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

Abstract

Background: Cross-sectional studies have shown associations between stunting and overweight; however, there are few prospective studies of stunted children. Objectives: To determine whether stunting before age 2 years is associated with overweight and central adiposity at 17-18 years and whether growth in height among stunted children predicts body mass index (BMI) in late adolescence. Design: Prospective cohort study. Participants: One-hundred and three participants stunted by age 2 years and 64 non-stunted participants (78% of participants enrolled in childhood). Participants were measured in early childhood and at ages 7, 11 and 17 years. Results: Stunted subjects remained shorter and had lower BMIs, smaller skinfolds and circumferences than non-stunted subjects. Overweight (BMI X25 m 2 ) was not significantly different among stunted and non-stunted male subjects (5.2 and 12.5%) but non-stunted female subjects were more likely to be overweight than those who experienced early childhood stunting (11.1 and 34.4%, P ¼ 0.013). Centralization of fat (waist to hip ratio (WHR), subscapular/triceps skinfold ratio (SSF/TSF)) did not differ between stunted and non-stunted groups (mean WHR 0.77 and mean SSF/TSF 1.18 in both groups). Stunted subjects with greater increases in height-for-age for the intervals 3-7 and 7-11 years had higher BMI at age 17 years (P ¼ 0.04 and P ¼ 0.001, respectively). Conclusion: Participants stunted by age 2 years were less likely to be overweight than those who were never stunted. This suggests that cross-sectional studies of the association between stunting and overweight may be misleading. Among stunted children, greater linear growth during mid-to late childhood was associated with greater BMI at age 17 years.

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

“…A greater prevalence of overweight in stunted children has been reported in cross-sectional studies (11, 12). These findings are not consistent with prospective studies that have found that stunting in early childhood is associated with decreased BMI or body fat in childhood (13, 14), adolescence (15–17), and adulthood (18), and other prospective studies have found null associations (17, 19, 20). To our knowledge, few studies have measured outcomes at >1 follow-up age (13, 14, 17), and none have considered age-specific patterns of overweight incidence and reversion.…”

Early Life Adversity with Height Stunting Is Associated with Cardiometabolic Risk in Adolescents Independent of Body Mass Index

“…Indeed, results on early growth stunting and later visceral adiposity have been mixed. 37 An obesogenic environment may be the critical component in the association of early life catch-up growth with later obesity and/or increased VAT. 38 …”

Fat free mass explains the relationship between stunting and energy expenditure in urban Mexican Maya children

“…Stunted and short height-for-age individuals may be at an increased risk of overweight or obesity (OW/OB) during the growing years compared with their non-stunted peers (Bogin and Loucky 1997;Smith et al 2003;Martins et al 2004;Hoffman et al 2007;Walker et al 2007;Corvalan et al 2008;Mardones et al 2008). Changes in resting metabolic rate (RMR) occur during the first 5 years of life (Grillo et al 2005), the same period that stunting most often occurs (Fox and Hillsdon 2007).…”