Preschool stunting, age at menarche and adolescent height: a longitudinal study in rural Senegal

Abstract

Objective: To study the impact of preschool stunting on adolescent height and age at menarche in rural West Africa. Design: A longitudinal, population-based study. Setting: The Niakhar study area in Central Senegal. Subjects: 1650 children aged 12±17 y with known height-for-age at the age of 2±5 y. Main outcome measures: Adolescent height; mean age at menarche of girls estimated by the status quo method. Results: The subjects were divided into three groups of preschool height-for-age:`72, 72 to 71 and b 71 z-score of the NCHS reference. The mean height during adolescence differed signi®cantly according to preschool height-for-age for both boys and girls (P`0.001). Relative risk of adolescent stunting according to preschool stunting varied from 2.0 ± 4.0 depending on age and sex. Estimated mean age at menarche was 17.2 (95% ®ducial con®dence interval: 16.6 ±18.7), 16.5 (16.1±17.2) and 15.6 (15.2±16.0) y, respectively, for the three groups of preschool height-for-age (P`0.001). Mean increment from age 5 y to adolescence did not differ signi®cantly among the boys according to preschool stunting, but among the girls aged 16 ±17 y, the increment was higher for those who had been stunted during preschool life (P`0.01). Conclusion: Some evidence of catch-up growth between the ages of 5 and 17 y was found for stunted girls. The signi®cant delay in sexual maturation of the stunted girls suggests that stunted children of both sexes have a possibility of catch-up growth after the age of 17 y. Sponsorship: The preschool study was supported by the EEC (TSD-036).

Age patterns in stunting and anaemia in African schoolchildren: a cross-sectional study in Tanzania

“…The parasitological ®ndings and their signi®cance have been discussed elsewhere (Lwambo et al, in press). The nutritional patterns revealed in the present study are similar to those already described in cross-sectional studies (Martorell et al, 1994;Stoltzfus et al, 1997a;Partnership for Child Development, 1998a, b) and in longitudinal anlaysis (Cameron et al, 1994;Simondon et al, 1998). The present results are noteworthy because of the large sample size covering a broad age range, and in particular the extension into the adolescents years.…”

“…Among girls, it is apparent that compensatory growth in height begins to occur at 12 y. This explanation is supported by recent longitudinal data from Senegal which show that mean height of girls was characterized by progressive catch-up, with full compensatory growth occurring, whereas there was an increasing de®cit among boys with a possible upturn at 17 y (Simondon et al, 1998). Longitudinal data from South Africa also demonstrates that the progressive decrease in z-scores is reversed in girls at 13.5 y and in boys at 15.5 y (Cameron et al, 1994).…”

“…Recently this absence of data has been reversed with an increasing number of published surveys among schoolchildren in Africa (Cameron et al, 1994;Partnership for Child Development, 1998a, b;Simondon et al 1998;Stoltzfus et al, 1997a, b). These studies have shown a trend for stunting to increase with age, suggesting that linear growth is retarded and that stunting is persistent throughout the early school-aged years.…”

“…Moreover, these studies have demonstrated a reduction in stunting among older girls at an age when the prevalence of stunting amongst boys is progressively increasing. This is thought to be a function of differential drop out of relatively disadvantaged girls leaving better-nourished girls in school (Partnership for Child Development, 1998b) or due to age-speci®c differences in catch-up growth between the sexes (Simondon et al, 1998). A reduction in the prevalence of anaemia throughout the school-aged years has also been observed, with more boys than girls being anaemic in the younger years, but anaemia becoming more common girls during adolescence (Stoltzfus et al, 1997b).…”

Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents

“…The current study found no significant differences between socioeconomic levels and BMI or nutritional status, so there may be other factors connecting socioeconomic status and age at menarche. Studies in Africa have suggested that malnutrition in early childhood can delay pubertal development, menarche, and other growth processes 31 . It is unlikely that this would explain the findings among girls in the current study, since nutritional status during early childhood is adequate in Chile, and malnutrition is rare among children under six years of age 32 .…”