title: Associations between cognitive function, blood lead concentration, and nutrition among children in the central Philippines.
abstract: OBJECTIVE
  Because little is known about its effects on cognitive function among children in less-developed countries, we determined the impact of lead exposure from other nutritional determinants of cognitive ability.
  
  
  METHODS
  Data were from a cross-sectional population-based stratified random sample of 877 children (age 6 months-5 years) participating in the Quality Improvement Demonstration Study we are conducting in the Philippines. With data from validated psychometric instruments, venous blood samples, and comprehensive survey instruments, we developed multi-stage models to account for endogenous determinants of blood lead levels (BLLs) and exogenous confounders of the association between BLLs and cognitive function.
  
  
  RESULTS
  A 1 microg/dL increase in BLL was associated with a 3.32 point decline in cognitive functioning in children aged 6 months to 3 years and a 2.47 point decline in children aged 3 to 5 years olds. BLL was inversely associated with hemoglobin and folate levels. Higher folate levels mitigated the negative association between BLL and cognitive function.
  
  
  CONCLUSIONS
  These population-based data suggest greater lead toxicity on cognitive function than previously reported. Our findings also suggest that folate and iron deficient children are more susceptible to the negative cognitive effects of lead. Folate supplementation may offer some protective effects against lead exposure.
authors.affiliation: School of Economics, University of the Philippines, Diliman, Quezon City.
authors.forename: Orville
authors.initials: O
authors.lastname: Solon
authors.forename: Travis J
authors.initials: TJ
authors.lastname: Riddell
authors.forename: Stella A
authors.initials: SA
authors.lastname: Quimbo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Butrick
authors.forename: Glen P
authors.initials: GP
authors.lastname: Aylward
authors.forename: Marife
authors.initials: M
authors.lastname: Lou Bacate
authors.forename: John W
authors.initials: JW
authors.lastname: Peabody
mesh_terms: D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005492:Folic Acid / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000175:diagnosis*; D015233:Models, Statistical; D052756:Nutritional Sciences; D010372:Pediatrics / Q000379:methods; D010679:Philippines; D012923:Social Class; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007854:Lead; D005492:Folic Acid