Neuroretinal and neuropsychological functional deficit in preadolescent children with stunted growth

Abstract Background Given the brain and eyes high sensitivity to nutrient deficiency, and stunting as a marker of chronic malnutrition, we hypothesized that children with stunted growth would show impaired neuroretinal and neuropsychological function compared to age-matched-well-nourished controls. This study examined the link between nutritional status, visual function, and cognitive performance in preadolescent children with stunted growth, aiming to identify early markers of malnutrition-related developmental risk. Methods Fifteen stunted and 275 non-stunted children (ages 8–13) were assessed using dietary recall, visual tests (ETDRS LogMAR, Pelli-Robson, heterochromatic flicker photometry), and CANTAB neuropsychological assessments. Results Stunted children consumed fewer macro- and micronutrients, including lutein and zeaxanthin, and showed reduced macular pigment optical density (MPOD) and critical flicker frequency (CFF). Cognitive testing revealed significant impairments in spatial planning, problem-solving, and visuospatial working memory. After adjusting for confounders, stunted children were more likely to show poor spatial planning on the Stockings of Cambridge (SOC) task (AOR = 1.43, 95% CI: 1.00–2.66; p = 0.049). Conclusion These results suggest that stunting is associated with both neuroretinal and neurocognitive deficits. The findings underscore the value of visual and cognitive biomarkers in detecting early functional effects of stunting and the critical need for timely nutritional interventions in at-risk children.