Stunting, adiposity, and the individual‐level “dual burden” among urban lowland and rural highland peruvian children

Pomeroy, Emma; Stock, Jay T.; Stanojevic, Sanja; Miranda, J. Jaime; Cole, Tim; Wells, Jonathan C. K.

doi:10.1002/ajhb.22551

Cited by 35 publications

(32 citation statements)

References 87 publications

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“…Although our study does not indicate an increased overall risk of higher BMIZ, we did find differences between urban and rural children at ages 5 and 8 y, and between indigenous and nonindigenous children at age 8 y. RRs of prevalent and incident BMIZ > 1 for rural and indigenous children were >1, but not significantly. Another study in Peru found that in urban lowland children, length was positively associated with BMI (37), which is consistent with our finding that infant stunting is associated with reduced prevalence and incidence of BMIZ > 1 at age 8 y in urban children. The authors of that study suggested that differences between rural and urban populations may arise from environments that present different opportunities for catch-up growth and the accrual of adipose tissue.…”

Section: Discussionsupporting

confidence: 92%

Stunting in Infancy Is Associated with Decreased Risk of High Body Mass Index for Age at 8 and 12 Years of Age

Andersen

Stein

Reynolds

et al. 2016

The Journal of Nutrition

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Background: Effects of early-life stunting on adiposity development later in childhood are not well understood, specifically with respect to age in the onset of overweight and obesity.Objectives: We analyzed associations of infant stunting with prevalence of, incidence of, and reversion from high body mass index–for-age z score (BMIZ) later in life. We then estimated whether associations of infant stunting with BMIZ varied by sex, indigenous status, and rural or urban residence.Methods: Data were collected from 1942 Peruvian children in the Young Lives cohort study at ages 1, 5, 8, and 12 y. Multivariable generalized linear models estimated associations of stunting (height-for-age z score <−2) at age 1 y with risk of BMIZ > 1 and BMIZ > 2 prevalence, incidence (moving above a BMIZ threshold between ages), and reversion (moving below a BMIZ threshold between ages) at later ages.Results: After adjustment for covariates, stunting at age 1 y was associated with a lower prevalence of BMIZ > 1 at age 8 y (RR: 0.81; 95% CI: 0.66, 1.00; P = 0.049) and 12 y (RR: 0.75; 95% CI: 0.61, 0.91; P = 0.004), as well as a lower prevalence of BMIZ > 2 at age 8 y. Stunting was not associated with incident risk of BMIZ > 1 or BMIZ > 2. Stunting was positively associated at age 5 y with risk of reversion from BMIZ > 1 (RR: 1.22; 95% CI: 1.05, 1.42; P = 0.008) and BMIZ > 2. We found evidence that the association of stunting with prevalent and incident BMIZ > 1 was stronger for urban children at ages 5 and 8 y, and for nonindigenous children at age 8 y.Conclusions: Stunting predicted a lower risk of prevalent BMIZ > 1 and BMIZ > 2, even after controlling for potential confounders. This finding may be driven in part by a higher risk of reversion from BMIZ > 1 by age 5 y. Our results contribute to an understanding of how nutritional stunting in infancy is associated with BMIZ later in life.

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Section: Discussionsupporting

confidence: 92%

Stunting in Infancy Is Associated with Decreased Risk of High Body Mass Index for Age at 8 and 12 Years of Age

Andersen

Stein

Reynolds

et al. 2016

The Journal of Nutrition

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“…However, other stressors such as increased radiation, aridity, broader temperature ranges, and poorer diets may also affect developmental characteristics in these environments (Leonard 1989;West et al 2007;Pomeroy et al 2014). Evidence for HA adaptation was shown in Tibetans (Beall et al 2010;Bigham et al 2010;Yi et al 2010;Peng et al 2011;Simonson et al 2012), Andeans Bigham et al 2009Bigham et al , 2010Zhou et al 2013;Eichstaedt et al 2014), and Ethiopians (Alkorta-Aranburu et al 2012;Scheinfeldt et al 2012;Huerta-Sanchez et al 2013;Udpa et al 2014), thus demonstrating the effects of long-term exposure to hypoxia above 3000 m. However, little is known about the effects of moderate levels of hypoxia on human physiology, such as those found at intermediate altitudes (IA), which we define hereafter as altitudes between 2000 and 3000 m. Some indication that moderate hypoxia may have a physiological impact comes from evidence of an albeit modest occurrence of Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE) (West et al 2007), and birth weight reduction (Mortola et al 2000) just above 2000 m.…”

Section: Introductionmentioning

confidence: 99%

Genetic and Phenotypic Differentiation of an Andean Intermediate Altitude Population

et al. 2016

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Highland populations living permanently under hypobaric hypoxia have been subject of extensive research because of the relevance of their physiological adaptations for the understanding of human health and disease. In this context, what is considered high altitude is a matter of interpretation and while the adaptive processes at high altitude (above 3000 m) are well documented, the effects of moderate altitude (below 3000 m) on the phenotype are less well established. In this study, we compare physiological and anthropometric characteristics as well as genetic variations in two Andean populations: the Calchaqu ıes (2300 m) and neighboring Collas (3500 m). We compare their phenotype and genotype to the sea-level Wich ı population. We measured physiological (heart rate, oxygen saturation, respiration rate, and lung function) as well as anthropometric traits (height, sitting height, weight, forearm, and tibia length). We conducted genome-wide genotyping on a subset of the sample (n = 74) and performed various scans for positive selection. At the phenotypic level (n = 179), increased lung capacity stood out in both Andean groups, whereas a growth reduction in distal limbs was only observed at high altitude. At the genome level, Calchaqu ıes revealed strong signals around PRKG1, suggesting that the nitric oxide pathway may be a target of selection. PRKG1 was highlighted by one of four selection tests among the top five genes using the population branch statistic. Selection tests results of Collas were reported previously. Overall, our study shows that some phenotypic and genetic differentiation occurs at intermediate altitude in response to moderate lifelong selection pressures.

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“…Much of the evidence to support the relationship between stunting and obesity emerges from some cross-sectional studies that point towards a possible risk of overweight/ obesity among stunted children (7)(8)(9)(10)(11) and adolescents (12)(13)(14) . Some studies have also shown that stunted children and adolescents have higher total body fat percentage (BF%) and central adiposity (14)(15)(16)(17)(18) .…”

mentioning

confidence: 99%

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

Savanur¹,

Ghugre²

2016

Public Health Nutr.

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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)

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Stunting, adiposity, and the individual‐level “dual burden” among urban lowland and rural highland peruvian children

Cited by 35 publications

References 87 publications

Stunting in Infancy Is Associated with Decreased Risk of High Body Mass Index for Age at 8 and 12 Years of Age

Stunting in Infancy Is Associated with Decreased Risk of High Body Mass Index for Age at 8 and 12 Years of Age

Genetic and Phenotypic Differentiation of an Andean Intermediate Altitude Population

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

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