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Fetal and neonatal
malnutrition can have global
or circuit-specific effects on
the developing brain
Nutrients have greater effects on
brain development
Effect of nutrient Deficiency or
Overabundance
on Brain governed by principle
Timing, Dose , Duration
Even though young brain is remarkably plastic and more
amenable to repair after nutrient repletion, the brain’s
vulnerability to nutritional insults likely outweighs its
plasticity.
That is why early nutritional insults result in brain
dysfunction not only while the nutrient is in deficit, but
also after repletion.
Hippocampus
It is memory that recognizes new
information and recent events.
This part of brain acts like a
primitive over ride switch meant
to stop you from over analyzing in
life threatening situations. It
comes into play at times of high
stress. It is designed for action
not diplomacy.
Corpus Striatum
(basal ganglia)
Corpus meant a mass of tissue in the
body that has a distinct structure or
function.
It is connection between cerebral
cortex and cerebellum. It helps to
regulate automatic movement.
Corpus striata (pural) networks are
responsible for managing memorized
movement – those we undertake
without forethought.
Visual and Auditory
Cortices
The auditory cortex and the areas
around it are involved in
processing language – both spoken
and written.
There is a visual cortex in each
hemisphere of the brain. The left
hemisphere visual cortex receives
signals from the right visual field
and the right visual cortex from the
left visual field.
During late fetal and early
neonatal life, regions such as the
hippocampus, the visual and
auditory cortices, and the
striatum are undergoing rapid
development characterized by
the morphogenesis and
synaptogenesis that make them
functional.
Glial Cells
Functions
• To surround neurons and
hold them in place
• To supply nutrients and
oxygen to neurons
• To insulate one neuron
from another
• To destroy and remove the
carcasses of dead
neurons
Astrocytes Oligodendrocytes Microglia Schwann Cells
Glial cells provide support and protection for neurons
Central nervous system consists of neurons and glial cells
Important nutrients during late fetal
and neonatal brain development
Nutrient Brain requirement for the nutrient Predominant brain circuitry or
process affected by deficiency
Protein-
energy
Cell Proliferation, cell differentiation Global
Synaptogenesis Cortex
Growth factor synthesis Hippocampus
Iron Myelin White matter
Monoamine synthesis Striatal-frontal
Neuronal and glial energy metabolism Hippocampal-frontal
Zinc DNA synthesis Autonomic nervous system
Neurotransmitter release Hippocampus, cerebellum
Copper Neurotransmitter synthesis, neuronal and glial
energy metabolism, antioxidant activity
Cerebellum
LC-PUFAs Synaptogenesis Eye
Myelin Cortex
Choline Neurotransmitter synthesis Global
DNA methylation Hippocampus
Myelin synthesis White matter
LC-PUFAs = Long-chain polyunsaturated fatty acids
Nutrients
can affect not only
Neuroanatomy,
but also
Neurochemistry and
Neurophysiology.
Electroretinogram
(ERG)
Event
Retated
Potential
(ERP)
Computerized
axial
tomography
(CAT)
Occipitofrontal
head
circumference
(OFC)
Types of Brain Development Assessments
Electro
Encephalogram
(EEG)
Auditory
Brainstem
evoked
response (ABR)
Functional
Magnetic
resonance
imaging
(fMRI)
Electro
Encephalogram
(EEG)
Diffusion
Tensor
Imaging
(DTI)
Visual
Evoked
Potential
(VEP)
Cambridge
Neuropsychological
Test Automated
Battery (CANTAB)
Magnetic
resonance
imaging
(MRI)
Visual Paired
Comparison
test (VPC)
Delay Non-Match
to Sample test
(DNMS) Infrared
spectroscopy
(NIRS)
Magnetoencephalography
(MEG)
Neurodevelopmental Assessments
for
Infants between 36 and 44 weeks after conception and relation to specific nutritional deficits
Assessment Brain region or process Risk nutrients
OFC Whole brain Protein-energy
Neurologic reflexes Whole brain, nervous system Protein-energy
Myelination Iron
Neurologic examination Whole brain, nervous system Protein-energy
Copper
EEG maturity Cortex Protein-energy (LC-PUFAs)
Stimulated heart rate, blood
pressure, salivary cortisol
responses
Autonomic nervous system Zinc (Protein-energy)
HPA axis
ABR, ERG Myelination Iron
Synaptic efficacy LC-PUFAs
Auditory ERP Hippocampal function Iron (Zinc) (Choline) (Protein-energy)
MRI (Structural) Global and regional volume
and structure
(Iron) (Zinc) (Copper) Protein-energy
MR - DTI Myelin and tract integrity (Iron) (Copper) Protein-energy
MR – proton spectroscopy Neurochemistry (Iron)
Neurobehavioral and neuroimaging Assessments
Effects of neonatal nutrients on general brain development during fist 6 years if postnatal life
Neurologic
domain
Risk
nutrients
for domain
Behavioral
assessment
Age of reliability Neuroimaging
technique
Age of reliability
Global
function
Protein-
energy,
iron, zinc,
LC-PUFAs
Bayley Scales 12-36 months OFC Any age
WPPSI >4 years MR regional
volumetrics
Newborn and >6
years
Myelination Iron Speed of
processing
4 months ABR, VEP Any age
LC-PUFAs ERP After term
DTI Newborn and >6
years
Motor
function
Protein-
energy
Bayley Scales
(PDI)
12 – 36 months Regional MR Newborn and >6
years
Iron Activity Any age Actigraph Any age
Copper Coordination Any age
Neurobehavioral and neuroimaging Assessments
Effects of neonatal nutrients on cognitive development during fist 6 years of postnatal life
Cognitive
domain
Risk
nutrients
for domain
Behavioral
assessment
Age of reliability Neuroimaging
technique
Age of reliability
Explicit
recognition
memory
Protein-
energy,
iron, zinc
VPC > 4 months ERP (auditory) Newborn
DNMS > 6 months ERP (visual) > 4 months
Elicited imitation > 12 months MR volume
(hippocampus)
Newborn and >
6 years
Working
memory
Protein-
energy
Elicited imitation > 12 months MR volume
(prefrontal
cortex)
Newborn and >
6 years
Iron CANTAB > 4 years
fMRI >6 years
Implicit
procedural
memory
Iron Priming > 4 months MR volume
(striatum)
Newborn and >
6 years
fMRI Newborn and >
6 years
Neurobehavioral and neuroimaging Assessments
Effects of neonatal nutrients on affective development during fist 6 years of postnatal life
Affective
domain
Risk
nutrients
for domain
Behavioral
assessment
Age of reliability Neuroimaging
technique
Age of reliability
Attention Iron, zinc Bayley Scales
rating
> 12 months MR volume
(prefrontal
cortex)
Newborn and >
6 years
CANTAB > 4 years
Flanker task > 5 years
Reactivity
(HPA / ANS)
Iron, zinc Response to: > Newborn
Restraint Salivary cortisol Any age
Separation HR response Any age
Immunization Vagal tone Any age
Social
interaction
Iron, zinc Spontaneous
movement
Any age fMRI > 6 years
Bayley Scales
rating
> 12 months
HPA (Hypothalamic pituitary adrenal) ANS (Autonomic nervous system)
Copper, Iron and Zinc are essential trace
nutrients because they cannot be made, or
synthesized in the body.
We need Copper for
blood vessel formation,
a healthy heart, and for
stabilizing the collagen,
or connective tissue,
which binds one part of
the body to another.
Copper is needed for
brain development and
for the effective
communication
between nerve cells in
the brain, as well as for
healthy bones and
We need Zinc for
biological
functions. Zinc’s
tasks are growth
and fertility, a
healthy immune
system, and
healthy skin, hair,
nails and eyes. It
plays a crucial role
in more than 300
enzymes.
We need Iron because
it is an integral part of
many proteins and
enzymes that maintain
good health such as
oxygen transport and
the regulation of cell
growth. Almost 2/3 of
iron in the body is
found in hemoglobin,
the protein in red
blood cells that carries
oxygen to tissues.
Recommended Daily Intakes
Copper :
• 1 mg/day for adults,
• 1.3 mg/day for pregnant and
lactating women;
Iron:
• 8 mg/day for men,
• 18 mg/day for women (27 mg/day
in pregnancy);
Zinc :
• 15 mg/day for men,
• 12 mg/day for women.
Reference: http://ajcn.nutrition.org/content/85/2/614S.full

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Importance of nutrition on development of brain

  • 1.
  • 2. Fetal and neonatal malnutrition can have global or circuit-specific effects on the developing brain Nutrients have greater effects on brain development Effect of nutrient Deficiency or Overabundance on Brain governed by principle Timing, Dose , Duration
  • 3. Even though young brain is remarkably plastic and more amenable to repair after nutrient repletion, the brain’s vulnerability to nutritional insults likely outweighs its plasticity. That is why early nutritional insults result in brain dysfunction not only while the nutrient is in deficit, but also after repletion.
  • 4. Hippocampus It is memory that recognizes new information and recent events. This part of brain acts like a primitive over ride switch meant to stop you from over analyzing in life threatening situations. It comes into play at times of high stress. It is designed for action not diplomacy.
  • 5. Corpus Striatum (basal ganglia) Corpus meant a mass of tissue in the body that has a distinct structure or function. It is connection between cerebral cortex and cerebellum. It helps to regulate automatic movement. Corpus striata (pural) networks are responsible for managing memorized movement – those we undertake without forethought.
  • 6. Visual and Auditory Cortices The auditory cortex and the areas around it are involved in processing language – both spoken and written. There is a visual cortex in each hemisphere of the brain. The left hemisphere visual cortex receives signals from the right visual field and the right visual cortex from the left visual field.
  • 7. During late fetal and early neonatal life, regions such as the hippocampus, the visual and auditory cortices, and the striatum are undergoing rapid development characterized by the morphogenesis and synaptogenesis that make them functional.
  • 8. Glial Cells Functions • To surround neurons and hold them in place • To supply nutrients and oxygen to neurons • To insulate one neuron from another • To destroy and remove the carcasses of dead neurons Astrocytes Oligodendrocytes Microglia Schwann Cells Glial cells provide support and protection for neurons Central nervous system consists of neurons and glial cells
  • 9. Important nutrients during late fetal and neonatal brain development Nutrient Brain requirement for the nutrient Predominant brain circuitry or process affected by deficiency Protein- energy Cell Proliferation, cell differentiation Global Synaptogenesis Cortex Growth factor synthesis Hippocampus Iron Myelin White matter Monoamine synthesis Striatal-frontal Neuronal and glial energy metabolism Hippocampal-frontal Zinc DNA synthesis Autonomic nervous system Neurotransmitter release Hippocampus, cerebellum Copper Neurotransmitter synthesis, neuronal and glial energy metabolism, antioxidant activity Cerebellum LC-PUFAs Synaptogenesis Eye Myelin Cortex Choline Neurotransmitter synthesis Global DNA methylation Hippocampus Myelin synthesis White matter LC-PUFAs = Long-chain polyunsaturated fatty acids
  • 10. Nutrients can affect not only Neuroanatomy, but also Neurochemistry and Neurophysiology.
  • 11. Electroretinogram (ERG) Event Retated Potential (ERP) Computerized axial tomography (CAT) Occipitofrontal head circumference (OFC) Types of Brain Development Assessments Electro Encephalogram (EEG) Auditory Brainstem evoked response (ABR) Functional Magnetic resonance imaging (fMRI) Electro Encephalogram (EEG) Diffusion Tensor Imaging (DTI) Visual Evoked Potential (VEP) Cambridge Neuropsychological Test Automated Battery (CANTAB) Magnetic resonance imaging (MRI) Visual Paired Comparison test (VPC) Delay Non-Match to Sample test (DNMS) Infrared spectroscopy (NIRS) Magnetoencephalography (MEG)
  • 12. Neurodevelopmental Assessments for Infants between 36 and 44 weeks after conception and relation to specific nutritional deficits Assessment Brain region or process Risk nutrients OFC Whole brain Protein-energy Neurologic reflexes Whole brain, nervous system Protein-energy Myelination Iron Neurologic examination Whole brain, nervous system Protein-energy Copper EEG maturity Cortex Protein-energy (LC-PUFAs) Stimulated heart rate, blood pressure, salivary cortisol responses Autonomic nervous system Zinc (Protein-energy) HPA axis ABR, ERG Myelination Iron Synaptic efficacy LC-PUFAs Auditory ERP Hippocampal function Iron (Zinc) (Choline) (Protein-energy) MRI (Structural) Global and regional volume and structure (Iron) (Zinc) (Copper) Protein-energy MR - DTI Myelin and tract integrity (Iron) (Copper) Protein-energy MR – proton spectroscopy Neurochemistry (Iron)
  • 13. Neurobehavioral and neuroimaging Assessments Effects of neonatal nutrients on general brain development during fist 6 years if postnatal life Neurologic domain Risk nutrients for domain Behavioral assessment Age of reliability Neuroimaging technique Age of reliability Global function Protein- energy, iron, zinc, LC-PUFAs Bayley Scales 12-36 months OFC Any age WPPSI >4 years MR regional volumetrics Newborn and >6 years Myelination Iron Speed of processing 4 months ABR, VEP Any age LC-PUFAs ERP After term DTI Newborn and >6 years Motor function Protein- energy Bayley Scales (PDI) 12 – 36 months Regional MR Newborn and >6 years Iron Activity Any age Actigraph Any age Copper Coordination Any age
  • 14. Neurobehavioral and neuroimaging Assessments Effects of neonatal nutrients on cognitive development during fist 6 years of postnatal life Cognitive domain Risk nutrients for domain Behavioral assessment Age of reliability Neuroimaging technique Age of reliability Explicit recognition memory Protein- energy, iron, zinc VPC > 4 months ERP (auditory) Newborn DNMS > 6 months ERP (visual) > 4 months Elicited imitation > 12 months MR volume (hippocampus) Newborn and > 6 years Working memory Protein- energy Elicited imitation > 12 months MR volume (prefrontal cortex) Newborn and > 6 years Iron CANTAB > 4 years fMRI >6 years Implicit procedural memory Iron Priming > 4 months MR volume (striatum) Newborn and > 6 years fMRI Newborn and > 6 years
  • 15. Neurobehavioral and neuroimaging Assessments Effects of neonatal nutrients on affective development during fist 6 years of postnatal life Affective domain Risk nutrients for domain Behavioral assessment Age of reliability Neuroimaging technique Age of reliability Attention Iron, zinc Bayley Scales rating > 12 months MR volume (prefrontal cortex) Newborn and > 6 years CANTAB > 4 years Flanker task > 5 years Reactivity (HPA / ANS) Iron, zinc Response to: > Newborn Restraint Salivary cortisol Any age Separation HR response Any age Immunization Vagal tone Any age Social interaction Iron, zinc Spontaneous movement Any age fMRI > 6 years Bayley Scales rating > 12 months HPA (Hypothalamic pituitary adrenal) ANS (Autonomic nervous system)
  • 16. Copper, Iron and Zinc are essential trace nutrients because they cannot be made, or synthesized in the body. We need Copper for blood vessel formation, a healthy heart, and for stabilizing the collagen, or connective tissue, which binds one part of the body to another. Copper is needed for brain development and for the effective communication between nerve cells in the brain, as well as for healthy bones and We need Zinc for biological functions. Zinc’s tasks are growth and fertility, a healthy immune system, and healthy skin, hair, nails and eyes. It plays a crucial role in more than 300 enzymes. We need Iron because it is an integral part of many proteins and enzymes that maintain good health such as oxygen transport and the regulation of cell growth. Almost 2/3 of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues.
  • 17. Recommended Daily Intakes Copper : • 1 mg/day for adults, • 1.3 mg/day for pregnant and lactating women; Iron: • 8 mg/day for men, • 18 mg/day for women (27 mg/day in pregnancy); Zinc : • 15 mg/day for men, • 12 mg/day for women.