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Effects of Prenatal and Postnatal Lipid-based Nutrient Supplementation on Child Development and Physical Activity at Preschool Age in Ghana
Başlık:
Effects of Prenatal and Postnatal Lipid-based Nutrient Supplementation on Child Development and Physical Activity at Preschool Age in Ghana
Yazar:
Ocansey, Eugenia Maku, author.
ISBN:
9780355967791
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (170 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 79-10(E), Section: B.
Advisors: Kathryn G. Dewey Committee members: Elizabeth L. Prado; Rebecca J. Schmidt.
Özet:
Adequate nutrition is necessary for brain development, especially during the first 1000 days encompassing pregnancy through age two years. There is a dearth of evidence from randomized controlled trials (RCTs) of combined nutritional supplementation during both prenatal and postnatal periods on developmental outcomes in later life. In the International Lipid-based Nutrient Supplements (iLiNS-DYAD) Project in Ghana, 1320 women were randomized to daily lipid-based nutrient supplements (LNS) or multiple micronutrient (MMN) tablets during pregnancy through 6 months postpartum or iron and folic acid (IFA) during pregnancy and calcium placebo during 6 months postpartum. Children in the LNS group received LNS from 6 to 18 months. In a follow-up study of preschool children who participated in the iLiNS-DYAD trial, we examined the effects of provision of prenatal and postnatal LNS on: (i) cognitive, motor, and socio-emotional function and (ii) physical activity (PA) and sedentary behavior (SB). We also examined the associations of early linear growth and hemoglobin (Hb) concentration with later cognitive, motor and socio-emotional development. The first study assessed the effects of LNS supplementation on cognitive, motor, and socio-emotional scores of 966 children at age 4-6 y, using standard tests that were adapted and validated for this population in Ghana including subtests of the Developmental Neuropsychological Assessment, National Institute of Health Toolbox, and the Strengths and Difficulties Questionnaire. In a 2 group comparison (LNS vs Control (MMN+IFA)), cognitive and motor scores did not significantly differ by intervention group (ps > 0.1). Children in the LNS group had a significantly lower socio-emotional difficulties score than children in the non-LNS group (unadjusted and adjusted differences in mean z-score (95% CI): ?0.12 (-0.25, 0.02) p=0.087; and -0.16 (-0.29, -0.03) p=0.013); and this difference was larger among children from households with lower Home Observation for the Measurement of the Environment (HOME) scores (P-interaction = 0.081). These findings highlight the importance and interplay of both early nutrition and nurturing and developmental stimulation from the home environment on long-term socio-emotional behavior. The second study examined the effects of LNS on objectively measured PA and SB among a sub-sample of 353 children at age 4-6 y. We measured PA and SB using an accelerometer worn on the hip continuously over a 1-week period to estimate the mean vector magnitude (VM) counts /min, percentage of time spent in SB, and moderate-to-vigorous PA (MVPA). There was a significant difference between intervention groups in mean VM counts/min (LNS vs. Control: 1340 (1298, 1382) vs. 1413 (1382, 1445), p=0.007) and SB (LNS vs Control: 32.3%; 30.5%, p=0.020), both in the opposite direction as expected; however, children did not differ significantly in MVPA (LNS vs. Control 4.4%; 4.7%, p=0.198). The reduced VM counts and higher SB in the LNS group may have been related to the reduced behavior problems found in this group, which included items probing hyperactive behavior and the ability to focus and sustain attention to a task. The final study investigated the association of developmental scores at 4-6 y with i) birth length and linear growth during 3 postnatal periods (birth to 6 mo, 6 -18 mo and 18 mo to 4-6 y), and ii) child hemoglobin (Hb) concentration at 6 mo, 18 mo, and 4-6 y. Cognitive development was associated with linear growth during the prenatal and 6-18 mo periods but not during birth to 6 mo or 18 mo to 4-6 y, and with Hb at 18 mo but not at 6 mo or at 4-6 y. Motor and socio-emotional development outcomes were not associated with any exposure variables. These results suggest that the periods during development that are most susceptible to long-term cognitive insults from risk factors related to faltering in length-for-age z-scores (LAZ) and Hb concentration, are prior to birth and from 6 to 18 months.
Notlar:
School code: 0029
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(678457.1) | 678457-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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