Nutrition and brain development

All pa rents want their children to be intelligent and smart. They are more than willing to spend on anything that will make their children bright kids. In recent years, we have witnessed a number of vitamins and various food supplements being marketed as food for the brain; and the number is still growing! How effective are they? Will they really be able to improve or enhance a childs IQ? We know for a fact t hat t he main det erminant of a persons IQ is his genet ic make-up. However, st udies have shown t hat t here are enviro nment al factors t hat can affect brain deve lopment and behavio ur. And nutrit ion is one of t he most import ant epigenet ic fact ors t hat can significant ly affect brain development and behavio ur.

No rma l growt h and develop men t of t h e h u man b rai n Brain development fo llows a highly ordered sequence of event s t hat are under strict genet ic control but can be influenced by epigenet ic fact ors. Pro per develo pment and mat ur at ion of t he brain is necessary for t he acquisit ion of t he full repertoire of int egrat ed funct ions and behaviours t hat make us human. And t he brain does t his t hrough it s approximat ely one billion cells t hat communicat e wit h each ot her via ver y specialized int erconnect ions. The act ions of t he brain under lie all behaviour ranging fro m t he simplest act s like walking or eat ing to complex act io ns such as t hinking, int eract ing or creat ing works of art. (Kandell et al., 1995).

Effects of malnutrition on behavioral an d intellectual develop ment Disorders of nutrit ion remain t he most commo n insult affect ing t he ner vous syst em (Winick, 1976). Approximat ely 150 millio n children worldwide are malnour ished (UNI CEF, 2001). This is an alar ming number of our populat ion t hat are at risk of developing lear ning and

behaviour problems! But how does nut rit ion affect cognit ion and behavio ur ? As early as t he mid 1960s, concept s on how malnut r it ion exper ienced in ear ly childhood could affect brain development have been invest igat ed. Animal st udies have shown t hat malnutrit ion can cause decrease in bra in vo lu me, number o f neur ons, s ynapses, dendr it es and r eact ive zones. Aft er nutrit ional rehabilitat ion, alt hough t here was significant catch up in br ain weight and vo lume, t here was persist ent reduct ion in t he number of dendrit ic and synapt ic spines and cort ical cells. These structures are import ant in t he cell-to-cell communicat ions. Specifically, t he alt erat ions in t he hip-pocampus (associat ed wit h short t erm memor y) and cerebellum (responsible for fine mot or cont rol and ba lance), ar e per manent . ( Levit sk y and St rupp, 1995). Obser ved pro ble ms amo ng malnour ished childr en consist o f att en-t ional dysfunct ion and impul- siveness, diminished abilit y to adapt to stressful sit uat ions, suscept ibilit y to affect ive disorders like anxiet y, and diminis hed mo t ivat io ns and exploratory behaviours. All of t hese may lead t o impa ired schoo l per- for mance and social and emot ional de ve lo pme nt . Plast icit y of t he brain is natures way of prot ect ing it from ext ernal influ-ences. It allows for adaptat ion to environment al influences ( i.e. undernutrit ion), but t his is dependent on t iming, durat io n and sever it y of t he insult . The great est effect of malnut r it ion on brain develo pment is exper ienced dur ing t he t ime o f rapid brain growth. This is t he period during which t he brain is vulnerable. Insults occurring at t his t ime will have significant negat ive effect s on brain development , cognit io n, and behavio ur.

Effects of malnutrition on the developin g hu man b rai n and cent ral nerv o u s sy st e m The fet al brain undergoes a growt h spurt during t he t hird t rimest er. An infant s brain triples in size during t he first year of life from 350 g to 1000 g and co nt inues t o develop rapidly during t he first 2-3 years of life during which it attains 80% of it s adult weight . A significant amount of brain building is happening at this t ime wher ein t he fo undat io ns for int elligence, visio n, and language are est ablished. It has to be emphasized, however, t hat t he groundwork for brain development begins at day one of concept ion. The prenat al period is t he t ime when t he organizat ion, neuronal different iat ion, synaptogenesis, glial proliferat ions, biochemical different iat ion of neurons, synt hesis of neuro-transmit t ers and myelinat ion are taking place. If we consider t his, t hen we will be able to underst and why

insult s to the mot her at different st ages of concept ion will cause specific deformit ies and congenit al malformat ions in t he fet us. For example, mat ernal insult incurred during t he fir st 3 mo nt hs o f pregnanc y ma y result in anencephaly, meningocele, and ot her neural tube defect s in t he baby. Co nsequent ly, fet al insult s incurred from t he 5t h mont h of gest at ion onwards may cause ment al retardat ion, Downs syndrome, aut ism, e t c . Effect s of protein-calorie or protein ener g y ma lnut r it io n ( P E M) and single nut rient deficiencies on brain development have been st udied . Amo ng c hildr e n w ho wer e bo r n small for gest at io nal age, t welve lo ngit udinal st udies were conduct ed and t he children were evaluat ed at ages 9-17 years. All st udies showed t hat babies who are small for gest at ional age have poorer cognit ion and schoo l per for mance co mpar ed t o babies wit h nor mal birt h weight s (Hack, 1998). Mild prenat al mat ernal undernutrit ion can also affect infant behaviour. When ear ly prevent ive food supple ment at io n t r ials wer e co nduct ed amo ng high r isk pregnant mot her s in endemic areas in Me xico , Guat e ma la, a nd Bo go t a, Co lo mbia, co ncurrent bene- fit s wer e demonst rat ed in all t he t rials (Chavez and Mart inez, 1982; Fr eeman et al., 1980; Waher et al., 1981).

Vi t a mi n an d t race elemen t d efi ci en c i e s Defic iencies in cert ain micro nut r ient s inc urr ed dur ing t he pr enat al per io d have bee n s ho wn t o cause specific neuro lo gic defic it s. T hese micronut rient s are: folic acid, iodine, iro n, zinc, seleniu m, copper, magnesiu m, Vit amins A, C, D, E, B6 and B12 ( S cr ims haw and S an G io vanni, 1 9 9 7 ) . Iodine defic ienc y is t he mo st significant cause o f irrever sible ment al i mp a ir me nt . Fo lic acid defic ienc y causes neur al t ube defect s, i. e. meningo cele and encephalo cele; and orofacia l cleft s, i. e. cleft lips and palat e. I r o n d e f ic ie nc y a ne m ia is t he mo st co mmo n nut r it io nal defic ienc y wor ldwide; it s highest preva lence is bet ween 6-24 mo nt hs o f age. It has a negat ive effect on t he infant s sleep- waking c yc le a nd o n ps yc ho mot o r and develo pment al mat ur at io n. Zinc is funct ionally an essent ial co mpo ne nt o f mo r e t han 200 enz yme s t hat per vade all met abo lic pat hways. Z inc defic ienc y causes s lo wing and restrict ion of behaviour, let hargy, apat hy and decreased

growt h rat e. It is a lso associat ed wit h a co mpro mised ho st - de fe nse me c ha n is m t her e b y predispos ing t he chil d t o recurrent infect io ns. P yr ido xine o r vit a m in B 6 is a nesse nt ia l co fact or in t he develo ping cent r a l ner vo us s yst e m. I t s defic ienc y in anima ls is associat ed wit h alt erat ion in t he glut amin-ergic neur ot r ans mit t er syst em whic h is invo lved in memor y and lear ning. Certain d ru gs, i. e. anti convu lsant s, alco h ol, an d smoki n g can d ep let e folic acid, zinc and i ron stores. Exces s an d d efi ci en cy of Vi t ami n A in t he mot hers diet dur ing pregna nc y ha ve be e n s ho w n t o cause ma lfo r mat io ns o f t he fet al brain and hydr o cepha lu s.

In fa nt nut rition b reast feed ing an d in fa n t d eve lop men t Th e in flu en ce of b reast feedi ng on co gnit io n and behavio ur canno t be o ver emphas ized. Land mar k st udies have shown a s ignificant neurodevelo p me nt al adva nt age amo ng br east fed infants. Result s o f st udies show t hat school age children have fewer neuro lo gical abnor malit ies ( Lant ing et al., 1999), bet t er schoo l gr ades ( Ro gan and Graden, 1993), bet t er cognit ive development up t o 8 year s o f age ( Lucas et al., 1992), and bet t er scores in visual acuit y up t o 3 year s of age (Uauy & de Andraca, 1995). Breast fed infant s also sho wed t he same deve lo p me nt al advant age even amo ng pr e-t er m and sma ll fo r gest at io nal age babies (Lucas et al., 1992).

Conclusions Nut rit io n plays a major ro le in t he deve lo pment o f t he ner vo us s yst em. St udies have shown t hat ma lnut r it ion causes a var iet y o f cognit ive and behavioral deficit s over a lifet ime. The sever it y, t iming and durat ion o f malnut r it io n ar e import ant det er minant s o f it s poss ible effect on t he neuro logical develo pment of t he child. The per iod of vulnerabilit y consist s of t he first 45 mont hs, t hat is, nine mont hs of prenat al life plus t he first t hree years of life. P ro per nut r it io n w i t h a d e q u a t e a mo unt s o f necessar y micr o nut r ient s, prot ein, and calo r ies, given at t he appropr iat e t ime ma y ensur e no r ma l br a in de ve lo p me nt . Ma jo r cat ast rophic co ngenit al ma lfo r mat io ns like neura l t ube defect s, hydr o - cephalus, ment a l r et ardat io n, and be ha v io ur pr o ble ms ma y be pr eve nt ed in

so me inst ances wit h proper nut r it io nal supple ment at io n and avo idance o f cert ain lifest yle beha vio ur s such as smo king and alco ho l int ake amo ng wo men o f child bear ing age. T her efor e, ensur ing an int elligent and smart child st art s wit h a healt hy mot her. Nurt uring nut r it ional well- being and healt h is a lifelo ng process, wit h each phase affect ing t he next . But in t urn- ing t he t ide of malnut rit io n, t ime is of t he essence! (Nutrit ion for Healt h and De v. , WH O) .