Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
J Nutr. 2021 Dec 3;151(12):3811-3819. doi: 10.1093/jn/nxab307.
Nutrition in early childhood is important for healthy growth and development. Achieving school readiness is considered one of the most important developmental milestones for young children.
The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten.
A prospective cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) primary care research network in Toronto, Canada, 2015-2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4-6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders.
The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P < 0.001). NutriSTEP total score and high nutritional risk were associated with lower scores on all 5 EDI domains, with the strongest association observed for the domains of language and cognitive development and communication skills and general knowledge.
Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered www.clinicaltrials.gov as NCT01869530.
儿童早期的营养对于健康成长和发育很重要。实现入学准备被认为是幼儿最重要的发展里程碑之一。
本研究旨在确定儿童早期的营养风险是否与幼儿园的入学准备相关。
2015 年至 2020 年，在加拿大多伦多的应用儿童研究组（TARGet Kids！）初级保健研究网络中进行了一项前瞻性队列研究。使用经过验证的父母完成的问卷（称为幼儿和学龄前儿童营养筛查（NutriSTEP））来衡量营养风险（18 个月至 5 岁）。高营养风险被归类为得分≥21。入学准备使用经过验证的教师完成的早期发展工具（EDI）进行衡量，该工具在幼儿园（2 年的学习，4-6 岁，在进入 1 年级之前）中测量 5 个发展领域。脆弱性表示在至少 1 个领域中，得分低于基于人口的第 10 个百分位数的分数。进行了多变量逻辑回归和线性回归模型，以调整相关混杂因素。
该研究纳入了 896 名儿童：53%为男性，9%存在高营养风险，17%在 EDI 上存在脆弱性。在幼儿园第二年的儿童中，NutriSTEP 总分每增加 1 个标准差，在 EDI 上易受影响的可能性就增加 1.54 倍（P=0.001）。高营养风险截止值与幼儿园第二年儿童在 EDI 上易受影响的可能性增加 4.28 倍相关（P<0.001）。NutriSTEP 总分和高营养风险与所有 5 个 EDI 领域的分数较低相关，在语言和认知发展以及沟通技巧和一般知识领域观察到最强的关联。
儿童早期的营养风险较高与幼儿园第二年的入学准备较差相关。生命早期的营养干预可能为提高入学准备提供机会。该试验在 www.clinicaltrials.gov 上注册为 NCT01869530。
