Protein energy malnutrition (PEM), brain and various facets of child development

Abstract

Protein energy malnutrition (PEM) is a global problem. Nearly 150 million children under 5 years in the world and 70-80 million in India suffer from PEM, nearly 20 million in the world and 4 million in India suffer from severe forms of PEM, viz., marasmus, kwashiorkor and marasmic kwashiorkor. The studies in experimental animals in the west and children in developing countries have revealed the adverse effects of PEM on the biochemistry of developing brain which leads to tissue damage and tissue contents, growth arrest, developmental differentiation, myelination, reduction of synapses, synaptic transmitters and overall development of dendritic activity. Many of these adverse effects have been described in children in clinical data, biochemical studies, reduction in brain size, histology of the spinal cord, quantitative studies and electron microscopy of sural nerve, neuro -CT scan, magnetic resonance imaging (MRI) and morphological changes in the cerebellar cells. Longer the PEM, younger the child, poorer the maternal health and literacy, more adverse are the effects of PEM on the nervous system. Just like the importance of nutrients on the developing brain, so are the adverse effects on the child development of lack of environmental stimulation, emotional support and love and affection to the child. When both the adverse factors are combined, the impact is severe. Hence prevention of PEM in pregnant and lactating mothers, breast feeding, adequate home based supplements, family support and love will improve the physical growth, mental development, social competence and academic performance of the child. Hence nutritional rehabilitation, psychosocial and psychomotor development of the child should begin in infancy and continue throughout. It should be at all levels, most important being in family, school, community and various intervention programmes, local, regional and national. Moreover medical students, health personnel, all medical disciplines concerned with total health care and school teachers should learn and concentrate on the developmental stimulation and enrichment of the child.

Nutritional status, brain development and scholastic achievement of Chilean high-school graduates from high and low intellectual quotient and socio-economic status

“…Undernutrition remains the most important nutritional problem in developing countries, and at an early age affects the growth and development of children, especially in conditions of poverty, and has been associated with retarded brain growth and functional development that persists into adult life, such as in our present study (Stoch & Smythe 1963, 1967Winick & Rosso, 1969a,b;Winick, 1975;Stoch et al 1982;Hack & Breslau, 1986;Hack et al 1991;Udani, 1992;Cordero et al 1993;Grantham-McGregor, 1995;Levitsky & Strupp 1995;Brown & Pollitt, 1996;Food and Agriculture Organization, 1996;Ivanovic, 1996;United Nations International Children's Emergency Fund, 1998;Ivanovic et al 2000b;Leiva et al 2001). However, these inter-relationships do not have a direct cause -effect relationship since complex interactions are established during the lifetime of the individuals.…”

An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure

“…The possible mechanism could be due to childhood under-nutrition resulting in a decrease in work performance due to suboptimal development of muscle and neuronal coordination. 32 There is a general consensus that under-nutrition, especially being under-weight, is associated with childhood morbidities. [33][34][35] However, scientific evidence of similar types of associations for developmental morbidities is very limited.…”

Poor Feeding Pattern as a Factor Militating Against Students’ Achievement in Chemistry; A Mechanism for Sustainable Development

“…The relationship between academic achievement and children nutrition are widely recognized [25,26,27]. Poor feeding practice are therefore a major threat to the social and economic development as they are among the most serious obstacles to attaining and maintaining normal academic achievement among secondary school students [28].…”