Interaction of nutritional and socioeconomic status as determinants of cognitive development in disadvantaged urban Guatemalan children

Abstract

The relationship between nutritional status, measured by height for age, and cognition, measured by WISC full-scale IQ, was studied in a longitudinal sample of 459 urban Guatemalan children, aged 4-9 years, from a disadvantage community of the fringe of Guatemala City, examined annually over a 3 year period. Socioeconomic status (SES) was controlled by developing a composite index for each home. The mean IQ differed significantly from the lowest to the highest quartiles of stature, the difference between the two extreme quartiles being approximately 0.3 SD of IQ. There was a significant interaction between SES and stature in their effects on IQ. Whereas nutritional status and SES affected IQ in an additive fashion in the upper three SES quartiles, there was no difference in IQ attributible to stature among children from the most disadvantaged homes. This analysis indicates that the mild-to-moderate protein-energy malnutrition (defined by height for age) that is prevalent among children from disadvantaged environments in developing countries is significantly related to cognitive development. However, in the poorest homes, SES is seen as a more important determinant of cognitive development than stature.

Nutrition, anaemia, geohelminth infection and school achievement in rural Jamaican primary school children

“…The ®nding that the children's height-for-age was associated with their achievement concurs with that of other studies (Agarwal et al, 1987;Florencio, 1988;Johnston et al, 1987), and this suggests that early nutritional de®cits may have persistent effects on children's achievement.…”

“…Nutritional status has been found to be associated with school achievement in many countries. For example, height-for-age was found to be a signi®cant predictor of school achievement, after controlling for socioeconomic status, in India (Agarwal et al, 1987), Nepal (Moock & Leslie, 1986), Guatemala (Johnston et al, 1987), Philippines (Florencio, 1988) and Jamaica (Clarke et al, 1991). Wasting predicted achievement in fewer studies (Popkin & Lim-Ybanez, 1982;Mason-Noel, 1983).…”

Health, Shocks, and Poverty Persistence

“…Children that experience slow height growth are found to perform less well in school, score poorly on tests of cognitive function, have poorer psychomotor development and fine motor skills. They tend to have lower activity levels, interact less frequently in their environments and fail to acquire skills at normal rates (Grantham-McGregor et al 1997Johnston et al 1987;Lasky et al 1981). A small but growing literature, discussed below, explores whether health shocks have permanent or transitory effects on child health status.…”

How consistent are associations between stunting and child development? Evidence from a meta-analysis of associations between stunting and multidimensional child development in fifteen low- and middle-income countries

“…Chronic early undernutrition is known to cause stunting (height-for-age ≥2 SD below a Z-score normed for a wellnourished population of children of the same age and sex) and decades of research has documented associations between stunting and developmental delay (1)(2)(3)(4) . Developmental insults such as undernutrition in a child's earliest years can have detrimental impacts on all developmental domains, as these years contain the most rapid changes in brain development (5,6) .…”