Eating well at the very beginning of life, during pregnancy and the first months, is essential for optimal brain development in children. Deficiencies in certain key nutrients (such as iron or iodine) are associated with developmental delays, but the results are less numerous and less consistent in healthy children. Therefore, the objective of this project was to assess the extent to which the intake of proteins, lipids and carbohydrates in the first year are associated with the cognitive development of preschool-aged children. We wanted to test the following hypotheses: (i) a lower protein intake and higher fat intake at 12 months would be associated with higher neurodevelopmental scores at 3 and 5-6 years of age; (ii) a high omega-6/omega-3 ratio would be linked to lower neurodevelopmental scores.
The data collected regularly in the EDEN cohort allowed us to address this research question. Indeed, at the 1-year follow-up, parents completed food diaries: all their children's consumption for 3 days was recorded and quantified. These data were then checked by a dietitian and we were able to deduce the amount of lipids, proteins and carbohydrates consumed by infants each day. The neurodevelopment of the children was then assessed using a questionnaire completed by parents at 3 years of age and by an interview with an investigator at 5-6 years of age. The 3-year questionnaire assessed several aspects of development: communication, motor skills, problem solving, and relational. The 5-6-year test with the investigator assessed verbal and nonverbal IQ. The analyses were conducted in 914 children at 3 years of age and 785 children at 5-6 years of age and took into account the main family characteristics.
In the EDEN mother-child cohort, the intake of macronutrients at 12 months did not appear to be a strong determinant of neurodevelopmental scores at 3 and 5-6 years of age. Some associations were found between the intake of polyunsaturated fatty acids - linoleic acid and α-linolenic acid - and the relational score at 3 years and the IQ at 5-6 years, but we cannot exclude the possibility that these results are due to chance, as they were not found in all analyses. The potential influence of the intake of polyunsaturated fatty acids at the end of the complementary feeding period should be further investigated in a larger population, with greater variability in the intake of polyunsaturated fatty acids and with more details on the different polyunsaturated fatty acids. It would also be essential to consider the influence of carbohydrate subtypes, such as added sugars, and the influence of micronutrient intake on child cognitive development in term and healthy infants from different backgrounds, for example from disadvantaged socioeconomic backgrounds.
From a public health perspective, a better understanding of the links between macronutrient intake in early childhood and cognition/neurological development would be important to allow the formulation of new recommendations aimed at improving the diet of the developing child, at a time so critical for brain development.
Author(s): Blandine de Lauzon-Guillain
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