The Ugly

Child Stunting

 

1. WHO child stunting in a nutshell

2. Our World in Data: What is Stunting

3. Cognitive development in children with chronic protein energy malnutrition

B. Kar, S. Rao and B. Chandramouli. Cognitive development in children with chronic protein energy malnutrition (2008).

Conclusion
“Chronic protein energy malnutrition (stunting) affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age-related improvement in certain and not all higher-order cognitive processes and may also result in long-lasting cognitive impairments.”

4. Drivers of child stunting

Danaei G, Andrews GK, Sudfeld RC, Fink G, McCoy DC, Peet E, Sania A, Fawzi MCS, Ezzati M & Fawzi WW (2016). Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLOS Medicine, 13(11): 1-18.

What did the Researchers do and find?
“We identified 18 key risk factors for stunting and grouped them into five clusters (maternal nutrition and infection, teenage motherhood and short birth intervals, fetal growth restriction and preterm birth, child nutrition and infection, and environmental factors). When we grouped the risks together, fetal growth restriction and preterm birth was the leading risk factor cluster in all regions, but there were differences in the ranking of other risk factor clusters across regions. For example, environmental risk factors (i.e., poor water quality, poor sanitary conditions, and use of solid fuels) had the second largest impact on stunting globally and in South Asia, sub-Saharan Africa, and East Asia and Pacific, whereas risk factors related to child nutrition and infection were the second leading risk factors in other regions.”

5. Early childhood stunting is associated with poor psychological functioning in late adolescence and effects are reduced by psychosocial stimulation

S Walker, S Chang, C Powell, E Simonoff, and S Grantham-McGregor. Early childhood stunting is associated with poor psychological functioning in late adolescence and effects are reduced by psychosocial stimulation (2007).

Conclusion
“In conclusion, we have previously shown that stunting in early childhood is associated with deficits in cognition and educational achievement in late adolescence (11). This study provides probably the first evidence, to our knowledge, linking stunting and poor psychological functioning, extending the range of disadvantages attributed to early childhood stunting. Deficits were seen in emotional outcomes and in some aspects of behaviour. Poor psychological functioning is likely to affect the participants’ quality of life and may influence their social competence and parenting.”

6. Cognitive development in children with chronic protein energy malnutrition (2008)

B. Kar, S. Rao and B. Chandramouli. Cognitive development in children with chronic protein energy malnutrition (2008)

Abstract
“Background: Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. The effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age). The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures.​

Methods: Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age-related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory.​

Results: The development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poorly on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age-related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age-related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children.

Conclusion: Chronic protein energy malnutrition (stunting) affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age-related improvement in certain and not all higher-order cognitive processes and may also result in long-lasting cognitive impairments.”

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