Influence of enhanced nutrition and psychosocial stimulation in early childhood on cognitive functioning and psychological well-being in Guatemalan adults. (April 2021)

• Record Type: Journal Article
• Authors: Ramírez-Luzuriaga, María J.; DiGirolamo, Ann M.; Martorell, Reynaldo; Ramírez-Zea, Manuel; Waford, Rachel; Stein, Aryeh D.
• Is Part Of: Social science & medicine. Volume 275(2021)
• Publication Date: 2021-04
• Subjects: Nutrition interventions -- Psychosocial stimulation -- Cognitive ability -- Executive function -- Psychological well-being -- Structural equation modeling; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2021.113810
• Languages: English
• ISSNs: 0277-9536

Abstract

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. Highlights: We assess the influence of early-life nutrition on neurodevelopmental outcomes. We use a theoretical approach to examine mediators of the association. We found no mediators of the association of early-life nutrition with adult psychological well-being. Psychosocial stimulation is strongly associated with neurodevelopmental outcomes. Improved child nutrition is positively associated with adult psychological well-being.