62 Nutritional risk in early childhood and later school concern outcomes

Nutrition in early childhood is important for healthy growth and development. Few studies have examined long-term developmental outcomes. To determine if nutritional risk in early childhood is associated with later school concern outcomes. This longitudinal cohort study including children enrolled in the TARGet Kids! research network in Toronto, Canada between 2008 and 2018. Nutritional risk was measured in early childhood using the NutriSTEPTM, a validated 17-item parent-completed questionnaire. The NutriSTEPTM total score ranges from 0–68, with eating behaviours and dietary intake sub-scores. High nutritional risk can be defined using a cut off score > 21. Parent reported school concerns were measured at 4–10 years using the question “has the school expressed any concern about your child: speech and language; learning; attention; behaviour; social relationships with other children; physical coordination; fine motor coordination; self help skill and independence; and no concern”. Multiple logistic regressions were used to examine the relationships between nutritional risk exposures and the school concern outcome (any concern or no concern), adjusting for child sex, age, ethnicity, maternal education, family income, family living arrangements, and a previous diagnosis of developmental delay. The study included 3650 children, 52% were male, 14% had high nutritional risk and 21% of parents reported school concern. Each one-unit increase in total NutriSTEPTM score was associated with an increased odds of school concern (adj OR: 1.02, 95% CI: 1.01 – 1.04) and high nutritional risk was associated with an increased odds of school concern (adj OR: 1.49, 95% CI: 1.12 – 1.96). The eating behaviours and dietary intake sub-scores were both significantly associated with an increased odds of school concern with the magnitude of association being stronger for eating behaviours (see table 1). Nutritional risk in early childhood was associated with later parent reported school concern, with the largest impact from high risk eating behaviours. Future research could assess this relationship using teacher reported measures of school readiness (i.e. Early Development Instrument). Clinical trials of nutritional interventions in early childhood could examine school developmental outcomes.