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Association between Breastfeeding Duration and Cognitive Development

Association between Breastfeeding Duration and Cognitive Development

A dose-response relationship links longer duration of breastfeeding with better cognitive and motor development in children

Nutrition Remarks Health News Highlights (June 21, 2013)

Written by Deeksha Sharma, Ph.D., Health News Writer for Nutrition Remarks, Solon, OH, USA

Reviewed by Jonathan Y. Bernard, Inserm, Center for research in Epidemiology and Population Health (CESP), U1018, Epidemiology of Diabetes, Obesity and Renal Diseases: Lifelong Approach Team, F-94807, Villejuif, France; Univ Paris-Sud, UMRS 1018, F94807, Villejuif, France.

In a mother-child cohort study, ever-breastfed children scored higher than never-breastfed children on language ability and overall development assessments, after adjustments for many potential confounders. Findings suggest a significant association between longer breastfeeding duration and better cognitive and motor development in 2- and 3-year-old children.

Breastfeeding is found associated with better language and cognitive abilities but these results could be due to the differences between confounding factors like the socio-demographic and occupational characteristics of mothers who breastfed and those who did not. Therefore, new data on the relationship between breastfeeding duration and the child’s cognitive development are required to make national public health policies, especially for countries where breastfeeding rates are low. This study examines the dose–response relationship between breast milk consumption and cognitive development, with an accurate, prospective data collection of breastfeeding from a large cohort.

French EDEN Mother-Child Cohort Study is an ongoing birth-cohort study that aims to investigate the role of pre- and post-natal determinants of child growth, development, and health. From the maternal declarations about child feeding modes in questionnaires at birth, 4, 8, 12 and 24 months, exclusive and any (exclusive and mixed) breastfeeding durations were estimated. The parent-reported questionnaires Communicative Development Inventory (CDI) and Ages and Stages Questionnaire (ASQ) were used respectively to evaluate language ability in 2-year-old and overall development in 3-year-old children.

In multivariable linear models, after adjustment for potential confounders, ever-breastfed scored 3.7 ± 1.8 (mean ± SE, P = .038) higher on the CDI and 6.2 ± 1.9 (P = .001) points higher on the ASQ than never-breastfed children. Among breastfed children, adjusted linear associations between breastfeeding durations and cognitive assessments were significant and positive. For any breastfeeding duration, an additional month was related with an increase of 0.58 ± 0.20 (P = .004) CDI points and 0.60 ± 0.20 (P = .003) ASQ points. An additional month of exclusive-breastfeeding was associated with an increase of 0.75 ± 0.33 (P = .02) CDI points, and 1.00 ± 0.33 (P = .002) ASQ points. Tests of hypotheses of non-linearity of the associations between breastfeeding durations and cognitive assessments were rejected. No interaction was found between breastfeeding durations and sex, gestational age, parental education, or household income.

Exclusive breastfeeding duration was more strongly associated with both cognitive development assessments than any breastfeeding duration, which is a further argument in favor of a dose–response relationship. The main biological hypothesis to explain this association between breastfeeding and child cognitive development is based on the content of breast milk, especially long-chain poly-unsaturated fatty acids (LCPUFA) that may be essential for brain maturation in the newborn.

Study results agree with previous studies showing a relationship between breastfeeding and cognitive and motor development in early childhood. In addition, by suggesting a dose–response relationship, it brings new evidence to the possible benefits of breastfeeding. This builds a stronger argument to public health professionals for promoting longer duration and continuation of breastfeeding as well, while promoting early initiation of it.

This news highlight is based on the following article published by Jonathan Y. Bernard et al. Additional general background information was acquired from PubMed.

Bernard JY et al. Breastfeeding Duration and Cognitive Development at 2 and 3 Years of Age in the EDEN Mother-Child Cohort. J Pediatr. 2013 Jan 10. pii: S0022-3476(12)01425-4.




Wise Food Choices May Delay Alzheimer’s Disease Development and Progression

How Nutrition can help in Alzheimer’s Disease

Frontier Voice of Nutrition Remarks (April 11, 2013)  Print PDF of Wise food choices may delay Alzheimer Disease progression

Nalin Siriwardhana, Ph.D., interviewed  Rusha Shah, BS  from Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO.

Reviewed by Prof. John Morley, Professor & Division Chief, Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO.

In Alzheimer’s Disease, certain areas in the brain that controls thinking, remembering and decision making are affected. Apart from well known contributing factors such as age and  genes (family history of Alzheimer’s Disease), chronic oxidative stress and inflammatory conditions can significantly increase the development and progression of the disease. Oxidants and inflammatory mediators are consistently produced in human body and excess production can cause variety of health problems including Alzheimer’s Disease.

Oxidative stress and inflammation can Damage nerve cells (neurons) Loss of brain nerve cells cause Alzheimer's Disease

Oxidative stress and inflammation can Damage nerve cells (neurons) Loss of brain nerve cells cause Alzheimer’s Disease

Nerve cells in the brain are organized and networked to perform various different tasks. Chronic oxidative and inflammatory stress can progressively damage those nerve cells as well as organized networks causing Alzheimer’s Disease. Therefore, food with anti-oxidative and anti-inflammatory effects may have a potential in preventing such nerve damages. Also, Alzheimer’s Disease is known to link with high blood pressure, diabetes and high cholesterol. Beneficial effects of healthy food in those disease conditions are well known. Further, unhealthy dietary fats and food additives can significantly increase oxidative stress and inflammation.

Nutrition Remarks interviewed Rusha Shah, BS  to further explain the beneficial effects of healthy diet against Alzheimer’s Disease. Below is a concise summary of the interview:

Question from Nutrition Remarks: How nutrition links with aging and Alzheimer’s Disease?

Answer from Shah: Oxidative stress is thought to play a fairly significant role in the development of Alzheimer’s disease. Oxidants can be from various different sources and processes. Commonly, they are produced as by-products of normal metabolic processes in the body, so as we age we naturally have more exposure to them. Also, people with chronic infections also tend to have more cellular production of oxidants. Diets high in antioxidants, which are abundant in fruits and vegetables, are thus thought to be beneficial in slowing Alzheimer’s disease progression.

Question: What are the foods that may enhance the progression of Alzheimer’s Disease?

Dietary anti-oxidants and anti-inflammatory compounds may reduce neuron damage

Dietary anti-oxidants and anti-inflammatory compounds may reduce neuron damage

Answer: It is difficult to say whether certain foods actually are likely to enhance the progression of Alzheimer’s disease. The Mediterranean diet, which has low amounts of red meat, may be beneficial in slowing the progression of Alzheimer’s disease.  Some studies have suggested that higher intakes of saturated fats, trans-unsaturated fats, and cholesterol may carry higher risks of Alzheimer’s disease or dementia. Other studies, however, have found no association between type of fat intake and risk of Alzheimer’s disease or dementia. Therefore, we cannot definitively say that certain foods enhance the progression of Alzheimer’s disease.

Question: Why folate is a concern in Alzheimer’s Disease?

Answer: Homocysteine is a natural compound found in blood; high levels of this compound may link to a higher risk of Alzheimer’s disease. Folate, amongst other vitamins, helps convert homocysteine to other compounds that the body can use that are not likely culprits in the development of Alzheimer’s disease.

Question: What are the specific functions/effects of n-3 PUFA, Vitamin B, E and  K and minerals such as Selenium in Alzheimer’s Disease?

Answer: It’s always a good idea to know the basis behind altering your diet to include more of these components. Omega-3 fatty acids help decrease the amount of a substance called amyloid that is found in brains of people with Alzheimer’s disease. Many B vitamins, one of which is folate, help to lower homocysteine levels, as discussed previously. Vitamin E and selenium are antioxidants, which help protect from the damage caused by oxidative stress. Vitamin K is not traditionally classified as an antioxidant, but it is thought to have similar effects in combating oxidants. Also, studies have shown that people with higher risk of Alzheimer’s disease have lower Vitamin K levels.

Question: What can be learned from reported beneficial effects of Mediterranean-type diet against Alzheimer’s Disease?

Answer: The important take-home message here is that the Mediterranean diet as a whole is associated with a reduced risk of Alzheimer’s disease. It consists of high amounts of plant foods, olive oil, and fish, moderate amounts of wine, and low amounts of red meat. Data on which individual vitamins and minerals may have effects like the Mediterranean diet is not consistent. There is little harm, if any, to adapting a Mediterranean diet, and it may have beneficial effects on many aspects of a person’s health.

Question: What are the other important information we did not discuss here?

Answer: There are many benefits and no real known harm to consuming a diet high in antioxidants or similar to the Mediterranean diet. Excess supplementation with multivitamins, on the other hand, has not been proven to protect against Alzheimer’s disease and can have adverse effects. Multivitamin supplementation should be done in moderation if necessary.

This news release is based on the following original scientific article published by Rusha Shah. Additional general background information has been acquired from PubMed, CDC, WHO, USDA and other NIH sources.

Rusha Shah, The Role of Nutrition and Diet in Alzheimer Disease: A Systematic Review. JAMDA (2013) Article in Press.

Rusha Shah would like to acknowledge the support of the Saint Louis University School of Medicine Geriatric department, especially its director, Dr. John Morley.

Written by Nalin Siriwardhana, Ph.D.

Copyright © 2013 Nutrition Remarks. All rights reserved