Table 3

Summary of results from studies assessing the effect of malnutrition on cognition and academic achievement

Study
(quality)
(outcome age)
Country		School, academic or language performanceExecutive function/intelligence
(assessment tool)
Chen et al 2021 (++)
(childhood)
China18		 No effect
(adjusted)
(WPPSI-IV)
Mwene-Batu et al 2020 (+)
(adulthood)
DRC19		Effect
(unadjusted)		Effect
(unadjusted)
(MMSE)
Asiki et al 2018 (++)
(adolescence)
Uganda20		Effect
(adjusted)		 
Lelijiveld et al 2018 (++)
(childhood)
Malawi23		Effect
(adjusted)		No effect
(adjusted)
(CANTAB)
Bogale et al 2013 (++)
(childhood)
Ethiopia28		 Effect
(adjusted)
(Raven’s CPM, KABC-II)
Warsito et al 2012 (-)
(childhood)
Indonesia29		 No effect
(unadjusted)
(Indonesian Department of National Education – child development instrument score)
Nassar et al 2012 (-)
(childhood)
Egypt30		Effect
(unadjusted)		Effect
(unadjusted)
(Stanford-Binet-Intelligence-Scale)
Liu et al 2003 (++)
(adolescence)
Mauritius34		Effect
(adjusted)		Effect
(adjusted)
(Bohem Test, Trail Making Test, WISC)
Perales et al 1996 (+)
(childhood)
Chile37		 Effect
(unadjusted)
[Continuous Performance Task,
Anstey Domino test]
Barbados Nutrition Study
Waber (1) et al 2014* (++)
(adulthood)
Barbados40		Effect
(adjusted)		Effect
(adjusted)
(WASI)
Waber (2) et al 2014* (++)
(adulthood)
Barbados41		 Effect
(adjusted)
[WAIS-III, D-KEFS, WRAML-2,
Wisconsin card sorting, Metacognitive index]
Waber et al 2011* (+)
(adolescence)
Barbados45		Effect
(adjusted)		Effect
(adjusted)
(WISC)

  • Effect (marked in green) —statistically significant difference in academic achievement/cognition between cases and controls.

  • No effect (marked in red)—no difference, or statistically insignificant difference, or statistically insignificant difference after adjusting for confounding variables, in academic achievement/cognition between cases and controls.

  • Adjusted—results adjusted for confounding variables.

  • Unadjusted—results unadjusted for confounding variables.

  • ++=high quality.

  • +=adequate quality.

  • -=poor quality.

  • *Studies are drawn from the same Barbados Nutrition Study.

  • CANTAB, Cambridge Neuropsychological Test Automated Battery; D-KEFS, Delis-Kaplan Executive Function System; KABC-II, Kaufman Assessment Battery for Children-II; MMSE, Mini-Mental State Exam; Raven’s CPM, Raven’s Coloured Progressive Matrices; WAIS-III, Wechsler Adult Intelligence Scale-III; WASI, Adult IQ: Wechsler Abbreviated Scale of Intelligence-Vocabulary and Matrix Reasoning subsets; WISC, Weschler Intelligence Scale for Children; WPPSI-IV, Wechsler Preschool and Primary Scale of Intelligence Fourth Edition; WRAML-II, Wide Range Assessment of Memory and Learning-II.