Relationships between physical growth, mental development and nutritional supplementation in stunted children: the Jamaican study

Powell, CA; Walker, Susan P.; Himes, John H.; Fletcher, P. R.; Grantham‐McGregor, SM

doi:10.1111/j.1651-2227.1995.tb13479.x

Cited by 37 publications

(31 citation statements)

References 20 publications

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“…In stunted Jamaican children aged between 6 and 24 months, change in height over the subsequent 24 months was associated with change in developmental levels. Furthermore, change in height in the first 12 months predicted change in mental age in the second 12 months even after controlling for height change in the second year 30 .…”

Section: Longitudinal Studies Of Undernourished Childrenmentioning

confidence: 89%

Review of the evidence linking protein and energy to mental development

Grantham‐McGregor

Baker‐Henningham

2005

Public Health Nutr.

117

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Objective: To examine the evidence as to whether the relationship between undernutrition and poor child development is causal. Design: Selected studies from developing countries were discussed. Observational studies were first considered then experimental studies of preventative and remedial supplementation. The type of functions affected, the presence of sensitive periods and the role of protein and energy versus that of micronutrients were reviewed. Results: Childhood undernutrition is generally associated with concurrent and longer term deficits in cognition, behaviour and motor skills, although the relationship is likely to be confounded by socio-economic factors. Supplementation trials have had many design problems. However, those beginning at any age from pregnancy up to 24 months have consistently had concurrent benefits suggesting a causal relationship. Supplement begun in older children had little or no effect, albeit there are too few studies to conclude with confidence. The limited evidence suggests that benefits are more likely to be sustained if supplementation begins in late pregnancy or at birth and is continued until the child is at least 24 months old.Deficits in cognition tend to be global and there is insufficient evidence of specific deficits. There is some evidence that the first 2 years of life are most sensitive to the effects of undernutrition. Most studies have failed to separate the effects of energy and protein from those of micronutrients. One study showed that energy and/or protein affects children's development. Psychosocial stimulation has had consistent benefits on undernourished childrens' development Conclusions: Public health nutrition programmes should include a component in which children who are at risk are targeted during the first 2 years of life with combined interventions involving nutrition, health care and early stimulation.

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Section: Longitudinal Studies Of Undernourished Childrenmentioning

confidence: 89%

Review of the evidence linking protein and energy to mental development

Grantham‐McGregor

Baker‐Henningham

2005

Public Health Nutr.

117

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“…The higher prevalence of deficiencies in iron and zinc may have contributed to these differences. Many studies have shown that among undernourished children, mental 34 -36 and motor development 37,38 are often below normal. The level of poverty may also contribute to the test results.…”

Section: Discussionmentioning

confidence: 99%

Disadvantaged black and coloured infants in two urban communities in the Western Cape, South Africa differ in micronutrient status

Oelofse

Raaij

Benadé

et al. 2002

Public Health Nutr.

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Objectives: To determine the nutritional and health status of urban infants in two disadvantaged communities in the Western Cape, South Africa with special reference to micronutrient status. The results of this study will serve to plan an intervention study in these communities in the same age group. Design: Cross-sectional study. Setting: Two disadvantaged urban black and 'coloured' communities in the Western Cape, South Africa. Subjects: Sixty infants aged 6 -12 months from each community. Outcome measures: Dietary intake, anthropometric measurements, micronutrient status and psychomotor development. Results: Stunting and underweight were more prevalent in coloured infants (18% and 7%, respectively) than in black infants (8% and 2%, respectively). Anaemia (haemoglobin ðHbÞ , 11 g dl 21 ) was prevalent in 64% of coloured and 83% of black infants. Iron-deficiency anaemia (Hb , 11 g dl 21 and ferritin , 10 ng ml 21 ) was found in 32% of coloured infants and in 46% of black infants. Zinc deficiency was prevalent in 35% and 33% of the coloured and black infants, respectively. Marginal vitamin A deficiency (serum retinol , 20 mg dl 21 ) was observed in 23% of black infants compared with 2% of coloured infants. Of black infants, 43% and of coloured infants 6% were deficient in two or more micronutrients. Six per cent of coloured infants had C-reactive protein concentrations above 5 mg l 21 compared with 38% of the black infants. The dietary intake of micronutrients was in general lower in black infants than in coloured infants. The overall psychomotor development, assessed by the Denver Developmental Screening Test, was different between the two groups. The coloured infants scored higher in three out of the four categories as well as in their overall score. Conclusions: This study shows that information on stunting and wasting only in urban disadvantaged infants is not sufficient to make recommendations about specific community intervention programmes. Information on the micronutrient status, independent of wasting and stunting, is necessary to design nutrition programmes for different communities. The study also showed a substantially higher prevalence of micronutrient deficiencies among black infants.

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“…15 In the present study, we attempted to disentangle the relationship between postnatal anthropometric status and PD among LBW children.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14] There is only one study which explores the association between the three anthropometric indicators and psychomotor development (PD) but it did not control for any confounding factors. 15 In the present study, we attempted to disentangle the relationship between postnatal anthropometric status and PD among LBW children.…”

Section: Introductionmentioning

confidence: 99%

An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure

Avan

Raza

Kirkwood

2014

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background: Low birth weight is known to be associated with postnatal growth failure. It is not yet established that both conditions are determinants of psychomotor development. The study investigated whether or not low birth weight leads to delayed psychomotor development of a child, and whether it can be mitigated by adequate postnatal growth.Methods: A cross-sectional study was conducted in 2002 in 15 rural and 11 urban communities of Sindh province, Pakistan. Assessment of 1234 children less than 3 years of age included Bayley's Scale of Infant Development II, socioeconomic questionnaire and anthropometry; WHO standards were used to calculate z-scores of height-for-age, weight-for-height and weight-for-age. The underlying study hypotheses were tested through multiple regression modelling.Results: Out of 1219 children, 283 (23.2%) had delayed psychomotor development and 639 (52.4%) were undernourished according to the composite index of anthropometric failure. Strong negative associations with the psychomotor development index were detected between stunting and being underweight, with a larger magnitude of effect for stunting (p,0.001). The strong relationship persisted even when the analysis was restricted to nonmalnourished children. The psychomotor index increased by 2.07 points with every unit increase in height-forage z-score. Conclusions:The relationship between low birth weight and psychomotor development appears to be mediated largely by postnatal growth and nutritional status. This association suggests that among undernourished children there is significant likelihood of a group that is developmentally delayed. It is important to emphasize developmental needs in programmes that target underprivileged children.Keywords: Child development, Low birth weight, Nutritional status, Postnatal growth failure, Psychomotor development IntroductionThe overwhelming effects of low birth weight (LBW) and child under-nutrition are increasingly recognized, and consequently improved nutrition is vital to achieve the Millennium Development Goals. Conventionally, a birth weight of less than 2.5 kg is considered LBW.1 About 21 million babies are born with low birth weight: i.e. more than 16% of all births annually. Low birth weight contributes to poor health outcomes, the effects of which are more pronounced in developing countries. [2][3][4] The magnitude of the problem is grave in south Asia where at least every fourth newborn has LBW. 3,4 Worldwide, an enormous burden of under-nutrition among children is strongly associated with poor levels of child survival, accounting for 55% of under-5 mortality, and it is estimated that about 25% of the world's children under 5 years suffer from under-nutrition, particularly in African and Asian regions. 2,4 Under-nutrition in children is commonly assessed through the measurement of weight and height, and it manifests in three ways: 1) a child can be too short for their age, i.e. stunted; 2) have low weight for their height i.e. wasted; 3) have low weight for their age, leading to...

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Relationships between physical growth, mental development and nutritional supplementation in stunted children: the Jamaican study

Cited by 37 publications

References 20 publications

Review of the evidence linking protein and energy to mental development

Review of the evidence linking protein and energy to mental development

Disadvantaged black and coloured infants in two urban communities in the Western Cape, South Africa differ in micronutrient status

An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure

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