BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case–control study

Abstract

Objective: To compare the BMI, body fat and waist-to-height ratio (WHtR) of stunted and non-stunted children following different growth trajectories from low socio-economic strata in Mumbai, India. Design: Cross-sectional, case-control study. Weight, height, skinfold thicknesses and waist circumference were measured. Information regarding the duration of breast-feeding, age at initiation of complementary feeding and income was obtained. Birth weight was obtained from records. BMI, body fat, WHtR and change in weight SD were calculated. Setting: Children who were beneficiaries of anganwadis, Mumbai city, India. Subjects: Three hundred and thirty children aged 2-4 years were selected in each of the stunted and non-stunted groups after matching for age and sex. Results: After adjusting for birth weight, change in weight SD, duration of breastfeeding, age at complementary feeding initiation and income, stunted children had significantly higher body fat, WHtR and BMI than the non-stunted (P < 0·01). The stunted and non-stunted children were classified based on their change in weight SD. Stunted children with no change in weight SD had higher mean body fat, BMI (P < 0·01) and WHtR (P < 0·05) than their non-stunted counterparts. In the catch-up growth group, stunted children had higher BMI and WHtR than the non-stunted (both P < 0·001). In the catch-down growth group, stunted children had higher BMI than the non-stunted (P < 0·001). Conclusions: Stunting was seen to increase the tendency of conserving body fat in young children. Such a tendency, if continued during later childhood and adolescence, can increase the risk of obesity and non-communicable diseases. KeywordsStunting Body fat BMI Waist-to-height ratio Children IndiaGlobally, 171 million children (27 %) below 5 years of age were stunted in 2010 (1) . The problem of stunting or chronic undernutrition is deeply rooted in poverty and deprivation, affecting mainly the developing and underdeveloped nations. Over the previous two decades, the prevalence of stunting in Asia has reduced by half from 48·6 % to 27·6 % in the years 1990 to 2010 (1) . In comparison with the global rates, the prevalence of stunting in India is much higher (i.e. 48 %) with the rate in rural areas (50·7 %) exceeding that in urban ones (39·6 %) (2)

Comparison of Child Health between Sandwich Generation and Non-Sandwich Generation

“…The decrease in obesity happened due to a decrease in stunting, as the development of toddlers' body lengthens. This is consistent with studies stating that stunted children have a BMI with fat or obese category (Savanur & Ghugre, 2016).…”

Socio-economic and demographic correlates of stunting among adolescents of Assam, North-east India

“…The adolescents suffering due to stunting are more likely to develop overweight and obesity in adulthood (Keino et al 2014;Savanur and Ghugre 2016). Thus, it is imperative to identify the magnitude of stunting at early stages in life.…”

Prevalence of stunting and obesity in Ecuador: a systematic review

“…This pattern of independent distribution does not, however, explain the fact that stunting and obesity co-exist within the same Indigenous communities in Ecuador (3) and other countries (59,62) . While this coexistence is unexpected, since stunting is caused by undernutrition and obesity is the result of over-nutrition, previous studies indicated that early life stunting is a risk factor for the development of obesity at later age (59,62,63) through a physiological adaptation mechanism referred to as 'catch-up' or 'post-starvation obesity' (64)(65)(66)(67) . Because stunting and obesity, considered separately, each presents an important risk factor for the development of diseases, the co-existence of both conditions represents a double burden that increases tremendously public health concerns.…”