Micronutrients and cognitive functions among urban school-going children and adolescents: A cross-sectional multicentric study from India

Abstract

Background Micronutrient deficiency (MD) is associated with deficits in cognitive functioning of children. However, no comprehensive multicentric study has been conducted in India to explore the role of multiple MD in cognition of children and adolescents. The present study aimed to explore association of MD with level of general intelligence and specific cognitive functions, in urban school-going children and adolescents across ten cities of India. Method Cross-sectional multicentric study, enrolled participants aged 6–16 years. Blood samples were collected for biochemical analysis of calcium, iron, zinc, selenium, folate, vitamin A, D and B12. Colored Progressive Matrices / Standard Progressive Matrices (CPM/SPM), Coding, Digit Span and Arithmetic tests were used for the assessment of cognitive functions of participants. Height and weight measures were collected along with socio-economic status. Results From April-2019 to February-2020, 2428 participants were recruited from 60 schools. No MD was found in 7.0% (134/1918), any one MD in 23.8% (457/1918) and ≥ 2 MD in 69.2% (1327/1918) participants. In presence of ≥ 2 MD, adjusted odds ratio (OR) for borderline or dull normal in CPM/SPM was 1.63, (95% CI: 1.05–2.52), coding was 1.66 (95% CI: 1.02–2.71), digit span was 1.55 (95% CI: 1.06–2.25) and arithmetic was 1.72 (95% CI: 1.17–2.53), controlling for gender, socioeconomic status and anthropometric indicators. Conclusion Since ≥ 2 MD were found in more than 2/3rd of participants and was associated with impairment in cognitive function, attempts must be made to ameliorate them on priority in school going children in India. Trial registration number CTRI/2019/02/017783.

Nutritional status, dietary habits, and their relation to cognitive functions: A cross-sectional study among the school aged (8–14 years) children of Bangladesh

“…Fat, protein, vitamin A, thiamine, riboflavin, niacin, folic acid, vitamin B12, vitamin C, and iodine are essential for children’s growth and development, specifically, the calcium intake for children between the age of 10 to 14 is significant due to their rapid growth [ 9 , 10 ]. Micronutrient deficiencies, including iron, vitamin B12, folate, zinc, and vitamin D, are significantly associated with poor cognitive functions [ 11 ]. However, an estimated 25–27% of adolescents in Bangladesh are anaemic (Hb 12 g/dL), and 30% of 14–18-year-olds are iron-deficient (15%); as many as half of all school aged children (47–54%) do not have sufficient vitamin A [ 12 ].…”

The Hidden Hunger among Nepalese Non-pregnant Women Aged 15–49 Years: The Role of Individual, Household, Community-Level Factors

“…Nutritional iron deficiency has been found to affect all populations across the globe and has been found to be most common in developing countries [10,11]; and this has substantial health and economic costs, which may include poor pregnancy outcomes, impaired academic performance among school children and a decrease in productivity [9]. Zinc plays a key role in the catalytic activity of about 100 enzymes [12], and is also vital in immune function [13][14][15], synthesis of protein [14], wound healing [16], and supports normal pregnancy growth and development, as well as normal growth during childhood and adolescence [17]. Additionally, a zinc shortage has been linked to impaired cognition and behaviour [15].…”

“…Zinc plays a key role in the catalytic activity of about 100 enzymes [12], and is also vital in immune function [13][14][15], synthesis of protein [14], wound healing [16], and supports normal pregnancy growth and development, as well as normal growth during childhood and adolescence [17]. Additionally, a zinc shortage has been linked to impaired cognition and behaviour [15]. Deficiency in zinc is characterised by loss of appetite, hair loss, diarrhoea, delayed sexual maturation, impotence in males, as well as eye and skin lesions [18,19].…”

Association of dietary intake with micronutrient deficiency in Indian school children: a cross-sectional study

“…Deficiency of two or more micronutrients is significantly associated with decreased cognitive performance. ( 2 ) Review of the literature suggests that deficiencies of iron, folate, and vitamin B12 can lead to anaemia, which further leads to delayed cognitive and motor development, low intelligent quotient, difficulties in functioning of work, education and community engagement. ( 3 , 4 ) Folate deficiency is also reported to be associated with loss of concentration.…”