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Background/objectives Adherence to a 'Western' style dietary pattern has been related to behavior problems in children in high-income countries; however, dietary patterns may differ in countries undergoing the nutrition transition. Associations of dietary patterns with behavior problems in a Latin American context have not been evaluated. Subjects/Methods Mothers of 385 children 5 to 12 y old completed a food frequency questionnaire (FFQ) on the children's usual intake at enrollment into a cohort study. Four dietary patterns were identified through principal component analysis of the FFQ: animal protein, snacking, cheaper protein, and traditional/starch. After a median 6 y follow-up, adolescents reported behavior problems via the Youth Self Report, a standardized questionnaire. We compared the continuous distributions of externalizing and internalizing behavior problems and their subscales across quartiles of adherence to the four dietary patterns using multivariable linear regression. Results Boys in the highest quartile of adherence to the animal protein pattern in middle childhood had an adjusted 5.5 units lower (95% CI -9.5, -1.5) mean total externalizing problems score compared with boys in the lowest quartile (P trend = 0.008). Adherence to the animal protein pattern was also inversely related to the aggressive behavior externalizing subscale in a dose-response manner among boys (P trend = 0.009). There were no associations between adherence to other dietary patterns and externalizing problems in boys or girls. There were no associations with internalizing problems. Conclusion Adherence to an animal protein dietary pattern in middle childhood was associated with less externalizing behavior problems in adolescent boys., Author(s): Sonia L. Robinson [sup.1] , Mercedes Mora-Plazas [sup.2] , Henry Oliveros [sup.3] , Constanza Marin [sup.3] , Betsy Lozoff [sup.4] , Eduardo Villamor [sup.1] Author Affiliations: (1) Department of [...]

Background/Objectives The contribution of iron status at birth to iron status in infancy is not known. We used a physiologic framework to evaluate how iron status at birth related to iron status at 9 months, taking iron needs and sources into account. Subjects/Methods In a longitudinal birth cohort in China, iron status measures in cord blood and venous blood in infancy (9 months) and clinical data were prospectively collected in 545 healthy term maternal-infant dyads. We used structural equation modeling (SEM) to create a 9-month iron composite and to assess direct and indirect contributions of multiple influences on 9-month iron status. Logistic regression was used to calculate odds ratios for iron deficiency (ID), iron deficiency anemia (IDA), and anemia. Results Approximately 15% (78/523) of infants were born with cord SF Conclusions Indicators of iron status at birth, postnatal iron needs, and iron sources independently related to iron status at 9 months. Sex was an additional factor. Public health policies to identify and protect infants at increased risk of ID should be prioritized., Author(s): Jie Shao [sup.1] [sup.2] , Blair Richards [sup.3] , Niko Kaciroti [sup.3] , Bingquan Zhu [sup.1] , Katy M. Clark [sup.3] , Betsy Lozoff [sup.3] [sup.4] Author Affiliations: (1) [...]

Background/Objectives We sought to determine the associations of n-3 and n-6 polyunsaturated fatty acids (PUFA) in middle childhood with externalizing and internalizing behavior problems in adolescence. Subjects/Methods Using gas-liquid chromatography, we quantified n-3 and n-6 PUFA in serum samples of 444 Colombian schoolchildren aged 5-12 years at the time of enrollment into a cohort study. After a median 6 years, adolescent externalizing and internalizing behavior problems were determined with the Youth Self Report (YSR) questionnaire. We estimated adjusted mean behavior problem score differences with 95% confidence intervals (CIs) between quartiles of each PUFA using multivariable linear regression. We also considered as exposures the [DELTA]6-desaturase (D6D) and [DELTA]5-desaturase (D5D) enzyme activity indices. Results Docosahexaenoic acid (DHA) was positively associated with externalizing problems; every standard deviation (SD) of DHA concentration was associated with an adjusted one unit higher externalizing problem score (95% CI: 0.1, 1.9). The D5D enzyme activity index was inversely related to externalizing problem scores. Alpha-linolenic acid concentration was positively associated with internalizing problem scores, whereas adrenic acid was inversely related to this outcome. Conclusions Serum PUFA in middle childhood were related to behavior problems in adolescence. Some of these associations might reflect the role of D5D enzyme activity., Author(s): Sonia L. Robinson [sup.1] , Henry Oliveros [sup.2] , Mercedes Mora-Plazas [sup.3] , Constanza Marín [sup.2] [sup.3] , Betsy Lozoff [sup.4] [sup.5] , Eduardo Villamor [sup.1] Author Affiliations: (1) [...]

Background Infants who are iron-deficient anemic seek and receive less stimulation from their caregivers, predisposing such children to be functionally isolated. Objectives To test the sequence whereby iron deficiency in infancy contributes to children's disengagement from the environment, which reduces parent stimulation which, in turn, contributes to children's poor verbal skills. Methods Chilean children (N = 875, 54% male) were studied, 45% of whom were iron deficient or iron-deficient anemic in infancy. We used structural equation modeling to test the sequence outlined above and to examine the effect of infant iron status on children's verbal performance at ages 5 and 10 years including the roles of child and parent intermediate variables. Results Severity of iron deficiency in infancy was associated with higher levels of children's dull affect and social reticence at 5 years ([beta] = .10, B = .26, SE = .12, p < .05), and these behaviors were associated with parent unresponsiveness ([beta] = .29, B = .13, SE = .03, p < .001), which related to children's lower verbal abilities at age 5 ([beta] = - .29, B = - 2.33, SE = .47, p < .001) and age 10 ([beta] = - .22, B = - 3.04, SE = .75, p < .001). An alternate model where poor iron status related directly to children's verbal ability was tested but not supported. Conclusions Findings support functional isolation processes resulting from a nutritional deficiency, with iron-deficient anemic infants showing affective and behavioral tendencies that limit developmentally stimulating caregiving which, in turn, hinder children's verbal abilities., Author(s): Patricia East [sup.1] , Erin Delker [sup.1] , Estela Blanco [sup.1] , Pamela Encina [sup.2] , Betsy Lozoff [sup.3] , Sheila Gahagan [sup.1] Author Affiliations: (Aff1) 0000 0001 2107 [...]

Iron deficiency has been shown to impair dopamine functioning in rodent models, but it is challenging to obtain evidence of such effects in human infants. Because spontaneous eye-blink rate may provide a noninvasive assessment of dopamine functioning, we hypothesized that eye-blink rate would be lower in infants with iron-deficiency anemia and would increase with iron therapy. A 4-min eye-blink assessment was conducted for quiet, alert infants sitting on their mother's lap. Data were available for 61 9- to 10-mo-old infants from inner-city Detroit (19 iron-deficient anemic, 23 nonanemic iron-deficient, and 19 nonanemic iron-sufficient). Iron-deficient and iron-sufficient nonanemic groups had similar eye-blink rates (P = 0.90) and were therefore combined. We used Poisson regression based on generalized estimation equation methodology to test for differences between iron-deficient anemic and nonanemic infants in blinks/min and change after 3 mo of iron therapy. Iron-deficient anemic infants had a lower initial eye-blink rate than nonanemic infants (mean [+ or -] SD) (4.0 [+ or -] 1.9 vs. 5.3 [+ or -] 2.8 blinks/min; P = 0.02; effect size = 0.6 SD). At 12 me, eye-blink rate increased by 2.1 blinks/min in the iron- deficient anemic group (P = 0.008); there was no change in the nonanemic group (P = 0.96). These results are consistent with reduced dopamine function in iron-deficient anemic infants. The clinical importance of a lower eye-blink rate is unclear, but impaired dopamine functioning is likely to have broader impact, given the role dopamine plays in regulating movement, motivation, cognition, and hormone release. doi: 0.3945/jn.110.120964.

Iron deficiency remains the most common nutritional deficiency worldwide and supplementation is recommended during periods of high risk, including infancy. However, questions have been raised about possible adverse effects of iron on growth in iron-sufficient (IS) infants and the advisability of across-the-board iron supplementation. This study examined whether short- of Iong-term growth was impaired in IS infants who received iron supplementation. From a longitudinal study of healthy, breast-fed, low-to middle-income Chilean infants randomly assigned to iron supplementation or usual nutrition at 6 of 12 mo, we retrospectively identified infants meeting criteria for iron sufficiency at the time of random assignment (n = 273). Using multilevel analysis, ponderal and linear growth were modeled before, during, and after iron supplementation up to 10 y in 3 comparisons: 1) iron supplementation compared with usual nutrition from 6 to 12 mo; 2) iron supplementation compared with usual nutrition from 12 to 18 mo; and 3) 15 mg/d of iron as drops compared with iron-fortified formula (12 mg/L). Growth trajectories did not differ during or after supplementation indicating no adverse effect of iron in any comparison. These results suggest that, at least in some environments iron does not impair growth in IS infants. J. Nutr. 139:2106-2112, 2009. doi: 10.3945/jn.108.100735

This study compared social looking and response to novelty in preschool-aged children (47-68 mo) with or without iron deficiency anemia (IDA). Iron status of the participants from a low-income community in New Delhi, India, was based on venous hemoglobin, mean corpuscular volume, and red cell distribution width. Children's social looking toward adults, affect, and wary or hesitant behavior in response to novelty were assessed in a semistructured paradigm during an inhome play observation. Affect and behavior were compared as a function of iron status: IDA (n = 74) vs. nonanemic (n = 164). Compared with nonanemic preschoolers, preschoolers with IDA displayed less social looking toward their mothers, moved close to their mothers more quickly, and were slower to display positive affect and touch novel toys for the first time. These results indicate that IDA in the preschool period has affective and behavioral effects similar to those reported for IDA in infancy.

OBJECTIVE: In this study we compared neurobehavioral development in Ecuadoran children living in two communities with high potential for exposure to organophosphate (OP) and carbamate pesticides to that of children [...]

Domestic violence against women is a pervasive, global health problem. This study investigates the correlates and psychological outcomes of domestic abuse among women in a semi-industrial country. The participants included 215 mothers residing in working-class communities located on the outskirts of Santiago, Chile. We utilized structural equation modeling to test the hypothesis that poverty and other structural inequalities would be related to incidents of domestic abuse in Chile. as they are in the United States. Our results suggest that lower socioeconomic status, even within poor communities, and stressful life events have a direct relationship to domestic conflict. Domestic abuse was, in turn. associated with women's mental health such that greater domestic conflict was related to higher reports of depressive affect and symptoms of posttraumatic stress disorder. The importance of identifying similarities and differences in the occurrence of domestic violence in developing countries as compared to industrialized countries is discussed.

Objective. To determine the behavioral and developmental effects of preventing iron-deficiency anemia in infancy. Methods. Healthy full-term Chilean infants who were free of iron-deficiency anemia at 6 months were assigned to high- or low-iron groups or to high- or no-added-iron groups. Behavioral/developmental outcomes at 12 months of age included overall mental and motor test scores and specific measures of motor functioning, cognitive processing, and behavior. There were no differences between high- and low-iron groups in the prevalence of iron-deficiency anemia or behavioral/developmental outcome, and they were combined to form an iron-supplemented group (n = 1123) for comparison with the no-added-iron group (n = 534). Results. At 12 months, iron-deficiency anemia was present in 3.1% and 22.6% of the supplemented and unsupplemented groups, respectively. The groups differed in specific behavioral/developmental outcomes but not on global test scores. Infants who did not receive supplemental iron processed information slower. They were less likely to show positive affect, interact socially, or check their caregivers&apos; reactions. A smaller proportion of them resisted giving up toys and test materials, and more could not be soothed by words or objects when upset. They crawled somewhat later and were more likely to be tremulous. Conclusions. The results suggest that unsupplemented infants responded less positively to the physical and social environment. The observed differences seem to be congruent with current understanding of the effects of iron deficiency on the developing brain. The study shows that healthy full-term infants may receive developmental and behavioral benefits from iron supplementation in the first year of life. Pediatrics 2003;112:846-854; iron deficiency, nutritional anemia, behavior, development, infant., Iron-deficiency anemia affects an estimated 20% to 25% of infants worldwide, with a higher proportion having iron deficiency without anemia, (1,3) Despite the high worldwide prevalence, many countries, both industrialized [...]

Previous studies in rats have shown that iron deficiency anemia (IDA) during brain development results in lower brain iron concentration and behavioral deficits that persist despite iron treatment after weaning. The present study used a developmental IDA model to determine whether earlier iron treatment might normalize brain iron concentration and behavior. One and one-half week periods of IDA were instituted during early or late gestation or lactation by providing low iron diet to adolescent rat dams and oral iron treatment at the end of the anemia period. The iron deficiency anemia of dams during gestation and lactation resulted in significantly lower pup brain iron concentrations at 3 mo of age (15-33% lower than control), despite iron treatment of dams as early as mid-gestation. Dam IDA during lactation lowered pup brain iron concentration significantly more than IDA during gestation (21% lower). All IDA groups had significantly poorer performance and lower activity compared with controls on a screen of home orientation at 8 d of age. Activity on this test was significantly less than controls at 12 d of age. Homing ability on d 12 and 16 and activity on d 16 did not differ from controls. Groups that were anemic around delivery had significant behavioral differences at 3 mo which included less defecation in the open field and greater swim distance in the Morris maze. These results raise the concern that iron sufficiency throughout the course of brain development is crucial to the achievement of normal brain iron concentration and behavior in rats. INDEXING KEY WORDS: * rats * development * iron deficiency anemia * brain * behavior

More than 20 percent of babies throughout the world suffer from iron deficiency anemia. These infants score lower on tests of mental and motor development than healthy infants. Because tests conducted during infancy do not necessarily predict how well a child will do later on, it is not clear whether these deficits will affect school performance. This study assessed 163 of 191 Costa Rican children diagnosed with and treated for iron deficiency anemia during infancy. They were retested at the age of five years. Although all the children had normal blood test results at follow-up, children who had moderate iron deficiency anemia as infants scored lower than their healthy counterparts on tests of mental and motor functions. Children with iron deficiency persisting after three months of treatment and those with moderate anemia scored lower than healthy children, suggesting that the duration and severity of iron deficiency may affect future performance. Children who did not respond to therapy may have suffered from other conditions that were undetected, such as giardiasis (infection caused by an intestinal parasite) or vitamin A deficiency. These results are consistent with those of other long-term studies of iron deficiency in infants, although the hemoglobin levels at which iron deficiency anemia was associated with lower scores varies among studies. Care must be taken in generalizing results from one region to another, because diet, prevalence of infectious diseases, and even altitude affect iron status. Similarly, many factors affect developmental outcomes. The current therapeutic approach does not significantly improve the prognosis of these children, and other changes must be implemented, particularly those emphasizing the prevention of iron deficiency anemia in infants. (Consumer Summary produced by Reliance Medical Information, Inc.)