| Abstract: | Two relatively unexplored questions--which specific components of chronic mild child malnutrition are associated with specific behavioral and cognitive deficits and do psychosocial child rearing factors moderate the nutrition-development relationship?--were investigated in a longitudinal study involving 153 toddlers from the Egyptian village of Kalama. Beginning at study entry at age 18 months and continuing until 30 months, food intake information was obtained for 2 consecutive days each month. During the same period, researchers visited the homes twice a month to observe both toddler behavior and caregiver styles. Finally, standardized infant development tests were administered at 24 months and 30 minutes and the capacity for exploratory, symbolic play was assessed. Specific components of nutritional intake at 18-23 months of age were confirmed to be uniquely related to specific developmental outcomes at 24 months of age. Changes in toddler intake from 18-30 months also predicted 30-month cognitive performance. At 24 months, general mental competence was associated positively with fat intake, total kilocalories, and total protein intake while symbolic play capacity was related only to total protein intake. Significant increases in predictive variance occurred when the model was expanded to encompass caregiver behaviors as well as nutritional factors. For example, when nonverbal response to child vocalizations was used as the environmental measure, there was evidence of both coactive and synergistic interactions for comparisons involving cognitive development indicators. For symbolic play, an increase in predictive variance was found when the model included the multiplicative interaction of animal kilocalories by nonverbal response to vocalizations. Also observed was a buffering effect against poor psychosocial rearing conditions given the presence of adequate nutritional intake. These findings suggest the feasibility of multidimensional risk profiles, the provision of specific nutrients targeted at specific deficits, and multidisciplinary interventions. |
