Effects of early-life nutritional supplementation on the brains, bodies, and behaviors of Ghanaian youths in middle adolescence

University Of California At Davis, Davis CA

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Abstract

PROJECT ABSTRACT 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 and adolescents 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 youth at 14-16 years whose mothers participated in a randomized controlled trial providing small-quantity lipid-based nutrient supplements (SQ-LNS) to pregnant women from ≤ 20 weeks of gestation through 6 months postpartum and to their infants from age 6 to 18 months (n = 440), comparing outcomes to youth from the control groups whose mothers received micronutrient capsules during pregnancy and postpartum (n = 880) without additional supplementation to the infants. Under protocol R01HD099811, we enrolled 979 children at 10-12 years in assessments of brain and body maturation, autonomic regulation, adrenocortical and adrenogonadal hormones, and behavioral and psychosocial functioning. Benefits of SQ-LNS, directly and in the context of home environment quality, were evident in white matter microstructure, height, pubertal development, and other measures. We seek to document the long-term effects of SQ-LNS on brain and nervous system development and biobehavioral functioning in middle adolescence, a pivotal period marking the onset of multiple mental and physical health problems. The specific aims are 1) To investigate the long- term effects of SQ-LNS on physical maturation, as seen in brain structure, height, and pubertal development; 2) To examine the emergent effects of SQ-LNS on brain function, autonomic regulation and hormonal activity in middle adolescence, both directly and in the context of quality of home environments; and 3) to show the neurobiological mechanisms through which SQ-LNS promotes psychosocial and cognitive competence and buffers the effects of disadvantaged environments on youth’s social-emotional difficulties. The hypotheses are that, compared to youth who did not receive early SQ-LNS, youth in the SQ-LNS group will H1) have better white matter microstructure, be taller, and have normatively timed pubertal milestones, and H2) evince stronger prefrontal cortex regulation of subcortical regions, more flexible autonomic regulation, and lower chronic cortisol levels, especially when raised in less advantaged home environments. Further, H3) intervention group differences in neurobiological structure and functioning are expected to mediate group differences in social-emotional development. This study will be the longest follow-up study in Africa of a RCT of pre- and post-natal nutritional supplementation covering most of the first 1000 days of life following conception. This study represents an unprecedented opportunity to examine the enduring and emergent effects in middle adolescence of a novel nutrient supplement in early life using a RCT design, and the underlying neural mechanisms of the effects of early nutrition on later adjustment and well-being.