Review of the evidence linking protein and energy to mental development

Grantham‐McGregor, Sally; Baker‐Henningham, Helen

doi:10.1079/phn2005805

Cited by 117 publications

(84 citation statements)

References 64 publications

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“…85,86 A few trials of energy supplementation have also indicated improved cognitive development for undernourished children or those at high risk of malnutrition. [87][88][89] Our finding that linear growth in the first 2 years of life appears to be a stronger independent predictor of both early and later childhood cognition as compared with growth after 2 years of age also corroborates a growing body of neuroscientific research showing that exposure to environmental and biological adversity during early sensitive periods of brain development can be particularly detrimental to cognitive development. 90 We found a significantly muted cross-sectional association of HAZ with cognition for children .2 years old.…”

Section: Figuresupporting

confidence: 68%

Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis

Sudfeld

McCoy

Danaei³

et al. 2015

Pediatrics

360

313

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BACKGROUND AND OBJECTIVE: The initial years of life are critical for physical growth and broader cognitive, motor, and socioemotional development, but the magnitude of the link between these processes remains unclear. Our objective was to produce quantitative estimates of the crosssectional and prospective association of height-for-age z score (HAZ) with child development. METHODS:Observational studies conducted in low-and middle-income countries (LMICs) presenting data on the relationship of linear growth with any measure of child development among children ,12 years of age were identified from a systematic search of PubMed, Embase, and PsycINFO. Two reviewers then extracted these data by using a standardized form.RESULTS: A total of 68 published studies conducted in 29 LMICs were included in the final database. The pooled adjusted standardized mean difference in cross-sectional cognitive ability per unit increase in HAZ for children #2 years old was +0.24 (95% confidence interval [CI], 0.14-0.33; I 2 = 53%) and +0.09 for children .2 years old (95% CI, 0.05-0.12; I 2 = 78%). Prospectively, each unit increase in HAZ for children #2 years old was associated with a +0.22-SD increase in cognition at 5 to 11 years after multivariate adjustment (95% CI, 0.17-0.27; I 2 = 0%). HAZ was also significantly associated with earlier walking age and better motor scores (P , .05).CONCLUSIONS: Observational evidence suggests a robust positive association between linear growth during the first 2 years of life with cognitive and motor development. Effective interventions that reduce linear growth restriction may improve developmental outcomes; however, integration with environmental, educational, and stimulation interventions may produce larger positive effects.

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Section: Figuresupporting

confidence: 68%

Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis

Sudfeld

McCoy

Danaei³

et al. 2015

Pediatrics

360

313

View full text Add to dashboard Cite

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“…Over 40-60 % of childhood deaths from diarrhoea, pneumonia, malaria and measles in Africa have been attributed to undernutrition (4) and over 50 % of in-patient hospital admissions and deaths in Kenya were ascribed to malnutrition (5) . Early childhood stunting has been associated with long-term cognitive, motor and behavioural deficits including lower levels of intelligence, attention deficits, poor school achievement, impaired fine motor function and social skills, and low work capacity (6,7) . While previous research studies have helped to identify a number of determinants of child undernutrition in Kenya and other low-income nations (8)(9)(10) , most studies often approach the under-5s as a single group of children.…”

mentioning

confidence: 99%

Undernutrition among Kenyan children: contribution of child, maternal and household factors

Gewa

Yandell

2011

Public Health Nutr.

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Objective: To examine the contribution of selected child-, maternal-and householdrelated factors to child undernutrition across two different age groups of Kenyan under-5s. Design: Demographic and Health Survey data, multistage stratified cluster sampling methodology. Setting: Rural and urban areas of Kenya. Subjects: A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya. Results: Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children. Conclusions: The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

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“…Cross-sectional studies have linked stunting (short stature for age) and low weight-for-age to poor development and school achievement in infants and children (2) . The detrimental effects of undernutrition early in life (, 2 years of age) on intellectual development seem irreversible and remain apparent during childhood and adolescence (3,4) .…”

mentioning

confidence: 99%

Undernutrition, fatty acid and micronutrient status in relation to cognitive performance in Indian school children: a cross-sectional study

et al. 2009

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While undernutrition and anaemia have previously been linked to poor development of children, relatively little is known about the role of B-vitamins and fatty acids on cognition. The present study aims to explore the associations between indicators of body size, fatty acid and micronutrient status on cognitive performance in 598 Indian school children aged 6 -10 years. Baseline data of a clinical study were used to assess these associations by analyses of variance adjusting for age, sex, school, maternal education and cognitive tester. The Kaufman Assessment Battery for Children II was used to measure four cognitive domains, including fluid reasoning, short-term memory, retrieval ability and cognitive speediness. Scores were combined into an overall measure, named mental processing index (MPI). Body size indicators and Hb concentrations were significantly positively related to cognitive domains and MPI, such that increases of 1 SD in height-for-age and weight-for-age z-scores would each translate into a 0·09 SD increase in MPI, P¼0·0006 and 0·002, respectively. A 10 g/l increase in Hb concentrations would translate into a 0·08 SD increase in MPI, P¼ 0·0008. Log-transformed vitamin B 12 concentrations were significantly inversely associated with short-term memory, retrieval ability and MPI (b (95 % CI) ¼ 20·124 (20·224, 20·023), P¼ 0·02). Other indicators of Fe, iodine, folate and fatty acid status were not significantly related to cognition. Our findings for body size, fatty acids and micronutrients were in agreement with previous observational studies. The inverse association of vitamin B 12 with mental development was unexpected and needed further study.

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Review of the evidence linking protein and energy to mental development

Cited by 117 publications

References 64 publications

Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis

Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis

Undernutrition among Kenyan children: contribution of child, maternal and household factors

Undernutrition, fatty acid and micronutrient status in relation to cognitive performance in Indian school children: a cross-sectional study

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