Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children

Bee Koon Poh, Shoo Thien Lee, Giin Shang Yeo, Kean Choon Tang, Ab Rahim Noor Afifah, Awal Siti Hanisa, Panam Parikh, Jyh Eiin Wong, Alvin Lai Oon Ng, Norimah A. Karim, Ruzita Abd. Talib, Siti Balkis Budin, Mohd Din Siti Haslinda, Mohd Noor Ismail, A. Rahman A. Jamal, Nor Azmi Kamaruddin, Nik Shanita Safii, Yit Siew Chin, Bee Suan Wee, Nor Aini Jamil @ A. Wahab

Research output: Contribution to journalArticle

Abstract

Background: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Methods: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Results: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. Conclusions: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

Original languageEnglish
Article number541
JournalBMC Public Health
Volume19
DOIs
Publication statusPublished - 13 Jun 2019

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Morbid Obesity
Social Class
Intelligence
Body Mass Index
Nutritional Status
Education
Parents
Crows
Nutrition Surveys
Vulnerable Populations
Mothers
Weights and Measures

Keywords

  • Child
  • Cognition
  • Economic status
  • Intelligence
  • Malaysia
  • Nutritional status
  • Obesity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children. / Poh, Bee Koon; Lee, Shoo Thien; Yeo, Giin Shang; Tang, Kean Choon; Noor Afifah, Ab Rahim; Siti Hanisa, Awal; Parikh, Panam; Wong, Jyh Eiin; Ng, Alvin Lai Oon; A. Karim, Norimah; Abd. Talib, Ruzita; Budin, Siti Balkis; Siti Haslinda, Mohd Din; Ismail, Mohd Noor; A. Jamal, A. Rahman; Kamaruddin, Nor Azmi; Safii, Nik Shanita; Chin, Yit Siew; Wee, Bee Suan; Jamil @ A. Wahab, Nor Aini.

In: BMC Public Health, Vol. 19, 541, 13.06.2019.

Research output: Contribution to journalArticle

Poh, Bee Koon ; Lee, Shoo Thien ; Yeo, Giin Shang ; Tang, Kean Choon ; Noor Afifah, Ab Rahim ; Siti Hanisa, Awal ; Parikh, Panam ; Wong, Jyh Eiin ; Ng, Alvin Lai Oon ; A. Karim, Norimah ; Abd. Talib, Ruzita ; Budin, Siti Balkis ; Siti Haslinda, Mohd Din ; Ismail, Mohd Noor ; A. Jamal, A. Rahman ; Kamaruddin, Nor Azmi ; Safii, Nik Shanita ; Chin, Yit Siew ; Wee, Bee Suan ; Jamil @ A. Wahab, Nor Aini. / Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children. In: BMC Public Health. 2019 ; Vol. 19.
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abstract = "Background: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Methods: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Results: Overall, about a third (35.0{\%}) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2{\%} were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95{\%}CI 1.22, 4.62); maternal, OR = 2.64 (95{\%}CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95{\%}CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95{\%}CI 1.23, 4.24)]. Conclusions: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.",
keywords = "Child, Cognition, Economic status, Intelligence, Malaysia, Nutritional status, Obesity",
author = "Poh, {Bee Koon} and Lee, {Shoo Thien} and Yeo, {Giin Shang} and Tang, {Kean Choon} and {Noor Afifah}, {Ab Rahim} and {Siti Hanisa}, Awal and Panam Parikh and Wong, {Jyh Eiin} and Ng, {Alvin Lai Oon} and {A. Karim}, Norimah and {Abd. Talib}, Ruzita and Budin, {Siti Balkis} and {Siti Haslinda}, {Mohd Din} and Ismail, {Mohd Noor} and {A. Jamal}, {A. Rahman} and Kamaruddin, {Nor Azmi} and Safii, {Nik Shanita} and Chin, {Yit Siew} and Wee, {Bee Suan} and {Jamil @ A. Wahab}, {Nor Aini}",
year = "2019",
month = "6",
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TY - JOUR

T1 - Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children

AU - Poh, Bee Koon

AU - Lee, Shoo Thien

AU - Yeo, Giin Shang

AU - Tang, Kean Choon

AU - Noor Afifah, Ab Rahim

AU - Siti Hanisa, Awal

AU - Parikh, Panam

AU - Wong, Jyh Eiin

AU - Ng, Alvin Lai Oon

AU - A. Karim, Norimah

AU - Abd. Talib, Ruzita

AU - Budin, Siti Balkis

AU - Siti Haslinda, Mohd Din

AU - Ismail, Mohd Noor

AU - A. Jamal, A. Rahman

AU - Kamaruddin, Nor Azmi

AU - Safii, Nik Shanita

AU - Chin, Yit Siew

AU - Wee, Bee Suan

AU - Jamil @ A. Wahab, Nor Aini

PY - 2019/6/13

Y1 - 2019/6/13

N2 - Background: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Methods: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Results: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. Conclusions: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

AB - Background: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Methods: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Results: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. Conclusions: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

KW - Child

KW - Cognition

KW - Economic status

KW - Intelligence

KW - Malaysia

KW - Nutritional status

KW - Obesity

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U2 - 10.1186/s12889-019-6856-4

DO - 10.1186/s12889-019-6856-4

M3 - Article

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

M1 - 541

ER -