title: Micronutrient status and neurodevelopment in internationally adopted children.
abstract: OBJECTIVE
  To assess the status of nutrients relevant for brain development in internationally adoptees from disparate global regions and determine whether identified deficiencies are associated with neurodevelopment.
  
  
  METHODS
  Participants included children adopted from Post-Soviet States (n = 15), Ethiopia (n = 26) or China (n = 17), ages 8-18 months. A comprehensive nutritional battery and a neurodevelopmental assessment were completed at baseline (within one month of arrival) and follow-up (six months later).
  
  
  RESULTS
  At baseline, 35% were stunted, and 68% had at least one abnormal nutritional biochemical marker. The most common were low retinol-binding protein (33%), zinc deficiency (29%), vitamin D insufficiency/deficiency (21%), and iron deficiency (15%). There was significant catch-up growth in height and weight at follow-up, but little improvement in micronutrient deficiencies. Iron deficiency was associated with lower cognitive scores on the Bayley Scales of Infant Development-III, p = 0.027, and slower speed of processing, p = 0.012. Zinc deficiency was associated with compromised memory functioning, p = 0.001.
  
  
  CONCLUSIONS
  Nutrient deficiencies were common during the early adoption period in internationally adoptees from three global regions, and iron and zinc deficiencies were associated with poorer neurodevelopmental outcomes. Results emphasise the importance of monitoring micronutrient status at arrival and during the early adoption period, irrespective of country of origin.
authors.affiliation: Department of Psychology, University of North Florida, Jacksonville, FL, USA.
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Fuglestad
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Kroupina
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Dana E
authors.initials: DE
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Georgieff
mesh_terms: D000300:Adoption; D000886:Anthropometry; D001921:Brain / Q000254:growth & development*; D002675:Child, Preschool; D002681:China / Q000208:ethnology; D002658:Developmental Disabilities / Q000209:etiology; D005002:Ethiopia / Q000208:ethnology; D005074:Evoked Potentials, Visual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D000090463:Iron Deficiencies; D008297:Male; D018977:Micronutrients / Q000032:analysis* / Q000172:deficiency; D009752:Nutritional Status; D012177:Retinol-Binding Proteins / Q000172:deficiency; D014586:USSR / Q000208:ethnology; D014808:Vitamin D Deficiency / Q000453:epidemiology; D015032:Zinc / Q000172:deficiency
chemical_list: D018977:Micronutrients; D012177:Retinol-Binding Proteins; D015032:Zinc
keywords: Early adversity; Growth; International adoption; Micronutrient deficiencies; Nutrition