Malnutrition in early childhood is linked to deficits in the cognitive development of children. Stunting in children delays school enrolment and is found to be associated with grade repetition and a higher dropout in primary school children. Children who suffered from early malnutrition were also found to have greater behavioural problems. Deficiency of micronutrients such as iron, iodine and zinc is associated with a lower attention span, poor memory, mental retardation and poor school achievement. Continuous low nutritional intake combined with poor access to healthcare is likely to impact on children’s psychological development in terms of attentiveness, emotional expression, motivation, learning ability and school performance. Nutrition is interconnected with the environment, psychological health, health and education. Considering these issues separately results in an incomplete understanding of poverty and a reduced ability to ameliorate problems. Malnutrition must be considered alongside other factors in childhood development. Psychosocial stimulation received by the children seems to make a significant contribution in alleviating the effects of malnutrition. Several studies show that nutritional supplementation when combined with stimulation has substantial benefits for cognitive development. Children who experience under nutrition are also likely to grow up in an under-stimulated social and psychological environment and it is the complex interaction between these factors that causes cognitive deficits. Since it is difficult to unravel the complexity of the mechanisms and sift out the effect of psycho-social stimulation, it is difficult to establish the existence of a causal relationship between under-nutrition alone and cognitive development of children. The present Article Reviews the role of Malnutrition among children in India & its impact on their cognitive development.
Keywords: Malnutrition, Childhood, Deficiency, Primary school children.
1. Afridi, F. (2005) Mid-Day Meals in Two States: Comparing the Financial and Institutional Organisation of the Programme. Economic and Political Weekly, April 09 - April 15, 40 (15) pp.1528-1534.
2. Agarwal, D.K., Upadhyay, S.K., Tripathi, A. M. & Agarwal, K.N. (1987) Nutritional Status, Physical Work Capacity and Mental Function in School Children. Scientific Report no. 6, New Delhi: Nutrition Foundation of India.
3. Alderman, H., Behrman, J. R., Lavy, V. & Menon, R. (1997) Child Nutrition, Child Health,and School Enrollment: A Longitudinal Analysis. Policy Research Working Paper no. 1700, January, Policy Research Department, Poverty and Human Resources Division. Washington, D.C.: The World Bank.
4. Alderman, H., Behrman, J. R., Victor, L. & Menon, R. (2001) Child Health and School Enrollment: A Longitudinal Analysis. The Journal of Human Resources, 36(1) pp. 185- 205.
5. Asian Development Bank (ADB) (2007) Millennium Development Goals: Progress in Asia & the Pacific 2007. Bangkok: Economic & Social Commission for Asia and the Pacific (ESCAP)/ United Nations/ADB.
6. Babu, S. C. & Hallam, J. A. (1989) Socioeconomic Impacts of School Feeding Programs: Empirical Evidence from a South Indian Village. Food Policy, 14(1) pp. 58-66.
7. Behrman, J. R. (1996) The Impact of Health and Nutrition on Education. World Bank Research Observer, 11(1) pp. 23-37.
8. Berkman, D. S., Lescano, A. G., Gilman, R. H., Lopez, S. L. & Black, M. M. (2002) Effects of Stunting, Diarrhoea Disease, and Parasitic Infection during Infancy on Cognition in late Childhood: A Follow-up Study. The Lancet, Feb, 16(359) pp. 564-571.
9. Bhalotra, S. (2006) Childhood Mortality and Economic Growth, Department of Economics, University of Bristol, UK, UN University – WIDER Research Paper No. 2006/79, Helsinki: World Institute for Development Economics Research of the United Nations University (UNU-WIDER).
10. Bhatia, D., & Seshadri, S. (1993) Growth Performance in Anemia and Following Iron Supplementation. Indian Paediatrics, 30 (2) pp. 195-200.
11. Black, M. M. (2003) Micronutrient Deficiencies and Cognitive Functioning. Journal of Nutrition, November, 133(11) pp. 3927S - 3931.
12. Bleakley, H. (2003) Disease and Development: Evidence from the American South. Journal of the European Economic Association, April/May, 1(2-3) pp. 376-386.
13. Blue, J. (2005) The Government Primary School Mid-day Meals Scheme: An Assessment of Programme Implementation and Impact in Udaipur District. Udaipur: Sewa Mandir.
14. Bobonis, G. J., Miguel, E. & Sharma, C. P. (2004) Iron Deficiency Anemia and School Participation. Paper no. 7, Massachusetts: Poverty Action Lab.
15. Brahmam, G.N.V. (2003) Evaluation of Mid-day Meal Programme in the States of Andhra Pradesh, Karnataka, Orissa, Tamil Nadu, Kerala, and Gujarat. Paper presented in the Review Workshop on National Programme of Nutritional Support to Primary Education (Mid-Day Meal Scheme), January 23-25, 2006. New Delhi: National Institute of Educational Planning and Administration (NIEPA).
16. Brito, G. N. O. & de Onis, M. (2006) Growth Status and Academic Performance in Brazilian School Age Children. Arq Neuropsiquiatr, 64(4) pp. 921-925.
17. Buzina-Suboticanec, K., Buzina, R., Stavljeic, A., Tadinac-B., M., & Juhovic-Markus, V. (1998) Effects of Iron Supplementation on Iron Nutrition Status and Cognitive Functions in Children. Food Nutr Bull. 19 (4) pp.298–306.
18. Cao, X.Y., Jiang, X.M., Dou, Z.H., Rakeman, M. A., Zhang, M.L., O'Donnell, K., Tai Ma, Amette, K., DeLong, N. and DeLong, G. R. (1994) Timing of Vulnerability of the Brain to Iodine Deficiency in Endemic Cretinism. New England Journal of Medicine, 331(26) pp. 1739-1744.
19. Daniels, M. C. & Adair, L. S. (2004) Growth in Young Filipino Children Predicts Schooling Trajectories through High School. The Journal of Nutrition, June, 134 (6) pp.1439-1446.
20. De, A., Noronha, C., & Samson, M. (2006) The Mid-day Meal Scheme in Delhi – A Functioning Programme. Paper presented in the Review Workshop on National Programme of Nutritional Support to Primary Education (Mid-Day Meal Scheme), 2006. New Delhi: National Institute of Educational Planning and Administration.
21. De, A., Noronha, C., & Samson, M. (2005) Towards More Benefits from Delhi’s Mid-day Meal Scheme. October, New Delhi: Collaborative Research and Dissemination (CORD).
22. Dreze, J. (2006) Mid-Day Meals and the Joy of Learning, Learning Curve. [Cited in Khera, R. (2006)].
23. Dreze, J. & Goyal, A. (2003) The Future of Mid -Day Meals. Eco. and Pol. Weekly, 38 (44): pp. 4673- 4683.
24. Dreze, J. & Kingdon, G. G. (2001) School Participation in Rural India, Review of Development Economics, February, 5 (1) pp. 1-24.
25. Ghuman, S., Behrman, J., Gultiano, S., Armecin, G., Bas, I., Duazo, P., King, E.M. & Lee, N. (2006) Early Childhood Development: A Review of Findings from a Longitudinal Study in the Philippines. East Asian Economic Perspectives, 17(2) pp. 1–24.
26. Glewwe, P. (2005) The Impact of Child Health and Nutrition on Education in Developing Countries: Theory, Econometric Issues, and Recent Empirical Evidence. Food and Nutrition Bulletin, 26(2 Suppl 2) pp. S235-S250.
27. Glewwe, P. & Jacoby, H. G. (1995) An Economic-Analysis of Delayed Primary-School Enrollment in a Low-Income Country: The Role of Early-Childhood Nutrition. The Review of Economics and Statistics, February, 77(1) pp. 156-169.
28. Glewwe, P. & King, E. M. (2001) The Impact of Early Childhood Nutritional Status on Cognitive Development: Does the Timing of Malnutrition Matter? The World Bank Economics Review, 15(1) pp. 81-113.
29. Glewwe, P., Jacoby, H. G. & King, E. M. (2001) Early Childhood Nutrition and Academic Achievement: A Longitudinal Analysis. Journal of Public Economics, 81(3) pp. 345-368.
30. GoI. [Government of India]. (1974) National Policy for Children. August, Department of Social Welfare.
31. GoI. (2004a) National Programme of Nutritional Support to Primary Education 2004 [Midday Meal Scheme] Guidelines. New Delhi: Ministry of Human Resource Development.
32. GoI. (2004b) Integrated Child Development Services- Manual. New Delhi: Ministry of Women and Child Dev.
33. GoI. (2005) Sixth Report of the Commissioners to the Supreme Court of India, December, New Delhi: Office of the Commissioner.
34. GoI. (2007a) Economic Survey 2006-07. New Delhi: Ministry of Finance.
35. GoI. (2007b) Seventh Report of the Commissioners of the Supreme Court in the case: PUCL v. UOI & Ors. Writ Petition (Civil) No. 196 of 2001, November. New Delhi. Office of the Commissioner. Available from: http://www.righttofoodindia.org/data/comm2007seventhreport.pdf [Accessed November 5, 2007].
36. Gragnolati, M., Bredenkamp, C., Gupta, M. D., Lee, Yi-Kyoung. & Shekhar, M. (2004) ICDS and Persistent Undernutrition – Strategies to Enhance the Impact. Economic and Political Weekly, 41 (12) March, pp. 1193-1201.
37. Gragnolati, M., Shekar, M., Gupta, D. M., Bradenkamp, C., Lee, Yi-Kyoung (2005) India's Undernourished Children: A Call for Reform and Action. HNP discussion paper, August, Washington, DC: The World Bank.
38. Grantham-McGregor, S. (1995) A Review of the Studies of the Effect of Severe Malnutrition on Mental Development. The Journal of Nutrition, 125(8) pp.2233-2238.
39. Grantham-McGregor, S. and Ani, C.C. (1999) The Role of Micronutrients in Psychomotor and Cognitive Development. British Medical Bulletin, 55(3) pp. 511-527.
40. Grantham-McGregor, S., Powell, C.A., Walker, S.P. & Himes, J.H. (1991) Nutritional Supplementation Psychosocial Stimulation and Mental Redevelopment of Stunted Children: The Jamaican Study. The Lancet, 338 (8758) pp. 1-5.
41. Grantham-McGregor, S., Cheung, Y. B., Cueto, S., Glewwe, P., Richter, L., Strupp, B., and the international Child Development Steering Group (2007) ‘Developing potential in the first 5 years for children in developing countries. Child development in developing countries 1’. The Lancet, Vol 369 January 6, pp. 60-70.
42. Hall, A., Bobrow, E., Brooker, S., Jukes, M., Nokes, K., Lambo, J., Guyatt, H., Bundy, D., Adjei, S., Wen, S.T., Satoto , Subagio, H., Rafiluddin, M.Z., Miguel, T., Moulin, S., de Graft Johnson, J., Mukaka, M., Roschnik, N., Sacko, M., Zacher, A., Mahumane, B., Kihamia, C., Mwanri, L., Tatala, S., Lwambo, N., Siza, J., Khanh, L.N, Khoi, H. H, Toan, N. D., (2001) Anaemia in Schoolchildren in Eight Countries in Africa and Asia, Public Health Nutrition, 4 (3) pp. 749-756.
43. Huda, S.N., et al. (1999) Biochemical hypothyroidism secondary to iodine deficiency is associated with poor school achievement and cognition in Bangladeshi children. Journal of Nutrition, 129 (5) pp. 980-987.
44. Hurtado, E.K., Claussen, A. H., & Scott, K. G., (1999) Early Childhood Anemia and Mild or Moderate Mental Retardation. The American Journal of Clinical Nutrition, January, 69 (1), pp. 115-119.
45. IIPS [International Institute for Population Sciences] (1995) National Family Health Survey (MCH and Family Planning) India 1992-93, NFHS-1, Mumbai: International Institute for Population Sciences.
46. IIPS and ORC Macro (2000) National Family Health Survey (NFHS-2), 1998-99, Mumbai: International Institute for Population Sciences.
47. IIPS (2007) National Family Health Survey (NFHS-3), Fact sheets for 29 States. Mumbai: International Institute for Population Sciences.
48. Jain, J. & Shah, M. (2005) Antyodaya Anna Yojana and Mid-Day Meals. Economic and Political Weekly, 26 November, 40(48) pp. 5076 – 5092.
49. Jamison, D. T. (1986) Child Malnutrition and School Performance in China. Journal of Development Economics, March, 20(2) pp. 299-309.
50. Jyoti, D. F., Frongillo, E.A and Jones, S.J. (2005) Food Insecurity Affects School Children’s Academic Performance, Weight Gain, and Social Skills 1-3. The Journal of Nutrition, December.
51. Kapur, S. & Murthi, M., (2009) ’Literacy in India’, Birkbeck Working Papers in Economics and Finance 0907, Birkbeck, Department of Economics, Mathematics & Statistics.
52. Khera, R. (2002) Mid-day Meals in Rajasthan. The Hindu, November 13, Bangalore edition.
53. Khera, R. (2006) Mid-day Meals in Primary Schools: Achievements and Challenges. Economic and Political Weekly, November 18 – November, 41 (50) pp. 4742-4750.
54. Lancaster, G., Maitra, P. & Ray, R. (2006) Gender Bias in Nutrient Intake: Evidence from Selected Indian States. South Asia Economic Journal, 7 (2) pp. 255-299.
55. Lewin, K. (2007) Improving Access, Equity and Transitions in Education: Creating a Research Agenda. CREATE Pathways to Access Monograph No.1.
56. Lozoff, B., Jimenez, E. Smith, J. B. (2006) Double Burden of Iron Deficiency in Infancy and Low Socioeconomic Status. A Longitudinal Analysis of Cognitive Test Scores to Age 19 years. Archives of Paediatrics and Adolescent Medicine. November, 160 (11) pp. 1108-1113.
57. Mason, J., Deitchler, M., Mathys, E., Winichagoon, P. & Tuazon, M.A. (2004) Lessons from Successful Micronutrient Programs. Food and Nutrition Bulletin, 25(1), pp.53-78.
58. McKay, A. & McKay, H. (1983) Primary School Progress after Preschool Experience: Troublesome Issues in the Conduct of Follow-up Research and Findings from Cali, Colombia Study. In: King, K. & Meyers, R. (eds.) (1983) Preventing School Failure: The Relationship between Preschool and Primary Education. Ottawa: International Development Research Center.
59. Mehrotra, S. (2006) Child Malnutrition and Gender Discrimination in South Asia. Economic and Political Weekly. March 11- March 17, 41(10) pp. 912-918.
60. Micronutrient Initiative (2006) Controlling Vitamin & Mineral Deficiencies in India-Meeting the Goal, New Delhi: Micronutrient Initiative.
61. Miguel, E. & Kremer, M. (2004) Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities, Econometrica, 72 (1) pp. 159-217.
62. Mishra, V. K., Lahiri, S. and Norman, Y. L. (1999) Child Nutrition in India. National Family Health Survey Subject Report Number 14. Mumbai: International Institute for Population Sciences.
63. Mishra, V. K. & Retherford, R.D. (2000) Women’s Education Can Improve Child Nutrition in India. National Family Health Survey Bulletin, No. 15, February, pp. 4, Mumbai: International Institute for Population Sciences.
64. Montresor, A., Ramsan, M., Chwaya, H., Ameir, H., Foum, A., Albonico, M., Gyorkos, T. W. & Savioli, L. (2001) School Enrolment in Zanzibar Linked to Children's Age and Helminth Infections. Tropical Medicine & International Health, March, 6 (3) pp. 227-231.
65. Moock, P. R., & Leslie, J. (1986) Childhood Malnutrition and Schooling in the Terai Region of Nepal. Journal of Development Economics, 20 (1), pp. 33-52.
66. Mosley, W.H. & Chen, L.C. (1984) An Analytical Framework for the Study of Child Survival in Developing Countries. Population and Development Review, Vol. 10, pp. 25- 45.
67. Nair, K.R.G, (2007) Malnourishment among Children in India: Regional Analysis. Economic and Political Weekly, September 15-September 21, 42 (37) pp. 3797- 3803. Malnourishment Among Children in India: Linkages with Cognitive Development and School Participation 35.
68. NIEPA [National Institute of Educational Planning and Administration]. (2006) Report of the Review Workshop on National Programme of Nutritional Support to Primary Education (Mid-Day Meal Scheme). 2006.
69. National Institute of Educational Planning and Administration, pp. 41-44.
70. NIPCCD [National Institute of Public Cooperation and Child Development]. (1992) National Evaluation of Integrated Child Development Services. New Delhi: NIPCCD.
71. Pandey, A. (2007) Mother’s Status in the Family and Nutritional Status of Their under Five Children. Raipur: Regional Leprosy Training and Research Institute.
72. Pollitt, E. (1990) Malnutrition and Infection in the Classroom. Paris: UNESCO.
73. Pratichi (India) Trust (2002) The Pratichi Education Report. New Delhi: TLM Books.
74. Radhakrishna, R., & Ravi, C. (2004a) Malnutrition in India- Trends and Determinants Economic and Political Weekly, February 14 – February 20, 39 (7) pp. 671-676.
75. Rajan, S. I. & Jayakumar, A. (1992) Impact of Noon Meal Program on Primary Education An Exploratory Study in Tamil Nadu. Economic and Political Weekly, October 24- October 31, pp. 2372-2380.
76. Ramakrishnan, U., Martorell, R., Latham, M. and Abel, R. (1999) Dietary Vitamin A Intakes of Preschool-Age Children in South India, The Journal of Nutrition, 129 (11) pp. 2021-2071.
77. Ramachandran, V., Jandhyala, K. & Saihjee, A. (2003) Through the Life Cycle of Children- Factors that Facilitate/impede Successful Primary School Completion. Economic and Political Weekly. November 22 - November 28, 38 (47) pp. 4994-5002.
78. Rosso, J.M. D. (1999) School Feeding Programs: Improving Effectiveness and Increasing the Benefit to Education. A Guide for Development and Human Development Program Managers. August, Partnership for Child Network, World Bank: Washington, DC.
79. Roy, T.K., Kulkarni, S, & Vaidehi, Y. (2004) Social Inequalities in Health and Nutrition in Selected States. Economic and Political Weekly, February 14 – February 20, 39 (7), pp. 677–683.
80. Sandstead, H.H., Penland, J.G., Alcock, N.W., Dayal, H.H., Chen, X.C., Li J.S, Zhao, F. & Yang, J.J. (1998) Effects of Repletion with Zinc and other Micronutrients on Neuropsychologic Performance and Growth of Chinese Children. American Journal of Clinical Nutrition, 68 (2) pp. 470S-475S.
81. Sen, A. & Kanani, S. J. (2006) Deleterious Functional Impact of Anemia on Young Adolescent School Girls. Indian Pediatrics, March 17, 43 (3)pp. 219-226.
82. Sarika More, V. B. Shivkumar, Nitin Gangane, Sumeet Shende, "Effects of Iron Deficiency on Cognitive Function in School Going Adolescent Females in Rural Area of Central India", Anemia, vol. 2013, Article ID 819136, 5 pages, 2013. https://doi.org/10.1155/2013/819136.
83. http://journals.elsevierhealth.com/periodicals/ymai/medline/related/MDLN.16356022.
84. Sen, A. & Sengupta, S. (1983) Malnutrition of Rural Children and the Sex Bias. Economic and Political Weekly, Annual Number, May, pp.855-864.
85. Sethi, B. (2003) Midday Meal Programme and its Impact in Improving Enrolment in Rayagada District. Rayagada: Office of the District Magistrate.
86. Seshadri, S & Gopaldas, T. (1989) Impact of Iron Supplementation on Cognitive Functions in Pre-school and School-aged Children: The Indian Experience. American Journal of Clinical Nutrition, September, 50, 675S-684S.
87. Shariff, Z.M., Bond, J.T. & Johnson, N.E. (2000) Nutrition and Educational Achievement of Urban Primary Schoolchildren in Malaysia. Asia Pacific Journal of Clinical Nutrition, 9(4) pp. 264-273.
88. Shiva Kumar A. K. (2007) Why are Levels of Child Malnutrition not Improving? Economic and Political Weekly, April 14 – April 20, 42 (15) pp. 1337–1345.
89. Simeon, D.T. & Grantham-McGregor., S.M (1990) Nutritional Deficiencies and Children’s Behaviour and Mental Development. Nutrition Research Review, January, 3 (1) pp.1-24.
90. Sood, N. (1987) An Evaluation of Non-formal Pre-school Education Component in ICDS Technical Bulletin, April, Number 1, New Delhi: NIPCCD.
91. Sood, N. (1992) Pre-school Education in ICDS: An Appraisal. Technical Bulletin, March, Number 5, New Delhi: NIPCCD
92. Sood, N. (2006) Malnutrition Malady: A Hurdle in Achieving Universal Elementary Education. New Frontiers in Education, April-June, 36 (2) pp.176-181.
93. Srihari, G., Eilander, A., Muthayya, S., Kurpad, A.V. & Seshadri S. (2007) Nutritional Status of Affluent Indian School Children: What and How Much Do We Know? Indian Pediatrics, March, 44 (3) pp. 204-213.
94. Tarozzi, A. & Mahajan, A. (2005) Child Nutrition in India in the Nineties. A Story of Increased Gender Inequality, Working paper no. 05-06, Department of Economics, North Carolina: Duke University.
95. The Lancet (2008) The Lancet’s Series on Maternal and Child Undernutrition. Executive Summary, 12 p.
96. Thorat, S & Lee, J. (2005) Caste Discrimination and Food Security Programmes. Economic and Political Weekly, September 24- September 30, 40 (39) pp. 4198-4201.
97. UNICEF (2006) The State of the World's Children Report 2006: Excluded and Invisible. New York: UNICEF.
98. Verma, A., Rawal, V.S., Kedia, G., Kumar, D. & Chauhab, J. (2004) Factors Influencing Anaemia Among Girls Of School Going Age (6-18Years) From The Slums Of Ahmedabad City. Indian Journal of Community Medicine, January-March, 29 (1) pp. 25-26.
99. Wachs, T.D. (1995) Relation of Mild-to-moderate Malnutrition to Human Development: Correlational Studies. The Journal of Nutrition, August, 125 (8) Suppl pp.2245-2254.
100. Walker, S.P., Grantham-McGregor, S.M., Powell, C.A. & Chang, S.M. (2000) Effects of Growth Restriction in Early Childhood on Growth, IQ, and Cognition at Age 11 to 12 Years and the Benefits of Nutritional Supplementation and Psychosocial Stimulation. Journal of Pediatrics, 137 (1) pp. 36-41.
101. Walker, S., Wachs, T., Meeks Gardner, J., Lozoff, B., Wasserman, G., Pollit, E. and Carter, J. (2007) Child Development: Risk Factors for Adverse Outcomes in Developing Countries. The Lancet, January, 369(9556) pp.145-157.
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