Effect of Early-Life Lipid-Based Nutrient Supplement and Home Environment on Autonomic Nervous System Regulation at...

Nutrition and the home environment contribute to the development of the autonomic nervous system (ANS). However, no study has examined the long-term effects of prenatal and postnatal small-quantity lipid-based nutrient supplements (SQ-LNS) and home environment on ANS regulation. We investigated the effect of early-life SQ-LNS and home environment on ANS regulation at 9-11 years. Participants were children born to women who participated in a randomized controlled trial in Ghana from 2009 to 2014. Women were randomized to receive daily, from pregnancy until delivery, either SQ-LNS, multiple micronutrients (MMN) or iron and folic acid (IFA) followed by SQ-LNS, MMN or placebo, respectively, until 6 months postpartum. Infants in the SQ-LNS group received SQ-LNS from 6 to 18 months. Quality of home environment was observed at 4-6 and 9-11 years. At 9-11 years, 965 children had their respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) measured at baseline and during two inhibitory control tasks, the RACER Simon and Emotion Go/No-Go (EGNG) tasks. PEP reactivity to the RACER Simon task was greater in the MMN (-2.54 ± 4.45, p = 0.016) and SQ-LNS (-2.31 ± 4.94, p = 0.093) groups than in the IFA group (-1.57 ± 3.51). A better home environment at 4-6 predicted longer baseline PEP (β = 0.13, 95% CI: 0.02, 0.23, p = 0.016) and more PEP reactivity during the EGNG task (β = -0.06, 95% CI: -0.00, -0.02, p = 0.001). Prenatal micronutrient supplementation appears to increase SNS reactivity. Children raised in disadvantaged early home environments had more tonic SNS activation and less SNS reactivity, suggesting a predisposition for stronger fight-or-flight activation and less likelihood to modulate arousal in response to acute situations. Trial Registration: ClinicalTrials.gov identifier: NCT00970866.