Post-infancy growth, schooling, and cognitive achievement: Young Lives

Summary of research paper: Crookston, B.G. et al. American Journal of Clinical Nutrition. 2013 Sep; 1-9

Early life growth failure and resulting cognitive deficits are often assumed to be very difficult to reverse after infancy. The objective of this study was to use data from ‘Young Lives’, an observational cohort of 8062 children in Ethiopia, India, Peru and Vietnam, to determine whether changes in growth after infancy were associated with schooling and cognitive achievement at age 8 years. Height-for-age z-score (HAZ) was measured at 1 year and 8 years. Results showed that stunting at 1 year (Height-for-Age Z score <-2.0) was associated with being older than normal for school grade/year and lower scores in mathematics, reading comprehension and vocabulary. Lower than expected growth from 1 to 8 years of age was also associated with being older than normal for school grade/year and lower scores in mathematics, reading comprehension and vocabulary. Children who recovered from stunting had better outcomes than children who remained persistently stunted, whereas children who became stunted tended to perform worse than children who were never stunted. The study authors conclude that improvements in child growth after early faltering might have significant benefits on schooling and cognitive achievement. Hence, although early interventions remain critical, interventions to improve the nutrition of pre-primary and early primary school–age children are also important.