Nutritional supplementation improves cognitive function in malnourished children
Researchers have recently reported that supplementary feeding for 23 weeks can improve executive function, brain health, and nutritional status in vulnerable young children living in low income countries. Under nutrition in the early years of life is thought to cause permanent damage to cognitive function that is not reversed by later nutritional supplementation.
An
increasing body of pre-clinical research has suggested that traditional
supplementary foods for young children might lack key food constituents that
could support regenerative changes in the brain.
Susan B Roberts from Tufts University, Boston, along with associates have
carried out the study in West Africa and published their findings in the
British Medical Journal. The main goal of the study was to assess the effects
of food supplementation on improving working memory and additional measures
including cerebral blood flow in children at risk of under nutrition.
The study
design was a randomized controlled trial in 10 villages in Guinea-Bissau of
West Africa with 1059 children aged 15 months to 7 years as participants
;children younger than 4 were the primary population. The children were
provided with Supervised isocaloric servings (≈1300 kJ, five mornings each
week, 23 weeks) of a new food supplement (NEWSUP, high in plant polyphenols and
omega 3 fatty acids, within a wide variety and high fortification of
micronutrients, and a high protein content), or a fortified blended food (FBF)
used in nutrition programs, or a control meal (traditional rice breakfast).
The
primary outcome that was measured was working memory. Additional outcomes were
hemoglobin concentration, growth, body composition, and index of cerebral blood
flow (CBFi). In addition to an intention-to-treat analysis, a predefined per
protocol analysis was conducted in children who consumed at least 75% of the
supplement (820/925, 89%). The key findings were- Ø Among children younger than
4, randomization to NEWSUP increased working memory compared with the control
meal (rate ratio 1.20, 95% confidence interval 1.02 to 1.41, P=0.03), with a
larger effect in the per protocol population (1.25, 1.06 to 1.47, P=0.009)
NEWSUP also increased hemoglobin concentration among children with anemia
compared with the control meal, decreased body mass index z score gain (−0.23,
−0.43 to −0.02, P=0.03), and increased lean tissue accretion (2.98 cm2, 0.04 to
5.92, P=0.046) with less fat (−5.82 cm2, −11.28 to −0.36, P=0.04) compared with
FBF. Ø Additionally, NEWSUP increased CBFi compared with the control meal and
FBF in both age groups combined. Ø Among children aged 4 and older, NEWSUP had
no significant effect on working memory or anemia, but increased lean tissue
compared with FBF. Researchers concluded that childhood under-nutrition is
associated with long term impairment in cognition. Maximum beneficial effects
were seen in children up to 4 years old with the new food supplement. Further
research is needed to optimize the supplement composition and examine cognition
more extensively for NEWSUP and traditional supplementary foods, the authors
said.