Stunting trajectories from post‐infancy to adolescence in Ethiopia, India, Peru, and Vietnam

Abstract

Many interventions focus on preventing stunting in the first 1,000 days of life. We take a broader perspective on childhood growth to assess the proportions of children who suffer persistent stunting, recover, and falter and become newly stunted between birth and adolescence. We use longitudinal data collected on 7,128 children in Ethiopia, India, Peru, and Vietnam. Data were collected in five survey waves between the ages of 1 to 15 years. We use descriptive and graphical approaches to compare the trajectories of children first stunted by age 1, first stunted by age 5, and those remained not stunted until age 5. On average, 29.6% of children were first stunted by age 1, 12.9% of children were first stunted by the age 5, and 68.7% of children were not stunted at either age 1 or age 5. A larger percentage of children stunted by age 1 remained stunted at age 15 (40.7%) compared with those who were first stunted by age 5 (32.3%); 33.7% of children first stunted by age 1 and 31.1% of children first stunted by age 5 go on to recover, but then falter during later childhood. 13.1% of children who were not stunted at age 1 or age 5 become newly stunted between the ages of 8 and 15. Our results show that children both become stunted and recover from stunting into adolescence. More attention should be paid to interventions to support healthy growth throughout childhood.

WITHDRAWN: A Comparison of International and National References to the Prevalence of Stunting in Pakistani School-age Girls

“…The results of present study highlight the importance of choice of references used to estimate the height status of children and adolescents to determine stunting, as it can signi cantly impact the strategies implemented by policy makers to address this abnormality. An appropriate assessment of stunting can also affect the decision of paediatricians to treat such a condition as now there is growing evidence that catch-up growth is possible till 15 years of age (14), thereby children can be stunted during early adolescence and can recover also by the use of timely strategies.…”

“…Recent researches in different populations provide growing body of evidence that there is a potential of catch-up growth in adolescent age among children with stunting. This catch-up linear growth can possibly lead to transition from stunted to non-stunted state during a growth phase known as the window period (14,15). The chances of catch-up growth are increased by adequate hygiene and nutrition, since children continuing to live in poorer/inadequate environments have limited potential for catch-up growth (16).…”

Stunting among Preschool Children in India: Temporal Analysis of Age-Specific Wealth Inequalities

“…While the relevance of nutrition-specific interventions during the first two years of life cannot be contested, evidence on reversible nature of growth failures at later ages should also be emphasized. For example, a recent study analyzing longitudinal data from multiple LMICs found that children are both at risk of becoming stunted and potentially recovering post two years of age [9]. Randomized control trials (RCT) have claimed that improvements in the living environment and overall socioeconomic well-being can significantly improve anthropometric outcomes irrespective of children's age [11,12].…”

“…This is a key concern for researchers as well as policymakers. Studies based on longitudinal data suggest that children can become stunted or recover from stunting during birth to adolescence [9] and therefore, this limitation does not affect inferences made in this study. Third, the wealth index provided by NFHS was taken as a proxy for household income; therefore, any conclusion regarding poverty and deprivation can be sensitive to the adopted proxy for household economic status.…”

“…This presumption implies that anthropometric failures are not only irreversible but also new incidences of undernutrition at later ages result solely from earlier deprivation. However, it is apparent that children with normal growth in the first two years of life are at risk of growth faltering in later years [9]. At the same time, while some children may suffer from irreversible forms of undernutrition, others can display substantial catch-up growth potentials [10][11][12].…”