The impact of maternal/child nutrition on cognitive development: Prevention implications

The research that supports the concept that maternal and child nutrition status has a significant impact on childhood cognitive development has a long and compelling history. Ancient texts as well as manuscripts published during the age of enlightenment and the industrial revolution highlight the importance of maternal health and well-being in producing a healthy vigorous offspring. Moreover, maternal post-partum nutritional status and health have direct effects on the adequacy of the infant's primary nutritional source, breast milk. The adequacy of the infant's postnatal diet has a large impact on concurrent and subsequent cognitive development. These effects were so apparent historically that humanmilk substitutes were present in ancient times in order to nurture infants whose mothers were unable to provide adequate nutrition for their offspring. The modern research context for the effect of fetal and neonatal nutrition status on cognitive development can be traced to the seminal work of Myron Winick and colleagues in the early 1960s (Winick and Rosso, 1969). His work demonstrated that intrauterine growth restriction (IUGR) due to malnutrition results in reduction in brain size, neuronal number, and neuronal complexity. Maternal malnutrition during pregnancy, a potentially preventable condition, is a primary cause of IUGR world-wide. Societies in which mothers are chronically malnourished are likely to have malnourished children as well. Given that a major portion of brain development in humans occurs between the last trimester in fetal life and 3 years postnatally (Dobbing and Sands, 1979; Thompson and Nelson, 2001) it is not surprising that a malnourished maternal-fetus/infant dyad poses a significant risk to cognitive development. It has been estimated that correction of nutrient deficits could shift the world’s intelligence quotient (IQ) by 10 points to the positive (Morris, Cogill, and Uauy, 2008).