Relationship between stunting in infancy and growth and fat distribution during adolescence in Senegalese girls

Abstract

Objective: To study the long-term impact of stunting during infancy on maturation, growth and fat distribution in adolescence. Design: A cohort of 406 Senegalese adolescent girls of rural origin underwent clinical and growth assessments every year from 1995 to 1999. Subjects: Mean coverage rate was 82% at each round. Adolescent girls were 11.4 AE 0.5 y of age in 1995 and 15.5 AE 0.5 y of age in 1999. Their growth status during infancy was known. About 20% of the girls had a height ± age (H ± age) below À2 Z-scores (chronic malnutrition or stunting) when they were 6 ± 18 months of age. As adolescents, the girls were divided into two groups on the basis of H ± age: those stunted and those non-stunted during infancy. Measurements: Sexual maturation was assessed by stage of breast development and menarche. Height, body mass, sitting height, bi-iliac and bi-acromial diameters, and six skinfolds were measured. Results: Differences in sexual maturation between previously stunted and non-stunted girls were not signi®cant. Girls stunted at infancy caught up in body weight and subcutaneous fat mass during puberty, but they did not catch up on stature, sitting height or skeletal breadths (bi-acromial and bi-iliac diameters) until the ®nal observation in 1999. Stunted girls did not have less subcutaneous fat (sum of six skinfolds) or a lower BMI. Regional variation in subcutaneous fat distribution (Z-score pro®le) indicated greater accretion at the biceps and subscapular sites in stunted compared to the non-stunted girls. Regional fat distribution was also assessed by principal component analysis (PCA) performed on the residuals of the six skinfolds measured during the ®nal round (1999). PCA identi®ed three components. Stunted and non-stunted girls were similar for the ®rst (trunk ± extremity contrast) and second (anterior ± posterior contrast) components. However, there was a difference for the third component: stunted girls tended to accumulate more subcutaneous fat on the upper part of the body (trunk or arms) than nonstunted girls. Conclusion: Stunted Senegalese girls have a potential for catching up in growth during puberty. The greater accumulation of subcutaneous fat on the upper body in stunted girls may be a consequence of complex hormonal adjustments at the onset of puberty. Sponsorship: Institut de Recherche pour le De Âveloppement (IRD anciennement ORSTOM) and the Nestle  Foundation.

The association between early childhood stunting and weight status in late adolescence

“…17 This tendency for stunted girls to catch up in body fat was also reported in Senegalese girls at age 11-15 years. 11 However, in neither study was there any evidence that stunted girls became fatter than those who were never stunted.…”

“…We previously reported that stunted children identified at age 9-24 months remained thinner at age 11 years than non-stunted children from the same neighborhoods. 10 A study of girls aged 11-15 years in Senegal found no difference in body mass index (BMI) or body fat between those stunted or non-stunted in infancy, 11 suggesting some catch-up in weight in the stunted group as they were thinner in infancy. Follow-up of Guatemalan children showed that childhood stunting was associated with lower BMI and body fat among men at age 18-24 years but no relation was found in women.…”

Nutritional status, growth and sleep habits among Senegalese adolescent girls

“…Measurements were taken in duplicate and were averaged to minimize the variance. Interand intraobserver coefficients of variation were low (Bénéfice et al, 2001b).…”

“…Since 1995, our group has been performing a follow-up study on growth and maturation throughout puberty in a sample of approximately 390 adolescents, including almost all the girls in the district of Niakhar (Center of Senegal) born in 1983 and 1984 (Bénéfice et al, 2001b). We hypothesized that growth and maturation delays observed in these adolescent girls were linked to high daily energy expenditure due to an excessive workload that may create competition between familial and social pressure to work, and the satisfaction of their nutritional and energy needs.…”

Proporcionalidade corporal na avaliação antropométrica de adolescentes pós-menarca

“…Isso porque os eventos da puberdade relacionam--se ao estado nutricional, especialmente ao perfil de composição corporal e, portanto, esse aspecto constitui um potencial fator de confusão 25 .…”