Effect of Small-Quantity Lipid-Based Nutrient Supplementation on Children's Cortisol Concentration

Area of Science:

• Nutritional science and developmental pediatrics
• Endocrinology and stress physiology

Background:

• Early-life nutrition influences the development of the hypothalamic-pituitary-adrenal (HPA) axis, a key stress response system.
• Understanding how different nutritional interventions impact HPA axis activity is crucial for child development.

Purpose of the Study:

• To investigate the effect of early-life nutrition supplementation on hypothalamic-pituitary-adrenal (HPA) axis activity, measured by hair cortisol concentration (HCC).
• To examine if maternal education modifies the relationship between nutritional supplementation and HPA axis regulation in children.

Main Methods:

• Analysis of hair cortisol concentration (HCC) in 680 children aged 9-11 years from the iLiNS-DYAD randomized controlled trial in Ghana.
• Participants were randomized to receive iron-folic acid (IFA), multiple micronutrients (MMN), or small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and postpartum.
• ANCOVA models were used to assess differences between groups, with maternal education identified as a key effect modifier.

Main Results:

• No significant overall difference in HCC was found between the SQ-LNS and control groups.
• Maternal education significantly modified the effect of SQ-LNS on HCC (P-interaction = 0.043).
• Children exposed to SQ-LNS had lower HCC among those whose mothers had 0-5 years of schooling, but not among those with >5 years of schooling.

Conclusions:

• Early-life SQ-LNS supplementation may buffer physiological stress responses in children born to less educated mothers.
• This suggests SQ-LNS could potentially mitigate the effects of socioeconomic disadvantage on HPA axis regulation.
• Findings highlight the importance of considering socioeconomic factors in nutritional intervention effectiveness.