Effects of an energy and micronutrient supplement on mental development and behavior under natural conditions in undernourished children in Indonesia.
OBJECTIVE
This paper reports the effects of an energy and micronutrient supplement on mental development and on the social cognitive and emotionally regulatory behaviors of nutritionally at risk infants and toddlers in Pangalengan, Indonesia.


METHODS
Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 12 mg iron + 209 kJ; S = 104 kJoule. Supplementation was given for 12 months.


METHODS
The sites were six tea plantations in Pangalengan, West Java.


METHODS
A 12-month-old (N = 53) and an 18-month-old (N = 83) cohort were recruited from day-care-centers. Twenty children who received S belonged to the 12- and 18-month-old cohort. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization.


METHODS
Evaluations of intake were made at baseline and every 2 months thereafter. Motor development was assessed with the Bayley Scale and with a custom-made scale to assess gross motor development leading to bipedal locomotion. Four hours of continuous observations were made of the child's interaction with the social and physical environment.


RESULTS
In the 12-month-old cohort, as compared with the M and S groups, the children who received the E supplement walked at an earlier age, had higher scores in the Bayley Scale and showed more mature social-cognitive and emotional regulatory behaviors. Similar intergroup differences were observed in the 18-month-old cohort in social cognition and regulation of emotions.
Pollitt
E
E
Department of Pediatrics and Program in International Nutrition, University of California, Davis 95616-8538, USA.
Saco-Pollitt
C
C
Jahari
A
A
Husaini
M A
MA
Huang
J
J
D018798:Anemia, Iron-Deficiency / Q000150:complications; D001519:Behavior / Q000502:physiology*; D001921:Brain / Q000254:growth & development; D002657:Child Development; D002669:Child Welfare / Q000523:psychology; D002675:Child, Preschool; D003071:Cognition; D015331:Cohort Studies; D019587:Dietary Supplements; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000494:pharmacology; D009748:Nutrition Disorders / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*
D018977:Micronutrients