title: Influence of domestic violence on the association between malnutrition and low cognitive development.
abstract: OBJECTIVE
  To investigate the size and direction of the association between malnutrition and low cognitive performance and to evaluate the effect of domestic violence on this association.
  
  
  METHODS
  This cross-sectional study enrolled students of both sexes, aged 7 to 14 years old, attending public elementary schools. The Raven's Progressive Matrices Test was used to measure cognitive development, the Revised Conflict Tactics Scales (CTS2), to measure domestic violence, and the body mass index (BMI) for age and sex, to define anthropometric indices. Socioeconomic data and information about food intake were also collected. Malnutrition was defined as BMI < 3rd percentile. Cognitive deficit was defined when the results of Raven's test were ≤ 25th percentile. Family violence was defined as a positive answer in at least one item about severe physical violence in the last 12 months. The size of the associations of interest was expressed as prevalence ratio (PR) and 95% confidence interval (95%CI).
  
  
  RESULTS
  Below-average intellectual development was found for 63.3% of the participants. Malnutrition was identified in 9.5%. Malnutrition had a negative effect on cognitive performance (adjusted prevalence ratio [aPR] = 1.60, 95% CI = 1.01 - 2.52; p = 0.042) when adjusted for the association between exposure to domestic violence and age.
  
  
  CONCLUSIONS
  The association between malnutrition and below-average intellectual development found in this study was affected by domestic violence, which must be taken into account when addressing the problem.
authors.affiliation: Departamento Ciência da Nutrição, Programa de pós-graduação em Alimentação e Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, BA, Brazil. rcrsilva@ufba.br
authors.forename: Rita de C R
authors.initials: Rde C
authors.lastname: Silva
authors.forename: Ana M O
authors.initials: AM
authors.lastname: Assis
authors.forename: Maria H
authors.initials: MH
authors.lastname: Hasselmann
authors.forename: Letícia M
authors.initials: LM
authors.lastname: dos Santos
authors.forename: Elizabete de J
authors.initials: Ede J
authors.lastname: Pinto
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rodrigues
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology; D017579:Domestic Violence / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D012016:Reference Values