The relationship between undernutrition, activity levels and development in young children

ABSTRACT

We examine the evidence that, in undernourished children, low levels of exploration and activity lead to poor development. In one study, children in the acute stage of severe undernutrition had reduced activity and exploration levels which readily improved with nutritional rehabilitation. Their developmental levels (i.e., developmental quotients = DQs) were low and remained so for several years. No association was found between activity and exploration levels and DQs. Mildly to moderately undernourished children generally have low DQs. In both severely and moderately undernourished children, DQs and school achievement levels are more often associated with height-for-age than weight-for-height. In two studies in clinical settings, when energy intake was reduced, children's activity levels or energy expenditure were also reduced. There is only limited evidence of reduced activity and exploration from studies of young undernourished children in their own homes. Undernourished school children were studied only once, and no evidence of reduced energy expenditure was found. DQs and activity have not been examined together often. In one Asian study low exploration and DQs were found in undernourished children. In three studies of nutritional supplementation some evidence of increased activity and exploration and of improved development was found. However, there were problems in study design in two of them. No evidence was found linking low activity to poor development in a causal relationship. We present preliminary findings from a Jamaican study of nutritional supplementation in 129 stunted children aged, 9-24 months. They were compared with 32 non-stunted children from the same neighborhoods. The stunted group had lower scores on every subscale of the Griffiths Mental Development Scale. Using time-motion observation methods, they were also found to be less active than the non-stunted group. However, the stunted children had higher energy intakes per kilogram body weight. Activity levels were related to the children's locomotor quotients. When we controlled for locomotor quotients, no group differences remained (AU)