The link between nutrition in early life and brain development

The human brain develops rapidly during the first 2 years of life and it has been found that nutritional factors play a significant role in healthy brain growth and cognitive development. ¹

In fact, nutrient inadequacy may well result in compromised structural development of the brain ^{1 & 2} , affecting memory, IQ and the development of social skills, for example. The resulting deficits in brain function may not be reversed, despite subsequent nutrient repletion. This is referred to as ‘programming’- when a stimulus during a critical period of development can have long-term effects. ³

Interestingly, scientists have found that during the first 2 to 3 years of life, the gut microbiota of infants becomes diverse, quickly. Disruptions to this microbiota during this period are also found to have an impact on brain development. ^{4 & 5 & 6}

A holistic functional nutrition approach, therefore, may be effective in promoting healthy brain development and programming, as well as healthy gut microbiota. ⁷

Adopting a functional nutrition approach during pregnancy, sets a favourable foundation for good health in the mother and, by extension, in the baby. ⁸ Yet nutrition during early post-natal life is equally important. UNICEF’s 2019 State of the Children report found that “diet and nutrition play a key role in brain development right into adulthood… Children provided with a nutritious, safe and diverse diet are equipped for the physical and cognitive development, school performance and healthy life that awaits them”. ⁹

Adequate breastfeeding has been noted as a significant contributor to healthy cognitive development. ^{10 & 7} Research studies seem to suggest that the nutrients in breastmilk improve cognition, while the act of nursing has a positive impact on memory. ¹¹

Micronutrients, such as fatty acids, iron, zinc, iodine, choline and Vitamins D and B12, among others, have been found to play important roles in the structural, hormonal, functional or cognitive development of the brain. ¹²

Sufficient protein intake is also important, with protein-energy malnutrition found to have lasting effects on cognition. ¹³ In fact, pre-clinical malnutrition models indicate that protein-energy restriction results in a smaller brain with fewer neurons and neurotransmitters. ¹⁴

Nutrition is one of a number of factors in neurodevelopmental development. “Why nutrition is so key among these other factors is because it is one of the modifiable factors. It’s one of the things that you can educate and generate awareness about, and help children get the nutrition they need during this critical period,” says Dr Ryan Carvalho, Chief Medical Officer, Nestle Nutrition. ¹⁵

Taking all this into consideration – along with the fact that diet and nutrition can be controlled – HCPs may consider the following nutrition tips:

Age: birth to 6 months

The recommendation of both UNICEF and WHO, is that infants be breastfed exclusively for the first 6 months, and continue breastfeeding up to 2 years of age. ¹⁰

Age: 6 months to 1 year ¹⁰

From 6 months of age, baby should be fed small amounts of age appropriate complementary foods.
Slowly increase the variety and amounts of food, feeding meals 5 times a day.
Offer baby clean drinking water, regularly (teaching them to drink from a cup). ¹⁷
It’s recommended to feed baby fortified foods as well as leafy greens and vegetables, as well as fruit.
Sugary drinks and treats as well as salty snacks should be avoided.

Age: 1 to 3 years

The child’s daily diet should be balanced, incorporating a selection of the major food groups. ¹⁸
Start with a schedule of 3 to 4 meals, with another 2 to 3 snacks daily; as the child grows, this can be cut back to 2 to 3 meals, with 2 to 3 snacks over the course of the day. ^{20 & 19}
Starchy foods should be part of most meals ¹⁷
The Mediterranean diet is associated with a reduced risk of developing cognitive disorders. Therefore, families may be encouraged to follow the diet, by eating plenty of fruit, vegetables, plant oils such as olive oil, whole grains and fish. Foods to be avoided include high fat dairy, carbonated drinks, sweets and processed meats. ^{20 & 21}
Prebiotic and probiotic foods should be included in the diet, to encourage the establishment and development of a healthy gut microbiome. Foods rich in dietary fibre are especially important (e.g. fruit and vegetables). ^{22 & 23}
Parents should model healthy food choices and ensure that the foods available in the home, are healthy too. ²⁴

Age: older children & adults

Be active every day.
Eat a wide variety of foods daily, including plenty of fresh fruit and vegetables. ¹⁷
Children can eat chicken, fish, meat, eggs, beans, soya or peanut butter daily.
Children should eat 5 small meals each day. ¹⁷
Make starchy foods part of most meals.
Eat dry beans, split peas, lentils and soya regularly.
Have milk, maas or yoghurt every day.
Drink lots of clean, safe water.
Use fats sparingly. Choose vegetable oils, rather than hard fats.
Foods and drinks high in sugar should be consumed sparingly.

1 Nurliyana, A., Mohd Shariff, Z., Mohd Taib, M., Gan, W. and Tan, K., 2016. Early nutrition, growth and cognitive development of infants from birth to 2 years in Malaysia: a study protocol. BMC Pediatrics, [online] 16(1). Available at: <https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-016-0700-0> [Accessed 9 July 2021].
2 Ratsika, A., Codagnone, M., O’Mahony, S., Stanton, C. and Cryan, J., 2021. Priming for Life: Early Life Nutrition and the Microbiota-Gut-Brain Axis. Nutrients, [online] 13(2), p.423. Available at: <https://www.researchgate.net/publication/348862731_Priming_for_Life_Early_Life_Nutrition_and_the_Microbiota-Gut-Brain_Axis>.
3 Lucas, A., 2005. Long-Term Programming Effects of Early Nutrition — Implications for the Preterm Infant. Journal of Perinatology, [online] 25(S2), pp.S2-S6. Available at: <https://www.nature.com/articles/7211308.> [Accessed 9 July 2021].
4 Wang, S., Harvey, L., Martin, R., van der Beek, E., Knol, J., Cryan, J. and Renes, I., 2018. Targeting the gut microbiota to influence brain development and function in early life. Neuroscience & Biobehavioral Reviews, [online] 95, pp.191-201. Available at: <https://www.sciencedirect.com/science/article/abs/pii/S014976341730670X> [Accessed 9 July 2021].
5 O’Mahony, S., Clarke, G., Dinan, T. and Cryan, J., 2017. Early-life adversity and brain development: Is the microbiome a missing piece of the puzzle?. Neuroscience, [online] 342, pp.37-54. Available at: <https://www.researchgate.net/publication/282428317_Early_Life_Adversity_and_Brain_Development_Is_the_Microbiome_a_Missing_Piece_of_the_Puzzle> [Accessed 9 July 2021].
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7 Wang, S., Harvey, L., Martin, R., van der Beek, E., Knol, J., Cryan, J. and Renes, I., 2018. Targeting the gut microbiota to influence brain development and function in early life. Neuroscience & Biobehavioral Reviews, [online] 95, pp.191-201. Available at: <https://www.sciencedirect.com/science/article/abs/pii/S014976341730670X> [Accessed 13 June 2021].
8 Nestlé Nutrition Institute. 2021. Supporting mother & child during pregnancy with functional nutrition. [online] Available at: <https://nnia.nestlenutrition-institute.org/news/article/2021/03/11/supporting-mother-child-during-pregnancy-functional-nutrition> [Accessed 26 June 2021].
9 Unicef.org. 2021. The State Of The World's Children 2019. [online] Available at: <https://www.unicef.org/media/60806/file/SOWC-2019.pdf> [Accessed 7 July 2021].
10 Grantham-McGregor, S., Walker, S. and Chang, S., 2000. Nutritional deficiencies and later behavioural development. Proceedings of the Nutrition Society, [online] 59(1), pp.47-54. Available at: <https://www.cambridge.org/core/services/aop-cambridge-core/content/view/9CBDE50E1D3566212208440D1B952409/S0029665100000069a.pdf/nutritional-deficiencies-and-later-behavioural-development.pdf> [Accessed 7 July 2021].
11 Pang, W., Tan, P., Cai, S., Fok, D., Chua, M., Lim, S., Shek, L., Chan, S., Tan, K., Yap, F., Gluckman, P., Godfrey, K., Meaney, M., Broekman, B., Kramer, M., Chong, Y. and Rifkin-Graboi, A., 2019. Nutrients or nursing? Understanding how breast milk feeding affects child cognition. European Journal of Nutrition, [online] 59(2), pp.609-619. Available at: <https://link.springer.com/article/10.1007/s00394-019-01929-2> [Accessed 27 June 2021].
12 Karavida, V., Tympa, E. and Charissi, A., 2019. The Role of Nutrients in Child’s Brain Development. JOURNAL OF EDUCATION AND HUMAN DEVELOPMENT, [online] 8(2). Available at: <https://www.researchgate.net/publication/335379195_The_Role_of_Nutrients_in_Child's_Brain_Development> [Accessed 27 June 2021].
13 Kar, B., Rao, S. and Chandramouli, B., 2008. Cognitive development in children with chronic protein energy malnutrition. Behavioral and Brain Functions, [online] 4(1), p.31. Available at: <https://www.researchgate.net/publication/51426100_Cognitive_development_in_children_with_chronic_protein_energy_malnutrition> [Accessed 26 June 2021].
14 Cusick, S. and Georgieff, M., 2016. The Role of Nutrition in Brain Development: The Golden Opportunity of the “First 1000 Days”. The Journal of Pediatrics, [online] 175, pp.16-21. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981537/> [Accessed 4 July 2021].
15 Nestle Nutrition Institute, 2020. Webinar: Nutrition for Brain Development. [video] Available at: <https://www.youtube.com/watch?v=ba4tX5bsVOQ> [Accessed 10 July 2021].
16 Nestlé. n.d. The South African food-based Dietary guidelines. [online] Available at: <https://www.nestle-esar.com/nhw/nutritionbasics/sa-food-based-dietary-guidline> [Accessed 7 July 2021].
17 Bourne, L., Marais, D. and Love, P., 2007. The process followed in the development of the paediatric food-based dietary guidelines for South Africa. Maternal & Child Nutrition, [online] 3(4), pp.239-250. Available at: <https://www.researchgate.net/publication/6015318_The_process_followed_in_the_development_of_the_paediatric_food-based_dietary_guidelines_in_South_Africa> [Accessed 10 July 2021].
18 Childrens.com. n.d. How Can I Improve My Child's Gut Health? - Children's Health. [online] Available at: <https://www.childrens.com/health-wellness/what-should-my-child-eat-to-promote-gut-health> [Accessed 29 June 2021].
19 Who.int. 2021. Infant and young child feeding. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding> [Accessed 25 June 2021].
20 Jennings, A., Cunnane, S. and Minihane, A., 2020. Can nutrition support healthy cognitive ageing and reduce dementia risk?. BMJ, [online] p.m2269. Available at: <https://www.bmj.com/content/369/bmj.m2269> [Accessed 4 July 2021].
21 Childrens.com. n.d. Is the Mediterranean diet healthy for kids? - Children's Health. [online] Available at: <https://www.childrens.com/health-wellness/is-the-mediterranean-diet-heathy-for-kids> [Accessed 4 July 2021].
22 Hanson, P. and Barber, T., 2021. Should we consider the microbiome to be another organ?. [online] Medicalnewstoday.com. Available at: <https://www.medicalnewstoday.com/articles/is-the-microbiome-another-organ-maybe-we-should-treat-it-like-it-is#Prebiotics> [Accessed 27 June 2021].
23 Valdes, A., Walter, J., Segal, E. and Spector, T., 2018. Role of the gut microbiota in nutrition and health. BMJ, [online] p.k2179. Available at: <https://www.bmj.com/content/361/bmj.k2179> [Accessed 22 June 2021].
24 Nestlé Nutrition Institute. 2021. Family nutrition: Creating a healthier food environment for lifelong wellness. [online] Available at: <https://nnia.nestlenutrition-institute.org/news/article/2021/04/23/family-nutrition-creating-healthier-food-environment-lifelong-wellness> [Accessed 2 July 2021].