Unravelling the relationship between nutritional status and cognitive and school performance among school-aged children in Taabo, Côte d'Ivoire: A school-based observational study

Achil TIA^1,2*Jonas Hauser³Georgette Amoin Konan²Olivier Ciclet³Yohan Grzywinski³Fabio Mainardi³Gioele Visconti³Adrien Frézal³Charlemagne Nindjin^1,2

• ¹University of Nangui Abrogoua, Abidjan, Côte d'Ivoire
• ²Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d'Ivoire
• ³Nestlé, Lausanne, Switzerland

Background: Nutritional deficiencies are one of the main factors that affect cognitive development. In Côte d'Ivoire, although nutritional deficiencies have been reported among schoolchildren, their association with cognitive function or academic performance remains unexplored. Objective: The objective of this study was to investigate the relationship between nutritional status, cognition and school performance in school-aged children from Taabo, Côte d'Ivoire. Methods: A sample of 252 schoolchildren (6-12 years) was recruited. Nutrient biomarkers were measured in blood samples, cognition (fluid intelligence) was assessed using the Raven's Coloured Progressive Matrices (RCPM) and school performance was quantified using academic results in mathematics and literature. Results: Overall scores were 15.4 ± 4.4 for the RCPM, 6.0 ± 2.4 for mathematics, and 5.4 ± 1.8 for literature (out of a maximum of 36, 10 and 10, respectively). Most of the children had normal nutritional status, but all had inadequate plasma levels of iron, folate, thiamine, and vitamin B12. Significant correlations (p < 0.05) were found between biomarkers of iron, folate, tryptophan, calcium, potassium, and omega-3 fatty acids with cognition or school performance. In contrast, no associations were found with zinc, iodine, riboflavin, vitamin B12, or vitamin D. After adjusting for sociodemographic factors in regression models, calcium was identified as a predictor of cognitive skills (R² = 0.3, p = 0.020; 95% CI: 8.2×10⁻⁶–9.3×10⁻⁵) and folate as a predictor of performance in both mathematics (R² = 0.1, p = 0.006; 95% CI: 0.1–0.3) and literature (R² = 0.1, p = 0.005; 95% CI: 0.1– 0.2). Conclusions: This study found high rates of B vitamin and iron deficiencies in Ivorian school-aged children. Iron, folate, tryptophan, calcium, potassium, and omega-3 fatty acid biomarkers showed promising correlations with cognition and academic performance. Further research aimed at investigating such relationships is needed.