Malnutrition, Maleducation
A balanced diet provides children with the energy and nutrients they need to maintain a healthy lifestyle. Therefore, when that diet fails to meet the necessary ingredients to sustain a strong and active life, the child suffers. Malnutrition refers to both underweight and overweight as well as the categories that these two types have. I will be incorporating all types of malnutrition, and focussing in on it’s specific effects on cognitive development during adolescence. The key to understanding malnourishment and its effect on academic performance is to know when a child is most vulnerable to malnourishment, the correlation between nutrition and school, and its long-term effects.
From the mid-1900s, knowledge has accumulated about the way that malnutrition, under different circumstances and during different phases of development, has influenced the central nervous system in animals. We have come to understand that not all children undergo malnutrition during the same times or for the same reasons. It is significant to note that nutrition specifically plays a vital role in the initial development of the brain. In fact, nutrition is possibly the single environmental variable that can have the widest range of effects on brain development (Isaacs 1). However, we also need to consider that many other environmental factors such as level of parental education, socioeconomic status, and maternal attachment play significant roles in neural development as well.
Children of all ages can be malnourished, but they are most vulnerable during their early childhood. In other words, the CNS is most vulnerable to environmental influence, such as nutrition, when it is in a state of change and plasticity is at its greatest; in the case of the human infant, this period of rapid growth and development, known as the “brain spurt,” extends from the beginning of the third trimester of pregnancy until ~2 years of age (Nyaradi 8). The brain is particularly vulnerable to the influences of nutrition between 24 and 42 weeks of gestatioN, and ,during these weeks and beyond, plenty of things can happen (Isaacs 1).
Malnutrition can also develop in the utero, when the mother is malnourished. Specific studies have been done in low income countries to examine the variety of difficulties that arise from the unhealthy habits of mothers. Examinations have concluded that intrauterine growth retardation (IUGR) or small-for-gestational age (SGA) at birth is associated with cognitive developmental delays and a decrease of 4–8 points in IQ scores compared to infants with a birth weight that is appropriate-for-gestational-age (Nyaradi 9). We see many of these studies are executed in developing countries, but using different methods to conclude the effects of malnutrition.
One important tool called neuroimaging is a fascinating way to measure the effects of dietary intake. Neuroimaging was invented in the late 1800’s, but was not used to determine effects of nutrition during early life until thirty years ago. Since then, researchers have been able to perform many trials, using different methods of neuroimaging, to prove the correlation between nutrition and cognitive development. The most frequently used supplement in these trials has probably been LCPUFAs and systematic reviews of studies in both term (Simmer et al., 2011) and preterm infants (Schulzke et al., 2011) have recently appeared. Breastfeeding has also generated a lot of interest with regards to nutrition. Carried out pioneering studies with random assignments to either high or low nutrient diets in terms of protein/calorie content in preterm infants describe protein as the most critical component of dietary intake for the development of neurological function. These RCTs marked a shift in the context of early nutrition research to include studies set in developed, industrialized societies consuming a typical Western diet where lack of calories is not often a problem (Isaacs 3).
The common expression “ breakfast is the most important meal of the day”, is more than just an expression. Children are also likely to become vulnerable to malnutrition when they skip breakfast. The theories for this are quite complex, however, and are hard to prove. It is difficult conduct studies of schools when they come from different economic, cultural, and ethnic areas. There are reports that show that when breakfast is provided in the same school, students perform better.
For example, a controlled trial of giving breakfast to Jamaican primary school children was recently conducted. A total of 16 primary schools were chosen out of a possible 21; of the remaining schools, 3 were too small and the principles of the other 2 schools did not wish to participate. All children in grades 2–5 were weighed and their dates of births were collected from school records. Four hundred seven children whose weights-for- age on screening were ≤ 1 SD of the National Center for Health Statistics (NCHS) references (15) were selected as the under- nourished group (Powell 874). The students were given a questionnaire to gather their socioeconomic status, the amount of money they brought to school, and what breakfast they had the day of the interview as well as other background questions.
All subjects were tested, measured, and interviewed at the start of the 1994 academic year. The breakfast consisted of a cheese sandwich or spiced bun and cheese and flavored milk and supplied 2419–2953 kJ (576–703 kcal) and 27.1 g protein. The control group was given one-quarter of an orange, which served as a proxy for a placebo and supplied 76 kJ (18 kcal) and 0.4 g protein. The conclusion of the experiment stated that the adequately nourished children were significantly better than the undernourished group in all measures of nutritional status. The mean BMIs of the adequately nourished children were similar to the 50th percentile values for black American children, whereas those of the undernourished approached the 15th percentile (Powell 875).
Not only did the nourished group excel in the beginning, but they developed long-term habits. They had increase in attendance, nutritional status, arithmetic skills, and gained an average of .25 cm during the 8 mo of exploration which kept increasing through older grades (Powell 876). This is not the only observation done that explains the long term effects.
Studies done during early life generally show that those suffering from malnutrition had poorer IQ levels, cognitive function, school achievement, and greater behavior problems (Dewey and Prado 274). Specifically, a recent study in Barbados showed that adults who had suffered from an episode of moderate to severe malnutrition in the first year of life showed more attention problems and lower social status and standard of living than matched controls, even after 37–43 years (Dewey and Prado 275). It is responsible for the highest mortality rate in children and has long-lasting physiologic effects, including an increased susceptibility to fat accumulation mostly in the central region of the body, lower fat oxidation, lower resting and postprandial energy expenditure, insulin resistance in adulthood, hypertension, dyslipidemia and a reduced capacity for manual work, among other impairments (Martins 1). Some of these effects can even pass onto the next generation.