To investigate whether nutrition plays a role in inhibitory control and executive functioning early in life, we collected data on behavior using different tasks (see previous blog). To perform these tasks, we choose to visit the children at home with the aim 1) to burden the families less, and 2) to test the children in their home environments where they are probably more at ease. Testing 3-year-old children is very fun a

October 1

nd can also be challenging at the same time. I will share some anecdotes and experiences of my data collection as inspiration for others testing young children.

Some tasks had lengthy instructions and required the child to perform several practice trials, resulting in the child losing his/her attention. The sequence of the tasks was constructed in such a way that the child’s attention was maintained as long as possible. For example, the tasks that required more attention, focus and instructions were performed first.

Sometimes children said to be not in the mood to play anymore, or that they didn’t know what to do despite passing the practice trials. Repeating the rules is not possible, because it means that some children will receive more instructions than other children. I solved this problem by telling the child that he/she would be rewarded if he/she finished the task. Rewards could be a fun game they can play next, or some snacks that the parents agreed to giving.

Parents sometimes tended to help their child. To prevent this, it is very important to instruct the parents not to help their child. Another way to prevent the parent from helping is to keep them busy by having them fill in a questionnaire, or to turn to the child and say things like: “are you a bit nervous because Mum is looking?” Sentences as these work very well, as you are not telling the parent directly what to do, but they understand the hint immediately.

Toddlers often have siblings; sometimes younger siblings and sometimes older siblings. If possible, parents are asked to arrange the situation this way that the siblings are not at home and/or are asleep. When not possible, an assistant accompanying the experimenter can take care of the siblings, for example by taking the sibling outside and play soccer in the neighborhood. Everything for science!

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For my research, I measured impulsive behaviour in 3-year-old children. Briefly, impulsivity is the opposite of inhibitory control. There are several forms of inhibitory control, and although there is no official categorisation of different forms of inhibitory control in young children, Anderson & Reidy (2012) defined five categories. The categories are:

  • Delay of gratification: the ability to resist direct temptation in order to receive a bigger reward after the delay.
  • Impulse control: the ability to inhibit an instinctive response.
  • Verbal inhibition: the ability to inhibit verbal responses.
  • Motoric inhibition: the ability to learn response sets that conflict with an established behaviour.
  • Go/No go: the ability to perform certain behaviour after being shown a certain stimuli but to inhibit that behaviour after being shown a different stimuli.

The Marshmallow test is a famous example of an inhibitory control task (more specifically: delay of gratification). For this task, a marshmallow is placed in front of the child. The child is told that if s/he refrains from eating the marshmallow while the examiner is gone, s/he will receive two marshmallows when the examiner returns. Another example of an inhibitory control task (more specifically: Go/No go) is the Bear/Dragon task. For this test, the child has to obey the commands (e.g. ‘hands on your head’) of the bear hand puppet, but must inhibit obeying the commands of the dragon hand puppet.

When comparing the Marshmallow task with the Bear/Dragon task, similarities and differences can be found. They are similar in the way that both tests require the child to inhibit their impulses. However, the Marshmallow task requires minimal working memory demand, while the Bear/Dragon task requires complex greater working memory demand (Petersen, Hoyniak, McQuillan, Bates, & Staples, 2016). The Bear/Dragon task is thus a complex inhibitory control task, because children are instructed to not only inhibit a prepotent response, but also to respond in a certain way to a salient, conflicting response option.

In my research, I used both behavioural tasks and parental report (both mothers and fathers) to assess inhibitory control. However, results from the behavioural tests and the parental questionnaires correlate poorly with each other; a finding which is also often reported in other studies. While behavioural tests show objective observations of the child’s behaviour, these observations are mostly only carried out at one specific time point (e.g. during a home visit). As such, the child’s performance might be prone to noise, such as that the child slept poorly the past night. Reports of behaviour, on the other hand, reflect the behaviour of the child during daily life. However, these reports can be prone to social desirable answering and parental perceptions of their child’s behaviour. By measuring inhibitory control with both behavioural tasks and parental reports, we obtain the most robust view of the child’s behaviour.

Overall, measuring inhibitory control behaviour in 3-year-olds can be challenging, but also a lot of fun! (Stay tuned for a blog on interesting anecdotes during my data collection.)


Anderson, P. J., & Reidy, N. (2012). Assessing Executive Function in Preschoolers. Neuropsychology Review, 22(4), 345–360.

Petersen, I. T., Hoyniak, C. P., McQuillan, M. E., Bates, J. E., & Staples, A. D. (2016). Measuring the development of inhibitory control: The challenge of heterotypic continuity. Developmental Review: DR, 40, 25–71.

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In my previous blogs, I explained the research questions of my study. This study will be performed in two cohorts which I will elaborate on in this current blog about early life nutrition and studying gut microbiota. The cohorts are called BIBO and BINGO.  

BIBO stands for ‘Basale Invloeden op de Baby’s Ontwikkeling’ (in English: basal influences on  infant’s development). Recruitment of this cohort started in 2006, and a total of 193 mothers and their infants were included. At age 10, 168 mothers and their children still joined the BIBO study; the attrition rate is thus low. The majority of the mothers are highly educated (76%). The number of boys (52%) and girls (48%) in this cohort are roughly equally divided. A unique aspect of the BIBO study is the number of stool samples collected in early life. Also, detailed information about early life nutrition has been recorded during the first six months of life (e.g. information on daily frequency of breastfeeding, formula feeding, and mixed feeding). Together, these stool samples and nutrition diaries provide important insights in the relations between early life nutrition and gut microbiota development. Data about children within the BIBO cohort will be collected at age 12,5 years and 14 years. At 12,5 years, the participants will be invited to the university for an fMRI scan (more information about the fMRI scan will be given in a future blog). At age 14, children’s impulsive behavior will be assessed by means of behavioral tests and (self- and mother-report) questionnaires.

BINGO stands for ‘Biologische INvloeden op baby’s Gezondheid en Ontwikkeling’ (in English: biological influences on infant’s health and development). When investigating biological influences on infant’s health and development, it is important to start before birth. Therefore, 86 healthy women were recruited during pregnancy. Recruitment took place in 2014 and 2015. One unique property of the BINGO cohort is the fact that not only mothers were recruited, but also their partners. The role of fathers is often neglected in research, and thus an important strength of this BINGO cohort. Another unique property is that samples of mothers’ milk were collected three times during the first three months of life, to investigate breast milk composition. As for many infants their diet early in life primarily consists of breast milk, it is interesting to relate breast milk composition to later gut microbiota composition and development. Currently, 79 mothers and children, and 54 fathers are still joining the BINGO study. The average age of the participants at the time of recruitment was 32 years for mothers and 33 years for the father. Majority of the parents within this cohort are highly educated (77%) and from Dutch origin (89%). The number of boys (52%) and girls (48%) in this cohort are roughly equally divided. At age 3, children’s impulsive behavior will be assessed by means of behavioral tests and mother-report questionnaires.

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As described in my previous blog post (Nutrition, Gut Microbiota and Behavior, 4th of April), I will investigate the association between nutrition, gut microbiota and behavior. One of the main focuses within my research is to investigate the association between early life nutrition, gut microbiota development and inhibitory control within toddlers and pubertal children.

The first 1000 days of life (starting from conception) were shown to be a critical window for child development. In this phase, nutritional intake of the infant can stimulate the body and brain towards a healthy development, also known as nutritional programming1. Hence, early life nutrition, i.e. breastfeeding, can exert a major influence on infant development and thus future behavior. Breast milk contains many beneficial components such as sugars, immune factors and bacteria which are difficult to process in bottle formulas. Thus, exclusive breastfeeding is recommended until six months of age in the Netherlands.breastfeeding and early nutrition

Several studies have looked at the association between infant breastfeeding duration and future executive functioning. (Executive functions are cognitive processes in the brain that contribute to regulating thoughts and behaviors. Executive functions can be roughly divided into three core functions, namely: inhibitory control, working memory, and cognitive flexibility. Inhibitory control, which can be interpreted as the opposite of impulsivity, is necessary to suppress impulses.) Two studies found positive associations with breastfeeding duration and executive functioning in childhood2,3. However, some studies have found no associations between infant breastfeeding and future executive functioning 4,5. These studies have examined general executive functioning and mainly focussed on attention, and not inhibitory control. Furthermore, different ages and populations were examined which makes it difficult to draw firm conclusions about the association between breastfeeding duration and future executive functioning. Thus, it is of particular interest whether inhibitory control is association with breastfeeding duration.

In addition, previous literature has focused mostly on duration of breastfeeding, while the composition of breast milk is also of major importance. Breastmilk contains many nutrients that are finely attuned to the needs of the infant. It contains biologically active compounds which have diverse roles, among others guiding the development of the infant’s intestinal microbiota6. Breast milk also contains specific sugars, also known as human oligosaccharides, which have been shown to influence the types of microbiota colonizing in the infant gut7. This may potentially be associated with impulsive behaviour8. Thus, in addition to examining breastfeeding duration in relation to inhibitory control, I will also examine the breastmilk composition in relation to inhibitory control.

  1. Agosti, M., Tandoi, F., Morlacchi, L. & Bossi, A. Nutritional and metabolic programming during the first thousand days of life. La Pediatr. Medica e Chir. 39, (2017).
  2. Hayatbakhsh, M. R., O’Callaghan, M. J., Bor, W., Williams, G. M. & Najman, J. M. Association of Breastfeeding and Adolescents’ Psychopathology: A Large Prospective Study. Breastfeed. Med. 7, 480–486 (2012).
  3. Julvez, J. et al. Attention behaviour and hyperactivity at age 4 and duration of breast-feeding. Acta Paediatr. 96, 842–847 (2007).
  4. Belfort, M. B. et al. Infant Breastfeeding Duration and Mid-Childhood Executive Function, Behavior, and Social-Emotional Development. J. Dev. Behav. Pediatr. 37, 43–52 (2016).
  5. Groen-Blokhuis, M. M. et al. A prospective study of the effects of breastfeeding and FADS2 polymorphisms on cognition and hyperactivity/attention problems. Am. J. Med. Genet. Part B Neuropsychiatr. Genet. 162, 457–465 (2013).
  6. Andreas, N. J., Kampmann, B. & Mehring Le-Doare, K. Human breast milk: A review on its composition and bioactivity. Early Hum. Dev. 91, 629–635 (2015).
  7. Lewis, Z. T. et al. Maternal fucosyltransferase 2 status affects the gut bifidobacterial communities of breastfed infants. Microbiome 3, 13 (2015).



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The reason why I look at impulsive behavior is because mental disorders are the single largest contributors to disease burden in Europe. Impulsivity and compulsivity increase the risk of psychiatric disorders, especially Attention Deficit Hyperactivity Disorder, alcohol and drug abuse disorders, conduct disorder and antisocial disorders (including aggression). The urgency of addressing impulsivity and compulsivity is additionally strongly supported by the fact that these problems increase the risk for mortality.

My name is Yvonne Willemsen and I have started my PhD track at Radboud University in the Netherlands in October 2017. For my project I will assess the association between nutrition, gut microbiota composition and impulsive behavior in toddlers and young adolescents. In the following paragraphs, I will explain the first study that I am currently conducting.

Many previous studies have examined the association between nutrition and executive functions. Executive functions are cognitive processes in the brain that contribute to regulating thoughts and behaviors. Executive functions can be roughly divided into three core functions, namely: inhibitory control, working memory, and cognitive flexibility. Inhibitory control, which can be interpreted as the opposite of impulsivity, is necessary to suppress impulses. It is also an important core function of executive functions, as it supports working memory and cognitive flexibility.  To date, studies have examined the association between nutrition and executive functions in general (1). Whether nutrition is related to inhibitory control specifically (in toddlers and young adolescents) is something that still needs to be investigated.

The next step of my study is to understand how nutrition is associated with inhibitory control. To explain a possible mechanism, we will look at the gut microbiota. The reason why the gut microbiota is a point of interest is because gut microbiota can secrete molecules that may influence brain function, and thus may influence inhibitory control (2). This connection between the gut and the brain is also known as the gut-brain axis. Gut microbiota composition can change according to nutritional intake, and can therefore play a role in the gut brain axis (3). To assess the association between nutrition, gut microbiota and behavior in toddlers and young adolescents, we will use questionnaires and different behavioural measures.

  1. Cohen, J. F. W., Gorski, M. T., Gruber, S. A., Kurdziel, L. B. F. & Rimm, E. B. The effect of healthy dietary consumption on executive cognitive functioning in children and adolescents: a systematic review. Br. J. Nutr. 116, 989–1000 (2016). Link
  2. Rogers, G. B. et al. From gut dysbiosis to altered brain function and mental illness: mechanisms and pathways. Mol. Psychiatry 21, 738–748 (2016). Link
  3. Oriach, C. S., Robertson, R. C., Stanton, C., Cryan, J. F. & Dinan, T. G. Food for thought: The role of nutrition in the microbiota-gut–brain axis. Clin. Nutr. Exp. 6, 25–38 (2016). Link

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