Beyond stunted growth, malnutrition limits children’s problem-solving skills — Nutritionists - Punch Newspapers

Children who experience severe malnutrition leading to stunting are at risk of impaired learning ability and academic performance, leading to poorer school outcomes, including repeating a grade, nutritionists have warned.

The experts noted that beyond restricting physical growth, prolonged undernutrition could affect brain development, attention, memory, comprehension and problem-solving, making it harder for affected children to learn and perform well academically.

They further explained that the effects of prolonged undernutrition could extend beyond childhood, limiting a child’s ability to attain their full physical and developmental potential and potentially contributing to an intergenerational cycle of undernutrition when affected girls later become mothers.

According to the World Health Organisation, stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.

The WHO defines children as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.

The United Nations Children’s Fund notes that poor nutrition during the first 1,000 days, from pregnancy to a child’s second birthday, can damage the developing brain, limit growth potential and affect a child’s ability to do well in school.

Supporting the academic-performance concerns, a systematic review and meta-analysis of 16 studies found that stunted children were more likely to repeat a grade than non-stunted children, with an odds ratio of 1.59. The researchers also found that better height-for-age was associated with earlier school enrolment, higher schooling levels and reduced school overage.

In Nigeria, recent data cited in the 2024 Situation Analysis of Children and Adolescents in Nigeria indicate that 40 per cent of children under five are stunted.

The report noted that stunting remains high and is linked to factors including household poverty, food availability and poor feeding practices.

PUNCH Healthwise recently reported that, according to the Nutrition Society of Nigeria, four in every 10 Nigerian children are stunted, eight per cent are wasted, almost half of women of reproductive age are anaemic, and only about one-third of women achieve minimum dietary diversity.

The association had urged the government, non-governmental organisations, private enterprises and academia to work more closely to end malnutrition in the country, particularly among children under five.

Commenting on the matter, the Assistant Director of Dietetics at the Lagos State Health Service Commission, Olusola Malomo, told PUNCH Healthwise that childhood stunting could affect learning and school performance because chronic undernutrition could interfere with brain development.

He explained that the effects could include impaired memory, attention, concentration and problem-solving, making it harder for affected children to absorb new information and participate effectively in classroom activities.

“Stunting is not only a growth problem—it can have lasting effects on brain development, learning and human potential, particularly when undernutrition begins early in life,” Malomo stated.

He explained that the effects could be particularly significant when stunting occurred during the early years of life, when the brain was undergoing rapid development.

“Compared with non-stunted children, those who experienced stunting—especially during the first 1,000 days—are more likely to have lower cognitive and language development scores, greater difficulties with attention, memory and learning, and lower school achievement,” he explained.

Malomo noted that the relationship between stunting and educational outcomes did not mean that every stunted child would perform poorly in school, stressing that other factors could influence a child’s educational performance.

He identified poverty, illness, household education and other environmental conditions as factors that could also affect learning and school outcomes.

On physical growth, Malomo explained that prolonged undernutrition could restrict a child’s linear growth even when the child had the genetic potential to become taller.

“Early and prolonged undernutrition can restrict linear growth, even when the child has a genetic potential for greater height,” Malomo stated.

According to him, some children could experience catch-up growth when adequate nutrition, healthcare and a healthy environment were restored, particularly when intervention was provided early.

“Catch-up growth is possible when adequate nutrition, health care and a healthy environment are restored—particularly when intervention occurs early,” he explained.

He noted, however, that complete catch-up might be less likely when growth restriction was prolonged or severe, meaning some children might not fully return to the growth trajectory they would otherwise have achieved.

Malomo further explained that the consequences of childhood undernutrition could extend to the next generation, particularly when a girl who experienced stunting entered adulthood with nutritional disadvantages.

He noted that maternal short stature and poor nutritional status were associated with increased risks of poor fetal growth and low birth weight, which could increase the risk of stunting in the next generation.

“This does not mean that every previously stunted girl will have a stunted child. Genetics, socioeconomic conditions, infections, healthcare and the mother’s nutrition all contribute,” he explained.

Malomo stressed that adequate nutrition before conception and during pregnancy could help reduce the risk of poor maternal and child growth and interrupt the cycle of undernutrition.

Also speaking, Assistant Director of Dietetics and Nutrition, Michael Shoretire, said stunting is a sign of chronic malnutrition that can affect a child’s cognitive development, learning ability, and overall development.

He explained that children affected by prolonged nutritional deprivation may struggle to comprehend and process information, making learning more challenging.

“Stunting can affect learning, the cognitive level, and brain development,” Shoretire stated.

He noted that the affected child might still understand what was being taught but could require more effort and take longer to grasp information compared with a child whose nutritional and developmental needs were adequately met.

“It means the child will find it difficult in terms of comprehension. Not that it will not comprehend, but the effort, the speed at which he or she grasps,” Shoretire explained.

The clinical dietitian further noted that the consequences of childhood malnutrition could extend beyond the immediate effects on learning, potentially affecting a child’s ability to attain their full intellectual and developmental potential.

“The majority of the children who are malnourished and stunted will not be able to attain their full potential in terms of their intellectual level in most cases,” Shoretire stated.

He explained that while some children could improve when their nutritional needs were adequately addressed, prolonged nutritional deprivation during critical stages of development could make complete recovery more difficult.

“Once the damage has been done to the brain, then the repair might not be possible,” the registered dietitian-nutritionist stated.

Shoretire further noted that the effects of childhood malnutrition could also be reflected in adulthood, particularly when inadequate nutrition during the early years had affected a child’s physical and intellectual development.

He explained that adequate nutrition during childhood was therefore important for helping children achieve their growth and developmental potential.

On the possible effect on the next generation, he stressed the importance of adequate nutrition before conception and during pregnancy, noting that a woman’s nutritional status could influence the growth and development of her child.

“Adequate nutrition before conception and during pregnancy can help,” Shoretire stated, emphasising the need for proper nutrition to support the growth and development of the next generation.

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