Academic journal article Bulletin of the World Health Organization

Nutritional Quality of Diet and Academic Performance in Chilean students/Qualite Nutritionnelle De L'alimentation et Resultats Scolaires Des Lyceens chiliens/Calidad Nutricional De la Dieta Y Rendimiento Academico De Los Estudiantes Chilenos

Academic journal article Bulletin of the World Health Organization

Nutritional Quality of Diet and Academic Performance in Chilean students/Qualite Nutritionnelle De L'alimentation et Resultats Scolaires Des Lyceens chiliens/Calidad Nutricional De la Dieta Y Rendimiento Academico De Los Estudiantes Chilenos

Article excerpt

Introduction

Health-related behaviours may play a role in the ability to learn. Although critical stages of brain maturation occur early in life, the development of certain structures and higher cognitive functions (e.g. abstract thinking, deductive reasoning and problem solving) takes place in adolescence and continues during early adulthood. (1-3) Brain development is strongly influenced by environmental factors, with nutrition playing a pivotal role. (4) Whereas the effect of nutritional deficits on cognition are well known, the impact of overnutrition became the focus of research in the past decade. (2,5,6)

In the United Kingdom of Great Britain and Northern Ireland, diet during infancy was associated with intelligence in mid-childhood and adolescence in two birth cohorts. (7-9) Similarly, in New Zealand, a positive association between cognitive skills and diet was found at 3.5 and 7 years of age. (10) In Australia, children with healthy diets during early childhood had higher verbal and non-verbal abilities in mid-childhood. (11) Because diet affects specific outcomes that are important for children's educational attainment, some authors tested the association of diet with school grades or standardized test scores. A positive association between good diet and academic performance was found in adolescents from Canada, (12) Chile, (13) Iceland, (14,15) the Netherlands, (16) Norway, (17) Sweden (18,19) and the United Kingdom. (20)

Research examining how overnutrition affects the academic performance of adolescents has been mainly conducted in high-income countries. However, unhealthy diet in children and adolescents is a major health problem in a growing number of low- and middle-income countries. (21,22) Adolescents with good academic performance are less likely to report unhealthy behaviours, including alcohol, tobacco and drug consumption, physical inactivity and risky sex. (23) Because little is known about the relation between overnutrition and academic performance in adolescents from low- and middle-income countries, we assessed the relation between Chilean students' diet at the age of 16 years and their academic performance. We hypothesized that a diet in accordance with food guidelines at age 16 years would be associated with better academic performance in both the college admission tests and high school grade-point average.

Methods

Study design and population

We studied 16 year-old students living in Santiago, Chile (from a region of low-to-middle socioeconomic status) who were part of a cohort study beginning in infancy. The infants, recruited at 4 months old, were healthy, full-term singletons weighing at least 3 kg at birth. They were assessed for developmental outcomes in infancy, and at age 5, 10 and 16 years. At 16, they were assessed for obesity and cardiovascular risk factors, including body-mass index (BMI), waist circumference, systolic and diastolic blood pressure, blood lipids, glucose and insulin. Enrolment and data from previous waves are described in detail elsewhere. (24-26) Data were collected in 2009-2012. Ethical approval was obtained by the institutional review boards of the University of Michigan, Institute of Nutrition and Food Technology (University of Chile) and the University of California, San Diego. Informed consent was provided in writing according to the requirements of the Declaration of Helsinki (1995).

Dietary assessment

The nutritional quality of diet at age 16 years was measured accounting for the amount of saturated fat, fibre, sugar and salt in the food. We used a validated food frequency questionnaire used in previous studies to assess the usual diet during breakfast, lunch, dinner, snacks at school and snacks at home. (27) A list of 110 foods and beverages was used. The frequency of food consumption was assessed by a multiple response grid; participants were asked to estimate how often a particular food or beverage was consumed. …

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