Nutritional Risk in Early Childhood and School Readiness

Abstract

<p><strong>Background</strong></p> <p>Nutrition in early childhood is important for healthy <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/growth-development-and-aging" target="_blank">growth and development</a>. Achieving school readiness is considered one of the most important <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/developmental-milestone" target="_blank">developmental milestones</a> for young children.</p> <p><strong>Objectives</strong></p> <p>The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten.</p> <p><strong>Methods</strong></p> <p>A <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/prospective-cohort-study" target="_blank">prospective cohort study</a> was conducted through The Applied Research Group for Kids (TARGet Kids!) <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/primary-health-care" target="_blank">primary care</a> research network in Toronto, Canada, 2015–2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4–6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders.</p> <p><strong>Results</strong></p> <p>The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (<em>P</em> = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (<em>P</em> < 0.001). NutriSTEP total score and high nutritional risk were associated with lower scores on all 5 EDI domains, with the strongest association observed for the domains of language and cognitive development and communication skills and general knowledge.</p> <p><strong>Conclusions</strong></p> <p>Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered <a href="https://www.clinicaltrials.gov/" target="_blank">http://www.clinicaltrials.gov</a> as NCT01869530.</p>