Neural mechanisms of protective effects of early nutrition on the development of social-emotional difficulties among children in Ghana

项目摘要 据估计，在低收入和中等收入国家中，有2.5亿儿童面临着无法实现他们的 发展潜力，部分原因是营养不良。这项建议的长期目标是让证据- 以方案和政策为基础，支持加纳和其他中低收入国家的儿童成长 并充分发挥他们的潜力。这项建议是对8-12岁的儿童进行跟踪研究 他们的母亲参加了一项随机对照试验，提供基于脂质的营养补充剂(LNS)以 孕妇从怀孕20周到产后6个月，以及从6岁到6岁的孩子 18个月(n=440)，与服用母亲微量营养素胶囊的对照组进行比较 孕期和产后(n=880)。目的是检查早期营养的长期效果。 大脑和神经系统发育，同时加强研究环境和能力 加纳大学进行神经行为和神经成像研究。具体目标是：1) 调查LNS对学龄儿童社交情绪发展的影响 家庭环境和2)调查潜在的神经机制，通过LNS缓冲 不利环境对儿童社交情绪困难发展的影响。这个 假设是1)LNS组的孩子会有较少的社交-情绪和行为问题， 与没有接受LNS的儿童相比，2)LNS的影响会在更多的儿童身上发现 不利的家庭环境，以及3)干预组自主神经系统的差异 弥散张量成像测量的调节和白质完整性将调解组内差异 社会-情感发展。其理论基础是基于之前的发现，LNS组中的儿童 在4-6岁时有较少的社交情绪困难，LNS对以下儿童的影响更大 不利的家庭环境，表明早期补充缓冲了 弱势环境对社会发展的影响--本样本中情绪困难者较高 儿童的社交-情绪困难得分在异常高的范围内的百分比。营养素 LNS中所含的铁和必需脂肪酸是相关脑区髓鞘形成所必需的 在社会情绪调节和处理中，这在怀孕和头两年迅速发生 出生后。这项研究将是非洲第一个对两个产前随机试验的长期随访研究 和产后营养补充，涵盖从受孕到两岁前1000天的大部分时间 几年来，只有两项此类研究提供了证据，这两项研究都是在拉丁美洲进行的(危地马拉和 哥伦比亚)在20世纪70年代。这项研究是检验长期影响的一个前所未有的机会。 在最初1000天的大部分时间里补充宏量和微量营养素 对照设计，以及早期营养对后期行为影响的潜在神经机制。

Project Summary An estimated 250 million children in low- and middle-income countries are at risk of not fulfilling their developmental potential, partly due to undernutrition. The long-term goal of this proposal is to inform evidence- based programs and policies to support children in Ghana and other low- and middle-income countries to grow and develop to their full potential. This proposal is to conduct a follow-up study of children at age 8-12 years whose mothers participated in a randomized control trial providing lipid-based nutrient supplements (LNS) to pregnant women from ≤ 20 weeks of gestation through 6 months postpartum and to their children from age 6 to 18 months (n = 440), comparing outcomes to control groups who received maternal micronutrient capsules during pregnancy and postpartum (n = 880). The objective is to examine the long-term effect of early nutrition on brain and nervous system development, while strengthening the research environment and capacity at the University of Ghana to conduct neurobehavioral and neuroimaging research. The specific aims are 1) To investigate the effect of LNS on social-emotional development at school age and in the context of children's home environments and 2) to investigate the potential neural mechanisms through which LNS buffers the effects of a disadvantaged environment on children's development of social-emotional difficulties. The hypotheses are that 1) children in the LNS group will have fewer social-emotional and behavioral problems, compared to children who did not receive LNS, 2) greater effects of LNS will be found in children from more disadvantaged home environments, and 3) intervention group differences in autonomic nervous system regulation and white matter integrity measured by diffusion tensor imaging will mediate group differences in social-emotional development. The rationale is based on the previous finding that children in the LNS group had fewer social-emotional difficulties at age 4-6 years, with greater effects of LNS in children from disadvantaged home environments, suggesting that early supplementation buffered the effect of a disadvantaged environment on the development of social-emotional difficulties in this sample, in which a high percentage of children had a social-emotional difficulties score in the abnormally high range. Nutrients contained in LNS, such as iron and essential fatty acids, are necessary for myelination of brain areas involved in social-emotional regulation and processing, which occurs rapidly during pregnancy and the first two years after birth. This study will be the first long-term follow-up study in Africa of a randomized trial of both pre-natal and post-natal nutritional supplementation covering most of the first 1000 days from conception to age two years, adding to evidence from only two other such studies, both conducted in Latin America (Guatemala and Colombia) in the 1970s. This study represents an unprecedented opportunity to examine the long-term effects of supplementation with both macro- and micro-nutrients during most of the first 1000 days using a randomized controlled design, and the underlying neural mechanisms of the effects of early nutrition on later behavior.