Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.

<h4>Background</h4>Millions of children worldwide especially in the Asian subcontinent are vulnerable to early childhood stunting. There are contradictory reports of the association between catch-up growth in childhood and school age cognition.<h4>Methods</h4>A community-base...

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Main Authors: Beena Koshy, Manikandan Srinivasan, Sowmiya Gopalakrishnan, Venkata Raghava Mohan, Rebecca Scharf, Laura Murray-Kolb, Sushil John, Rachel Beulah, Jayaprakash Muliyil, Gagandeep Kang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264010&type=printable
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author Beena Koshy
Manikandan Srinivasan
Sowmiya Gopalakrishnan
Venkata Raghava Mohan
Rebecca Scharf
Laura Murray-Kolb
Sushil John
Rachel Beulah
Jayaprakash Muliyil
Gagandeep Kang
author_facet Beena Koshy
Manikandan Srinivasan
Sowmiya Gopalakrishnan
Venkata Raghava Mohan
Rebecca Scharf
Laura Murray-Kolb
Sushil John
Rachel Beulah
Jayaprakash Muliyil
Gagandeep Kang
author_sort Beena Koshy
collection DOAJ
description <h4>Background</h4>Millions of children worldwide especially in the Asian subcontinent are vulnerable to early childhood stunting. There are contradictory reports of the association between catch-up growth in childhood and school age cognition.<h4>Methods</h4>A community-based birth cohort recruited between 2010 and 2012 from urban slums in Vellore, India was followed up until 9 years of age. From regular anthropometric measurements, stunting status for each individual child was calculated at 2, 5 and 9 years. Cognition was assessed at 9 years of age using the Malin's Intelligence Scale for Indian Children (MISIC). Children were divided into groups based on stunting at each time point as well as catch-up growth, and a regression model was utilised to evaluate their association with cognition at 9 years.<h4>Results</h4>Among 203 children included in this analysis, 94/203 (46.31%) children were stunted at 2 years of age, of whom 39.36% had a catch-up growth at 5 years of age, and 38.30% at 9 years. Around 10% of the cohort remained stunted at all time points. In the multivariable analysis, children who were stunted at 2, 5 and 9 years had a significantly lower verbal and total intelligence quotient (IQ) scores by 4.6 points compared to those who were never stunted. Children with catch up growth following stunting at 2 years had higher cognition scores than those who were persistently stunted throughout the childhood.<h4>Conclusions</h4>This study showed persistent stunting in childhood was associated with lowering of 4-5 IQ points in childhood cognition at 9 years of age. Recovery from early life stunting in children with catch up growth prevented further lowering of cognition scores in these children compared to persistently stunted children. Nutritional supplementation during late infancy and early toddlerhood in addition to continuing nutritional supplementation programmes for preschool and school children can improve childhood stunting and cognitive abilities in vulnerable populations.
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spelling doaj.art-bf21d51cf65c43e48f1246793dbc1b512025-03-04T05:31:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026401010.1371/journal.pone.0264010Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.Beena KoshyManikandan SrinivasanSowmiya GopalakrishnanVenkata Raghava MohanRebecca ScharfLaura Murray-KolbSushil JohnRachel BeulahJayaprakash MuliyilGagandeep Kang<h4>Background</h4>Millions of children worldwide especially in the Asian subcontinent are vulnerable to early childhood stunting. There are contradictory reports of the association between catch-up growth in childhood and school age cognition.<h4>Methods</h4>A community-based birth cohort recruited between 2010 and 2012 from urban slums in Vellore, India was followed up until 9 years of age. From regular anthropometric measurements, stunting status for each individual child was calculated at 2, 5 and 9 years. Cognition was assessed at 9 years of age using the Malin's Intelligence Scale for Indian Children (MISIC). Children were divided into groups based on stunting at each time point as well as catch-up growth, and a regression model was utilised to evaluate their association with cognition at 9 years.<h4>Results</h4>Among 203 children included in this analysis, 94/203 (46.31%) children were stunted at 2 years of age, of whom 39.36% had a catch-up growth at 5 years of age, and 38.30% at 9 years. Around 10% of the cohort remained stunted at all time points. In the multivariable analysis, children who were stunted at 2, 5 and 9 years had a significantly lower verbal and total intelligence quotient (IQ) scores by 4.6 points compared to those who were never stunted. Children with catch up growth following stunting at 2 years had higher cognition scores than those who were persistently stunted throughout the childhood.<h4>Conclusions</h4>This study showed persistent stunting in childhood was associated with lowering of 4-5 IQ points in childhood cognition at 9 years of age. Recovery from early life stunting in children with catch up growth prevented further lowering of cognition scores in these children compared to persistently stunted children. Nutritional supplementation during late infancy and early toddlerhood in addition to continuing nutritional supplementation programmes for preschool and school children can improve childhood stunting and cognitive abilities in vulnerable populations.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264010&type=printable
spellingShingle Beena Koshy
Manikandan Srinivasan
Sowmiya Gopalakrishnan
Venkata Raghava Mohan
Rebecca Scharf
Laura Murray-Kolb
Sushil John
Rachel Beulah
Jayaprakash Muliyil
Gagandeep Kang
Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
PLoS ONE
title Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
title_full Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
title_fullStr Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
title_full_unstemmed Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
title_short Are early childhood stunting and catch-up growth associated with school age cognition?-Evidence from an Indian birth cohort.
title_sort are early childhood stunting and catch up growth associated with school age cognition evidence from an indian birth cohort
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264010&type=printable
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