Prevalence of underweight, wasting and stunting among young children with a significant cognitive delay in 47 low-income and middle-income countries.
Preschoolers with big cognitive delays in low-income countries face twice the undernutrition risk, so screen and refer for food help.
01Research in Context
What this study did
Granieri et al. (2020) looked at nutrition in preschoolers with big cognitive delays.
They used cross-sectional surveys in 47 low- and middle-income countries.
The team compared underweight, wasting, and stunting rates to same-age peers.
What they found
Kids with significant cognitive delay were twice as likely to be severely undernourished.
Household wealth, not the delay itself, was the strongest predictor of poor nutrition.
How this fits with other research
Karpur et al. (2021) saw the same 2× risk in U.S. families of children with ASD plus ID, but measured food insecurity instead of underweight.
Barak-Levy et al. (2015) and Marí-Bauset et al. (2015) also found poorer nutrition in preschoolers with ASD, yet their samples showed higher BMI, not underweight—an apparent contradiction explained by different settings and diagnoses.
Emerson et al. (2010) foreshadowed the wealth link: in a UK cohort, low income drove most of the extra stress in parents of toddlers with early delay.
Why it matters
If you serve preschoolers with developmental delay, add a quick nutrition screen at intake. Ask about skipped meals, weight loss, and access to food. A simple referral to WIC, SNAP, or a feeding clinic can cut the doubled undernutrition risk these families face.
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02At a glance
03Original abstract
BACKGROUND: Undernutrition in early childhood is associated with a range of negative outcomes across the lifespan. Little is known about the prevalence of exposure to undernutrition among young children with significant cognitive delay. METHOD: Secondary analysis of data collected on 161 188 three- and four-year-old children in 47 low-income and middle-income countries in Rounds 4-6 of UNICEF's Multiple Indicator Cluster Surveys. Of these, 12.3% (95% confidence interval 11.8-12.8%) showed evidence of significant cognitive delay. RESULTS: In both middle-income and low-income countries, significant cognitive delay was associated with an increased prevalence of exposure to three indicators of undernutrition (underweight, wasting and stunting). Overall, children with significant cognitive delay were more than twice as likely than their peers to be exposed to severe underweight, severe wasting and severe stunting. Among children with significant cognitive delay (and after controlling for country economic classification group), relative household wealth was the strongest and most consistent predictor of exposure to undernutrition. CONCLUSIONS: Given that undernutrition in early childhood is associated with a range of negative outcomes in later life, it is possible that undernutrition in early childhood may play an important role in accounting for health inequalities and inequities experienced by people with significant cognitive delay in low-income and middle-income countries.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12698