title: Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children.
abstract: Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children's weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6-12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven's Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21% of the children in the four countries were underweight and 19% were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ < 89 (OR 3·53 and 95% CI 3·52, 3·54). The chance of having a non-verbal IQ < 89 was also doubled with low BAZ and HAZ. In contrast, except for severe obesity, the relationship between high BAZ and IQ was less clear and differed per country. The odds of having non-verbal IQ levels < 89 also increased with severe obesity. In conclusion, undernourishment and non-verbal IQ are significantly associated in 6-12-year-old children. Effective strategies to improve nutrition in preschoolers and school-aged children can have a pronounced effect on cognition and, in the longer term, help in positively contributing to individual and national development.
authors.affiliation: Persatuan Ahli Gizi Indonesia (PERSAGI), Bogor 16112, Indonesia.
authors.lastname: Sandjaja
authors.forename: Bee Koon
authors.initials: BK
authors.lastname: Poh
authors.forename: Nipa
authors.initials: N
authors.lastname: Rojroonwasinkul
authors.forename: Bao Khanh
authors.initials: BK
authors.lastname: Le Nyugen
authors.forename: Basuki
authors.initials: B
authors.lastname: Budiman
authors.forename: Lai Oon
authors.initials: LO
authors.lastname: Ng
authors.forename: Kusol
authors.initials: K
authors.lastname: Soonthorndhada
authors.forename: Hoang Thi
authors.initials: HT
authors.lastname: Xuyen
authors.forename: Paul
authors.initials: P
authors.lastname: Deurenberg
authors.forename: Panam
authors.initials: P
authors.lastname: Parikh
mesh_terms: D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D002657:Child Development; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007361:Intelligence Tests; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000503:physiopathology; D009752:Nutritional Status; D012424:Rural Population; D013334:Students; D013785:Thailand / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology; D014505:Urban Population; D014744:Vietnam / Q000453:epidemiology