Growth faltering and recovery in children aged 1-8 years in four low- and middle-income countries: Young Lives

• Authors: Elizabeth A. Lundeen, Emory University; Jere R. Behrman, University of Pennsylvania; Benjamin T. Crookston, Brigham Young University; Kirk A. Dearden, Boston University; Patrice Engle, Cal Poly State University; Andreas Georgiadis, University of Oxford; Mary E. Penny, Harvard University; Aryeh Stein, Emory University
• Journal Title: Public Health Nutrition
• Volume: Volume 17, Number 9
• Publisher: Cambridge University Press (CUP): PDF allowed | 2014-09-01, Pages 2131-2137
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1017/S1368980013003017
• Subjects: Health Sciences, Public Health; Sociology, Public and Social Welfare
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Nutrition & Dietetics; Child growth; Stunting; Growth faltering; Growth recovery; Height-for-age Z-score; CATCH-UP GROWTH; COHORT PROFILE; LINEAR GROWTH

Abstract

Objective: We characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting. Design: Data came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries. Setting: We analysed length/height measurements for children at ages 1, 5 and 8 years. Subjects: Children (n 7171) in Ethiopia, India, Peru and Vietnam. Results: Mean height-for-age Z-score (HAZ) at age 1 year ranged from -1.51 (Ethiopia) to -1.08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0.27 in Ethiopia (P < 0.001) and decreased among the other cohorts (range: -0.19 (Peru) to -0.32 (India); all P < 0.001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0.19 (India) to 0.38 (Peru); all P < 0.001). Prevalence of stunting (HAZ<-2.0) at 1 year ranged from 21 % (Vietnam) to 46 % (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15.1 percentage points in Ethiopia (P < 0.001) and increased in the other cohorts (range: 3.0 percentage points (Vietnam) to 5.3 percentage points (India); all P ≤ 0.001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5.0 percentage points (Vietnam) to 12.7 percentage points (Peru); all P < 0.001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11 % (Vietnam) to 22 % (India); between ages 5 to 8 years, it ranged from 3 % (Peru) to 6 % (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27 % (Vietnam) to 53 % (Ethiopia); between ages 5 and 8 years, it ranged from 30 % (India) to 47 % (Ethiopia). Conclusions: We found substantial recovery from early stunting among children in four low- and middle-income countries.