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Global Nutrition (Oral Session 1)

(OR01-02-25) Mikhuna Trial: Ecuadorian Dietary Pattern During Pregnancy Increases Growth in Sub-cortical Fetal Brain Regions

Saturday, May 31, 2025
10:12 AM - 10:24 AM ET
Location: S220 E-G
Objectives: Examine the effects of an Ecuadorian healthy dietary pattern on fetal and newborn growth and brain development applying novel ultrasound imaging.

Methods: This longitudinal, individually randomized controlled trial was conducted in two peri-urban, low-resource communities of Ecuador. Pregnant women in their first trimester were randomized to: 1) control group standard-of-care (n=82); or 2) Mikhuna (“nourish” in Kichwa) intervention (n=103). The intervention from 12w gestation to birth consisted of a weekly food delivery [8 eggs (4 servings); 500g fish (2 servings); variety of native fruits and vegetables] and social behavior change communication strategy encouraging diet diversity and limiting ultra-processed foods. Maternal blood, anthropometry, and food frequency dietary intakes were collected at baseline 12w, 21w, 35w gestation, and 2w postpartum. Standard and novel ultrasound protocols were followed at 21 and 35w gestation, and 2w post-partum. WHO references and equations from the literature generated Z scores and percentiles. Generalized linear models assessed for intervention effects controlling for gestational age and same parameter at 21w.

Results: Baseline characteristics were similar across trial groups. Newborn anthropometry showed non-significant differences in length-for-age Z, weight-for-age Z, and weight-for-height Z. After adjusting for gestational age at measure and parameter at 21w, significant increases in growth of the gangliothalamic ovoid, corpus callosum, and thalamus area (from 21 weeks to 35w) and corpus callosum Z score at 35w were evident in the intervention compared to control group. Other brain and bone parameters showed non-significant differences.

Conclusions: The Mikhuna intervention increased growth of subcortical fetal brain structures, with established roles in motor control, memory, and signal transmissions. These findings build on previous observational studies linking the brain regions to maternal and newborn nutrition. Field-friendly novel ultrasound protocols may be applied in other in community-based settings to gain insights into nutrition effects on bone and brain health.

Funding Sources: Children's Discovery Institute