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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
00:17:10
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
00:18:07
about each of naturally occurring
00:18:10
events. So the progressed early
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intervention project is a naturally
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occurring events and what happened is
00:18:19
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
00:18:40
placed you can debate the ethics of
00:18:43
this but what happens is that the
00:18:46
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
00:19:01
and then they have been followed
00:19:02
overtime there are a number of adoption
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studies but you know adoption studies
00:19:07
are far from random who but it gets
00:19:11
placed in foster care the yes those who
00:19:15
are able to reach out and pulled from
00:19:17
their environment so they're really
00:19:19
really quite a biased but in this one
00:19:22
they were placed randomly. So ah there
00:19:24
have been a thirty or forty at least at
00:19:27
starting looking at what has happened
00:19:30
to teach children and and we learn from
00:19:32
this so these are so I'll show you a
00:19:36
few of them if we looking growth in
00:19:38
what happens in this is not not
00:19:41
surprising that that children who go to
00:19:44
foster care role better within about a
00:19:47
year of their placement in terms of
00:19:49
their height and weight their head size
00:19:52
remains low and there were this
00:19:55
associated with their age at a
00:19:59
placement and their caregivers
00:20:01
sensitivity. So that this is not
00:20:04
surprising when we look at their like
00:20:07
you lose their I use of the children
00:20:11
who are in foster care are better than
00:20:14
those in the yeah institution not as
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high as those who not bin the the the
00:20:20
comparison group that was not
00:20:22
institutionalised but they're also
00:20:24
influenced by their birth weight and
00:20:28
they're an increase in high. So which
00:20:30
shows them nutritional relations with
00:20:33
it rolling in life as well as subs okay
00:20:39
if we yeah there neural development
00:20:42
this varies by their institutional
00:20:44
history in the way that you read this
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is the group that's labelled and IG
00:20:49
that stands for never institutionalise
00:20:51
so that comparison group. And this FCG
00:20:55
means they went to foster care and then
00:20:57
this C you they stayed
00:20:59
institutionalised. So if we look at
00:21:02
this we see that the in terms of grey
00:21:04
matter that children who are in foster
00:21:08
care look no different than the
00:21:10
children to remain institutionalised.
00:21:13
So we see that it suggests that the
00:21:16
institutionalisation disrupted the
00:21:19
brain development they have less grey
00:21:21
matter and there was no catcher in in
00:21:24
foster care. And if we look at like
00:21:28
matter we see a different picture at
00:21:30
this point. So there's no difference
00:21:34
here between foster care and the not
00:21:37
not institutionalised. So it looks as
00:21:41
though then there was a a disruption.
00:21:45
And the foster care children have to
00:21:47
catch up these are observational you
00:21:50
know they had an intervention and in
00:21:52
some ways these are hypothesis
00:21:54
generating calling that kinds of
00:21:56
bindings. This is one court so a
00:22:00
production at age twelve. And on this
00:22:04
site again you have to be on the this
00:22:07
is the the the yeah not
00:22:11
institutionalised group here and these
00:22:15
are the two foster care groups. So here
00:22:20
you see it no difference between the
00:22:22
foster care and the and the comparison.
00:22:26
Um in their stress response. So it
00:22:29
looks as though the foster care may
00:22:31
have that ten you waited that this
00:22:33
regulated HPA so that's that's pretty
00:22:37
exciting that so that shows that they
00:22:39
have have a a benefited from that on
00:22:43
the right or the two that the two
00:22:47
groups in foster care and they differ
00:22:49
by age. So you see an age difference
00:22:52
there and it looks as though the
00:22:54
intervention effects occurred for those
00:22:57
it a place prior to twenty four months
00:23:00
suggesting they sensitive period again
00:23:03
within that first thousand days these
00:23:06
kind of this information from the
00:23:10
progress study is can be really quite
00:23:13
quite fascinating and it suggests that
00:23:16
what development looks like in a in a
00:23:19
general sense is that if you were
00:23:22
raised with the what we call protective
00:23:26
factors then really at at or and this
00:23:29
is that this is this represents for
00:23:32
this represents a prenatal time again
00:23:35
of the first thousand days that you
00:23:37
better or and your development
00:23:40
continues if you are more with these
00:23:43
risk factors then the disparity occurs
00:23:47
it or and basically it it continues and
00:23:49
actually like the bloke represents an
00:23:52
intervention and so what the data
00:23:55
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
00:24:05
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

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Conference Program

Introduction to the 12th Nestlé International Nutrition Symposium
Thomas Beck, NRC Director
22 Oct. 2015 · 8:57 a.m.
418 views
Introduction to Session I - Cognitive & Brain Development
Susan Gasser, Friedrich Miescher Institute, Basel, Switzerland
22 Oct. 2015 · 9:04 a.m.
The development of a healthy brain
Michael Gazzaniga, University of California, Santa Barbara, USA
22 Oct. 2015 · 9:16 a.m.
221 views
Q&A - The development of a healthy brain
Michael Gazzaniga, University of California, Santa Barbara, USA
22 Oct. 2015 · 9:56 a.m.
Early influences on brain development and epigenetics
Stephen G. Matthews, University of Toronto, Canada
22 Oct. 2015 · 10:49 a.m.
Q&A - Early influences on brain development and epigenetics
Stephen G. Matthews, University of Toronto, Canada
22 Oct. 2015 · 11:29 a.m.
Building the physiology of thought
Rebecca Saxe, Massachusetts Institute of Technology, Cambridge, USA
22 Oct. 2015 · 11:38 a.m.
154 views
Q&A - Building the physiology of thought
Rebecca Saxe, Massachusetts Institute of Technology, Cambridge, USA
22 Oct. 2015 · 12:10 p.m.
Introduction to Session II - Cognitive Decline
Kathinka Evers
22 Oct. 2015 · 2:02 p.m.
Brain health & brain diseases - future perspectives
Richard Frackowiak, CHUV University Hospital, Lausanne, Switzerland
22 Oct. 2015 · 2:11 p.m.
Alzheimer's disease: genome-wide clues for novel therapies
Rudolph E. Tanzi, Massachusetts General Hospital, Charlestown, USA
22 Oct. 2015 · 3:15 p.m.
Q&A - Alzheimer's disease: genome-wide clues for novel therapies
Rudolph E. Tanzi, Massachusetts General Hospital, Charlestown, USA
22 Oct. 2015 · 3:59 p.m.
Immunometabolic regulators of age-related inflammation
Vishwa D. Dixit, Yale School of Medicine, New Haven, USA
22 Oct. 2015 · 4:21 p.m.
Q&A - Immunometabolic regulators of age-related inflammation
Vishwa D. Dixit, Yale School of Medicine, New Haven, USA
22 Oct. 2015 · 4:59 p.m.
Introduction to Session III - Nutrition & Cognitive Development
Pierre Magistretti, KAUST, Thuwal, Saudi Arabia and EPFL, Lausanne, Switzerland
23 Oct. 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
23 Oct. 2015 · 9:16 a.m.
129 views
Q&A - Energy metabolism in long-term memory formation and enhancement
Cristina M. Alberini, The Center for Neural Science, New York University, USA
23 Oct. 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
23 Oct. 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
23 Oct. 2015 · 10:57 a.m.
Nutrition, growth and the developing brain
Prof. Maureen Black, University of Maryland, School of Medicine, Baltimore, USA
23 Oct. 2015 · 11:09 a.m.
Q&A - Nutrition, growth and the developing brain
Prof. Maureen Black, University of Maryland, School of Medicine, Baltimore, USA
23 Oct. 2015 · 11:49 a.m.
Introduction to Session IV - Decline & Nutritional Intervention
Tamas Bartfai, The Scripps Research Institute, La Jolla, USA
23 Oct. 2015 · 12:48 p.m.
On multi-domain approaches for prevention trials
Miia Kivipelto, Karolinska Institutet, Stockholm, Sweden
23 Oct. 2015 · 1:04 p.m.
Q&A - On multi-domain approaches for prevention trials
Miia Kivipelto, MD, PhD, Karolinska Institutet
23 Oct. 2015 · 1:39 p.m.
Methodological challenges in Alzheimer clinical development
Lon S. Schneider, Keck School of Medicine of USC, Los Angeles, USA
23 Oct. 2015 · 1:49 p.m.
Q&A - Methodological challenges in Alzheimer clinical development
Lon S. Schneider, Keck School of Medicine of USC, Los Angeles, USA
23 Oct. 2015 · 2:32 p.m.
We are what we remember: memory and age related memory disorders
Eric R. Kandel, Columbia University, New York, USA
23 Oct. 2015 · 3:03 p.m.
138 views
Concluding Remarks
Stefan Catsicas, Chief Technology Officer, Nestlé SA
23 Oct. 2015 · 3:50 p.m.