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Nutrition, growth and the developing brain
Prof. Maureen Black, University of Maryland, School of Medicine, Baltimore, USA
Friday, Oct. 23, 2015 · 11:09 a.m. · 40m 09s
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Thank you very much. I mean absolutely
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delighted to have to be here so I think
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the organisers very much for the
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invitation and certainly thank the
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other speakers and the audience for
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very stimulating a day and a half of
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presentations and questions case you'll
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see my presentation move sauce into as
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some additional areas in lieu of sauce
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to communities low and middle income
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countries that it moves us into some
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policy issues. So I'm going to be
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talking about some about brain
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development the role of nutrients us of
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research related to nutrition and brain
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development we'll talk a bit about
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poverty and then we'll talk about
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interventions and these are community
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oriented interventions to promote
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nutrition brain development and
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function a star exhaustive it's about
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to rain architecture is you have heard
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is that that now make yeah interaction
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between genetic influences and
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environmental conditions. And if we
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think about two kinds of experiences.
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There's expect didn't experiences these
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are PC specific experiences that sam
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contribute to brain development and
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we'll show you some examples in
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nutrition as well as a visual images
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and then there are what are called
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experienced hand. And these are the
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kinds of experiences that are unique to
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the individual such things as one we
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speak the language that that we do that
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when we think about to the timing these
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experience is one of the examples that
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we use in terms of nutrition is the
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formation of the neural to that happens
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it approximately twenty two days post
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conception. And it's dependent on for
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like acid in and B twelve and if you
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don't have these then rolled to doesn't
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closers at risk for not closing and you
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can have an an italic child or one
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that's spine of it for that. So with an
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example of how intricate. And nutrition
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is too early brain development that we
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think about critical periods which are
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very tight and the neural to closure is
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used as one are we think of sensitive
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periods which have rather user
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boundaries and it looks as though we
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humans that we think more about
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sensitive periods than some of the the
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critical periods this is a I trail that
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use on the last presentation. And what
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it does is a show us that the first
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thousand days that has become very yeah
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very much in the division literature
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and as you can see it begins at
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conception. And extends entail H do
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when if you have back together it's a
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thousand days what this illustrates is
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a tremendous amount of development that
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you just heard. And that occurs during
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this period of time. Now we overlay
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nutrition onto this this is an example
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of the need for iron and so you'll see
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that period of time from six to twelve
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months is that I'm not very high irony.
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And so this is the time when infants
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are at risk for iron deficiency at this
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point. They are having complimentary
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food there is often very low in iron
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and if use the island stores that
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they've gotten from their mother so
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with a very vulnerable time and you'll
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see a great deal of for they're looking
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at is second six months of why because
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we know what's really very vulnerable
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and then after that the the right I
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mean for example goes down. Well what
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you just heard and the the timing of
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the presentations is to write fake that
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those of us who what interested in
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child development are happy with the
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emphasis on the first thousand eight
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and we say it's necessary but far from
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sufficient. And so this green line
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takes as to what would be the second
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thousand days and would be up until age
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five dollars often that in what happens
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in terms of opportunities for children
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during this time in low and middle
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income countries there's often not much
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of anything going on western countries
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children or in some sort of child care.
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So when we think about early
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development we certainly focus on this
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period of time as well not only the the
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first thousand days. So we're going to
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talk a bit about the nutrients and how
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they're related to early brain
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development that will go through this
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fairly quickly this is some evidence
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much of it coming from animal research
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and it it shows that's how batteries
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nutrients are related to early brain
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development. So this is this is early
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on your on proliferation. And you can
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see they range from protein energy
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needs you fatty acid starting and I
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time to think and and then when we look
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at on and ready route again we have
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some of the same candidates that
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beginning early just station continue
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to H two years. So this is the first
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thousand days when we look at synapse
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formation crooning again we see some of
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the same nutrients that are necessary
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during this time. Um we look at my one
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nation in this course continues much
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longer. But again some of the same
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nutrients that are necessary during
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this period of time this slide
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summarises the nutrients that are
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needed during the late feel and
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neonatal bring time the impact of these
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nutrients varies by the timing and it
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duos and the duration and there's a
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fair amount of research that looks at
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these this kind of work both in animals
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and in in children and much of this is
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in levelling middle income countries
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because that's where the deficiencies.
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Um no nutrients relate to children's
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growth and the development beyond the
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neural to close your well let's take a
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look at some of this. So these are
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children of mine descent. And on the
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left their children in Guatemala these
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are not year old children and on the
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right there in the US so they're from
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the same heritage and if we look at the
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line across that we can see that the
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children on the left or stunted and the
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children on the right are we are you
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would expect for age nine O one has
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happened is that I the yeah WHO had to
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a multi central growth study to look at
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the growth of children from think six
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very divers countries. So they enrol
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children who met the criteria that
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they're mother's agree no smoking
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during pregnancy and smoking after
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pregnancy. And to follow the WHO
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guidelines in terms of exclusive
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breastfeeding these were primarily
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middle class children from these divers
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countries and they they follow them
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longitudinally to look at their early
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row. And so let's look at their linear
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growth. Well this is what we see there
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from Brazil got it indian or way along
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and the US and we see that during the
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first two years of like there's no
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difference in their linear wrote. So
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despite very different countries very
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different heritage is that they are the
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same way. So we learn the children
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throughout the world grow similarly
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when their health needs are met. So
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therefore there something like a
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hundred and fifty or a hundred eighty
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or so countries that have adopted the
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WHO wrote standards are different from
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broke references this is how children
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should grow under optimal conditions.
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And this is what we used to look at
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early provincial but so if we look now
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at win wrote faltering occurs and these
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are data from fifty four countries the
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blue line at the bottom represents
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hiked. So and this represents the first
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thousand days and I'll draw your
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attention to what happens at work. So
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we see at bird that there are many
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children who begin already stunted. So
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all ready with the linear growth that
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is lower than expected. And you'll see
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that it's really during the first
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thousand days that the growth altering
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in terms of their linear growth occurs
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and then it it basically flattens out.
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So we see children right from the
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beginning we were behind well let's
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look at what wasting in standing look
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like. So if we look at the child on the
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left this child is not wasted. So that
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means that they're PBMI is within
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normal they're not stunt it. So that
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and they're they're not two standard
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deviations below the median in terms of
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Piper eight eight and they're not
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underweight. So their we were age is
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again not two standard deviations below
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the media the child in the middle is
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wasted not stuff. And underweight and
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the child on the right. Um it's not
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wasted the BM I.'s fine but is stunted
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and is underway which child is the
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biggest risk what two think well this
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is risk for subsequent development. So
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we're interested in cognitive
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development this. So this is the
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standing. So this child is at risk well
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let me show you some of the data and
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one risk and that the the middle child
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because this represents at that chronic
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under nutrition. So what we see this is
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a allegedly a a picture of a brain
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development in here brain cells by the
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child with standard these are some
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recent data and then analysis by fell
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and any yeah didn't net analysis of a
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cross sectional longitudinal studies
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these are some of the the longitudinal
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studies and so you can see that taken
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together and these are adjusted for
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some some baseline situations these are
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developmental risk for cognitive
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development of children during school
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age who were in fact it in the first
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two years of life. Um so this has there
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have certainly been other studies that
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have shown to be a long term
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consequences of really standing. Um if
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we look at where the word of
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malnutrition is globally. And you'll
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see that it's primarily in Africa and
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in south Asia so these thirty four
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countries account for ninety percent of
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the global bird of malnutrition. Now if
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we look at standing and underweight
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what we see is that there's been the
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good news is that there's any drastic
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reductions in in in standing both in
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the the prevalence E and in the burden
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and also in underweight. So there's
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been a drastic reduction so that's
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excellent use very good news. Here's a
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less good news and that is the twenty
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four percent of the children in the
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world under each by or standard that
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represents a hundred and sixty five
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million children primarily in sub
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saharan Africa and asia. So that yeah
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that the problem is enormous absolutely
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huge work what we know what about start
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to children well if there's a this
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series in the lancet in a on child
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development to series actually in the
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third one that is in process will be
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out in two thousand sixteen that and
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looked at the number of children who
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were in poverty or stunted. And then
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estimated that two hundred ninety
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million children were thirty nine
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percent of the world's children and
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lower middle income countries we're not
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reaching their development potential.
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Um so that's an enormous burden that
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the world is experiencing of we look a
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little bit poverty in you've heard some
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of property so far so this is a bit to
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what we you know in terms of of a child
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development. We've known known for a
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long time that properties associated
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with low cognitive functioning. And
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basically we thought that it's been
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related to limited access to resources
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and some poor hygiene with infections
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and or nutrition and and lack of books
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or opportunities for early learning and
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for enrichment. But what we've also
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seen from or neuroscience colleagues
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and has been presented here is that
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properties associated with small white
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matter and cortical brain matter. And
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hippocampus and and maybe a little ball
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you associated with early cognition
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these are data I think that we showed
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earlier from a recent study that you
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know did. So certainly quite concerning
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at the lower end this is parental
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education. And this is left camp will
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volume. So that the poverty association
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is really quite to quite concerned. Now
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what else is going on in poverty well
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we know that people living in poverty
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have what we call how we're covering
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and accumulated risks and this is some
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of what Stephen Matthews talked about
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yesterday there are children benefit
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from my own stress you all deal with
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stress if you couldn't deal with thrash
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wouldn't be here that so stress is not
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necessarily a bad thing at all. But one
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that is toxic stress. So this is very
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strong stress or unremitting stress and
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we think that it is completed this
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regulation in the HPA axis. So this is
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some of what Stephen talked about
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yesterday in terms of the stress
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response under normal conditions and we
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interface with stress there's a release
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of our quarters all to prepare the the
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body for this response so there's an
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increase in cardiovascular town and
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then one returns to hell with static
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balance. But if there's a this
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regulation then there's a a weathering
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that can occur and the inflammatory
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system can be that it is regulated and
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one can then be at risk for disease.
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And for both physical and mental
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illness is this is that portrayal of
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the real architecture that's related in
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in the case of a chronic stress were a
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toxic stress as it's called that we
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think how it undermines child
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development is that it has these non
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reversible changes to children's
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physiology that in disrupts
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inflammatory signalling and increases
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their risk for physical and mental
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illness. Um there are we have as you
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certainly heard from some of the very
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elegant are much more sophisticated way
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of trying to understand what happens in
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in children's brains we can look at the
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court of stalling week and then also
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what get blood oxygen nation to try and
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understand some of the the functions
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some of the structures and some of the
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functions that are happening in
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children's on brains the final one
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that's listed this functional near
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infrared spectroscopy was very
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interesting because you can take it to
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the field. So these show that that
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timing is believe that what time it
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leads to you okay and what time it gets
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to the Gambia and how long it takes to
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be set up. So you know the now some
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very sophisticated assessments that can
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be done looking at brain functioning
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you can also use with that infants. So
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what the field really has much that
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will be able to learn from some of the
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it is some of the new ram mechanisms
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that are that are available. Um I
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wanted to talk about it you know some
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of these things are really very hard to
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study and we have a history of taking
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about each of naturally occurring
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events. So the progressed early
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intervention project is a naturally
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occurring events and what happened is
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that one hundred thirty six children
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who were banned inadvertent placed in
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orphanages in in in Romania in quite
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quite dismal circumstances there were a
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number of well investigators to have a
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project that was funded that would out
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randomise wear these children were
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placed you can debate the ethics of
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this but what happens is that the
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children at approximately age at twenty
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one months went to foster care and the
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other half remained in the institution
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at the same time they have a comparison
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group of non institutionalise children
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and then they have been followed
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overtime there are a number of adoption
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studies but you know adoption studies
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are far from random who but it gets
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placed in foster care the yes those who
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are able to reach out and pulled from
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their environment so they're really
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really quite a biased but in this one
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they were placed randomly. So ah there
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have been a thirty or forty at least at
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starting looking at what has happened
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to teach children and and we learn from
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this so these are so I'll show you a
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few of them if we looking growth in
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what happens in this is not not
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surprising that that children who go to
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foster care role better within about a
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year of their placement in terms of
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their height and weight their head size
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remains low and there were this
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associated with their age at a
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placement and their caregivers
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sensitivity. So that this is not
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surprising when we look at their like
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you lose their I use of the children
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who are in foster care are better than
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those in the yeah institution not as
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high as those who not bin the the the
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comparison group that was not
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institutionalised but they're also
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influenced by their birth weight and
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they're an increase in high. So which
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shows them nutritional relations with
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it rolling in life as well as subs okay
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if we yeah there neural development
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this varies by their institutional
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history in the way that you read this
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is the group that's labelled and IG
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that stands for never institutionalise
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so that comparison group. And this FCG
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means they went to foster care and then
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this C you they stayed
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institutionalised. So if we look at
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this we see that the in terms of grey
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matter that children who are in foster
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care look no different than the
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children to remain institutionalised.
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So we see that it suggests that the
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institutionalisation disrupted the
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brain development they have less grey
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matter and there was no catcher in in
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foster care. And if we look at like
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matter we see a different picture at
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this point. So there's no difference
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here between foster care and the not
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not institutionalised. So it looks as
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though then there was a a disruption.
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And the foster care children have to
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catch up these are observational you
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know they had an intervention and in
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some ways these are hypothesis
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generating calling that kinds of
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bindings. This is one court so a
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production at age twelve. And on this
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site again you have to be on the this
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is the the the yeah not
00:22:11
institutionalised group here and these
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are the two foster care groups. So here
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you see it no difference between the
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foster care and the and the comparison.
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Um in their stress response. So it
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looks as though the foster care may
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have that ten you waited that this
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regulated HPA so that's that's pretty
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exciting that so that shows that they
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have have a a benefited from that on
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the right or the two that the two
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groups in foster care and they differ
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by age. So you see an age difference
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there and it looks as though the
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intervention effects occurred for those
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it a place prior to twenty four months
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suggesting they sensitive period again
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within that first thousand days these
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kind of this information from the
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progress study is can be really quite
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quite fascinating and it suggests that
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what development looks like in a in a
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general sense is that if you were
00:23:22
raised with the what we call protective
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factors then really at at or and this
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is that this is this represents for
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this represents a prenatal time again
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of the first thousand days that you
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better or and your development
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continues if you are more with these
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risk factors then the disparity occurs
00:23:47
it or and basically it it continues and
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actually like the bloke represents an
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intervention and so what the data
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suggest is that interventions can be
00:23:57
beneficial can in some ways whole one
00:24:01
closer to the green in some ways the
00:24:03
disparities remain. So the question is
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when does it happen and really what do
00:24:08
you do in terms of intervention to try
00:24:12
and reduce the disparities that occur
00:24:16
and reduce the thirty nine percent of
00:24:18
children you don't reach their
00:24:20
developmental potential. And so we
00:24:24
think about nutritional interventions
00:24:26
and if we if we intervene mons then we
00:24:29
can intervene in terms of improving
00:24:32
maternal nutritional status we could do
00:24:34
that prenatal E and what we've learned
00:24:37
is that prenatal lately too late. And
00:24:41
so we can do that preconception and
00:24:44
there are those studies that are in in
00:24:47
the field now looking at those timings
00:24:50
with children we can intervene by
00:24:53
removing breastfeeding and there's
00:24:54
evidence that breastfeeding insects
00:24:58
particularly exclusive breastfeeding is
00:25:00
beneficial to children in terms of
00:25:03
their where and in terms of their
00:25:04
development we can look at
00:25:06
complementary feeding and that's you
00:25:10
know those are the kinds of to spend
00:25:12
that children we used to call weaning
00:25:14
foods we can look at single mic or
00:25:16
nutrients we can look at multiple micro
00:25:18
nutrients you can look at proteins in
00:25:20
in calories and there are many ways of
00:25:22
doing this you can do this with
00:25:24
supplements. And you can do this with
00:25:27
fortification so that adding these some
00:25:31
of these it might be nutrients to food
00:25:35
and that's that's pop and how we do it.
00:25:37
Um in the west this is the conceptual
00:25:39
framework that sometimes we use
00:25:42
thinking about early child development.
00:25:45
So we've been talking about brain
00:25:47
development function and how that that
00:25:49
sounded children's development. And
00:25:51
there are biological factors this is
00:25:53
the nutrition that influence bring
00:25:56
development. And and their property and
00:25:58
socio cultural factors that influence
00:26:01
printed out. We know are also can
00:26:04
giving factors and certainly the the
00:26:06
progress studies have shown us that as
00:26:08
well as a number of other studies and
00:26:11
we know that that was included things
00:26:13
like responsible care giving in an
00:26:15
early learning opportunities. And what
00:26:18
happens in many of our studies what
00:26:20
we've done is we've just adjusted for
00:26:23
these up already and social cultural
00:26:26
factors in care giving factors will
00:26:28
kind of pesky. So we get them out of
00:26:31
the way but what happens is that if we
00:26:35
are just for those in we have you know
00:26:38
looking for additive or synergistic
00:26:41
effects of nutrition link here giving.
00:26:44
So we've me if we don't consider the
00:26:47
context then we may actually be missing
00:26:50
what the nutritional interventions to
00:26:53
so what we suggest is that rather than
00:26:56
getting rid of those but maybe we
00:26:59
should study they here giving factors
00:27:02
and the nutritional factors because we
00:27:05
know the children's development is
00:27:07
influenced I only by nutrition but we
00:27:10
know it's influenced by the environment
00:27:13
by the care giving environment that
00:27:15
their that every and that's represented
00:27:18
somewhat by already but it's
00:27:20
represented by the early learning and
00:27:22
unresponsive care giving. Um so those
00:27:25
are some of the studies that certainly
00:27:28
had been recommended this is that a
00:27:32
portrayal of how you might think about
00:27:35
some of the response of care giving
00:27:39
there are prenatal rats and post natal
00:27:42
threats. And then this buffering if
00:27:44
that are responsive care giving and we
00:27:47
think that that may influence the
00:27:49
immune system and then the ones brain
00:27:51
development. There's a a a study in the
00:27:55
it field now that's called malnutrition
00:27:58
and interrogate disease. And and what
00:28:01
they're looking at is how intro
00:28:05
pathogen infections at relate to
00:28:09
intestinal inflammation and how that
00:28:13
alters really not function and whether
00:28:16
that's related to under nutrition
00:28:19
cognitive development this is a study
00:28:21
that is taking place in eight low
00:28:24
income countries it's funded by Gates
00:28:27
and spearheaded really by the the but
00:28:32
really at the at the anyway. So the
00:28:38
this the data from this study you're
00:28:40
just starting to be available but
00:28:43
certainly interesting looking at the
00:28:45
combination of of the information some
00:28:48
of the things that we talked about I'm
00:28:51
gonna show you very quickly a study
00:28:53
that we've been doing in in in TI and
00:28:58
very consistent with the the last topic
00:29:02
we're focusing on children in that
00:29:04
three year age range not looking at
00:29:07
this this has an analogue where we look
00:29:09
the children the first thousand days
00:29:12
that these are the preschool children
00:29:14
but we do this study in in India
00:29:17
because that's where the problems are
00:29:20
and India has a system of the
00:29:23
integrated child development services
00:29:25
where they have three schools or on the
00:29:27
windy studies on the one centres
00:29:31
throughout the country when you have a
00:29:33
population of one point two billion
00:29:35
people and you have forty million
00:29:38
children. So we worked with is that it
00:29:42
takes place here in new state call
00:29:46
Helen gonna use to be a trooper dash
00:29:48
and we collaborate with the national
00:29:51
institute of a a creation. And we work
00:29:54
with this government agencies because
00:29:56
if things work then you have I yep
00:30:00
possibility of actually scaling up a
00:30:03
project sorcery very quickly I would
00:30:05
worked. So our research design was we
00:30:08
childcare centres are for preschool
00:30:11
come in all different qualities. So we
00:30:14
characterise low quality preschool and
00:30:16
high quality preschool. And then
00:30:18
randomised that they got a
00:30:20
fortification are there micro nutrients
00:30:23
for plus within each. Um these are the
00:30:28
baseline characteristics of our sample
00:30:32
and you can see this is the the issues
00:30:35
that over a third of the mothers are an
00:30:39
email. And we were when we look at the
00:30:41
three year old children twenty percent
00:30:43
are wasted forty percent or stunted. Um
00:30:48
that almost a half hour in email high
00:30:51
rates of iron deficiency so the problem
00:30:54
is absolutely there. And we that it's a
00:30:58
very straightforward design that and we
00:31:02
have a baseline and then and line the
00:31:05
eight monks study and the preschoolers
00:31:08
received and midday meal fortified by
00:31:12
with micro nutrients for placebo this
00:31:16
was the fortification. And which was
00:31:19
developed by the national institute of
00:31:22
nutrition in india. So they have
00:31:23
firemen thing again. But like acid in
00:31:26
vitamin a and CNB twelve and and be too
00:31:30
it came in these these packages given
00:31:35
with this balloon and the yeah at the
00:31:39
fortification was mixed in a small
00:31:42
amount of food in a hundred grams of
00:31:45
that need a for but this is what it
00:31:47
looked like the the the the children
00:31:50
eight was a a rice and they all went to
00:31:55
the she mix the this is the the these
00:31:59
are the children having the the hundred
00:32:00
grams is a very small amount. That's
00:32:03
what had that micro nutrients in once
00:32:05
they that amount then they could have
00:32:08
the rest of the the food but that way
00:32:11
we ensure that they actually got the
00:32:13
food. So when we look at what happened
00:32:18
in anaemia prevalence then we see a
00:32:21
dramatic that line there rates of
00:32:24
anaemia did decline from almost fifty
00:32:27
percent down to under under ten percent
00:32:32
if we look at the change in the buyer
00:32:35
markers of iron deficiency again you
00:32:38
can see dramatic changes in in a very
00:32:41
often in transparent receptor and in
00:32:44
the transparent receptor log ferret and
00:32:46
ratio. So certainly they got the micro
00:32:49
nutrients and had a a a dramatic change
00:32:52
on their micro nutrient status. Um when
00:32:57
we looked at their development we
00:32:59
looked at some markers of early child
00:33:01
development so we looked at a language
00:33:05
and visual perception motor inhibitory
00:33:08
control is an immeasurable executive on
00:33:11
functioning we looked at and a three
00:33:14
year old and then we have a rating of a
00:33:17
caregiver rating the child's behaviour
00:33:20
in the beginning we saw some
00:33:21
differences between the low quality and
00:33:23
high quality preschool no differences
00:33:27
by those randomised to get the micro
00:33:29
nutrients or not when we look at the
00:33:37
expressive language what we see is an
00:33:40
interaction between the quality of the
00:33:43
preschool and whether they got the mic
00:33:46
for nutrient or the placebo. And
00:33:49
basically what we find in the high
00:33:51
quality preschool there were no
00:33:55
differences on the language but in the
00:33:57
low quality preschool you see and an
00:34:00
increase in their expressive language
00:34:03
model music got the micro nutrients and
00:34:05
decrease among those who got the
00:34:07
placebo. So it was a benefit in the low
00:34:10
quality but not the high quality. And
00:34:13
actually the benefit in the low quality
00:34:15
then reduce the disparities in the
00:34:17
children deal then do different from
00:34:19
the high quality kids missus adjusting
00:34:22
for baseline and and so on. When we
00:34:25
looked at inhibitory control you see a
00:34:27
similar pattern in that you see an
00:34:30
interaction between the two not main
00:34:34
effects and so when we look at it again
00:34:38
you see the difference in the in the
00:34:40
low quality that those who receive the
00:34:43
micro nutrient I much greater benefit
00:34:47
than those who receive the placebo. So
00:34:50
we can the micro nutrients improved
00:34:52
inhibitory control in the locality
00:34:55
preschool. And similar pattern in the
00:34:59
caregiver purport of the child's
00:35:02
behaviour that was in the low quality
00:35:04
should benefit there was and high
00:35:07
already didn't so what a summary wise
00:35:11
that we won't when you when you
00:35:13
consider context you have a richer
00:35:16
story then if you don't consider
00:35:18
context. So there's a there is an
00:35:21
emphasis on integrating nutrition and
00:35:24
early parenting interventions for
00:35:27
children who were under age in each
00:35:30
three this usually occurs during home
00:35:32
visiting programs and the evidence
00:35:34
suggests that impacts are larger when
00:35:37
parents and children or involved
00:35:39
together and when it's an active
00:35:41
intervention and the targets the most
00:35:44
disadvantaged children again like on
00:35:47
low income three schools that's where
00:35:48
they that's where you see more and in
00:35:50
fact the the expressive language when
00:35:56
we look at early language environment
00:35:59
we see I don't really here have really
00:36:02
get paucity of language. So I'll show
00:36:04
you the way that we stimulate language
00:36:07
and that is by making box and we we
00:36:09
make box I have no words. So what they
00:36:13
and they have no words because often
00:36:16
mothers are illiterate. So when you
00:36:18
have them they include both descriptive
00:36:23
that what you see but they also include
00:36:25
aspect and then mothers are trained to
00:36:28
talk to their children about the box so
00:36:30
it's a storytelling and the books
00:36:32
provide a stimulus for for the
00:36:36
storytelling these are some that we
00:36:38
used in Guatemala these are some that
00:36:41
we know India and Bangladesh so they're
00:36:44
easy to make but they're very they're
00:36:47
very consistent with the culture. And
00:36:50
in it the three to five year old again
00:36:53
it integrating nutrition in preschool
00:36:55
up when you think about the cost of the
00:36:58
intervention that we did in India the
00:37:01
cost of the mighty nutrients it is
00:37:03
minuscule because it's adding it to the
00:37:06
food and really the cost is the
00:37:09
distribution to the preschoolers. So
00:37:12
it's an extremely low cost intervention
00:37:15
for incredible benefit this is the that
00:37:21
analysis looking at a number of a
00:37:24
nutritional interventions it's a bit
00:37:26
hard to understand because there's so
00:37:28
many of them that are here. But you can
00:37:31
see that there is an overall benefit
00:37:33
looking at invasions of mental
00:37:35
development this is looking at a
00:37:38
psychosocial development and again you
00:37:40
can see your benefit. So when you put
00:37:42
them together it in and stronger one
00:37:45
this represents a lot or set that we
00:37:49
need to have interventions not only
00:37:52
early but I continue to early childhood
00:37:55
and then on through adolescence to
00:37:57
ensure adult health and well being two
00:38:01
studies in a science last year that
00:38:03
were long term outcomes the one on the
00:38:06
left is from north Carolina it's a
00:38:08
thirty five your outcome of an early
00:38:11
childhood intervention and what you
00:38:13
found what they found we're benefits on
00:38:16
blood pressure metabolic syndrome and
00:38:19
also benefits on college attendance
00:38:22
sword very low income children in north
00:38:24
Carolina we also have one inside from
00:38:28
any intervention in Jamaica after
00:38:30
twenty five years. And they found
00:38:32
beneficial effects on wages as well as
00:38:36
less likelihood of being involved in
00:38:38
violence so strong effects from very
00:38:42
early interventions the what has
00:38:46
happened in terms of early child
00:38:48
development is that there's absolutely
00:38:50
dinner revolution. There's been
00:38:52
tremendous in a tremendous attention to
00:38:56
the millennium development goals or
00:38:58
what we now have as a sustainable
00:39:00
development goals and that of last
00:39:03
month they then renamed to the global
00:39:06
goals well these are statements from
00:39:09
the secretary general of the united
00:39:11
nations emphasising early child
00:39:14
development as a public priority. This
00:39:17
was never thought up before early child
00:39:20
development wasn't nowhere on the
00:39:21
radar. So the attention that has gone
00:39:24
into investing in young children and
00:39:27
investing in early child development is
00:39:30
monumental forty percent of low and
00:39:33
middle income countries have policies
00:39:35
related to early child development. So
00:39:37
this is really your time the brain
00:39:39
science has certainly contributed to
00:39:44
this revolution and there's really much
00:39:46
to be done. But this is our Ally team
00:39:49
it in India and thank you to some of
00:39:52
the the the donors this is an issue of
00:39:57
the annals of the new York academy of
00:39:58
sciences that contains twenty papers on
00:40:02
integrating encryption and early child
Conference Program
Introduction to the 12th Nestlé International Nutrition Symposium
Thomas Beck, NRC Director
Oct. 22, 2015 · 8:57 a.m.
790 views
Introduction to Session I - Cognitive & Brain Development
Susan Gasser, Friedrich Miescher Institute, Basel, Switzerland
Oct. 22, 2015 · 9:04 a.m.
161 views
The development of a healthy brain
Michael Gazzaniga, University of California, Santa Barbara, USA
Oct. 22, 2015 · 9:16 a.m.
398 views
Q&A - The development of a healthy brain
Michael Gazzaniga, University of California, Santa Barbara, USA
Oct. 22, 2015 · 9:56 a.m.
Early influences on brain development and epigenetics
Stephen G. Matthews, University of Toronto, Canada
Oct. 22, 2015 · 10:49 a.m.
154 views
Q&A - Early influences on brain development and epigenetics
Stephen G. Matthews, University of Toronto, Canada
Oct. 22, 2015 · 11:29 a.m.
Building the physiology of thought
Rebecca Saxe, Massachusetts Institute of Technology, Cambridge, USA
Oct. 22, 2015 · 11:38 a.m.
226 views
Q&A - Building the physiology of thought
Rebecca Saxe, Massachusetts Institute of Technology, Cambridge, USA
Oct. 22, 2015 · 12:10 p.m.
Introduction to Session II - Cognitive Decline
Kathinka Evers
Oct. 22, 2015 · 2:02 p.m.
Brain health & brain diseases - future perspectives
Richard Frackowiak, CHUV University Hospital, Lausanne, Switzerland
Oct. 22, 2015 · 2:11 p.m.
120 views
Alzheimer's disease: genome-wide clues for novel therapies
Rudolph E. Tanzi, Massachusetts General Hospital, Charlestown, USA
Oct. 22, 2015 · 3:15 p.m.
Q&A - Alzheimer's disease: genome-wide clues for novel therapies
Rudolph E. Tanzi, Massachusetts General Hospital, Charlestown, USA
Oct. 22, 2015 · 3:59 p.m.
Immunometabolic regulators of age-related inflammation
Vishwa D. Dixit, Yale School of Medicine, New Haven, USA
Oct. 22, 2015 · 4:21 p.m.
160 views
Q&A - Immunometabolic regulators of age-related inflammation
Vishwa D. Dixit, Yale School of Medicine, New Haven, USA
Oct. 22, 2015 · 4:59 p.m.
Introduction to Session III - Nutrition & Cognitive Development
Pierre Magistretti, KAUST, Thuwal, Saudi Arabia and EPFL, Lausanne, Switzerland
Oct. 23, 2015 · 9 a.m.
Energy metabolism in long-term memory formation and enhancement
Cristina M. Alberini, The Center for Neural Science, New York University, USA
Oct. 23, 2015 · 9:16 a.m.
413 views
Q&A - Energy metabolism in long-term memory formation and enhancement
Cristina M. Alberini, The Center for Neural Science, New York University, USA
Oct. 23, 2015 · 9:53 a.m.
Building the costly human brain: implications for the evolution of slow childhood growth and the origins of diabetes
Christopher Kuzawa, Northwestern University, Evanston, USA
Oct. 23, 2015 · 10:29 a.m.
Q&A - Building the costly human brain: implications for the evolution of slow childhood growth and the origins of diabetes
Christopher Kuzawa, Northwestern University, Evanston, USA
Oct. 23, 2015 · 10:57 a.m.
Nutrition, growth and the developing brain
Prof. Maureen Black, University of Maryland, School of Medicine, Baltimore, USA
Oct. 23, 2015 · 11:09 a.m.
152 views
Q&A - Nutrition, growth and the developing brain
Prof. Maureen Black, University of Maryland, School of Medicine, Baltimore, USA
Oct. 23, 2015 · 11:49 a.m.
Introduction to Session IV - Decline & Nutritional Intervention
Tamas Bartfai, The Scripps Research Institute, La Jolla, USA
Oct. 23, 2015 · 12:48 p.m.
179 views
On multi-domain approaches for prevention trials
Miia Kivipelto, Karolinska Institutet, Stockholm, Sweden
Oct. 23, 2015 · 1:04 p.m.
218 views
Q&A - On multi-domain approaches for prevention trials
Miia Kivipelto, MD, PhD, Karolinska Institutet
Oct. 23, 2015 · 1:39 p.m.
Methodological challenges in Alzheimer clinical development
Lon S. Schneider, Keck School of Medicine of USC, Los Angeles, USA
Oct. 23, 2015 · 1:49 p.m.
124 views
Q&A - Methodological challenges in Alzheimer clinical development
Lon S. Schneider, Keck School of Medicine of USC, Los Angeles, USA
Oct. 23, 2015 · 2:32 p.m.
We are what we remember: memory and age related memory disorders
Eric R. Kandel, Columbia University, New York, USA
Oct. 23, 2015 · 3:03 p.m.
230 views
Concluding Remarks
Stefan Catsicas, Chief Technology Officer, Nestlé SA
Oct. 23, 2015 · 3:50 p.m.
168 views
Recommended talks
Deeper down the rabbit hole of data, analysis, and inference errors and suggestions for digging back out
David Allison, Indiana University School of Public Health, Bloomington, USA
Sept. 29, 2017 · 1 p.m.
501 views