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Impact of early and concurrent stunting on cognition

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Undernutrition is associated with poor cognitive development, late entry into school, decreased years of schooling, reduced productivity and smaller adult stature. We use longitudinal data from 1674 Peruvian children participating in the Young Lives study to assess the relative impact of early stunting (stunted at 6–18 months of age) and concurrent stunting (stunted at 4.5–6 years of age) on cognitive ability. Anthropometric data were longitudinally collected for children at 6–18 months of age and 4.5–6 years of age at which time verbal and quantitative ability were also assessed. We estimate that an increase in concurrent height‐for‐age z‐scores (HAZ) by one standard deviation was associated with an increase in a child's score on the Peabody Picture Vocabulary Test (PPVT) by 2.35 points [confidence interval (CI): 1.55–3.15] and a 0.16 point increase on the cognitive development assessment (CDA) (CI: 0.05–0.27). Furthermore, we report that the estimate for concurrent HAZ and PPVT is significantly higher than the estimate for early stunting and PPVT. We found no significant difference between early and concurrent estimates for HAZ and CDA. Children from older mothers, children whose mothers had higher education levels, children living in urban areas, children who attended pre‐school, children with fewer siblings and children from wealthier backgrounds scored higher on both assessments. Cognitive skills of children entering school were associated with early stunting but the strongest association was found with concurrent stunting suggesting that interventions preventing linear growth faltering should not only focus on the under 2s but include children up to 5 years of age.
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Document Type: Research Article

Affiliations: 1: Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah 84108, USA, 2: Department of International Health, Center for International Health and Development, Boston University, Boston, Massachusetts 02118, USA, 3: Department of Health Sciences, Brigham Young University, Provo, Utah 84602, USA, 4: Department of Pediatrics, University of Utah, 100 North Mario Cappechi Drive, Primary Children's Medical Center, Salt Lake City, Utah 84113, USA, and 5: Instituto de Investigación Nutricional, Av. La Molina 1885, La Molina, Lima-12, Peru

Publication date: 01 October 2011

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