Adrianna Greco, PhD

Credit: LinkedIn

The consumption of enhanced growing-up milk (e-GUM) for 6 months had a beneficial effect on toddlers’ nutritional status of the nutrients DHA, choline, and lutein, a new study showed.¹ The research was presented at the 2024 Annual North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Meeting in Hollywood, Florida, from November 7 to November 9, 2024.

Although nutrition is recognized as an integral part of early life development, not many studies have assessed nutrition’s impact on neurodevelopment in toddlers. Research has, however, demonstrated the synergistic functions of docosahexaenoic acid (DHA), choline, and lutein in both fetal and early-life neurodevelopment.^2,3 Despite this, many toddlers do not often consume foods rich in these nutrients.¹

Investigators, led by Adrianna Greco, PhD candidate, from the Food, Nutrition, and Health department at The University of British Columbia in Vancouver, sought to investigate a dietary intervention’s impact on nutritional levels of DHA, choline, and lutein, as well as measures of emerging executive control in 408 healthy toddlers aged 17.5 to 18.5 months. In a 6-month study, the team examined the effect of growing-up milk (GUM) on levels of DHA, choline, lutein, and phospholipids, compared with the standard GUM (c-GUM), cow’s milk, and the non-intervention reference group.

Toddlers were recruited from the Lower Mainland, British Columbia, and Canada. Caregivers could self-select their child to enroll in either GUM, cow milk, or the reference group.

Participants in the GUM cohort were randomized to receive e-GUM or c-GUM daily for 6 months. At baseline and the 6-month follow-up, the team measured nutrient biomarkers in non-fasting blood samples. Executive control and impulse control were evaluated with the A-not-B task and Gift Delay task, respectively.

The team assessed the impact of the dietary intervention on blood biomarkers of key nutrients and executive function outcomes through ANCOVA models.

After adjusting for child sex and baseline nutrient status, investigators found toddlers in the e-GUM group had greater red blood cell DHA and plasma lutein/zeaxanthin than the toddlers in the c-GUM, cow milk, and reference groups (P < .05). Moreover, toddlers in the e-GUM group had greater plasma choline than those in the cow milk and reference group (P < .05) but not for the c-GUM group. However, the per-protocol analysis showed toddlers on e-GUM had greater plasma choline than toddlers on c-GUM, cow milk, or no intervention.

Furthermore, after adjusting for child sex, breastfeeding duration, parental mood, and parental assessed intelligence, toddlers in the e-GUM group had a better performance on the A-not-B task than toddlers on cow milk (55.2% vs 43.3%; P < .05), but the performance was not significantly better than the other groups.

As for the post-reversal trial on the A-not-B-task, the toddlers’ performance did not differ between groups. The team also observed no significant differences between groups for the gift delay task.

“In this sample of toddlers with normative development, toddlers receiving e-GUM for 6 months showed higher measures of working memory, as reflected in higher A-not-B task overall performance,” investigators wrote. “The effect on emerging working memory but not on impulse control may reflect the developmental trajectories of executive control and warrants follow-up in later childhood.”

References

1. ^{Greco, A. Montgomery, S, Tan, A, et al. Effect of Daily Consumption of Growing-Up Milk Enhanced with Specific Nutrients on Biomarker Concentrations of DHA, Choline, And Lutein and Executive Control in Toddlers. Presented at NASPHGAN 2024 in Hollywood, Florida, from November 7 – November 9, 2024.}
2. ^{Christifano DN, Chollet-Hinton L, Hoyer D, Schmidt A, Gustafson KM. Intake of eggs, choline, lutein, zeaxanthin, and DHA during pregnancy and their relationship to fetal neurodevelopment. Nutr Neurosci. 2023 Aug;26(8):749-755. doi: 10.1080/1028415X.2022.2088944. Epub 2022 Jun 17. PMID: 35715980; PMCID: PMC9758270.}
3. ^{Cheatham CL, Sheppard KW. Synergistic Effects of Human Milk Nutrients in the Support of Infant Recognition Memory: An Observational Study. Nutrients. 2015 Nov 3;7(11):9079-95. doi: 10.3390/nu7115452. PMID: 26540073; PMCID: PMC4663580.}