Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.
Poverty, Health and Nutrition Division, International Food Policy Research Institute, New Delhi, India.
Am J Clin Nutr. 2022 Jun 7;115(6):1549-1558. doi: 10.1093/ajcn/nqac028.
Anemia and poor physical growth during adolescence have far-ranging consequences, but limited longitudinal evidence exists on how changes in these factors relate to changes in learning skills as adolescents mature.
We examined the association between changes in anemia and physical growth during adolescence and learning outcomes.
We used longitudinal data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) project, which surveyed adolescents aged 10-19 y in northern India in 2015-2016 and 2018-2019 (n = 5963). We used multilevel mixed-effects logistic regression models to examine associations between changes in anemia/thinness/stunting status (4 groups: never, improved, new, and persistent) and reading (ability to read a story) and math proficiency (ability to solve division problems) at follow-up.
Persistent anemia and stunting were higher among girls than among boys (46% compared with 8% and 37% compared with 14%, respectively), but persistent thinness was lower (7% compared with 16%). Improvement in anemia, thinness, and stunting was 1.4-1.7 times higher among boys than among girls. Boys who were anemic in both waves were 74% [adjusted odds ratio (AOR): 0.26; 95% CI: 0.12, 0.59] and 65% (AOR: 0.35; 95% CI: 0.16, 0.76) less likely to be able to read a story and solve division problems, respectively, than boys who were nonanemic in both waves. Persistent thinness in boys was negatively associated with both reading (AOR: 0.37; 95% CI: 0.21, 0.66) and math proficiency (AOR: 0.27; 95% CI: 0.16, 0.46). Persistent stunting contributed to lower reading and math proficiency in boys and girls (AORs: 0.29-0.46). Boys whose anemia or thinness status improved and girls whose stunting status improved had similar learning skills at follow-up as those who were never anemic/thin/stunted.
Persistent anemia, thinness, and short stature during adolescence were associated with poor learning. Programs targeted at adolescents should contribute to nurturing environments that foster healthy growth and learning.
青少年时期的贫血和身体发育不良会产生深远的影响，但关于这些因素的变化如何与青少年成熟过程中学习技能的变化相关的纵向证据有限。
我们研究了青少年时期贫血和身体生长变化与学习成果之间的关系。
我们使用了来自印度北部青少年和年轻人生活研究（UDAYA）项目的纵向数据，该项目于 2015-2016 年和 2018-2019 年期间对 10-19 岁的青少年进行了调查（n=5963）。我们使用多层次混合效应逻辑回归模型，研究了在随访时，贫血/消瘦/发育迟缓状况（从未、改善、新发和持续）变化与阅读（阅读故事的能力）和数学能力（解决除法问题的能力）之间的关联。
持续性贫血和发育迟缓在女孩中比在男孩中更为常见（分别为 46%和 8%，37%和 14%），但消瘦在女孩中较低（7%和 16%）。男孩的贫血、消瘦和发育迟缓的改善率分别比女孩高 1.4-1.7 倍。在两次检测中都贫血的男孩，阅读故事和解决除法问题的能力分别比两次检测都不贫血的男孩低 74%（调整后的优势比（AOR）：0.26；95%置信区间（CI）：0.12，0.59）和 65%（AOR：0.35；95%CI：0.16，0.76）。男孩的持续性消瘦与阅读（AOR：0.37；95%CI：0.21，0.66）和数学能力（AOR：0.27；95%CI：0.16，0.46）均呈负相关。男孩的持续性发育迟缓导致阅读和数学能力降低（AOR：0.29-0.46）。男孩中贫血或消瘦状况改善，女孩中发育迟缓状况改善的，其学习技能与从未贫血/消瘦/发育迟缓的相似。
青少年时期的持续性贫血、消瘦和身材矮小与学习成绩差有关。针对青少年的项目应有助于营造促进健康成长和学习的环境。
