Influence of enhanced nutrition and psychosocial stimulation in early childhood on cognitive functioning and psychological well-being in Guatemalan adults

• Type of Material: Article
• Authors: María J. Ramirez-Luzuriaga, Emory University; Ann DiGirolamo, Emory University; Reynaldo Martorell, Emory University; Manuel Ramirez-Zea, Institute of Nutrition of Central America and Panama (INCAP); Rachel Waford, Emory University; Aryeh Stein, Emory University
• Language: English
• Date: 2021-03-10
• Publisher: Pergamon-Elsevier Science Ltd.
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Author(s). Published by Elsevier Ltd.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2021.113810
• Title of Journal or Parent Work: Social Science & Medicine
• Volume: 275
• Start Page: 113810
• End Page: 113810
• Grant/Funding Information: This study was funded by the Bill and Melinda Gates Foundation (OPP1164115).
• Keywords: Psychosocial stimulation; Age; Behavioral Sciences; Structural equation modeling; Brain development; Mental development; Life Sciences & Biomedicine; Executive function; Supplementation; Follow-up; Motor development; Growth; Public, Environmental & Occupational Health; Science & Technology; Executive function deficits; Social Sciences, Biomedical; Children; Social Sciences; Nutrition interventions; Cognitive ability; Biomedical Social Sciences; Psychological well-being
• Research Categories: Health Sciences, Public Health; Health Sciences, Health Care Management; Health Sciences, Nutrition

Abstract

Rationale Early-life nutrition interventions in low and middle-income countries have demonstrated long-term benefits on cognitive skills, however, their influence on socioemotional outcomes has not been fully explored. Moreover, the mediating processes through which nutrition intervention effects operate and are maintained over time are understudied. Methods We followed-up a cohort of Guatemalan adults who participated as children in a community randomized food-supplementation trial. We examined associations of exposure to nutritional supplementation from conception to age 2 years with executive function (measured using three sub-tests of the NIH Toolbox Cognition Battery) and psychological well-being (measured using two sub-scales of the NIH Toolbox Emotion Battery) at ages 40–57 years (n = 1268). We used structural equation modeling to investigate the mediating role of psychosocial stimulation (measured in childhood using parent reports and ratings of home environments), cognitive ability (measured at ages 26–42 years using standardized tests), and executive function on the association of early-life exposure to nutritional supplementation with adult psychological well-being (n = 1640). Results We found positive but inconsistent associations of nutritional supplementation in childhood with executive function and psychological well-being in adulthood. Psychosocial stimulation, cognitive ability, and executive function did not mediate the association of early-life nutritional supplementation with adult psychological well-being. We found strong and positive associations of psychosocial stimulation in childhood with cognitive ability, executive function, and psychological well-being in adulthood. Moreover, we observed no interaction of exposure to nutritional supplementation and psychosocial stimulation in childhood with cognitive and psychological well-being outcomes in adulthood. Conclusion Our findings suggest that childhood nutrition interventions have long-lasting effects on cognitive ability and psychological well-being outcomes.