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ARS Home » Southeast Area » Little Rock, Arkansas » Arkansas Children's Nutrition Center » Research » Publications at this Location » Publication #306271
Title: Sex-specific association between infant diet and white matter integrity in 8-y-old children

Author
item OU, XIAWEI - Arkansas Children'S Hospital
item ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC)
item CLEVES, MARIO - Arkansas Children'S Nutrition Research Center (ACNC)
item PIVIK, RUDOLPH - Arkansas Children'S Nutrition Research Center (ACNC)
item SNOW, JEFFREY - Arkansas Children'S Hospital
item DING, ZHAOHUA - Vanderbilt University
item Badger, Thomas

Submitted to: Pediatric Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/30/2014
Publication Date: 12/1/2014
Citation: Ou, X., Andres, A., Cleves, M.A., Pivik, R.T., Snow, J.H., Ding, Z., Badger, T.M. 2014. Sex-specific association between infant diet and white matter integrity in 8-y-old children. Pediatric Research. 76(6):535-543. doi: 10.1038/pr.2014.129.

Interpretive Summary: Although it is known that breast-fed (BF) children score higher than formula-fed (FF) children on standardize brain function tests, the biological basis for this is unknown. We have been studying how early infant diet might affect brain development. In this study, we examined brain structure, intelligence [Reynolds Intellectual Assessment Scale (RIAS)], and language fundamentals [Clinical Evaluation of Language Fundamentals (CELF-4)] in 8-year-old children who were either breast-fed or formula-fed as infants. We used state-of-the-art MRI imaging techniques to assess the amount and locations of brain white matter and correlated this to results of functional testing for intelligence and language. Male BF children showed multiple white matter regions in the left brain hemisphere, with significantly higher white matter than that in male FF children, while there were no significant differences in female BF vs. female FF children. The whole brain white matter level positively correlated with RIAS and CELF-4 scores. Our data suggest that 8-year-old boys (but not girls) who were BF as infants have better white matter development than those who were fed infant formula. These results may be the first evidence towards establishing the mechanisms by which early diet can influence brain development and function in children.

Technical Abstract: The purpose of this study was to evaluate brain white matter integrity in 8-year-old children who had predominant breast milk feeding or formula feeding as infants. Fifty-six healthy children were included in this study, including 22 breast-fed (BF, 12 females, 10 males) and 34 formula-fed (FF, 18 females, 16 males). Among them, 10 had exclusive breast milk feeding (EBF) and 13 had exclusive formula feeding (EFF) during the first year of life. All BF and FF children underwent Reynolds Intellectual Assessment Scale (RIAS) and Clinical Evaluation of Language Fundamentals (CELF-4) tests, as well as a magnetic resonance imaging (MRI) examination of the brain white matter, including diffusion tensor imaging (DTI). All studies were performed at age 7.5-8.5 years. The DTI measured fractional anisotropy (FA) value, which is a reflection of white matter integrity, was compared by both tract-based spatial statistics (TBSS) and region of interest (ROI) methods among groups, and was correlated with the RIAS and CELF-4 scores. Using TBSS analysis, male BF children showed multiple white matter regions in the left brain hemisphere with significantly higher FA (p<0.05, corrected) than that in male FF children, while there were no significant differences in female BF vs. female FF children. Mean FA for the whole brain white matter positively correlated with composite scores of RIAS (p=0.03) and CELF-4 (p=0.02), as well as most of the subtest scores (p<0.05). When considering the subgroups with exclusive neonatal diet for at least the first year of life, TBSS analysis also showed male EBF children had widespread white matter regions with significantly higher FA (p<0.05, corrected) than EFF children, while there were no significant differences in female EBF vs. female EFF children. In addition, ROI analysis revealed more regions with higher FA values when comparing all EBF to all EFF children, with the differences predominantly contributed by males. Our data suggest that 8-year-old boys (but not girls) who were breast-fed as infants have better white matter development than those who were fed infant formula. Prolonged and exclusive breast feeding (=12 months) in boys showed more improvement of white matter integrity.