CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF STUDY

Perceptions and understanding of the impact of diet on the physical health of children is an important public health issue, particularly in the context of growing concerns about childhood obesity, but traditionally little attention has been paid to lay views about the relationship between nutrition and a child’s mental development and performance. Food and nutrition, however, have important and pervasive impacts on brain development and cognitive functioning through effects on brain cell structure, neurotransmission, brain energy supply, and metabolism. A balanced diet is, thus, important for mental as well as physical development, with implications for school performance, achievement in adulthood and lifelong health and well-being. What parents and teachers believe about the relationship between nutrition and the mental development of children may affect their attitudes and behaviors regarding food provision for young people. The importance of developing good eating habits emerged as a concern for parents, as they perceived these habits could have long-term implications for health. Parents also identified conflict in trying to balance the provision of a healthy nutritious diet and satisfying their children’s food preferences.

Participants spoke of the effects of diet in terms of physical, mental, and behavioral outcomes, with attention and concentration being the aspects of mental performance most often mentioned by parents. They defined foods as ‘good’ and ‘bad’ with good foods having positive effects and bad foods having negative effects, especially as manifested by changes in mood and behavior. However, they ranked food-related factors (such as regularity of meals and what a child eats) significantly lower than physical (activity, sleep) and psychological (mood, behavior) factors and school environment as influences on cognitive development and mental performance

Cognition represents a complex set of higher mental functions sub-served by the brain, and includes attention, memory, thinking, learning, and perception (Bhatnagar and Taneja, 2001). Cognitive development in pre-schoolers is predictive of later school achievement (Tramontana et al., 1988; Clark et al., 2010; Engle, 2010). As Ross and Mirowsky (1999) state: “Schooling builds human capital - skills, abilities, and resources which ultimately shapes health and well-being.” Indeed, more education has been linked to better jobs, higher income, higher socio-economic status, better health care access and housing, better lifestyle, nutrition, and physical activity (Florence et al., 2008), which are all well-known health determinants. Education increases an individual’s sense of personal control and self-esteem; these factors have also been shown to influence better health behavior (Ross and Mirowsky, 1999; Logi Kristjánsson et al., 2010). Academic achievement is important for future personal health, and is therefore a significant concern for public health.

Cognitive development is influenced by many factors, including nutrition. There is an increasing body of literature that suggests a connection between improved nutrition and optimal brain function. Nutrients provide building blocks that play a critical role in cell proliferation, DNA synthesis, neurotransmitter and hormone metabolism, and are important constituents of enzyme systems in the brain (Bhatnagar and Taneja, 2001; Lozoff and Georgieff, 2006; Zeisel, 2009; De Souza et al., 2011; Zimmermann, 2011). Brain development is faster in the early years of life compared to the rest of the body (Benton, 2010a), which may make it more vulnerable to dietary deficiencies. In this literature review, we assess the current research evidence for a link between nutritional intake in pregnancy and childhood and children’s cognitive development. We first discuss individual micronutrients and single aspects of diet, which represents earlier research in this area. We next consider the more encompassing aspects of diet, which have emerged as researchers became more interested in diet as a comprehensive measurement. The most recent research trend in this area suggests a broader analysis of the role of nutrition in neuro-cognitive development, which we offer here in comparison to previous reviews (Black, 2003b; Bellisle, 2004; Stevenson, 2006; Georgieff, 2007; Benton, 2010a).

In recent years, there has been an increasing interest in the effect of essential fatty acids, particularly long chain polyunsaturated fatty acids (LCPUFA), on cognitive brain development. Of the human brain’s dry weight 60% is comprised of lipids, of which 20% are docosahexaenoic acid (DHA; which is an omega3 fatty acid) and arachidonic acid (AA; an omega-6 fatty acid). These represent the two core fatty acids found in gray matter (Benton, 2010b; De Souza et al., 2011). Furthermore, the supply of LCPUFAs from food, especially the omega-3 fatty acids, including DHA and eicosapentaenoic acid (EPA), is frequently inadequate for children as well as for adults (Schuchardt et al., Essential fatty acids play a central functional role in brain tissue. They are not only the basic components of neuronal membranes, but they modulate membrane fluidity and volume and thereby influence receptor and enzyme activities in addition to affecting ion channels. Essential fatty acids are also precursors for active mediators that play a key role in inflammation and immune reaction. They promote neuronal and dendritic spine growth and synaptic membrane synthesis, and hence influence signal processing, and neural transmission. In addition, essential fatty acids regulate gene expression in the brain (McCann and Ames, 2005; Eilander et al., 2007; Innis, 2007; Cetina, 2008; Wurtman, 2008; Ramakrishnan et al., 2009; Ryan et al., 2010; Schuchardt et al., 2010; De Souza et al., 2011). Therefore, the existing literature strongly suggests that essential fatty acids are critical for brain development and function. It has been suggested that the fast growth of the human cerebral cortex during the last two million years was strongly related to the balanced dietary intake of LCPUFAs (Broadhurst et al., 1998), specifically with an equal ratio of omega-6 and omega-3 fatty acids in the diet (Simopoulos, 1999). Evidence proposes that the modern Homo sapiens, whose brain developed significantly relative to its ancestors, lived near rivers and oceans, where seafood and fish were abundant (Crawford et al., 1999). The rise in intellectual and brain development in Homo Sapiens also coincided with tool making and language development (Crawford et al., 1999; Broadhurst et al., 2002). During the last 150 years, it is believed that the balance of omega-6 to omega-3 fatty acids has shifted in favor of omega-6 fatty acids in the diet, resulting in a ratio of 20–25:1 and a dietary deficiency in omega-3 fatty acids (Simopoulos, 1999). A diet that is deficient in omega-3 fatty acids may have health and developmental implications (Simopoulos, 2008).

Although it is important to investigate nutrients individually, deficiencies of nutrients rarely occur in isolation, and an inadequate diet typically causes multiple micronutrient deficiencies. In addition, nutrients interact with each other and do not work separately (Benton, 2010a). Thus, it is important to investigate the association between multiple mineral and vitamins supplementation or deficiencies and cognitive development. A recent systematic review of prenatal maternal micronutrient supplementation and children’s cognitive and psychomotor development considered 18 studies, including six multiple micronutrient supplementation trials. This review found some evidence that multivitamin and mineral supplementation might positively influence certain aspects of brain development in children (Leung et al., 2011). The review included six trials on multiple-micronutrient supplementations conducted in Peru, rural Taiwan, Tanzania (on HIV infected mothers), and in rural China, Indonesia and Bangladesh, where mothers were poorly nourished (Joos et al., 1983; Schmidt et al., 2004; McGrath et al., 2006; Tofail et al., 2008; Li et al., 2009; Caulfield et al., 2010). A very recent randomized controlled trial in Indonesia found that multiple micronutrient supplementation in undernourished pregnant mothers resulted in improved motor development, visual attention and spatial ability in pre-schoolers (Prado et al., 2012). All the above-mentioned trials are from low income countries, it is currently unknown whether the cognitive development of children of well-nourished mothers from higher income countries would benefit from multiple-micronutrient supplementation.

More consistent results from trials supplementing children with multiple-micronutrients have been shown. A meta-analysis investigated 20 randomized controlled trials published from 1970 to 2008 in developed as well as developing countries, and found that multiple-micronutrient supplementation may result in higher fluid intelligence (Eilander et al., 2010). However, this increase was only marginal, and no association was observed with crystallized intelligence in children. The finding of this review (i.e., that fluid intelligence, but not crystallized intelligence, may be influenced by multiple-micronutrient supplementation) is consistent with conclusions drawn from other studies (Benton, 2001, 2012). Fluid intelligence refers to reasoning ability that reflects the individual’s current neurological potential (indexed by measures such as speed of processing) rather than their level of past attainment and acquired, crystallized knowledge (which is measured by abilities such as depth of vocabulary). Fluid ability is typically measured via non-verbal cognitive tests, while crystallized intelligence is more usually measured by administering verbal cognitive tests (Eilander et al., 2010; Benton, 2012).

1.2 STATEMENT OF THE PROBLEM

 Mental well-being is a core component of optimal health, and is a status that individuals can manage stress from daily living and make positive achievements pursuing public interest and contribution to the community. Maintaining individual’s mental health is important to improve personal life values, to reduce medical cost and other social expenses to deal with mental disorders, and to enhance national competitiveness.

However, the type of food consumed everyday must be watched as its plays an important role in our health mentally and otherwise. Mental health diseases have represented the major contributors to years of life lost due to disability in many countries across the world. People especially parents are not enlightened on the danger mal-nutrition poses on the health of their children. Mental health is very important because is like the engine room that powers other parts of the body. If anything goes wrong with the mental development from childhood, it becomes a problem to the child through adulthood.  Therefore, the problem which necessitated this research is to understand what effect nutrition has on the mental health and total well being of children especially form age5-10.

1.3 AIMS AND OBJECTIVE

The main aim of the research is to examine the effect of nutrition on the mental health and well being of children between 5-10 years. Other specific objectives include:

1. to determine the relationship between nutrition, mental health, and well being of children between 5-10 years.
2. to examine the effect of nutrition on the mental health and well being of children between 5-10 years.
3. to examine types of nutrition suited for mental development and general well-being of children between 5-10 years.
4. to identify the causes of mental ill-health in children between 5-10 years.
5. to identify factors that militate against mental development of children between 5-10 years.
6. to proffer solution to the factors that militate against mental development of children between 5-10 years.

1.4 RESEARCH QUESTION

1. what is the relationship between nutrition, mental health, and well being of children between 5-10 years?
2. what is the effect of nutrition on the mental health and well being of children between 5-10 years?
3. what type of nutrition is suited for mental development and general well-being of children between 5-10 years?
4. what are the causes of mental ill-health in children between 5-10 years?
5. what are the factors that militate against mental development of children between 5-10 years?
6. what is the solution to the factors that militate against mental development of children between 5-10 years?

1.5 STATEMENT OF RESEARCH HYPOTHESIS

1. H0: nutrition has no significant effect on the mental health and well-being of children between 5-10 years.

2. H1: nutrition has significant effect on the mental health and well-being of children between 5-10 years.

1.6 SIGNIFICANCE OF STUDY

The findings of this study will be important on individuals on the importance of maintain healthy diets that promote mental health and general well-being. It will also enlighten them to understand that mental health is important to improve personal lives, to reduce medical cost and other social expenses to deal with mental disorders, and to enhance national competitiveness.

The findings of the study will also be significant to parents in understanding that nutrition is very important as far as a child’s mental health and general well-being ids concerned. No child should suffer as a result of an unhealthy nutrition leading to a stunted mental development or any other health related issue.

The study will also let doctors know that they have a part to play in a child’s mental development and well-being by educating the mother during antenatal and other means that present itself. Mothers should be educated on various nutrition and their uses in the development of a child.

Lastly, the study will contribute to the body of knowledge on already existing literature on the effect of nutrition on then mental health and well-being of children between 5-10 years.

1.7 SCOPE OF STUDY

The scope of this study will cover the effect of nutrition on the mental health and well-being of children between 5-10 years.

1.8 LIMITATION OF STUDY

1. Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview).

2. Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.9 DEFINITION OF TERMS

NUTRITION: Nutrition is the science that interprets the nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes ingestion, absorption, assimilation, biosynthesis, catabolism and excretion.

MENTAL HEALTH: Mental health, defined by the World Health Organization, is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

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