Grades of undernutrition and socioeconomic status influence cognitive development in school children of Kolkata

Early onset and increasing disparities in neurodevelopmental delays from birth to age 6 in children from low socioeconomic backgrounds

OBJECTIVE

To analyze the complex relationship between socioeconomic status (SES) and neurodevelopmental achievements by investigating the temporal dynamics of these associations from birth to age 6.

METHODS

This retrospective cohort study was conducted over 6 years using population-based data from the National Health Insurance Service and integrated data from the National Health Screening Program for Infants and Children. Participants were children born between 2009 and 2011 in Korea without neurodevelopmental delays with potential developmental implications. We analyzed results from the Korean Developmental Screening Test, administered at age 6, which covered overall assessment and six domains of gross and fine motor function, cognition, language, sociality, and self-care. The secondary outcome was to determine when neurodevelopmental outcomes began after birth and how these differences changed over time.

RESULTS

Of 276,167 individuals (49.2% males), 66,325, 138,980, and 60,862 had low, intermediate, and high SES, respectively. Neurodevelopmental delays observed across all developmental domains were more prevalent in the low-SES group than in the high-SES group. Disparities in neurodevelopment according to these statuses were apparent as early as age 2 and tended to increase over time (interaction, P < 0.001). The cognition and language domains exhibited the most substantial disparities between SES levels. These disparities persisted in subgroup analyses of sex, birthweight, head circumference, birth data, and breastfeeding variables.

CONCLUSIONS

Low SES was significantly associated with an increased risk of adverse neurodevelopmental outcomes in preschool children, particularly those affecting cognitive and language domains. These differences manifested in early childhood and widened over time.

Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O'Malley's framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity.

Why do humans undergo an adiposity rebound? Exploring links with the energetic costs of brain development in childhood using MRI-based 4D measures of total cerebral blood flow

Background

Individuals typically show a childhood nadir in adiposity termed the adiposity rebound (AR). The AR serves as an early predictor of obesity risk, with early rebounders often at increased risk; however, it is unclear why this phenomenon occurs, which could impede understandings of weight gain trajectories. The brain’s energy requirements account for a lifetime peak of 66% of the body’s resting metabolic expenditure during childhood, around the age of the AR, and relates inversely to weight gain, pointing to a potential energy trade-off between brain development and adiposity. However, no study has compared developmental trajectories of brain metabolism and adiposity in the same individuals, which would allow a preliminary test of a brain-AR link.

Methods

We used cubic splines and generalized additive models to compare age trajectories of previously collected MRI-based 4D flow measures of total cerebral blood flow (TCBF), a proxy for cerebral energy use, to the body mass index (BMI) in a cross-sectional sample of 82 healthy individuals (0–60 years). We restricted our AR analysis to pre-pubertal individuals (0–12 years, n = 42), predicting that peak TCBF would occur slightly after the BMI nadir, consistent with evidence that lowest BMI typically precedes the nadir in adiposity.

Results

TCBF and the BMI showed inverse trajectories throughout childhood, while the estimated age at peak TCBF (5.6 years) was close but slightly later than the estimated age of the BMI nadir (4.9 years).

Conclusions

The timing of peak TCBF in this sample points to a likely concordance between peak brain energetics and the nadir in adiposity. Inverse age trajectories between TCBF and BMI support the hypothesis that brain metabolism is a potentially important influence on early life adiposity. These findings also suggest that experiences influencing the pattern of childhood brain energy use could be important predictors of body composition trajectories.

Systematic review and meta-analysis found that malnutrition was associated with poor cognitive development

AIM

Malnutrition is a major public health issue that has been associated with high susceptibility for impaired brain development and mental functioning. However, to date studies on this topic have not been collated and appraised. This systematic review and meta-analysis investigated the association between malnutrition and cognitive development.

METHODS

We searched the MEDLINE, Scopus, CINAHL, Embase PsycINFO and Cochrane Library databases in English up to 8 December 2020. All studies reporting an association between nutritional status and cognitive development were included. p values of less than 0.05 were considered statistically significant and the results are reported as standardised mean differences (SMD), 95% confidence intervals (95%) and I² statistics.

RESULTS

We included 12 studies comprising 7,607 participants aged 1 to 12 years. Children with malnutrition had worse scores than controls for the Wechsler Intelligence Scale (SMD -0.40; 95% CI -0.60 to -0.20; p < 0.0001; I² 77.1%), the Raven's Coloured Progressive Matrices (SMD -3.75; 95% CI -5.68 to -1.83; p < 0.0001; I² 99.2%), visual processing (SMD -0.85; 95% CI -1.23 to -0.46; p 0.009; I² 11.0%) and short memory (SMD 0.85; 95% CI -1.21 to -0.49; p < 0.0001; I² 0%) tests.

CONCLUSION

Normal cognitive development requires access to good and safe nutrition.

Infant Cognitive Development and Stimulating Parenting Practices in Rural China

This study examines the prevalence of cognitive delay among infants and toddlers in rural China and its relationship with one of the potential sources of the observed delay: low levels of stimulating parenting practices (SPPs). Data were compiled from five distinct studies, resulting in a pooled sample of 4436 caregivers of 6-29-month-old infants. The sampling sites span five provinces in rural China. According to the data, on average, rates of delay are high-51 percent. The low rates of SPPs among our sample demonstrate that this may be one source of the high prevalence of delays. The results of the multivariate regression analysis reveal that reading books and singing songs are each significantly associated with an increase in infant cognitive score by 1.62 points (p = 0.003) and 2.00 points (p < 0.001), respectively. Telling stories to infants, however, is not significantly associated with infant cognitive scores. Our findings indicate that caregivers with different characteristics engage in various levels of stimulating practices and have infants with different rates of delay. Specifically, infants of better-educated mothers who have greater household assets are in families in which the caregivers provide more SPPs and have infants who score higher on the study's cognitive abilities scales.

Assessment of nutrition and learning skills in children aged 5-11 years old from two elementary schools in Chocó, Colombia

Background

Malnutrition has been identified as a factor in growth and learning. The current study aimed to determine the nutritional status and basic learning skills of children from Chocó, Colombia.

Methods

We conducted a cross-sectional study of 631 children aged 5-11 years from two schools, collecting anthropometric measurements, nutritional quality surveys and sociodemographic data. Neuropsychological batteries were applied.

Results

A total of 523 children were evaluated, with an average age of 8.49 ± 2.1 years. The results revealed that 2.9% of children were underweight, 0.4% were severely underweight, and 4.8% were diagnosed as having stunted growth. In addition, 71.8% of children were unable to draw a human figure. Beery-Buktenica Visual-Motor Integration test (VMI) performance was below the scores expected for these age groups in 73.9% of children. Battery of Differential and General Abilities (BADYG) performance revealed limited verbal skills. In a subsample of 117 children, anemia was detected in 12.8% of cases, and iron deficiency was present in 44.4% of cases. Global malnutrition was associated with impairments in BADYG performance (OR: 1.98; 95% CI: 1.07-3.86).

Conclusions

The current results revealed that learning performance was below the expected level for children in these age groups across all of the applied tests. Although malnutrition could partially explain the poor performance of children in tests of learning abilities, additional factors are likely to be involved.

Linguistic Diversity, Multilingualism, and Cognitive Skills: A Study of Disadvantaged Children in India

Multilingualism and linguistic diversity are the norm in India. Although studies have shown a relation between bilingualism and cognitive gains, linguistic diversity has so far been ignored as a potential factor affecting cognitive skills. This study aims to fill this gap by examining how cognitive skills—as measured by the n-back and Raven’s Colored Progressive Matrices tasks—are affected by multilingualism and/or sociolinguistic diversity in a large cohort of socioeconomically disadvantaged primary school children in two urban sites of India: Delhi and Hyderabad. We present a questionnaire estimating sociolinguistic diversity and show that this measure assesses a distinct construct, as compared to a child’s multilingualism. Children were classified as growing up monolingually or bilingually, depending on whether they grew up with one or more languages in the home. Regarding cognitive performance, bilinguals were found to outperform monolinguals on the n-back task, as well as on the Raven’s task. In addition, a socially and linguistically diverse environment seems to enhance cognitive performance for children who are not multilingual themselves. Finally, several contextual factors such as city were found to influence cognitive performance. Overall, this shows that cognitive tasks are subject to contextual effects and that bilingualism and linguistic diversity can enhance cognitive performance of children in disadvantaged contexts.

How healthy are children at the beginning of primary school in Iran?

Background:

Childhood is the most important life stages where personality is built and formed. Since children are as a treasured capital for each society, assessment of their health status is so vital. This study assessed the health indices of children starting the primary school and considered parental factors influencing kid's health.

Methods:

An analytical descriptive cross-sectional study applied to measure the health status of children at the beginning primary school. The data extracted from 7768 primary school children with an average value of age 7 years and their parents, who were referred to Children Health Testing centers in the school year of 2016, in all provinces of Iran.

Results:

From 7768 kids, 52.3% were boys and 47.7% were girls. The mean of weight and height of children was 20.65 kg, and 115.84 cm, respectively. The mean body mass index (BMI, kg/m2) for age ratio of children in the country was 16.26. In addition, 4.9% of boys and 3.7% of girls were short stature, 0.5% of boys and 1.8% of girls were tall and 94.5% of kids had normal growth. About 5.3% of boys and 6.8% of girls were underweight, 9.2% of boys and 7.7% of girls were overweight, and 4.7% of boys and 3.4% of girls were obese.

Conclusions:

The overweight and severe short stature problems in children were more dominant than underweight and severe tall. Although underweight is more common in girls than boys, it is reversed in the case of overweight and obesity. In addition, the ratio of health problems among children in different provinces was dissimilar, thus considering the health status of children in each province to find a solution was crucial.

Influence of Socio-Economic Status on Psychopathology in Ecuadorian Children

The socioeconomic status (SES) of parents has been reported to have a crucial impact on emotional competence in childhood. However, studies have largely been carried out in developed countries and in children in a specific age range, and it is not clear whether the effect of the SES of parents varies by age. The objective of this study was to investigate the psychopathological profile (including externalizing and internalizing problems) of children aged 7, 9, and 11 years old with low SES in a developing country (Ecuador). The study included 274 children (139 boys and 135 girls), who were divided between medium-SES (n = 133) and low-SES (n = 141) groups. Data were gathered on socioeconomic and anthropometric variables of the children, and the parents completed the Child Behavior Check-List (CBCL). In comparison to the medium-SES group, children in the low-SES group obtained higher scores for internalizing and externalizing symptoms and for total problems, and they obtained lower scores for social competence skills. The housing risk index and school competence were the two main predictors of internalizing and externalizing problems in this population.

Interaction between Socioeconomic Status and Cognitive Development in Children Aged 7, 9, and 11 Years: A Cross-Sectional Study

The socioeconomic status (SES) of parents has a crucial influence on the cognitive development of children, but it is not clear whether this effect varies as a function of the children's age. The objective of this study was to investigate the development of children aged 7, 9, and 11 years of parents with extremely low SES in a developing country (Ecuador). Participating children were divided between a medium-SES group and a low-SES group. Statistically significant differences were observed as a function of SES group and age in verbal memory, language, and executive function, observing wider between-group differences among the 11-year-olds.

Child stunting is associated with weaker human capital among native Amazonians

OBJECTIVES

We assessed associations between child stunting, recovery, and faltering with schooling and human capital skills in a native Amazonian society of horticulturalists-foragers (Tsimane').

METHODS

We used cross-sectional data (2008) from 1262 children aged 6 to 16 years in 53 villages to assess contemporaneous associations between three height categories: stunted (height-for-age Z score, HAZ<-2), moderately stunted (-2 ≤ HAZ≤-1), and nonstunted (HAZ>-1), and three categories of human capital: completed grades of schooling, test-based academic skills (math, reading, writing), and local plant knowledge. We used annual longitudinal data (2002-2010) from all children (n = 853) in 13 villages to estimate the association between changes in height categories between the first and last years of measure and schooling and academic skills.

RESULTS

Stunting was associated with 0.4 fewer completed grades of schooling (∼24% less) and with 13-15% lower probability of showing any writing or math skills. Moderate stunting was associated with ∼20% lower scores in local plant knowledge and 9% lower probability of showing writing skills, but was not associated with schooling or math and writing skills. Compared with nonstunted children, children who became stunted had 18-21% and 15-21% lower probabilities of showing math and writing skills, and stunted children had 0.4 fewer completed grades of schooling. Stunted children who recovered showed human capital outcomes that were indistinguishable from nonstunted children.

CONCLUSIONS

The results confirm adverse associations between child stunting and human capital skills. Predictors of growth recovery and faltering can affect human capital outcomes, even in a remote, economically self-sufficient society.

Cognitive functioning in children from Nigeria with sickle cell anemia

BACKGROUND

Cognitive impairment is a major neurological complication of sickle cell anemia (SCA) in the United States, but there are limited studies of cognitive impairment in Nigeria, the country with the highest SCA burden. We hypothesized that children from Nigeria with SCA have worse cognitive functioning than comparison children and explored the association between lower cognitive functioning and key laboratory demographic and socioeconomic variables among children with SCA.

PROCEDURE

We conducted a cross-sectional survey, supplemented by anthropomorphic and laboratory data, among a convenience sample of children from Nigeria with and without SCA. We administered the Wechsler Intelligence Scale for Children, Version IV. Our primary outcome measures included (1) estimated IQ (Est. IQ), (2) working memory (WM), and (3) processing speed (PS).

RESULTS

The sample included 56 children with SCA (mean age 9.20 [SD 2.75], 46.43% girls) and 44 comparison children (mean age 9.41 [SD 2.49], 40.91% girls). Children with SCA performed worse on Est. IQ (84.58 vs. 96.10, P = 0.006) and PS (86.69 vs 96.91, P = 0.009) than comparison children. There was no significant difference in WM between both groups. Factors associated with lower Est. IQ and PS among children with SCA included age, maternal education, weight-for-age Z scores, and height-for age Z scores.

CONCLUSION

In this small sample of children from Nigeria, we found worse cognitive functioning in children with SCA than in comparison children, and that sociodemographic and anthropomorphic factors were correlated with cognitive functioning.

Factors associated With the development of motor proficiency in school children of Kolkata: A cross-sectional study to assess the role of chronic nutritional and socio-economic status

BACKGROUND

Development of coordinated movements is determined among others by individual growth and environmental factors, but the dynamic relationship between motor proficiency and potential contributing factors such as chronic nutritional status and socio-economic status (SES) is not known in school children of Kolkata.

AIM

To characterize the motor proficiency in school children of Kolkata and to investigate association of chronic nutritional and SES on motor proficiency.

METHODS

Motor proficiency in 843 school children of Kolkata aged 5-12 years was assessed by the Bruininks-Oseretsky Test of Motor-Proficiency-Second Edition-Short Form (BOT-2 SF). Chronic nutritional status was determined from height-for-age Z-scores (HAZ) using WHO reference and SES was measured using the updated Kuppuswamy's scale.

RESULTS

Children's motor proficiency was poor compared with the reference values. Children classified as severely undernourished and children of lower SES were found to be "below average" and "well-below average" in motor proficiency categories compared with normal nourished groups and children of upper SES. Children's BOT-2 SF standardized scores decreased incrementally with the severity of chronic undernutrition and lower grades of SES.

CONCLUSION

Chronic undernutrition and lower SES are associated with poorer motor proficiency in children. Understanding the complex interrelationships that shape childen's motor skills can help inform the development of health promotion programs and tailored interventions to help children reach their full potential. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 58:734-744, 2016.

Determinants of Body Mass Index and Intelligence Quotient of Elementary School Children in Mountain Area of Nepal: An Explorative Study

The physical growth and cognitive development of elementary school children are very crucial and this group is large in number but has little research dedicated to it. The physical growth and cognitive development of children occur simultaneously and can be measured by body mass index (BMI) and intelligence quotient (IQ). Previous studies could not sufficiently focus on both aspects. The aim of this study was to identify determinants of BMI and IQ of students in two elementary schools in the Humla district of Nepal. Two randomly selected elementary schools and all children available there (n = 173) participated in the study. BMI was calculated with the objective of proper measurement of height and weight of the children. Likewise, the updated universal nonverbal intelligence test (UNIT) was applied for IQ. Descriptive statistics, t-test, analysis of variance and multiple linear regressions were used when appropriate. Study findings showed that one-tenth of the children had grade 2 thinness (-2SD) and about one-third had poor IQ (<85). The age of the children (p < 0.05) and household economic status (p < 0.001) were significant for the BMI. Likewise, frequencies of illness in the previous year, mother's education (p < 0.05) and father's education (p < 0.001) were significant factors for the IQ score. More commonly, BMI and IQ scores were significantly lower in the ultra-poor group. Economic status and parent education are still major determinants of IQ and BMI in these students. Special programs and strategies should be launched to improve the poor ranking of IQ and BMI.