Early Life Child Micronutrient Status, Maternal Reasoning, and a Nurturing Household Environment have Persistent Influences on Child Cognitive Development at Age 5 years: Results from MAL-ED

Benjamin J.J. McCormick, Stephanie A. Richard, Laura E. Caulfield, Laura L. Pendergast, Jessica C. Seidman, Beena Koshy, Reeba Roshan, Rita Shrestha, Erling Svensen, Ladislaus Blacy, Zeba Rasmussen, Angelina Maphula, Rebecca Scharf, Baitun Nahar, Sayma Haque, Muneera Rasheed, Reinaldo Oria, Elizabeth T. Rogawski, Laura E. Murray-Kolb, Angel Mendez AcostaRosa Rios De Burga, Cesar Banda Chavez, Julian Torres Flores, Maribel Paredes Olotegui, Silvia Rengifo Pinedo, Mery Siguas Salas, Dixner Rengifo Trigoso, Angel Orbe Vasquez, Imran Ahmed, Didar Alam, Asad Ali, Zulfiqar A. Bhutta, Shahida Qureshi, Sajid Soofi, Ali Turab, Anita K.M. Zaidi, Ladaporn Bodhidatta, Carl J. Mason, Sudhir Babji, Anuradha Bose, Ajila T. George, Dinesh Hariraju, M. Steffi Jennifer, Sushil John, Shiny Kaki, Gagandeep Kang, Priyadarshani Karunakaran, Robin P. Lazarus, Jayaprakash Muliyil, Mohan Venkata Raghava, Sophy Raju, Anup Ramachandran, Rakhi Ramadas, Karthikeyan Ramanujam, Srujan L. Sharma, Shanmuga E. Sundaram, Rahul J. Thomas, William K. Pan, Ramya Ambikapathi, J. Daniel Carreon, Vivek Charu, Viyada Doan, Jhanelle Graham, Christel Hoest, Stacey Knobler, Dennis R. Lang, Monica McGrath, Mark A. Miller, Archana Mohale, Gaurvika Nayyar, Stephanie Psaki, Vivian Wang, Rebecca Blank, Michael Gottlieb, Karen H. Tountas, Caroline Amour, Eliwaza Bayyo, Estomih R. Mduma, Regisiana Mvungi, Rosemary Nshama, John Pascal, Buliga Mujaga Swema, Ladislaus Yarrot, Tahmeed Ahmed, A. M.Shamsir Ahmed, Rashidul Haque, Iqbal Hossain, Munirul Islam, Mustafa Mahfuz, Dinesh Mondal, Fahmida Tofail, Ram Krishna Chandyo, Prakash Sunder Shrestha, Manjeswori Ulak, Aubrey Bauck, Robert E. Black, William Checkley, Margaret N. Kosek, Gwenyth Lee, Kerry Schulze, Pablo Peñataro Yori, A. Catharine Ross, Barbara Schaefer, Suzanne Simons, Samuel P. Scott, Cláudia B. Abreu, Hilda Costa, Alessandra Di Moura, José Quirino Filho, Alexandre Havt, Álvaro M. Leite, Aldo A.M. Lima, Noélia L. Lima, Ila F. Lima, Bruna L.L. Maciel, Pedro H.Q.S. Medeiros, Milena Moraes, Francisco S. Mota, Reinaldo B. Oriá, Josiane Quetz, Alberto M. Soares, Rosa M.S. Mota, Crystal L. Patil, Pascal Bessong, Cloupas Mahopo, Emanuel Nyathi, Amidou Samie, Leah Barrett, Rebecca Dillingham, Jean Gratz, Richard L. Guerrant, Eric Houpt, William A. Petri, James Platts-Mills, Binob Shrestha, Sanjaya Kumar Shrestha, Tor Strand

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7 Scopus citations

Abstract

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown. Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y. Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured and their relation with the Wechsler Preschool Primary Scales of Intelligence at 5 y was examined through use of linear regression. Results: Cognitive T-scores from 813 of 1198 (68%) children were examined and 5 variables had significant associations in multivariable models: mean child plasma transferrin receptor concentration (β: -1.81, 95% CI: -2.75, -0.86), number of years of maternal education (β: 0.27, 95% CI: 0.08, 0.45), maternal cognitive reasoning score (β: 0.09, 95% CI: 0.03, 0.15), household assets score (β: 0.64, 95% CI: 0.24, 1.04), and HOME child cleanliness factor (β: 0.60, 95% CI: 0.05, 1.15). In multivariable models, the mean rate of enteropathogen detections, burden of illness, and complementary food intakes between birth and 2 y were not significantly related to 5-y cognition. Conclusions: A nurturing home context in terms of a healthy/clean environment and household wealth, provision of adequate micronutrients, maternal education, and cognitive reasoning have a strong and persistent influence on child cognitive development. Efforts addressing aspects of poverty around micronutrient status, nurturing caregiving, and enabling home environments are likely to have lasting positive impacts on child cognitive development.

Original languageEnglish (US)
Pages (from-to)1460-1469
Number of pages10
JournalJournal of Nutrition
Volume149
Issue number8
DOIs
StatePublished - Aug 1 2019

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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