Behavioral problems in preadolescence: Does nutritional status have a role?

Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR= 2.05, P= 0.003 and AOR= 2.09, P= 0.039, respectively) than normal ones. Over-nutrition was not associated with any behavioral issues. According to the composite index of anthropometric failure, 40% of preadolescents had at least one type of malnutrition, and among them, about 3% had co-occurring malnutrition (stunted and thin or overweight).

They had a higher risk of being associated with internalizing problems (AOR 2.92, P = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co-occurring malnutrition on the internalizing problems. Our study concludes that over- and under-nutrition are prevalent in preadolescents, with a significant association of under-nutrition with internalizing problems.

Moreover, our study is the first that report that the co-occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programs for addressing preadolescents' issues.