Associations of stunting at 2 years with body composition and blood pressure at 8 years of age: longitudinal cohort analysis from lowland Nepal

Wells, Jonathan C. K.; Devakumar, Delan; Manandhar, Dharma S; Saville, Naomi; Chaube, Shiva Shankar; Costello, Anthony; Osrin, David

doi:10.1038/s41430-018-0291-y

Cited by 22 publications

(23 citation statements)

References 38 publications

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“…The association between child weight and stunting could be very strong because there are a few children with a large weight and being stunted at the same time; hence, this could inflate the association. Children’s weights reflect body composition with a recent study finding that stunted mothers have low body composition, including small kidneys and other organs, are thin, and give birth to small infants [ 31 ]. The implication of this finding is that weight monitoring of children is critical in preventing and intervening in cases of stunting.…”

Section: Discussionmentioning

confidence: 99%

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS)

et al. 2020

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Background Despite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data. Methods This study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model. Results The study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6–24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations. Conclusion The model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24–59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

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Section: Discussionmentioning

confidence: 99%

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS)

et al. 2020

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“…As with the loss of muscle mass during severe weight loss, stunted children show persistent deficits in lean mass, including small organ size 19 and lower muscle mass, which raises mortality risk during infections. 20 Furthermore, children who are wasted or stunted also have lower fat mass, 19,21,22 which might harm systemic immune function through the mediating effects of the hormone leptin. Because leptin also stimulates bone growth, this effect might explain why children who are wasted have slow linear growth.…”

Section: New Evidencementioning

confidence: 99%

Beyond wasted and stunted—a major shift to fight child undernutrition

Wells

Briend

Boyd

et al. 2019

The Lancet Child & Adolescent Health

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Child undernutrition refers broadly to the condition in which food intake is inadequate to meet a child's needs for physiological function, growth, and the capacity to respond to illness. Since the 1970s, nutritionists have categorised undernutrition in two major ways, either as wasted (i.e., low weight for height, or small mid-upper arm circumference) or stunted (i.e., low height for age). This approach, although useful for identifying populations at risk of undernutrition, creates several problems: the focus is on children who have already become undernourished, and this approach draws an artificial distinction between two idealised types of undernourished children that are widely interpreted as indicative of either acute or chronic undernutrition. This distinction in turn has led to the separation of programmatic approaches to prevent and treat child undernutrition. In the past 3 years, research has shown that individual children are at risk of both conditions, might be born with both, pass from one state to the other over time, and accumulate risks to their health and life through their combined effects. The current emphasis on identifying children who are already wasted or stunted detracts attention from the larger number of children undergoing the process of becoming undernourished. We call for a major shift in thinking regarding how we assess child undernutrition, and how prevention and treatment programmes can best address the diverse causes and dynamic biological processes that underlie undernutrition. The problem framed Child undernutrition refers broadly to the condition in which food intake does not meet the needs of physiological function, growth, and the capacity to respond to illness. Despite substantial progress in preventing and treating child undernutrition in the past three decades, approximately 5 million annual deaths in children younger than 5 years occur worldwide, 1 of which nutrition-associated factors still account for almost half of these deaths. 2 In the longer term, child undernutrition is associated with adverse effects on health and human capital. 3 The overarching strategy to address these issues is to bring together nutrition-specific interventions, targeting both mothers and their offspring in populations at risk, with nutrition-sensitive approaches that address broader underlying factors such as women's empowerment, food systems, socioeconomic factors, and disease prevention. 4 These efforts are central to Sustainable Development Goal 2.2, which aims to end all forms of malnutrition by 2030, and to reach internationally agreed targets on stunting and wasting in children under 5 years by 2025. 5 Our focus in this Viewpoint is on how the efforts to meet this goal are shaped by the way that agencies conceptualise undernutrition at the level of the individual child.

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“…The association is very strong as there are a few children with a large weight and being stunted at same time; hence, this inflates the association. Child weight reflects body composition with a recent study finding that stunted mother have low body composition including small kidneys and other organs, are thin, and birth small infants [31]. The implication of this finding is that weight monitoring of children is critical in preventing and intervening stunting.…”

Section: Discussionmentioning

confidence: 99%

Modeling the Predictors of Stunting in Ethiopia: Analysis of 2016 Ethiopian Demographic Health Survey Data (EDHS)

Mengesha

Vatanparast

Feng

et al. 2019

Preprint

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Background Despite the continued effort to address malnutrition, there is a minimal reduction in the rate of stunting in developing countries including Ethiopia. Nutritional and socioeconomic factors have not been assed using a rigorous analysis so far. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic health survey. Methods This study is a secondary of data analysis of the 2016 EDHS survey. 7909 children of age 6-59 months were included. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding and multicolinearity were checked. Bivariable and multivariable logistic regression were carried out. Odds ratio and 95% confidence interval were calculated. Receiver operative curve was built to estimate the sensitivity and specificity of the model. Result The study identified as 39.2% of children included to this analysis were stunted. 76.47%, 84.27%, 92.62% of the children did not consume fruits and vegetables, legumes and lentils, and meat and its products respectively. Children aged 24 month to 59 months were at 9.71 times higher risk of being stunted compared to younger children of age 6-24 months old (AOR: 9.71; CI: 8.07, 11.6 children) with weights below 9.1 kilogram were at 27.86 odds of being stunted compared to those weight of 23.3 kg and above. Moreover, mothers below 150 cm tall (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54) and being male (AOR: 1.4; CI: 1.26, 1.56) were associated with stunting. Predictive ability of the model was 77% correctly such pair of observation. Conclusion The model indicates that being born male, being from a mother of short stature, living in the rural area, small child size, mother with mild anemia, being from a husband with no education or primary education only, having low weight, and reaching age above 24 months increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

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Associations of stunting at 2 years with body composition and blood pressure at 8 years of age: longitudinal cohort analysis from lowland Nepal

Cited by 22 publications

References 38 publications

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS)

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS)

Beyond wasted and stunted—a major shift to fight child undernutrition

Modeling the Predictors of Stunting in Ethiopia: Analysis of 2016 Ethiopian Demographic Health Survey Data (EDHS)

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