The developing brain and the environment – psych notes continued. Malnutrition and HIV

The developing brain and the environment – psych notes continued.

                                   Malnutrition and HIV

                                   Interactive Model

Under nutrition ------------------------------------------------------------------Health factors

‘                                                                                                                             ‘

‘                                         Impaired Brain and                                                     ‘

‘                                         Behavioral Development                                            ‘

‘                                                                                                                              ‘

Psychological        ………………………………………………………….External                                                                                               

Parental education, level, toys, lethargy                                          health care available

                                                                                                      Environment (eg pollution)

                                                                                              Home environment, economics .

                                                                                               Housing, sanitation, etc …

Many things may have direct or indirect effects – no fine line- Especially for chronic marginal nutrition  - on going – generally through lifetime and through generations.

Type of Studies:

Retrospective:  looks backward in time from effects to causes

Prospective:  looks forward in time, assessing outcome

Both are correlation.  Studies can look at nutrition level or mothers’ report of toys, of what she ate……You can’t say that A led to B.  Correlation is not causation. 

     Intervention Studies:  eg drug trial – don’t know if placebo or drug assigned randomly.  Different to conduct random assignments. One is in readings and other adds on to first one. 

The INCAP study Institute of Nutrition of Central America and Panama

     - Two Protein villages (atole). ( Atole is a corn based drink.)

    -   Two control villages (fresco) (something like koolade with sugar)

     Supplemental vitamins (both groups)

      Minerals to both

-add libitum supplementation two times per day

(four villages – all poor, very rural and agrarian, limited education esp. women

   Children under seven and pregnant women and then focused on children under three years of age.  (Could be differences in Families – what eat at home, status within)

Five year study – born and developed, birthrate, head circumference, psychological testing when older- ran out of money?  Ten years later follow-up (1986 or 7)- assessed

Early Results 

Protein did not cause any difference between groups

Total Caloric intake was

.effect of total caloric intake on:

-Height

-Weight

-head circumference

INCAP preschool battery

Overall score and some subtests

Follow up results (1988-9)

“psycho educational tests”

Vocabulary

Numeracy

Reading

Knowledge

Suggests long term effect  (lots of things wrong with this study)

.information processing tests

. raven’s progressive matrices

Interactions between nutrition and socio – economic status (SES)