How socioeconomic status moderates the stunting-age relationship in low-income and middle-income countries

Bommer, Christian; Vollmer, Sebastián; Subramanian, S. V.

doi:10.1136/bmjgh-2018-001175

Cited by 37 publications

(30 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additional analysis from a univariate analysis indicated that children aged 0–23 months from poorest households were 2.45 times [OR = 2.45, 95% CI (1.99–3.02)] more likely to be stunted than those from richest households but after adjusting for underlying factors, household wealth index was not associated with stunting. The finding was in contrary to previous research [ 56 ].…”

Section: Discussioncontrasting

confidence: 99%

Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

2020

View full text Add to dashboard Cite

South Asia continues to be the global hub for child undernutrition with 35% of children still stunted in 2017. This paper aimed to identify factors associated with stunting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent Demographic and Health Surveys (2014–2018) was combined of five countries in South Asia. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. The common factors associated with stunting in three age groups were mothers with no schooling ([adjusted odds ratio (AOR) for 0–23 months = 1.65; 95% CI: (1.29, 2.13)]; [AOR for 24–59 months = AOR = 1.46; 95% CI: (1.27, 1. 69)] and [AOR for 0–59 months = AOR = 1.59; 95% CI: (1.34, 1. 88)]) and maternal short stature (height < 150 cm) ([AOR for 0–23 months = 2.00; 95% CI: (1.51, 2.65)]; [AOR for 24–59 months = 3.63; 95% CI: (2.87, 4.60)] and [AOR for 0–59 months = 2.87; 95% CI: (2.37, 3.48)]). Study findings suggest the need for a balanced and integrated nutrition strategy that incorporates nutrition-specific and nutrition-sensitive interventions with an increased focus on interventions for children aged 24–59 months.

show abstract

Section: Discussioncontrasting

confidence: 99%

Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

2020

View full text Add to dashboard Cite

show abstract

“…IUGR is an interesting intersection point for the purpose of this study that is environment driven, highly prevalent in developing nations, results in smaller organs and low birth weight infants with a higher susceptibility to diarrheal and lower respiratory tract infections. This sequence, which may even persist beyond a single generation since maternal size is in itself a limiting point for fetal growth, leads to repeated growth faltering and reinfections, which are implicated in stunting 28 – 31 . IUGR, as a consequence of maternal loss of growth potential, may be considered a point of convergence in the pathways for poor lung development and stunting, for which we have more data than either of the two alone.…”

Section: Resultsmentioning

confidence: 99%

Low lung function in the developing world is analogous to stunting: a review of the evidence

Mishra

Salvi²,

Lyngdoh

et al. 2020

Wellcome Open Res

View full text Add to dashboard Cite

Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than just genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with genetic, environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates shared chronic inflammatory pathways, indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, with malnutrition at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. This counter the idea of redefining the normal for lung function measurements, since observed inter-ethnic variations are likely a mix of natural genetic differences as well as differences in nurture such that reduced lung function reflects early life adversities.

show abstract

“…A large number of studies across and within the countries suggests the strong and significant association of malnutrition with economic factors. While a limited number of studies use income as an economic measures, many studies used consumption expenditure and assetbased index (henceforth refer as wealth index) in explaining malnutrition [25][26][27][28][29]. Cross-country studies found that the gross domestic products (GDP) per capita is negatively associated with malnutrition [30,31].…”

Section: Introductionmentioning

confidence: 99%

“…Other than economic factors, many non-economic factors such as social identity, household environment, water and sanitation are considered as significant predictors of child malnutrition at household level [3,[35][36][37]. The maternal characteristics such as maternal education, anthropometry, mothers' hygienic practice and individual characteristics such as child's sex, birth order, immunisation, and birth weight are factors associated with malnutrition [25,36,[38][39][40][41][42].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition and poverty in India: does the use of public distribution system matter?

et al. 2020

View full text Add to dashboard Cite

Background Large scale public investment in Public Distribution System (PDS) have aimed to reduce poverty and malnutrition in India. The PDS is the largest ever welfare programme which provides subsidised food grain to the poor households. This study attempt to examine the extent of stunting and underweight among the children from poor and non-poor households by use of public distribution system (PDS) in India. Methods Data from the National Family and Health Survey-4 (NFHS-4), was used for the analysis. A composite variable based on asset deprivation and possession of welfare card provided under PDS (BPL card), was computed for all households and categorised into four mutually exclusive groups, namely real poor, excluded poor, privileged non-poor and non-poor. Real poor are those economically poor and have a welfare card, excluded poor are those economically poor and do not have welfare card, privileged poor are those economically non-poor but have welfare card, and non-poor are those who are not economically poor and do not have welfare card. Estimates of stunting and underweight were provided by these four categories. Descriptive statistics and logistic regression were used for the analysis. Results About half of the children from each real poor and excluded poor, two-fifths among privileged non-poor and less than one-third among non-poor households were stunted in India. Controlling for socio-economic and demographic covariates, the adjusted odds ratio of being stunted among real poor was 1.42 [95% CI: 1.38, 1.46], 1.43 [95% CI: 1.39, 1.47], among excluded poor and 1.15 [95% CI: 1.12, 1.18], among privileged non-poor. The pattern was similar for underweight and held true in most of the states of India. Conclusions Undernutrition among children from poor households those excluded from PDS is highest, and it warrants inclusion in PDS. Improving the quality of food grains and widening food basket in PDS is recommended for reduction in level of malnutrition in India.

show abstract

How socioeconomic status moderates the stunting-age relationship in low-income and middle-income countries

Cited by 37 publications

References 29 publications

Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

Low lung function in the developing world is analogous to stunting: a review of the evidence

Malnutrition and poverty in India: does the use of public distribution system matter?

Contact Info

Product

Resources

About