A cross-sectional survey in rural Bihar, India, indicates that nutritional status, diet, and stimulation are associated with motor and mental development in young children

• Type of Material: Article
• Authors: Leila M. Larson, Emory University; Melissa Young, Emory University; Usha Ramakrishnan, Emory University; Amy Girard, Emory University; Pankaj Verma, CARE India; Indrajit Chaudhuri, CARE India; Sridhar Srikantiah, CARE India; Reynaldo Martorell, Emory University
• Language: English
• Date: 2017-08-01
• Publisher: OMICS International
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Society for Nutrition
• License: Creative Commons Attribution 3.0 IGO License
• Final Published Version (URL): http://dx.doi.org/10.3945/jn.117.251231
• Title of Journal or Parent Work: Journal of Nutrition and Food Sciences
• ISSN: 2155-9600
• Volume: 147
• Issue: 8
• Start Page: 1578
• End Page: 1585
• Grant/Funding Information: Supported by a Bill & Melinda Gates Foundation grant through a subcontract with CARE India.; LML received PhD funding from the Laney Graduate School, Emory University.
• Keywords: child development; Nutritional Status; Female; nutrition; Psychosocial Deprivation; Motor Skills; India; Feeding Behavior; Age Factors; dietary diversity; Surveys and Questionnaires; malnutrition; Infant; Male; mental; Humans; Infant Nutritional Physiological Phenomena; Social Environment; Cross-Sectional Studies; Child Development; motor; Diet
• Research Categories: Health Sciences, Public Health

Abstract

Background: Many malnourished children in resource-poor settings fail to fulfill their developmental potential. Objective: The objectives of this analysis were to examine the nutritional, psychosocial, environmental, and household correlates of child development in Bihar, India, and identify mediators between dietary diversity and mental development. Methods: Using 2-stage cluster randomized sampling, we surveyed 4360 households with children 6-18 mo of age in the West Champaran district of Bihar. We measured motor and mental development with the use of the Developmental Milestones Checklist II. In a random subsample (n = 2838), we measured anthropometric characteristics and hemoglobin. Cluster-adjusted multiple linear regression analysis was used to examine the associations between nutrition indicators and development scores. Sobel's test was used to assess significant mediators in the association between diet diversity and development scores. Analyses were stratified by children 6-11 and 12-18 mo of age. Results: In all children, length-for-age z score (LAZ), dietary diversity, and psychosocial stimulation were significant (P < 0.05) correlates of motor development scores [(β coefficient ± SE) in children 6-11 mo: LAZ = 0.46 ± 0.08, dietary diversity = 0.43±0.09, and stimulation = 0.15±0.04; in children 12-18 mo: LAZ = 0.73±0.07, dietary diversity = 0.30±0.09, and stimulation = 0.316 0.05] and mental development scores [(b coefficient6 SE) in children 6-11 mo: LAZ = 0.576 0.10, dietary diversity = 0.84±0.13, and stimulation = 0.54±0.07; in children 12-18 mo: LAZ = 0.54±0.11, dietary diversity = 0.40±0.16, and stimulation = 0.62±0.09] . Stimulation, gross motor development, and fine motor development were significant mediators in the relation between dietary diversity and mental development. Conclusion: Strategies to improve dietary diversity and psychosocial stimulation could have important implications for child development of young North Indian children.