Iron status predicts cognitive test performance of primary school children from Kumasi, Ghana

Comparative analysis of methyl-donor nutrient intakes and RCPM cognitive performance among school-aged children

BACKGROUND

Evidence shows a link between methyl-donor nutrient intakes and a child's cognitive ability. However, this is less known among Ghanaian children who might be at higher risk of methyl-donor nutrient deficiencies. This study showed comparative analysis of methyl-donor nutrient intakes and Raven's Coloured Progressive Matrices (RCPM) test performance among 2073 Ghanaian school children aged 9-13 years across four regions of Ghana.

METHODS

Data for the present study were obtained from the Child Nutrition, Fitness, and Cognition project; a cross-sectional survey conducted in four regions of Ghana. Dietary methyl-donor nutrient values were based on repeated 24 h recall data collected during the study periods. Cognitive tests were performed on the 2073 children using Raven's Coloured Progressive Matrices (RCPM) test.

RESULTS

We found dietary zinc (adjusted: β = 0.21, p = 0.003) and methionine (adjusted: β = 0.60, p = 0.044) intakes to be associated with RCPM scores in the linear regression model. School children living in Northern Region (adjusted OR = 0.6, p < 0.001, 95% CI = 0.4-0.7) and Volta Region (adjusted OR = 0.7, p = 0.006, 95% CI = 0.5-0.9) had lower odds of scoring above the 50th percentile on the RCPM test compared with those living in Greater Accra Region. Children who consumed below the RDA for dietary folate (unadjusted OR = 0.8, p = 0.055, 95% CI = 0.7-1.0) and zinc (unadjusted OR = 0.8, p = 0.049, 95%CI = 0.7-1.0) had lower odds of scoring above the 50th percentile on the RCPM test compared with those who consumed above the RDA for dietary folate and zinc respectively. Children who consumed below the EAR for dietary vitamin B₁₂ (unadjusted OR = 0.7, p = 0.004, 95% CI = 0.6-0.9) had reduced odds of scoring above the 50th percentile on the RCPM test compared with those who consumed above the EAR for dietary vitamin B₁₂.

CONCLUSIONS

Higher dietary methionine intake was strongly associated with higher RCPM scores. Regional differences, and children's dietary consumption below the EAR/RDA for dietary folate, vitamin B₁₂, and zinc were associated with poor RCPM test performance. School children's nutrient intake should be prioritized for improved cognition.

The Effectiveness of Iron-folic Acid Supplementation and Education Intervention to Hemoglobin Level, Knowledge, and Compliance among Adolescent Girls in Islamic Boarding School

Abstract BACKGROUND: Adolescent girls are at a high risk of iron deficiency anemia. Weekly iron-folic acid supplementation (WIFAS) is recommended to address anemia, but it is still ineffective to reduce the prevalence of anemia in Indonesia. Lack of knowledge and low adherence are the factors associated with the problem. AIM: The study aimed to assess the effectiveness of education-combined WIFAS intervention compared to WIFAS intervention, and to identify the compliance of iron-folic acid tablets intake. METHODS: A quasi-experimental study was carried out on November 2020 to March 2021. By simple random sampling, a total of 135 adolescent girls in islamic boarding schools in Semarang, Indonesia were divided into two groups: WIFAS group only received WIFAS and the WIFAS+Education group received combination of WIFAS and education intervention for 16 weeks. Hemoglobin level was measured by Cyanmethemoglobin method. The knowledge and compliance were determined through the questionnaires. Mann-Whitney, Wilcoxon, and McNemar tests were performed to analyze the effect of intervention by SPSS 22 software. RESULTS: Mean of Hb levels and knowledge scores before and after intervention in the WIFAS group were 13.38 g/dL and 13.08 g/dL (p=0.055); and 79.08 and 76.21 (p=0.93), respectively, meanwhile in the WIFAS+Education group were 12.79 g/dL and 12.69 g/dL (p=0.248); and 78.67 and 82.10 (p=0.008), respectively. The increases of anemia prevalence both in the WIFAS group and the WIFAS+Education group was not statistically significant. There was no significant difference of the compliance both groups (p=0.095). CONCLUSION: Education intervention was effective to increase the knowledge regarding anemia and nutrition. The education intervention to trustees of islamic boarding school is needed to increase the compliance of WIFAS, so it can improve the effectiveness of WIFAS among adolescent girls.