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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.

field work Ravi Prakash Upadhyay
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Ravi Prakash Upadhyay

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My career in research started with post-graduation (MD) in Community Medicine from the prestigious . Currently, I am working in the capacity of a research scientist at 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 )

鈥淢y motivation to pursue research comes from the amalgamation of critical thinking, independence of pursing 鈥渙ut of the box鈥 ideas and seeing those ideas transform into actual piece of work.鈥 ()

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.

  • ciKMC

鈥淚 was a part of the team that tested the effect of听community-initiated Kangaroo Mother Care (ciKMC)听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.听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.鈥

  • Vitamin B12 & folic acid

I was a part of .听I was involved in听the analysis of data from this trial. The trial aimed to understand the effect of Vitamin B12 and folic acid supplementation听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 鈥渄evelopment and delivery鈥 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.听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, , 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 (). 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 (). Our meta-analysis showed that LBW children <鈥10鈥墆ears 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.

鈥淢y long-term vision is to create a niche for myself and be known for cross-cutting research in the domain of child development.鈥