Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.

<h4>Background</h4>There is a lack of nationally representative estimates for the consequences of early childhood undernutrition on preadolescent outcomes in India. Understanding this relationship is helpful to develop interventions that not only prevent child undernutrition but also mit...

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Autores principales:	Apurv Soni, Nisha Fahey, Zulfiqar A Bhutta, Wenjun Li, Jean A Frazier, Tiffany Moore Simas, Somashekhar M Nimbalkar, Jeroan J Allison
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/06a5bbc8176f4d0091e462816e22b05c
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spelling	oai:doaj.org-article:06a5bbc8176f4d0091e462816e22b05c2021-12-02T19:55:43ZEarly childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.1549-12771549-167610.1371/journal.pmed.1003838https://doaj.org/article/06a5bbc8176f4d0091e462816e22b05c2021-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003838https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>There is a lack of nationally representative estimates for the consequences of early childhood undernutrition on preadolescent outcomes in India. Understanding this relationship is helpful to develop interventions that not only prevent child undernutrition but also mitigate its consequences.<h4>Methods and findings</h4>In this cohort study, we analyzed prospectively gathered data from 2 waves of the India Human Development Survey (IHDS) to investigate the association of undernutrition during early childhood (0 to 5 years) in 2004 to 2005 with physical and cognitive outcomes during preadolescent (8 to 11 years) years in 2011 to 2012. These surveys interviewed 41,554 households across all 33 states and union territories in India in 2004 to 2005 and reinterviewed 83% of the households in 2011 to 2012. Primary exposure was assessed using the Composite Index of Anthropometric Failure (CIAF) based on 2004 to 2005 survey. Primary outcomes were short stature (height-for-age z-score [HAZ] <-2), thinness (body mass index [BMI] <18.5 kg/m2), reading, and arithmetic skills during preadolescence based on the 2011 to 2012 survey. Survey-weighted generalized linear models were used, and effect modification based on child sex and sociodemographic variables were evaluated using 3-way interaction terms. Of the 7,868 children included in this analysis, 4,334 (57.3%) were undernourished. Being undernourished was associated with increased odds of short stature (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.45 to 2.06) and thinness (OR 1.52, 95% CI 1.33 to 1.73) during the preadolescent period, while it was associated with decreased odds of achieving a higher reading (cumulative odds ratio [cumOR]: 0.76, 0.66 to 0.87) and arithmetic (cumOR: 0.72, 0.63 to 0.82) outcomes. The disparity in outcomes based on CIAF increased with age, especially for female children. Increased level of female education within the household reduced the disadvantages of undernutrition among female children. Study limitations include observational and missing data, which limit our ability to draw strong causal inferences.<h4>Conclusions</h4>In this study, we found that early child undernutrition was associated with several adverse preadolescent physical and cognitive outcomes, especially among female children. Improved female education mitigates this association. Female education promotion should assume a central role in Indian public health policy making.Apurv SoniNisha FaheyZulfiqar A BhuttaWenjun LiJean A FrazierTiffany Moore SimasSomashekhar M NimbalkarJeroan J AllisonPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 10, p e1003838 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Apurv Soni Nisha Fahey Zulfiqar A Bhutta Wenjun Li Jean A Frazier Tiffany Moore Simas Somashekhar M Nimbalkar Jeroan J Allison Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
description	<h4>Background</h4>There is a lack of nationally representative estimates for the consequences of early childhood undernutrition on preadolescent outcomes in India. Understanding this relationship is helpful to develop interventions that not only prevent child undernutrition but also mitigate its consequences.<h4>Methods and findings</h4>In this cohort study, we analyzed prospectively gathered data from 2 waves of the India Human Development Survey (IHDS) to investigate the association of undernutrition during early childhood (0 to 5 years) in 2004 to 2005 with physical and cognitive outcomes during preadolescent (8 to 11 years) years in 2011 to 2012. These surveys interviewed 41,554 households across all 33 states and union territories in India in 2004 to 2005 and reinterviewed 83% of the households in 2011 to 2012. Primary exposure was assessed using the Composite Index of Anthropometric Failure (CIAF) based on 2004 to 2005 survey. Primary outcomes were short stature (height-for-age z-score [HAZ] <-2), thinness (body mass index [BMI] <18.5 kg/m2), reading, and arithmetic skills during preadolescence based on the 2011 to 2012 survey. Survey-weighted generalized linear models were used, and effect modification based on child sex and sociodemographic variables were evaluated using 3-way interaction terms. Of the 7,868 children included in this analysis, 4,334 (57.3%) were undernourished. Being undernourished was associated with increased odds of short stature (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.45 to 2.06) and thinness (OR 1.52, 95% CI 1.33 to 1.73) during the preadolescent period, while it was associated with decreased odds of achieving a higher reading (cumulative odds ratio [cumOR]: 0.76, 0.66 to 0.87) and arithmetic (cumOR: 0.72, 0.63 to 0.82) outcomes. The disparity in outcomes based on CIAF increased with age, especially for female children. Increased level of female education within the household reduced the disadvantages of undernutrition among female children. Study limitations include observational and missing data, which limit our ability to draw strong causal inferences.<h4>Conclusions</h4>In this study, we found that early child undernutrition was associated with several adverse preadolescent physical and cognitive outcomes, especially among female children. Improved female education mitigates this association. Female education promotion should assume a central role in Indian public health policy making.
format	article
author	Apurv Soni Nisha Fahey Zulfiqar A Bhutta Wenjun Li Jean A Frazier Tiffany Moore Simas Somashekhar M Nimbalkar Jeroan J Allison
author_facet	Apurv Soni Nisha Fahey Zulfiqar A Bhutta Wenjun Li Jean A Frazier Tiffany Moore Simas Somashekhar M Nimbalkar Jeroan J Allison
author_sort	Apurv Soni
title	Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
title_short	Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
title_full	Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
title_fullStr	Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
title_full_unstemmed	Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.
title_sort	early childhood undernutrition, preadolescent physical growth, and cognitive achievement in india: a population-based cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/06a5bbc8176f4d0091e462816e22b05c
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Early childhood undernutrition, preadolescent physical growth, and cognitive achievement in India: A population-based cohort study.

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