Open Access Research article

Maternal education, anthropometric markers of malnutrition and cognitive function (ELSA-Brasil)

Larissa Fortunato Araújo1*, Luana Giatti12, Dora Chor3, Valéria Maria Azeredo Passos1 and Sandhi Maria Barreto1*

Author Affiliations

1 Research Group on Epidemiology of Chronic Diseases (GERMINAL), Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil

2 School of Nutrition, Universidade Federal de Ouro Preto, Minas Gerais, Brazil

3 National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

For all author emails, please log on.

BMC Public Health 2014, 14:673  doi:10.1186/1471-2458-14-673

Published: 2 July 2014



The early exposure to poor social and nutritional conditions may influence cognitive function during adult age. However, the relative impact of these factors has not yet been established and they can vary during the course of life.


Analysis of data from 12,997 participants (35-64 years) of the baseline exams (2008-2010) of the Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of Brazilian civil servants. Four cognitive tests were applied: learning, recall and word recognition; semantic and phonemic verbal fluency; trail-making test version B. The markers of early nutritional and social conditions were maternal educational level, birth weight, and length of trunk and leg. The presence of independent association between every early marker and the poor performance in each cognitive test was investigated by multiple logistic regression, after mutual adjustment and considering the effects of gender, age and participant’s schooling level. The cut off for poor performance was the worst age-specific percentile of the final score distribution for each test.


After full adjustments, lower maternal education increased the chances of poor performance in all cognitive tests, with a dose-response gradient; low birth-weight was related to poor performance in the trail-making test B (OR = 1.63, 95% IC = 1.29-2.06); and greater trunk length decreased the chances of poor performance in the semantic and phonemic verbal fluency (OR = 0.96, 95% IC = 0.94-0.97) and in the trail-making test B (OR = 0.94, 95% IC = 0.92-0.95). Leg length was not associated with any of the tests examined. The associations found were not modified by the educational attainment of the participants.


Early exposure to adverse social and nutritional conditions appear detrimental to semantic memory, learning, concentration, executive control and language among adults, independent of adulthood educational achievement.

Maternal education; Nutritional markers; Life course; Cognitive function