Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
FrieslandCampina, Amersfoort, LE 3818, The Netherlands.
BMC Public Health. 2019 Jun 13;19(Suppl 4):541. doi: 10.1186/s12889-019-6856-4.
Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children.
A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference.
Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)].
Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.
社会经济因素和营养状况与儿童认知发展有关。然而，之前的马来西亚研究都是在小范围内进行的，结果也不一致。因此，本研究旨在确定在马来西亚具有代表性的儿童样本中，社会经济和营养状况与认知表现之间的关系。
本研究共纳入了 2406 名年龄在 5 至 12 岁之间的马来西亚儿童，他们参加了东南亚营养调查（SEANUTS）。使用瑞文渐进式矩阵（Raven's Progressive Matrices）来测量认知表现（非言语智商），而社会经济特征则通过家长报告问卷来确定。使用测量体重和身高计算体重指数（BMI），而 BMI 年龄 Z 评分（BAZ）和身高年龄 Z 评分（HAZ）则使用世卫组织 2007 年生长标准来确定。
总体而言，约三分之一（35.0%）的儿童具有较高的非言语智商（高平均：110-119；优秀：≥120 及以上），而只有 12.2%的儿童被归类为低/边缘智商（<80）。与非肥胖和较高社会经济地位的儿童相比，严重肥胖（BAZ>3SD）、来自非常低收入家庭的儿童和父母只有小学学历的儿童，其低/边缘非言语智商的比例最高。父母缺乏教育与低/边缘/低于平均智商相关[父亲，OR=2.38（95%CI 1.22, 4.62）；母亲，OR=2.64（95%CI 1.32, 5.30）]。来自最低收入组的儿童有两倍的可能性出现低/边缘/低于平均智商[OR=2.01（95%CI 1.16, 3.49）]。严重肥胖的儿童出现非言语智商低下的可能性是正常 BMI 儿童的两倍[OR=2.28（95%CI 1.23, 4.24）]。
来自弱势群体（即来自非常低收入家庭和父母只有小学或以下学历的儿童）和严重肥胖的儿童更有可能出现非言语智商低下。进一步研究与认知表现相关的社会和环境因素将深入了解可以采取哪些措施来提高马来西亚儿童的认知表现。
