Weight-for-Height, Body Fat, and Development in Children in the East Asia and Pacific Region

Abstract

IMPORTANCE Weight-for-height z score (WHZ) is a standard indicator of children's nutritional status even though it does not fully reflect body fat. OBJECTIVE To examine the combined association of WHZ and body fat with early development in the East Asia and Pacific region. DESIGN, SETTING, AND PARTICIPANTS Children from the East Asia-Pacific Early Child Development Scales validation study, with full data available regarding their nutritional status and outcomes, were included in this cross-sectional analysis. In brief, a multilevel stratified random sampling was used to select representative samples from each participating country in the study. WHZ and body fat were independently trichotomized using established references and were combined to form a 9-category exposure variable. Data collection was performed between 2012 and 2014, and the analyses were conducted in June 2021. MAIN OUTCOMES AND MEASURES The binary outcome variable of not being developmentally on track (hereafter referred to as poor development) was defined as a score less than the 25th percentile in the following domains: cognitive, language, socioemotional, motor development, and total development score. Poisson regression models were used to analyze the associations between the combined categories and poor development, adjusted for sociodemographic factors. RESULTS A total of 6815 children (mean [SD] age, 4.02 [0.8] years; 3434 girls [50.4%]) had full data available and were included in this study. Compared with children with normal weight and normalfat, those with wasting and low body fat had the highest likelihood of total poor development (prevalence ratio, 1.47; 95% CI, 1.28-1.70), followed by those with normal weight but low fat (prevalence ratio, 1.23; 95% CI,. Similar associations were found in language, cognitive, and socioemotional development, but not in motor development. CONCLUSIONS AND RELEVANCEPoor development was more commonly found in children with low body fat independent of WHZ (wasted or normal weight). Early public health strategies may consider using a combination of WHZ and body fat as an indicator of poor development.

Hygiene Practices and Early Childhood Development in the East Asia-Pacific Region: A Cross-Sectional Analysis

“…Moreover, cumulative microbial ingestion may lead to chronic inflammation and can subsequently contribute to malnutrition and altered brain development, two conditions directly associated with ECD during the critical development period [6]. In fact, we previously showed the relevance of nutritional status on ECD using the EAP-ECDS data [25,26]. On the other hand, poor oral health is an important driver of caries, which is associated with speech problems, cognition, and overall development [6,13].…”

Nominal Group Technique Application Towards Design of Nutrition Education Module to Prevent Stunting Problems among Preschool Children

“…In total, 149 million children under five years of age suffer from stunting (Global Nutrition Report, 2020;Laureati, 2022). In 2020, it was found that the total number of children suffering from stunting was 149.2 million (Petermann-Rocha et al, 2022). The problem of child stunting has recently gained public attention in Malaysia, but there is still a general lack of understanding about this issue (Kok, 2020).…”

Stunting among Preschool Children: A Review of The Effects of Cognitive and Literacy Development

“…As we can see, there are several forms of malnutrition. Most of the children suffered from thin (underweight) weight below the recommended level for a particular age; too thin (wasting) weight below the recommended level for a particular height; and short (stunting) height below the recommended level for a particular age (Petermann-rocha et al, 2022). All of these causes affect children's developing physical and mental that cause various forms of malnutrition.…”

“…Among the effects caused by this problem, stunting children is increasing and deserves attention. Petermann et al (2022) found that by 2020, approximately 149.2 million children will be stunting (Petermann-rocha et al, 2022). By 2025, the number of stunted children is estimated at 131 million (27 million exceeding the expected 40% reduction in the target number of stunting children) (Ali, 2021;Woreda et al, 2021).…”