What advice would you give to parents wishing to use nutrition to help the

cognitive development of their child? Justify your recommendations with

reference to evidence.

Word count without references: 998

Date of completion: 15/05/2022

 What advice would you give to parents wishing to use nutrition to help the
cognitive development of their child? Justify your recommendations with
reference to evidence.

Small changes in diet can greatly impact a child’s cognitive development and improve their mental
condition, both short and long term (Unicef, 2019). In fact, deficiencies in the prenatal diet can cause
cognitive impairment not noticeable until later on in life (50+ years) (De Rooij, 2010). For this reason,
encouraging mothers and children to partake in dietary considerations, especially during critical
periods of development could result in a healthier childhood as well as reduce the effects of ageing
and the risk of dementia (De Rooij, 2010). However, children vary significantly in food
responsiveness, meaning that specific recommendations would be impossible to give without
meeting the child or observing their medical history, instead general advice on important nutrients
which have been shown to affect cognitive development is offered.

The first decision most parents make on their child’s postnatal diet involves breastfeeding.
Anderson’s metanalysis has shown that in comparison to using cow’s milk, 20-27 weeks of
breastfeeding can increase cognitive ability in infants (6-23 months +3.11 IQ) and adolescent youths
(10-15 years +3.19 IQ) (Anderson, 1999). Considering that breast milk has evolved in mammals over
the ages it is not surprising that it is more optimised towards benefiting humans than cow’s milk
(Anderson, 1999). Even when controlling for extraneous variables, such as child rearing, a similar
effect was noted, children that were reared in an incubator and given formula milk with added
protein and minerals still demonstrated heightened social and psychomotor skills despite the lack of
motherly attention (Morley, 1988). Human milk contains high amounts of polyunsaturated fatty
acids which make up a quarter of the adult brain and are important in determining the brains
“integrity and ability to perform” (Chang, 2009). When comparing brain scans of children who had
been given cows milk and breastfed children, it was clear that there were far more fatty acids in the
corpus callosum of the latter group (Blesa, 2019).Two conclusions can be derived from this. Firstly,
the nutrients present in breast milk influence the structural composition of the brain, secondly,
these changes can have positive impacts on brain connectivity and therefore cognitive development.
However meta-analyses such as Anderson’s have been criticised, one reason is due to the variety of
studies used. It is hard to equate 17 studies which use different independent variables and control
for different variables (Sharpe, 1997) . For example, differences in intelligence scores decreased
when controlling for maternal IQ (Horta, 2015) and when considering differences in parenting styles.
Although socioeconomic status of parents was shown to be unimportant (Lucas, 1992).
Neuroimaging studies such as the one conducted by Belsa, again demonstrate that changes in diet
can affect brain structure (Blesa, 2019). Breast fed children had larger caudate nuclei. Meta-analysis
results coupled with neuroimaging studies are enough to demonstrate that nutrients found in breast
milk can have an effect on brain structure and therefore cognitive ability.

Gross malnutrition such as during the Dutch famine caused by World War 2 also show the adverse
effects of reduced nutrition in children. On average women were consuming 672 calories a day
whilst in the first trimester of pregnancy (Stein, 2013)(quarter of the recommended amount), this is
a critical period where many important functions including auditory systems are developing.
Therefore, babies born during this period of famine, performed worse on cognitive tasks such as
attention tests and were more susceptible to stress compared to their Dutch counterparts who lived
in less affected areas (Painter, 2006). What was curious though was that these effects were not
limited to early life and in fact cognitive impairment was noticed at 56-59 years old (De Rooij S. W.,
2010). What this means is that during the highly vulnerable period of early gestation, malnutrition
must be avoided to increase the chance of developing a child with strong mental health and limit the
likelihood of developing disorders such as depression and schizophrenia in later life (Susser, 1996).
 What advice would you give to parents wishing to use nutrition to help the
cognitive development of their child? Justify your recommendations with
reference to evidence.

The areas most affected by the famine were shown to be more susceptible to these diseases, it
could be argued however the war would have caused a lowered general mood and reductions in
average affluency of citizens. Not many disasters cause as much social and economic conflict as a
war, that must have played a part in hindering the children’s development and could partially
explain their worse cognitive scores. Nether the less, children born after the famine showed less
adverse effects to gross malnutrition than the ones born during this period, meaning prenatal
nutrition can also have effect on a child’s cognitive development.

Explanations have been offered for why nutrient deficiencies should be avoided, for example iodine,
which can be readily found in animal protein food and sea vegetables, is a composite of thyroid
(Rousset, 2015). Lack of thyroxin release will lead to increased chance of developing goitre and
mental retardation (Kapil, 2007), studies in China have shown iodine deficiency can lead to
reductions of up to 15 iq points in later life (Qian, 2005). Even during pregnancy, especially in the
first and third trimesters, mothers who consume iodine below the recommended dose (140
micrograms) can cause irreversible damage to their child’s cognitive development (Zimmerman,
2012). Many other nutrients seem to have a similar effect in developing cognitive ability, iron
deficiency below 2 years of age has been shown to cause permanent damage to motor coordination
and language skills (INACG, 1987), whilst deficiencies in the omega-3 protein found in fish would halt
the production of essential fatty acids such as DHA (Hibbeln, 2007).

These considerations should be taken with a pinch of salt, it has been shown that these effects can
change depending on child’s food responsiveness. Children with ADHD have been shown to have a
positive cognitive reaction to limiting additives though no effect was noted in non-ADHD children
(Nigg, 2012). My recommendation would be to specify diets towards children, whilst still ensuring
they are intaking all required nutrients. Even though the literature is imperfect, breast feeding or at
least usage of optimised milk has been shown to increase cognitive ability. Suitable intake of iodine
and omega 3 would also be recommended to ensure physical and mental welfare of children.

References
Anderson, J. J. (1999). Breast-feeding and cognitive development: a meta-analysis. Am j clin nutr,
525-535.

Blesa, M. S. (2019). Early breast milk exposure modifies brain connectivity in preterm infants.
Neuroimage, 431-439.

Chang, C.-Y. K.-S. (2009). Essential fatty acids and human brain. Acta Neurol Taiwan, 231-241.

De Rooij, S. W. (2010). Prenatal undernutrition and cognitive function in late adulthood.

Developmental Biology, Psychological and Cognitive Sciences, 16881-16886.

De Rooij, W. Y. (2010). Prenatal undernutrition and cognitive function in late adulthood. Proc Natl
Acad Sci USA, 16881-16886.

Hibbeln, J. D. (2007). Maternal seafood consumption in pregnancy and neurodevelopmental

outcomes in childhood (ALSPAC study): an observational cohort study. Lancet, 578-585.

Horta, B. M. (2015). Breastfeeding and inteligence: a systematic review and meta-analysis. Acta
Paediatr, 14-19.
 What advice would you give to parents wishing to use nutrition to help the
cognitive development of their child? Justify your recommendations with
reference to evidence.

INACG. (1987). INTERNATIONAL NUTRITIONAL ANEMIA CONSULTATIVE GROUP@. 1-187.

Kapil, U. (2007). Health Consequences of Iodine Deficiency. Sultan Qaboos Univ Med, 267-272.

Lucas, A. M. (1992). Breast milk and subsequent intelligence quotient in children born preterm. The
Lancet, 261-264.

Morley, R. C. (1988). Mother's choice to provide breast milk and developmental outcome. Archives
of Disease in Childhood,, 1382-1385.

Nigg, J. L. (2012). Meta-analysis of attention-deficit/hyperactivity disorder or

attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color
additives. J am Acad Child Adolesc Psychiatry, 86-97.

Painter, R. D. (2006). Early onset of coronary artery disease after prenatal exposure to the Dutch
famine. The american journal of clinical nutrition, 322-327.

Qian, M. W. (2005). The effects of iodine on intelligence in children: a meta-analysis of studies

conducted in China. Asia Pac J Clin Nutr, 32-42.

Rousset, B. D. (2015). Chapter 2 Thyroid Hormone Synthesis And Secretion. Endotext.

Sharpe, D. (1997). Of apples and oranges, file drawers and garbage: why validity issues in meta-
analysis will not go away. Clinical Psychology Review, 881-901.

Stein, A. P. (2013). Maternal exposure to the Dutch Famine before conception and during pregnancy:
quality of life and depressive symptoms in adult offspring. Epidemiology, 909-915.

Susser, E. N. (1996). Schizophrenia After Prenatal Famine. Arch Gen Psych, 25-31.

Unicef. (2019, 10 15). POOR DIETS DAMAGING CHILDREN’S HEALTH, WARNS UNICEF. Retrieved from
https://www.unicef.org.uk/press-releases/poor-diets-damaging-childrens-health-warns-
unicef/

Zimmerman, M. (2012). The effects of iodine defeciency in pregnancy and infancy. paediatric and
perinatal epidemiology, 108-116.