MTAG = 2.00 × 10-8, p replication = 0.004), and 9q33.3 (rs7048271 p MTAG = 9.23 × 10-10, p replication = 1.14 × 10-4). Each of the three lead SNPs was associated with at least one of eight brain-related traits including intelligence and educational attainment. Credible risk variants, defined as those SNPs located within 500 kb of the lead SNP and with p values within two orders of magnitude of the lead SNP, were enriched in DNase I hypersensitive site region in brain. Nine candidate genes were prioritized at the three novel loci using multiple sources of information. Gene set enrichment analysis identified one associated pathway GO:0048009, which participates in the development of nervous system. Our findings provide useful insights into the genetic basis of HC and the relationship between brain growth and mental health.
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Affiliation(s)
- Xiao-Lin Yang
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Shao-Yan Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Department of Epidemiology and Health Statistics, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Hong Zhang
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Xin-Tong Wei
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Gui-Juan Feng
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Yu-Fang Pei
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Department of Epidemiology and Health Statistics, School of Public Health, Medical College, Soochow University, Jiangsu, China
| | - Lei Zhang
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College, Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College, Soochow University, Jiangsu, China
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Chang CH, Huang YF, Wang PW, Lai CH, Huang LW, Chen HC, Lin MH, Yang W, Mao IF, Chen ML. Associations between prenatal exposure to bisphenol a and neonatal outcomes in a Taiwanese cohort study: Mediated through oxidative stress? CHEMOSPHERE 2019; 226:290-297. [PMID: 30933738 DOI: 10.1016/j.chemosphere.2019.03.093] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 06/09/2023]
Abstract
This study determined whether maternal bisphenol A (BPA) exposure influences birth outcomes through oxidative stress and estimated the daily intake of BPA through breast milk for infants. One hundred and eighty-six pregnant women without pregnancy complications were enrolled and maternal urine was collected in the third trimester. Postnatal breast milk was collected in the first and third months after delivery. Concentrations of BPA were determined through ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Generalized additive model-penalized regression splines and a multivariable regression model were employed to determine the effects of BPA exposure and oxidative stress levels on birth outcomes. A causal mediation analysis was conducted to clarify the mediation effects of oxidative stress due to maternal BPA exposure on birth outcomes. The daily intake of BPA in breast milk was calculated using probabilistic risk assessment methods. The geometric means (geometric standard deviation) of BPA levels for maternal urine and first- and third-month breast milk were 2.19 (2.88) μg/g creatinine., 1.35 (3.53) ng/g, and 3.17 (2.97) ng/g, respectively. No significant mediation existed among maternal BPA exposure, oxidative stress level, and neonatal head circumference. Three percent of 1-monthold babies and 1% of 3-month-old babies exceeded the BPA tolerable daily intake of 4 μg/kg-bw/day proposed by the European Food Safety Authority. This study revealed the BPA exposure profile for pregnant women and infants in northern Taiwan. The marginally significant correlation between maternal BPA exposure and neonatal head circumference should be considered.
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Affiliation(s)
- Chia-Huang Chang
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Yu-Fang Huang
- Department of Safety, Health and Environmental Engineering, National United University, Miaoli, Taiwan
| | - Pei-Wei Wang
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Pediatrics, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Chun-Hao Lai
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Li-Wei Huang
- Department of Obstetrics & Gynecology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Hsin-Chang Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taiwan
| | - Meng-Han Lin
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Winnie Yang
- Division of Pediatrics, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - I-Fang Mao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung, Taiwan
| | - Mei-Lien Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan.
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23
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Sindhu KN, Ramamurthy P, Ramanujam K, Henry A, Bondu JD, John SM, Babji S, Koshy B, Bose A, Kang G, Mohan VR. Low head circumference during early childhood and its predictors in a semi-urban settlement of Vellore, Southern India. BMC Pediatr 2019; 19:182. [PMID: 31170939 PMCID: PMC6552319 DOI: 10.1186/s12887-019-1553-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 05/22/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Stunting in developing countries continues to be a major public health problem. Measuring head circumference (HC) during clinical anthropometric assessment can help predict stunting. The aim of this study was to assess burden and determine the predictors of low HC (<- 2 SD) at birth and during first 2 years of life in a semi- urban settlement of Vellore. METHODS The study uses baseline data and serial HC measurements from the birth cohort of MAL-ED study, where 228 children from Vellore completed follow-up between March 2010 to February 2014. Analysis of baseline, maternal and paternal characteristics, micro-nutrient status and cognition with HC measurements was performed using STATA version 13.0 software. RESULTS The mean HC (±SD) at 1st, 12th and 24th month were 33.37 (1.29) cm, 42.76 (1.23) cm and 44.9 (1.22) cm respectively. A third of the infants (75/228) had HC less than - 2 SD at first month of life, and on follow-up, 50% of the cohort had HC ≤ -2 SD both at 12th and 24th month. Low HC measurements at all three time-points were observed for 21.6% (46/222) infants. Low HC was significantly associated with stunting in 37.3% (OR = 10.8), 57.3% (OR = 3.1) and 44.4% (OR = 2.6) children at 1st, 12th and 24th month respectively. Bivariate analysis of low HC (<- 2 SD) at 12th month showed a statistically significant association with lower socioeconomic status, low paternal and maternal HC and low maternal IQ. Multivariable logistic regression analysis showed maternal (AOR = 0.759, 95% CI = 0.604 to 0.954) and paternal (AOR = 0.734, 95% CI = 0.581 to 0.930) HC to be significantly associated with HC attained by the infant at the end of 12 months. CONCLUSIONS One-third of the children in our cohort had low head circumference (HC) at birth, with one-fifth recording low HC at all time-points until 2 years of age. Low HC was significantly associated with stunting. Paternal and maternal HC predicted HC in children. HC measurement, often less used, can be a simple tool that can be additionally used by clinicians as well as parents/caregivers to monitor child growth.
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Affiliation(s)
| | - Prashanth Ramamurthy
- Rural Unit for Health and Social Affairs, Christian Medical College, Vellore, Tamil Nadu, 632 209, India.
| | - Karthikeyan Ramanujam
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ankita Henry
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Joseph Dian Bondu
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sushil Mathew John
- Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sudhir Babji
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Developmental Pediatric Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Bose
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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Soheilipour F, Salehiniya H, Farajpour Kh M, Pishgahroudsari M. Breakfast habits, nutritional status and their relationship with academic performance in elementary school students of Tehran, Iran. Med Pharm Rep 2019; 92:52-58. [PMID: 30957087 PMCID: PMC6448497 DOI: 10.15386/cjmed-956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 07/27/2018] [Accepted: 10/08/2018] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this study was to examine the breakfast habits, nutritional status and their relationship with academic performance in primary school students in Tehran, Iran. Method In this cross-sectional study 829 primary school children were included. Child Body Mass Index (BMI) was calculated based on the objective measures of height and weight as well as adjusted for age and gender. Data on Breakfast habits and academic performance were collected by a valid checklist. For data analysis we used Chi-squared and Fisher’s exact test using SPSS software, version 11.5; statistical significance was assumed if p-value is below the 0.05 Results The average breakfast consumption per week was 5.5 times (days) with a standard deviation of 2.9. Based on the results, 30.9% of participants did not consume full breakfast (six times or less) and 69.1% had a complete one. In terms of academic grade level, 88.4% of the participants were in a high level, 10.3% in appropriate conditions and only 1.3% of the respondents required more effort (inappropriate). There was no significant correlation between breakfast consumption and academic status (p=0.73), nutritional status of the participants according to the academic performance status Individuals showed no statistically significant relationship (P=0.9). Conclusion Unlike previous studies, this study revealed no correlation between the academic grade level of elementary students with nutritional status and breakfast habits. It is suggested that according to the qualitative school scoring method, future studies are needed to assessing the students’ academic performance. Other parameters will be considered in addition to the average in order to provide a better perspective of students’ academic performance.
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Affiliation(s)
- Fahimeh Soheilipour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Zabol Medical Science University, Zabol, Iran.,Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Farajpour Kh
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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Ferrer M, García-Esteban R, Iñiguez C, Costa O, Fernández-Somoano A, Rodríguez-Delhi C, Ibarluzea J, Lertxundi A, Tonne C, Sunyer J, Julvez J. Head circumference and child ADHD symptoms and cognitive functioning: results from a large population-based cohort study. Eur Child Adolesc Psychiatry 2019; 28:377-388. [PMID: 30027417 DOI: 10.1007/s00787-018-1202-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/16/2018] [Indexed: 12/24/2022]
Abstract
The aim of this study is to understand the association between prenatal, newborn and postnatal head circumference (HC) and preschool neurodevelopment in a large population-based birth cohort. The INMA project followed 1795 children from 12 weeks of pregnancy to preschool years. HC measurements were carried out prospectively, and following a standardized protocol during pregnancy (12, 20 and 34 weeks), birth, and child ages of 1-1.5 and 4 years old; and z-scores were further estimated. Prenatal head growth was assessed using conditional z-scores between weeks 12-20 and 20-34. Several neuropsychological tests [MSCA (cognition), CPT (attention)] and behavioral rating scales [DSM-IV-ADHD, CAST (autism), CPSCS (social competence)] were carried out during the last follow-up (5 years old). Multivariable models adjusted for family and child characteristics were applied to analyze associations between HC and neurodevelopment. In fully adjusted models, prenatal HC and head growth showed little or no associations with the neurodevelopment outcomes. Independent associations were observed between HC z-scores at birth, 1-1.5 years and 4 years and MSCA global cognitive scores and DSM-IV inattention symptoms. Specifically, z-score at birth was positively associated with general cognitive scores [β 1.22, 95% confidence interval (CI) 0.59, 1.85], and we observed a protective association with ADHD-DSM-IV total symptoms, mean ratio (MR) 0.85 (0.75, 0.96). Prenatal HC and head growth measurements gave little information about child cognitive abilities and behavior at preschool years. However, HC at birth and early childhood was positively associated with a range of neuropsychological outcomes, including protective associations with ADHD symptoms.
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Affiliation(s)
- Muriel Ferrer
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
| | - Raquel García-Esteban
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Iñiguez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat, Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - Olga Costa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat, Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - Ana Fernández-Somoano
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | | | - Jesús Ibarluzea
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, Gipuzkoa, San Sebastian, Spain.,Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Aitana Lertxundi
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Cathryn Tonne
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
| | - Jordi Sunyer
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Jordi Julvez
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain. .,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.
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26
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Ivanovic DM, Almagià AF, Arancibia VC, Ibaceta CV, Arias VF, Rojas TR, Flores OC, Villagrán FS, Tapia LU, Acevedo JA, Morales GI, Martínez VC, Larraín CG, Silva CFA, Valenzuela RB, Barrera CR, Billeke PB, Zamorano FM, Orellana YZ. A multifactorial approach of nutritional, intellectual, brain development, cardiovascular risk, socio-economic, demographic and educational variables affecting the scholastic achievement in Chilean students: An eight- year follow-up study. PLoS One 2019; 14:e0212279. [PMID: 30785935 PMCID: PMC6382269 DOI: 10.1371/journal.pone.0212279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/30/2019] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to quantitate the relative impact of nutritional, intellectual, brain development, cardiovascular risk, socio-economic, demographic and educational variables on the results of the 2009 Quality Education Measurement System (SIMCE) tests of language and mathematics for scholastic achievement (SA) applying a multifactorial approach, in school-age children of the 2010 5th elementary school grade (5ESG) and of the 1st grade of high school (1HSG). The purposes were: i) to test the hypothesis that intellectual ability, the level of SA of the educational establishments in the 2009 SIMCE tests, sex, parental schooling levels, and head circumference-for-age Z-score are the most relevant parameters associated with 2009 SIMCE outcomes; ii) to determine the predictive ability of the 2009 SIMCE results in determining the 2013 SIMCE outcomes for the 2010 5ESG cohort (when they graduated from elementary school, 8th grade) and for determining the 2013 University Selection Test (PSU) outcomes for the 2010 1HSG group (for university admission, when they graduated from high school, 4th grade); iii) to determine the association between the 2009 SIMCE results with the 2017 PSU outcomes for the 2010 5ESG group (for university admission, when they graduated from high school, 4th grade). A representative, proportional and stratified sample of 33 schools of the Metropolitan Region of Chile was randomly chosen. In these schools, 1,353 school-age children of both sexes, of the 2010 5ESG (n = 682; mean age = 10.8 years, SD = 0.6) and of the 2010 1HSG (n = 671; mean age = 14.8 years, SD = 0.6) participated. In both grades and tests, the findings confirm the hypotheses formulated. 2009 SIMCE outcomes were positively and significantly associated with 2013 SIMCE and with 2017 PSU and, with 2013 PSU outcomes in school-age children from 2010 5ESG and 1HSG, respectively. These findings may be useful for educational and health planning in Chile and countries in a comparable stage of development.
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Affiliation(s)
- Daniza M. Ivanovic
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Atilio F. Almagià
- Laboratory of Physical Anthropology and Human Anatomy, Institute of Biology, Faculty of Sciences, Pontifical Catholic University of Valparaíso, Valparaíso, Chile
| | - Violeta C. Arancibia
- Center for Research in Education and Learning, University of Los Andes, Santiago, Chile
| | - Camila V. Ibaceta
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Vanessa F. Arias
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
- School of Nutrition and Dietetics, Faculty of Medicine, Andres Bello University, Santiago, Chile
| | - Tatiana R. Rojas
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Ofelia C. Flores
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
- School of Nutrition, Faculty of Medicine, University of Costa Rica, San José, Costa Rica
| | - Francisca S. Villagrán
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Liliana U. Tapia
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Javiera A. Acevedo
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Gladys I. Morales
- Public Health Department, Faculty of Medicine, University of La Frontera, Temuco, Chile
| | - Víctor C. Martínez
- Department of Commercial Engineering, Faculty of Economics and Business, University of Chile, Santiago, Chile
| | - Cristián G. Larraín
- Radiology Department, Faculty of Medicine-German Clinic of Santiago, University of Development, Santiago, Chile
| | - Claudio F. A. Silva
- Radiology Department, Faculty of Medicine-German Clinic of Santiago, University of Development, Santiago, Chile
| | | | - Cynthia R. Barrera
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Pablo B. Billeke
- Division of Neuroscience, Center for Research in Social Complexity (neuroSIS), Faculty of Government, University of Development, Santiago, Chile
| | - Francisco M. Zamorano
- Division of Neuroscience, Center for Research in Social Complexity (neuroSIS), Faculty of Government, University of Development, Santiago, Chile
- Advanced Quantitative Imaging Unit, Image Department, German Clinic of Santiago-University of Development, Santiago, Chile
| | - Yasna Z. Orellana
- Laboratory of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
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Zeng X, Xu X, Qin Q, Ye K, Wu W, Huo X. Heavy metal exposure has adverse effects on the growth and development of preschool children. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2019; 41:309-321. [PMID: 29696494 DOI: 10.1007/s10653-018-0114-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 04/18/2018] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to investigate the associations between levels of lead (Pb), cadmium (Cd), chromium (Cr), and manganese (Mn) in the PM2.5 and blood and physical growth, and development parameters including birth length and weight, height, weight, body mass index (BMI), head circumference, and chest circumference in preschool children from Guiyu (e-waste exposure area) and Haojiang (the reference area). A total of 470 preschool children from Guiyu and Haojiang located in southeast coast of China were recruited and required to undergo physical examination and blood tests during the study period. Birth length and weight were obtained by birth records and questionnaire. Pb and Cd in both PM2.5 and blood were significantly higher in Guiyu than Haojiang. Remarkably, the children of Guiyu had significantly lower birth weight and length, BMI, and chest circumference when compare to their peers from the reference area (all p value < 0.05). Spearman correlation analyses showed that blood Pb was negatively correlated with height (r = -0.130, p < 0.001), weight (r = -0.169, p < 0.001), BMI (r = -0.100, p < 0.05), head circumference (r = -0.095, p < 0.05), and chest circumference (r = -0.112, p < 0.05). After adjustment for the potential confounders in further linear regression analyses, blood Pb was negatively associated with height (β = -0.066, p < 0.05), weight (β = -0.119, p < 0.001), head circumference (β = -0.123, p < 0.01), and chest circumference (β = -0.104, p < 0.05), respectively. No significant association between blood Cd, Cr, or Mn was found with any of our developmental outcomes. Taken together, lead exposure limits or delays the growth and development of preschool children.
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Affiliation(s)
- Xiang Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology and Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, 22 Xinling Road, Shantou, 515041, Guangdong, China
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 1 Hanzeplein, 9700 RB, Groningen, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology and Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, 22 Xinling Road, Shantou, 515041, Guangdong, China
| | - Qilin Qin
- Key Laboratory in Environmental Exposure and Health of Guangzhou and Guangdong, School of Environment, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Kai Ye
- Key Laboratory in Environmental Exposure and Health of Guangzhou and Guangdong, School of Environment, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Weidong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
| | - Xia Huo
- Key Laboratory in Environmental Exposure and Health of Guangzhou and Guangdong, School of Environment, Jinan University, Guangzhou, 510632, Guangdong, China.
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28
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Cho SM, Park DH, Yoon SH. Continuous Intracranial Pressure Monitoring in 24 Microcephalic Children with Developmental Delay: A Significant Portion of Microcephalic Children with Developmental Delay Have High Intracranial Pressure. World Neurosurg 2018; 123:e760-e765. [PMID: 30579032 DOI: 10.1016/j.wneu.2018.12.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The new direct gradual cranial expansion surgical technique has been used to treat children with postshunt microcephaly and slit ventricle syndrome. To evaluate the feasibility of this new surgical treatment, we studied intracranial pressure (ICP) in microcephalic children with developmental delay. METHODS Mean ICP, age, sex, head size, and developmental assessments were compared in 24 microcephalic children with developmental delay who had had continuous ICP monitoring. RESULTS Children studied included 9 boys and 15 girls with a mean age of 4.9 ± 2.0 years. Mean ICP was 18.7 ± 8.6 mm Hg. Children with high ICP had significantly lower age and higher B wave ratios than children with low ICP. There were no statistically significant differences in developmental scores and head sizes between children with high ICP and children with low ICP. In multiple linear regression analysis, we observed significantly increased risk of mean ICP elevation by B wave ratio and developmental score and decreased risk of mean ICP elevation by age, but not significantly increased risk of mean ICP elevation by head circumferences (z score). CONCLUSIONS Our findings suggest that a portion of microcephalic children with developmental delay have high ICP that cannot be expected from head sizes, and high ICP has decreasing tendency with age.
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Affiliation(s)
- Sung Min Cho
- Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong Ha Park
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Soo Han Yoon
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
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Valenzuela R, Barrera C, Orellana Y, Almagià A, Arancibia V, Larraín C, Silva C, Billeke P, Zamorano F, Martínez V, Valenzuela A, Ivanovic D. Docosahexaenoic acid levels in erythrocytes and their association with the University Selection Test Outcomes in Chile. Prostaglandins Leukot Essent Fatty Acids 2018; 139:25-30. [PMID: 30471770 DOI: 10.1016/j.plefa.2018.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/25/2022]
Abstract
The aim of this study was to quantitate the relative impact of DHA and AA levels in erythrocytes, anthropometric parameters and socio-economic status of school-age children, of both genders, graduated from high school in Chile, on the scholastic achievement in the University Selection Test (Prueba de Selección Universitaria, PSU) both language scholastic achievement (LSA) and mathematics scholastic achievement (MSA). A representative sample of 671 school-age young graduated from high school in 2013, 550 and 548 of them took the PSU for LSA and MSA, respectively. Only school-age young with high (n = 91) and low (n = 69) SA in both tests were considered. A total of 122 school-age children agreed to participate in the study and were divided as follows: Group 1: high PSU outcome (n = 70; males n = 48) and Group 2: low PSU outcome (n = 52; males n = 23). Data were analyzed by means of SAS software. Independently of gender, DHA, socio-economic status and head circumference-for-age Z-score were the most relevant parameters explaining both LSA (R2 = 0.650; p < 0.0001) and MSA outcomes (R2 = 0.700; p < 0.0001). These results can be useful for nutrition, health and education planning, in order to protect children starting from an early age and thus increase their school outcomes.
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Affiliation(s)
- Rodrigo Valenzuela
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Cynthia Barrera
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Yasna Orellana
- Laboraroty of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Atilio Almagià
- Laboratory of Physical Anthropology and Human Anatomy, Institute of Biology, Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Violeta Arancibia
- Center for Research in Education and Learning, Universidad de Los Andes, Santiago, Chile
| | - Cristián Larraín
- Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Claudio Silva
- Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Billeke
- División de Neurociencia, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Francisco Zamorano
- División de Neurociencia, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile; Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Santiago, Chile
| | - Víctor Martínez
- Department of Commercial Engineering, Faculty of Economics and Business, University of Chile, Santiago, Chile
| | - Alfonso Valenzuela
- Laboraroty of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Daniza Ivanovic
- Laboraroty of Nutrition and Neurological Sciences, Human Nutrition Area, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile.
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30
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Leijser LM, Siddiqi A, Miller SP. Imaging Evidence of the Effect of Socio-Economic Status on Brain Structure and Development. Semin Pediatr Neurol 2018; 27:26-34. [PMID: 30293587 DOI: 10.1016/j.spen.2018.03.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Numerous studies have shown an association between children's socio-economic status (SES) and disparities in neurocognitive development, achievements, and function later in life. Research focus has recently shifted to imaging of the brain's response to the child's environment. This review summarizes the emerging studies on the influences of early-life SES on brain structure and development, and addresses the relation between brain development and enriched environments. The studies provide evidence of significant associations between SES and brain structure, growth and maturation, not only in healthy infants and children but also in infants with medical conditions. This suggests that the relation between SES and later-life function and achievements operates through alterations in brain maturation. Although the brain changes seem to persist without intervention, animal models of environmental enrichment show the potential of SES-related brain changes to be reversible and dynamic. This review underscores the critical need for reducing the impact of socio-economic disparities and early targeted and prolonged interventions, and highlights the potential of these interventions leading to optimal opportunities for our youngest.
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Affiliation(s)
- Lara Maria Leijser
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children and The University of Toronto, Toronto, Canada
| | - Arjumand Siddiqi
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Steven Paul Miller
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children and The University of Toronto, Toronto, Canada.
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31
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Kawasaki Y, Yoshida T, Matsui M, Hiraiwa A, Inomata S, Tamura K, Makimoto M, Oishi K. Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very-Low-Birth-Weight Infants. J Neuroimaging 2018; 29:104-110. [PMID: 30260528 DOI: 10.1111/jon.12558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Measuring head circumference (HC) in infants is an easy screening procedure with which to detect abnormalities in brain growth. It has been demonstrated that HC can predict total brain volume (TBV) in very-low-birth-weight (VLBW) infants. However, the correlation between HC and TBV was weaker than that observed in healthy term-born toddlers, suggesting that there are factors that influence the relationship between HC and TBV. The aim of this study was to identify the clinical risk factors that caused a deviation from the regression line obtained between HC and TBV. METHODS The study population was based on 37 VLBW infants, who underwent a clinical magnetic resonance imaging (MRI) examination at a term-equivalent age, during 2013-2015, at Toyama University Hospital. The HC and the TBV were both adjusted for sex, multiple births, and postmenstrual age. The relationship between TBV/HC and clinical characteristics was evaluated. RESULTS There was a positive correlation between HC and TBV (r = .58, P = .000168). Two clinical factors, the lower birth body weight (BBW) (r = .38, P = .02) and dolichocephaly (r = 0.46, P = .006), were identified as factors that negatively affected the TBV/HC ratio. After excluding infants with low BBW or with dolichocephaly, the correlation between HC and TBV was higher (r = .63). CONCLUSIONS Although HC has predictive value for TBV in VLBW infants, care should be taken in infants with low BBW (BBW less than 600 g) or dolichocephaly (MRI-based cranial index less than .68), which were related to overestimation of TBV.
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Affiliation(s)
- Yukako Kawasaki
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan.,The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Mie Matsui
- Laboratory of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, Japan
| | - Akiko Hiraiwa
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Satomi Inomata
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Kentaro Tamura
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Masami Makimoto
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Kenichi Oishi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
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32
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Ivanovic DM, Valenzuela RB, Almagià AF, Barrera CR, Arancibia VC, Larraín CG, Silva CFA, Billeke PB, Zamorano FM, Villagrán FS, Orellana YZ, Martínez VC. Impact of anthropometric nutritional parameters on the university selection test in Chile: A multifactorial approach. Nutrition 2018; 57:74-83. [PMID: 30153583 DOI: 10.1016/j.nut.2018.05.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/08/2018] [Accepted: 05/13/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Scholastic achievement (SA) is a multifactorial problem that depends on factors related to the child, the child's family, and the educational system. The aim of this study was to quantify the relative impact of significant variables at the beginning of high school during 2010 (first grade of high school [1 HSG]) on 2013 university selection test (Prueba de Seleccion Universitaria [PSU]) outcomes, both in language scholastic achievement (LSA) and mathematics scholastic achievement (MSA), when students graduated from high school (4 HSG). This was done at the time of university admission with a multicausal approach. The purpose was to confirm the hypothesis that the level of educational establishment SA, intellectual ability, sex, parental schooling levels, and head circumference for age Z-score at the onset of high school are the most relevant parameters associated with 2013 PSU outcomes, both in LSA and MSA. METHODS A representative, proportional, and stratified sample of 671 children of both sexes who enrolled in 1 HSG in 2010 (mean age: 14.8 ± 0.6 y) participated in the study. Nutritional, intellectual, brain developmental, cardiovascular risk, socio-to-economic, demographic, and educational variables were quantitated. SA was assessed at 4 HSG with the 2013 PSU tests. Data were analyzed with SAS software. RESULTS Educational establishment SA, intellectual ability, maternal schooling, and age Z-score were the most relevant parameters to explain LSA (R2 = 0.493; P < 0.0001) and MSA variance in addition to sex (male), but only in MSA (R2 = 0.600; P < 0.0001). CONCLUSIONS These findings confirm the hypothesis and can be useful to support nutritional, health, and educational planning.
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Affiliation(s)
- Daniza M Ivanovic
- Institute of Nutrition and Food Technology, Dr. Fernando Monckeberg Barros, University of Chile, Santiago, Chile.
| | - Rodrigo B Valenzuela
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Atilio F Almagià
- Institute of Biology, Laboratory of Physical Anthropology and Human Anatomy, Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Cynthia R Barrera
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Violeta C Arancibia
- Faculty of Social Sciences, School of Psychology, Pontifical University of Chile, Santiago, Chile; Facultad de Educación, Universidad de Los Andes, Institute of Nutrition and Food Technology Dr. Fernando Monckeberg Barros (INTA), University of Chile, Santiago, Chile
| | - Cristián G Larraín
- Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Claudio F A Silva
- Radiology Department, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Pablo B Billeke
- División de Neurociencia, Centro de Investigación en Complejidad Social, Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Francisco M Zamorano
- División de Neurociencia, Centro de Investigación en Complejidad Social, Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile; Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Santiago, Chile
| | - Francisca S Villagrán
- Institute of Nutrition and Food Technology, Dr. Fernando Monckeberg Barros, University of Chile, Santiago, Chile
| | - Yasna Z Orellana
- Institute of Nutrition and Food Technology, Dr. Fernando Monckeberg Barros, University of Chile, Santiago, Chile
| | - Víctor C Martínez
- Department of Commercial Engineering, Faculty of Economics and Business, University of Chile, Santiago, Chile
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33
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Schmidt R, Vogel M, Hiemisch A, Kiess W, Hilbert A. Pathological and non-pathological variants of restrictive eating behaviors in middle childhood: A latent class analysis. Appetite 2018; 127:257-265. [DOI: 10.1016/j.appet.2018.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 04/12/2018] [Accepted: 04/30/2018] [Indexed: 10/17/2022]
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34
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Scharf RJ, Rogawski ET, Murray-Kolb LE, Maphula A, Svensen E, Tofail F, Rasheed M, Abreu C, Vasquez AO, Shrestha R, Pendergast L, Mduma E, Koshy B, Conaway MR, Platts-Mills JA, Guerrant RL, DeBoer MD. Early childhood growth and cognitive outcomes: Findings from the MAL-ED study. MATERNAL AND CHILD NUTRITION 2018; 14:e12584. [PMID: 29392824 DOI: 10.1111/mcn.12584] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/10/2017] [Accepted: 11/27/2017] [Indexed: 01/08/2023]
Abstract
Although many studies around the world hope to measure or improve developmental progress in children to promote community flourishing and productivity, growth is sometimes used as a surrogate because cognitive skills are more difficult to measure. Our objective was to assess how childhood measures of anthropometry correlate with measures of child development in low-income settings with high prevalence of poor nutrition and enteric disease, to inform studies considering growth outcomes in the absence of direct child developmental skill assessment. Children from the MAL-ED study were followed from birth to 24 months of age in field sites in 8 low- and middle-income countries across 3 continents. Monthly weight, length, and head circumference measurements were performed. At 24 months, the Bayley Scales of Infant and Toddler Development was administered. We correlated cognitive measures at 24 months with anthropometric measurements from birth to 2 years comparing 3 constructs: absolute attained monthly measures, summative difference in measures from the mean growth curve, and rate of change in measures. Growth faltering at multiple time periods is related to Bayley cognitive outcomes at 24 months. Birthweight, overall growth by 18-24 months, and rate of growth in the 6- to 18-month period were most associated with 24-month developmental scores. In this study, head circumference measurements, compared with length, was more closely linked to cognitive scores at 24 months. Notably, all studies between growth and cognitive outcomes exhibited low r2 values (0.001-0.049). Anthropometric measures, particularly head circumference, were related to cognitive development, although explaining a low percent of variance. When feasible, direct measures of child development may be more useful.
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Affiliation(s)
- Rebecca J Scharf
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA.,Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Elizabeth T Rogawski
- Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.,Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Laura E Murray-Kolb
- Department of Nutrition Sciences, Penn State University, University Park, Pennsylvania, USA
| | - Angelina Maphula
- Department of Psychology, University of Venda, Thohoyandou, South Africa
| | - Erling Svensen
- Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Fahmida Tofail
- Center for Nutrition and Food Security, icddr-b, Dhaka, Bangladesh
| | - Muneera Rasheed
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Claudia Abreu
- Department of Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | | | - Rita Shrestha
- Department of Psychology, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | - Laura Pendergast
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Estomih Mduma
- Haydom Global Health Research Centre, Haydom, Tanzania
| | - Beena Koshy
- Department of Developmental Pediatrics, Christian Medical College, Vellore, India
| | - Mark R Conaway
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - James A Platts-Mills
- Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Richard L Guerrant
- Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Mark D DeBoer
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
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Martini M, Klausing A, Lüchters G, Heim N, Messing-Jünger M. Head circumference - a useful single parameter for skull volume development in cranial growth analysis? Head Face Med 2018; 14:3. [PMID: 29321071 PMCID: PMC5764008 DOI: 10.1186/s13005-017-0159-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/22/2017] [Indexed: 02/05/2023] Open
Abstract
Background The measurement of maximal head circumference is a standard procedure in the examination of childrens’ cranial growth and brain development. The objective of the study was to evaluate the validity of maximal head circumference to cranial volume in the first year of life using a new method which includes ear-to-ear over the head distance and maximal cranial length measurement. Methods 3D surface scans for cranial volume assessment were conducted in this method comparison study of 44 healthy Caucasian children (29 male, 15 female) at the ages of 4 and 12 months. Results Cranial volume increased from measurements made at 4 months to 12 months of age by an average of 1174 ± 106 to 1579 ± 79 ml. Maximal cranial circumference increased from 43.4 ± 9 cm to 46.9 ± 7 cm and the ear-to ear measurement increased from 26.3 ± 21 cm to 31.6 ± 18 cm at the same time points. There was a monotone association between maximal head circumference (HC) and increase in volume, yet a backwards inference from maximal circumference to the volume had a predictive value of only 78% (adjusted R2). Including the additional measurement of distance from ear to ear strengthened the ability of the model to predict the true value attained to 90%. The addition of the parameter skull length appeared to be negligible. Conclusion The results demonstrate that for a distinct improvement in the evaluation of a physiological cranial volume development, the additional measurement of the ear-to ear distance using a measuring tape is expedient, and, especially for cases with pathological skull changes, such as craniosynostosis, ought to be conducted.
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Affiliation(s)
- Markus Martini
- Department of Maxillofacial and Plastic Surgery, University of Bonn, Sigmund-Freud Str. 25, 53127, Bonn, Germany. .,Department of Oral, Maxillofacial and Plastic Surgery, University of Bonn, Welschnonnenstraße 17, D - 53111, Bonn, Germany.
| | - Anne Klausing
- Department of Maxillofacial and Plastic Surgery, University of Bonn, Sigmund-Freud Str. 25, 53127, Bonn, Germany
| | - Guido Lüchters
- Center for Development Research (ZEF), University of Bonn, Walter-Flex-Str. 3, 53113, Bonn, Germany
| | - Nils Heim
- Department of Maxillofacial and Plastic Surgery, University of Bonn, Sigmund-Freud Str. 25, 53127, Bonn, Germany
| | - Martina Messing-Jünger
- Department of Neurosurgery, Asklepios Children's Hospital, Arnold-Janssen-Str. 29, 53757, Sankt Augustin, Germany
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36
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Wang X, Amei A, de Belle JS, Roberts SP. Environmental effects on Drosophila brain development and learning. ACTA ACUST UNITED AC 2018; 221:jeb.169375. [PMID: 29061687 DOI: 10.1242/jeb.169375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/18/2017] [Indexed: 01/18/2023]
Abstract
Brain development and behavior are sensitive to a variety of environmental influences including social interactions and physicochemical stressors. Sensory input in situ is a mosaic of both enrichment and stress, yet little is known about how multiple environmental factors interact to affect brain anatomical structures, circuits and cognitive function. In this study, we addressed these issues by testing the individual and combined effects of sub-adult thermal stress, larval density and early-adult living spatial enrichment on brain anatomy and olfactory associative learning in adult Drosophila melanogaster In response to heat stress, the mushroom bodies (MBs) were the most volumetrically impaired among all of the brain structures, an effect highly correlated with reduced odor learning performance. However, MBs were not sensitive to either larval culture density or early-adult living conditions. Extreme larval crowding reduced the volume of the antennal lobes, optic lobes and central complex. Neither larval crowding nor early-adult spatial enrichment affected olfactory learning. These results illustrate that various brain structures react differently to environmental inputs, and that MB development and learning are highly sensitive to certain stressors (pre-adult hyperthermia) and resistant to others (larval crowding).
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Affiliation(s)
- Xia Wang
- School of Life Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Amei Amei
- Department of Mathematical Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - J Steven de Belle
- School of Life Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Stephen P Roberts
- School of Life Sciences, University of Nevada, Las Vegas, NV 89154, USA
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37
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Nunes PV, Suemoto CK, Leite REP, Ferretti-Rebustini REDL, Pasqualucci CA, Nitrini R, Farfel JM, de Oliveira KC, Grinberg LT, da Costa NR, Nascimento CF, Salmasi F, Kim HK, Young LT, Jacob-Filho W, Lafer B. Factors associated with brain volume in major depression in older adults without dementia: results from a large autopsy study. Int J Geriatr Psychiatry 2018; 33:14-20. [PMID: 28055136 DOI: 10.1002/gps.4649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/25/2016] [Accepted: 11/29/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We examined brain volume and atrophy in individuals with major depressive disorder (MDD) without dementia that were referred to a large autopsy service. We also examined potential risk factors for brain atrophy, including demographics and clinical variables. METHODS In this study, 1373 participants (787 male) aged 50 years or older who died from natural causes were included. Participants with no reliable informant, with cognitive impairment or dementia, with a medical history of severe chronic disease, or with prolonged agonal state were excluded. Presence of MDD at least once in their lifetime was defined according to the Structured Clinical Interview for DSM. Brain volume was measured immediately after removal from the skull. RESULTS Mean age at death was 68.6 ± 11.6, and MDD was present in 185 (14%) individuals. Smaller brain volume was associated with older age (p < 0.001), lower education (years; p < 0.001), hypertension (p = 0.001), diabetes (p = 0.006), and female gender (p < 0.001). In the multivariate analysis adjusted for sociodemographics and cardiovascular risk factors, smaller brain volume was not associated with major depression (β = -0.86, 95% CI = -26.50 to 24.77, p = 0.95). CONCLUSIONS In this large autopsy study of older adults, MDD was not associated with smaller brain volumes. Regardless of the presence of MDD, in this sample of older adults without dementia, we found that smaller brain volumes were associated with risk factors for brain neurodegeneration such as older age, diabetes, hypertension, and lower education. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lea Tenenholz Grinberg
- University of São Paulo Medical School, Sao Paulo, Brazil.,Memory and Aging Center University of California, San Francisco, CA, USA
| | | | | | - Faraz Salmasi
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Helena Kyunghee Kim
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Lionel Trevor Young
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Beny Lafer
- University of São Paulo Medical School, Sao Paulo, Brazil
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Papadatou-Pastou M, Haliou E, Vlachos F. Brain Knowledge and the Prevalence of Neuromyths among Prospective Teachers in Greece. Front Psychol 2017; 8:804. [PMID: 28611700 PMCID: PMC5447089 DOI: 10.3389/fpsyg.2017.00804] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 05/02/2017] [Indexed: 12/02/2022] Open
Abstract
Although very often teachers show a great interest in introducing findings from the field of neuroscience in their classrooms, there is growing concern about the lack of academic instruction on neuroscience on teachers' curricula because this has led to a proliferation of neuromyths. We surveyed 479 undergraduate (mean age = 19.60 years, SD = 2.29) and 94 postgraduate students (mean age = 28.52 years, SD = 7.16) enrolled in Departments of Education at the University of Thessaly and the National and Kapodistrian University of Athens. We used a 70-item questionnaire aiming to explore general knowledge on the brain, neuromyths, the participants' attitude toward neuroeducation as well as their reading habits. Prospective teachers were found to believe that neuroscience knowledge is useful for teachers (90.3% agreement), to be somewhat knowledgeable when it comes to the brain (47.33% of the assertions were answered correctly), but to be less well informed when it comes to neuroscientific issues related to special education (36.86% correct responses). Findings further indicate that general knowledge about the brain was found to be the best safeguard against believing in neuromyths. Based on our results we suggest that prospective teachers can benefit from academic instruction on neuroscience. We propose that such instruction takes place in undergraduate courses of Departments of Education and that emphasis is given in debunking neuromyths, enhancing critical reading skills, and dealing with topics relevant to special education.
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Affiliation(s)
- Marietta Papadatou-Pastou
- Faculty of Primary Education, Research Center for Psychophysiology and Education, School of Education, National and Kapodistrian University of AthensAthens, Greece.,Cognition and Health Research Group, Department of Experimental Psychology, University of OxfordOxford, United Kingdom
| | - Eleni Haliou
- Faculty of Primary Education, Research Center for Psychophysiology and Education, School of Education, National and Kapodistrian University of AthensAthens, Greece
| | - Filippos Vlachos
- Department of Special Education, University of ThessalyVolos, Greece
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On the relationship between head circumference, brain size, prenatal long-chain PUFA/5-methyltetrahydrofolate supplementation and cognitive abilities during childhood. Br J Nutr 2017; 122:S40-S48. [PMID: 28351446 DOI: 10.1017/s0007114516004281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Head circumference in infants has been reported to predict brain size, total grey matter volume (GMV) and neurocognitive development. However, it is unknown whether it has predictive value on regional and subcortical brain volumes. We aimed to explore the relationship between several head circumference measurements since birth and distributions of GMV and subcortical volumes at later childhood. We examined seventy-four, Caucasian, singleton, term-born infants born to mothers randomised to receive fish oil and/or 5-methyltetrahydrofolate or placebo prenatal supplementation. We assessed head circumference at birth and at 4 and 10 years of age and cognitive abilities at 7 years of age. We obtained brain MRI at 10 years of age, on which we performed voxel-based morphometry, cortical surface extraction and subcortical segmentation. Analyses were controlled for sex, age, height, weight, family status, laterality and total intracranial volume. Prenatal supplementation did not affect head circumference at any age, cognitive abilities or total brain volumes. Head circumference at 4 years presented the highest correlation with total GMV, white matter volume and brain surface area, and was also strongly associated with GMV of frontal, temporal and occipital areas, as well as with caudate nucleus, globus pallidus, putamen and thalamus volumes. As relationships between brain volumes in childhood and several outcomes extend into adulthood, we have found that ages between 0 and 4 years as the optimal time for brain growth; postnatal factors might have the most relevant impact on structural maturation of certain cortical areas and subcortical nuclei, independent of prenatal supplementation.
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The Total Calvarial Transsutural Distraction Osteogenesis for 26 Children with Slit Ventricle, Craniosynostosis, or Microcephaly After Shunt Operation. World Neurosurg 2017; 97:701-709.e1. [DOI: 10.1016/j.wneu.2016.09.093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 11/17/2022]
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Senbanjo IO, Oshikoya KA, Salisu M, Diaku-Akinwumi IN. Head circumference of children with sickle cell disease in Lagos, Nigeria. Pan Afr Med J 2016; 25:4. [PMID: 28154697 PMCID: PMC5268792 DOI: 10.11604/pamj.2016.25.4.8030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/21/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction Growth retardation and under-nutrition are common in children with sickle cell disease (SCD). The aim of this study was to compare the head circumference (HC) of SCD children and non-SCD children and to determine the effect of malnutrition on head circumference of children with SCD. Methods This was a prospective case-control study conducted at the Lagos State University Teaching Hospital, Nigeria, involving SCD children (subject, n = 118) and non-SCD children (control, n = 118) matched for age, sex, and socioeconomic status. Weight, height and HC were measured using standard techniques. Results The mean ages of children with and without SCD were 7.46 ± 3.69 years and 7.01 ± 3.58 years, respectively. The HC increased significantly with age in both males and females (r = 0.75, p = < 0.001; r = 0.70, p < 0.001 respectively). There was no significant difference in HC between males and females (p > 0.05). At all ages, the mean head circumference of SCD children was not significantly (p > 0.05) different from non-SCD children. The In the age group 11-15 years, the prevalence of stunting was significantly higher among SCD children than non-SCD children. The mean HC of SCD children with stunting was significantly lower than those not stunted (51.7 vs. 53.5; P= 0.006) in age group 11.15 years. Conclusion The head circumference of children with SCD is not significantly different from that of non-SCD children. Therefore, the HC chart for the general population is also applicable for monitoring head growth in children with SCD. The effect of malnutrition on head circumference of SCD children is most marked in age group 11-15 years.
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Affiliation(s)
- Idowu Odunayo Senbanjo
- Department of Paediatrics and Child Health, Lagos State University College of Medicine, PMB 21266, Ikeja, Lagos, Nigeria
| | - Kazeem Adeola Oshikoya
- Department of Pharmacology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Mohammed Salisu
- Department of Pharmacology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Ijeoma Nnenna Diaku-Akinwumi
- Department of Paediatrics and Child Health, Lagos State University College of Medicine, PMB 21266, Ikeja, Lagos, Nigeria
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Sun Y, Zhang L, Ancharaz SS, Cheng S, Sun W, Wang H, Sun Y. Decreased fractional anisotropy values in two clusters of white matter in patients with schizotypal personality disorder: A DTI study. Behav Brain Res 2016; 310:68-75. [DOI: 10.1016/j.bbr.2016.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/16/2016] [Accepted: 05/09/2016] [Indexed: 11/24/2022]
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Paul EJ, Larsen RJ, Nikolaidis A, Ward N, Hillman CH, Cohen NJ, Kramer AF, Barbey AK. Dissociable brain biomarkers of fluid intelligence. Neuroimage 2016; 137:201-211. [DOI: 10.1016/j.neuroimage.2016.05.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 05/06/2016] [Accepted: 05/11/2016] [Indexed: 01/01/2023] Open
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Muhoozi GKM, Atukunda P, Mwadime R, Iversen PO, Westerberg AC. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study. Food Nutr Res 2016; 60:30270. [PMID: 27238555 PMCID: PMC4884678 DOI: 10.3402/fnr.v60.30270] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. OBJECTIVE In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. DESIGN Five hundred and twelve households with mother-infant (6-8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. RESULTS The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains. CONCLUSION Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.
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Affiliation(s)
- Grace K M Muhoozi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda;
| | - Prudence Atukunda
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Robert Mwadime
- School of Food Technology, Nutrition and Bioengineering, Makerere University, Kampala, Uganda
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Ane C Westerberg
- Institute of Health Sciences, Kristiania University College, Oslo, Norway
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Hein S, Tan M, Reich J, Thuma PE, Grigorenko EL. School effects on non-verbal intelligence and nutritional status in rural Zambia. LEARNING AND INDIVIDUAL DIFFERENCES 2016; 46:25-37. [PMID: 27175053 DOI: 10.1016/j.lindif.2015.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study uses hierarchical linear modeling (HLM) to examine the school factors (i.e., related to school organization and teacher and student body) associated with non-verbal intelligence (NI) and nutritional status (i.e., body mass index; BMI) of 4204 3rd to 7th graders in rural areas of Southern Province, Zambia. Results showed that 23.5% and 7.7% of the NI and BMI variance, respectively, were conditioned by differences between schools. The set of 14 school factors accounted for 58.8% and 75.9% of the between-school differences in NI and BMI, respectively. Grade-specific HLM yielded higher between-school variation of NI (41%) and BMI (14.6%) for students in grade 3 compared to grades 4 to 7. School factors showed a differential pattern of associations with NI and BMI across grades. The distance to a health post and teacher's teaching experience were the strongest predictors of NI (particularly in grades 4, 6 and 7); the presence of a preschool was linked to lower BMI in grades 4 to 6. Implications for improving access and quality of education in rural Zambia are discussed.
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Affiliation(s)
| | | | - Jodi Reich
- Yale University, USA; Temple University, USA
| | | | - Elena L Grigorenko
- Yale University, USA; Moscow State University of Psychology and Education, Russia
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Miller LC, Joshi N, Lohani M, Singh R, Bhatta N, Rogers B, Griffiths JK, Ghosh S, Mahato S, Singh P, Webb P. Head growth of undernourished children in rural Nepal: association with demographics, health and diet. Paediatr Int Child Health 2016; 36:91-101. [PMID: 27077633 DOI: 10.1080/20469047.2015.1133517] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Brain development in early childhood is a key determinant of later cognition, social achievement and educational success. Head circumference (HC) measurements are a simple method to assess brain growth, yet reports of these measurements are uncommon in nutritional surveys of undernourished children. OBJECTIVE To evaluate HC measurements in a population of rural Nepali children and relate these measurements to demographics, health and diet. METHODS An observational study of head growth was nested within a longitudinal evaluation of a livestock-based agricultural intervention in rural Nepal. Between 538 and 689 children (aged 6 months to 8 years) were measured (height, weight, HC) at each of six survey visits. A total of 3652 HC measurements were obtained. Results were converted to Z-scores (WHO Anthro). RESULTS Mean head circumference Z-scores (HCZ) diminished progressively over the first 4 years of life; a decline of 30% occurred between 3 and 4 years of age (-1.73 to -2.45, P < 0.0001). Overall, 56% of HCZ were <-2. Gender-adjusted HCZ (but not other measurements) were significantly lower for girls than boys [mean (SD) -2.31 (1.0) vs -1.99 (0.094), P < 0.0001]; girls more often had microcephaly (61% vs 50%, P < 0.0001). For children <3 years of age, HCZ were better in those who had eaten two or more animal-source foods (ASFs) within the previous 24 h [-1.69 (.05) vs -2.08 (0.10), P = 0.001] than in those who had eaten none or only one; HCZ correlated with the number of ASFs consumed (P < 0.001). Regression analyses demonstrated that the main determinants of HCZ were age, weight-for-age Z-scores (WAZ) and gender; 43% of the variance in HCZ in younger children was explained by WAZ and ASF consumption. CONCLUSION HCs reflect brain size in young children; brain size is linked to cognitive function. Poor head growth represents another facet of the 'silent emergency' of child undernutrition. Routine HCZ assessments may contribute to better understanding of the links between poverty and cognitive development.
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Affiliation(s)
- Laurie C Miller
- a Department of Pediatrics , Tufts Medical Center , Boston , MA , USA.,b Friedman School of Nutrition Science and Policy, Tufts University , Boston , MA , USA
| | | | | | - Rupa Singh
- e B. P. Koirala Institute of Health Sciences , Dharan , Nepal
| | - Nisha Bhatta
- e B. P. Koirala Institute of Health Sciences , Dharan , Nepal
| | - Beatrice Rogers
- b Friedman School of Nutrition Science and Policy, Tufts University , Boston , MA , USA
| | - Jeffrey K Griffiths
- b Friedman School of Nutrition Science and Policy, Tufts University , Boston , MA , USA
| | - Shibani Ghosh
- b Friedman School of Nutrition Science and Policy, Tufts University , Boston , MA , USA
| | | | - Padma Singh
- c Heifer International , Little Rock , AR , USA
| | - Patrick Webb
- b Friedman School of Nutrition Science and Policy, Tufts University , Boston , MA , USA
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Treit S, Zhou D, Chudley AE, Andrew G, Rasmussen C, Nikkel SM, Samdup D, Hanlon-Dearman A, Loock C, Beaulieu C. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS One 2016; 11:e0150370. [PMID: 26928125 PMCID: PMC4771159 DOI: 10.1371/journal.pone.0150370] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 02/12/2016] [Indexed: 11/18/2022] Open
Abstract
Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5-19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol exposure, but raise concerns about the predictive value of this metric at an individual-subject level.
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Affiliation(s)
- Sarah Treit
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Dongming Zhou
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Albert E. Chudley
- Departments of Pediatrics and Child Health and Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gail Andrew
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- FASD Diagnostic Clinic, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah M. Nikkel
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Dawa Samdup
- Department of Pediatrics, Queens University, Kingston, Ontario, Canada
| | - Ana Hanlon-Dearman
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine Loock
- Department of Pediatrics, University of British Columbia and Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
| | - Christian Beaulieu
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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Pietschnig J, Penke L, Wicherts JM, Zeiler M, Voracek M. Meta-analysis of associations between human brain volume and intelligence differences: How strong are they and what do they mean? Neurosci Biobehav Rev 2015; 57:411-32. [PMID: 26449760 DOI: 10.1016/j.neubiorev.2015.09.017] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 09/07/2015] [Accepted: 09/30/2015] [Indexed: 11/16/2022]
Abstract
Positive associations between human intelligence and brain size have been suspected for more than 150 years. Nowadays, modern non-invasive measures of in vivo brain volume (Magnetic Resonance Imaging) make it possible to reliably assess associations with IQ. By means of a systematic review of published studies and unpublished results obtained by personal communications with researchers, we identified 88 studies examining effect sizes of 148 healthy and clinical mixed-sex samples (>8000 individuals). Our results showed significant positive associations of brain volume and IQ (r=.24, R(2)=.06) that generalize over age (children vs. adults), IQ domain (full-scale, performance, and verbal IQ), and sex. Application of a number of methods for detection of publication bias indicates that strong and positive correlation coefficients have been reported frequently in the literature whilst small and non-significant associations appear to have been often omitted from reports. We show that the strength of the positive association of brain volume and IQ has been overestimated in the literature, but remains robust even when accounting for different types of dissemination bias, although reported effects have been declining over time. While it is tempting to interpret this association in the context of human cognitive evolution and species differences in brain size and cognitive ability, we show that it is not warranted to interpret brain size as an isomorphic proxy of human intelligence differences.
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Affiliation(s)
- Jakob Pietschnig
- Department of Applied Psychology-Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Psychology, School of Science and Technology, Middlesex University Dubai, Dubai, United Arab Emirates.
| | - Lars Penke
- Georg Elias Müller Department of Psychology, Georg August University Göttingen, Göttingen, Germany
| | - Jelte M Wicherts
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Michael Zeiler
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria; Georg Elias Müller Department of Psychology, Georg August University Göttingen, Göttingen, Germany; Department of Psychology, University of Zürich, Zürich, Switzerland
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Connolly EJ, Beaver KM. Prenatal Caloric Intake and the Development of Academic Achievement Among U.S. Children From Ages 5 to 14. Child Dev 2015; 86:1738-58. [DOI: 10.1111/cdev.12409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Kristjansson E, Francis DK, Liberato S, Benkhalti Jandu M, Welch V, Batal M, Greenhalgh T, Rader T, Noonan E, Shea B, Janzen L, Wells GA, Petticrew M. Food supplementation for improving the physical and psychosocial health of socio-economically disadvantaged children aged three months to five years. Cochrane Database Syst Rev 2015; 2015:CD009924. [PMID: 25739460 PMCID: PMC6885042 DOI: 10.1002/14651858.cd009924.pub2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Undernutrition contributes to five million deaths of children under five each year. Furthermore, throughout the life cycle, undernutrition contributes to increased risk of infection, poor cognitive functioning, chronic disease, and mortality. It is thus important for decision-makers to have evidence about the effectiveness of nutrition interventions for young children. OBJECTIVES Primary objective1. To assess the effectiveness of supplementary feeding interventions, alone or with co-intervention, for improving the physical and psychosocial health of disadvantaged children aged three months to five years.Secondary objectives1. To assess the potential of such programmes to reduce socio-economic inequalities in undernutrition.2. To evaluate implementation and to understand how this may impact on outcomes.3. To determine whether there are any adverse effects of supplementary feeding. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, PsycINFO, and seven other databases for all available years up to January 2014. We also searched ClinicalTrials.gov and several sources of grey literature. In addition, we searched the reference lists of relevant articles and reviews, and asked experts in the area about ongoing and unpublished trials. SELECTION CRITERIA Randomised controlled trials (RCTs), cluster-RCTs, controlled clinical trials (CCTs), controlled before-and-after studies (CBAs), and interrupted time series (ITS) that provided supplementary food (with or without co-intervention) to children aged three months to five years, from all countries. Adjunctive treatments, such as nutrition education, were allowed. Controls had to be untreated. DATA COLLECTION AND ANALYSIS Two or more review authors independently reviewed searches, selected studies for inclusion or exclusion, extracted data, and assessed risk of bias. We conducted meta-analyses for continuous data using the mean difference (MD) or the standardised mean difference (SMD) with a 95% confidence interval (CI), correcting for clustering if necessary. We analysed studies from low- and middle-income countries and from high-income countries separately, and RCTs separately from CBAs. We conducted a process evaluation to understand which factors impact on effectiveness. MAIN RESULTS We included 32 studies (21 RCTs and 11 CBAs); 26 of these (16 RCTs and 10 CBAs) were in meta-analyses. More than 50% of the RCTs were judged to have low risk of bias for random selection and incomplete outcome assessment. We judged most RCTS to be unclear for allocation concealment, blinding of outcome assessment, and selective outcome reporting. Because children and parents knew that they were given food, we judged blinding of participants and personnel to be at high risk for all studies.Growth. Supplementary feeding had positive effects on growth in low- and middle-income countries. Meta-analysis of the RCTs showed that supplemented children gained an average of 0.12 kg more than controls over six months (95% confidence interval (CI) 0.05 to 0.18, 9 trials, 1057 participants, moderate quality evidence). In the CBAs, the effect was similar; 0.24 kg over a year (95% CI 0.09 to 0.39, 1784 participants, very low quality evidence). In high-income countries, one RCT found no difference in weight, but in a CBA with 116 Aboriginal children in Australia, the effect on weight was 0.95 kg (95% CI 0.58 to 1.33). For height, meta-analysis of nine RCTs revealed that supplemented children grew an average of 0.27 cm more over six months than those who were not supplemented (95% CI 0.07 to 0.48, 1463 participants, moderate quality evidence). Meta-analysis of seven CBAs showed no evidence of an effect (mean difference (MD) 0.52 cm, 95% CI -0.07 to 1.10, 7 trials, 1782 participants, very low quality evidence). Meta-analyses of the RCTs demonstrated benefits for weight-for-age z-scores (WAZ) (MD 0.15, 95% CI 0.05 to 0.24, 8 trials, 1565 participants, moderate quality evidence), and height-for-age z-scores (HAZ) (MD 0.15, 95% CI 0.06 to 0.24, 9 trials, 4638 participants, moderate quality evidence), but not for weight-for-height z-scores MD 0.10 (95% CI -0.02 to 0.22, 7 trials, 4176 participants, moderate quality evidence). Meta-analyses of the CBAs showed no effects on WAZ, HAZ, or WHZ (very low quality evidence). We found moderate positive effects for haemoglobin (SMD 0.49, 95% CI 0.07 to 0.91, 5 trials, 300 participants) in a meta-analysis of the RCTs.Psychosocial outcomes. Eight RCTs in low- and middle-income countries assessed psychosocial outcomes. Our meta-analysis of two studies showed moderate positive effects of feeding on psychomotor development (SMD 0.41, 95% CI 0.10 to 0.72, 178 participants). The evidence of effects on cognitive development was sparse and mixed.We found evidence of substantial leakage. When feeding was given at home, children benefited from only 36% of the energy in the supplement. However, when the supplementary food was given in day cares or feeding centres, there was less leakage; children took in 85% of the energy provided in the supplement. Supplementary food was generally more effective for younger children (less than two years of age) and for those who were poorer/ less well-nourished. Results for sex were equivocal. Our results also suggested that feeding programmes which were given in day-care/feeding centres and those which provided a moderate-to-high proportion of the recommended daily intake (% RDI) for energy were more effective. AUTHORS' CONCLUSIONS Feeding programmes for young children in low- and middle-income countries can work, but good implementation is key.
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Affiliation(s)
- Elizabeth Kristjansson
- University of OttawaSchool of Psychology, Faculty of Social SciencesRoom 407C, Montpetit Hall125 UniversityOttawaCanadaK1N 6N5
| | - Damian K Francis
- University of West IndiesEpidemiology Research UnitMona Kingston 7Jamaica
| | - Selma Liberato
- Menzies School of Health Research, Charles Darwin UniversityNutrition Research TeamPO Box 41096DarwinAustralia0811
| | - Maria Benkhalti Jandu
- University of OttawaCentre for Global Health, Institute of Population Health1 Stewart StreetOttawaCanadaK1N 6N5
| | - Vivian Welch
- University of OttawaBruyère Research Institute85 Primrose StreetOttawaCanadaK1N 5C8
| | - Malek Batal
- University of MontrealWHO Collaborating Centre on Nutrition Changes and Development (TRANSNUT), Nutrition Department, Faculty of MedicinePavillon Liliane de Stewart2405, Chemin de la Côte‐Sainte‐Catherine l MontréalQuebecCanadaH3C 3J7
| | - Trish Greenhalgh
- Barts and the London School of Medicine and DentistryCentre for Primary Care and Public Health58 Turner StWhitechapelLondonUKE1 2AB
| | - Tamara Rader
- Cochrane Musculoskeletal GroupOttawa Hospital Research Institute501 Smyth RoadOttawaCanadaK1H 8L6
| | - Eamonn Noonan
- Norwegian Knowledge Centre for the Health ServicesPO Box 7004St Olavs plassOsloNorwayN‐0130
| | - Beverley Shea
- University of OttawaDepartment of Epidemiology and Community Medicine501 Smyth RoadOttawaCanadaK1H 8L6
| | - Laura Janzen
- The Hospital for Sick ChildrenDepartment of Psychology & Division of Haematology/Oncology555 University AvenueTorontoCanadaM5G 1X8
| | - George A Wells
- University of OttawaDepartment of Epidemiology and Community Medicine501 Smyth RoadOttawaCanadaK1H 8L6
| | - Mark Petticrew
- London School of Hygiene and Tropical MedicineDepartment of Social & Environmental Health Research, Faculty of Public Health & Policy15‐17 Tavistock PlaceLondonUKWC1H 9SH
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