Nutrition during adolescence: A missed opportunity for optimal cognitive health?

Optimization and maintenance of cognitive performance over the lifespan has implications for overall quality of life and cognitive function later in life. It is well-established that the prenatal period and infancy (the first 1000 days) are critical for cognitive development, and nutrition during these periods can impact cognitive performance later in life.¹ Specific nutrients are therefore emphasized during pregnancy and infancy, to include choline, iron, folate and iodine,^2,3 with emerging evidence for a role for many other nutrients and food components.

Less attention has been paid to the effects of nutrition in early childhood through adolescence. In 2022, a systematic review noted positive effects of nutritional interventions on cognitive development in children ages 1 through 6 years.⁴

The Cognitive Health Committee of the Institute for the Advancement of Food and Nutrition Sciences (IAFNS) is interested in focusing on adolescence, a life stage of potential outsized impact for later life brain health. Looking into what is known, the committee was not able to identify this same type of evidence review for adolescence, either examining effects of nutrients consumed during adolescence on cognitive performance at that age, or later in life.

In fact, a 2022 series on nutrition in adolescence published in The Lancet⁵ notes that adolescence has been overlooked as a critical growth period. The series cites the example of the complete lack of adolescence-specific targets in the Sustainable Development Goals for nutrition. A scan of PubMed identifies only one recent systematic review — focused specifically on iron supplementation and academic performance in adolescents globally.⁶ Another systematic review suggested a positive effect of breakfast consumption (compared to no breakfast) on cognitive performance in children, but the authors noted that very little information was available on adolescents.⁷

There do not appear to be other reviews, systematic or otherwise, on the topic of the role of nutrient intake broadly in cognitive development and performance during adolescence — or effects of nutrients in adolescence on cognition later in life. Yet, we know the teen years are key to “fine-tuning” how the brain works,⁸ especially as many scholars now say the brain is not fully formed and functioning until age 25. Are we missing a critical window of opportunity by overlooking this impactful life-stage?

First, what is “adolescence”? This is a moving target and it depends who you ask. The U.S. Census Bureau applies the age range 10 through 19 years. If we look to the Dietary Reference Intakes reports, puberty or adolescence is defined as ages 9 through 18 years. The 2020 Dietary Guidelines for Americans uses two categories: children and adolescents ages 9 through 13 and 14 through 18 years. Both of the most recent Dietary Guidelines Advisory Committee Reports apply the age range of 12 to 19 years. Thus, there is no absolute consensus on the specific window, but over this age range the brain remains susceptible to many influences, and nutrition is an important one.

We also know that adolescents “eat differently.” Their eating patterns can be erratic and easily influenced by peers and the environment. At the same time, nutrition and dietary behaviors at this life stage may have implications for life-long eating and health.

To highlight opportunities to learn more about the impact of nutrition during adolescence, the IAFNS committee initiated a systematic review, led by researchers at Swansea University, focused on a comprehensive age range of 8 to 19 years (see the Open Science Framework entry). In total, 48 randomized controlled trials and 25 prospective cohort studies met the inclusion criteria. Because of lack of consistency across studies, it was difficult to discern the impacts of specific nutrients on cognition and academic achievement. There were beneficial effects for some nutrients such as Vitamin D, choline, polyphenols, and whole grains, but evidence was sparse. Although conclusions were elusive, this review points to a significant gap in knowledge about how nutrition can be impactful in adolescence. This becomes even more important as risk factors for cognitive decline have been identified as early as age 24.⁹ This new IAFNS review, slated for submission to a peer-reviewed journal, intends to boost research into this important life stage.

As more attention is focused on the importance of cognitive health by public health authorities, consumers, and the food industry, stakeholders are interested in evidence-based dietary guidance to support and optimize brain health. While it is clear that the prenatal period and infancy are critical windows for cognitive development, the period spanning adolescence may have equally strong implications for cognitive outcomes in early and late adulthood.

To our knowledge, the IAFNS’ review of what is known about the impact of nutrition during adolescence on later life cognition is the first of its kind. The hope is that this study inspires new research focused on adolescence as this may be one key to impacting quality of life, cognitive function and improving cognitive longevity across populations.

References

1. Prado, E.L.; Dewey KG. Nutrition and brain development in early life. Nutr Rev. 2014, 72(4), 267–284. DOI: 10.1111/nure.12102
2. Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academies Press; 1998.
3. Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Institute of Medicine (US) Panel on Micronutrients. Washington (DC): National Academies Press (US); 2001.
4. Roberts M.; Tolar-Peterson, T.; Reynolds, A.; Wall, C.; Reeder, N.; Mendez, G.C. The Effects of Nutritional Interventions on the Cognitive Development of Preschool-Age Children: A Systematic Review. Nutrients. 2022, 14(3), 532. DOI: 10.3390/nu14030532
5. Patton G.; Neufeld, L.M.; Dogra, S.; Frongillo, E.A.; Hargreaves, D.; He, S.; Mates, E.; Menon, P.; Naguib, M.; Norris, S.A. Nourishing our future: the Lancet Series on adolescent nutrition. 2022, 399(10320), 123-125. DOI: 10.1016/S0140-6736(21)02140-1 
6. Samson, K.L.I.; Fischer, J.A.J.; Roche, M.L. Iron Status, Anemia, and Iron Interventions and Their Associations with Cognitive and Academic Performance in Adolescents: A Systematic Review. Nutrients. 2022, 14(1), 224. DOI: 10.3390/nu14010224
7. Hoyland, A.; Dye, L.; Lawton, C.L. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev. 2009, 22 (2), 220–243. DOI: 10.1017/s0954422409990175
8. National Institute for Mental Health. 2024. The Teen Brain – 7 Things to Know. Accessible at: https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know.
9. Aiello, A.E.; Momkus, J.; Stebbins, R.C.; Zhang, Y.S.; Martin, C.L.; Yang, Y.C.; Gaydosh, L.; Hargrove, T.; Hazzouri, A.Z.A.; Harris, K.M. Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based study. The Lancet Reg Health Americas. 2025, 45, 101087. DOI: 10.1016/j.lana.2025.101087