Nutritional status, brain development and scholastic achievement of Chilean high-school graduates from high and low intellectual quotient and socio-economic status

Anthropometric proxies for child neurodevelopment in low-resource settings: length- or height-for-age, head circumference or both?

Stunting (<-2 SD of length- or height-for-age on WHO growth curves) is the most used predictor of child neurodevelopmental (ND) risk. Occipitofrontal head circumference (OFC) may be an equally feasible, but more direct and robust predictor. We explored association of the two measurements with ND outcome, separately and combined, and examined if cutoffs are more efficacious than continuous measures in predicting ND risk. Infants and young children in rural Guatemala (n = 642; age range = 0.1-35.9 months) were enrolled in a prospective natural history study, and their ND was tested using the Mullen Scales of Early Learning (MSEL) longitudinally. Length- or height-for-age and OFC-for-age were calculated. We performed age-adjusted multivariable regression analyses to explore the association between 1) length or height and ND, 2) OFC and ND, and 3) both length or height and OFC combined, with ND; concurrently, predictively, and longitudinally, as continuous variables and using WHO z-score cutoffs. Continuous length- or height-for-age and OFC z-scores were more strongly associated with MSEL than the traditional -2 SD WHO cutoff. The combination of height-for-age z-score and OFC z-score was consistently, strongly associated with the MSEL Early Learning Composite concurrently (p-values 0.0004-0.11), predictively (p-value 0.001-0.07), with the exception of the 18-24 months age group which had very few records, and in the longitudinal model (p-value <0.0001-0.004). The combination of continuous length- or height-for-age and OFC shows additional utility in estimating ND risk in infants and young children. Measurement of OFC may improve precision of prediction of ND risk in infants and young children.

Brain structural parameters correlate with University Selection Test outcomes in Chilean high school graduates

How well students learn and perform in academic contexts is a focus of interest for the students, their families, and the entire educational system. Although evidence has shown that several neurobiological factors are involved in scholastic achievement (SA), specific brain measures associated with academic outcomes and whether such associations are independent of other factors remain unclear. This study attempts to identify the relationship between brain structural parameters, and the Chilean national University Selection Test (PSU) results in high school graduates within a multidimensional approach that considers socio-economic, intellectual, nutritional, and demographic variables. To this end, the brain morphology of a sample of 102 students who took the PSU test was estimated using Magnetic Resonance Imaging. Anthropometric parameters, intellectual ability (IA), and socioeconomic status (SES) were also measured. The results revealed that, independently of sex, IA, gray matter volume, right inferior frontal gyrus thickness, and SES were significantly associated with SA. These findings highlight the role of nutrition, health, and socioeconomic variables in academic success.

Tap Water Consumption Is Associated with Schoolchildren’s Cognitive Deficits in Afghanistan

Environmental influence on intelligence quotient (IQ) is poorly understood in developing countries. We conducted the first cross-sectional investigation to assess the role of socio-economic and environmental factors on schoolchildren’s IQ in Jalalabad, Afghanistan. A representative sample of 245 schoolchildren aged 7–15 was randomly selected in five schools. Children’s records included: non-verbal IQ TONI-1 scale, body mass index, socio-economic status, and further environmental indicators (water supply, proximity to a heavy-traffic road, use of surma traditional cosmetics). The mean age of the children was 11.7 years old (±2.0 years), and 70.2% and 29.8% were male and female, respectively. The children’s mean IQ was 83.8 (±12.6). In total, 37 (14.9%) of the children were overweight, 78 (31.5%) were living below the USD 1.25 poverty line, 133 (53.6%) used tap water supply, 76 (30.6%) used surma, and 166 (66.9%) were exposed to heavy road traffic. The children’s IQ was significantly and independently lowered by tap water use (−3.9; 95% CI [−7.1; −0.6]) and by aging (−1.4; 95% CI [−2.2; −0.6]), as revealed in multivariate analysis, independently of gender, socio-economic status, exposure to heavy road traffic, overweight status, and surma use. Lower IQ among older children is possibly attributed to chronic stress experienced by adolescents due to living conditions in Afghanistan. While using tap water prevents fecal peril, it may expose children to toxic elements such as lead which is known to lower their intellectual development.

A prospective cohort study of head circumference and its association with neurodevelopmental outcomes in infants and young children in rural Guatemala

Microcephaly, an anthropometric marker of reduced brain volume and predictor of developmental disability, is rare in high-income countries. Recent reports show the prevalence of microcephaly to be much higher in lower resource settings. We calculated the prevalence of microcephaly in infants and young children (n = 642; age range = 0.1-35.9 months), examined trends in occipitofrontal circumference (OFC) growth in the year after birth and evaluated the relationship between OFC and performance on the Mullen Scales of Early Learning (MSEL) in rural Guatemala. Multivariable regression analyses adjusted for age were performed: (1) a model comparing concurrent MSEL performance and OFC at all visits per child, (2) concurrent OFC and MSEL performance by age group, and (3) OFC at enrollment and MSEL at final visit by age group. Prevalence of microcephaly ranged from 10.1% to 25.0%. OFC z-score decreased for most infants throughout the first year after birth. A significant positive association between continuous OFC measurement and MSEL score suggested that children with smaller OFC may do worse on ND tests conducted both concurrently and ∼1 year later. Results were variable when analyzed by OFC cutoff scores and stratified by 6-month age groups. OFC should be considered for inclusion in developmental screening assessments at the individual and population level, especially when performance-based testing is not feasible.

Estimulación temprana en el hogar de infantes que asisten a un centro infantil

Introducción. En el ambiente del hogar se propician estilos de crianza, aprendizajes, actividades, experiencias y estímulos que modulan la estimulación del niño(a). Objetivo. Identificar el grado de estimulación temprana y su relación con variables de tipología familiar y participación en el cuidado de niños(as) entre 1 y 4 años de un centro de desarrollo infantil en Pereira, Colombia, en 2019. Métodos. Estudio transversal. Se realizó un muestreo tipo censo que incluyó a todos los niños y cuidadores, que cumplían con los criterios de selección (niños sin antecedente de patologías neurológicas, consentimiento informado de cuidadores). Se midieron variables sociodemográficas y de tipología familiar. Se empleó el Inventario de estimulación temprana en el hogar HOME45 (Home Observation for Measurement of the Environment). Se realizó análisis univariado y bivariado. Para la asociación entre predictores y el puntaje global de estimulación temprana (desenlace: alta/media/baja) se efectuó una regresión logística ordinal. Resultados. Participaron 76 diadas madre-hijo. La mediana de edad de los niños fue 36 meses (RIQ=11, 12-48). El cuidado diario fue brindado en un 67% por la madre. Se evidenció una alta estimulación en el 50% de las diadas. Los predictores que redujeron la probabilidad de estimulación alta fueron (p<0,05): hábito de lectura (No, RP=0,29 (0,09-0,87)), participación en fiestas infantiles (No, RP=0,24 (0,07–0,79)), edad del cuidador (mayor a 36 años, RP=0,95 (0,92-1,00)), estrategia de corrección (castigo verbal o físico, RP=0,16 (0,03-0,98)). Conclusión. Corregir al niño mediante diálogo, incentivar la lectura y participar de fiestas infantiles, además de tener un cuidador menor de 35 años, fueron variables que incrementaron la probabilidad de presentar una alta estimulación.

Current Socioeconomic Status Correlates With Brain Volumes in Healthy Children and Adolescents but Not in Children With Prenatal Alcohol Exposure

Individuals with prenatal alcohol exposure (PAE) exhibit neurological deficits associated with brain injury including smaller brain volumes. Additional risk factors such as lower socioeconomic status (SES) may also have an impact on brain development for this population. This study examined how brain volumes are related to SES in both neurotypically developing children and adolescents, and those with PAE. 3D T1-weighted MPRAGE images were acquired from 69 participants with PAE (13.0 ± 3.2 years, range 7.1–18.8 years, 49% female) and 70 neurotypical controls (12.4 ± 2.9 years, range 7.0–18.5 years, 60% female) from four scanning sites in Canada. SES scores calculated using Hollingshead’s Four-Factor Index of Social Status from current caregiver placement were not significantly different between groups, though more children with PAE had lower SES scores compared to controls. Psychometric data comprised 14 cognitive measures, including executive functioning, attention and working memory, memory, math/numerical ability, and word reading. All cognitive scores were significantly worse in children with PAE compared to controls, though SES was not correlated with cognitive scores in either group after correction for multiple comparisons. All 13 brain volumes were smaller in children with PAE compared to children in the control group. Higher SES was associated with larger hippocampus and amygdala volumes in controls, but there were no such associations in children with PAE. Direct evaluation of the interaction between SES and diagnostic group did not show a significant differential impact of SES on these structures. These findings support previous links between SES and brain volumes in neurotypically developing children, but the lack of such a relationship with SES in children with PAE may be due to the markedly smaller brain volumes resulting from the initial brain injury and postpartum brain development, regardless of later SES.

Diet quality over time is associated with better development in rural Nepali children

Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p = .04) or dairy products (aOR 0.95, p = .05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality.

Hubungan Pemberian Asi Eksklusif Dan Status Gizi Ibu Dengan Pertumbuhan Lingkar Kepala Bayi Usia 6 Bulan

Background: Measurement of head circumference is highly crucial during the early years of life which considered as an anthropometric parameter substantially correlated with brain size. The emergence of head circumference aberration functions to warn of abnormal brain development. Breast milk is the ideal nutritional provider that babies need for optimal healthy growth. Nursing mothers with good nutrition will affect their nutritional status. The nutritional status will determine the quantity and quality of dairy products that indirectly play a role in determining children’s nutritional status.Objective: Analyzing the relationship between exclusive breastfeeding and maternal nutritional status with the growth of the head circumference of 6 months old infants.Method: Using a cross-sectional design in the Kaliwates, Jember. Subjects were 6 months old infants in which 128 babies were selected by purposive sampling. Data on maternal nutritional status were based on Body Mass Index (BMI). Data on exclusive breastfeeding were based on interviews and KMS data. The baby’s head circumference data were based on direct measurements and those were interpreted using WHO growth charts. Then, the data were analyzed using Chi-Square test.Results: The results showed that there was a significant relationship between exclusive breastfeeding (p<0.001) and maternal nutritional status (p=0.028) with the growth of the baby’s head circumference.Conclusion: Exclusive breastfeeding and maternal nutritional status are associated with the growth of the baby’s head circumference. ABSTRAKLatar Belakang : Pengukuran lingkar kepala sangat penting selama tahun awal kehidupan, hal ini merupakan parameter antropometri yang sangat berkorelasi dengan ukuran otak. Terjadi penyimpangan pada lingkar kepala, maka memperingatkan perkembangan otak yang tidak normal. Air susu ibu merupakan penyedia nutrisi ideal yang dibutuhkan bayi untuk pertumbuhan yang sehat secara optimal. Ibu menyusui dengan pemenuhan gizi yang baik akan mempengaruhi status gizinya. Status gizi tersebut akan menentukan kuantitas dan kualitas produk susu yang secara tidak langsung berperan dalam menentukan status gizi anak.Tujuan : Menganalisis hubungan pemberian ASI eksklusif dan status gizi ibu dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Metode : Menggunakan desain cross-sectional di wilayah Kecamatan Kaliwates, Kabupaten Jember. Subjek penelitian adalah bayi usia 6 bulan, 128 bayi dipilih dengan purposive sampling. Data status gizi ibu berdasarkan IMT. Data pemberian ASI eksklusif berdasarkan wawancara dan data KMS. Data lingkar kepala bayi berdasarkan pengukuran langsung dan diinterprestasikan menggunakan grafik pertumbuhan WHO. Analisis data menggunakan uji Chi-Square.Hasil : Hasil penelitian menunjukkan bahwa ada hubungan yang bermakna antara pemberian ASI eksklusif (ρ = <0,001 dan OR 9,58) dan status gizi ibu (ρ = 0,028 dan OR 0,28) dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Kesimpulan : Pemberian ASI eksklusif pada bayi akan memberikan pertumbuhan lingkar kepala yang normal dibandingkan bayi yang tidak diberikan ASI eksklusif dan pada ibu yang memiliki status gizi baik juga akan memberikan pertumbuhan lingkar kepala bayi yang normal dibandingkan dengan ibu berstatus gizi kurang dan gemuk. Kata kunci : status gizi, ASI eksklusif, lingkar kepala

An Age-Adjusted EEG Source Classifier Accurately Detects School-Aged Barbadian Children That Had Protein Energy Malnutrition in the First Year of Life

We have identified an electroencephalographic (EEG) based statistical classifier that correctly distinguishes children with histories of Protein Energy Malnutrition (PEM) in the first year of life from healthy controls with 0.82% accuracy (area under the ROC curve). Our previous study achieved similar accuracy but was based on scalp quantitative EEG features that precluded anatomical interpretation. We have now employed BC-VARETA, a novel high-resolution EEG source imaging method with minimal leakage and maximal sparseness, which allowed us to identify a classifier in the source space. The EEGs were recorded in 1978 in a sample of 108 children who were 5-11 years old and were participants in the 45+ year longitudinal Barbados Nutrition Study. The PEM cohort experienced moderate-severe PEM limited to the first year of life and were age, handedness and gender-matched with healthy classmates who served as controls. In the current study, we utilized a machine learning approach based on the elastic net to create a stable sparse classifier. Interestingly, the classifier was driven predominantly by nutrition group differences in alpha activity in the lingual gyrus. This structure is part of the pathway associated with generating alpha rhythms that increase with normal maturation. Our findings indicate that the PEM group showed a significant decrease in alpha activity, suggestive of a delay in brain development. Childhood malnutrition is still a serious worldwide public health problem and its consequences are particularly severe when present during early life. Deficits during this critical period are permanent and predict impaired cognitive and behavioral functioning later in life. Our EEG source classifier may provide a functionally interpretable diagnostic technology to study the effects of early childhood malnutrition on the brain, and may have far-reaching applicability in low resource settings.

A multifactorial approach of nutritional, intellectual, brain development, cardiovascular risk, socio-economic, demographic and educational variables affecting the scholastic achievement in Chilean students: An eight- year follow-up study

The aim of this study was to quantitate the relative impact of nutritional, intellectual, brain development, cardiovascular risk, socio-economic, demographic and educational variables on the results of the 2009 Quality Education Measurement System (SIMCE) tests of language and mathematics for scholastic achievement (SA) applying a multifactorial approach, in school-age children of the 2010 5th elementary school grade (5ESG) and of the 1st grade of high school (1HSG). The purposes were: i) to test the hypothesis that intellectual ability, the level of SA of the educational establishments in the 2009 SIMCE tests, sex, parental schooling levels, and head circumference-for-age Z-score are the most relevant parameters associated with 2009 SIMCE outcomes; ii) to determine the predictive ability of the 2009 SIMCE results in determining the 2013 SIMCE outcomes for the 2010 5ESG cohort (when they graduated from elementary school, 8th grade) and for determining the 2013 University Selection Test (PSU) outcomes for the 2010 1HSG group (for university admission, when they graduated from high school, 4th grade); iii) to determine the association between the 2009 SIMCE results with the 2017 PSU outcomes for the 2010 5ESG group (for university admission, when they graduated from high school, 4th grade). A representative, proportional and stratified sample of 33 schools of the Metropolitan Region of Chile was randomly chosen. In these schools, 1,353 school-age children of both sexes, of the 2010 5ESG (n = 682; mean age = 10.8 years, SD = 0.6) and of the 2010 1HSG (n = 671; mean age = 14.8 years, SD = 0.6) participated. In both grades and tests, the findings confirm the hypotheses formulated. 2009 SIMCE outcomes were positively and significantly associated with 2013 SIMCE and with 2017 PSU and, with 2013 PSU outcomes in school-age children from 2010 5ESG and 1HSG, respectively. These findings may be useful for educational and health planning in Chile and countries in a comparable stage of development.

Early undernutrition as a cause of changes in phonological processing skills

ABSTRACT Purpose: to determine whether undernutrition in the first years of life affects the phonological awareness skills, the phonological working memory and the school performance of children. Methods: the participants were children with a history of moderate/severe undernutrition during their first years of life (G1) who achieved nutritional recovery (n = 15). The performance of G1 in different cognitive tasks (phonological awareness at the syllable and phoneme level, phonological working memory - repetition of digits and pseudowords, and reading, writing and arithmetic activities) was compared to that of children with school difficulties (G2) (n = 15) and without school difficulties (G3) (n = 15), all eutrophic ones. Results: the performance of G1 was worse than that of the other two groups in all tasks evaluated (mean score of G1, G2 and G3 and p-values: phonological awareness: 31, 41, 57 - 0.01; repetition of direct order digits: 18, 23, 28 - 0.001; writing: 4, 10, 22 - 0.001; reading: 26, 45, 65-0.001; arithmetic: 4, 7, 11- 0.001). Conclusion: the results demonstrate that undernutrition affected the cognitive development, causing changes in important cognitive skills for the development of written language.

Docosahexaenoic acid levels in erythrocytes and their association with the University Selection Test Outcomes in Chile

The aim of this study was to quantitate the relative impact of DHA and AA levels in erythrocytes, anthropometric parameters and socio-economic status of school-age children, of both genders, graduated from high school in Chile, on the scholastic achievement in the University Selection Test (Prueba de Selección Universitaria, PSU) both language scholastic achievement (LSA) and mathematics scholastic achievement (MSA). A representative sample of 671 school-age young graduated from high school in 2013, 550 and 548 of them took the PSU for LSA and MSA, respectively. Only school-age young with high (n = 91) and low (n = 69) SA in both tests were considered. A total of 122 school-age children agreed to participate in the study and were divided as follows: Group 1: high PSU outcome (n = 70; males n = 48) and Group 2: low PSU outcome (n = 52; males n = 23). Data were analyzed by means of SAS software. Independently of gender, DHA, socio-economic status and head circumference-for-age Z-score were the most relevant parameters explaining both LSA (R²= 0.650; p < 0.0001) and MSA outcomes (R²= 0.700; p < 0.0001). These results can be useful for nutrition, health and education planning, in order to protect children starting from an early age and thus increase their school outcomes.

Impact of anthropometric nutritional parameters on the university selection test in Chile: A multifactorial approach

OBJECTIVES

Scholastic achievement (SA) is a multifactorial problem that depends on factors related to the child, the child's family, and the educational system. The aim of this study was to quantify the relative impact of significant variables at the beginning of high school during 2010 (first grade of high school [1 HSG]) on 2013 university selection test (Prueba de Seleccion Universitaria [PSU]) outcomes, both in language scholastic achievement (LSA) and mathematics scholastic achievement (MSA), when students graduated from high school (4 HSG). This was done at the time of university admission with a multicausal approach. The purpose was to confirm the hypothesis that the level of educational establishment SA, intellectual ability, sex, parental schooling levels, and head circumference for age Z-score at the onset of high school are the most relevant parameters associated with 2013 PSU outcomes, both in LSA and MSA.

METHODS

A representative, proportional, and stratified sample of 671 children of both sexes who enrolled in 1 HSG in 2010 (mean age: 14.8 ± 0.6 y) participated in the study. Nutritional, intellectual, brain developmental, cardiovascular risk, socio-to-economic, demographic, and educational variables were quantitated. SA was assessed at 4 HSG with the 2013 PSU tests. Data were analyzed with SAS software.

RESULTS

Educational establishment SA, intellectual ability, maternal schooling, and age Z-score were the most relevant parameters to explain LSA (R² = 0.493; P < 0.0001) and MSA variance in addition to sex (male), but only in MSA (R² = 0.600; P < 0.0001).

CONCLUSIONS

These findings confirm the hypothesis and can be useful to support nutritional, health, and educational planning.

Overnutrition and Scholastic Achievement: Is There a Relationship? An 8-Year Follow-Up Study

OBJECTIVE

The aim of this study was to assess the association between overnutrition and scholastic achievement (SA).

METHODS

A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Chile. SA was measured through the 2009 Education Quality Measurement System (SIMCE) tests of language (LSA), mathematics (MSA) and understanding of the natural environment (UNESA). Current nutritional status was assessed through the body mass index Z-score (Z-BMI). Nutritional quality of diet, schedule exercise, socioeconomic status, family, and educational variables were also recorded. Four and 8 years later, SA was assessed through the 2013 SIMCE and the University Selection Test (2017 PSU), respectively.

RESULTS

Socioeconomic status, the number of repeated school years, and maternal schooling were strong predictors of 2009 SIMCE and the independent variables with the greatest explanatory power for LSA (Model R2 = 0.178; p < 0.00001) variances, besides of gender for MSA (Model R2 = 0.205; p< 0.00001) and UNESA (Model R2 = 0.272; p < 0.00001). Overnourished children did not have significantly lower 2009 and 2013 SIMCE and 2017 PSU outcomes.

CONCLUSIONS

These results confirm that overnourished children did not achieve significantly lower SA.

Head circumference, leg length and its association with dementia among older adult population in Singapore

BACKGROUND

Head circumference and leg length serve as reliable proxy indicators of early-life environment. Research studies have shown that these anthropometric measurements are associated with cognitive impairment and dementia among older adults. The aim of the present study was to assess the associations between dementia with head circumference and leg length among the older adult population in Singapore. This study also aimed to examine the sociodemographic correlates of these anthropometric measurements.

METHODS

Data were collected from 2565 older adults aged 60 years and above, in a population study on the Well-being of the Singapore Elderly. Head circumference and leg length measurements were obtained, and sociodemographic information was recorded. Dementia diagnosis was made using the 10/66 dementia algorithm. Anthropometric measurements were first stratified into quarters, and then logistic regression analysis was used to examine factors associated with head circumference and leg length, as well as to examine the association between dementia with these measurements.

RESULTS

Sociodemographic correlates of head circumference and leg length include age, gender, ethnicity and education level. Smaller head circumference was independently associated with higher odds of 10/66 dementia (OR = 2.173-2.709). When the regression analysis was stratified by gender, the association was found only in the male sample. Leg length was not significantly associated with dementia after controlling for sociodemographic variables.

CONCLUSION

Smaller head circumference is independently associated with dementia among older adults in Singapore. Findings from this study suggest that risk factors for dementia begin their influence in early life. Copyright © 2017 John Wiley & Sons, Ltd.

Head growth of undernourished children in rural Nepal: association with demographics, health and diet

BACKGROUND

Brain development in early childhood is a key determinant of later cognition, social achievement and educational success. Head circumference (HC) measurements are a simple method to assess brain growth, yet reports of these measurements are uncommon in nutritional surveys of undernourished children.

OBJECTIVE

To evaluate HC measurements in a population of rural Nepali children and relate these measurements to demographics, health and diet.

METHODS

An observational study of head growth was nested within a longitudinal evaluation of a livestock-based agricultural intervention in rural Nepal. Between 538 and 689 children (aged 6 months to 8 years) were measured (height, weight, HC) at each of six survey visits. A total of 3652 HC measurements were obtained. Results were converted to Z-scores (WHO Anthro).

RESULTS

Mean head circumference Z-scores (HCZ) diminished progressively over the first 4 years of life; a decline of 30% occurred between 3 and 4 years of age (-1.73 to -2.45, P < 0.0001). Overall, 56% of HCZ were <-2. Gender-adjusted HCZ (but not other measurements) were significantly lower for girls than boys [mean (SD) -2.31 (1.0) vs -1.99 (0.094), P < 0.0001]; girls more often had microcephaly (61% vs 50%, P < 0.0001). For children <3 years of age, HCZ were better in those who had eaten two or more animal-source foods (ASFs) within the previous 24 h [-1.69 (.05) vs -2.08 (0.10), P = 0.001] than in those who had eaten none or only one; HCZ correlated with the number of ASFs consumed (P < 0.001). Regression analyses demonstrated that the main determinants of HCZ were age, weight-for-age Z-scores (WAZ) and gender; 43% of the variance in HCZ in younger children was explained by WAZ and ASF consumption.

CONCLUSION

HCs reflect brain size in young children; brain size is linked to cognitive function. Poor head growth represents another facet of the 'silent emergency' of child undernutrition. Routine HCZ assessments may contribute to better understanding of the links between poverty and cognitive development.

Prolonged maternal separation induces undernutrition and systemic inflammation with disrupted hippocampal development in mice

OBJECTIVE

Prolonged maternal separation (PMS) in the first 2 wk of life has been associated with poor growth with lasting effects in brain structure and function. This study aimed to investigate whether PMS-induced undernutrition could cause systemic inflammation and changes in nutrition-related hormonal levels, affecting hippocampal structure and neurotransmission in C57BL/6J suckling mice.

METHODS

This study assessed mouse growth parameters coupled with insulin-like growth factor-1 (IGF-1) serum levels. In addition, leptin, adiponectin, and corticosterone serum levels were measured following PMS. Hippocampal stereology and the amino acid levels were also assessed. Furthermore, we measured myelin basic protein and synapthophysin (SYN) expression in the overall brain tissue and hippocampal SYN immunolabeling. For behavioral tests, we analyzed the ontogeny of selected neonatal reflexes. PMS was induced by separating half the pups in each litter from their lactating dams for defined periods each day (4 h on day 1, 8 h on day 2, and 12 h thereafter). A total of 67 suckling pups were used in this study.

RESULTS

PMS induced significant slowdown in weight gain and growth impairment. Significant reductions in serum leptin and IGF-1 levels were found following PMS. Total CA3 area and volume were reduced, specifically affecting the pyramidal layer in PMS mice. CA1 pyramidal layer area was also reduced. Overall hippocampal SYN immunolabeling was lower, especially in CA3 field and dentate gyrus. Furthermore, PMS reduced hippocampal aspartate, glutamate, and gamma-aminobutyric acid levels, as compared with unseparated controls.

CONCLUSION

These findings suggest that PMS causes significant growth deficits and alterations in hippocampal morphology and neurotransmission.

The long-term cognitive consequences of early childhood malnutrition: the case of famine in Ghana

We examine the role of early childhood health in human capital accumulation. Using a unique data set from Ghana with comprehensive information on individual, family, community, school quality characteristics and a direct measure of intelligence together with test scores, we examine the long-term cognitive effects of the 1983 famine on survivors. We show that differences in intelligence test scores can be robustly explained by the differential impact of the famine in different parts of the country and the impacts are most severe for children under two years of age during the famine. We also account for model uncertainty by using Bayesian Model Averaging.

No genes for intelligence in the fluid genome

Revolution is brewing belatedly within the heartlands of the genetic determinist establishment still in denial about the fluid genome that makes identifying genes even for common disease well-nigh impossible. The fruitless hunt for intelligence genes serves to expose the poverty of an obsolete paradigm that is obstructing knowledge and preventing fruitful policies from being widely implemented. Genome-wide scans using state-of-the art technologies on extensive databases have failed to find a single gene for intelligence; instead, environment and maternal effects may account for most, if not all correlation among relatives, while identical twins diverge genetically and epigenetically throughout life. Abundant evidence points to the enormous potential for improving intellectual abilities (and health) through simple environmental and social interventions.

Nutritional disorders in tropical neurology

About three-fourths of the total world population live in the tropics but consume only 6% of worldwide food production and contribute 15% of the world's net revenue explaining the short life expectancy, high infantile mortality, and poor daily caloric intake; moreover, lack of clean drinking water and deficient sanitation promote water-borne infections, diarrhea, and risk of malabsorption that contribute to the prevalence of malnutrition in the tropics. One-third of the world's population consumes insufficient iodine increasing the risk for mental retardation and deafness due to maternal hypothyroidism. The main nutritional syndromes comprise protein-energy malnutrition (marasmus and kwashiorkor); nutritional neuropathies, myelopathies and neuromyelopathies, as well as specific deficiencies of vitamins and micronutrients including iodine, iron, zinc, and selenium.

Head circumference of infants born to mothers with different educational levels; the Generation R Study

OBJECTIVE

Head circumference (HC) reflect growth and development of the brain in early childhood. It is unknown whether socioeconomic differences in HC are present in early childhood. Therefore, we investigated the association between socioeconomic position (SEP) and HC in early childhood, and potential underlying factors.

METHODS

The study focused on Dutch children born between April 2002 and January 2006 who participated in The Generation R Study, a population-based prospective cohort study in Rotterdam, The Netherlands. Maternal educational level was used as indicator of SEP. HC measures were concentrated around 1, 3, 6 and 11 months. Associations and explanatory factors were investigated using linear regression analysis, adjusted for potential mediators.

RESULTS

The study included 3383 children. At 1, 3 and 6 months of age, children of mothers with a low education had a smaller HC than those with a high education (difference at 1 month: -0.42 SD; 95% CI: -0.54,-0.30; at 3 months: -0.27 SD; 95% CI -0.40,-0.15; and at 6 months: -0.13 SD; 95% CI -0.24,-0.02). Child's length and weight could only partially explain the smaller HC at 1 and 3 months of age. At 6 months, birth weight, gestational age and parental height explained the HC differences. At 11 months, no HC differences were found.

CONCLUSION

Educational inequalities in HC in the first 6 months of life can be mainly explained by pregnancy-related factors, such as birth weight and gestational age. These findings further support public health policies to prevent negative birth outcomes in lower socioeconomic groups.

Chilean School-Age Children Twin Registry: Planning, Sampling and Implications

We describe subject recruitment from the University of Chile School-Age Children Twin Registry (REMEUCHI). The research aim of REMEUCHI is to quantify the impact of genetic and environmental factors on scholastic achievement in a multicausal approach. The Ministry of Education of Chile, in collaboration with the Registry Office, provided the list of possible twin pairs graduated from high school in 2004 in Chile's metropolitan region. From a population of 70,065 school-age children who had graduated from high school, 434 possible twin pairs were analyzed. Of these, 327 were twins reared together (75.3% of the 434 possible twins pairs) and born between 1986 and 1987 in Chile (mean age 18 years), and approximately 8% were not twins despite matches on full name and birth data. The rest of the possible twin pairs were probably twins reared apart, since one member of the pair had moved to study in another region of Chile. Zygosity was determined through questionnaires, maternal reports of twin similarities, and by the hospital records of the twins at the time of birth. Three hundred and twenty-seven pairs were identified, where monozygotic (MZ) and dizygotic (DZ) twins represented 46.8% and 53.2% of pairs, respectively, with a DZ/MZ ratio of 1.14. Considering same-sex MZ pairs, the percentage of female pairs was greater (55.6%) than male pairs (44.4%). When DZ pairs were analyzed, 47.7% were of opposite sex, 20.1% were male pairs and 32.2% female pairs. In Chile, these findings represent a baseline study to contribute to the establishment of a national twin registry in the future.

High folate intake is related to better academic achievement in Swedish adolescents

BACKGROUND

Adolescents are vulnerable to increased plasma total homocysteine (tHcy) and to insufficient folate status. Folate status and Hcy metabolism are linked to cognitive functions, but academic achievement by adolescents has not been studied in this respect.

OBJECTIVE

To assess a possible link between academic achievement in adolescents and tHcy and its determinants, dietary folate intake, MTHFR 677 TT homozygosity, and socioeconomic status (SES).

SUBJECTS AND METHODS

A study of 386 Swedish adolescents aged 15 years in whom plasma tHcy and MTHFR 677C →T genotype were assayed. The sum of school grades in 10 core subjects obtained in the final semester of compulsory 9 years of schooling was used as outcome measure of academic achievement. Lifestyle and SES data were obtained from questionnaires.

RESULTS

Academic achievement was strongly correlated to tertiles of tHcy (negatively; P = .023) and to tertiles of folate intake (positively; P < .001). Other significant predictors were gender, smoking, and SES (proxied by school, mother's education, and father's income). When these were controlled for, tertiles of folate intake (P < .002) but not tertiles of tHcy (P = .523) or MTHFR genotype remained significantly related to academic achievement.

CONCLUSION

Folate intake had a positive association with academic achievement in the 15-year-olds, which was not attenuated by SES or MTHFR 677 TT homozygosity. These results provide new information that points to the importance of keeping a closer watch on folate status in childhood and adolescence. They may also have direct implications for school meal provisions, school teaching programs, and information to parents.

Dietary intake, zincemia and cupremia of Cameroonian schoolchildren of Ngali II

The present study is aimed at investigating the dietary intake, zincemia and cupremia of Cameroonian schoolchildren of Ngali II. A total of 211 and 200 schoolchildren aged between 7 and 18 years were recruited during the rainy season and dry season, respectively. Information on dietary intake was collected using 7-day measured food diaries. The zincemia and cupremia of the subjects were determined by atomic absorption spectrophotometry. The energy, nutrient intakes, zincemia and cupremia obtained were compared with reference values. The energy and most nutrient intakes of these schoolchildren were higher in the rainy season than in the dry season. Energy and nutrient intakes were generally insufficient, when compared with reference values in children except zinc, iron, magnesium and vitamin E intakes and in adolescents (except magnesium and vitamin E intakes). The zincemia and cupremia of the subjects were low when compared with standard values.

Impact of nutritional status at the onset of elementary school on academic aptitude test achievement at the end of high school in a multicausal approach

Like in many other countries, few investigations have been carried out in Chile to measure the long-term effects of nutritional status at an early age on scholastic achievement in a multicausal approach. The objectives of the present study were to describe the impact of nutritional, intellectual, family, educational and socio-economic variables at the onset of elementary school in 1987 that may affect achievement on the academic aptitude test (AAT) taken in 1998 at the end of high school, and to quantify the impact of these independent variables on the AAT. The present study comprises two cross-sectional stages: in 1987, a representative sample of 813 elementary school first-grader Chilean children from the Metropolitan Region was randomly chosen; in 1998, 12 years later, 632 school-age children were located and only 351 of them graduated from high school and, from these, 260 students took the AAT. In 1987 nutritional status was assessed through anthropometric parameters, intellectual ability by the Raven's Progressive Matrices Test, scholastic achievement through Spanish language and mathematics tests, and socio-economic status using Graffar's modified scale; family variables were also recorded. Maternal schooling, scholastic achievement, intellectual ability and head circumference-for-age z-score (anthropometric indicator of both nutritional background and brain development) all in 1987 were the independent variables with the greatest explanatory power for AAT variance in 1998 (r2 0·402). These results provide a foundation to identify the risk factors at an early age that affect AAT scores and should be useful to improve nutritional and educational policies.

Twelve-year follow-up study of the impact of nutritional status at the onset of elementary school on later educational situation of Chilean school-age children

OBJECTIVE

To determine the impact of nutritional status in a multicausal approach of socio-economic, socio-cultural, family, intellectual, educational and demographic variables at the onset of elementary school in 1987 on the educational situation of these children in 1998, when they should have graduated from high school.

SETTING

Chile's Metropolitan Region.

DESIGN

Prospective, observational and 12-year follow-up study.

METHODS

A representative sample of 813 elementary first grade school-age children was randomly chosen in 1987. The sample was assessed in two cross-sectional studies. The first cross-sectional study was carried out in at the onset of elementary school in 1987 and the second was carried out in 1998, 12-years later, when they should be graduating from high school. In 1998, 632 adolescent students were located and their educational situation was registered (dropout, delayed, graduated and not located). At the onset of elementary school were determined the nutritional status, socio-economic status (SES), family characteristics, intellectual ability (IA), scholastic achievement (SA) and demographic variables. Statistical analysis included variance tests and Scheffe's test was used for comparison of means. Pearson correlation coefficients and logistic regression were used to establish the most important independent variables at the onset of elementary school in 1987 that affect the educational situation 1998. Data were analysed using the statistical analysis system (SAS).

RESULTS

Logistic regression revealed that SES, IA, SA and head circumference-for-age Z score at the onset of elementary school in 1987 were the independent variables with the greatest explanatory power in the educational situation of school-age children in 1998.

CONCLUSIONS

These parameters at an early school age are good predictors of the educational situation later and these results can be useful for nutrition and educational planning in early childhood.

Weaning foods and their impact on child-feeding practices among low-income Nigerian mothers

BACKGROUND

Many children in rural communities of developing countries die of nutrition-related causes due to lack of nutrition education and low purchasing power of the families, which result in low-quality weaning foods and poor feeding practices.

OBJECTIVE

To evaluate the nutritional composition of local weaning foods and their impact on child feeding practices among low-income Nigerian mothers.

METHODS

A cross-sectional survey was conducted between March and June 2005 among 294 randomly selected pairs of nursing mothers and their children who attended the postnatal clinic of State Specialist Hospital and Comprehensive Health Centers in Akure community, Ondo State, Nigeria. A structured, self-or interviewer-administered questionnaire was used to collect information on infant demographic characteristics, feeding, and socioeconomic characteristics of the parents. The children's weights were recorded, and samples of the weaning foods were analyzed.

RESULTS

The mothers' ages ranged from 22 to 37 years, and the children's from one to 12 months. Among the parents, two-fifths of the respondents worked as drivers, mechanics, carpenters, and the like, while the remaining respondents were civil servants, health professionals, teachers, merchants, and housewives. The educational attainment of the parents ranged from no formal education (1.4%) to higher education (46%); 13% had completed primary school, and 39.6% had completed secondary school. The average monthly family income was between 3,500 and 30,000 naira (US dollar 23.3-dollar 200). Among the children, 58.3% were of normal weight, 41.1% were mildly underweight, 0.3% moderately underweight, and 0.3% severely underweight; 23.1% were exclusively breastfed, 9.5% received breastmilk and traditional medicinal herbs, 15.6% received breastmilk and commercial weaning food, 7.4% received commercial weaning food only, 14.8% received local weaning foods only, 24.1% received local weaning foods plus breastmilk, and 5.8% received the family diet.

CONCLUSIONS

We found that a high proportion of the nursing mothers used local ingredients to formulate weaning foods for their babies. The nutritional compositions of these foods is of high quality and are suitable as weaning foods, particularly for infants of low-income parents who do not have access to commercial weaning foods.

Role of apolipoprotein E4 in protecting children against early childhood diarrhea outcomes and implications for later development

Our group and others have reported a series of studies showing that heavy burdens of diarrheal diseases in the formative first two years of life in children in urban shantytowns have profound consequences of impaired physical and cognitive development lasting into later childhood and schooling. Based on these previous studies showing that apolipoprotein E4 (APOE4) is relatively common in favela children, we review recent data suggesting a protective role for the APOE4 allele in the cognitive and physical development of children with heavy burdens of diarrhea in early childhood. Despite being a marker for cognitive decline with Alzheimer's and cardiovascular diseases later in life, APOE4 appears to be important for cognitive development under the stress of heavy diarrhea. The reviewed findings provide a potential explanation for the survival advantage in evolution of the thrifty APOE4 allele and raise questions about its implications for human development under life-style changes and environmental challenges.

Scholastic achievement: a multivariate analysis of nutritional, intellectual, socioeconomic, sociocultural, familial, and demographic variables in Chilean school-age children

OBJECTIVE

We determined relative effects of nutritional status, intellectual ability, exposure to mass media, and socioeconomic, sociocultural, familial, demographic, and educational variables on scholastic achievement (SA).

METHODS

This was a cross-sectional study. Exposure to mass media and nutritional, intellectual, socioeconomic, sociocultural, familial, demographic, and educational factors, including approximately 2000 variables, were measured in a representative and proportional sample of 4509 school-age children from elementary and high schools in Chile's Metropolitan Region. The field study was carried out between 1986 and 1987, and data processing, which lasted 15 y, was completed in 2002.

RESULTS

Within the total sample, intellectual ability, level of maternal schooling, head circumference-for-age Z score, book reading, in-door plumbing, level of paternal schooling, type of school, quality of housing, height-for-age Z score, and calcium intake were the independent variables with the greatest explanatory power in SA variance (r(2) = 0.508). In most grades, IA was the independent variable with the greatest explanatory power in SA variance. In adolescents in their fourth year of high school and whose physical growth and intellectual development processes are consolidated, intellectual ability, age, head circumference-for-age Z score, book reading, type of school, and level of paternal schooling were the independent variables with the greatest explanatory power in SA variance (r(2) = 0.60).

CONCLUSIONS

These findings show that SA is conditioned by multiple factors depending on the characteristics of school-age children, their families, and the educational system. Nutritional indicators of past nutrition are significantly associated with SA, especially head circumference-for-age Z score. This information may be useful for health and educational planning.

The impact of child maltreatment on expressive syntax at 60 months

Although child maltreatment has often been described as leading to language deficits, the few well-controlled investigations of language acquisition in maltreated children have focused on language content rather than form, or have used qualitative rather than quantitative measures. This study examines syntactic complexity in 19 maltreated and 14 nonmaltreated preschool-aged children. Mother-child dyads participated in play sessions that were transcribed and scored for the presence of morphosyntactic forms in child speech and for specific sentence constructions in maternal speech. Findings indicated that child maltreatment was associated with language delay in both vocabulary and production of syntactic structures. There were also qualitative differences in characteristics of maternal utterances between maltreating and comparison groups. Because maltreatment initially occurred before age 2, this study highlights the long-lasting negative influence of maltreatment on language development and also provides the first demonstration of child language delays and differences in maternal speech within a single maltreatment sample.

Head size and intelligence, learning, nutritional status and brain development

This multifactorial study investigates the interrelationships between head circumference (HC) and intellectual quotient (IQ), learning, nutritional status and brain development in Chilean school-age children graduating from high school, of both sexes and with high and low IQ and socio-economic strata (SES). The sample consisted of 96 right-handed healthy students (mean age 18.0 +/- 0.9 years) born at term. HC was measured both in the children and their parents and was expressed as Z-score (Z-HC). In children, IQ was determined by means of the Wechsler Intelligence Scale for Adults-Revised (WAIS-R), scholastic achievement (SA) through the standard Spanish language and mathematics tests and the academic aptitude test (AAT) score, nutritional status was assessed through anthropometric indicators, brain development was determined by magnetic resonance imaging (MRI) and SES applying the Graffar modified method. Results showed that microcephalic children (Z-HC < or = 2 S.D.) had significantly lower values mainly for brain volume (BV), parental Z-HC, IQ, SA, AAT, birth length (BL) and a significantly higher incidence of undernutrition in the first year of life compared with their macrocephalic peers (Z-HC > 2S.D.). Multiple regression analysis revealed that BV, parental Z-HC and BL were the independent variables with the greatest explanatory power for child's Z-HC variance (r(2) = 0.727). These findings confirm the hypothesis formulated in this study: (1) independently of age, sex and SES, brain parameters, parental HC and prenatal nutritional indicators are the most important independent variables that determine HC and (2) microcephalic children present multiple disorders not only related to BV but also to IQ, SA and nutritional background.