Carotenoids, cognitive function, and brain health in pediatric populations

Background: Most children and adults in the U.S. consume insufficient quantities of fruits and vegetables. This is especially concerning for children, as early life and adolescence are critical periods for brain development. Carotenoids, antioxidant plant pigments that accumulate in human tissues (i.e., skin, macula, and brain), have been linked to various health and cognitive benefits. While studies have shown associations between carotenoids and cognitive performance in adults, their role in supporting cognitive function and brain health in childhood remains comparatively underexplored. This research aimed to investigate the relationship between carotenoids and cognitive outcomes in school-aged children and toddlers. Specific objectives included: 1) Examining associations between skin and macular carotenoids and academic achievement in school-aged children, 2) exploring links between skin carotenoids and sensory, cognitive, language, and motor skills in toddlers; 3) assessing longitudinal changes in dietary and skin carotenoid levels in toddlers over 12 months; 4) investigating how skin carotenoids may relate to sensory and cognitive developmental milestones over 12 months; and 5) evaluating how skin and macular carotenoids may relate to brain structure and function in school-aged children. Methods: For Aim 1, cross-sectional data were collected from 81 school-aged children (7–12 years). Aim 2 involved cross-sectional analyses of 45 toddlers (12–18 months). Aims 3 and 4 assessed 51 toddlers who were initially recruited between 12 and 18 months of age. They were followed over two 6-month increments, with assessments occurring at three timepoints: baseline (12–18 months), midpoint (18–24 months), and final (24–30 months). Aim 5 analyzed cross-sectional data from 47 school-aged children (7–13 years). Skin carotenoids were measured using reflection spectroscopy (Veggie Meter™) and macular pigment via heterochromatic flicker photometry. Academic abilities were assessed in school-aged children using the Woodcock-Johnson IV Tests of Achievement (WJ-IV) and cognitive, language, and motor skills were evaluated in toddlers using the Bayley Scales of Infant and Toddler Development IV (BSID-IV). Electroencephalography was used to collect mismatch negativity (MMN), which reflects sensory memory, and visual evoked potentials (VEPs), which reflect visual processing, in toddlers. Brain structure and function data were acquired in school-aged children with a 3T MRI scanner (Siemens Medical Solutions; Erlangen, Germany). Results: Skin carotenoids were positively associated with academic achievement in math subsections (β = 0.27–0.38, p <= 0.02) and demonstrated a trending relationship with reading subsections (β = 0.22–0.33, p = 0.05-0.07) among school-aged children, whereas macular carotenoids did not show significant associations. In toddlers, skin carotenoids were significantly related to cognitive function (β = 0.24, p=0.04) but not language or motor skills; no significant associations were observed with neurophysiological measures (i.e., MMN, VEPs). Longitudinal analysis in toddlers revealed no significant changes in skin carotenoids over time; however, increased carotenoid intake (β = 0.52, p = 0.02) and decreased deep-yellow vegetable intake (β =-0.45, p = 0.03) were associated with increased skin carotenoid levels across 12 months. Greater increases in skin carotenoids were related to greater gains in VEP N75-P100 amplitude (β=0.39, p=0.02), cognition (β=0.30, p=0.07), and gross motor skills (β=0.34, p=0.051), and reduced gains in fine motor skills (β=-0.30, p=0.04) across time. Baseline skin carotenoids predicted greater improvements in cognitive (β=0.35, p=0.057), fine motor skills (β=0.46, p=0.01), and receptive communication (β=0.44, p=0.01), but not sensory processing outcomes (i.e., MMN, VEPs) across 12 months. MPOD correlated with optic chiasm volume (β=-0.34, p<0.01) and inferior frontal gyrus (pars opercularis) activation (β=-0.38, p=0.054). Skin carotenoids were associated with choroid plexus (β=-0.33, p=0.03) and inferior temporal white matter volumes (β=0.23, p<0.01). Conclusions: Skin carotenoids among school-aged children were positively associated with math and reading performance; however, the lack of associations with macular pigment suggests potential differences in the functional roles or accessibility of carotenoids in the skin or macula in relation to cognitive outcomes. Longitudinal data among infants and toddlers showed that increased dietary carotenoid intake and decreased deep-yellow vegetable intake were related to increased skin carotenoids. Baseline skin carotenoids predicted baseline cognitive function, as well as greater increases in cognitive, receptive communication, and fine motor skills in toddlers over 12 months. In addition, greater increases in skin carotenoids were linked to greater gains in N75-P100 amplitude, cognition, and gross motor skills and decreased gains in fine motor skills. The contradictory relationship seen with fine motor skills may be due to the lack of significant change in skin carotenoids over time, indicating that baseline carotenoids may be a better predictor of developmental gains than changes in skin carotenoid levels. Finally, skin and macular carotenoids were associated with specific brain structures and functions among school-aged children, highlighting the potential of carotenoid status in explaining brain structure and function in children. Future research is needed to further explore the role of carotenoids in enhancing cognitive function, academic outcomes, and brain health during critical developmental periods.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Neuroscience

Grantor

University of Illinois Urbana-Champaign

Year dc:date

2025

Author dc:creator

• Rosok, Laura Madeline

Contributors dc:contributor

• Khan, Naiman A
• Dilger, Ryan N
• Federmeier, Kara D
• Walk, Anne M

• skin carotenoids
• macular pigment
• dietary carotenoids
• academic achievement
• cognitive function
• sensory processing
• MMN
• VEPs
• EEG
• MRI
• children
• longitudinal

Statement dc:rights

• Copyright 2025 Laura Rosok

Language dc:language

en, eng

Handle dc:identifier

https://hdl.handle.net/2142/129504

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F129504