The Role of Micronutrients on toddler's growth, immunity and brain development

Key messages:

• Micronutrients are essential components to promote adequate growth and development in the pediatric stage

• Suboptimal status of micronutrients negatively affects immune function and may decrease resistance to infection

• A correct diet in the first years of life will have a positive impact on the neurodevelopment of children

Micronutrients are an essential component of the diet and are necessary for cellular and molecular function. Children under 5 are most vulnerable to nutrient deficiency, with immediate and late consequences which can include stunting, greater risk of infection and poor cognitive performance all of which can prevent children from attaining their full potential.

Growth

Children require multiple micronutrients for optimal growth and development.2 For example, vitamin A deficiency increases the risk of serious infections and compromises childhood growth and development. Zinc deficiency causes stunting, which is why a high prevalence of stunting is an indicator of zinc deficiency in a specific population.2 Other micronutrients such as calcium, iron, copper, iodine, and magnesium play very important role in child growth and development have been ncluded in the infant growth pattern.3,4 (Table 1)

Immunity and Infections

The role of nutrition on the immune system is well established. Clinical data have shown that vitamins A, B6, B12, C, D, E, folic acid, trace elements (zinc, iron, selenium, magnesium, copper) and omega-3 fatty acid have an important role and complementary functions that support the innate and adaptive immune system.4,5 Micronutrient deficiencies, or suboptimal status, have a negative effect on the immune function and can affect resistance to infections.5 (Table 1)

Brain

Nutrition in the first years of life offers a prime opportunity to program normal brain development.6  Neurodevelopment is a very complex process and environmental factors can have a profound impact on early brain development. Nutrition is one area where intervention can produce significant results.6

Evidence suggests that diet affects genetic expression through epigenetic mechanisms when deficiencies happen in early development. This could cause disease later in life. While almost all nutrients are needed in the diet, there is a subgroup, including iron, iodine, zinc, and some vitamins such as B vitamins which play a significant role in neurodevelopment critical processes; specifically, iron deficiency has been related to brain damage and poor learning capacity.3,4,6 (Table 1) In membranes at synaptic sites, arachidonic acid and docosahexaenoic acid play a role in the maturation of synapses and in neurotransmission.7

Conclusions

For a child to attain optimal growth and development, a plan for an adequate diet and supplementation should be developed before conception. Evidence has shown that regardless of the cause, deficiencies have long-term consequences on health, learning, career potential, and mental health in adulthood. Children who receive an adequate diet have a greater likelihood of attaining their full potential in cognitive, motor, and socioemotional skills.

Preventative strategies have been developed globally to address micronutrient deficiencies in children, including supplements and fortified foods.

References

1. Tam E, Keats EC, Rind F, Das JK, Bhutta ZA. Micronutrient supplementation and fortification interventions on health and development outcomes among children under-five in low-and middle income countries: A systematic review and meta-analysis. Nutrients. 2020;12(2).

2. Sharma R, Vaivada T, Bhutta ZA. Micronutrients and child growth: Current evidence and progress. Nestle Nutr Inst Workshop Ser. 2018;89:115–26.

3. Farias PM, Marcelino G, Santana LF, Borges de Almeida E, Guimaraes RCA, Pott A, Hiane PA, Freitas KC.. Minerals in Pregnancy and Their Impact on Child Growth and Development. Molecules 2020 Nov 30;25(23):5630.

6. Mattei D, Pietrobelli A. Micronutrients and Brain Development. Curr Nutr Rep. 2019;8(2):99–107.

4. Cao J, Gao Z, Yan J, Li M, Su J, Xu J, et al. Evaluation of Trace Elements and Their Relationship with Growth and Development of Young Children. Biol Trace Elem Res. 2016;171(2):270–4.

5. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients 2020;12(4):1181.

7. Prado E, Dewey K. Nutrition and brain development in early life. Nutrition Reviews, 2014; 72(4), 267–284.

8. Kurpad A, Edward B. Micronutrient supply and health outcomes in children. Current Opinion in Clinical Nutrition and Metabolic Care, 2013; 16(3), 328–338.

9. Maggini S, Pierre A, Calder PC. Immune function and micronutrient requirements change over the life course. Nutrients. 2018;10(10).