Prado Elizabeth L, Dewey Kathryn G
Department of Nutrition, University of California at Davis, Davis, CA, USA; SUMMIT Institute of Development, Mataram, Nusa Tenggara Barat, Indonesia.
Nutr Rev. 2014 Apr;72(4):267-84. doi: 10.1111/nure.12102. Epub 2014 Mar 28.
Presented here is an overview of the pathway from early nutrient deficiency to long-term brain function, cognition, and productivity, focusing on research from low- and middle-income countries. Animal models have demonstrated the importance of adequate nutrition for the neurodevelopmental processes that occur rapidly during pregnancy and infancy, such as neuron proliferation and myelination. However, several factors influence whether nutrient deficiencies during this period cause permanent cognitive deficits in human populations, including the child's interaction with the environment, the timing and degree of nutrient deficiency, and the possibility of recovery. These factors should be taken into account in the design and interpretation of future research. Certain types of nutritional deficiency clearly impair brain development, including severe acute malnutrition, chronic undernutrition, iron deficiency, and iodine deficiency. While strategies such as salt iodization and micronutrient powders have been shown to improve these conditions, direct evidence of their impact on brain development is scarce. Other strategies also require further research, including supplementation with iron and other micronutrients, essential fatty acids, and fortified food supplements during pregnancy and infancy.
本文概述了从早期营养缺乏到长期脑功能、认知和生产力的路径,重点关注低收入和中等收入国家的研究。动物模型已经证明了充足营养对于孕期和婴儿期快速发生的神经发育过程(如神经元增殖和髓鞘形成)的重要性。然而,有几个因素会影响这一时期的营养缺乏是否会导致人群永久性认知缺陷,包括儿童与环境的相互作用、营养缺乏的时间和程度以及恢复的可能性。在未来研究的设计和解释中应考虑这些因素。某些类型的营养缺乏明显会损害大脑发育,包括严重急性营养不良、慢性营养不良、缺铁和缺碘。虽然诸如食盐碘化和微量营养素粉等策略已被证明可改善这些状况,但它们对大脑发育影响的直接证据却很少。其他策略也需要进一步研究,包括在孕期和婴儿期补充铁和其他微量营养素、必需脂肪酸以及强化食品补充剂。