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Nutrition

Nutrition and brain development


-ENDOZA 3ALONGA! M.D, FPNA, FCNSP
Professor and Chair,
Department of Neurosciences,
University of the Philippines, Manila, Philippines

Adapted FROM: Nestlé Nutrition - The Nest (16)June 2004

All parents want their children to be in- behaviour problems! But how does nu- of life from 350 g to 1000 g and contin-
telligent and smart. They are more than trition affect cognition and behaviour? ues to develop rapidly during the first
willing to spend on anything that will As early as the mid 1960’s, concepts on 2-3 years of life during which it attains
make their children "bright kids". In re- how malnutrition experienced in early 80% of its adult weight. A significant
cent years, we have witnessed a num- childhood could affect brain develop- amount of brain building is happening
ber of vitamins and various food supple- ment have been investigated. Animal at this time wherein the foundations for
ments being marketed as "food for the studies have shown that malnutrition intelligence, vision, and language are
brain"; and the number is still growing! can cause decrease in brain volume, established. It has to be emphasized,
How effective are they? Will they really number of neurons, synapses, den- however, that the groundwork for brain
be able to improve or enhance a child’s drites and reactive zones. After nutri- development begins at day one of con-
IQ? tional rehabilitation, although there was ception. The prenatal period is the time
We know for a fact that the main de- significant "catch up" in brain weight and when the organization, neuronal differ-
terminant of a person’s IQ is his genetic volume, there was persistent reduction entiation, synaptogenesis, glial prolif-
make-up. However, studies have shown in the number of dendritic and synaptic erations, biochemical differentiation of
that there are environmental factors that spines and cortical cells. These struc- neurons, synthesis of neuro-transmit-
can affect brain development and be- tures are important in the cell-to-cell ters and myelination are taking place.
haviour. And nutrition is one of the most communications. Specifically, the alter- If we consider this, then we will be
important epigenetic factors that can ations in the hip-pocampus (associated able to understand why insults to the
significantly affect brain development with short term memory) and cerebel- mother at different stages of concep-
and behaviour. lum (responsible for fine motor control tion will cause specific deformities and
and balance), are permanent. (Levitsky congenital malformations in the fetus.
Normal growth and development of and Strupp, 1995). Observed problems For example, maternal insult incurred
the human brain among malnourished children consist during the first 3 months of pregnancy
Brain development follows a highly of atten-tional dysfunction and impul- may result in anencephaly, meningo-
ordered sequence of events that are siveness, diminished ability to adapt cele, and other neural tube defects in
under strict genetic control but can to stressful situations, susceptibility to the baby. Consequently, fetal insults in-
be influenced by epigenetic factors. affective disorders like anxiety, and di- curred from the 5th month of gestation
Proper development and maturation of minished motivations and exploratory onwards may cause mental retardation,
the brain is necessary for the acquisi- behaviours. All of these may lead to im- Down’s syndrome, autism, etc.
tion of the full repertoire of integrated paired school performance and social Effects of protein-calorie or protein
functions and behaviours that make us and emotional development. energy malnutrition (PEM) and single
human. And the brain does this through Plasticity of the brain is nature’s way nutrient deficiencies on brain develop-
its approximately one billion cells that of protecting it from external influ-ences. ment have been studied. Among chil-
communicate with each other via very It allows for adaptation to environmental dren who were born small for gestation-
specialized interconnections. influences (i.e. undernutrition), but this al age, twelve longitudinal studies were
The actions of the brain underlie all is dependent on timing, duration and conducted and the children were evalu-
behaviour ranging from the simplest severity of the insult. The greatest effect ated at ages 9-17 years. All studies
acts like walking or eating to complex of malnutrition on brain development is showed that babies who are small for
actions such as thinking, interacting or experienced during the time of rapid gestational age have poorer cognition
creating works of art. (Kandell et al., brain growth. This is the period during and school performance compared to
1995). which the brain is vulnerable. Insults oc- babies with normal birth weights (Hack,
curring at this time will have significant 1998). Mild prenatal maternal undernu-
Effects of malnutrition on behavioral negative effects on brain development, trition can also affect infant behaviour.
and intellectual development cognition, and behaviour. When early preventive food supple-
Disorders of nutrition remain the most mentation trials were conducted among
common insult affecting the nervous Effects of malnutrition on the devel- high risk pregnant mothers in endemic
system (Winick, 1976). Approximately oping human brain and central ner- areas in Mexico, Guatemala, and Bogo-
150 million children worldwide are mal- vous system ta, Colombia, concurrent bene-fits were
nourished (UNICEF, 2001). This is an The fetal brain undergoes a growth spurt demonstrated in all the trials (Chavez
alarming number of our population that during the third trimester. An infant’s and Martinez, 1982; Freeman et al.,
are at risk of developing learning and brain triples in size during the first year 1980; Waher et al., 1981).

 3!&AM0RACT
Nutrition

Vitamin and trace element deficien- ter school grades (Rogan and Graden, of California, Davis, CA. Décembre 1993. J Nutr.
125:2239S-2245S,1995.
cies 1993), better cognitive development up 5. Levitsky D & Strupp B. Malnutrition and the
Deficiencies in certain micronutrients in- to 8 years of age (Lucas et al., 1992), Brain: Changing Concepts, Changing Con-
curred during the prenatal period have cerns. International Dietary Energy Consulta-
and better scores in visual acuity up to 3 tive Group (IDECG) Task Force Workshop on
been shown to cause specific neuro- years of age (Uauy & de Andraca, 1995). Malnutrition and Behaviour at the University of
logic deficits. These micronutrients are: Breastfed infants also showed the same California, Davis, CA. Décembre 1993. J Nutri-
tion 125:2212S-220S,1995.
folic acid, iodine, iron, zinc, selenium, developmental advantage even among 6. Schurch B. Malnutrition and Behavioral Devel-
copper, magnesium, Vitamins A, C, D, pre-term and small for gestational age opment: the nutritional variable. International
E, B6 and B12 (Scrimshaw and San Dietary Energy Consultative Group (IDECG)
babies (Lucas et al., 1992). Task Force Workshop on Malnutrition and Be-
Giovanni, 1997). haviour at the University of California, Davis, CA.
Conclusions Décembre 1993. J. Nutr. 125: 2255S-2262S,
1995.
• Iodine deficiency is the most sig- • Nutrition plays a major role in the 7. Strupp B & Levitsky D. Enduring Cognitive
nificant cause of irreversible mental development of the nervous system. Effects of Early Malnutrition: a theoretical ap-
impairment. praisal. International Dietary Energy Consulta-
Studies have shown that malnutrition tive Group (IDECG) Task Force Workshop on
• Folic acid deficiency causes neural causes a variety of cognitive and Malnutrition and Behaviour at the University of
tube defects, i.e. meningocele and behavioral deficits over a lifetime. California, Davis, CA. Décembre 1993. J.Nutr.
125:221S-2232S,1995.
encephalocele; and The severity, timing and duration of 8. Wachs T. Relation of Mild-to-Moderate Mal-
orofacial clefts, i.e. cleft lips and pal- malnutrition are important determi- nutrition to Human Development: correlational
ate. studies. International Dietary Energy Consulta-
nants of its possible effect on the tive Group (IDECG) Task Force Workshop on
• Iron deficiency anemia is the most neurological development of the Malnutrition and Behaviour at the University of
common nutritional deficiency world- child. The period of vulnerability California, Davis, CA. Décembre 1993. J. Nutri-
tion 125:2245S-2254S,1995.
wide; its highest prevalence is be- consists of the first 45 months, that 9. Rama Krishna. Vitamins and Brain Develop-
tween 6-24 months of age. It has a is, nine months of prenatal life plus ment. Physiol. Research, 1999, Vol. 48(3),p.175-
negative effect on the infant’s sleep- 187.
the first three years of life. 10. Baer, MT, Poulsen, MK et coll. Effects of
waking cycle and on psychomotor • Proper nutrition with adequate Nutrition on Development and Behaviour.
and developmental maturation. amounts of necessary micronutri- Ch.29,p.294-311.
11. Lucas, A., Morley, R. et coll. Breast Milk and
• Zinc is functionally an essential com- ents, protein, and calories, given Subsequent Intelligence Quotient in Children
ponent of more than 200 enzymes at the appropriate time may ensure Born Preterm. The Lancet, Vol.339:261-264.1er
that pervade all metabolic pathways. fév. 1992.
normal brain development. Major 12. Menkes, John H. Early Feeding History of Chil-
Zinc deficiency causes slowing and catastrophic congenital malforma- dren with Learning Disorders. Deve. Med. Child
restriction of behaviour, lethargy, ap- tions like neural tube defects, hy- Neu-rol., Vol.19:169-171,1977.
13. Grantham-McGregor SM, Walker SP & Chang S.
athy and decreased growth rate. It is dro-cephalus, mental retardation, Nutritional Deficiencies and Later Behaviourial
also associated with a compromised and behaviour problems may be Development. Proceedings of the Nutrition so-
host-defense mechanism thereby ciety, Vol.59:47-54,2000.
prevented in some instances with 14. Fernstorm, J.D. Can Nutrient Supplementation
predisposing the child to recurrent proper nutritional supplementation Modify Brain Function. American Journal of Clin.
infections. and avoidance of certain lifestyle Nutrition, Vol 71(6):1669S-1675S, Juin 2000.
• Pyridoxine or vitamin B6 is an behaviours such as smoking and al-
essential cofactor in the develop- cohol intake among women of child-
ing central nervous system. Its bearing age. Therefore, ensuring an
deficiency in animals is associated intelligent and smart child starts with
with alteration in the glutamin-ergic a healthy mother.
neurotransmitter system which is • Nurturing nutritional well-being and
involved in memory and learning. health is a lifelong process, with
• Certain drugs, i.e. anticonvulsants, each phase affecting the next. But
alcohol, and smoking can deplete in turning the tide of malnutrition,
folic acid, zinc and iron stores. time is of the essence! (Nutrition for
• Excess and deficiency of Vitamin Health and Dev., WHO).
A in the mother’s diet during preg-
nancy have been shown to cause References
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The influence of breastfeeding on cog- nutrition during the first year of life on brain de-
velopment and learning in Chilean high-school
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emphasized. Landmark studies have International de Nutrition, Montréal, Canada,
27 juillet au 1er août 1997. Nutrition 16:11-12,
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Results of studies show that school ment: evidence from experimental/quasi-ex-
perimental studies among mild-to-moderately
age children have fewer neurological malnourished. International Dietary Energy Con-
abnormalities (Lanting et al., 1999), bet- sultative Group (IDECG) Task Force Workshop
on Malnutrition and Behaviour at the University

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