Abstract
BackgroundSocioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children.MethodsA total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven’s Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference.ResultsOverall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110–119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)].ConclusionsChildren from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.
Highlights
Socioeconomic factors and nutritional status have been associated with childhood cognitive development
An Indonesian study found that height-for-age Z-score (HAZ) of preschool children was positively associated with cognitive development [18]; while another study showed that stunted Indonesian children had slower development in fine and gross motor skills as well as poorer language skills, compared to non-stunted children [19]
A third of the children were from very low income households (< MYR1500 per month) and less than one fifth belonged to high income households (≥ MYR5600 per month)
Summary
Socioeconomic factors and nutritional status have been associated with childhood cognitive development. Previous Malaysian studies had been conducted with small populations and had inconsistent results This present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Results from developed and developing countries consistently supported the links among SES, nutritional status and cognitive performance [13,14,15,16,17,18,19,20,21,22,23]. Studies from developing countries, such as Vietnam [21], Indonesia [22] and Guatemala [23], have reported similar results
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