{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:08:04Z","timestamp":1755799684332,"version":"3.44.0"},"reference-count":112,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study examines how an early-life small-quantity lipid-based nutrient supplement (LNS) interacts with the home environment to influence Ghanaian children's social-emotional functioning at preschool age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In a randomized controlled trial, 1,320 Ghanaian women received either daily LNS, multiple micronutrients (MMN) or iron and folic acid (IFA) during pregnancy through 6 months postpartum. Infants in the LNS group received the daily supplement from 6 to 18 months. The IFA and MMN groups were combined to be the control group. At 4\u20136 years (<jats:italic>n<\/jats:italic> = 966), we assessed children's home environments (caregiver responsivity, negative behavior acceptance, physical environment, learning materials, academic stimulation) and their social-emotional strengths and difficulties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both LNS and higher quality home environments\u2014particularly caregiver responsivity and negative behavior acceptance\u2014predicted children having fewer social-emotional difficulties. LNS supplementation moderated relations between the home environment and children's hyperactivity\/inattention and total difficulties. Living in a safer physical environment was related to fewer hyperactivity\/inattention problems and total difficulties only for children who received LNS. Less academic stimulation was related to more hyperactivity\/inattention only for children in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early-life LNS supplementation and supportive home environments reduce social-emotional difficulties in Ghanaian children. Nutritional interventions are most effective in the context of safe, stimulating households, demonstrating that integrated interventions support children's wellbeing in low- and middle-income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>clinicaltrials.gov<\/jats:ext-link>; identifier: NCT00970866.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1571677","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T04:14:36Z","timestamp":1755663276000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early-life nutritional supplementation protects against home environmental risks in Ghanaian children's social-emotional development"],"prefix":"10.3389","volume":"12","author":[{"given":"Lindsey 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