The State of the World's Children 1998: Focus on Nutrition

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Panel 3

Stunting linked to impaired intellectual development

Photo: Nearly 40 per cent of all children under five in the world are stunted due to malnutrition. Many of them will also face challenges in school as a result. Here, a contrast in stature is apparent between two girls the same age in Bangladesh..

Malnutrition early in life is linked to deficits in children's intellectual development that persist in spite of schooling and impair their learning ability, according to a recent study in the Phil ippines. The study analysed stunting - which is low height for age and a basic indicator of malnutrition - among more than 2,000 children living in metropolitan Cebu, the Phil ippines' second largest city. Nearly two thirds of the children studied were stunted. Those stunted earliest in life, before six months of age, were the most severely stunted by age two, the study found. The same children scored significantly lower on intelligence tests at 8 and 11 years of age than children who were not stunted.

The study holds profound implications on a global level: 226 million children under age five in developing countries, nearly 40 per cent of this age group, suffer from moderate or severe stunting. "High levels of stunt ing among children suggest that there will also be long-term deficits in men tal and physical development that can leave children ill-prepared to take maximum advantage of learning opportunities in school. This can also have consequences for children's suc cess later in life," says Linda S. Adair, Ph.D., Associate Professor of Nu trition at the University of North Carolina, in Chapel Hill (US), one of the researchers.

"Stunting does not directly cause poor intellectual development in children," emphasizes Professor Adair. "Rather, the same underlying factors that cause stunting are also likely to impair children's intellectual growth." Among children in Cebu, the causes include low birthweight, insufficient breastfeeding, nutritionally inadequate food given to complement or replace breastmilk, and frequent diarrhoea and respiratory infections. Stunted children tend to enter school later and miss more days of school than well-nourished children, the study also found.

The study, part of a collaborative research programme of the Office of Population Studies at the University of San Carlos in Cebu and the Uni versity of North Carolina, found that 28 per cent of the children surveyed were severely stunted. At age two, these children were nearly 11 centimeters (5 inches) shorter than children who were not stunted. The IQ scores of the severely stunted children at eight years of age were 11 points lower than those of the children who were not stunted.

When the children in the study were tested again at age 11, those who had been most severely stunted at age 2 still scored lower on the intelligence test than children who had not been stunted, although the gap was narrower at about 5 IQ points. Children who were severely stunted also had significantly lower scores on language and math achievement tests.

Most of the children in the study were from poor families, and their diets, and those of their mothers, were below the nutritional levels recom mended by the Philippine Gov ern ment. They came from densely populated, poor urban communities, from newly settled areas on the outskirts of the city and from rural communities.

This study underscores the importance and lasting impact of nutrition in the crucial months of infancy and beginning before birth with sound maternal nutrition. Infants denied a strong start in life face problems in making up the lost ground, and the impact on their own development and that of their societies can be a lasting one.

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