Infant diets, brain cortical development, and executive functions in children

Authors: LI, TING - University Arkansas For Medical Sciences (UAMS); Badger, Thomas; BELLANDO, BETTY JAYNE - University Arkansas For Medical Sciences (UAMS); SORENSEN, SETH - University Arkansas For Medical Sciences (UAMS); OU, XIAWEI - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 2/10/2020
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: While it is known that breastfeeding promotes healthy brain development in children, the comparative effects of formulas feeding substantially differing in composition (i.e., milk-based vs. soy-based) on brain development are unclear. In this study, we recruited healthy 8-year-old children who were predominately breastfed, cow's milk formula fed, or soy-based formula fed during infancy, and evaluated their brain cortical development using MRI. We also assessed their executive functions using parental-reported Behavior Rating Inventory of Executive Function (BRIEF) assessment. Differences in cortical thickness in multiple brain regions and differences in BRIEF scores were both observed for children in different infant diet groups. The most recent Center for Disease Control and Prevention Breastfeeding Report Card shows that currently 83.2% born in the US started out breastfeeding, and 46.9% were exclusively breastfed at 3 months. For those who did not start out breastfeeding or ended sooner than recommended, cow's milk protein-based formula has been the main alternative. In addition, soy protein-based formula currently also accounts for a small percentage of the infant formula market in the US and remains useful for infants allergic to milk formula or for parents wishing to maintain a vegetarian lifestyle. While soy-based formula and milk-based formula sold in the US all meet specific requirements of the FDA for nutrient content, a major difference in soy formula and all other formulas is that the soy protein used in soy-based formula contains isoflavones which can have weak estrogenic activity, and this has led to some health professionals to be concerned about sexual development and reproduction in children fed soy formula. Many studies have observed benefits to children's health and development associated with breastfeeding. Few studies have evaluated whether there are brain developmental differences associated with soy- vs. milk- based formula, despite recent findings that estrogen may play an important role in neurodevelopment and soy isoflavone may have important implications in cognitive function. In this study, we aim to evaluate whether different types of infant formula feeding (particularly soy vs. milk based formula) during the first year of life would have impact on children's brain development and neurodevelopmental outcomes such as executive functions. Healthy 8-year-old children were recruited for this imaging study. Inclusion criteria for the participants were: age 90-101 months at time of study, parental report of an uncomplicated full-term gestation, birth weight between 5-95th percentile-for-age (5.5-9.25 pounds), and the type of infant diet between birth and age 8 months. They were either predominately breast-fed (BF) or predominately fed commercially available milk formula (MF) or soy formula (SF) during infancy. BF children were breastfed for about 8 months or longer before completely transitioning to formula and/or other diets. MF and SF children were fed the same types of formula (cow's milk-based or soy-based) since first weeks of life through age ~8 months or above. Exclusion criteria for the participants included: maternal use of alcohol, tobacco, illicit drugs, or psychotropic medications during pregnancy; illnesses and chronic diseases which may affect children's growth or development; psychological/psychiatric diagnoses; neurological impairment or injury; history or current use of anticonvulsant, stimulant, or mood-stabilizing medications; and history or current use of remedial special education services. The children were scanned on a 1.5T Achieva scanner (Philips Healthcare, Best, the Netherlands) with an 8-channel SENSE head coil. Pulse sequences included a T1-weighted 3D turbo field echo pulse sequence with the following parameters: 7.3 ms TR; 3.4 ms TE; 8degree flip angle; 1x1x1 mm acquisition v