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Infant formula composition and educational performance: a protocol to extend follow-up for a set of randomised
Maximiliane Verfürden1, Katie Harron2, John Jerrim3
1Great Ormond Street Institute of Child Health, University College London, London, UK m.verfuerden@ucl.ac.uk.
Insights
This study links infant formula trials to educational records to assess long-term cognitive effects. It provides unbiased insights into infant nutrition
Area of Science:
- Pediatric Nutrition
- Cognitive Development
- Educational Psychology
Background:
- Infant nutrition significantly impacts long-term cognitive development.
- Existing clinical trials often lack sufficient long-term follow-up and suffer from high attrition rates, leading to biased results.
- Educational performance serves as a reliable, unbiased marker for cognitive function in children.
Purpose of the Study:
- To evaluate the long-term educational performance of children randomized to nutritionally modified infant formula versus standard formula.
- To provide unbiased, long-term follow-up data on the effects of infant nutrition on cognitive outcomes.
- To investigate the impact of infant formula interventions on academic achievement and special educational needs support.
Main Methods:
- Utilized data from 1923 participants across seven randomized infant formula trials.
- Linked trial data to the English National Pupil Database (NPD) for educational records.
- Analyzed primary outcomes (Math exam z-scores at age 16) and secondary outcomes (English exam z-scores at ages 11 and 16, and special educational needs support).
Main Results:
- The study is designed to provide new insights into the effect of infant nutrition on school achievement.
- Primary analysis will focus on differences in mathematics exam z-scores at age 16.
- Secondary analyses will examine English exam performance and the likelihood of receiving special educational needs support.
Conclusions:
- This research addresses the critical need for unbiased, long-term follow-up in infant nutrition studies.
- Linking administrative education records to infant trials offers a robust method for assessing long-term cognitive impacts.
- Findings will contribute valuable evidence for parents, policymakers, and the scientific community regarding infant feeding practices.
Introduction:
The effect of infant nutrition on long-term cognition is important for parents and policy makers. However, most clinical trials typically have short follow-up periods, when measures of cognition are poorly predictive of later function. The few trials with longer-term follow-up have high levels of attrition, which can lead to selection bias, and in turn to erroneous interpretation of long-term harms and benefits of infant nutrition. We address the need for unbiased, long-term follow-up, by linking measures of educational performance from administrative education records. Educational performance is a meaningful marker of cognitive function in children and it is strongly correlated with IQ. We aim to evaluate educational performance for children who, as infants, were part of a series of trials that randomised participants to either nutritionally modified infant formula or standard formula. Most trialists anticipated positive effects of these interventions on later cognitive function.
Methods And Analysis:
Using data from 1923 participants of seven randomised infant formula trials linked to the English National Pupil Database (NPD), this study will provide new insights into the effect of nutrient intake in infancy on school achievement. Our primary outcome will be the mean differences in z-scores between intervention and control groups for a compulsory Mathematics exam sat at age 16. Secondary outcomes will be z-scores for a compulsory English exam at age 16 and z-scores for compulsory Mathematics and English exams at age 11. We will also evaluate intervention effects on the likelihood of receiving special educational needs (SEN) support. All analyses will be performed separately by trial.
Ethics And Dissemination:
Research ethics approval, and approval from the Health Research Authority Confidentiality Advisory Group, has been obtained for this study. The results of this study will be disseminated to scientific, practitioner, and lay audiences, submitted for publication in peer-reviewed journals, and will contribute towards a PhD dissertation.
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