Improving Metabolic Health in Children: A Path to Optimal Learning and Development

As an Occupational Therapist and Nutrition Network Practitioner, I'm passionate about helping children reach their full potential through optimized metabolic health. In today's world of processed foods and increasing childhood obesity, understanding the connection between metabolism and brain development has never been more crucial.

Understanding Metabolic Health

Metabolism is the body's process of converting food into energy—energy that's essential for growth, movement, and cognitive functions. When we talk about metabolic health in children, we're focusing on how efficiently their bodies use nutrients to fuel optimal brain development and bodily functions.

Unfortunately, South Africa faces significant challenges in this area. According to recent national surveys, approximately 13% of children under 5 are overweight, setting them on a path toward potential metabolic disorders as they grow older.

The Growing Concern of Metabolic Syndrome in Children

Metabolic syndrome—characterised by central obesity plus at least two other conditions like hypertension, elevated triglycerides, low HDL cholesterol, or impaired glucose metabolism—is increasingly being diagnosed in children over 10 years old.

The health risks associated with this condition are significant:

• Non-alcoholic fatty liver disease

• Irregular blood lipid profiles

• High blood pressure

• Cardiovascular disease

• Insulin resistance

• Type 2 diabetes

What's particularly concerning is that obese children are more likely to become obese adults, creating a lifelong pattern of health challenges. The root cause? Chronic overconsumption of carbohydrates, sugar, and processed foods which leads to insulin resistance.

Metabolism and Brain Development

The connection between metabolism and brain development is fascinating and critical to understand:

• The developing brain requires enormous energy—in fact, a newborn's brain uses about 75% of the body's energy!

• Brain development relies on specific nutrients including ketones (derived from fat), cholesterol, omega-3 and omega-6 fatty acids, amino acids, glucose, and various vitamins and minerals.

• The brain itself is composed of 35-40% fat, with a significant portion being saturated fat.

This is why breast milk—which contains approximately 50% saturated fat—provides such perfect nutrition for developing infant brains.

The Metabolism-Neurodevelopment Connection

Research increasingly shows that metabolic dysfunction plays a significant role in many neurodevelopmental conditions. Problems with energy production at the cellular level—specifically in the mitochondria, our cells' energy factories—have been identified in conditions including:

• Autism Spectrum Disorder

• Rett Syndrome

• Fragile X Syndrome

• Down Syndrome

• Schizophrenia

• Epilepsy

The prevalence of mitochondrial disease in the ASD population is estimated to be 500 times higher than in the general population, with approximately 30% of children with ASD experiencing metabolic abnormalities.

Ketogenic Dietary Therapy: A Promising Approach

Given these connections, metabolic therapy—particularly the ketogenic diet (KD)—shows promising results for some children with neurodevelopmental conditions. The ketogenic diet is a high-fat, low-carbohydrate approach that shifts the body from using glucose as its primary fuel to using ketones.

Clinical evidence for its effectiveness includes:

• A study by Evangeliou et al. (2003) showed improved scores on the Childhood Autism Rating Scale in most of the 18 children who adhered to a modified MCT diet.

• Spilioti et al. (2013) reported significant improvements in Greek children with ASD aged 3.5-6 years.

• Studies by Masino et al. (2011) and Ijff et al. (2016) demonstrated improvements in cognition, mood, and behaviour in children on ketogenic diets.

Perhaps most remarkable is a case study by Herbert and Buckley (2013) describing a 12-year-old girl with co-morbid autism and epilepsy. After adopting a ketogenic diet while remaining gluten and casein-free, she experienced not only a significant reduction in seizures but also resolution of obesity and dramatic improvements in cognitive and behavioural function. Over several years, her autism rating score decreased from 49 (severe autism) to 17 (non-autistic state), and her IQ increased by 70 points.

Real-World Challenges and Solutions

While the potential benefits are significant, implementing ketogenic metabolic therapies presents practical challenges such as food selectivity and preference, social situations, financial and resource constraints, monitoring and adherence as well as cultural and traditional food preferances.

How Occupational Therapy Can Help

As an Occupational Therapist with a deep understanding of neurological and metabolic health, I'm uniquely positioned to help families navigate these challenges. My holistic approach addresses not just the dietary aspects, but also the practical, everyday implementation within your child's overall developmental context.

Our services include:

• Assessment and screening

• Mealtime adaptations and interventions

• Family education and coaching

• Collaboration with your multidisciplinary team

• Environmental adaptations

• Developmental monitoring

• Advocacy and community integration

By addressing metabolic health through evidence-based interventions, we can support your child's optimal development, learning, and quality of life. If you're concerned about your child's metabolic health or are interested in exploring dietary approaches to support neurodevelopment, I'd love to help you navigate this journey.

This blog is for informational purposes only and is not intended to replace medical advice. Always consult with healthcare providers before making significant dietary changes, especially for children with existing health conditions.

Resources for Further Information

• The Charlie Foundation: charliefoundation.org

• Nutrition Network: nutrition-network.org

• Matthews Friends: matthewsfriends.org

• MetabolicaMed: metabolicamed.co.za

• NutriPaeds: nutripaeds.co.za

Jennifer Brueton is an Occupational Therapist and Nutrition Network Practitioner specialising in metabolic health approaches for children and adults with neurological conditions.