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Cultural effects on neurodevelopmental testing in children from six European countries: an analysis of NUTRIMENTHE Global Database.

  • Pérez-García, Miguel1
  • Luna, Juan de Dios2
  • Torres-Espínola, Francisco J3
  • Martínez-Zaldívar, Cristina3
  • Anjos, Tania3
  • Steenweg-de Graaff, Jolien4
  • Weber, Martina5
  • Grote, Veit5
  • Gruszfeld, Dariusz6
  • Verduci, Elvira7
  • Poncelet, Pascale8
  • Escribano, Joaquín9
  • Tiemeier, Henning4
  • Koletzko, Berthold5
  • Campoy, Cristina3, 10
  • 1 Mind, Brain and Behaviour Research Center (CIMCYC), University of Granada, Campus de Cartuja, 18071 Granada, Spain. , (Spain)
  • 2 Department of Biostatistics, University of Granada, Avda de la Investigación 11, 18016 Granada, Spain. , (Spain)
  • 3 Excellence Centre for Paediatrics Research (EURISTIKOS), University of Granada, Avda de la Investigación 11, 18016 Granada, Spain. , (Spain)
  • 4 The Generation R Study Group, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands. , (Netherlands)
  • 5 Division of Metabolism and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich Medical Centre, Lindwurmstr, 4, D-80337 Munich, Germany. , (Germany)
  • 6 Neonatal Intensive Care Unit, Department of Gastroenterology, Hepatology and Immunology, Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-736 Warsaw, Poland. , (Poland)
  • 7 Department of Paediatrics, San Paolo Hospital, University of Milan, 8 Via A di Rudinì, 20142 Milano, Italy. , (Italy)
  • 8 Department of Paediatrics, Centre Hospitalier Chrétien (CHC) St Vincent, 4000 Liège-Rocourt, Belgium. , (Belgium)
  • 9 Pediatrics Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira I Virgili, 43201 Reus, Spain. , (Spain)
  • 10 Department of Paediatrics, University of Granada, Avda de la Investigación 11, 18016 Granada, Spain. , (Spain)
Published Article
British Journal Of Nutrition
Cambridge University Press
Publication Date
Sep 01, 2019
DOI: 10.1017/S0007114517000824
PMID: 28587705


Cultural background is an important variable influencing neuropsychological performance. Multinational projects usually involve gathering data from participants from different countries and/or different cultures. Little is known about the influence of culture on neuropsychological testing results in children and especially in European children. The objectives of this study were to compare neuropsychological performance of children from six European countries (Belgium, Germany, Italy, The Netherlands, Poland and Spain) using a comprehensive neuropsychological battery and to apply a statistical procedure to reduce the influence of country/cultural differences in neuropsychological performance. As expected, the results demonstrated differences in neuropsychological performance among children of the six countries involved. Cultural differences remained after adjusting for other confounders related to neuropsychological execution, such as sex, type of delivery, maternal age, gestational age and maternal educational level. Differences between countries disappeared and influence of culture was considerably reduced when standardised scores by country and sex were used. These results highlight the need for developing specific procedures to compare neuropsychological performance among children from different cultures to be used in multicentre studies.

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