Year: 2019

Nutrition Programs Alone Aren’t Enough to Support Healthy Brain Development

Study Looks at Preventing Stunted Brains, Not Just Stunted Growth

By Amy Quinton on September 16, 2019 in Human & Animal Health

A new study led by researchers at the University of California, Davis, shows that caregiving programs are five times more effective than nutrition programs in supporting smarter, not just taller, children in low- and middle-income countries.

The research, published in the journal The Lancet Global Health, examined 75 early intervention programs and their effects on children’s growth and brain development. Researchers have known adequate nutrition during pregnancy and childhood improve both conditions. But children growing up in poverty face a variety of risk factors that could govern growth and development differently.

“Our study found that we can’t just focus on nutrition. Other aspects of nurturing care are just as, if not more important in supporting healthy brains,” said lead author Elizabeth Prado, assistant professor of nutrition at UC Davis.

Prado says interventions that promote caregiving and learning, such as parents playing games, singing songs and telling stories with their children, have far bigger effects on children’s cognitive skills, language skills and motor development.

“We knew that nurturing care was important but were struck by how big its benefits were compared to nutrition and growth,” added Leila Larson, a lead collaborator from the University of Melbourne.

Investing in caregiving and learning

Global health programs typically focus on preventing stunting, when children are not growing in height the way they should for their age. Stunted growth has also been associated with lower than average school achievement and cognitive scores.

“The association has been influential in prioritizing a global agenda to promote nutrition and growth,” said senior author Anuraj Shankar, with the Center for Tropical Medicine and Global Health at Oxford University. “However, our true goal isn’t just for children to grow taller but for them to fulfill their developmental potential. The study shows that won’t happen unless we target caregiving to nurture thriving individuals and communities.”

Globally, an estimated 156 million children younger than 5 years have stunted growth and an estimated 250 million are at risk of not fulfilling their developmental potential.

Media contact(s)

Elizabeth Prado, UC Davis Department of Nutrition, 301-697-9542,

Amy Quinton, UC Davis News and Media Relations, 530-752-9843, cell 530-601-8077,

Karen Nikos-Rose, UC Davis News and Media Relations, 530-219-5472,

Anuraj Shankar, Center for Tropical Medicine and Global Health, Oxford University, 617-955-6724,

New TRELLIS Lab findings published in Jan/Feb, 2019

Two new papers from the TRELLIS lab have been published early this year in the American Journal of Clinical Nutrition and the BMJ Global Health.

In the American Journal of Clinical Nutrition, Ocansey and colleagues report that lipid-based nutrient supplements (LNS) provided to pregnant women and their children from 0-18 months in Ghana reduced social-emotional problems 5 years later, compared to groups who received only micronutrients. Children with lower home environment scores showed the greatest benefits of LNS, suggesting that early nutritional supplementation buffered the effect of a poor home environment on the development of behavioral problems. This study is the first long-term follow-up of a randomized controlled trial of both prenatal and postnatal LNS supplementation, and suggests that such supplementation may be part of an effective strategy to prevent the development of behavioral problems.

In the BMJ Global Health, Prado and colleagues reported factors that contribute to linear growth faltering in 4 longitudinal cohorts of young children, totaling more than 4000, in Ghana, Malawi, and Burkina Faso. We found consistent associations of 18-mo LAZ with maternal height and maternal body mass index (BMI) in 3-4 cohorts. The factors with the strongest associations with 18-mo LAZ were length for gestational age z-score at birth, maternal height, and gestational age at birth. Other factors that showed significant associations with 18-mo LAZ in 2 cohorts, though with smaller coefficients, were improved household water source, child dietary diversity, childhood diarrhea incidence, and 6 or 9-mo hemoglobin concentration. Interventions targeting these factors associated with LAZ may accelerate progress toward reducing stunting, however, much of the variance in linear growth status remained unaccounted for by individual-level factors suggesting that community-level changes may be needed to achieve substantial progress and further research is needed to understand the causes of stunting.

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