Related Experiment Video
Updated: Jun 12, 2025

Breakfast Habits among Schoolchildren in the City of Uruguaiana, Brazil
Published on: July 29, 2020
Behavioural Problems in Preadolescence: Does Nutritional Status Have a Role?
Bushra Khan1, Waqas Hameed2, Bilal Iqbal Avan3
1Department of Psychology, Faculty of Arts & Social Sciences, University of Karachi, Karachi, Pakistan.
Insights
Undernutrition in preadolescents, including being thin or stunted, significantly increases the risk of internalizing behavioral problems. Co-occurring malnutrition poses an even greater risk, highlighting the link between physical and mental health.
Area of Science:
- Child and Adolescent Health
- Public Health
- Mental Health
Background:
- Malnutrition is a global issue affecting children and adolescents, particularly in low- and middle-income countries.
- Behavioral problems are a growing concern in child and adolescent mental health.
- Few studies have examined the association between malnutrition and behavioral problems in preadolescence.
Purpose of the Study:
- To assess the epidemiological relationship between malnutrition and behavioral problems in preadolescence.
- To investigate the impact of different types of malnutrition on behavioral issues.
Main Methods:
- A school-based, cross-sectional survey was conducted in Karachi, Pakistan, involving 660 preadolescents aged 11–12 years.
- Data collected through sociodemographic questionnaires, the Youth Self-Report Form (YSR), and anthropometric assessments.
- The Youth Self-Report Form (YSR) is the child and adolescent reported version of the Child Behavior Checklist (CBCL).
Main Results:
- Thin and stunted preadolescents showed significantly higher odds of internalizing problems (AOR=2.05-2.09).
- Overnutrition was not associated with any behavioral issues.
- 40% of preadolescents exhibited at least one type of malnutrition, with 3% having co-occurring malnutrition (stunted and thin or overweight).
- Co-occurring malnutrition significantly increased the risk of internalizing problems (AOR=2.92), with a greater impact than single forms of malnutrition.
Conclusions:
- Undernutrition is prevalent and significantly associated with internalizing problems in preadolescents.
- This study is the first to report a significant association between co-occurring malnutrition and an increased risk of internalizing problems.
- Highlights the importance of the physical-mental health link and the need for holistic interventions for preadolescents.
Introduction:
Malnutrition in children and adolescents is a global issue particularly in low- and middle-income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence.
Methods:
A school based, cross-sectional survey was conducted in Karachi, Pakistan. Total 660, 11- to 12-year-old preadolescents were selected from a middle-class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self-Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol.
Results:
Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co-occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co-occurring malnutrition on the internalizing problems.
Conclusion:
Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co-occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues.
Related Concept Videos
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
Anorexia Nervosa
Symptoms and Physical Effects
Individuals with anorexia nervosa commonly exhibit extreme...
Bullying
Bulimia Nervosa
Nature and Nurture
Conduct Disorder

