Millions of dollars are being invested in maternal and child nutrition programs aiming to reduce stunted growth in low- and middle-income countries. The association between stunted growth and poor cognitive development is a large part of the motivation for this investment. In a systematic review and meta-analysis of 75 early intervention programs, we found that effects of interventions on growth in height were not associated with effects on cognitive development. This contradicts the assumption that improvements in growth correspond to improvements in neurodevelopment. Moreover, we found that programs promoting responsive care and learning opportunities had 5 times larger effects on cognitive, language, and motor development than nutrition programs. Our true goal isn’t just for children to grow taller but for them to fulfill their developmental potential. This study shows that we will not reach that goal unless we target caregiving to nurture thriving individuals and communities.
In another systematic review and meta-analysis we investigated the World Health Organization recommended cut-off to define anemia in children under age 5 years. If a child’s hemoglobin concentration is less than 11 g/dL, that child is considered to be anemic. Although this is a widely used definition, few studies have examined whether this cut point accurately coincides with negative functional consequences, such as growth and development. We reviewed 20 observational studies and 56 iron supplementation studies. Although available evidence was not able to establish an inflection point at which decreasing Hb begins to be associated with negative functional outcomes, we found that effects of iron supplementation on Hb were associated with effects on motor and mental development and these associations were stronger among children with lower Hb concentrations at baseline.
Individual patient data analysis of effects of lipid-based nutrient supplements on child development.
Prado, E. L., Larson, L. M., Cox, K., Bettencourt, K., Kubes, J. N., Shankar, A. H. (2019). Do effects of early life interventions on linear growth correspond to effects on neurobehavioral development? A systematic review and meta-analysis. The Lancet Global Health. Epub ahead of print. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30361-4/fulltext
Larson, L. M., Kubes, J. N., Ramírez-Luzuriaga, M. J., Khishen, S., Shankar, A. H., Prado, E. L. (2019). Effects of increased hemoglobin on child growth, development, and disease: a systematic review and meta-analysis. Annals of the New York Academy of Sciences. Epub ahead of print. https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1111/nyas.14105