Factors associated with cognitive ability among 12- to 13-year-old Malay adolescents from selected urban schools in Gombak, Malaysia

Adolescence is a transitional period where the brain matures to achieve its adult structure and functions. However, many factors tend to influence cognition in a multidirectional manner during this period. This cross-sectional study aimed to determine factors associated with cognitive ability among 12 to 13 year-old (M=12.4, SD=0.5) Malay adolescents from selected urban schools in Gombak, Selangor (N=416; male=161, female=255). Socio-demographic background including parents’ education level and monthly household income was obtained from parents through a short questionnaire. A questionnaire on meal consumption, personality, eating attitudes, sleep quality, chronic sleep reduction, physical activity and pubertal development was administered in class. Height, weight and waist circumference were measured. Body mass index (BMI)-for-age, height-for-age and waist-to-height ratio were determined. A semi-quantitative food frequency questionnaire was used to determine habitual dietary intake and 24-hour dietary recall was used to determine current nutrient intake. Dietary patterns were constructed using principal component factor analysis. Cognitive ability was assessed using Wechsler Nonverbal Scale of Ability (WNV) in a one-to-one manner. There were 38.7% boys and 61.3% girls. A majority of the adolescents’ fathers attained tertiary education (50.0%), while a majority of their mothers attained secondary education (47.2%). Most boys were in the mid-pubertal development (37.0%), while most girls were in the late pubertal development (70.9%). The prevalence of overweight and obesity were 20.4% and 15.1% respectively. About 38.7% of the adolescents skipped breakfast, 34.4% skipped lunch and 31.2% skipped dinner at least once in a week. The mean energy intake per day was 1748 kcal (SD=548). For personality, the mean score for neuroticism (M=2.9, SD=0.6) was low, while the mean scores for conscientiousness (M=3.2, SD=0.5), extraversion (M=3.3, SD=0.5), openness to experience (M=3.4, SD=0.5) and agreeableness (M=3.6, SD=0.5) were moderate. It was found that 20.5% of the adolescents were at risk for disordered eating. The mean sleeping duration was 8.8 hours (SD=1.5), while the mean score for sleep quality was 13.4 (SD=2.0). For chronic sleep reduction, the mean score was 35.2 (SD=4.9). Scores for physical activity was moderate (M=2.4, SD=0.6). Four major dietary patterns were extracted from the principal component factor analysis and labelled as refined-grain pattern, snack-food pattern, plant-based food pattern and high-energy food pattern. The mean score for general cognitive ability was 101.8 (SD=12.4). Monthly household income (r=0.235, p<0.001), high-energy food pattern (r=-0.11, p<0.05), carbohydrate intake (r=0.10, p<0.05), openness to experience (r=0.212,p<0.001), physical activity (r=0.097, p<0.05) and sleep duration (r=-0.104, p<0.05) were associated with general cognitive ability. Adolescents whose fathers had tertiary education (t=5.28, p<0.001), not skipping dinner (t=4.26, p<0.001) and rarely snacked (t=2.73, p<0.01) scored better on the cognitive tests compared to adolescents whose fathers had secondary education and below, skipped dinner and snacked. Multiple linear regression analysis showed that monthly household income, consumption of dinner, openness to experience, carbohydrate intake, high-energy food pattern and father’s education level explained 21.6% of the variances in cognitive ability (F=14.76, p<0.001). Therefore, adolescents should be encouraged to consume dinner regularly, decrease consumption of high-energy foods and be more open to experience.

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