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

早期营养对加纳儿童社交情感困难发展的保护作用的神经机制

• 批准号: 10393172
• 负责人: Brietta Michelle Oaks
• 金额: $ 15.69万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-04 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10393172
• 关键词: 2 year old; Address; Administrative Supplement; Adolescent; Adult; Africa; Age; Age-Years; Area; Autonomic nervous system; Behavior; Behavioral; Birth; Brain; Buffers; Caregivers; Child; Child Development; Child Nutrition; Child Support; Childhood; Colombia; Competence; Conceptions; Control Groups; Development; Dietary Intervention; Diffusion Magnetic Resonance Imaging; Disadvantaged; Effectiveness; Electrocardiogram; Emotional; Environment; Essential Fatty Acids; Estradiol; Estrogens; Evidence based program; Family Relationship; Follow-Up Studies; Foundations; Funding; Ghana; Goals; Gonadal Steroid Hormones; Guatemala; Hair; Health Policy; Healthcare Systems; Home environment; Hormones; Hydrocortisone; Hypothalamic structure; Impedance Cardiography; Infant; Information Systems; Intake; Investments; Iron; Knowledge; Lactation; Late pregnancy; Latin America; Life; Lipids; Long-Term Effects; Longterm Follow-up; Malnutrition; Measurement; Measures; Mediating; Mediator of activation protein; Mental Health; Mental Health Services; Methods; Micronutrients; Mothers; Nervous System Physiology; Neurosecretory Systems; Nutrient; Outcome; Parents; Pattern; Pituitary-Adrenal System; Policies; Postpartum Period; Pregnancy; Pregnant Women; Prevention strategy; Problem behavior; Progesterone; Puberty; Questionnaires; Randomized; Randomized Controlled Trials; Regulation; Research; Research Personnel; Risk; Salivary; Sampling; School-Age Population; Schools; Social Development; Stress; Supplementation; Testosterone; Universities; Well in self; Workplace; World Health Organization; arm; base; biological adaptation to stress; capsule; control trial; dietary supplements; early childhood; emotion regulation; evidence base; follow-up; group intervention; improved; infancy; intervention effect; low and middle-income countries; mental health organization; mother nutrition; myelination; nervous system development; neurobehavioral; neuroimaging; neuromechanism; nutrition; nutritional supplementation; peer; prenatal; programs; protective effect; randomized controlled design; randomized trial; skills; social; social disadvantage; success; trend; white matter; young woman

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.

项目摘要 据估计，低收入和中等收入国家有2.5亿儿童面临无法履行其义务的风险。 发展潜力，部分原因是营养不良。这项提案的长期目标是提供证据- 基于计划和政策，以支持加纳和其他低收入和中等收入国家的儿童 充分发挥他们的潜力这项建议是对8-12岁的儿童进行随访研究 其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）， 妊娠≤ 20周至产后6个月的孕妇及其6岁至 18个月（n = 440），将结果与接受母体微量营养素胶囊的对照组进行比较 妊娠期和产后（n = 880）。目的是研究早期营养的长期效果 在大脑和神经系统发育方面，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对学龄儿童社会情感发展的影响，以及在儿童 家庭环境和2）调查潜在的神经机制，通过LNS缓冲， 不利的环境对儿童发展社会情绪困难的影响。的 假设是：1）LNS组的儿童有较少的社会情感和行为问题， 与未接受LNS的儿童相比，2）LNS的效果更大， 不利的家庭环境; 3）自主神经系统的干预组差异 通过扩散张量成像测量的调节和白色物质完整性将介导 社会情感发展理由是基于先前的发现，LNS组的儿童 在4-6岁时有较少的社会情感困难，LNS对儿童的影响更大， 不利的家庭环境，表明早期补充缓冲的影响， 不利的环境对社会情绪困难的发展，在这个样本中，其中高 有百分之一的儿童有一个社会情绪困难的分数在异常高的范围。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，这在怀孕期间和头两年迅速发生 出生后这项研究将是第一个长期的后续研究在非洲的随机试验， 以及产后营养补充，覆盖从受孕到两岁的前1000天的大部分时间 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1970年代。这项研究代表了一个前所未有的机会来检查长期影响 在最初1000天的大部分时间里，使用随机 控制设计，以及早期营养对后期行为影响的潜在神经机制。