Malnutrition in infancy and possibly intestinal disease due to giardia infection could be associated with poor cognitive function in children at 9 years of age, suggest results of a study of Peruvian children in this week’s issue of THE LANCET.
Chronic malnutrition during infancy, marked by stunted growth, has been associated with poor cognitive function. Douglas Berkman from the University of Medicine & Dentistry of New Jersey, USA, and colleagues assessed the effect of stunting, diarrhoeal disease, and parasitic infections during infancy on cognitive function in late childhood.
239 Peruvian children were followed up (from birth to two years) for social factors, stool samples, and diarrhoeal status. Cognitive function was assessed at 9 years of age in 143 (69%) children, with the full-scale intelligence quotient of the Wechsler intelligence scale for children-revised (WISC-R).
All findings were adjusted for socioeconomic factors and educational status; additionally, findings related to Giardia lamblia were adjusted for severe stunting. During the first 2 years of life 46 (32%) of 143 children were stunted. Children with severe stunting in the second year of life scored 10 points lower on the WISC-R than children without severe stunting. Children with more than 1 G lamblia episode per year scored 4.1 points lower than children with one episode or fewer per year at risk.
In an accompanying Commentary (p 542), Sally Grantham McGregor from the Institute for Child Health, London, UK, concludes: “Stunting clearly represents an enormous waste of potential in millions of children in developing countries, and urgent attention needs to be paid to both their nutrition and stimulation. The difficulties in obtaining sustained benefits from supplementation indicates that prevention must be the goal”.
Contact: Dr Douglas S Berkman, University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School, 6 Cedarbrook Drive, Somerset, NJ 08873, USA; T) +1 609 575 4099; F) +1 508 462 0721; E) berkmado@umdnj.edu
Professor Sally Grantham McGregor, Center for International Child Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; T) +44 (0)20 7905 2122; F) +44(0)20 7404 2062; E) s.mcgregor@ich.ucl.ac.uk
Journal
The Lancet