Jessica A Omand1, Magdalena Janus2, Jonathon L Maguire3,4,5,6,7,8, Patricia C Parkin1,4,5,7,8, Janis Randall Simpson9, Charles Dg Keown-Stoneman10,11, Mary Aglipay11, Catherine S Birken1,4,5,7,8. 1. Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 555 University Ave, Toronto, ON M5G 1X8, Canada. 2. Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, Faculty of Health Sciences, Hamilton, ON, Canada. 3. The Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada. 4. Division of Pediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada. 5. Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada. 6. Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada. 7. Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 8. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada. 9. Applied Human Nutrition, University of Guelph, Guelph, ON, Canada. 10. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 11. Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
Abstract
OBJECTIVE: To determine if nutritional risk in early childhood is associated with parent-reported school concerns. DESIGN: A prospective cohort study conducted through the TARGet Kids! primary care research network (2011-2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4-10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. SETTING: Toronto, Canada. PARTICIPANTS: Children aged 18 months to 10 years. RESULTS: The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). CONCLUSIONS: Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes.
OBJECTIVE: To determine if nutritional risk in early childhood is associated with parent-reported school concerns. DESIGN: A prospective cohort study conducted through the TARGet Kids! primary care research network (2011-2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4-10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. SETTING: Toronto, Canada. PARTICIPANTS: Children aged 18 months to 10 years. RESULTS: The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). CONCLUSIONS: Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes.