Department of Child Health, Faculty of Medicine, Universitas Airlangga, Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Paediatrics, Faculty of Medicine, University Malaya, 59100 Kuala Lumpur, Malaysia.
Nutr Res Rev. 2022 Jun;35(1):136-149. doi: 10.1017/S0954422421000159. Epub 2021 Jun 8.
The negative impact of stunting and severe underweight on cognitive neurodevelopment of children is well documented; however, the effect of overweight/obesity is still unclear. The 2018 Global Nutrition Report reported that stunting and overweight concurrently affect 189 million children worldwide. As existing reviews discuss undernutrition and overweight/obesity separately, this scoping review aims to document the impact of mild/moderate and severe underweight, stunting, and overweight/obesity among children aged 0-60 months on their cognitive neurodevelopmental trajectories. Twenty-six articles were analysed to extract significant information from literature retrieved from PubMed and Cochrane databases published from 1 January 2009 to 31 October 2019. Length gain is associated with cognitive neurodevelopment in normo-nourished and stunted children aged under 24 months. Among stunted children, it seems that cognitive and neurodevelopmental deficits can potentially be recovered before 8 years of age, particularly in those whose nutritional status has improved. The impact of overweight/obesity on cognitive neurodevelopment appears to be limited to attention, gross motor skills and executive control. Parental education level, birth weight/length, breastfeeding duration, and sanitation level are some identifiable factors that modify the impact of undernutrition and overweight/obesity on cognitive and neurodevelopment. In conclusion, underweight, stunting and overweight/obesity have a significant impact on cognitive neurodevelopment. Multidimensional approaches with various stakeholders should address all issues simultaneously, such as improving sanitation levels, assuring parental job security and adequate social welfare, and providing access to adequate nutrients for catch-up growth among underweight or stunted children and to affordable healthy foods for those who are overweight/obese and from low socio-economic status.
发育迟缓与严重体重不足对儿童认知神经发育的负面影响已有充分记录；然而，超重/肥胖的影响仍不清楚。2018 年全球营养报告显示，发育迟缓与超重/肥胖同时影响全球 1.89 亿儿童。由于现有的综述分别讨论了营养不良和超重/肥胖，因此本范围综述旨在记录 0-60 个月儿童的轻度/中度和重度体重不足、发育迟缓以及超重/肥胖对其认知神经发育轨迹的影响。分析了 26 篇文章，以从 2009 年 1 月 1 日至 2019 年 10 月 31 日发表的 PubMed 和 Cochrane 数据库的文献中提取重要信息。在营养良好和 24 个月以下的发育迟缓儿童中，身高增长与认知神经发育有关。在发育迟缓儿童中，认知和神经发育缺陷似乎可以在 8 岁之前得到恢复，特别是那些营养状况得到改善的儿童。超重/肥胖对认知神经发育的影响似乎仅限于注意力、粗大运动技能和执行控制。父母的教育水平、出生体重/长度、母乳喂养持续时间和卫生水平是一些可识别的因素，这些因素会改变营养不良和超重/肥胖对认知和神经发育的影响。总之，体重不足、发育迟缓与超重/肥胖对认知神经发育有重大影响。多方面的方法需要各种利益攸关方共同解决所有问题，例如提高卫生水平、确保父母有稳定的工作和足够的社会福利，并为体重不足或发育迟缓的儿童提供充足的营养以促进追赶生长，为超重/肥胖且来自低社会经济地位的儿童提供负担得起的健康食品。
