Childhood Metabolic Biomarkers Are Associated with Performance on Cognitive Tasks in Young Children

J Pediatr. 2019 Aug;211:92-97. doi: 10.1016/j.jpeds.2019.03.043. Epub 2019 May 3.


Objective: To evaluate the hypothesis that metabolic measures (fasting glucose, insulin, and Homeostatic Model of Assessment for Insulin Resistance [HOMA-IR] levels) are inversely associated with performance on cognitive tasks using data from young (4- to 6-year-old), typically developing, healthy children.

Study design: Data were obtained from children participating in the Healthy Start study, a pre-birth cohort in Colorado. HOMA-IR, glucose, and insulin values were centered and scaled using the study sample means and SD. Thus, they are reported in number of SD units from the mean. Fully corrected T scores for inhibitory control (Flanker task), cognitive flexibility (Dimensional Change Card Sort test), and receptive language (Picture Vocabulary test) were obtained via the National Institutes of Health Toolbox cognition battery.

Results: Children included in this analysis (n = 137) were 4.6 years old, on average. Per 1-SD unit, fasting glucose (B = -2.0, 95% CI -3.5, -0.5), insulin (B = -1.7, 95% CI -3.0, -0.4), and HOMA-IR values (B = -1.8, 95% CI -3.1, -0.5) were each significantly and inversely associated with inhibitory control (P < .05 for all, respectively). Fasting glucose levels were also inversely associated with cognitive flexibility (B = -2.0, 95% CI -3.7, -0.2, P = .03).

Conclusions: Our data suggest that metabolic health may impact fluid cognitive function in healthy, young children.

Keywords: childhood; cognition; executive function; insulin resistance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Biomarkers / blood*
  • Blood Glucose / analysis*
  • Child
  • Child, Preschool
  • Cognition Disorders / blood
  • Cognition*
  • Cohort Studies
  • Colorado / epidemiology
  • Fasting
  • Female
  • Homeostasis
  • Humans
  • Insulin / blood
  • Insulin / metabolism*
  • Insulin Resistance
  • Language
  • Male
  • Mothers
  • Neuropsychological Tests
  • Regression Analysis


  • Biomarkers
  • Blood Glucose
  • Insulin