Ravi Prakash Upadhyay: Investigating the impact of nutritional interventions on neurodevelopment in young Indian children
PhD Candidate, Ravi Prakash Upadhyay, writes about his PhD and research activity.
My career in research started with post-graduation (MD) in Community Medicine from the prestigious All India Institute of Medical Sciences, New Delhi, India. Currently, I am working in the capacity of a research scientist at Centre for Health Research and Development, Society for Applied Studies (CHRD-SAS) and engaged in a wide spectrum of research related activities ranging from study conceptualization and grant writing to implementation of trials and data analysis. (Meet Ravi Upadhyay on ResearchGate)
“My motivation to pursue research comes from the amalgamation of critical thinking, independence of pursing “out of the box” ideas and seeing those ideas transform into actual piece of work.” (Learn more)
Exploring ways to accelerate neurodevelopment in young Indian children
My area of research is mostly around identifying ways and mechanisms to accelerate neurodevelopment in children from resource-limited settings. As part of my PhD, I am looking at the effect of providing daily balanced protein energy micronutrient enriched cereal mix (for a period of 6 months) to infants aged 6 months on their cognitive, motor and language performance at 12 and 24 months of age.
“I was a part of the team that tested the effect of community-initiated Kangaroo Mother Care (ciKMC) during the neonatal period on cognitive, motor and language scores at 12 months of corrected age. I was primarily involved in the data analysis, interpretation and manuscript preparation. We did not find any discernible effect of the intervention on neurodevelopmental outcomes. However, we are planning a follow up of these children to see if the effects emerge later in the childhood.”
- Vitamin B12 & folic acid
I was a part of another trial that looked at the effect of Vitamin B12 and folic acid supplementation. I was involved in the analysis of data from this trial. The trial aimed to understand the effect of Vitamin B12 and folic acid supplementation in Indian children aged 6 to 24 months on their cognitive and higher executive scores at ages 6 to 9 years. We did not find enough evidence to suggest long term benefits on cognitive functioning.
- Psychosocial intervention package
Recently, one of the most challenging studies I am involved in is one in which I am responsible for “development and delivery” of the psychosocial interventions. The study aims at understanding the effect of a package of growth and development sensitive interventions (comprising of nutrition, WASH, health care and psychosocial interventions), which are delivered across the continuum of pre-pregnancy, pregnancy and postnatal period. The study will evaluate their effects on growth and neurodevelopmental outcomes at 24 months of age.
Learning more about early childhood
Early child development is an emerging field of research and newer assessment techniques provide a completely new dimensions to how we understand brain maturation and functioning. My colleagues and I have recently developed a proposal to understand the strength of correlation between eye tracking parameters measured in early infancy with neurodevelopmental outcomes at 24 months of age. In an ongoing effort, I am looking at the association of catch-up growth between early and middle childhood with cognitive outcomes at 6-9 years of age.
An overlapping area that interests me is the relationship between linear growth in children and their neurodevelopment. In a recently published study entitled, Parental height modifies the association between linear growth and neurodevelopment in infancy, that utilizes data from Nepal, my colleagues and I have shown that the association between linear growth and neurodevelopmental outcomes during infancy is influenced by parental height. We conclude that therefore, parental height should be taken into consideration when using linear growth as a proxy for neurodevelopment in young infants. In an ongoing effort, I am looking at the association of catch-up growth between early and middle childhood and cognitive outcomes at 6-9 years of age.
Summarising available evidence into systematic reviews and meta-analyses
Apart from conducting intervention trials, I have a strong inclination towards synthesizing available evidence to generate useful information. This is reflected in the systematic reviews and meta-analyses that I have conducted. One such meta-analysis aimed to understand the effect of prebiotic and probiotic supplementation in preterm very low birth weight babies on their neurodevelopmental outcomes (Effect of prebiotic and probiotic supplementation on neurodevelopment in preterm very low birth weight infants: findings from a meta-analysis). Through this review, we concluded that there are limited randomized controlled trials (RCTs) on this aspect and the available evidence does not demonstrate a difference in neurodevelopmental outcomes between prebiotic/probiotic treated and untreated control groups.
Another meta-analysis was directed towards estimating the quantum of cognitive and motor deficits that children born low birth weight (LBW) experience, compared to those born with normal birth weight, in a south Asian setting (Cognitive and motor outcomes in children born low birth weight: a systematic review and meta-analysis of studies from South Asia). Our meta-analysis showed that LBW children < 10 years of age had around 5 points lower cognitive and 4 points lower motor scores compared to children with normal birth weight. The findings underscored the need for prioritization of early child development interventions for children born LBW.
“My long-term vision is to create a niche for myself and be known for cross-cutting research in the domain of child development.“