Topical Area: Nutritional Epidemiology
Objectives : To examine the association between micronutrient fortified food consumption compared with standard foods and cognitive functioning among low-income children.
Methods : Low-income children (ages 8-12 years) participating in an afterschool program were recruited for this randomized-controlled trial. At baseline, trained research assistants measured IQ (Shipley-2 Composite Standard Scores) and cognitive functioning (Stroop Color Word Test [Golden Version], Trail Making Test, and Conners Continuous Performance Test [CPT-3]) to evaluate executive functioning, selective attention, and processing speed. Children were then randomly assigned to receive either micronutrient fortified foods (n=19) or to continue receiving standard foods (n=16) daily at the afterschool program for approximately three months. The intervention foods contained 75% Daily Value for all essential vitamins and minerals, omega-3 and omega-6 fatty acids, protein, one cup of milk, and one serving of fruits. The standard foods consisted of juice and primarily processed meats with refined grains. The cognitive tests were re-administered post-implementation. Differences in cognitive scores between the intervention and control groups were assessed using repeated measures ANOVAs and ANCOVAs, adjusting for age
Results : A total of n=35 children were eligible to participate and had regular attendance at the afterschool program during the study period. When examining differences between the control and intervention groups over time, the results were suggestive of a trend towards the control group performing worse over time CPT Omissions T-scores (p=0.10), CPT Hit Reaction Time (HRT) T-scores (p=0.06), and CPT HRT Block Change T-Score (p=0.09) compared with the intervention group. However, there was a trend towards worse performance in the intervention group on CPT Perseverations T-Scores (p=0.07) compared with the control group. There were no significant differences between-groups over time on the Trail Making test or Stroop test
Conclusions : Overall, there was some evidence of improved cognitive scores over time among low-income children provided with micronutrient fortified foods relative to the control group. It is possible that these nutrient-dense, fortified foods may be cognitively protective in this population and future larger studies should examine these associations
Funding Sources : This study was funded by an unrestricted gift from the 43ForKids Foundation.
M. Kathryn Dahlgren
Professor in the Departments of Epidemiology and Nutrition
Harvard TH Chan School of Public Health