Exploring the Nutritional Ecology of Stunting: New Approaches to an Old Problem

Abstract

Despite a declining prevalence, stunting remains an elusive target for the global health community. The perception is that stunting represents chronic undernutrition (i.e., due to inadequate nutrient intake associated with food insecurity, low-quality diet, and suboptimal infant feeding practices in the first two years of life). However, other causes include maternal–fetal interactions leading to intrauterine growth retardation, poor maternal nutrition during pregnancy and lactation, and maternal and pediatric infections. Moreover, physical, economic, demographic, and social environments are major contributors to both food insecurity and conditions that limit linear growth. Overall, factors representing both the internal and external “nutritional ecologies” need to be considered in efforts to reduce stunting rates. Nutritional assessment requires better understanding of the mechanism and role of nutrition in growth, clear expectations about the sensitivity and specificity of the tools used, and inclusion of bio-indicators reflecting the extent and nature of the functional effect of poor nutrition and environmental factors contributing to human physical growth. We provide a perspective on current knowledge about: (i) the biology and contribution of nutrition to stunting/poor growth; (ii) our current nutritional assessment toolkit; (iii) the implications of current assessment approaches for clinical care and public interventions; and (iv) future directions for addressing these challenges in a changing global health environment.

Synbiotic Fermented Milk with Double Fortification (Fe-Zn) as a Strategy to Address Stunting: A Randomized Controlled Trial among Children under Five in Yogyakarta, Indonesia

“…Nutrition intake, health status, and biological systems interact with each other [44]. The mechanisms underlying this interaction occur locally as well as systemically.…”

Nutritional profile of kian marine worm from kei islands maluku as a potential high protein food resource

“…Protein is a crucial nutrient in the regeneration of cells and tissues (Erviani & Arif, 2017). The implication of lack protein is increasing of susceptibility over disease and causes growth disorder in children namely stunting (Raiten & Bremer, 2020). Proteins also have an important role in the formation of biomolecules, such as enzymes (Alberts et al, 2002).…”

Nutrigenomics in Regulating the Expression of Genes Related to Type 2 Diabetes Mellitus

“…The genes may change during intrauterine life, when the nutrients and other food compounds can modulate gene expressions or even change the nucleotide sequence and modify the response of the organism in the presence of toxic and infectious compounds, in addition, the inherited individual genetic sequence can also influence diet, leading to the suppression of nutrients and risks for NCDs. The knowledge of these interactions between the genome and food contributes to the promotion of health and reduces the risks for NCDs through personalized diets ( Paparo et al, 2014 ; Raiten and Bremer, 2020 ).…”