Associations Between Nutritional Status, Cognitive Performance, and Surrogate Metabolic Profiles in School-Aged Children

Background: Childhood malnutrition, manifesting as both underweight and obesity, is a global health concern with potential repercussions on neurodevelopment and metabolic health. Objective: To analyze the relationship between nutritional status, metabolic biomarkers, and cognitive performance in school-aged children. Methods: A cross-sectional study was conducted with 100 children between 6 and 12 years of age from a public elementary school in the municipality of Chiconcuac de Juárez, Mexico. Participants were categorized according to BMI: underweight (UW), normal weight (NW), overweight (OW), and obesity (OB). Anthropometric evaluation, serum biochemical markers, and three surrogate metabolic indices, namely the Triglyceride–Glucose (TyG), Triglyceride/high-density lipoprotein cholesterol (TG/HDL), and TyG-Body Mass Index (TyG-BMI), were calculated. Cognitive performance was assessed using the Wechsler Intelligence Scale for Children (WISC-IV). Results: The OB group children showed significantly higher levels of TG, TC and LDL-C, as well as elevated levels of TyG, TG/HDL and TyG-BMI indices (p < 0.05) and lower HDL-C concentration. While no significant differences were found in Full-Scale IQ (FSIQ), the NW group showed significantly higher performance in the PSI compared to all other groups outside the healthy weight range after FDR correction. Spearman’s correlation showed that surrogate metabolic indices exhibited exclusive negative correlations with the PSI in unadjusted bivariate models. Conclusions: The extremes of the nutritional status spectrum (UW and OB) are concurrently associated with early metabolic alterations and latent cardiovascular risk, while concurrently tracking with lower performance in selective fluid cognitive domains within unadjusted models. Furthermore, surrogate metabolic indices were shown to be valuable tools that co-vary with neurocognitive profiles.