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Nutrient trajectories during infancy and their associations with childhood neurodevelopment

  • Original Contribution
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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

To examine the associations between infants’ dietary nutrient trajectories and subsequent neurodevelopment during childhood in the Growing Up in Singapore Towards healthy Outcomes study.

Methods

One-day food records were collected at ages 6, 9 and 12 months, whilst Bayley Scales of Infant and Toddler Development-III and Kaufman Brief Intelligence Test-2 were conducted at ages 24 and 54 months respectively. Nutrient trajectories were constructed using multi-level mixed modelling and associations with neurodevelopment (24 months: n = 484; 54 months: n = 444) were examined using adjusted multivariable linear regression.

Results

At age 24 months, higher protein intake (at 6 months) and increasing rate of intake (from 6 to 12 months) were associated with higher fine motor score [β = 0.17 SD (95% CI 0.03, 0.31) and 0.62 SD (0.10, 1.14) respectively]. Higher fat intake was associated with higher receptive language score [0.04 SD (0.003, 0.07)], but increasing rate of intake was associated with lower expressive language [− 0.20 SD (− 0.39, − 0.01)] and fine motor [− 0.29 SD (− 0.48, − 0.10)] scores. Higher carbohydrate intake was associated with lower gross motor score [− 0.07 SD (− 0.14, − 0.005)], but increasing rate of intake was associated with higher receptive language [0.44 SD (0.08, 0.81)] and fine motor [0.56 SD (0.18, 0.93)] scores. Increasing rate of dietary fibre intake was associated with higher fine motor scores [0.63 SD (0.16, 1.10)]. No significant associations were observed with neurodevelopment at 54 months.

Conclusion

Our findings provide greater understanding of how nutrition over time could have varying effects on child neurodevelopment.

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Data availability

The datasets generated and/or analysed during the current study are not publicly available due to an ethical restriction (patient confidentiality) which was imposed by the Centralised Institutional Review Board of SingHealth. Interested researchers may request for the data by contacting the corresponding author.

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Acknowledgements

We would like to thank the participants for their contributions to this study. We would also like to thank and acknowledge the GUSTO study group. The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit Froukje Philipp Broekman, Boon Long Quah, Chai Kiat Chng, Cheryl Shufen Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Daniel Yam Thiam Goh, Doris Ngiuk Lan Loh, Fabian Kok Peng Yap, George Seow Heong Yeo, Helen Yu Chen, Hugo P. S. van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Jeevesh Kapur, Jenny L. Richmond, Jerry Kok Yen Chan, Joanna Dawn Holbrook, Joshua J. Gooley, Keith M. Godfrey, Kenneth Yung Chiang Kwek, Kok Hian Tan, Krishnamoorthy Naiduvaje, Leher Singh, Lin Su, Lourdes Mary Daniel, Lynette Pei-Chi Shek, Marielle V. Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Michael J. Meaney, Mya Thway Tint, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, P. C. Wong, Peter David Gluckman, Pratibha Keshav Agarwal, Rob Martinus van Dam, Salome A. Rebello, Seang Mei Saw, Shang Chee Chong, Shirong Cai, Shu-E Soh, Sok Bee Lim, Stephen Chin-Ying Hsu, Victor Samuel Rajadurai, Walter Stunkel, Wee Meng Han, Wei Pang, Yap Seng Chong, Yin Bun Cheung, Yiong Huak Chan and Yung Seng Lee.

Funding

The GUSTO cohort study was funded by the Singapore National Research Foundation’s Translational and Clinical Research (TCR) Flagship Programme and was administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding was given by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator NF-SI-0515-10042), NIHR Southampton 1000DaysPlus Global Nutrition Research Group (17/63/154) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004), the British Heart Foundation (RG/15/17/3174) and by the European Union (Erasmus + Programme Early Nutrition eAcademy Southeast Asia-573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP and ImpENSA).

Author information

Authors and Affiliations

  1. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore

    Jia Ying Toh, Shirong Cai, Yung Seng Lee, Yap-Seng Chong, Johan G. Eriksson, Birit F. P. Broekman & Mary F. F. Chong

  2. Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Shirong Cai & Johan G. Eriksson

  3. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore

    Shan Xuan Lim & Mary F. F. Chong

  4. Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Wei Wei Pang, Yap-Seng Chong & Johan G. Eriksson

  5. Medical Research Council Lifecourse Epidemiology Centre and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, UK

    Keith M. Godfrey

  6. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Lynette P. Shek & Yung Seng Lee

  7. Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore

    Lynette P. Shek

  8. Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore

    Kok Hian Tan

  9. Duke-National University of Singapore Graduate Medical School, Singapore, Singapore

    Kok Hian Tan & Fabian Yap

  10. Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore, Singapore

    Fabian Yap

  11. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Fabian Yap

  12. Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore

    Yung Seng Lee

  13. Folkhälsan Research Center, Helsinki, Finland

    Johan G. Eriksson

  14. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Johan G. Eriksson

  15. Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam, The Netherlands

    Birit F. P. Broekman

  16. Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore

    Anne Rifkin‑Graboi

Authors
  1. Jia Ying Toh
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  2. Shirong Cai
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  3. Shan Xuan Lim
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  4. Wei Wei Pang
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  5. Keith M. Godfrey
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  6. Lynette P. Shek
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  7. Kok Hian Tan
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  8. Fabian Yap
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  9. Yung Seng Lee
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  10. Yap-Seng Chong
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  11. Johan G. Eriksson
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  12. Birit F. P. Broekman
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  13. Anne Rifkin‑Graboi
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  14. Mary F. F. Chong
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Contributions

The authors’ responsibilities were as follows: YSL, LP-CS, KHT, FY, KMG, Y-SC, JGE, BFPB and AR-G were responsible for conceiving designing and leading the GUSTO cohort study. JYT and MF-FC designed the present work. JYT, SC, SXL and WWP contributed to the data collection. JYT, SC, SXL and WWP contributed to data processing and cleaning. MF-FC supervised and guided the data collection and cleaning process. JYT and MF-FC analysed and interpreted the data. JYT and MF-FC were responsible for drafting and finalising the manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Mary F. F. Chong.

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K.M.G. and Y.-S.C. report being part of an academic consortium that has received research funding from Abbott Nutrition, Nestle and Danone. K.M.G. and Y.-S.C. report receiving reimbursement for speaking at conferences sponsored by companies selling nutritional products. The other authors declared no conflict of interests. The funders had no role in the choice of research project, design of this study, data collection and statistical analyses, preparation of manuscript and decision to publish.

Ethical standards

The GUSTO study was approved by the National Healthcare Group Domain Specific Review Board (D/2009/00021 and D/2014/00414) and Singhealth Centralized Institutional Review Board (2018/2767/D). All procedures were performed in line with the principles of the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed written consent at each study visit. The GUSTO study was registered at http://www.clinicaltrials.gov as NCT01174875.

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Toh, J.Y., Cai, S., Lim, S.X. et al. Nutrient trajectories during infancy and their associations with childhood neurodevelopment. Eur J Nutr 62, 2429–2439 (2023). https://doi.org/10.1007/s00394-023-03164-2

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