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Song W, Su F, Li S, Wang S. The association between soyfoods or soybean products consumption and executive functioning among Chinese adolescents: A cross-sectional multicenter study. Acta Psychol (Amst) 2024; 246:104260. [PMID: 38626599 DOI: 10.1016/j.actpsy.2024.104260] [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: 01/08/2024] [Revised: 03/14/2024] [Accepted: 04/08/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND The association of soyfoods or soybean products with executive functions in the brain has been less well studied. In this study, we investigated the consumption of soyfoods or soybean products and its association with executive functions in Chinese adolescents. METHODS A three-stage stratified whole group sampling method was used to investigate the consumption of soyfoods or soybean products and executive functions among 1643 Chinese adolescents aged 13-15 years. One-way ANOVA and chi-square test were used to compare the basic conditions and executive functions of adolescents with different soyfoods or soybean products consumption. Linear regression analysis and logistic regression analysis were used to analyze the association between soyfoods or soybean products and executive functions. RESULTS The proportions of Chinese adolescents with soyfoods or soybean products consumption ≤0 time/week, 1-3 time/week, and ≥4 time/week were 41.14 %, 46.80 %, and 12.05 %, respectively. Logistic regression analysis showed that with adolescents with soyfoods or soybean products consumption ≥4 time/week as a reference, adolescents with ≤0 time/week were less likely to have executive dysfunction in inhibiting functional (OR = 17.523, 95 % CI: 7.501, 40.938), 2back (OR = 3.384, 95 % CI: 1.729, 6.623), and switching functional (OR = 7.846, 95 % CI: 3.300, 18.657), were at higher risk of executive dysfunction (P < 0.001). CONCLUSION Chinese adolescents' consumption of soyfoods or soybean products is inadequate and has a positive association with executive functions. The consumption of soyfoods or soybean products among Chinese adolescents should be increased in the future.
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Affiliation(s)
- Wei Song
- College of Education and Sports Sciences, Yangtze University, Hubei, Jingzhou 434023, PR China
| | - Fan Su
- College of Physical Education, China Three Gorges University, Hubei, Yichang 443002, PR China
| | - Shengpeng Li
- School of Preschool Education, Jingzhou Institute of Technology, Hubei, Jingzhou 434020, PR China
| | - Shoudu Wang
- School of Sports Science, Wenzhou Medical University, Zhejiang, Wenzhou 325000, PR China.
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2
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Perkins SC, Shaun Ho S, Evans GW, Liberzon I, Gopang M, Swain JE. Language processing following childhood poverty: Evidence for disrupted neural networks. BRAIN AND LANGUAGE 2024; 252:105414. [PMID: 38640643 DOI: 10.1016/j.bandl.2024.105414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 01/31/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
Childhood poverty is related to deficits in multiple cognitive domains including adult language function. It is unknown if the brain basis of language is disrupted in adults with childhood poverty backgrounds, controlling for current functioning. Fifty-one adults (age 24) from an existing longitudinal study of childhood poverty, beginning at age 9, were examined on behavioral phonological awareness (LP) and completed an event-related fMRI speech/print processing LP task. Adults from childhood poverty backgrounds exhibited lower LP in adulthood. The middle-income group exhibited greater activation of the bilateral IFG and hippocampus during language processing. In psychophysiological interaction (PPI) analyses, the childhood poverty group exhibited greater coupling between ventral Broca's and the middle temporal gyrus (MTG) as well as coupling between Wernicke's region and bilateralization. Childhood poverty disrupts language processing neural networks in adulthood, after controlling for LP, suggesting that poverty in childhood influences the neurophysiological basis for language processing into adulthood.
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Affiliation(s)
- Suzanne C Perkins
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, United States.
| | - S Shaun Ho
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8434, United States
| | - Gary W Evans
- Departments of Human Centered Design and Psychology, Cornell University, Ithaca, NY 14853-4401, United States
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M University, Bryan, TX 77802, United States
| | - Meroona Gopang
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8434, United States; Program in Public Health, Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8434, United States
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8434, United States; Psychology, Obstetrics, Gynecology & Reproductive Medicine, Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8434, United States
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3
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Nampijja M, Kitsao-Wekulo P, Hughes RC, Griffiths P, Elsey H. Editorial: Day-care for healthy child development and wider social and economic gain in urban areas in low- and middle income countries. Front Public Health 2024; 12:1386958. [PMID: 38590807 PMCID: PMC11000632 DOI: 10.3389/fpubh.2024.1386958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Affiliation(s)
- Margaret Nampijja
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | | | - Robert C. Hughes
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
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González-Rojas A, Valencia-Narbona M. Neurodevelopmental Disruptions in Children of Preeclamptic Mothers: Pathophysiological Mechanisms and Consequences. Int J Mol Sci 2024; 25:3632. [PMID: 38612445 PMCID: PMC11012011 DOI: 10.3390/ijms25073632] [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: 01/24/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Preeclampsia (PE) is a multisystem disorder characterized by elevated blood pressure in the mother, typically occurring after 20 weeks of gestation and posing risks to both maternal and fetal health. PE causes placental changes that can affect the fetus, particularly neurodevelopment. Its key pathophysiological mechanisms encompass hypoxia, vascular and angiogenic dysregulation, inflammation, neuronal and glial alterations, and disruptions in neuronal signaling. Animal models indicate that PE is correlated with neurodevelopmental alterations and cognitive dysfunctions in offspring and in humans, an association between PE and conditions such as cerebral palsy, autism spectrum disorder, attention deficit hyperactivity disorder, and sexual dimorphism has been observed. Considering the relevance for mothers and children, we conducted a narrative literature review to describe the relationships between the pathophysiological mechanisms behind neurodevelopmental alterations in the offspring of PE mothers, along with their potential consequences. Furthermore, we emphasize aspects pertinent to the prevention/treatment of PE in pregnant mothers and alterations observed in their offspring. The present narrative review offers a current, complete, and exhaustive analysis of (i) the pathophysiological mechanisms that can affect neurodevelopment in the children of PE mothers, (ii) the relationship between PE and neurological alterations in offspring, and (iii) the prevention/treatment of PE.
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Affiliation(s)
- Andrea González-Rojas
- Laboratorio de Neurociencias Aplicadas, Escuela de Kinesiología, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Avenida Brasil 2950, Valparaíso 2340025, Chile;
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5
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Imaizumi K, Murata T, Isogami H, Fukuda T, Kyozuka H, Yasuda S, Yamaguchi A, Sato A, Ogata Y, Shinoki K, Hosoya M, Yasumura S, Hashimoto K, Fujimori K, Nishigori H. Association between daily breakfast habit during pregnancy and neurodevelopment in 3-year-old offspring: The Japan Environment and Children's Study. Sci Rep 2024; 14:6337. [PMID: 38491068 PMCID: PMC10943246 DOI: 10.1038/s41598-024-55912-x] [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: 02/28/2024] [Indexed: 03/18/2024] Open
Abstract
The association between daily breakfast habits during pregnancy and offspring neurodevelopment remains unknown. We evaluated the association between breakfast habits during pregnancy and offspring neurodevelopment. Data of 72,260 women with singleton deliveries at and after 37 weeks of gestation enrolled during 2011-2014 in the Japan Environment and Children's Study were analysed. Offspring neurodevelopmental delays at 3 years of age were evaluated using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Participants were stratified by tertiles of maternal daily energy intake (DEI) (Groups 1, 2, and 3:< 1400, 1400-1799, and ≥ 1800 kcal, respectively) during pregnancy and by offspring sex. The adjusted odds ratio (aOR) for abnormality in communication among participants with daily breakfast consumption habit was 0.87 (95% confidence interval, 0.80-0.96). A stratified analysis based on total DEI showed no significant differences in the neurodevelopment of Group 1 offspring. The aOR for abnormality in communication was 0.80 (95% confidence interval, 0.68-0.94) in Group 2. The aOR for abnormality in personal-social characteristics was 0.84 (95% confidence interval, 0.71-0.99) in Group 3. Maternal daily breakfast habits are associated with offspring neurodevelopment at 3 years of age, with the association influenced by maternal DEI and offspring sex.
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Affiliation(s)
- Karin Imaizumi
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | - Hirotaka Isogami
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Toma Fukuda
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Shun Yasuda
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Akiko Yamaguchi
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Koichi Hashimoto
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hidekazu Nishigori
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
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Benedict RK, Pullum TW, Riese S, Milner E. Is child anemia associated with early childhood development? A cross-sectional analysis of nine Demographic and Health Surveys. PLoS One 2024; 19:e0298967. [PMID: 38416752 PMCID: PMC10901303 DOI: 10.1371/journal.pone.0298967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/01/2024] [Indexed: 03/01/2024] Open
Abstract
Anemia is a significant public health problem in many low- and middle-income countries (LMICs), with young children being especially vulnerable. Iron deficiency is a leading cause of anemia and prior studies have shown associations between low iron status/iron deficiency anemia and poor child development outcomes. In LMICs, 43% of children under the age of five years are at risk of not meeting their developmental potential. However, few studies have examined associations between anemia status and early childhood development (ECD) in large population-based surveys. We examined the associations between severe or moderate anemia and ECD domains (literacy-numeracy, physical, social-emotional, and learning) and an overall ECD index among children age 36-59 months. Nine Demographic and Health Surveys (DHS) from phase VII of The DHS Program (DHS-7) that included the ECD module and hemoglobin testing in children under age five years were used. Bivariate and multivariate logistic regressions were run for each of the five outcomes. Multivariate models controlled for early learning/interaction variables, child, maternal, and paternal characteristics, and socio-economic and household characteristics. Results showed almost no significant associations between anemia and ECD domains or the overall ECD index except for social-emotional development in Benin (AOR = 1.00 p < 0.05) and physical development in Maldives (AORs = 0.97 p < 0.05). Attendance at an early childhood education program was also significantly associated with the outcomes in many of the countries. Our findings reinforce the importance of the Nurturing Care Framework which describes a multi-sectoral approach to promote ECD in LMICs.
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Affiliation(s)
- Rukundo K. Benedict
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Thomas W. Pullum
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Sara Riese
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Erin Milner
- Public Health Institute/ USAID Sustaining Technical and Analytical Resources, Washington, DC, United States of America
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Ejiohuo O, Onyeaka H, Unegbu KC, Chikezie OG, Odeyemi OA, Lawal A, Odeyemi OA. Nourishing the Mind: How Food Security Influences Mental Wellbeing. Nutrients 2024; 16:501. [PMID: 38398825 PMCID: PMC10893396 DOI: 10.3390/nu16040501] [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: 01/14/2024] [Revised: 01/25/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Food insecurity is a significant public health problem worldwide and critical to mental health. There is a complex relationship between food security and mental health. We carried out a narrative review study aiming to address how food insecurity impacts mental wellbeing by focusing on the mental health repercussions of food insecurity, recognizing its pivotal role in attaining Sustainable Development Goals 2 (on hunger) and 3 (on enhancing global wellbeing). A comprehensive search was conducted on PubMed and Google Scholar, incorporating Google searches for pertinent reports and policy documents. To address these questions, we emphasized and elucidated the interconnectedness between food security and mental health. The review shows that food security and mental health share a profound relationship influenced by multifaceted factors like socioeconomic conditions, access to nutritious food, and societal inequalities. We then provide recommendations for integrating food security into mental health strategies based on the insights and conclusions drawn. Strategies ranging from sustainable farming practices to urban agriculture initiatives and digital mental health services demonstrate avenues for enhancing food safety and mental wellbeing. This highlights the need for collaborative interdisciplinary efforts and systemic reforms to address these interconnected challenges.
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Affiliation(s)
- Ovinuchi Ejiohuo
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, 60-806 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Kingsley C. Unegbu
- Department of Vegetable Crops, Poznan University of Life Sciences, 60-594 Poznan, Poland;
| | - Obinna G. Chikezie
- Department of Seed Science and Technology, Poznan University of Life Sciences, 62-081 Poznan, Poland;
| | - Omowale A. Odeyemi
- College of Nursing, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife 220005, Osun, Nigeria;
| | - Adebola Lawal
- Hospital Management Board, Government House and Protocol Clinic, Akure 340283, Ondo, Nigeria;
| | - Olumide A. Odeyemi
- Office of Research Services, Research Division, University of Tasmania, Hobart, TAS 7001, Australia;
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Li J. Less stunted? The impact of Chinese health aid on child nutrition. Soc Sci Med 2024; 342:116559. [PMID: 38183933 DOI: 10.1016/j.socscimed.2024.116559] [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: 07/16/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
Despite the increasing recognition of China's role as a global health donor, particularly in Africa, few studies have explored its effectiveness. We geographically matched project-level aid data from AidData with household survey data from Demographic and Health Surveys across eight African countries to examine the effect of Chinese health aid on the nutritional status of children in recipient countries. In addition to adopting a spatiotemporal identification strategy, we also included mother fixed-effects to examine variations among siblings who were exposed to Chinese health aid projects at different times. The empirical results consistently indicated that children living adjacent to Chinese health aid projects had a better nutritional status. The treatment effect of Chinese health aid projects is heterogeneous across household characteristics, types, and sectors of aid projects. Finally, vaccination may serve as a mechanism linking Chinese health aid and child nutrition in the treatment areas of recipient countries.
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Affiliation(s)
- Jia Li
- Yangtze River Institute of International Digital Trade Innovation and Development, Nanjing University of Information Science and Technology, No. 219 Ningliu Road, Pukou District, Nanjing, 210044, China; School of Business, Nanjing University of Information Science and Technology, No. 219 Ningliu Road, Pukou District, Nanjing, 210044, China.
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Litt JS, Halfon N, Msall ME, Russ SA, Hintz SR. Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up. CHILDREN (BASEL, SWITZERLAND) 2024; 11:146. [PMID: 38397258 PMCID: PMC10886801 DOI: 10.3390/children11020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
Children born prematurely (<37 weeks' gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course.
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Affiliation(s)
- Jonathan S. Litt
- Division of Newborn Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Department of Social and Behavioral Pediatrics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Neal Halfon
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA 90024, USA; (N.H.); (S.A.R.)
- Department of Pediatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90024, USA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA
- Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA
| | - Michael E. Msall
- Department of Pediatrics, Sections of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, University of Chicago Medicine, Chicago, IL 60637, USA;
| | - Shirley Ann Russ
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA 90024, USA; (N.H.); (S.A.R.)
- Department of Pediatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90024, USA
| | - Susan R. Hintz
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94305, USA;
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Abstract
The developing brain is particularly vulnerable to extrinsic environmental events such as anemia and iron deficiency during periods of rapid development. Studies of infants with postnatal iron deficiency and iron deficiency anemia clearly demonstrated negative effects on short-term and long-term brain development and function. Randomized interventional trials studied erythropoiesis-stimulating agents and hemoglobin-based red blood cell transfusion thresholds to determine how they affect preterm infant neurodevelopment. Studies of red blood cell transfusion components are limited in preterm neonates. A biomarker strategy measuring brain iron status and health in the preanemic period is desirable to evaluate treatment options and brain response.
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Affiliation(s)
- Tate Gisslen
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Academic Office Building, 2450 Riverside Avenue, SAO-401, Minneapolis, MN 55454, USA.
| | - Raghavendra Rao
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Academic Office Building, 2450 Riverside Avenue, SAO-401, Minneapolis, MN 55454, USA
| | - Michael K Georgieff
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Academic Office Building, 2450 Riverside Avenue, SAO-401, Minneapolis, MN 55454, USA
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Ragsdale K, Read-Wahidi MR, Mudege NN, Iannotti LL, Muzungaire L, Funduluka P. Sensory panel results of a dried fish powder supplement among caregivers and young children in Zambia. Public Health Nutr 2023; 27:e32. [PMID: 38031467 PMCID: PMC10897570 DOI: 10.1017/s1368980023002586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To evaluate the acceptability of traditional Zambian dishes fortified with Complementary Food for Africa+Dried Fish Powder (ComFA+Fish), a locally sourced protein/micronutrient blend designed to impact nutrient deficiencies among infants and young children (IYC) and improve pregnancy and birth outcomes among women of reproductive age (WRA). DESIGN During two sensory panels, caregivers evaluated: (1) the acceptability of four ComFA+Fish dishes for household consumption, including fortified chibwabwa fisashi, savory Kapenta chutney, fortified complementary maize porridge and fortified bean-vegetable soup and (2) whether their IYC found the fortified complementary maize porridge acceptable. SETTING Lake Kariba, Southern Province, Zambia. PARTICIPANTS Women of reproductive age (n 42) and their IYC aged 6-11 months (n 16) and 12-23 months (n 26) were recruited from fishing villages in Gwembe, Siavonga and Sinazongwe District. RESULTS A majority of caregivers extremely liked/liked the: (1) fortified chibwabwa fisashi's sensory attributes (94·7 %), convenience (92·8 %) and overall acceptability (100 %); (2) savory Kapenta chutney's sensory attributes (81·8 %), convenience (92·8 %) and overall acceptability (100 %); (3) fortified complementary porridge's sensory attributes (83·5 %), convenience (90·5 %) and overall acceptability (88·1 %) and (4) fortified bean-vegetable soup's sensory attributes (66·8 %), convenience (87·5 %) and overall acceptability (87·5 %). Further, a majority of caregivers evaluated the fortified complementary porridge as highly acceptable to their IYC. CONCLUSIONS Results suggest that ComFA+Fish is strategically well placed to fill nutritional gaps among IYC and WRA in Zambia and has the potential to be scaled across sub-Saharan Africa.
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Affiliation(s)
- Kathleen Ragsdale
- Social Science Research Center, Mississippi State University, PO Box 5287, Mississippi State, MS39762, USA
| | - Mary R Read-Wahidi
- Social Science Research Center, Mississippi State University, PO Box 5287, Mississippi State, MS39762, USA
| | | | - Lora L Iannotti
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Priscilla Funduluka
- School of Public Health and Environmental Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
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Zhai Y, Xie H, Zhao H, Wang W, Lu C. Neural synchrony underlies the positive effect of shared reading on children's language ability. Cereb Cortex 2023; 33:10426-10440. [PMID: 37562850 DOI: 10.1093/cercor/bhad293] [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: 06/01/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Although it is well recognized that parent-child shared reading produces positive effects on children's language ability, the underlying neurocognitive mechanisms are not well understood. Here, we addressed this issue by measuring brain activities from mother-child dyads simultaneously during a shared book reading task using functional near infrared spectroscopy hyperscanning. The behavioral results showed that the long-term experience of shared reading significantly predicted children's language ability. Interestingly, the prediction was moderated by children's age: for older children over 30 months, the more the shared reading experience, the better the language performance; for younger children below 30 months, however, no significant relationship was observed. The brain results showed significant interpersonal neural synchronization between mothers and children at the superior temporal cortex, which was closely associated with older children's language ability through the mediation of long-term experience of shared reading. Finally, the results showed that the instantaneous quality of shared reading contributed to children's language ability through enhancing interpersonal neural synchronization and increasing long-term experience. Based on these findings, we tentatively proposed a theoretical model for the relationship among interpersonal neural synchronization, shared reading and children's language ability. These findings will facilitate our understanding on the role of shared reading in children's language development.
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Affiliation(s)
- Yu Zhai
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Huixin Xie
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
- School of Preschool Education, Beijing Institute of Education, Beijing 100009, China
| | - Hui Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Wenjing Wang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Chunming Lu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
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13
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Georgieff MK. The importance of iron deficiency in pregnancy on fetal, neonatal, and infant neurodevelopmental outcomes. Int J Gynaecol Obstet 2023; 162 Suppl 2:83-88. [PMID: 37538010 PMCID: PMC10421617 DOI: 10.1002/ijgo.14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
The role of iron in neurodevelopment has long been recognized, and the adverse effects of early-life iron deficiency on brain development and subsequent function across the lifespan continue to be a subject of research. A greater appreciation of the contribution of maternal preconceptional iron status and fetal iron accretion to offspring, postnatal iron status, and brain health across the lifespan has occurred over the past decade. This paradigm shift in thinking links two previously relatively siloed literatures: neonatal iron deficiency and postnatal iron deficiency. The understanding that iron accretion during the fetal period strongly influences postnatal iron balance has led to an appreciation of the importance and value of ensuring proper fetal iron loading. This article reviews the dynamics of fetal iron metabolism, the role of iron in the developing fetal brain, the short- and long-term neurobehavioral consequences of fetal iron underloading, and the potential mechanisms that account for the long-term effects of fetal/neonatal iron deficiency.
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14
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Bekelman TA, Trasande L, Law A, Blackwell CK, Jacobson LP, Bastain TM, Breton CV, Elliott AJ, Ferrara A, Karagas MR, Aschner JL, Bornkamp N, Camargo CA, Comstock SS, Dunlop AL, Ganiban JM, Gern JE, Karr CJ, Kelly RS, Lyall K, O’Shea TM, Schweitzer JB, LeWinn KZ. Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program. Front Pediatr 2023; 11:1171214. [PMID: 37397146 PMCID: PMC10308998 DOI: 10.3389/fped.2023.1171214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity. Methods ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement. Results This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native, <1% Native Hawaiian or Pacific Islander, 10% Multiple race and 2% Other race), Hispanic ethnicity (22% Hispanic), and were similarly distributed across the four United States Census regions and Puerto Rico. Conclusion ECHO data collected during the pandemic can be used to conduct solution-oriented research to inform the development of programs and policies to support child health during the pandemic and in the post-pandemic era.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Leonardo Trasande
- Department of Pediatrics, Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa P. Jacobson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Elliott
- Avera Research Institute, Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Judy L. Aschner
- Departments of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Nicole Bornkamp
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jody M. Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, United States
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Catherine J. Karr
- Departments of Pediatrics & Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, United States
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Julie B. Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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15
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Hasan F, Nguyen AV, Reynolds AR, You W, Zoellner J, Nguyen AJ, Swift D, Kranz S. Preschool- and childcare center-based interventions to increase fruit and vegetable intake in preschool children in the United States: a systematic review of effectiveness and behavior change techniques. Int J Behav Nutr Phys Act 2023; 20:66. [PMID: 37268953 DOI: 10.1186/s12966-023-01472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Fruit and vegetable (FV) consumption in children in the United States (US) is very low. Adequate FV consumption is required for proper development during childhood, and dietary habits are established during preschool-age and tend to persist into adulthood. As most U.S. preschool-aged children attend childcare or preschool, this may be an opportune time and setting to conduct interventions to improve FV intake. These interventions should be based in theory and use behavior change techniques (BCTs) to explain mechanisms for expected change. To date, no published reviews have examined the effectiveness of childcare- or preschool-based FV interventions in preschoolers and their use of theoretical frameworks and BCTs. METHODS This systematic review was completed adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were randomized controlled trials (RCTs) published between 2012 and 2022 of interventions to improve diet or FV intake in preschoolers (aged 2-5 years) in childcare or preschool-settings. A search of four databases was conducted between in September 2022 using search terms pertaining to the study's primary aim (FV consumption), age group (preschool-aged), settings (US childcare or preschool settings), and study design (RCT). Additional criteria were objective measures of FV consumption or skin carotenoids, as a proxy for FV intake. Included studies were narratively synthesized based on intervention type, measured effect, and use of theory and BCTs. RESULTS The search resulted in six studies that reported on nine interventions. Overall, six interventions increased FV intake, of which five used nutrition education and one manipulated the feeding environment. Among the three interventions with no measured effect, two manipulated the feeding environment and one used peer modeling. Effective studies used at least three BCTs, though no pattern was observed between use of theory or BCTs and intervention effect. CONCLUSIONS While several studies have shown promising results, the limited number of studies identified in this review highlights key gaps in this field: there is a need for studies to test FV interventions in US childcare settings that use objective measures of FV intake, directly compare intervention components and BCTs, are theory-based, and assess long-term behavior change.
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Affiliation(s)
- Faten Hasan
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Andy V Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amaya R Reynolds
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Wen You
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amanda J Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Damon Swift
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Sibylle Kranz
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA.
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16
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Nigg JT. Considerations toward an epigenetic and common pathways theory of mental disorder. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:297-313. [PMID: 37126061 PMCID: PMC10153068 DOI: 10.1037/abn0000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Psychopathology emerges from the dynamic interplay of physiological and mental processes and ecological context. It can be seen as a failure of recursive, homeostatic processes to achieve adaptive re-equilibrium. This general statement can be actualized with consideration of polygenic liability, early exposures, and multiunit (multi-"level") analysis of the psychological action and the associated physiological and neural operations, all in the context of the developmental exposome. This article begins by identifying key principles and clarifying key terms necessary to mental disorder theory. It then ventures a sketch of a model that highlights epigenetic dynamics and proposes a common pathways hypothesis toward psychopathology. An epigenetic perspective elevates the importance of developmental context and adaptive systems, particularly in early life, while opening the door to new mechanistic discovery. The key proposal is that a finite number of homeostatic biological and psychological mechanisms are shared across most risky environments (and possibly many genetic liabilities) for psychopathology. Perturbation of these mediating mechanisms leads to development of psychopathology. A focus on dynamic changes in these homeostatic mechanisms across multiple units of analysis and time points can render the problem of explaining psychopathology tractable. Key questions include the mapping of recursive processes over time, at adequate density, as mental disorders unfold across development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University
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17
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He D, Wang X, Ye J, Yao Y, Wen Y, Jia Y, Meng P, Yang X, Wu C, Ning Y, Wang S, Zhang F. Evaluating the genetic interaction effects of gut microbiome and diet on the risk of neuroticism in the UK Biobank cohort. Psychiatr Genet 2023; 33:59-68. [PMID: 36924244 DOI: 10.1097/ypg.0000000000000334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVES In this study designed to investigate the effect of diet and gut microbiome on neuropsychiatric disorders, we explored the mechanisms of the interaction between diet and gut microbiome on the risk of neuroticism. METHODS First, using the individual genotype data from the UK Biobank cohort (N = 306 165), we calculated the polygenic risk score (PRS) based on 814 dietary habits single nucleotide polymorphisms (SNPs), 21 diet compositions SNPs and 1001 gut microbiome SNPs, respectively. Gut microbiome and diet-associated SNPs were collected from three genome-wide association studies (GWAS), including the gut microbiome (N = 3890), diet compositions (over 235 000 subjects) and dietary habits (N = 449 210). The neuroticism score was calculated by 12 questions from the Eysenck Personality Inventory Neuroticism scale. Then, regression analysis was performed to evaluate the interaction effects between diet and the gut microbiome on the risk of neuroticism. RESULTS Our studies demonstrated multiple candidate interactions between diet and gut microbiome, such as protein vs. Bifidobacterium (β = 4.59 × 10-3; P = 9.45 × 10-3) and fat vs. Clostridia (β = 3.67 × 10-3; P = 3.90 × 10-2). In addition, pieces of fresh fruit per day vs. Ruminococcus (β = -5.79 × 10-3, P = 1.10 × 10-3) and pieces of dried fruit per day vs. Clostridiales (β = -5.63 × 10-3, P = 1.49 × 10-3) were found to be negatively associated with neuroticism in fruit types. We also identified several positive interactions, such as tablespoons of raw vegetables per day vs. Veillonella (β = 5.92 × 10-3, P = 9.21 × 10-4) and cooked vegetables per day vs. Acidaminococcaceae (β = 5.69 × 10-3, P = 1.24 × 10-3). CONCLUSIONS Our results provide novel clues for understanding the roles of diet and gut microbiome in the development of neuroticism.
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Affiliation(s)
- Dan He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
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18
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Fang H, Li J, Lu L, Yang J, Feng H, Yin X, Wang S, He X, Song L, Shi Y, Gao Y, Shi H, Yin X. Long-lasting and sex-dependent effects of late lactational maternal deprivation on socioemotional behaviors in adult mice. Neurosci Lett 2023; 799:137096. [PMID: 36738955 DOI: 10.1016/j.neulet.2023.137096] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/30/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
The lactation period is an important period for individual development and a sensitive period for the behavioral phenotypes and plasticity of individual offspring. Early life experiences (e.g., maternal deprivation (MD) and neglect) have significant long-lasting and dual effects on individual stress reactivities during adulthood. Theoretically, stress inoculation can improve the adaptive capacity of the body, but overstress can lead to dysfunction when adaptive mechanisms fail.To date, the potential effects of late lactational MD on the socioemotional behaviors of mouse offspring during adulthood are still not fully understood. In the present study, mice were subjected to early deprivation by individually separating pups from their dam for 0 min, 15 min, and 3 h per day from PND 13-25. The social dominance test (SDT), social interaction test (SI), open field test (OFT), and forced swim test (FST) were carried out during adulthood. The results showed that the social dominance of male mice in the 15 min/d MD group significantly increased, especially in low-rank mice. In the 3 h/d MD group, the social dominance of female mice was decreased, especially in the lower-rank mice. The anxiolytic and antidepressant-like effects of the 15 min/d MD group were significantly increased in male mice. Our study provides direct evidence that MD during late lactation period results in long-lasting effects on social dominance as well as on anxiety and depression phenotypes in a sex-dependent manner.
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Affiliation(s)
- Hanlu Fang
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Jiabo Li
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Liuhua Lu
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Jingyu Yang
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Hao Feng
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Xueyong Yin
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Shuang Wang
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Xinyue He
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China
| | - Li Song
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medical University, 050017, China
| | - Yun Shi
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medical University, 050017, China
| | - Yuan Gao
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medical University, 050017, China
| | - Haishui Shi
- Neuroscience Research Center, Institute of Medical and Health Science of Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medical University, 050017, China.
| | - Xi Yin
- Department of Functional Region of Diagnosis, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
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Ding X, Liang M, Song Q, Su W, Li N, Liu H, Wu Y, Guo X, Wang H, Zhang J, Qin Q, Sun L, Chen M, Sun Y. Development of psychological resilience and associations with emotional and behavioral health among preschool left-behind children. Soc Psychiatry Psychiatr Epidemiol 2023; 58:467-476. [PMID: 35788881 DOI: 10.1007/s00127-022-02325-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to explore the development of psychological resilience and its associations with emotional and behavioral health among preschool left-behind children (LBC). METHODS LBC in 26 preschools of Fuyang City, Hefei City, and Maanshan City of Anhui Province were included at baseline survey; and baseline children in the junior and middle classes of preschools as targeted samples were recruited for the 1-year follow-up. Multivariable linear regression models were performed to examine associations of psychological resilience with emotional and behavioral health. RESULTS In total, 1463 LBC were included at baseline and 568 of the 905 targeted LBC completed the 1-year follow-up. Change patterns of psychological resilience were identified as the stable-high pattern (19.0%), increasing pattern (18.3%), declining pattern (15.9%), and stable-low pattern (46.8%). The results showed that psychological resilience at baseline was positively associated with later dietary behavior habits and prosocial behaviors, and negatively associated with later problematic behaviors and sleep problems. In addition, children with the declining pattern had more problematic behaviors and sleep problems, and fewer prosocial behaviors at follow-up. Children with the increasing pattern and stable-high pattern had more prosocial behaviors, better dietary behavior habits, and fewer problematic behaviors and sleep problems at follow-up. CONCLUSIONS The majority of preschool LBC had lower psychological resilience and its level among some LBC changed during the follow-up. Higher psychological resilience was a protective factor for emotional and behavioral health. Timely assessing psychological resilience and then strengthening it are needed to promote the emotional and behavioral health of preschool LBC.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jian Zhang
- Department of Neonatology, Anhui Provincial Children's Hospital, Hefei, 230051, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, 243011, Ma'anshan, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, 236030, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, 231100, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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20
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Schneider N, Mainardi F, Budisavljevic S, Rolands M, Deoni S. Associations between Early Life Nutrient Intakes and Brain Maturation Show Developmental Dynamics from Infancy to Toddlerhood: A Neuroimaging Observation Study. J Nutr 2023; 153:897-908. [PMID: 36931756 PMCID: PMC10196598 DOI: 10.1016/j.tjnut.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Myelin imaging has increasingly been applied to study the impact of nutrition on brain development in recent years. Although individual dynamics for nutrient intakes and myelin trajectories previously have been investigated across childhood, the longitudinal interaction between both remains unclear in typically developed children. OBJECTIVES The objective of this work was to explore the developmental dynamics of nutrient-myelin interactions from infancy to early childhood using myelin imaging as a marker for brain maturation. METHODS Brain neuroimaging (1 scan per child) and dietary nutrient intake data were analyzed for 88 nutrients from 293 children (127 female, 62% White) from a longitudinal cohort study in the United States. A sliding window approach was used to investigate correlations between nutrient intakes and brain myelination over a continuous set of age windows. Image processing techniques (Sobel-filter vertical edge detection) were applied to determine age windows with unique association profiles, providing novel insight into how these relationships change with child age. RESULTS We identified 3 nutrient-myelin windows covering the age range of 1-5 y: window 1 from 6 to 20 mo with 60% positive nutrient correlations, window 2 from 20 to 30 mo with 20% positive correlations, and window 3 from 30 to 60 mo with 37% positive correlations. The windows are aligned with reported myelin and white matter dynamics that change in the first 5 y from fast and steep (window 1) to continued but slower growth (window 3), with window 2 possibly representing the inflection period. CONCLUSIONS To our knowledge, this is the first study in typically developing children demonstrating the developmental dynamics between early life nutrient intakes and brain maturation in toddlerhood. The knowledge can be applied for identifying targeted and brain-stage-appropriate nutritional interventions for this critical stage of brain development.
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Affiliation(s)
- Nora Schneider
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, Lausanne, Switzerland.
| | - Fabio Mainardi
- Applied Data Analytics Group, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, Lausanne, Switzerland
| | - Sanja Budisavljevic
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, Lausanne, Switzerland
| | - Maryann Rolands
- Nutrition Science Group, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, Lausanne, Switzerland
| | - Sean Deoni
- Advanced Baby Imaging Lab, Rhode Island Hospital, Providence, RI, USA; Department of Radiology, Warren Alpert Medical School at Brown University, Providence, RI, USA; Spinn Neuroscience, Seattle, WA, USA
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21
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Ding X, Ma S, Liu H, Wang H, Li N, Song Q, Su W, Liang M, Guo X, Sun L, Qin Q, Chen M, Sun Y. The relationships between sleep disturbances, resilience and anxiety among preschool children: A three-wave longitudinal study. J Psychosom Res 2023; 168:111203. [PMID: 36868111 DOI: 10.1016/j.jpsychores.2023.111203] [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: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE This study, based on a three-wave longitudinal study, aimed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms among preschool children. METHODS In total, 1169 children in the junior class of preschools were investigated three times with an interval of one year, in Anhui Province, China. Children's sleep disturbances, resilience and anxiety symptoms were all assessed in the three-wave surveys. Then, 906 children at baseline (T1), 788 children in the first follow-up study (T2), and 656 children in the second follow-up study (T3) were included in the analysis. Autoregressive cross-lagged modeling analyses were performed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms using Mplus 8.3. RESULTS The mean age of the children was 3.6 ± 0.4 years at T1, 4.6 ± 0.4 years at T2, and 5.6 ± 0.4 years at T3, respectively. The results indicated that sleep disturbances at T1 significantly predicted anxiety symptoms at T2 (β = 0.111, P = 0.001); and sleep disturbances at T2 significantly predicted anxiety symptoms at T3 (β = 0.108, P = 0.008). Resilience only at T2 significantly predicted anxiety symptoms at T3 (β = -0.120, P = 0.002). Anxiety symptoms did not significantly predict the two variables (sleep disturbances and resilience) at any wave. CONCLUSION This study suggests that more sleep disturbances are longitudinally associated with subsequent high anxiety symptoms; inversely, high resilience will alleviate subsequent anxiety symptoms. These findings highlight the importance that early screening for sleep disturbances and anxiety, and strengthening resilience are beneficial to prevent preschool children from developing higher anxiety symptoms.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang 236069, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan 243011, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Hefei 231199, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei 238000, Anhui, China.
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22
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Dong X, Zhou A. Associations of maternal pre-pregnancy body mass index and gestational weight gain with risk of offspring neurodevelopment at 2 years: A Chinese birth cohort study. Front Pediatr 2023; 11:1165743. [PMID: 37144148 PMCID: PMC10151668 DOI: 10.3389/fped.2023.1165743] [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: 02/14/2023] [Accepted: 03/21/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction In recent decades, there has been a surge in both obesity and developmental impairments. Only a few research have looked at the relationship between gestational weight growth and pre-pregnancy BMI in mothers and the neurobehavioral development of their infants. The current research investigates the associations among maternal pre-pregnancy BMI, GWG, and the risk of child neural development at 2 years of age depending on a Chinese birth prospective study. Methods The study population was 3,115 mother-infant pairs were registered in the Wuhan Health Baby cohort between September 2013 and October 2018, and data from this cohort was used in this investigation. The Chinese classification was used to group maternal BMI before conception. Based on the 2019 Life Cycle Project-Maternal Obesity and Childhood Outcomes Study Group, categories for GWG were created. The outcome was an assessment of child neural development at age 2 which was measured by employing a Chinese translation of the Bayley scales (BSID-CR). The multivariate regression models were used to calculate the beta (β) coefficients and 95% confidence intervals (CIs) for estimating the associations between continuous Bayley scores and maternal pre-pregnancy BMI categories, as same as in GWG categories. Results Infants of overweight and obese moms exhibited lower MDI scores than those of mothers with normal pre-pregnancy BMI (β = -2.510, 95%CI = -4.821 to -0.200) in the entire sample. Meanwhile, we find among the normal pre-pregnancy BMI mothers, infants of inadequate GWG mothers had lower MDI scores (β = -3.952, 95%CI = -7.809 to -0.094) compared with the referenced adequate GWG mothers, as well as the infants of excessive GWG mothers among the underweight pre-pregnancy BMI mothers (β = -5.173, 95%CI = -9.803 to -0.543). The PDI scores of the infants were not affected by the maternal pre-pregnancy BMI or GWG. Conclusion For Chinese babies aged 2 in this nationally representative sample, aberrant pre-pregnancy BMI and GWG can impair infants' mental development, but not psychomotor development. Such results are significant given the incidence of overweight and obesity as well as the long-term effects of early brain development. In this study we found optimal GWG recommendations proposed by 2019 Life Cycle Project-Maternal Obesity and Childhood Outcomes Study Group were more suitable for Chinese women than 2009 Institute of Medicine(IOM) guidelines. Additionally, women should be given general advice on how to achieve their ideal pre-pregnancy BMI and GWG.
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Affiliation(s)
- Xiaohan Dong
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Aifen Zhou
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Institute of Maternal and Child Health, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Correspondence: Aifen Zhou
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23
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Stein AD, Adair LS, Donati G, Wray C, Richter LM, Norris SA, Stein A, Martorell R, Ramirez-Zea M, Menezes AMB, Murray J, Victora C, Lee N, Bas I. Early-life stature, preschool cognitive development, schooling attainment, and cognitive functioning in adulthood: a prospective study in four birth cohorts. Lancet Glob Health 2023; 11:e95-e104. [PMID: 36521958 PMCID: PMC9764453 DOI: 10.1016/s2214-109x(22)00448-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nutrition is important for growth and brain development and therefore cognitive ability. Growth faltering in early childhood, an important indicator of early adversity, is associated with poorer developmental outcomes, some into adulthood, but this association probably reflects early-life deprivation. We aimed to investigate the associations between early-life stature, child IQ, and adult IQ. METHODS In this cohort study, we used prospective longitudinal data collected in four birth cohorts from Brazil (born in 1993), Guatemala (born in 1969-77), the Philippines (born in 1983-84), and South Africa (born in 1990). Using multivariable linear models, we estimated the relative contributions of early-life stature, child IQ, and schooling (highest school year completed) to adult IQ, including interaction effects among the early-childhood measures and schooling. FINDINGS We included 2614 individuals in the analysis. Early-life stature was associated with adult IQ (range across eight site-by-sex groups -0·14 to 3·17 IQ points) and schooling (-0·05 to 0·77 years) per height-for-age Z-score. These associations were attenuated when controlling for child IQ (-0·86 to 1·72 for adult IQ and -0·5 to 0·60 for schooling). The association of early-life stature with adult IQ was further attenuated when controlling for schooling (-1·86 to 1·21). Child IQ was associated with adult IQ (range 3·91 to 10·02 points) and schooling (0·25 to 1·30 years) per SD of child IQ in all groups; these associations were unattenuated by the addition of early-life stature to the models. The interaction between schooling and child IQ, but not that between schooling and early-life stature, was positively associated with adult IQ across groups. INTERPRETATION The observed associations of early-life stature with adult IQ and schooling varied across cohorts and sexes and explained little variance in adult IQ beyond that explained by child IQ. These findings suggest that interventions targeted at growth for health and early development are important. Our results are consistent with the inference that improving long-term cognitive outcomes might require interventions that more specifically target early cognitive ability. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Charlotte Wray
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Global Health Research Institute, School of Human Development and Health & NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Manuel Ramirez-Zea
- INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Cesar Victora
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Nanette Lee
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, Cebu, Philippines
| | - Isabelita Bas
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, Cebu, Philippines
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Gimbel BA, Anthony ME, Ernst AM, Roediger DJ, de Water E, Eckerle JK, Boys CJ, Radke JP, Mueller BA, Fuglestad AJ, Zeisel SH, Georgieff MK, Wozniak JR. Long-term follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder: corpus callosum white matter microstructure and neurocognitive outcomes. J Neurodev Disord 2022; 14:59. [PMID: 36526961 PMCID: PMC9756672 DOI: 10.1186/s11689-022-09470-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a lifelong condition. Early interventions targeting core neurocognitive deficits have the potential to confer long-term neurodevelopmental benefits. Time-targeted choline supplementation is one such intervention that has been shown to provide neurodevelopmental benefits that emerge with age during childhood. We present a long-term follow-up study evaluating the neurodevelopmental effects of early choline supplementation in children with FASD approximately 7 years on average after an initial efficacy trial. METHODS The initial study was a randomized, double-blind, placebo-controlled trial of choline vs. placebo in 2.5 to 5 year olds with FASD. Participants in this long-term follow-up study include 18 children (9 placebo; 9 choline) seen 7 years on average following initial trial completion. The mean age at follow-up was 11.0 years old. Diagnoses were 28% fetal alcohol syndrome (FAS), 28% partial FAS, and 44% alcohol-related neurodevelopmental disorder. The follow-up included measures of executive functioning and an MRI scan. RESULTS Children who received choline had better performance on several tasks of lower-order executive function (e.g., processing speed) and showed higher white matter microstructure organization (i.e., greater axon coherence) in the splenium of the corpus callosum compared to the placebo group. CONCLUSIONS These preliminary findings, although exploratory at this stage, highlight potential long-term benefits of choline as a neurodevelopmental intervention for FASD and suggest that choline may affect white matter development, representing a potential target of choline in this population. TRIAL REGISTRATION Prior to enrollment, this trial was registered with clinicaltrials.gov ( NCT01149538 ) on June 23, 2010.
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Affiliation(s)
- Blake A. Gimbel
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | - Mary E. Anthony
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | - Abigail M. Ernst
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | - Donovan J. Roediger
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | | | - Judith K. Eckerle
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | | | | | - Bryon A. Mueller
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | - Anita J. Fuglestad
- grid.266865.90000 0001 2109 4358University of North Florida, Jacksonville, USA
| | - Steven H. Zeisel
- grid.410711.20000 0001 1034 1720University of North Carolina, Chapel Hill, USA
| | - Michael K. Georgieff
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
| | - Jeffrey R. Wozniak
- grid.17635.360000000419368657University of Minnesota Twin Cities, 2025 E. River Parkway, Minneapolis, MN 55414 USA
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Busse CE, Donney JF, Busse KR, Ghandour RM, Vladutiu CJ. Household food insufficiency and flourishing in a nationally representative sample of young children in the U.S. Ann Epidemiol 2022; 76:91-97. [PMID: 36283627 PMCID: PMC10150385 DOI: 10.1016/j.annepidem.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study examined the association between household food insufficiency and flourishing among young children (6 months-5 years) in the U.S. and assessed whether sleep adequacy modifies this association. METHODS We used data from the 2018-2020 National Surveys of Children's Health. Adjusted prevalence differences and 95% confidence intervals (CI) for the association between household food insufficiency and flourishing were modeled using average marginal predictions from logistic regression models. Sleep adequacy was assessed as an effect measure modifier on the additive scale. RESULTS Evidence supports additive scale effect measure modification of the food insufficiency-flourishing association by sleep adequacy (Likelihood Ratio Test statistic = 12.4, degrees of freedom = 2, P < .05). Adjusted for potential confounders, the prevalence of flourishing was 13.2 percentage points lower (95% CI: -22.6, -3.7) for children in households with insufficient food and inadequate sleep compared to those with sufficient food and adequate sleep. CONCLUSIONS Our findings suggest that having enough food and enough sleep are associated with greater wellbeing. These modifiable factors should be targeted by public health interventions to facilitate flourishing among young children in the U.S.
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Affiliation(s)
- Clara E Busse
- Oak Ridge Institute for Science and Education (ORISE), Office of Science, U.S. Department of Energy, Oak Ridge, TN; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Julie Fife Donney
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD
| | - Kyle R Busse
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Reem M Ghandour
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD
| | - Catherine J Vladutiu
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD
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26
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Early life nutrition and brain development: breakthroughs, challenges and new horizons. Proc Nutr Soc 2022:1-9. [PMID: 36321424 DOI: 10.1017/s0029665122002774] [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: 11/07/2022]
Abstract
The role of early life nutrition's impact on relevant health outcomes across the lifespan laid the foundation for the field titled the developmental origins of health and disease. Studies in this area initially concentrated on nutrition and the risk of adverse cardio-metabolic and cancer outcomes. More recently the role of nutrition in early brain development and the subsequent influence of later mental health has become more evident. Scientific breakthroughs have elucidated two mechanisms behind long-term nutrient effects on the brain, including the existence of critical periods for certain nutrients during brain development and nutrient-driven epigenetic modifications of chromatin. While multiple nutrients and nutritional conditions have the potential to modify brain development, iron can serve as a paradigm to understand both mechanisms. New horizons in nutritional medicine include leveraging the mechanistic knowledge of nutrient-brain interactions to propose novel nutritional approaches that protect the developing brain through better timing of nutrient delivery and potential reversal of negative epigenetic marks. The main challenge in the field is detecting whether a change in nutritional status truly affects the brain's development and performance in human subjects. To that end, a strong case can be made to develop and utilise bioindicators of a nutrient's effect on the developing brain instead of relying exclusively on biomarkers of the nutrient's status.
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Waid J, Tomfohrde O, Kutzler C. Promoting health and social equity through family navigation to prevention and early intervention services: a proof of concept study. BMC Public Health 2022; 22:1972. [PMID: 36303175 PMCID: PMC9610316 DOI: 10.1186/s12889-022-14320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health and social inequality are associated with multiple adverse childhood experiences including poverty, mental illness, and child maltreatment. While effective interventions currently exist for many health and social problems, large segments of the population experience barriers accessing needed services. In alignment with broader public health efforts to reduce health and social inequality in one state in the U.S.A., the current study describes the development and formative evaluation of a brief, low cost, portable model of prevention-oriented family service navigation called Navigate Your Way. METHODS Caregivers of children experiencing significant unmet health or social service needs were recruited to the study. Participants completed an initial and closing telephone interview which included measures of past and current family health and social service utilization, service barriers, parenting stress, and child internalizing/externalizing behaviors. Between interviews participants created a family service plan and received 10 weeks of telephone and web-mediated family navigation, at which time process and fidelity of implementation data were collected. Frequency and descriptive statistics are provided for participant demographic characteristics, service barriers, intervention engagement, and primary and secondary study outcomes. Paired samples t-tests examined changes in study outcomes between initial and closing telephone interviews. RESULTS Thirty two caregivers enrolled, twenty-nine completed the study. The age range was 20-59 (M = 39.5, SD = 10.0). The majority identified as female (96.9%, n = 31), racial/ethnic minority (56.2%, n = 18), and reported an average 10 barriers to care (M = 10.4, SD = 4.1). The most frequently reported service needs were mental health care, housing, food security, transportation, and health insurance. The mean duration of intervention delivery was 83 days. Most participants (82.8%, n = 24) were connected to one or more health or social services. Caregivers reported significant improvements to youth internalizing behaviors (d = 2.5, p = .05) and high levels of overall satisfaction with the navigation approach. CONCLUSION Telephone and web-mediated service navigation is a feasible and practical approach to supporting families in rapidly connecting to health and social care. Future research investigating the efficacy and implementation of Navigate Your Way in routine settings is indicated.
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Affiliation(s)
- Jeffrey Waid
- School of Social Work, University of Minnesota - Twin Cities, 1404 Gortner Ave, 105 Peters Hall, 55108, St. Paul, MN, USA.
| | - Olivia Tomfohrde
- Family Social Science, University of Minnesota - Twin Cities, 1985 Buford Ave, 55108, St. Paul, MN, USA
| | - Courtney Kutzler
- School of Social Work, University of Minnesota - Twin Cities, 1404 Gortner Ave, 105 Peters Hall, 55108, St. Paul, MN, USA.,School of Public Health, University of Minnesota - Twin Cities, 420 Delaware St SE, 55455, Minneapolis, MN, USA
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Ursache A, Barajas-Gonzalez RG, Dawson-McClure S. Neighborhood influences on the development of self-regulation among children of color living in historically disinvested neighborhoods: Moderators and mediating mechanisms. Front Psychol 2022; 13:953304. [PMID: 36389468 PMCID: PMC9643166 DOI: 10.3389/fpsyg.2022.953304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/04/2022] [Indexed: 09/15/2023] Open
Abstract
We present a conceptual model of the ways in which built and social environments shape the development of self-regulation in early childhood. Importantly, in centering children of color growing up in historically disinvested neighborhoods, we first describe how systemic structures of racism and social stratification have shaped neighborhood built and social environment features. We then present evidence linking these neighborhood features to children's development of self-regulation. Furthermore, we take a multilevel approach to examining three potential pathways linking neighborhood contexts to self-regulation: school environment and resources, home environment and resources, and child health behaviors. Finally, we consider how racial-ethnic-cultural strengths and multilevel interventions have the potential to buffer children's development of self-regulation in disinvested neighborhood contexts. Advancing multilevel approaches to understand the development of self-regulation among children of color living in historically disinvested neighborhoods is an important step in efforts to promote equity in health and education.
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Affiliation(s)
- Alexandra Ursache
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
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Muggli Z, Mertens T, Amado R, Teixeira AL, Vaz D, Pires M, Loureiro H, Fronteira I, Abecassis A, Silva AC, Martins MRO. Cohort profile: Health trajectories of Immigrant Children (CRIAS)-a prospective cohort study in the metropolitan area of Lisbon, Portugal. BMJ Open 2022; 12:e061919. [PMID: 36283755 PMCID: PMC9608527 DOI: 10.1136/bmjopen-2022-061919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The CRIAS (Health trajectories of Immigrant Children in Amadora) cohort study was created to explore whether children exposed to a migratory process experience different health risks over time, including physical health, cognitive, socioemotional and behavioural challenges and different healthcare utilisation patterns. PARTICIPANTS The original CRIAS was set up to include 604 children born in 2015, of whom 50% were immigrants, and their parents. Recruitment of 420 children took place between June 2019 and March 2020 at age 4/5 years, with follow-up carried out at age 5/6 years, at age 6/7 years currently under way. FINDINGS TO DATE Baseline data at age 4/5 years (2019-2020) suggested immigrant children to be more likely to belong to families with less income, compared with non-immigrant children. Being a first-generation immigrant child increased the odds of emotional and behavioural difficulties (adjusted OR 2.2; 95% CI: 1.06 to 4.76); more immigrant children required monitoring of items in the psychomotor development test (38.5% vs 28.3%). The prevalence of primary care utilisation was slightly higher among immigrant children (78.0% vs 73.8%), yet they received less health monitoring assessments for age 4 years. Utilisation of the hospital emergency department was higher among immigrants (53.2% vs 40.6%). Age 5 years follow-up (2020-2021) confirmed more immigrant children requiring monitoring of psychomotor development, compared with non-immigrant children (33.9% vs 21.6%). Economic inequalities exacerbated by post-COVID-19 pandemic confinement with parents of immigrant children 3.2 times more likely to have their household income decreased. FUTURE PLANS Further follow-up will take place at 8, 10, 12/13 and 15 years of age. Funds awarded by the National Science Foundation will allow 900 more children from four other Lisbon area municipalities to be included in the cohort (cohort-sequential design).
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Affiliation(s)
- Zélia Muggli
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
| | - Thierry Mertens
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
| | - Regina Amado
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Lúcia Teixeira
- Interdisciplinary Centre of Social Sciences (CICS.NOVA), Faculty of Social Sciences and Humanities (NOVA FCSH), NOVA University of Lisbon, Lisbon, Portugal
| | - Dora Vaz
- Amadora Primary Care Health Centres Group, Regional Health Administration of Lisbon and Tagus Valley, Ministry of Health, Lisbon, Portugal
| | - Melanie Pires
- Amadora Primary Care Health Centres Group, Regional Health Administration of Lisbon and Tagus Valley, Ministry of Health, Lisbon, Portugal
| | - Helena Loureiro
- Paediatrics Department, Hospital Professor Doutor Fernando da Fonseca, Amadora, Portugal
| | - Inês Fronteira
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Abecassis
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
| | - António Carlos Silva
- Public Health Department, Regional Health Administration of Lisbon and Tagus Valley, Ministry of Health, Lisbon, Portugal
- AJPAS-Associação de Intervenção Comunitária, Desenvolvimento Social e de Saúde, Amadora, Portugal
| | - Maria Rosário O Martins
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University of Lisbon, Lisbon, Portugal
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30
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Rahman MM, Islam MR, Emran TB. Impact of nutrition in brain function and development: Potential brain foods. Int J Surg 2022; 106:106908. [PMID: 36108908 DOI: 10.1016/j.ijsu.2022.106908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Md Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh.
| | - Md Rezaul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh.
| | - Talha Bin Emran
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh; Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh.
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Household food insecurity and obesity risk in preschool-aged children: A three-year prospective study. Soc Sci Med 2022; 307:115176. [PMID: 35816836 DOI: 10.1016/j.socscimed.2022.115176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/16/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Household food insecurity (FI) is a pressing social, economic and public health issue. However, little is known regarding the effect of FI exposure during the first few years of life, the most active postnatal time for neurobiological and physiological development, on patterns of weight gain during early childhood. It is also unknown whether dietary quality would serve as a pathway through which FI affects children's weight development. METHOD This was a secondary data analysis from a three-year randomized clinical trial with five hundred and thirty-four parent/child dyads. Household FI in the past year was reported by parents at baseline when children were 2-4 years of age using the USDA Household Food Security Survey Module-Six Item Short Form. Children's dietary quality at baseline was measured by the US Department of Agriculture Healthy Eating Index (HEI). Child body mass index (BMI) was measured following standardized protocols at baseline and 12-, 24-, and 36-month follow-up. A latent growth curve model was used to examine 1) the association between baseline FI and sex-and-age-adjusted BMI z-scores in children and 2) the HEI pathway between the FI- BMI association. RESULTS FI early in life was associated with higher baseline BMI z-scores. Children who had higher BMI at baseline maintained their higher BMI status over the next three years. Children's dietary intake quality did not explain the association between baseline FI and BMI z-scores. CONCLUSION Early exposure to FI was associated with higher BMI in children as early as two years of age, setting them up for an increased likelihood of persistently high BMI-for-age in later childhood. These data suggest that the first few years may be a critical time for developing obesity risk, calling for policy and practices designed for early intervention of food insecurity.
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Xu S, Ma L, Li H, Wang X, Wu M, Jing J, Chen X, Lan R, Tang W, Zhu Y. Iron Supplementation Is Associated with Improvement of Motor Development, Hemoglobin Level, and Weight in Preterm Infants during the First Year of Life in China. Nutrients 2022; 14:nu14132624. [PMID: 35807810 PMCID: PMC9267941 DOI: 10.3390/nu14132624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 01/27/2023] Open
Abstract
Iron supplementation is recommended for preterm infants due to impaired iron endowment. However, the health outcomes of this recommendation remain controversial. Thus, this study aimed to determine the association of iron supplementation with neurobehavioral development, hemoglobin (Hb), and anthropometric characteristics in preterm infants. A retrospective cohort design was applied to collect data from 1568 preterm infants at 0–3 months of corrected age (mo CA) from a hospital in South China. Infants were categorized into a 3-month iron supplementation group (IG, n = 697) or a control group (CG, n = 871) according to medical records, and then followed through to 12 mo CA. Data on neurobehavioral development, anthropometry, Hb level, history of diseases, and nutrition were collected at 3, 6, and 12 mo CA. The results showed that, compared with the CG, iron supplementation was positively related to improved gross motor skills and weight at 6 mo CA (β = 1.894, β = 5.322) and 12 mo CA (β = 4.019, β = 6.830) and fine motor skills at 12 mo CA (β = 1.980), after adjustment for confounding factors including illness, nutritional supplements, and diet. Iron supplementation was also related to elevated Hb levels and its increase at 3 mo CA (β = 2.196, β = 3.920) and 6 mo CA (β = 3.011, β = 7.259). In conclusion, iron supplementation for 3 months in Chinese preterm infants is positively associated with improved motor development, elevated Hb levels, and higher body weight during the first year of life.
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Affiliation(s)
- Suhua Xu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Liya Ma
- Shenzhen Bao’an Women and Children’s Hospital, Jinan University, Shenzhen 518102, China;
| | - Hailin Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Xiaotong Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Miao Wu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Jiajia Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Xiaoyan Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Ruiling Lan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Weike Tang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.X.); (H.L.); (X.W.); (M.W.); (J.J.); (X.C.); (R.L.); (W.T.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Correspondence: ; Tel.: +86-20-87334627; Fax: +86-20-87330446
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She X, Perera S, Andre M, St. Fleur J, Hilaire J, Evans A, Long J, Wing D, Carpenter C, Wilson K, Palfrey J, Stulac S. Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children. Glob Pediatr Health 2022; 9:2333794X221098311. [PMID: 35592789 PMCID: PMC9112296 DOI: 10.1177/2333794x221098311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.
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Affiliation(s)
- Xinshu She
- Stanford U School of Medicine,
Stanford, CA, USA
| | | | | | | | | | - Andrea Evans
- Toronto University School of Medicine,
Toronto, ON, Canada
| | - Jack Long
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | - Delight Wing
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | | | - Kim Wilson
- Harvard U Medical School, Boston, MA,
USA
| | | | - Sara Stulac
- Boston U School of Medicine, Boston,
MA, USA
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Kruk ME, Lewis TP, Arsenault C, Bhutta ZA, Irimu G, Jeong J, Lassi ZS, Sawyer SM, Vaivada T, Waiswa P, Yousafzai AK. Improving health and social systems for all children in LMICs: structural innovations to deliver high-quality services. Lancet 2022; 399:1830-1844. [PMID: 35489361 PMCID: PMC9077444 DOI: 10.1016/s0140-6736(21)02532-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/10/2021] [Accepted: 11/11/2021] [Indexed: 12/25/2022]
Abstract
Despite health gains over the past 30 years, children and adolescents are not reaching their health potential in many low-income and middle-income countries (LMICs). In addition to health systems, social systems, such as schools, communities, families, and digital platforms, can be used to promote health. We did a targeted literature review of how well health and social systems are meeting the needs of children in LMICs using the framework of The Lancet Global Health Commission on high-quality health systems and we reviewed evidence for structural reforms in health and social sectors. We found that quality of services for children is substandard across both health and social systems. Health systems have deficits in care competence (eg, diagnosis and management), system competence (eg, timeliness, continuity, and referral), user experience (eg, respect and usability), service provision for common and serious conditions (eg, cancer, trauma, and mental health), and service offerings for adolescents. Education and social services for child health are limited by low funding and poor coordination with other sectors. Structural reforms are more likely to improve service quality substantially and at scale than are micro-level efforts. Promising approaches include governing for quality (eg, leadership, expert management, and learning systems), redesigning service delivery to maximise outcomes, and empowering families to better care for children and to demand quality care from health and social systems. Additional research is needed on health needs across the life course, health system performance for children and families, and large-scale evaluation of promising health and social programmes.
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Affiliation(s)
- Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Todd P Lewis
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Catherine Arsenault
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health and Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Grace Irimu
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Tyler Vaivada
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Peter Waiswa
- Maternal, Newborn and Child Health Centre of Excellence, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
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Saiote C, Sutter E, Xenopoulos-Oddsson A, Rao R, Georgieff M, Rudser K, Peyton C, Dean D, McAdams RM, Gillick B. Study Protocol: Multimodal Longitudinal Assessment of Infant Brain Organization and Recovery in Perinatal Brain Injury. Pediatr Phys Ther 2022; 34:268-276. [PMID: 35385465 PMCID: PMC9200232 DOI: 10.1097/pep.0000000000000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Perinatal brain injury is a primary cause of cerebral palsy, a condition resulting in lifelong motor impairment. Infancy is an important period of motor system development, including development of the corticospinal tract (CST), the primary pathway for cortical movement control. The interaction between perinatal stroke recovery, CST organization, and resultant motor outcome in infants is not well understood. METHODS Here, we present a protocol for multimodal longitudinal assessment of brain development and motor function following perinatal brain injury using transcranial magnetic stimulation and magnetic resonance imaging to noninvasively measure CST functional and structural integrity across multiple time points in infants 3 to 24 months of age. We will further assess the association between cortical excitability, integrity, and motor function. DISCUSSION This protocol will identify bioindicators of motor outcome and neuroplasticity and subsequently inform early detection, diagnosis, and intervention strategies for infants with perinatal stroke, brain bleeds, and related diagnoses.
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Affiliation(s)
- Catarina Saiote
- Waisman Center (Drs Saiote, Sutter, Dean, and Gillick), Department of Pediatrics (Drs Dean, McAdams, and Gillick), and Department of Medical Physics (Dr Dean), University of Wisconsin-Madison, Madison, Wisconsin; Department of Rehabilitation Medicine (Dr Sutter and Ms Xenopoulos-Oddsson), Department of Pediatrics (Drs Rao and Georgieff), and Division of Biostatistics (Dr Rudser), University of Minnesota, Minneapolis, Minnesota; Department of Physical Therapy and Human Movement Sciences, Department of Pediatrics (Dr Peyton), Northwestern University, Chicago, Illinois
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Tomlinson M, Skeen S, Melendez-Torres GJ, Hunt X, Desmond C, Morgan B, Murray L, Cooper PJ, Rathod SD, Marlow M, Fearon P. First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial. J Child Psychol Psychiatry 2022; 63:261-272. [PMID: 34227113 DOI: 10.1111/jcpp.13482] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13 years of age. We also estimated the current costs to replicate the intervention. METHOD We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13 years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES = -0.17 [CI: -1.95, 0.05] and SRQ-20, ES = -0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13 years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important.
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Affiliation(s)
- Mark Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa.,School of Nursing and Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Sarah Skeen
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group, University of Exeter Medical School, Exeter, UK
| | - Xanthe Hunt
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Chris Desmond
- Priceless, School of Public Health, Wits University, Johannesburg, South Africa
| | - Barak Morgan
- Global Risk Governance Programme, Institute for Safety Governance and Criminology, Law Faculty, University of Cape Town, Cape Town, South Africa
| | - Lynne Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Peter J Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Sujit D Rathod
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Marguerite Marlow
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Pasco Fearon
- Developmental Neuroscience Unit, University College London, London, UK
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Bach AM, Xie W, Piazzoli L, Jensen SKG, Afreen S, Haque R, Petri WA, Nelson CA. Systemic inflammation during the first year of life is associated with brain functional connectivity and future cognitive outcomes. Dev Cogn Neurosci 2022; 53:101041. [PMID: 34973509 PMCID: PMC8728426 DOI: 10.1016/j.dcn.2021.101041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/09/2021] [Accepted: 11/27/2021] [Indexed: 01/01/2023] Open
Abstract
The first years of life are a sensitive period of rapid neural and immune system development vulnerable to the impact of adverse experiences. Several studies support inflammation as a consequence of various adversities and an exposure negatively associated with developmental outcomes. The mechanism by which systemic inflammation may affect brain development and later cognitive outcomes remains unclear. In this longitudinal cohort study, we examine the associations between recurrent systemic inflammation, defined as C-reactive protein elevation on ≥ 2 of 4 measurements across the first year of life, electroencephalography (EEG) functional connectivity (FC) at 36 months, and composite cognitive outcomes at 3, 4, and 5 years among 122 children living in a limited-resource setting in Dhaka, Bangladesh. Recurrent systemic inflammation during the first year of life is significantly negatively associated with cognitive outcomes at 3, 4, and 5 years, after accounting for stunting and family care indicators (a measure of stimulation in the home environment). Recurrent systemic inflammation is significantly positively associated with parietal-occipital FC in the Beta band at 36 months, which in turn is significantly negatively associated with composite cognitive scores at 3 and 4 years. However, FC does not mediate the relationship between recurrent systemic inflammation and cognitive outcomes.
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Affiliation(s)
- Ashley M Bach
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard T.H. Chan School of Public Health, USA
| | - Wanze Xie
- School of Psychological and Cognitive Sciences, Peking University, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, China; Beijing Key Laboratory of Behavior and Mental Health, Peking University, China
| | - Laura Piazzoli
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard Medical School, USA
| | | | - Sajia Afreen
- International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh
| | - William A Petri
- Division of Infectious Diseases, University of Virginia School of Medicine, USA
| | - Charles A Nelson
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard Medical School, USA; Harvard Graduate School of Education, USA.
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Stelle I, Bah M, Silverio SA, Verhoef H, Comma E, Prentice AM, Moore SE, Cerami C. Iron supplementation of breastfed Gambian infants from 6 weeks to 6 months of age: protocol for a randomised controlled trial. Wellcome Open Res 2022; 7:16. [PMID: 36874582 PMCID: PMC9975413 DOI: 10.12688/wellcomeopenres.17507.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: A recent analysis showed that plasma iron concentrations decline rapidly from birth in Gambian infants, irrespective of sex or birthweight, to concentrations well below normal expected values for iron-replete children older than two months of age (typically >10 μmol/L). The development and function of neural and immune cells may thus be compromised before the minimum age at which children should receive iron supplementation as per World Health Organisation recommendations. Methods: This study is a two-arm, double-blind, placebo-controlled, randomised superiority trial. Infants will be randomised to receive iron drops (7.5mg/day of iron as ferrous sulphate) or placebo daily for 98 days, to test the impact on serum iron concentrations in healthy, breastfed infants (n = 100) aged 6-10 weeks at enrolment. Participants will be visited daily and supplemented by the field team. Daily health and weekly breastfeeding questionnaires will be administered. Anthropometry, and venous blood and faecal samples will be collected at enrolment and after 98 days of supplementation with serum iron as the primary endpoint. Low birthweight (less than 2.5kg at birth) and infants born prematurely (< 37 weeks) will not be excluded. Formula-fed and infants with any illness will be excluded. An additional study exploring maternal stakeholder perspectives of the intervention will be conducted by means of maternal interviews and four focus group discussions with local stakeholders. Discussion: Most breast-fed Gambian infants have very low circulating iron levels by five months of age. This study will introduce iron supplements much earlier in infancy than has previously been attempted in a low-income setting with the primary aim of increasing serum iron concentration. Trial registration: Clincaltrials.gov ( NCT04751994); 12 th February 2021.
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Affiliation(s)
- Isabella Stelle
- Department of Women and Children's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Mamadou Bah
- Nutrition and Planetary Health Theme, MRC Unit The Gambia @ the London School of Hygiene and Tropical Medicine, PO Box 273, Banjul, The Gambia
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Sergio A. Silverio
- Department of Women and Children's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Hans Verhoef
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Ebrima Comma
- Nutrition and Planetary Health Theme, MRC Unit The Gambia @ the London School of Hygiene and Tropical Medicine, PO Box 273, Banjul, The Gambia
| | - Andrew M. Prentice
- Nutrition and Planetary Health Theme, MRC Unit The Gambia @ the London School of Hygiene and Tropical Medicine, PO Box 273, Banjul, The Gambia
| | - Sophie E. Moore
- Department of Women and Children's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Nutrition and Planetary Health Theme, MRC Unit The Gambia @ the London School of Hygiene and Tropical Medicine, PO Box 273, Banjul, The Gambia
| | - Carla Cerami
- Nutrition and Planetary Health Theme, MRC Unit The Gambia @ the London School of Hygiene and Tropical Medicine, PO Box 273, Banjul, The Gambia
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Insufficient maternal gestational weight gain and infant neurodevelopment at 12 months of age: the Japan Environment and Children's Study. Eur J Pediatr 2022; 181:921-931. [PMID: 34642790 PMCID: PMC8897327 DOI: 10.1007/s00431-021-04232-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Abnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children's Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal-social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09-1.34), gross motor (OR 1.14, 95% CI 1.05-1.24), fine motor (OR 1.13, 95% CI 1.04-1.24), problem-solving (OR 1.09, 95% CI 1.01-1.18), and personal-social (OR 1.15, 95% CI 1.07-1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children's Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known: • Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes. • Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New: • This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age. • Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.
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Munhoz TN, Santos IS, Blumenberg C, Barcelos RS, Bortolotto CC, Matijasevich A, Santos Júnior HG, Santos LMD, Correa LL, Souza MRD, Lira PIC, Altafim ERP, Macana EC, Victora CG. Fatores associados ao desenvolvimento infantil em crianças brasileiras: linha de base da avaliação do impacto do Programa Criança Feliz. CAD SAUDE PUBLICA 2022; 38:e00316920. [DOI: 10.1590/0102-311x00316920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/24/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo: O objetivo deste artigo foi avaliar os fatores socioeconômicos, familiares e individuais associados ao desenvolvimento infantil no primeiro ano de vida, entre famílias em vulnerabilidade social. Trata-se de uma análise transversal, com dados da linha de base de um ensaio randomizado. O estudo incluiu 3.242 crianças < 12 meses de idade, residentes em 30 municípios de cinco regiões do Brasil. A escolha de estados e municípios foi intencional, tendo como base a implementação do Programa Criança Feliz. A amostra foi selecionada a partir de crianças elegíveis para o Programa Criança Feliz, cujo objetivo é promover a estimulação e o desenvolvimento infantil. O Ages and Stages Questionnaire (ASQ) foi utilizado para avaliação do desenvolvimento infantil. Um modelo de análise multinível em três níveis (estado, município e indivíduos), usando teste de Wald para heterogeneidade e tendência linear, estimou a média do ASQ-3 e intervalo de 95% de confiança (IC95%). Análises foram ajustadas para potenciais confundidores. Foram analisadas informações de 3.061 (94,4%) crianças com dados disponíveis para ASQ-3. Escores de desenvolvimento infantil (total e em todos os domínios) foram cerca de 12% menores em crianças nascidas pré-termo e com restrição do crescimento intrauterino (pequenas para idade gestacional). Observou-se menores escores em filhos de mães com baixa escolaridade, com sintomas de depressão, com duas ou mais crianças menores de sete anos residindo no domicílio e que não relataram autopercepção de apoio/ajuda durante a gestação. Conclui-se que características potencialmente modificáveis (escolaridade, depressão materna e prematuridade/restrição do crescimento intrauterino) apresentaram maior impacto na redução do escore de desenvolvimento em todos os domínios avaliados.
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Affiliation(s)
- Tiago N. Munhoz
- Universidade Federal de Pelotas, Brazil; Universidade Federal de Pelotas, Brazil
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Cusick SE, Barks A, Georgieff MK. Nutrition and Brain Development. Curr Top Behav Neurosci 2022; 53:131-165. [PMID: 34622395 DOI: 10.1007/7854_2021_244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
All nutrients are essential for brain development, but pre-clinical and clinical studies have revealed sensitive periods of brain development during which key nutrients are critical. An understanding of these nutrient-specific sensitive periods and the accompanying brain regions or processes that are developing can guide effective nutrition interventions as well as the choice of meaningful circuit-specific neurobehavioral tests to best determine outcome. For several nutrients including protein, iron, iodine, and choline, pre-clinical and clinical studies align to identify the same sensitive periods, while for other nutrients, such as long-chain polyunsaturated fatty acids, zinc, and vitamin D, pre-clinical models demonstrate benefit which is not consistently shown in clinical studies. This discordance of pre-clinical and clinical results is potentially due to key differences in the timing, dose, and/or duration of the nutritional intervention as well as the pre-existing nutritional status of the target population. In general, however, the optimal window of success for nutritional intervention to best support brain development is in late fetal and early postnatal life. Lack of essential nutrients during these times can lead to long-lasting dysfunction and significant loss of developmental potential.
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Affiliation(s)
- Sarah E Cusick
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA.
| | - Amanda Barks
- University of Minnesota Medical School, Minneapolis, MN, USA
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Yang JH, Strodl E, Wu CA, Yin XN, Wen GM, Sun DL, Xian DX, Chen JY, Chen YJ, Chen J, Chen WQ. Association between environmental tobacco smoke exposure in early life and autistic-like behaviors in Chinese preschoolers. J Psychosom Res 2021; 152:110680. [PMID: 34826656 DOI: 10.1016/j.jpsychores.2021.110680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Few studies have evaluated the association between children's exposure to environmental tobacco smoke (ETS) in early life (during pregnancy, from birth to one year and from one to three years) and autistic-like behaviors. This study aimed to explore this association. METHODS This cross-sectional study analyzed data collected in 2017 as part of the Longhua Child Cohort Study. Autistic-like behaviors were measured using the Autism Behavior Checklist (ABC). Data on ETS exposure and autistic-like behaviors of children were collected via self-administered questionnaires completed by the mothers. Multivariate logistic regression models were undertaken to assess the associations. RESULTS Of the 65,243 participants included in this study, 1958 children met criteria for having autistic-like behaviors. The results showed that children were more likely to exhibit autistic-like behaviors when they were exposed to ETS in early life (AOR = 1.38; 95% CI = 1.26-1.52), compared to preschoolers without ETS exposure at any period of their early life. Compared with their unexposed counterparts, children who were exposed to ETS during gestation (AOR = 1.42; 95% CI = 1.29-1.57), or from birth to one year old (AOR = 1.42; 95% CI = 1.19-1.69) had significantly increased risk of autistic-like behaviors. In addition, with the increase in duration of exposure and average number of cigarettes smoked in the child's immediate environment, the risk of autistic-like behaviors increased. CONCLUSION Our study indicated that children's ETS exposure in early life was significantly associated with autistic-like behaviors. When children's exposure to cigarettes in early life increased in duration and number, the likelihood of the presence of autistic-like behaviors was higher.
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Affiliation(s)
- Jian-Hui Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Chuan-An Wu
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Xiao-Na Yin
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Guo-Min Wen
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Deng-Li Sun
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Dan-Xia Xian
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Jing-Yi Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying-Jie Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Health, Xinhua College of Guangzhou, China.
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Nevins JEH, Donovan SM, Snetselaar L, Dewey KG, Novotny R, Stang J, Taveras EM, Kleinman RE, Bailey RL, Raghavan R, Scinto-Madonich SR, Venkatramanan S, Butera G, Terry N, Altman J, Adler M, Obbagy JE, Stoody EE, de Jesus J. Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review. J Nutr 2021; 151:3483-3494. [PMID: 34383914 PMCID: PMC8764572 DOI: 10.1093/jn/nxab238] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/08/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period. OBJECTIVES We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. METHODS We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0-18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability. RESULTS We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200-2200 mg/d DHA and 0-1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%-11% (P < 0.05), but all 8 studies also reported ≥1 nonsignificant (P > 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity. CONCLUSIONS Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.
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Affiliation(s)
- Julie E H Nevins
- Panum Group, Bethesda, MD, USA
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Sharon M Donovan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, IL, USA
| | - Linda Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, CA, USA
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, University of Hawaii at Manoa, Manoa, HI, USA
| | - Jamie Stang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Elsie M Taveras
- Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ronald E Kleinman
- Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Ramkripa Raghavan
- Panum Group, Bethesda, MD, USA
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Sara R Scinto-Madonich
- Panum Group, Bethesda, MD, USA
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Sudha Venkatramanan
- Panum Group, Bethesda, MD, USA
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Gisela Butera
- Panum Group, Bethesda, MD, USA
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | | | - Jean Altman
- Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Meghan Adler
- Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Julie E Obbagy
- Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Eve E Stoody
- Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, HHS, United States Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA, USA
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Nordenswan E, Deater-Deckard K, Karrasch M, Laine M, Kataja EL, Holmberg E, Eskola E, Hakanen H, Karlsson H, Karlsson L, Korja R. Maternal Executive Functioning, Emotional Availability and Psychological Distress During Toddlerhood: A FinnBrain Birth Cohort Study. Front Psychol 2021; 12:735734. [PMID: 34690890 PMCID: PMC8533223 DOI: 10.3389/fpsyg.2021.735734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Executive functioning (EF) is one of the building blocks in parental caregiving behavior, and contextual variables have been reported to moderate the link between EF and caregiving behavior. Although psychological distress due to various factors is prevalent during early parenthood and is negatively associated with adult EF, it is not known whether psychological distress influences the maternal EF/caregiving link. This study explored the association between maternal EF and caregiving behavior (more specifically, Emotional Availability/EA), and whether single and cumulative maternal psychological distress domains moderated the EF/EA association in a general population sample of 137 Finnish birth cohort mothers with 2.5-year-old children. EF was measured with a composite of five computerized Cogstate tasks, EA with the Emotional Availability Scales, and three psychological distress domains with self-report questionnaires (depression: EPDS, anxiety: SCL-90, insomnia: AIS). Better EF was significantly associated with more positive, sensitive caregiving, but this association was no longer significant when controlling for education level. Neither individual nor cumulative distress domains moderated the EF/EA association significantly, although the observed moderation effects were in the expected direction. These findings suggest that EF should be recognized alongside socioemotional factors as variables that are associated with parental caregiving behavior during toddlerhood. Furthermore, if the non-significant moderation results are replicated, they indicate that mothers in community samples are not at great risk for psychological distress that would compromise their capacity to utilize their EF while caring for their child. Further studies are needed to confirm these findings, as well as to examine these associations among fathers and in samples that have higher levels of chronic stressors. Studies with more diverse samples in terms of distress levels and EF performance would provide further insight into early childhood parenting and its risk factors.
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Affiliation(s)
- Elisabeth Nordenswan
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Kirby Deater-Deckard
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Mira Karrasch
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Eeva-Leena Kataja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Eeva Holmberg
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Eeva Eskola
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Hetti Hakanen
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Hasse Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Department of Clinical Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Department of Clinical Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Riikka Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Turku, Turku, Finland
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Zhang L, Ssewanyana D, Martin MC, Lye S, Moran G, Abubakar A, Marfo K, Marangu J, Proulx K, Malti T. Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review. Front Public Health 2021; 9:671988. [PMID: 34336768 PMCID: PMC8322584 DOI: 10.3389/fpubh.2021.671988] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Over 250 million children in low- and middle-income countries are at risk of not achieving their fullest developmental potential due to co-occurring risks such as poor nutrition and inadequate learning opportunities. Early intervention programs integrating the aspects of nurturing care, that is, good health, adequate nutrition, safety and security, responsive caregiving, and learning opportunities, may ameliorate against the negative impact of these adverse conditions. Methods: This meta-analytic review updates the evidence base of parenting interventions comprising stimulation and responsive caregiving components on developmental outcomes for children under age 2 years in low- and middle-income countries. It also describes and assesses the moderation effects of population characteristics and implementation features on the intervention effectiveness. Studies were identified based on previous systematic reviews and an updated literature search in eight databases and the gray literature up to December 2020. A random-effect model was used to explore the pooled effect sizes accounted for by the intervention for developmental outcome of cognition, language, motor, and social-emotional capacities. Exploratory moderation analyses were also conducted. Results: Twenty-one randomized controlled trials representing over 10,400 children from 12 low- and middle-income countries and regions across three continents (Africa, Latin America, and Asia) were identified. The interventions showed overall small-to-moderate effects on children's cognitive development (ES = 0.44; 95% CI = [0.30, 0.57]); language development (ES = 0.33; 95% CI = [0.18, 0.49]); and motor skills (ES = 0.21; 95% CI = [0.10, 0.32]). The overall effect on social-emotional development was non-significant (ES = 0.17; 95% CI = [-0.01, 0.34]). Effect sizes (ES) varied significantly across the studies. Parenting programs that targeted vulnerable groups, including rural communities and caregivers with lower education levels, had more significant effects on children's development. Group sessions (vs. individual visits) and high program dose (≥12 sessions) were also associated with stronger effects on child development. Further research is needed to determine the effectiveness of the workforce and training on programmatic outcomes. Conclusion: The findings indicate that parenting interventions that encourage nurturing care are effective in improving the early development of children, especially among vulnerable populations. We discuss opportunities to strengthen the implementation of research-based parenting interventions in such contexts.
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Affiliation(s)
- Linlin Zhang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Greg Moran
- Department of Psychology, Western University, London, ON, Canada
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Tina Malti
- Centre for Child Development, Mental Health, and Policy, University of Toronto Mississauga, Mississauga, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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A O, U M, Lf B, A GC. Energy metabolism in childhood neurodevelopmental disorders. EBioMedicine 2021; 69:103474. [PMID: 34256347 PMCID: PMC8324816 DOI: 10.1016/j.ebiom.2021.103474] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/30/2021] [Accepted: 06/18/2021] [Indexed: 12/24/2022] Open
Abstract
Whereas energy function in the aging brain and their related neurodegenerative diseases has been explored in some detail, there is limited knowledge about molecular mechanisms and brain networks of energy metabolism during infancy and childhood. In this review we describe current insights on physiological brain energetics at prenatal and neonatal stages, and in childhood. We then describe the main groups of inborn errors of energy metabolism affecting the brain. Of note, scarce basic neuroscience research in this field limits the opportunity for these disorders to provide paradigms of energy utilization during neurodevelopment. Finally, we report energy metabolism disturbances in well-known non-metabolic neurodevelopmental disorders. As energy metabolism is a fundamental biological function, brain energy utilization is likely altered in most neuropediatric diseases. Precise knowledge on mechanisms of brain energy disturbance will open the possibility of metabolic modulation therapies regardless of disease etiology.
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Affiliation(s)
- Oyarzábal A
- Neurometabolic Unit and Laboratory of Synaptic Metabolism. IPR, CIBERER (ISCIII) and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Musokhranova U
- Neurometabolic Unit and Laboratory of Synaptic Metabolism. IPR, CIBERER (ISCIII) and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Barros Lf
- Center for Scientific Studies - CECs, Valdivia 5110466, Chile
| | - García-Cazorla A
- Neurometabolic Unit and Laboratory of Synaptic Metabolism. IPR, CIBERER (ISCIII) and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain.
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Bettiol A, Gelain E, Milanesio E, Asta F, Rusconi F. The first 1000 days of life: traffic-related air pollution and development of wheezing and asthma in childhood. A systematic review of birth cohort studies. Environ Health 2021; 20:46. [PMID: 33865406 PMCID: PMC8053261 DOI: 10.1186/s12940-021-00728-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/12/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND The first 1000 days of life -including pregnancy and the first 2 years after birth- represent a critical window for health interventions. This systematic review aimed to summarize the evidence on the relationship between traffic-related air pollutants exposure in the first 1000 days of life and the development of wheezing and asthma, with a particular focus on windows of exposure. METHODS Medline and Embase were searched from January 2000 to May 2020 to retrieve population-based birth-cohort studies, including registries, providing quantitative information on the association between exposure to traffic-related air pollutants during pregnancy or early life, and the risk of developing wheezing and asthma in childhood. Screening and selection of the articles were completed independently by three reviewers. The quality of studies was assessed using the Newcastle-Ottawa scale. RESULTS Out of 9681 records retrieved, 26 studies from 21 cohorts were included. The most common traffic-related air pollutant markers were particulate matter (PM) and nitric oxides (NOx). The variability in terms of pollutants, exposure assessment methods, and exposure levels chosen to present the results did not allow a meta-analysis. Exposure to PM and NOx in pregnancy (10 cohorts) was consistently associated with an increased risk of asthma development, while the association with wheezing development was unclear. The second trimester of pregnancy seemed to be particularly critical for asthma risk. As for exposure during early life (15 cohorts), most studies found a positive association between PM (7/10 studies) and NOx (11/13 studies) and the risk of asthma development, while the risk of wheezing development was controversial. The period of postnatal exposure, however, was less precisely defined and a partial overlap between the period of exposure measurement and that of outcome development was present in a consistent number of studies (14 out of 15) raising doubts on the associations found. CONCLUSIONS Traffic-related air pollution during pregnancy is associated with an increased risk of asthma development among children and adolescents. The relationship between exposure in the first two years of life and the development of wheezing and asthma needs to be confirmed in studies with more precise exposure assessment.
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Affiliation(s)
- Alessandra Bettiol
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Elena Gelain
- Coordinating Centre for Paediatric Rare Diseases, Meyer Children’s University Hospital, Florence, Italy
| | | | - Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Franca Rusconi
- Unit of Epidemiology, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
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McCarthy EK, Murray DM, Hourihane JOB, Kenny LC, Irvine AD, Kiely ME. Behavioral consequences at 5 y of neonatal iron deficiency in a low-risk maternal-infant cohort. Am J Clin Nutr 2021; 113:1032-1041. [PMID: 33515035 DOI: 10.1093/ajcn/nqaa367] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/12/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Iron is critical to the developing brain, but fetal iron accretion is compromised by several maternal and pregnancy-related factors. Little consideration has been given to the long-term neurologic consequences of neonatal iron deficiency, especially in generally healthy, low-risk populations. OBJECTIVE We aimed to investigate the association between neonatal iron deficiency and neurologic development at 2 and 5 y of age. DESIGN We measured umbilical cord serum ferritin concentrations in the prospective maternal-infant Cork BASELINE (Babies after SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints) Birth Cohort. Lifestyle and clinical data were collected from 15 weeks of gestation to 5 y of age. Standardized neurologic assessments were performed at 2 y [Bayley Scales of Infant Development/Child Behavior Checklist (CBCL)] and 5 y (Kaufman Brief Intelligence Test/CBCL). RESULTS Among 697 maternal-infant pairs, median (IQR) cord ferritin concentrations were 200.9 (139.0, 265.8) µg/L; 8% had neonatal iron deficiency (ferritin <76 µg/L). Using fully adjusted models, there was no association between neonatal iron deficiency and cognitive or behavioral outcomes at 2 or 5 y. We conducted an a priori sensitivity analysis in 306 high-risk children, selected using known risk factors for neonatal iron deficiency (smoking/obesity/cesarean section delivery/small-for-gestational age birth). In this high-risk subgroup, children with iron deficiency at birth (12%) had similar cognitive outcomes, but the behavioral assessments showed higher internalizing [9.0 (5.3, 12.0) compared with 5.0 (3.0, 10.0), P = 0.006; adjusted estimate (95% CI): 2.8 (0.5, 5.1), P = 0.015] and total [24.5 (15.3, 40.8) compared with 16.0 (10.0, 30.0), P = 0.009; adjusted estimate (95% CI): 6.6 (0.1, 13.1), P = 0.047] problem behavior scores at 5 y compared with those born iron sufficient. CONCLUSIONS We have demonstrated lasting behavioral consequences of neonatal iron deficiency in high-risk children from our generally healthy, low-risk maternal-infant cohort. Although larger investigations are warranted, this study provides strong association data to suggest that interventions and strategies targeting the fetal and neonatal period should be prioritized for the prevention of iron deficiency and associated neurologic consequences.
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Affiliation(s)
- Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,INFANT Research Centre, Cork, Ireland
| | - Deirdre M Murray
- INFANT Research Centre, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Jonathan O B Hourihane
- INFANT Research Centre, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Louise C Kenny
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Alan D Irvine
- INFANT Research Centre, Cork, Ireland.,Department of Clinical Medicine, Trinity College, Dublin, Ireland.,Department of Paediatric Dermatology, Children's Health Ireland at Crumlin, Dublin, Ireland.,National Children's Research Centre, Dublin, Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,INFANT Research Centre, Cork, Ireland
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49
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Black MM, Behrman JR, Daelmans B, Prado EL, Richter L, Tomlinson M, Trude ACB, Wertlieb D, Wuermli AJ, Yoshikawa H. The principles of Nurturing Care promote human capital and mitigate adversities from preconception through adolescence. BMJ Glob Health 2021; 6:e004436. [PMID: 33875519 PMCID: PMC8057542 DOI: 10.1136/bmjgh-2020-004436] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/17/2021] [Accepted: 03/27/2021] [Indexed: 01/31/2023] Open
Abstract
A comprehensive evidence-based framework is needed to guide policies and programmes that enable children and adolescents to accrue the human capital required to meet the Sustainable Development Goals (SDGs). This paper proposes a comprehensive, multisectoral, multilevel life-course conceptualisation of human capital development by building on the Nurturing Care Framework (NCF), originally developed for the foundational period of growth and development through the age 3 years. Nurturing care (NC) comprises stable environments that promote children's health and nutrition, protect from threats, and provide opportunities for learning and responsive, emotionally supportive and developmentally enriching relationships. NC is fostered by families, communities, services, national policies and beyond. The principles apply across the life course, endorse equity and human rights, and promote long-term human capital. This paper presents an evidence-based argument for the extension of the NCF from preconception through adolescence (0-20 years), organised into six developmental periods: preconception/prenatal, newborn/birth, infancy/toddlerhood, preschool, middle childhood and adolescence. The proposed framework advances human capital within each developmental period by promoting resilience and adaptive developmental trajectories while mitigating negative consequences of adversities.Attaining the SDGs depends on strengthening human capital formation, extending throughout childhood and adolescence and supported by NC. Embedded in enabling laws, policies and services, the dynamic NCF components can mitigate adversities, enhance resilience and promote the well-being of marginalised groups. The life-course extension of the NCF is strategically positioned to enhance human capital, to attain the SDGs and to ensure that children or adolescents are not left behind in reaching their developmental potential.
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Affiliation(s)
- Maureen M Black
- Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | - Jere R Behrman
- Department of Economics, University of Pennsylvania School of Arts and Sciences, Philadelphia, Pennsylvania, USA
- Population Studies Center, University of Pennsylvania School of Arts and Sciences, Philadelphia, Pennsylvania, USA
| | - Bernadette Daelmans
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | | | - Linda Richter
- Centre of Wxcellence in Human Development, University of the Witwatersrand, Johannesburg, Soutn Africa
| | - Mark Tomlinson
- Global Health, Stellenbosch University, Cape Town, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Angela C B Trude
- Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Donald Wertlieb
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, Massachusetts, USA
| | - Alice J Wuermli
- Global TIES for Children, New York University, New York, New York, USA
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50
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Trude ACB, Richter LM, Behrman JR, Stein AD, Menezes AMB, Black MM. Effects of responsive caregiving and learning opportunities during pre-school ages on the association of early adversities and adolescent human capital: an analysis of birth cohorts in two middle-income countries. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:37-46. [PMID: 33340466 PMCID: PMC7763480 DOI: 10.1016/s2352-4642(20)30309-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Millions of children globally are at risk of not reaching their developmental potential because of early adversities. We hypothesised that responsive caregiving and learning opportunities, components of nurturing care, at pre-school ages might mitigate the effects of adversities. METHODS We analysed longitudinal birth cohort data from Brazil (1993 Pelotas Birth Cohort, n=632) and South Africa (Birth to Twenty Plus [Bt20+] Birth Cohort, n=1130) to assess whether responsive caregiving and learning opportunities at pre-school ages (2-4 years) modified associations between cumulative early adversities and adolescent human capital. The cumulative adversities score (range 0-9) included household wealth and crowding; mothers' schooling, height, age, and mental health; and children's birthweight, gestational age, and length at age 12 months. We extracted data on responsive caregiving and learning opportunities from the Early Childhood Home Observation for Measurement of the Environment inventory, assessed at age 4 years (1993 Pelotas cohort) and 2 years (Bt20+ cohort). We examined three human capital indicators: intelligence quotient (IQ) assessed at age 18 years (1993 Pelotas cohort) and 16 years (Bt20+ cohort); psychosocial adjustment assessed at age 15 years and 14 years, respectively; and height assessed at age 18 years and 16 years, respectively. We used linear models with interaction terms between cumulative adversities, and responsive caregiving and learning opportunities, to predict adolescent human capital. FINDINGS For each additional Z score of total cumulative adversity, adolescent IQ decreased by 5·89 (95% CI -7·29 to -4·50) points in the 1993 Pelotas cohort (p<0·0001) and 2·69 (-4·52 to -0·86) points in the Bt20+ cohort (p=0·0039). After adjusting for total cumulative adversities, adolescent IQ points increased by 5·47 (95% CI 4·20 to 6·74) with each additional Z score of learning opportunities and by 2·26 (0·93 to 3·59) with each additional Z score of responsive caregiving in the 1993 Pelotas cohort, but not in the Bt20+ cohort (0·86 [-0·12 to 1·83] and 0·65 [-0·32 to 1·61], respectively). Associations between early adversities and IQ were modified by learning opportunities in the 1993 Pelotas cohort (beta coefficient for interaction 1·74, 95% CI 0·43 to 3·04; p=0·0092) and by responsive caregiving in the Bt20+ cohort (2·24, 0·94 to 3·54; p=0·0075). High nurturing environment attenuated the negative effects of early cumulative adversities on IQ. INTERPRETATION Early nurturing home environments protect young children against effects of early adversities on adolescent IQ, with long-term positive associations on adolescent cognition in two middle-income countries. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Angela C B Trude
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Jere R Behrman
- Economics Department, The Ronald O Perelman Center for Political Science and Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, GA, USA
| | - Ana M B Menezes
- Postgraduate Program of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maureen M Black
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; RTI International, Durham, NC, USA.
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