Early protein intake predicts functional connectivity and neurocognition in preterm born children
Emma G. Duerden, Benjamin Thompson, Tanya Poppe, Jane M. Alsweiler, Greg Gamble, Yannan Jiang, Myra Leung, Anna C. Tottman, Trecia A. Wouldes, Steven P. Miller, Jane E. Harding, PIANO study group, Jane M. Alsweiler, Janene B. Biggs, Coila Bevan, Joanna Black, Frank H. Bloomfield, Kelly Fredell, Greg Gamble, Jane E. Harding, Sabine Huth, Yannan Jiang, Christine Kevan, Myra Leung, Geraint Phillips, Tanya Poppe, Jenny Rogers, Heather Stewart, Benjamin Thompson, Anna C. Tottman, Kathryn A. Williamson, Trecia A. Wouldes
Abstract
Nutritional intake can promote early neonatal brain development in very preterm born neonates (< 32 weeks' gestation). In a group of 7-year-old very preterm born children followed since birth, we examined whether early nutrient intake in the first weeks of life would be associated with long-term brain function and neurocognitive skills at school age. Children underwent resting-state functional MRI (fMRI), intelligence testing (Wechsler Intelligence Scale for Children, 5th Ed) and visual-motor processing (Beery-Buktenica, 5th Ed) at 7 years. Relationships were assessed between neonatal macronutrient intakes, functional connectivity strength between thalamic and default mode networks (DMN), and neuro-cognitive function using multivariable regression. Greater functional connectivity strength between thalamic networks and DMN was associated with greater intake of protein in the first week (β = 0.17; 95% CI 0.11, 0.23, p < 0.001) but lower intakes of fat (β = - 0.06; 95% CI - 0.09, - 0.02, p = 0.001) and carbohydrates (β = - 0.03; 95% CI - 0.04, - 0.01, p = 0.003). Connectivity strength was also associated with protein intake during the first month (β = 0.22; 95% CI 0.06, 0.37, p = 0.006). Importantly, greater thalamic-DMN connectivity strength was associated with higher processing speed indices (β = 26.9; 95% CI 4.21, 49.49, p = 0.02) and visual processing scores (β = 9.03; 95% CI 2.27, 15.79, p = 0.009). Optimizing early protein intake may contribute to promoting long-term brain health in preterm-born children.