Nutritional Support of Neurodevelopment and Cognitive Function in Infants and Young Children-An Update and Novel Insights

Global Levels and Variations of Cholesterol and Polar Lipids of Human Milk: A Systematic Review and Meta-analysis

Polar lipids and cholesterol are vital structural components of the milk fat globule membrane, playing a crucial role in infant growth and development; however, systematic global reports on their content in human milk are currently lacking. This study conducted a systematic literature search in Chinese and English databases, including 69,392 human milk samples from 96 studies. A random-effects model based on global data was used to assess the content of total lipids, cholesterol, gangliosides, and phospholipids in human milk and their variations with the lactation stage, geographical region, and sample year. The mean contents of total lipids, cholesterol, and total phospholipids were 2774.15 mg/100 g (95% CI: 2614.88, 2933.42 mg/100 g), 21.15 mg/100 g (18.35, 23.95 mg/100 g), and 70.72 mg/100 g (68.84, 72.60 mg/100 g), respectively, with gangliosides GM3 and GD3 at 0.63 mg/100 g (0.54, 0.72 mg/100 g) and 0.34 mg/100 g (0.32, 0.36 mg/100 g). The major phospholipids SM, PC, PE, PS, and PI averaged 24.19 mg/100 g (23.17 and 25.21 mg/100 g), 21.27 mg/100 g (19.92 and 22.62 mg/100 g), 18.28 mg/100 g (17.46 and 19.10 mg/100 g), 2.86 mg/100 g (2.32 and 3.40 mg/100 g), and 2.12 mg/100 g (1.75 and 2.49 mg/100 g). With the progression of lactation, total lipids, gangliosides, and most phospholipids (SM, PC, PS, PI) increased, while cholesterol and PE decreased. Over the years, total lipids, gangliosides, and PE showed an upward trend, whereas cholesterol and most phospholipids declined. Human milk from Europe had lower total lipid and cholesterol levels compared with other regions. While the total phospholipid content did not show significant regional differences (P > 0.05), variations in phospholipid composition were observed. These findings emphasize the importance of understanding spatiotemporal changes in human milk lipids to develop personalized nutrition strategies that support optimal infant growth and development.

The Longitudinal Relationship Between Diet Quality and Executive Functioning Development of Hispanic Preschoolers in Houston, Texas

BACKGROUND

Diet quality has been found to be related to cognitive health in school-aged children. However, this relationship remains understudied among Hispanic preschool-aged children, who are vulnerable to poor dietary habits and low cognitive development due to socioeconomic, cultural, and structural disparities.

OBJECTIVE

This longitudinal study evaluated whether the diet quality of preschool-aged children would be associated with executive functions (EFs) in later childhood.

DESIGN

This is a secondary analysis of a longitudinal study of Hispanic preschool-aged children (age 4 and 5 years) at baseline (Time 1) and 18 months (Time 2).

PARTICIPANTS AND SETTING

This study included 185 mother-child dyads with complete data at Time 1, recruited through Head Start centers in Houston, TX, beginning in 2011.

MAIN OUTCOME MEASURES

Mothers reported on their child's dietary intake via 3 24-hour recalls, which was used to calculate Healthy Eating Index (HEI)-2010 component and total scores. Laboratory tasks assessed cold EFs (tapping and Flexible Item Selection Tasks) and hot EFs (delay of gratification and gift-wrapping tasks). Whereas higher scores on tapping, Flexible Item Selection Task, and delay of gratification tasks represent a high EF, higher scores in gift-wrapping task represent a low EF.

STATISTICAL ANALYSES PERFORMED

Hierarchical linear regression analyses assessed the relationship between diet quality, as measured by HEI-2010 total and component scores, at Time 1 (independent variables) and EF outcomes (dependent variables) at Time 2, controlling for child sex, age, body mass index z score, and EF at Time 1.

RESULTS

HEI-2010 component score for fatty acids (b = -.13; P = .04) and seafood and plant proteins (b = .09; P = .05), were respectively related to later cold and hot EFs of Hispanic preschool-aged children. Other HEI components or the overall score did not predict EFs.

CONCLUSIONS

This study shows that specific HEI components support cold and hot EFs development among Hispanic preschool-aged children, but total HEI-2010 score does not. Experimental research is needed to assess the influence of dietary interventions on cognitive development of Hispanic preschool-aged children.

Habitual caffeine intake, genetics and cognitive performance

BACKGROUND

Research on caffeine and cognitive performance remains controversial. Variations in genes associated with caffeine metabolism and response such as CYP1A2, AHR and ADORA2A may account for variable findings.

AIM

To investigate caffeine × gene interactions on cognitive performance in all key domains of cognition in healthy individuals.

METHODS

Participants completed a lifestyle and food frequency questionnaire and a cognitive test battery including validated tasks to assess the domains of social cognition, memory, attention and executive function. Genotyping was performed for AHR rs6968554, CYP1A2 rs2472297, ADORA2A rs5751876, ADA rs73598374 and APOE rs429358 and rs7412.

RESULTS

Significant gene × caffeine interactions were observed for the domains of social cognition, (F2, 123 = 5.848, p = 0.004) and executive function (F2, 109 = 3.690, p = 0.028). 'Slow' metabolisers had a higher performance in social cognition compared with 'fast' metabolisers among high-caffeine consumers (p = 0.004), while 'fast' metabolisers had a higher performance in executive function compared with 'slow' metabolisers among moderate caffeine consumers (p = 0.002).

CONCLUSIONS

The present findings suggest an association between genetic caffeine metabolism, habitual caffeine intake and cognitive function in the domains of social cognition and executive function. More research in naturalistic environments using larger cohorts is needed to confirm these findings to add to our understanding of how habitual caffeine may influence cognitive function based on individual genotype.

Considering the nutritional benefits and health implications of red meat in the era of meatless initiatives

Driven by perceived health and environmental benefits, initiatives to remove red meat from recommended eating patterns are increasingly being implemented in United States institutions, including schools and hospitals. While these efforts aim to address important issues, they may inadvertently lead to unintended consequences, particularly regarding essential nutrient intake for certain populations. This perspective considers the nutritional value of red meat, examines its potential health benefits, and highlights nutritional risks when intake is reduced or eliminated. Red meat is a nutrient-dense food that provides highly bioavailable protein and several essential micronutrients often lacking in the diet, including iron, zinc, and vitamin B12. These nutrients can be limited or absent in many plant-source foods as well as in some animal-source foods. Red meat's micronutrient profile is especially valuable for young children and women of reproductive age, including pregnant women. In addition, the protein density of red meat is beneficial for individuals managing obesity and older adults at risk of sarcopenia. Many epidemiological studies suggest potential associations between excessive red meat consumption and increased risk of certain chronic diseases, but this evidence does not conclusively implicate red meat in the development or progression of chronic disease. The nutritional and health implications of reducing red meat consumption must be balanced against the low certainty of evidence used to discourage red meat intake when making dietary recommendations.

Association between birth length, linear growth velocities, and primary school achievement at age 10 years: evidence from the Ethiopian iABC birth cohort

BACKGROUND

Childhood is a period marked by dynamic growth. Evidence of the association between childhood linear growth and school achievement comes mostly from cross-sectional data. We assessed associations between birth length, childhood linear growth velocities, and stunting with school achievement.

METHODS

Newborns were recruited into the Ethiopian infant Anthropometry and Body Composition (iABC) birth cohort and followed from birth to 10 years. Velocities from 0 to 6 years were computed using linear spline mixed effect modelling. Stunting (height-for-age < -2 z-scores) was assessed at the ages of 1, 2, 4, 5, and 6 years. School achievement was measured by having a high (≥ 80%) combined high math, English, and science (MES) score and being at appropriate grade-for-age. Logistic regression models assessed associations between birth length, linear growth velocities and stunting with school achievement.

RESULTS

Children's mean age was 9.8 years (standard deviation, SD 1.0, range 7-12 years). A 1 SD greater birth length increased the odds of achieving a high MES combined score by 1.42 (95% CI: 0.99, 2.03). A 1 SD increase in linear growth velocity from 6 to 24 months increased the odds of being in the appropriate grade-for-age by 1.66 (95% CI: 1.14, 2.43). Stunting at ages 4 and 6 years was associated with lower odds of achieving a high MES combined score: 0.43 (95% CI: 0.20, 0.93) and 0.31 (95% CI: 0.11, 0.89), respectively. Faster post-natal linear growth was not associated with school achievement.

CONCLUSION

Greater birth length and higher growth velocity from 6 to 24 months were associated with higher school achievement and being in the appropriate grade-for-age, respectively. Children who experienced growth failure were less likely to achieve a high MES score. Interventions aimed at improving school achievement should address maternal and fetal nutrition and health, and monitor post-natal growth.

Characteristics of gut microbiota of premature infants in the early postnatal period and their relationship with intraventricular hemorrhage

BACKGROUND

Studies have shown correlations between gut microbiota and neurocognitive function, but little was known about the early postnatal gut microbiota and intraventricular hemorrhage (IVH). We aimed to explore the characteristics of gut microbiota in premature infants and their relationship with IVH, further exploring potential therapeutic targets.

METHODS

Premature infants delivered at Peking University First Hospital from February 2023 to August 2023 were recruited as a cohort. Feces samples were collected on postnatal days 1, 3, and 5. Premature infants were divided into normal, mild IVH, and severe IVH groups based on cranial ultrasound. 16S rRNA amplicon sequencing technology was used to determine the fecal microbiota, and the results were analyzed.

RESULTS

Thirty-eight premature infants were enrolled. There was a significant difference in alpha and beta diversity among the three groups. The relative abundance of E. coli and A. muciniphila was different among the three groups. Further random forest analysis indicated that S. lutetiensis, L. mirabilis, and N. macacae can effectively distinguish premature infants with IVH. Finally, the phylogenetic investigation of communities by reconstruction of unobserved states2 (PICRUSt2) functional gene analysis predicted significant differences in energy metabolism, carbohydrate metabolism, metabolism of cofactors and vitamins, and membrane transport between normal and severe IVH groups.

CONCLUSIONS

The gut microbiota in the early postnatal period of premature infants is closely associated with the IVH status. As age increases, the differences in gut microbiota of premature infants with different degrees of IVH continue to increase, and the trend of changes with severity of IVH becomes more and more obvious. E. coli, A. muciniphila, S. lutetiensis, L. mirabilis, N. macacae, G. haemolysans, and S. oralis can effectively distinguish between IVH infants and normal premature infants. The results indicate that gut microbiota is expected to provide effective therapeutic targets for the diagnosis and treatment of IVH.

Protecting optimal childhood growth: systematic nutritional screening, assessment, and intervention for children at risk of malnutrition in the Kingdom of Saudi Arabia

Background

In 2024, the Kingdom of Saudi Arabia Advisory Board on Pediatric Nutrition (KSA-ABPN) reviewed childhood undernutrition in the Middle East. We sought to foster efficient nutritional care for infants and children at nutritional risk. Severe malnutrition due to starvation is rare in Saudi Arabia, so we focused on early recognition and treatment of children with mild growth impairment that forewarns risk for further nutritional decline. This paper summarizes our findings and introduces a recommended guide for nutritional screening, assessment, and follow-up interventions.

Objective

The KSA-ABPN aimed to build an algorithm with pathways and tools to facilitate up-to-date nutrition-care practices for infants and children. The algorithm is intended to encourage consistent professional training-for and use-of validated tools, adoption of standardized thresholds for intervention, and delivery of nutritional support. Consistent care will increase opportunities for comparative analyses of various treatment strategies and their health and cost outcomes.

Recommendations

We developed a 4-stage algorithm for identifying and caring for children at nutritional risk: (i) screening for clinical risk factors and age-related growth measures, (ii) observation of malnutrition-related physical signs, diet history, and/or laboratory detection of evidence indicating specific nutrient deficiencies, (iii) assessment of the severity of nutritional deficit, and (iv) development of a patient-specific Nutrition Care Plan that includes diet counseling, supplementation, routine monitoring, and follow-up.

Conclusions

By helping professionals identify nutritional risk and specific nutritional deficits in infants and children early in the clinical course, we seek to expand quality nutritional care and ensure that children grow and develop fully.

A randomized controlled trial protocol for the introduction of a multidisciplinary individualized nutritional intervention in children with cerebral palsy

Introduction

Children with Cerebral Palsy (CP) encounter substantial nutritional challenges that impair their health and quality of life. Despite the importance of nutrition in managing CP and the recognition of physiological, behavioral, and social causes of malnutrition, research on the effectiveness of individualized nutritional interventions developed and supported by multidisciplinary teams is scarce.

Aim

The study will evaluate the impact of an individualized nutritional intervention developed and supported by a multidisciplinary team on the anthropometric outcomes and overall health of children with CP.

Methods

A single-center, randomized controlled trial, conducted at the Medical University of Varna, Bulgaria, will enroll 100 children aged 2-12 years and diagnosed with CP. Participants will be randomly assigned to either an intervention group, receiving comprehensive structured dietary assessment and individualized nutrition plan developed by a multidisciplinary team of experts, or to a standard care group. Outcomes assessed will focus on anthropometric measures of nutritional status, but also include health outcomes, child development and clinical assessments, and quality of life indicators.

Ethics

Ethical approval for this study has been obtained from the Medical Ethics Committee at the Medical University of Varna (Protocol No. 134 dated 20.07.2023).

Conclusion

This study will assess the benefits of a multidisciplinary, individualized nutritional intervention for children with CP. The findings will have implications for clinical guidelines and interventions aiming to improve their care and quality of life.

The influence of multivitamins on neurological and growth disorders: a cross-sectional study

Background

While vitamin deficiencies can pose serious health consequences for the body, excessive intake of vitamins can also lead to health risks. However, there is limited data about the impact of multivitamins on neurological and growth disorders. This study aimed to investigate the relationship between multivitamins and neurological and growth disorders.

Methods

A cross-sectional study was conducted with 16,921 subjects who visited the Children's Hospital of Nanjing Medical University from 2019 to 2021. The subjects were categorized into two groups based on their health status including 9,368 cases (4,484 with neurological disorders and 4,884 with growth disorders) and 7,553 healthy controls. Statistical tests including the T-test, Wilcoxon Rank Sum test, and Chi-Square test were employed to compare the groups, and logistic regression and Weighted Quantile Sum (WQS) regression were used to identify associations.

Results

In the adjusted logistic regression, serum 25 hydroxyvitamin D [25(OH)D], vitamin B2, and vitamin B9 were associated with decreasing risks of neurological disorders, whereas vitamin A, vitamin B1, and vitamin B12 were associated with increasing risks of neurological disorders. Nevertheless, vitamin A and vitamin B2 were associated with increasing risks of growth disorders. In the WQS model, nine multivitamins were positively associated with risks of neurological disorders, and Vitamins D and C were weighted the most. In addition, the inverse association but not statistically significant was observed between multivitamins and growth disorders, particularly growth retardation revealed a negative association, and some individual growth disorders revealed positive associations including obesity and malnutrition.

Conclusion

In general, the study observed that multivitamins may be associated with neurological and growth disorders either positive or negative depending on the type of disorder.

Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort

A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city. We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education. Six dietary patterns were identified in PCA analyses. "low consumption of calorie-dense foods" dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and "Nuts" dietary pattern showed a negative (protective) association with impulsivity index( β 1 = -24.60, 95% CI = -36.80, -12.41, p value < 0.001). Overall, our main results suggest that healthy dietary patterns, including higher intakes of "nuts" and a preference of "low consumption of calorie-dense foods" dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.

Negative Aspects of Dietary Habits in Children and Adolescents with Autism Spectrum Disorders

BACKGROUND/OBJECTIVES

Diet therapy is a key component of a holistic approach to the physiological and psychological health of children with autism spectrum disorders. A personalized diet, tailored to clinical symptoms, yields positive therapeutic effects. The aim of this study was to assess the intake of specific food groups and the dietary methods used among children and adolescents with autism.

METHODS

This study included 141 patients from neuropediatric centers diagnosed with autism spectrum disorders. Inclusion criteria were parental consent for the study, age of the child, and autism diagnosis. The research tool was a custom questionnaire covering patients' demographic data, type of disorder, and a qualitative analysis of the dietary habits of selected products.

RESULTS

The predominant dietary models were the basic diet (n = 26; 72.22%) and the elimination diet (n = 9; 25%), with a higher application rate among children with autism spectrum disorders. Aversion to specific foods/products was more prevalent in children with autism (n = 79; 75.24%) compared to those with other neurodevelopmental disorders (n = 10; 27.78%). Snacking between meals was significantly more common among the overall neuropediatric patient group (n = 140; 99.29%), with fruit purees (n = 33; 23.57%) and fruits (n = 28; 20%) being the most frequently consumed snacks.

CONCLUSIONS

The qualitative analysis of dietary habits revealed selective food aversions and eating disorders due to a narrow range of frequently consumed products within dietary groups.

Association of prenatal multiple metal exposures with child neurodevelopment at 3 years of age: A prospective birth cohort study

Prenatal exposures to toxic metals and trace elements have been linked to childhood neurodevelopment. However, existing evidence remains inconclusive, and further research is needed to investigate the mixture effects of multiple metal exposures on childhood neurodevelopment. We aimed to examine the associations between prenatal exposure to specific metals and metal mixtures and neurodevelopment in children. In this prospective cohort study, we used the multivariable linear regressions and the robust modified Poisson regressions to explore the associations of prenatal exposure to 25 specific metals with neurodevelopment among children at 3 years of age in 854 mother-child pairs from the Jiangsu Birth Cohort (JBC) Study. The Bayesian kernel machine regression (BKMR) was employed to assess the joint effects of multiple metals on neurodevelopment. Prenatal manganese (Mn) exposure was negatively associated with the risk of non-optimal cognition development of children, while vanadium (V), copper (Cu), zinc (Zn), antimony (Sb), cerium (Ce) and uranium (U) exposures were positively associated with the risk of non-optimal gross motor development. BKMR identified an interaction effect between Sb and Ce on non-optimal gross motor development. Additionally, an element risk score (ERS), representing the mixture effect of multiple metal exposures including V, Cu, Zn, Sb, Ce and U was constructed based on weights from a Poisson regression model. Children with ERS in the highest tertile had higher probability of non-optimal gross motor development (RR = 2.37, 95 % CI: 1.15, 4.86) versus those at the lowest tertile. Notably, Sb [conditional-posterior inclusion probabilities (cPIP) = 0.511] and U (cPIP = 0.386) mainly contributed to the increased risk of non-optimal gross motor development. The findings highlight the importance of paying attention to the joint effects of multiple metals on children's neurodevelopment. The ERS score may serve as an indicator of comprehensive metal exposure risk for children's neurodevelopment.

Brain reserve and physical disability in secondary progressive multiple sclerosis

Background

The brain reserve hypothesis posits that larger maximal lifetime brain growth (MLBG) may confer protection against physical disability in multiple sclerosis (MS). Larger MLBG as a proxy for brain reserve, has been associated with reduced progression of physical disability in patients with early MS; however, it is unknown whether this association remains once in the secondary progressive phase of MS (SPMS). Our aim was to assess whether larger MLBG is associated with decreased physical disability progression in SPMS.

Methods

We conducted a post hoc analysis of participants in the MS-Secondary Progressive Multi-Arm Randomisation Trial (NCT01910259), a multicentre randomised placebo-controlled trial of the neuroprotective potential of three agents in SPMS. Physical disability was measured by Expanded Disability Status Scale (EDSS), 9-hole peg test (9HPT) and 25-foot timed walk test (T25FW) at baseline, 48 and 96 weeks. MLBG was estimated by baseline intracranial volume (ICV). Multivariable time-varying Cox regression models were used to investigate the association between MLBG and physical disability progression.

Results

383 participants (mean age 54.5 years, 298 female) were followed up over 96 weeks. Median baseline EDSS was 6.0 (range 4.0-6.5). Adjusted for covariates, larger MLBG was associated with a reduced risk of EDSS progression (HR 0.84,95% CI:0.72 to 0.99;p=0.04). MLBG was not independently associated with time to progression as measured by 9HPT or T25FW.

Conclusion

Larger MLBG is independently associated with physical disability progression over 96 weeks as measured by EDSS in SPMS. This suggests that MLBG as a proxy for brain reserve may continue to confer protection against disability when in the secondary progression phase of MS.

Trail registration number

NCT01910259.

The Influence of Nutritional Status on Brain Development: Benefits of Exclusive Breastfeeding

BACKGROUND

This study aimed to conduct a narrative review approaching the effects of exclusive breastfeeding on neuropsychomotor development. The goal was to provide evidence-based knowledge to inform healthcare practices and policies and promote optimized infant feeding strategies.

METHODS

Our study reviewed the relevant literature from May and June 2024, covering the publication period between 2013 and 2024. The PubMed database was utilized and searched for articles using keywords such as "Brain", "Growth", "Development", and "Breastfeeding", employing Boolean operators such as "AND", "OR", and "NOT."

RESULTS

Our search initially screened 15,412 studies, resulting in 600 articles. Eleven studies met our inclusion criteria and provided relevant information on the topic. Several studies have shown that exclusive breastfeeding and its duration are beneficial for neural development. Research suggests that breastfeeding improves brain architecture, white matter development, and cognitive performance. Additionally, studies indicate that the mother's intake of omega-3 fatty acids can enhance infant brain development, and specific micronutrients in breast milk, such as myo-inositol, may contribute to neural connectivity. Some findings also suggest that the child's sex may play a role in how breast milk benefits the brain. Furthermore, there is evidence of the strong influence of epigenetic compounds on the neurodevelopmental benefits of exclusive breastfeeding.

CONCLUSIONS

This narrative review revealed findings that indicate breast milk has a positive impact on brain development. This emphasizes that breast milk has a positive impact on brain development. It underscores the importance of conducting additional research to understand how breastfeeding specifically influences neurodevelopment.

Correlation between maternal and infant vitamin B12 levels in severe malnutrition in infants under 6 months

BACKGROUND

Malnutrition poses a significant global health challenge, affecting various age groups, with infants under 6 months being particularly vulnerable. Vitamin B12, an essential micronutrient critical for neurological development, has been identified as a key player in the overall health of both mothers and infants.

AIM

To find the correlation between serum vitamin B12 levels in infants, 1-6 months of age with severe malnutrition and maternal levels at tertiary care hospitals in western Rajasthan.

METHODS

The cross-sectional study was conducted in the UNICEF Regional Center of Excellence-supported Nutrition Rehabilitation Center in Rajasthan, India, through simple random sampling. One hundred ten infants with their mothers were enrolled after consent and approval from the Institutional Ethics Committee.

RESULTS

Severe malnutrition predominantly affected infants aged 1-2 months, with 77% born small for gestational age and 66.4% belonging to the multiple birth order group. Serum vitamin B12 levels showed a significant positive correlation between mothers and infants (p < 0.001), while exclusive breastfeeding correlated positively with age-appropriate milestones (p = 0.033).

CONCLUSION

The findings emphasize the importance of targeted interventions addressing maternal and infant nutrition, with a focus on ensuring adequate vitamin B12 levels.

Impact of varying maternal dietary folate intake on cerebellar cortex histomorphology and cell density in offspring rats

The cerebellum has a long, protracted developmental period that spans from the embryonic to postnatal periods; as a result, it is more sensitive to intrauterine and postnatal insults like nutritional deficiencies. Folate is crucial for foetal and early postnatal brain development; however, its effects on cerebellar growth and development are unknown. The aim of this study was to examine the effects of maternal folate intake on the histomorphology and cell density of the developing cerebellum. Twelve adult female rats (rattus norvegicus) were randomly assigned to one of four premixed diet groups: standard (2 mg/kg), folate-deficient (0 mg/kg), folate-supplemented (8 mg/kg) or folate supra-supplemented (40 mg/kg). The rats started their diets 14 days before mating and consumed them throughout pregnancy and lactation. On postnatal days 1, 7, 21 and 35, five pups from each group were sacrificed, and their brains were processed for light microscopic analysis. Histomorphology and cell density of the external granule, molecular, Purkinje and internal granule layers were obtained. The folate-deficient diet group had smaller, dysmorphic cells and significantly lower densities of external granule, molecular, Purkinje and internal granule cells. Although the folate-enriched groups had greater cell densities than the controls, the folate-supplemented group had considerably higher cell densities than the supra-supplemented group. The folate supra-supplemented group had ectopic Purkinje cells in the internal granule cell layer. These findings imply that a folate-deficient diet impairs cellular growth and reduces cell density in the cerebellar cortex. On the other hand, folate supplementation increases cell densities, but there appears to be an optimal dose of supplementation since excessive folate levels may be detrimental.

Relationship of nutritional behaviors and parent-child interactions with developmental domains of Iranian toddlers: a cross-sectional study

BACKGROUND

Health service providers closely monitor the developmental state of toddlers to identify the factors affecting this process because any defect during this period will cause irreversible damage. Therefore, this study investigated the relationship of nutritional behaviors and parent-child interactions with the developmental domains of Iranian toddlers.

METHODS

This cross-sectional, descriptive-analytical study was conducted on 341 toddlers aged 12-36 months covered by comprehensive health centers in the south of Tehran in 2021-2022. The participants were selected through single-stage cluster sampling. To this end, 16 comprehensive health centers were randomly selected, and then some of the clients from each center were randomly selected as the sample. The required data were collected through the Ages and Stages Questionnaire (ASQ), the Children's Eating Behavior Questionnaire (CEBQ), the Child-Parent Relationship Scale (CPRS), and a demographics form. They were then analyzed statistically using descriptive and inferential statistics in SPSS-21, considering a significance level of p < 0.05.

RESULTS

The results showed that most participants were normal in all developmental domains (communication, gross motor, fine motor, personal-social, and problem-solving), with a mean developmental delay ranging from 1.8 to 7%. The most serious problem of participants requiring medical referral was related to gross motor (7%) with a mean of 54.35 ± 7.28 followed by communication (6.5%) with a mean of 49.41 ± 9.67. The mean nutritional behavior of participants was 77.9 ± 21.7. A significant relationship was found between the nutritional behaviors of participants and the problem-solving domain of development (p = 0.018). The results also indicated a mean parent-child interaction score of 94.26 ± 12.63. There was a significant relationship between parent-child interactions and the communication area of development (p = 0.04).

CONCLUSION

Since some areas of toddler development are influenced by children's nutritional behavior and parent-child interactions, it is necessary to train families to identify, monitor, and correct the factors affecting the development of their children. Health system officials and planners are also recommended to develop interventions to improve the nutritional behaviors of children and parent-child interactions.

Proteomic Profiling Reveals Age-Related Changes in Transporter Proteins in the Human Blood-Brain Barrier

The Blood-Brain Barrier (BBB) is a crucial, selective barrier that regulates the entry of molecules including nutrients, environmental toxins, and therapeutic medications into the brain. This function relies heavily on brain endothelial cell proteins, particularly transporters and tight junction proteins. The BBB continues to develop postnatally, adapting its selective barrier function across different developmental phases, and alters with aging and disease. Here we present a global proteomics analysis focused on the ontogeny and aging of proteins in human brain microvessels (BMVs), predominantly composed of brain endothelial cells. Our proteomic profiling quantified 6,223 proteins and revealed possible age-related alteration in BBB permeability due to basement membrane component changes through the early developmental stage and age-dependent changes in transporter expression. Notable changes in expression levels were observed with development and age in nutrient transporters and transporters that play critical roles in drug disposition. This research 1) provides important information on the mechanisms that drive changes in the metabolic content of the brain with age and 2) enables the creation of physiologically based pharmacokinetic models for CNS drug distribution across different life stages.

Lipid analysis of breast milk and formula for preterm infants and the application and prospects of novel structural lipids - a comprehensive review

Preterm infants, often characterized by lower birth weights and underdeveloped physiologies, necessitate specialized nutritional care. While breast milk stands as the ideal nutritional source, offering substantial energy through its fatty acid content to support the infants' growth and developmental needs, its usage might not always be feasible. Fatty acids in breast milk are critical for the development of these infants. In scenarios where breast milk is not an option, formula feeding becomes a necessary alternative. Thus, a comprehensive understanding of the fatty acid profiles in both breast milk and formulas is crucial for addressing the distinct nutritional requirements of preterm infants. This paper aims to summarize the effects of lipid composition, structure, and positioning in breast milk and formula on the growth and development of preterm infants. Furthermore, it explores recent advancements in the use of novel structural lipids in formulas, laying the groundwork for future innovations in formula design specifically catered to the needs of preterm infants.

The contribution of milk substitutes to the nutritional status of children with cow's milk allergy

BACKGROUND

The impact of alternative milk substitutes on the nutritional status of children with cow's milk allergy (CMA), the prevailing cause of food allergies, is unresolved.

METHODS

A cross-sectional study was performed in children older than 2 years with IgE-mediated CMA. Patients' clinical characteristics, anthropometric measurements, dietary intake (by 3-day food diary), and biochemical markers of nutritional status were assessed.

RESULTS

One hundred two children with CMA (68.6% boys; median age, 3.7 years; 51% multiple food allergies) were evaluated. 44.1% of the children consumed plant-based beverages (PBB), 19.6% therapeutic formula and 36.3% did not consume any milk substitutes. In all age groups, dietary calcium, riboflavin, and vitamin D intake of those who did not use milk substitutes were lower than those who consumed formula or PBB (p < .01). Also in the 2-3 years old age group, dietary zinc (p = .011) and iron intake (p = .004) of the formula-fed group was higher. Formula-fed patients had higher levels of 25-OH vitamin D (μg/L) and serum vitamin B12 (ng/L) than PBB-fed patients (respectively; p < .001, p = .005) and those who did not consume any milk substitute (p < .001). Patients of all ages who did not utilize a milk substitute failed to obtain an adequate amount of dietary calcium.

CONCLUSION

The use of milk substitutes positively affects dietary calcium, riboflavin, and vitamin D intake in CMA, but their contribution is variable. Those who do not use milk substitutes are at greater risk inadequate of dietary calcium intake. Personalized nutritional advice, given the clinical diversity and the impact of individual differences, is required.

Milk fat globule membrane and its polar lipids: reviewing preclinical and clinical trials on cognition

In most parts of the world, life expectancy is increasing thanks to improved healthcare, public health policies, nutrition, and treatment. This increase in lifespan is often not accompanied by an increase in health span, which severely affects people as they age. One notable consequence of this is the increasing prevalence of neurodegenerative diseases such as mild cognitive impairment, dementia, and Alzheimer's disease. Therefore, dietary and pharmaceutical measures must be taken to reduce the burden of such pathologies. Among the different types of nutrients found in the diet, lipids and especially polar lipids are very important for cognition due to their abundance in the brain. Amid the most studied sources of polar lipids, milk fat globule membrane (MFGM) stands out as it is abundant in industrial by-products such as buttermilk. In this narrative review, we discuss the latest, i.e. less than five years old, scientific evidence on the use of MFGM and its polar lipids in cognitive neurodevelopment in early life and their potential effect in preventing neurodegeneration in old age. We conclude that MFGM is an interesting, abundant and exploitable source of relatively inexpensive bioactive molecules that could be properly formulated and utilized in the areas of neurodevelopment and cognitive decline. Sufficiently large randomized controlled trials are required before health-related statements can be made. However, research in this area is progressing rapidly and the evidence gathered points to biological, health-promoting effects.

Pregestational fructose-induced metabolic syndrome in Wistar rats causes sexually dimorphic behavioral changes in their offspring

Metabolic syndrome (MetS), marked by enduring metabolic inflammation, has detrimental effects on cognitive performance and brain structure, influencing behavior. This study aimed to investigate whether maternal MetS could negatively impact the neurodevelopment and metabolism of offspring. To test this hypothesis, 2 months old female Wistar rats were subjected to a 10-week regimen of tap water alone or supplemented with 20% fructose to induce MetS. Dams were mated with healthy males to generate litters: OC (offspring from control dams) and OMetS (offspring from dams with MetS). To isolate prenatal effects, all pups were breastfed by control nurse dams, maintaining a standard diet and water ad libitum until weaning. Behavioral assessments were conducted between postnatal days (PN) 22 and 95, and metabolic parameters were analyzed post-sacrifice on PN100. Results from the elevated plus maze, the open field, and the marble burying tests revealed a heightened anxiety-like phenotype in OMetS females. The novel object recognition test showed that exclusively OMetS males had long-term memory impairment. In the reciprocal social interaction test, OMetS displayed a lower number of social interactions, with a notable increase in "socially inactive" behavior observed exclusively in females. Additionally, in the three-chamber test, social preference and social novelty indexes were found to be lower solely among OMetS females. An increase in visceral fat concomitantly with hypertriglyceridemia was the relevant postmortem metabolic finding in OMetS females. In summary, maternal MetS leads to enduring damage and adverse effects on offspring neurobehavior and metabolism, with notable sexual dimorphism.

A Systematic Review over the Effect of Early Infant Diet on Neurodevelopment: Insights from Neuroimaging

The optimization of infant neuronal development through nutrition is an increasingly studied area. While human milk consumption during infancy is thought to give a slight cognitive advantage throughout early childhood in comparison to commercial formula, the biological underpinnings of this process are less well-known and debated in the literature. This systematic review seeks to quantitatively analyze whether early diet affects infant neurodevelopment as measured by various neuroimaging modalities and techniques. Results presented suggest that human milk does have a slight positive impact on the structural development of the infant brain-and that this impact is larger in preterm infants. Other diets with distinct macronutrient compositions were also considered, although these had more conflicting results.

Impact of a structured sleep education program on mothers' knowledge and attitudes toward infant sleeping

Introduction

Sleeping is necessary for the infant growth and development. Sufficient and quality of sleep can have an impact on physical, cognitive, and emotional functioning. Infancy is a critical time for establishing healthy habits and routines. However, many infants were suffering from sleeping issues that impact their health.

Objectives

This study aims to evaluate the effect of educational programs given to mothers regarding their infants' sleep on mothers' knowledge and attitudes toward infant's sleeping.

Method

A quasi-experimental design for nonequivalent groups was used, and data was collected from 208 mothers with infants aged 5-12 months from all Jordanian governorates who had not been exposed to educational programs prior to this study. Data was collected in two stages: pre-test and post-test, with two weeks in between for both groups.

Results

The final results indicated that the educational intervention had a significant impact on mothers' knowledge over time. It was found that mothers in the intervention group had significantly higher mean of infant sleep health knowledge at follow up time compared to their baseline time (B = 0.236, P 0.001). Also, the yielded analysis showed that there was no significant change in mothers' mean attitudes toward infants sleeping over time (P = 0.011). The mothers' measured sleep health knowledge correlated positively and significantly statistically with their sleep health attitudes score (r = 0.436, P 0.010).

Association between breakfast patterns and executive function among adolescents in Shanghai, China

Introduction

The aim of this cross-sectional study was to investigate the association between breakfast patterns and executive function among adolescents in Shanghai, China.

Methods

In 2022, we randomly recruited 3,012 adolescents aged 12-13 years from all administrative districts in Shanghai. Breakfast information was collected by parents using a one-day recall method. Executive function was measured using the Behavior Rating Inventory of Executive Function-Parent Version. Latent Class Analysis was performed to identify breakfast patterns based on the food groups in the Diet Quality Questionnaire for China.

Results

Breakfast patterns were classified into three categories: "Egg and milk foods", "Grain foods", and "Abundant foods", except for adolescents who skipped breakfast. Logistic regression was used to estimate the multivariate odds ratio (ORs) and 95% confidence intervals (95% CI) for the association between breakfast patterns and potential executive dysfunction. Adolescents in the "Abundant foods" class had a lower risk of executive dysfunction in terms of initiate (OR: 0.36; 95% CI: 0.17-0.76), and organization of materials (OR: 0.18; 95% CI: 0.04-0.94), compared to those who skipped breakfast. Similarly, the breakfast patterns of "Grain foods" and "Egg and milk foods" were associated with a lower risk of executive dysfunction, including initiate and working memory.

Discussion

Our findings suggest that breakfast patterns were associated with executive function. The improvement of breakfast patterns among adolescents should be a significant public health intervention.

Association between Prenatal Dietary Toxicants and Infant Neurodevelopment: The Role of Fish

More research is needed to understand how the maternal consumption of fish and fish-borne toxicants impacts infant neurodevelopment. The present analysis was conducted over 460 mother-infant pairs within the ECLIPSES study. Dietary intake of metals and persistent organic pollutants from fish (including white fish, blue fish, and seafood) was estimated in pregnant women. The infants underwent cognitive, language, and motor function assessments using the Bayley Scales of Infant Development-III at the 40-day postpartum. Associations between dietary toxicants and outcomes were assessed using multivariable linear regression models. Estimated prenatal exposure to fish-borne toxicants, such as arsenic, inorganic arsenic, methylmercury, dioxin-like polychlorinated biphenyls (DL-PCBs), and non-DL-PCBs, was associated with poorer language functions in infants, whereas no significant associations were found with motor or cognitive functions. Maternal fish consumption exceeding the Spanish recommendation of no more than 71 g per day was linked to these adverse effects on language abilities without affecting motor or cognitive development. This highlights the importance of vigilant monitoring of environmental toxicants and the provision of dietary guidance for pregnant women, with potential implications for public health and child development.

Nutrient-epigenome interactions: Implications for personalized nutrition against aging-associated diseases

Aging is a multifaceted process involving genetic and environmental interactions often resulting in epigenetic changes, potentially leading to aging-related diseases. Various strategies, like dietary interventions and calorie restrictions, have been employed to modify these epigenetic landscapes. A burgeoning field of interest focuses on the role of microbiota in human health, emphasizing system biology and computational approaches. These methods help decipher the intricate interplay between diet and gut microbiota, facilitating the creation of personalized nutrition strategies. In this review, we analysed the mechanisms related to nutritional interventions while highlighting the influence of dietary strategies, like calorie restriction and intermittent fasting, on microbial composition and function. We explore how gut microbiota affects the efficacy of interventions using tools like multi-omics data integration, network analysis, and machine learning. These tools enable us to pinpoint critical regulatory elements and generate individualized models for dietary responses. Lastly, we emphasize the need for a deeper comprehension of nutrient-epigenome interactions and the potential of personalized nutrition informed by individual genetic and epigenetic profiles. As knowledge and technology advance, dietary epigenetics stands on the cusp of reshaping our strategy against aging and related diseases.

Exploration of the impact of dysbiosis in the gut microbiota on microbial composition in children's neurodevelopment

OBJECTIVE

To investigate the impact of gut microbiota dysbiosis on neurodevelopment in children.

METHODS

This study included 338 children aged 0-3 years admitted to our hospital from January to December 2022, The children were divided into a normal neurodevelopment group (169 cases) and a poor neurodevelopment group (169 cases). Basic personal information and clinical data were collected through a detailed questionnaire, and the microbial composition in fecal samples was analyzed using 16S rRNA gene sequencing.

RESULTS

Children in the poor neurodevelopment group showed a significant decrease in gut microbiota diversity compared to those in the normal neurodevelopment group (Shannon index, p < 0.05). The abundance of Bifidobacterium and Veillonella genera significantly decreased (p < 0.05), while the abundance of Streptococcus genus increased significantly (p < 0.05).

CONCLUSION

There is an association between gut microbiota dysbiosis and poor neurodevelopment in children. The increased abundance of Streptococcus genus and decreased abundance of Bifidobacterium and Veillonella genera in the gut microbiota may be potential risk factors for poor neurodevelopment in preterm infants. Future research should further explore the potential beneficial effects of gut microbiota modulation on neurodevelopment in children.

Nutritional Quality Implications: Exploring the Impact of a Fatty Acid-Rich Diet on Central Nervous System Development

Given the comprehensive examination of the role of fatty acid-rich diets in central nervous system development in children, this study bridges significant gaps in the understanding of dietary effects on neurodevelopment. It delves into the essential functions of fatty acids in neurodevelopment, including their contributions to neuronal membrane formation, neuroinflammatory modulation, neurogenesis, and synaptic plasticity. Despite the acknowledged importance of these nutrients, this review reveals a lack of comprehensive synthesis in current research, particularly regarding the broader spectrum of fatty acids and their optimal levels throughout childhood. By consolidating the existing knowledge and highlighting critical research gaps, such as the effects of fatty acid metabolism on neurodevelopmental disorders and the need for age-specific dietary guidelines, this study sets a foundation for future studies. This underscores the potential of nutritional strategies to significantly influence neurodevelopmental trajectories, advocating an enriched academic and clinical understanding that can inform dietary recommendations and interventions aimed at optimizing neurological health from infancy.

A review of dairy food intake for improving health among black infants, toddlers, and young children in the US

Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.

Unfavorable nutrient intakes in children up to school entry age: results from the nationwide German KiESEL study

Background

Nutrition in the first years of life is a cornerstone for child development and long-term health, yet there is a lack of current data on energy and nutrient intake among toddlers and preschoolers in Germany.

Objective

To analyze energy and nutrient intake in toddlers (1- to 2-year-olds) and preschoolers (3- to 5-year-olds) in Germany and compare the results with the Dietary Reference Values (DRVs) by the European Food Safety Authority.

Design

Dietary intake was assessed by weighed food record data (3 + 1 day) of 890 children from the representative cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL), carried out in 2014-2017 as a module of the German Health Interview and Examination Survey for Children and Adolescents Wave 2. For the calculation of energy and nutrient intake, the German Nutrient Database BLS 3.02, LEBTAB, and a supplement database were used.

Results

Median intakes of energy and most nutrients met or exceeded the DRVs in both toddlers and preschoolers. However, low intakes relative to DRVs were found for vitamin D (6-9% of DRV, including supplements) and iodine (57-65% of DRV). Age specific downward deviations were observed for iron intake in toddlers (75% of DRV) and for calcium intake in preschoolers (67-77% of DRV). In contrast, intakes were high for saturated fatty acids (SFA) (14-16 E%), mono-/disaccharides (60-87 g/day), and protein [2.1-2.6 g/(kg body weight*day)].

Conclusion

Nutrient imbalances in toddlers and preschoolers in Germany, which are partly age-related, give rise to concern. Research is needed to determine if routine vitamin D supplementation should be extended beyond infancy. Public health efforts to increase the rate of use of iodized salt and to reduce the intake of SFA and mono-/disaccharides in children's diets are to be strengthened.

Treadmill Exercise Reverses the Adverse Effects of Intermittent Fasting on Behavior and Cortical Spreading Depression in Young Rats

Intermittent fasting (IF) and physical exercise (PE) have beneficial psychological and physiological effects, improving memory and anxiety-like behavior. However, the impact of this combination on brain electrophysiological patterns is unknown. We aimed to evaluate the behavior and parameters of a brain excitability-related phenomenon named cortical spreading depression (CSD) in young rats (31-87 days of life) submitted to IF and treadmill PE for eight weeks. Sixty-four male and female Wistar rats aged 24 days were randomized into control, IF, PE, and IF+PE groups. Behavioral tests (open field (OF), object recognition, and elevated plus maze (EPM)) were performed, and the CSD propagation features were recorded. IF caused behavioral responses indicative of anxiety (lower number of entries and time spent in the OF center and EPM open arms). IF also reduced the discrimination index for object recognition memory tests and increased the propagation velocity of CSD. PE rats displayed more entries into the OF center and lowered CSD propagation speed. Data suggest that IF worsens anxiety-like behavior and memory and accelerates CSD in young rats. In contrast, PE reverted the unfavorable effects of IF. The brain effects of IF and PE at younger ages are recommended for study.

The Attitudes of 7-9 Year Old Primary School Students towards Food and Nutrition: Insights from Qualitative FGI Research-The Junior-Edu-Żywienie (JEŻ) Project

Optimal nutrition is one of the most significant environmental factors affecting human health. The aim of this study was to assess the attitudes of primary school students aged 7-9 towards nutrition considering three fundamental components: knowledge, emotional disposition, and dietary behaviors. The research was conducted using the Focus Group Interview (FGI) technique among 78 children. Considering their attitudes towards food and nutrition, four profiles were identified: "engaged", "obedient", "reluctant", and "indifferent". Children who were "engaged" and "obedient" due to their parents' involvement in creating their dietary attitudes exhibited the most alignment with the principles of optimal nutrition. Regardless of profile type, it was observed that children were familiar with recommended and unrecommended food products, as well as the role of water in proper nutrition. It was demonstrated that parents wield the most substantial influence on children's nutrition. As a result, initiatives promoting the proper nutrition and a healthy lifestyle should commence with parents. Children of nutritionally conscious parents tend to eat more healthily and demonstrate a high nutritional awareness. Conversely, the children of busy parents who lack time for meal preparation more frequently replicate their parents' nutritional mistakes. These findings emphasize the importance of the family environment in shaping the dietary behaviors of children and youth.

Improved Neurodevelopmental Outcomes at 5.5 Years of Age in Children Who Received Bovine Milk Fat Globule Membrane and Lactoferrin in Infant Formula Through 12 Months: A Randomized Controlled Trial

OBJECTIVE

To evaluate the neurodevelopmental outcomes at 5.5 years of age in children who were previously randomized to cow milk-based infant formula (control) or similar formula (milk fat globule membrane + lactoferrin) with added sources of bovine milk fat globule membrane and bovine lactoferrin through 12 months of age.

DESIGN

Children who completed study feeding were invited to participate in follow-up assessments: cognitive development across multiple domains (primary outcome; Wechsler Preschool & Primary Scale of Intelligence, 4th Edition), inhibitory control/rule learning (Stroop Task), flexibility/rule learning (Dimensional Change Card Sort), and behavior/emotion (Child Behavior Checklist).

RESULTS

Of 292 eligible participants (control: 148, milk fat globule membrane + lactoferrin: 144), 116 enrolled and completed assessments (control: 59, milk fat globule membrane + LF: 57). There were no group demographic differences except family income (milk fat globule membrane + lactoferrin significantly higher). Wechsler Preschool & Primary Scale of Intelligence, 4th Edition composite scores (mean ± standard error) for Visual Spatial (100.6 ± 1.7 vs 95.3 ± 1.7; P = .027), Processing Speed (107.1 ± 1.4 vs 100.0 ± 1.4; P < .001), and Full-Scale IQ (98.7 ± 1.4 vs 93.5 ± 1.5; P = .012) were significantly higher for milk fat globule membrane + lactoferrin versus control, even after controlling for demographic/socioeconomic factors. Stroop Task scores were significantly higher in milk fat globule membrane + lactoferrin versus control (P < .001). Higher Dimensional Change Card Sort scores (P = .013) in the border phase (most complex/challenging) were detected, and more children passed the border phase (32% vs 12%; P = .039) for milk fat globule membrane versus control. No group differences in Child Behavior Checklist score were detected.

CONCLUSIONS

Children who received infant formula to 12 months of age with added bovine milk fat globule membrane and bovine lactoferrin versus standard formula demonstrated improved cognitive outcomes in multiple domains at 5.5 years of age, including measures of intelligence and executive function.

TRIAL REGISTRATION

Clinicaltrials.gov: https://clinicaltrials.gov/ct2/show/NCT04442477.

Milk-cereal mix supplementation during infancy and impact on neurodevelopmental outcomes at 12 and 24 months of age: a randomised controlled trial in India

Inadequate protein intake and lack of micronutrients may affect neurodevelopment in infants. This randomised controlled trial was conducted to measure the effect of two milk-cereal mixes with modest and high amounts of protein and enriched with multiple micronutrients, given between 6 and 12 months, on cognitive, language, motor and behavioural scores at 12 and 24 months of age, compared with no-supplementation. The two supplements were also compared with each other. The study was conducted in urban Delhi, India, and the infants were randomised in a 1:1:1 ratio to the three study groups. At 12 and 24 months of age, 1134 and 1214 children were available, respectively. At 12 months of age, compared with no-supplement group, an increase in the motor scores (mean difference, MD 1·52, 95 % CI: 0·28, 2·75) and a decrease in the infant temperament scores (MD - 2·76, 95 % CI: -4·23, -1·29) in the modest-protein group was observed. Those in the high-protein group had lower socio-emotional scores (MD - 1·40, 95 % CI: -2·43, -0·37) and higher scores on Infant Temperament Scale (MD 2·05, 95 % CI: 0·62, 3·48) when compared with modest-protein group. At 24 months, no significant differences in any of the neurodevelopment scores between the three study groups was found. In conclusion, supplementation with modest amount of protein and multiple micronutrients may lead to short-term small improvements in motor function and infant temperament. There appears no advantage of supplementing with high protein, rather negative effects on infant behaviour were observed.

Nutrient trajectories during infancy and their associations with childhood neurodevelopment

PURPOSE

To examine the associations between infants' dietary nutrient trajectories and subsequent neurodevelopment during childhood in the Growing Up in Singapore Towards healthy Outcomes study.

METHODS

One-day food records were collected at ages 6, 9 and 12 months, whilst Bayley Scales of Infant and Toddler Development-III and Kaufman Brief Intelligence Test-2 were conducted at ages 24 and 54 months respectively. Nutrient trajectories were constructed using multi-level mixed modelling and associations with neurodevelopment (24 months: n = 484; 54 months: n = 444) were examined using adjusted multivariable linear regression.

RESULTS

At age 24 months, higher protein intake (at 6 months) and increasing rate of intake (from 6 to 12 months) were associated with higher fine motor score [β = 0.17 SD (95% CI 0.03, 0.31) and 0.62 SD (0.10, 1.14) respectively]. Higher fat intake was associated with higher receptive language score [0.04 SD (0.003, 0.07)], but increasing rate of intake was associated with lower expressive language [- 0.20 SD (- 0.39, - 0.01)] and fine motor [- 0.29 SD (- 0.48, - 0.10)] scores. Higher carbohydrate intake was associated with lower gross motor score [- 0.07 SD (- 0.14, - 0.005)], but increasing rate of intake was associated with higher receptive language [0.44 SD (0.08, 0.81)] and fine motor [0.56 SD (0.18, 0.93)] scores. Increasing rate of dietary fibre intake was associated with higher fine motor scores [0.63 SD (0.16, 1.10)]. No significant associations were observed with neurodevelopment at 54 months.

CONCLUSION

Our findings provide greater understanding of how nutrition over time could have varying effects on child neurodevelopment.

Associations between Early Life Nutrient Intakes and Brain Maturation Show Developmental Dynamics from Infancy to Toddlerhood: A Neuroimaging Observation Study

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.

Toward assessing the role of dietary fatty acids in lamb's neurological and cognitive development

Understanding and measuring sheep cognition and behavior can provide us with measures to safeguard the welfare of these animals in production systems. Optimal neurological and cognitive development of lambs is important to equip individuals with the ability to better cope with environmental stressors. However, this development can be affected by nutrition with a special role from long-chain fatty acid supply from the dam to the fetus or in lamb's early life. Neurological development in lambs takes place primarily during the first two trimesters of gestation. Through late fetal and early postnatal life, the lamb brain has a high level of cholesterol synthesis. This rate declines rapidly at weaning and remains low throughout adulthood. The main polyunsaturated fatty acids (PUFA) in the brain are ω-6 arachidonic acid and ω-3 docosahexaenoic acid (DHA), which are elements of plasma membranes' phospholipids in neuronal cells. DHA is essential for keeping membrane integrity and is vital for normal development of the central nervous system (CNS), and its insufficiency can damage cerebral functions and the development of cognitive capacities. In sheep, there is evidence that supplying PUFA during gestation or after birth may be beneficial to lamb productive performance and expression of species-specific behaviors. The objective of this perspective is to discuss concepts of ruminant behavior and nutrition and reflect on future research directions that could help to improve our knowledge on how dietary fatty acids (FA) relate to optimal neurological and cognitive development in sheep.

Liquid Biopsy in Adverse Neurodevelopment of Children: Problems and Prospects

Neurodevelopmental disorders in children have an important impact on the quality of life in the whole life cycle. Severe neurodevelopmental disorders will become a serious social and family burden and an important social and economic problem. The early and middle childhood is the critical period of children's neurodevelopment. Early diagnosis of neurological disorders plays an important role in guiding children's neurological development. Existing monitoring tools lack prenatal and even early assessment of children's neurodevelopment, so reliable biomarkers are conducive to personalized care at an earlier stage. In this review, we will discuss different methods of neurodevelopmental monitoring at different times and the role and evaluation of liquid biopsy in neurodevelopmental monitoring.

Dairy fortification as a good option for dietary nutrition status improvement of 676 preschool children in China: A simulation study based on a cross-sectional diet survey (2018-2019)

Background

Chinese children are deficient in several essential nutrients due to poor dietary choices. Dairy products are a source of many under-consumed nutrients, but preschool children in China consume dairy products significantly less than the recommended level.

Methods

From the cross-sectional dietary intake survey of infants and young children aged 0-6 years in China (2018-2019), preschool children (age: 3-6 years) (n = 676) were selected. The four-day dietary data (including 2 working days and 2 weekends) collected through an online diary with reference to the food atlas were used for analysis and simulation. In scenario 1, individual intake of liquid milk equivalents was substituted at a corresponding volume by soymilk, cow's milk, or formulated milk powder for preschool children (FMP-PSC). In scenario 2, the amount of cow's milk or FMP-PSC increased to ensure each child's dairy intake reached the recommended amount (350 g/day). In both scenarios, the simulated nutrient intakes and nutritional inadequacy or surplus were compared to the survey's actual baseline data.

Results

It was suggested suggested that replacing dairy foods with FMP-PSC at matching volume is better than replacing them with soymilk or cow's milk to increase the intake of DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₁₂, vitamin C and vitamin D. Moreover, our results suggested that adding FMP-PSC to bring each child's dairy intake to the recommended amount can bring the intakes of dietary fiber, DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₉, vitamin B₁₂, vitamin C and vitamin D more in line with the recommendations when compared with cow's milk.

Conclusion

Accurate nutrition information should be provided to the parents of preschool children so as to guide their scientific consumption of dairy products and the usage and addition of fortified dairy products can be encouraged as needed.

Effect of a Child-Owned Poultry Intervention Providing Eggs on Nutrition Status and Motor Skills of Young Children in Southern Ethiopia: A Cluster Randomized and Controlled Community Trial

Eggs are highly nutritious foods, yet intake by children in Ethiopia is low. We hypothesized that a nutrition-sensitive poultry intervention improves nutritional status of children 6-18 months using a 6-month cluster randomized controlled community trial. Intervention group (IG) children received a gift of two egg-laying hens in a ceremony where children's ownership of the chickens was declared by community leaders. Parents promised to add more hens and feed the owner-child one-egg-a-day. Trained community workers reinforced egg feeding, environmental sanitation and poultry husbandry. Control group (CG) mothers received usual nutrition education on child feeding. At baseline 29.6% of children were stunted, 19.4% underweight and 8.6% wasted. Egg consumption significantly increased only in IG, at 6 months. The intervention increased weight-for-age and weight-for-height z-scores by 0.38 (95% CI = 0.13-0.63) and 0.43 (95% CI = 0.21-0.64), respectively. Binary logit model indicated IG children were 54% (Odds ratio [OR] = 0.46; 95% CI = 0.26-0.84) and 42% (OR = 0.58; 95% CI = 0.37-0.91) less likely to be underweight and stunted, respectively, compared to CG. IG children attained the milestone of running (p = 0.022; AHR = 1.43; 95% CI = 1.05-1.95), kicking a ball (p = 0.027; AHR = 1.39; 95% CI = 1.04-1.87) and throwing a ball (p = 0.045; AHR = 1.37; 95% CI = 1.01-1.86) earlier than CG. This nutrition-sensitive child-owned poultry approach should be implemented where animal-source food intake is low.

Paternal preconceptional diet enriched with n-3 polyunsaturated fatty acids affects offspring brain function in mice

Recent studies demonstrate that paternal nutrition prior to conception may determine offspring development and health through epigenetic modification. This study aims to investigate the effects of paternal supplementation of n-3 polyunsaturated fatty acids (n-3 PUFAs) on the brain development and function, and associated gene imprinting in the offspring. Three to four-week-old male C57BL/6J mice (founder) were fed with an n-3 PUFA-deficient diet (n-3 D), and two n-3 PUFA supplementation diets – a normal n-3 PUFA content diet (n-3 N) and a high n-3 PUFA content diet (n-3 H) for 12 weeks. Then they were mated to 10-week-old virgin female C57BL/6J mice to generate the offspring. The results showed that paternal n-3 PUFA supplementation in preconception reduced the anxiety- and depressive-like behavior, and improved sociability, learning and memory in the offspring, along with increased synaptic number, upregulated expressions of neuron specific enolase, myelin basic protein, glial fibrillary acidic protein, brain-derived neurotrophic factor in the hippocampus and cerebral cortex, and altered expressions of genes associated with mitochondria biogenesis, fusion, fission and autophagy. Furthermore, with paternal n-3 PUFA supplementation, the expression of imprinted gene Snrpn was downregulated both in testes of the founder mice and their offspring, but upregulated in the cerebral cortex and hippocampus, with altered DNA methylation in its differentially methylated region. The data suggest that higher paternal intake of n-3 PUFAs in preconception may help to maintain optimal brain development and function in the offspring, and further raise the possibility of paternal nutritional intervention for mental health issues in subsequent generations.

Infant exposure to trace elements in breast milk, infant formulas and complementary foods from southern China

Excessive intake of essential trace elements or exposure to potentially toxic elements above certain thresholds may cause adverse health effects in humans. To date, there is scarce evidence concerning Chinese infant exposure to trace elements and the associated risks. In this study, we collected 61 breast milk, 54 infant formula and 90 complementary food samples from southern China to investigate the levels of cobalt (Co), chromium (Cr), copper (Cu), selenium (Se), zinc (Zn), arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). The concentrations of these elements in the breast milk samples ranged from under the limit of detection (<LOD)-0.65, <LOD-65.5, 107-1040, 6.17-27.9, 820-10,160, <LOD-2.96, <LOD-0.52, <LOD-230, and <LOD-19.1 μg/L, respectively. In infant formula samples, the concentrations of these elements ranged from 2.77 to 7.56, 27.5-205, 188-4321, 69.7-322, 40,793-84,405, 2.47-12.2, 0.15-3.57, <LOD-505 and 2.19-26.5 μg/kg, respectively, while the concentrations detected in complementary food samples ranged from <LOD-23.7, <LOD-224, <LOD-3705, <LOD-219, 15,335-100,905, <LOD-159, <LOD-66.6, <LOD-502 and <LOD-25.6 μg/kg, respectively. The results showed that the levels of Cr, Cu and Se in 14.8-55.6 % of the infant formula and complementary food samples were lower than the reference values set by Codex Alimentarius or Chinese National Standards, while the levels of Zn in commercial food samples exceeded the corresponding reference values in 9.3-27.8 % of cases; these results suggest a potential risk via the consumption of commercial infant foods. To the best of our knowledge, this is the first study that has comprehensively assessed whether exposure to trace elements via food intake poses potential health risks to Chinese infants.

Characteristics of gut microbiota of term small gestational age infants within 1 week and their relationship with neurodevelopment at 6 months

Introduction

Small for gestational age (SGA) infants are at a higher risk of neurodevelopmental delay than infants appropriate for gestational age (AGA). Previous studies have confirmed that gut microbiota in early life influences subsequent neurodevelopment. However, few studies have reported corresponding data in SGA populations.

Objective

We aimed to evaluate the characteristics of the gut microbiota of term SGA infants and the associations between the gut microbiota in SGA infants and neurodevelopmental outcomes at 6 months of age.

Methods

Fecal samples were collected on days 1, 3, 5, and 7 from term SGA and AGA infants born between June 2020 and June 2021 at the Peking University First Hospital. 16S ribosomal deoxyribonucleic acid amplicon sequencing was used to analyze the fecal microbiota. We followed up for 6 months and used the Ages and Stages Questionnaires-3 (ASQ-3) to evaluate the neurodevelopmental outcomes among SGA infants.

Results

A total of 162 neonates were enrolled, with 41 SGA infants (25.3%) in the study group and 121 AGA infants (74.7%) in the control group. The gut microbial diversity in the SGA group was lower than that in the AGA group on days 1, 3, 5, and 7. Non-metric multidimensional scaling and analysis of similarities showed significant differences between the two groups. The SGA group had increased relative abundances of Ralstonia (3, 5, and 7 days) and Clostridium (3 and 7 days). The dominant microorganisms of the SGA group were Ralstonia on day 1, Escherichia_Shigella on days 3 and 7, and Clostridia on day 5. We found that the gut microbial diversity of SGA infants with poor communication scores was higher than that of SGA infants with good communication scores on day 3. Fine motor scores were negatively correlated with the relative abundance of Bacteroides_fragilis on day 1. A negative correlation was observed between gross motor scores and relative abundance of Clostridium_saccharobutylicum on day 7. Bacteroidota, Bacteroidia, Bacteroides, and Bacteroides_fragilis were the dominant microorganisms in the good communication score group on day 7. Communication scores were positively correlated with the relative abundance of Bacteroidota, Bacteroides, and Bacteroides_fragilis on day 7.

Conclusion

The gut microbial diversity of term SGA infants was significantly lower in the first week of life than that of term AGA infants. Certain pathogenic and conditional pathogenic bacteria, such as Escherichia_Shigella, Ralstonia and Clostridium increased or formed the dominant microbiota in SGA infants. Alpha diversity, Bacteroidota, Bacteroides, Bacteroides_fragilis, and Clostridium_saccharobutylicum found in SGA infants may be associated with neurodevelopmental outcomes at 6 months of age, indicating possible therapeutic targets for clinical intervention.

Milk polar lipids composition and functionality: a systematic review

Polar lipids including glycerophospholipids and sphingophospholipids are important nutrients and milk is a major source, particularly for infants. This systematic review describes the human and bovine milk polar lipid composition, structural organization, sources for formulation, and physiological functionality. A total of 2840 records were retrieved through Scopus, 378 were included. Bovine milk is a good source of polar lipids, where yield and composition are highly dependent on the choice of dairy streams and processing. In milk, polar lipids are organized in the milk fat globule membrane as a tri-layer encapsulating triglyceride. The overall polar lipid concentration in human milk is dependent on many factors including lactational stage and maternal diet. Here, reasonable ranges were determined where possible. Similar for bovine milk, where differences in milk lipid concentration proved the largest factor determining variation. The role of milk polar lipids in human health has been demonstrated in several areas and critical review indicated that brain, immune and effects on lipid metabolism are best substantiated areas. Moreover, insights related to the milk fat globule membrane structure-function relation as well as superior activity of milk derived polar lipid compared to plant-derived sources are emerging areas of interest regarding future research and food innovations.

Associations among prenatal and postnatal arsenic, lead, and cadmium exposures and motor development in 3-year-old children: a longitudinal birth cohort study in Taiwan

Prenatal and postnatal exposures to heavy metals have been suggested to interfere with neurodevelopment, but the neurotoxicity of lead (Pb), arsenic (As), and cadmium (Cd) is still unclear. In this study, we aimed to assess the associations between the levels of As, Cd, and Pb and children's neurodevelopment. A total of 299 mother-infant pairs were recruited in this study and their meconium were collected. After three years, 53 children underwent the Bayley Scales of Infant and Toddler Development (Bayley-III) examinations and provided hair and fingernail specimens. The levels of As, Cd, and Pb in the meconium, hair, and fingernail were measured by inductively coupled plasma mass spectrometry; the median levels were the following: meconium, 42.7, 5.57, and 25.6 ng/g, respectively; hair, 0.19, 0.05, and 3.61 μg/g, respectively; and fingernail, 0.29, 0.04, and 0.84 μg/g, respectively. After adjusting for potential confounding factors, we found that the log-transformed levels of As in the hair samples was negatively associated with gross motor development (β =  - 0.032; 95% confidence interval: - 0.061 to - 0.004). We conclude that postnatal exposure to As is a crucial period for gross motor development in children, while the effects of Cd and Pb on neurodevelopment are less clear.