Association between nutritional status and cognitive development in preschool children: A cross‐sectional study

Early childhood nutrition is key to healthy brain and cognitive growth. Nepal lacks direct studies on nutrition and preschool cognitive outcomes. This study examines the association between nutrition and cognitive development in Nepali preschoolers aged 3–5. A cross-sectional survey design was employed, using multi-stage random sampling to collect data from 389 preschool children in Nepal’s Rupandehi District aged 3–5. Data were collected through scheduled interviews and direct observation to assess socio-economic, demographic, and cognitive characteristics. Nutritional status, measured using Height-for-Age (HAZ) and Weight-for-Age (WAZ), was a strong positive predictor of cognitive scores (β = 0.337; p < 0.0001). Children from socially advantaged groups also showed higher cognitive outcomes (β = 0.199; p < 0.0001), while children from joint-family households (β = −0.126; p < 0.010) and older children (β = −0.120; p < 0.014) had slightly lower cognitive scores. Nutritional status was a key determinant of preschoolers’ cognitive development, with social status, family structure, and age also playing significant roles.These findings highlight the need for targeted interventions to improve nutrition and support equitable cognitive growth, providing evidence to inform public health strategies and policy planning in Nepal. • Nutrition strongly predicts preschool cognitive development. • Stunting and underweight reduce children’s cognitive scores. • Social status, age, and family setup influence cognitive outcomes. • Validated cognitive tool (α = 0.90) ensured reliable measurements. • Findings support integrated nutrition and early learning programs.