TY - JOUR

T1 - Wasting is associated with stunting in early childhood

AU - Richard, Stephanie A

AU - Black, Robert E

AU - Gilman, Robert H

AU - Guerrant, Richard L

AU - Kang, Gagandeep

AU - Lanata, Claudio F

AU - Mølbak, Kåre

AU - Rasmussen, Zeba A

AU - Sack, R Bradley

AU - Valentiner-Branth, Palle

AU - Checkley, William

AU - Childhood Infection and Malnutrition Network

A2 - Fischer, Thea Kølsen

PY - 2012/7

Y1 - 2012/7

N2 - The longitudinal relationship between stunting and wasting in children is poorly characterized. Instances of wasting or poor weight gain may precede linear growth retardation. We analyzed longitudinal anthropometric data for 1599 children from 8 cohort studies to determine the effect of wasting [weight-for-length Z-score (WLZ) < -2] and variability in WLZ in the first 17 mo on length-for-age Z-score (LAZ) at 18-24 mo of age. In addition, we considered the effects of change in WLZ during the previous 6-mo period on length at 18 and 24 mo. Wasting at 6-11 or 12-17 mo was associated with decreased LAZ; however, children who experienced wasting only at 0-5 mo did not suffer any long-term growth deficits compared with children with no wasting during any period. Children with greater WLZ variability (≥0.5 SD) in the first 17 mo of life were shorter [LAZ = -0.51 SD (95% CI: -0.67, -0.36 SD)] at 18-24 mo of age than children with WLZ variability <0.5. Change in WLZ in the previous 6-mo period was directly associated with greater attained length at 18 mo [0.33 cm (95% CI: 0.11, 0.54 cm)] and 24 mo [0.72 cm (95% CI: 0.52, 0.92 cm)]. Children with wasting, highly variable WLZ, or negative changes in WLZ are at a higher risk for linear growth retardation, although instances of wasting may not be the primary cause of stunting in developing countries.

AB - The longitudinal relationship between stunting and wasting in children is poorly characterized. Instances of wasting or poor weight gain may precede linear growth retardation. We analyzed longitudinal anthropometric data for 1599 children from 8 cohort studies to determine the effect of wasting [weight-for-length Z-score (WLZ) < -2] and variability in WLZ in the first 17 mo on length-for-age Z-score (LAZ) at 18-24 mo of age. In addition, we considered the effects of change in WLZ during the previous 6-mo period on length at 18 and 24 mo. Wasting at 6-11 or 12-17 mo was associated with decreased LAZ; however, children who experienced wasting only at 0-5 mo did not suffer any long-term growth deficits compared with children with no wasting during any period. Children with greater WLZ variability (≥0.5 SD) in the first 17 mo of life were shorter [LAZ = -0.51 SD (95% CI: -0.67, -0.36 SD)] at 18-24 mo of age than children with WLZ variability <0.5. Change in WLZ in the previous 6-mo period was directly associated with greater attained length at 18 mo [0.33 cm (95% CI: 0.11, 0.54 cm)] and 24 mo [0.72 cm (95% CI: 0.52, 0.92 cm)]. Children with wasting, highly variable WLZ, or negative changes in WLZ are at a higher risk for linear growth retardation, although instances of wasting may not be the primary cause of stunting in developing countries.

KW - Anthropometry

KW - Body Height

KW - Body Weight

KW - Child, Preschool

KW - Developing Countries

KW - Female

KW - Growth

KW - Growth Disorders/etiology

KW - Humans

KW - Infant

KW - Longitudinal Studies

KW - Male

KW - Wasting Syndrome/complications

U2 - 10.3945/jn.111.154922

DO - 10.3945/jn.111.154922

M3 - Journal article

VL - 142

SP - 1291

EP - 1296

JO - The Journal of Nutrition

JF - The Journal of Nutrition

SN - 0022-3166

IS - 7

ER -