Associations between Cognitive Function, Blood Lead Concentration, and Nutrition among Children in the Central Philippines

Objective Because little is known about its effects on cognitive function among children in less-developed countries, we determined the impact of lead exposure from other nutritional determinants of cognitive ability. Study design Data were from a cross-sectional population-based stratified random s...

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Bibliographic Details
Published in:The Journal of pediatrics 2008-02, Vol.152 (2), p.237-243.e1
Main Authors: Solon, Orville, PhD, Riddell, Travis J., MD, MPH, Quimbo, Stella A., PhD, Butrick, Elizabeth, MS, MPH, Aylward, Glen P., PhD, Lou Bacate, Marife, MA, Peabody, John W., MD, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers
Child
Child, Preschool
Cognition
Folic Acid - pharmacology
General aspects
Humans
Infant
Lead - blood
Lead Poisoning - diagnosis
Medical sciences
Metabolic diseases
Models, Statistical
Nutritional Sciences
Pediatrics
Pediatrics - methods
Philippines
Social Class
Time Factors
Treatment Outcome
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Summary:Objective Because little is known about its effects on cognitive function among children in less-developed countries, we determined the impact of lead exposure from other nutritional determinants of cognitive ability. Study design Data were from a cross-sectional population-based stratified random sample of 877 children (age 6 months-5 years) participating in the Quality Improvement Demonstration Study we are conducting in the Philippines. With data from validated psychometric instruments, venous blood samples, and comprehensive survey instruments, we developed multi-stage models to account for endogenous determinants of blood lead levels (BLLs) and exogenous confounders of the association between BLLs and cognitive function. Results A 1 μg/dL increase in BLL was associated with a 3.32 point decline in cognitive functioning in children aged 6 months to 3 years and a 2.47 point decline in children aged 3 to 5 years olds. BLL was inversely associated with hemoglobin and folate levels. Higher folate levels mitigated the negative association between BLL and cognitive function. Conclusions These population-based data suggest greater lead toxicity on cognitive function than previously reported. Our findings also suggest that folate and iron deficient children are more susceptible to the negative cognitive effects of lead. Folate supplementation may offer some protective effects against lead exposure.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2007.09.008