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Long-term effects of early kwashiorkor compared with marasmus. II. Intellectual performance
J R Galler1, F C Ramsey, V Forde
1Center for Behavioral Development, Boston University School of Medicine, MA 02118.
Insights
Children with a history of kwashiorkor or marasmus malnutrition in infancy showed significantly lower intellectual performance, including IQ and conservation skills, compared to healthy peers. These effects persisted even when controlling for current environmental factors.
Area of Science:
- Pediatric Nutrition
- Developmental Psychology
- Public Health
Background:
- Early childhood malnutrition, specifically kwashiorkor and marasmus, can have long-term impacts on child development.
- Understanding the lasting effects of severe malnutrition on cognitive functions is crucial for intervention strategies.
Purpose of the Study:
- To assess the long-term intellectual performance of children who experienced kwashiorkor or marasmus in infancy.
- To compare cognitive outcomes between previously malnourished children and healthy controls.
Main Methods:
- A follow-up study involving Barbadian children aged 11-18 years.
- Assessment of intellectual performance using the Wechsler Intelligence Scale for Children-Revised (WISC-R) and conservation tasks.
- Comparison between children with histories of kwashiorkor/marasmus and matched healthy controls.
Main Results:
- Children with a history of kwashiorkor or marasmus scored significantly lower on both IQ and conservation tests compared to healthy children.
- The cognitive deficits were observed despite similar current environmental conditions between the malnourished and control groups.
- Early malnutrition's impact remained significant even after controlling for current environmental factors.
Conclusions:
- Early severe malnutrition (kwashiorkor, marasmus) has a lasting negative effect on intellectual performance in children.
- Cognitive deficits associated with early malnutrition persist into later childhood and adolescence.
- Interventions addressing early malnutrition are critical for long-term cognitive development, independent of current socioeconomic status.
Abstract:
Intellectual performance including IQ (Wechsler Intelligence Scale for Children-Revised) and conservation was measured at ages 11-18 years in a follow-up study of Barbadian girls and boys who had histories of kwashiorkor (n = 53) or marasmus (n = 55) in their first year of life. They were compared with healthy neighborhood children matched by sex and age who had normal patterns of growth in early childhood (n = 58). On both IQ and conservation tests, children with previous kwashiorkor or marasmus had similar scores, which were significantly lower than scores of healthy comparison children. These findings were examined in relationship to current environmental conditions, which were similar in children with histories of kwashiorkor or marasmus and somewhat less advantaged than those of the comparison children. The effect of early malnutrition and related conditions at the time of episode still emerged as significant even when the current environmental factors were controlled for.