Abstract
BackgroundMalnutrition among children is one of the most pressing health concerns middle- and low-income countries face today, particularly those in Sub-Saharan Africa and South Asia. Early-life malnutrition has been shown to affect long-term health and income. One hypothesized channel linking early-life malnutrition and long-term outcomes is cognitive development. However, there is limited empirical evidence on the relationship between nutritional status and cognitive achievement in middle childhood.Study designAs part of the South India Community Health Study (SICHS), we collected educational attainment and anthropometric data from 1,194 children in rural Vellore district of Tamil Nadu, India, and assessed their math and reading skills. We analyzed the relationship between continuous and binary anthropometric measures of nutritional status and three measures of cognitive achievement (reading, math, and grade level), adjusting for potential confounders, using a regression framework.ResultsLower height-for-age and weight-for-age and their corresponding binary measures (stunting, underweight) were associated with lower reading scores, lower math scores, and lower grade level, with the exception of the association between weight-for-age and reading, which was marginally significant. A stunted child had one-third of a grade disadvantage compared to a non-stunted counterpart, whereas an underweight child had one-fourth of a grade disadvantage compared to a non-underweight counterpart. Lower BMI-for-age was associated with grade level and marginally associated with lower math scores, and its binary measure (thinness) was marginally associated with lower math scores.ConclusionsAcute and chronic malnutrition in middle childhood were negatively associated with math scores, reading scores, and educational attainment. Our study provides new evidence that cognitive achievement during middle childhood could be an important mechanism underlying the association between early-life malnutrition and long-term wellbeing.
Highlights
Malnutrition among children is one of the most pressing health concerns low- and middleincome countries face today, in Sub-Saharan Africa and South Asia
Acute and chronic malnutrition in middle childhood were negatively associated with math scores, reading scores, and educational attainment
Our study provides new evidence that cognitive achievement during middle childhood could be an important mechanism underlying the association between early-life malnutrition and long-term wellbeing
Summary
Malnutrition among children is one of the most pressing health concerns low- and middleincome countries face today, in Sub-Saharan Africa and South Asia. Early-life nutrition is an important determinant of one’s long-term productivity, earnings, and health [2,3,4,5] This evidence, coupled with the announcement of the Sustainable Development Goals, has prompted renewed efforts around the world to design and implement policies to address child malnutrition. A number of these studies focused on the nutritional status of children below age five This choice is not surprising given the critical role that early-life nutrition, during the first 1,000 days of life, has been shown to have on cognitive development and subsequent educational attainment [15,16]. Malnutrition among children is one of the most pressing health concerns middle- and lowincome countries face today, those in Sub-Saharan Africa and South Asia. There is limited empirical evidence on the relationship between nutritional status and cognitive achievement in middle childhood
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