Risk assessment of low cognitive performance among fishermen's children in Malaysia

Abstract

Objectives: Low cognitive performance is a major concern among fishermen's children in Malaysia. Thus, this study was aimed at assessing dietary intake, nutritional status, physical activity, and socio-economic status, and their associations with cognitive performance among fishermen's children in Terengganu, Malaysia. We also investigated the risk associated with low cognitive performance.

Methods: This cross-sectional study included 94 children 7-11 years of age in Terengganu. Dietary adequacy was assessed with two 24-h dietary recall surveys. Anthropometric measurements were assessed by calculation of the body mass index (BMI)-for-age Z-score and height-for-age Z-score. In addition, median urinary iodine tests were conducted to determine iodine concentrations. Physical activity was measured with the Physical Activity Questionnaire for Children (PAQ-C). Raven's coloured progressive matrices were used to determine cognitive performance. Binominal logistic regressions were performed on factors associated with cognitive performance, to identify the risk factors with the strongest association with cognitive performance.

Results: The children of fishermen had adequate intake of all necessary nutrients except for fat, dietary fibre, thiamine, folate, vitamin C, vitamin E, calcium, zinc, and potassium. Most of the children had normal BMI-for-age [median = -0.86 (2.11)] and height-for-age (mean = -1.01 ± 1.03). However, more than half had iodine deficiency [median = 83.9 (102)]. In addition, 16% had low physical activity levels, and their cognitive performance was classified with a low average score [median = 80.0 (21.0)]. The mother's education level (p = 0.037), children's BMI-for-age (p = 0.012), protein (p = 0.020), and niacin (p = 0.032), exhibited significant relationships with cognitive performance (p < 0.05). Of these variables, BMI-for-age (OR = 0.290, p = 0.036) and fourth quartile protein intake (≥52.69 g) (OR = 7.565, p = 0.015) were significant risk factors for low cognitive performance among fishermen's children in Terengganu.

Conclusion: A balanced diet and healthy lifestyle are crucial for children's cognitive development. Thus, interventions emphasising the promotion of healthy lifestyles, particularly focusing on BMI-for-age and protein intake, are advised.

Keywords: Cognitive performance; Dietary intake; Fishermen's children; Malaysia; Nutritional status; Physical activity.