A substantial body of literature has implicated metabolic health as a significant contributor to cognitive functioning in adults. However, this has not been investigated among young children whose cognitive functions are still developing. Using data from 4 to 6-year-old healthy children participating in the Healthy Start study, an ongoing pre-birth cohort, we tested the hypothesis that current metabolic parameters (fasting glucose, insulin and Homeostatic Model of Assessment for Insulin Resistance [HOMA-IR] levels) are inversely associated with performance on cognitive tasks, measured via the NIH Toolbox cognition battery. Fully corrected T-scores for inhibitory control (Flanker task), cognitive flexibility (Dimensional Change Card Sort test), and language (Picture Vocabulary test) were obtained. General linear models were used to test the associations between child metabolic markers and cognitive test scores. All models were stratified by race/ethnicity (n = 53 non-Hispanic white [NHW]; n = 45 others) and adjusted for APGAR scores at birth. Among NHW children, fasting glucose, insulin, and HOMA-IR were inversely associated with scores for inhibitory control (β = -3.16, β = -4.46; β = -3.90; p<0.for all), while fasting glucose was also associated with lower language scores (β = -3.88, p<0.05). Among children of other racial/ethnic groups, only fasting glucose was significantly associated with lower cognitive flexibility scores (β = -4.19, p<0.05). Our data suggest that metabolic health may impact cognitive development in young children. Further work is needed to replicate these findings and explore the neural underpinnings of these associations.


A.L.B. Shapiro: None. G. Wilkening: None. J.R. Tregellas: None. J. Aalborg: None. B. Ringham: None. A.V. Stamatoiu: None. A. Banning: None. D. Dabelea: None.

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