Relationship between Nutrition, Brain, Cognition, Learning, and Behavior in School Age Children: Systematic Evidence and Future Opportunities

Abstract Context Nutrition plays a fundamental role in the growth and healthy upbringing of children. While substantial evidence highlights the significance of nutrition during early life, the understanding of its impact on brain development and function, cognition, behavior, and learning throughout childhood and beyond is limited. Objective In this systematic review we addressed this knowledge gap by assessing the existing evidence on how nutrition influences brain structure and function, cognitive abilities, behavior, and learning skills in school-aged children (ages 5-18 years). Data Sources A systematic search of MEDLINE (via PubMed, Science Direct, and Google Scholar) for published and clinical nutrition-based intervention studies was performed with the focus on effects significantly improving brain, cognition, behavior, and learning in children 5-18 years old for relevant studies published after January 2010. Data Extraction A total of 977 studies were identified, out of which 76 studies fit the inclusion criteria and were included in the systematic analysis. Data Analysis Included studies were systematically assessed to provide a comprehensive overview of the relationship between nutritional intake and its impact on brain structure and function, cognition, behavior, and learning skills. In addition, for intervention studies, quality assessment was performed. Conclusions Findings suggest that, despite the limited number of studies specifically examining brain-related benefits, nutrition plays a significant role in enhancing and supporting typical neurocognitive development during school age. Current results indicate that diet quality (eg, Mediterranean and Nordic) and the intake of specific nutrients, such as lipids, seem to have the most promising impact and are associated with positive effects. However studies’ diversity (ie, intervention versus observational) and methodologies employed, limits drawing strong conclusions regarding the most effective nutritional interventions and their underlying causative mechanisms. In sum, this work provides a systematic summary of the available evidence, by identifying common findings across multiple studies, and suggesting avenues for future research in this important, yet underexplored, area. Systematic Review Registration PROSPERO registration No. 580224.