Impaired IQ and academic skills in adults who experienced moderate to severe infantile malnutrition: A 40-year study

Abstract

Objectives To evaluate IQ and academic skills in adults who experienced an episode of moderate to severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. Methods IQ and academic skills were assessed in 77 previously malnourished adults (mean age=38.4 years; 53% male) and 59 controls (mean age=38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. Results The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (p<0.0001). IQ scores in the Intellectual Disability range (< 70) were 9 times more prevalent in the previously malnourished group (OR=9.18; 95% CI=3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Discussion Moderate to severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity.

DNA Methylation Signatures of Early Childhood Malnutrition Associated With Impairments in Attention and Cognition

“…Malnutrition in the first year of life causes long-term impairments in cognition and, independent of the lower IQ, attention deficits (primarily inattention), lasting into adulthood(2, 23). Given the strong link between childhood malnutrition and adult attention-deficit hyperactivity disorder (ADHD)(23), together with the cognitive deficits and lower IQ(2), we then asked whether such neuropsychiatric sequels are associated with specific DNA methylation signatures.…”

“…The research design and sample recruitment for the Barbados Nutrition Study have been described elsewhere(2, 4, 10). Epigenetic data were collected in the original cohort and their offspring between 2012 and 2014, when the G1 participants were in their fifth decade of life and their offspring were young adults (Figure 1).…”

“…This includes a poorly understood long-lasting vulnerability to psychiatric disease, with increased risk for attention deficits, personality disorders and impaired cognition, even decades after exposure(2–4). The underlying mechanisms remain poorly understood.…”

“…Our population is unique, because it has been monitored and examined for 48 years, in the context of the Barbados Nutrition Study (BNS). The study, launched in 1967, provided critical insight into the longitudinal course of malnutrition-related neuropsychological functioning and vulnerability to psychiatric and medical disease 2–4 . Here, we provide multiple evidence that infant malnutrition triggers long-lasting DNA methylation changes associated with liability for defective attention and cognition in adult life.…”

Neuropsychological outcomes at midlife following moderate to severe malnutrition in infancy.

“…Finally, although group differences in IQ in the Barbados sample are relatively stable over time (Waber, et al, 2013), the observed profiles are not necessarily direct sequelae of brain alterations associated with the episode of malnutrition. They may also reflect the developmental interactions of the neurologically compromised child with the physical and social environment, and in particular with an impoverished environment (Gottlieb & Halpern, 2002; Wachs, 2009).…”