Perspective: What Does Stunting Really Mean? A Critical Review of the Evidence

Advances in Nutrition

Volumn 10, Issue 2, 2019, Pages 196-204

  Leroy, Jef L ^a   Frongillo, Edward A ^b  

^a INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE   (United States)

^b UNIVERSITY OF SOUTH CAROLINA   (United States)

Author keywords

birth outcomes; causality; child development; chronic disease; earnings; global development objective; linear growth retardation; marker; stunting; undernutrition

Indexed keywords

CHILD; CHILD DEVELOPMENT; CHILD NUTRITION; FEMALE; GLOBAL HEALTH; GROWTH DISORDER; HUMAN; INFANT; MALE; NUTRITIONAL STATUS; PRESCHOOL CHILD;

CHILD; CHILD DEVELOPMENT; CHILD NUTRITIONAL PHYSIOLOGICAL PHENOMENA; CHILD, PRESCHOOL; FEMALE; GLOBAL HEALTH; GROWTH DISORDERS; HUMANS; INFANT; MALE; NUTRITIONAL STATUS;

EID: 85062855120     PISSN: 21618313     EISSN: 21565376     Source Type: Journal    
DOI: 10.1093/advances/nmy101     Document Type: Review

References (63)

1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, et al. Maternal and child undernutrition and overweight in low-income and middleincome countries. Lancet 2013; 382: 427-51.
2. Gillespie S, van den BoldM. Stories of change in nutrition: an overview. Glob Food Sec 2017; 13: 1-11.
3. WHO. Global Nutrition Targets 2025: Stunting Policy Brief (WHO/NMH/NHD/14. 3). Geneva: WHO; 2014.
4. WHO Expert Committee on Physical Status. Physical Status: The Use and Interpretation of Anthropometry. Geneva: WHO; 1995.
5. WHOMulticentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age. Acta Paediatr 2006; Suppl 405: 76-85.
6. Sudfeld CR, Charles McCoy D, Danaei G, Fink G, Ezzati M, Andrews KG, Fawzi WW. Linear growth and child development in low-and middle-income countries: a meta-analysis. Pediatrics 2015; 135: e1266-75.
7. Bossavie L, Alderman H, Giles J, Mete C. The Effect of Height on Earnings: Is Stature Just a Proxy for Cognitive andNon-cognitive Skills? Washington, DC: World Bank; 2017. Report No. 8254.
8. Qureshy LF, Alderman H, Rokx C, Pinto R, Wai-Poi M, Tandon A. Positive returns: cost-benefit analysis of a stunting intervention in Indonesia. J Dev Eff 2013; 5: 447-65.
9. Guerrant RL, DeBoer MD, Moore SR, Scharf RJ, Lima AAM. The impoverished gut-a triple burden of diarrhoea, stunting and chronic disease. Nat Rev Gastroenterol Hepatol 2013; 10: 220-9.
10. Addo OY, Stein AD, Fall CH, Gigante DP, Guntupalli AM, Horta BL, Kuzawa CW, Lee N, Norris SA, Osmond C, et al. Parental childhood growth and offspring birthweight: pooled analyses fromfour birth cohorts in low and middle income countries. Am J Hum Biol 2015; 27: 99-105.
11. McGovern ME, KrishnaA, AguayoVM, Subramanian S. Areviewof the evidence linking child stunting to economic outcomes. Int J Epidemiol 2017; 46: 1171-91.
12. Turner PC, Collinson AC, Cheung YB, Gong Y, Hall AJ, Prentice AM, Wild CP. Aflatoxin exposure in utero causes growth faltering in Gambian infants. Int J Epidemiol 2007; 36: 1119-25.
13. Gong YY, Cardwell K, Hounsa A, Egal S, Turner PC, HallAJ, Wild CP. Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: cross sectional study. BMJ 2002; 325: 20-1.
14. Khlangwiset P, Shephard GS, Wu F. Aflatoxins and growth impairment: a review. Crit Rev Toxicol 2011; 41: 740-55.
15. Etzel RA. Reducing malnutrition: time to consider potential links between stunting and mycotoxin exposure? Pediatrics 2014; 134: 4-6.
16. Wild CP, Miller JD, Groopman JD. Mycotoxin Control in Low-and Middle-income Countries, Lyon, France: WHO; 2016.
17. Roy D. Trade impacts of aflatoxin standards. In: Unnevehr L, Grace D, editors. Aflatoxins: Finding Solutions for Improved Food Safety. 2020 Vision Focus. Washington, DC: International Food Policy Research Institute (IFPRI); 2013.
18. Smith LE, Stoltzfus RJ, Prendergast A. Food chainmycotoxin exposure, gut health, and impaired growth: a conceptual framework 1. Adv Nutr 2012; 3: 526-31.
19. Prendergast AJ, Kelly P. Interactions between intestinal pathogens, enteropathy and malnutrition in developing countries. CurrOpin Infect Dis 2016; 29: 229-36.
20. Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health 2014; 34: 250-65.
21. Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. AnnNYAcad Sci 2014; 1308: 118-28.
22. Leroy JL, Ruel M, Habicht J-P, Frongillo EA. Using height-for-age differences (HAD) instead of height-for-age z-scores (HAZ) for the meaningful measurement of population-level catch-up in linear growth in children less than 5 years of age. BMC Pediatr 2015; 15: 145.
23. Hirvonen K. Measuring catch-up growth in malnourished populations. Ann Hum Biol 2013; 4460: 1-10.
24. Handa S, Peterman A. Is there catch-up growth? Evidence from three continents. Oxf Bull Econ Stat 2016; 78: 470-500.
25. Georgiadis A, Benny L, Duc LT, Galab S, Reddy P, Woldehanna T. Growth recovery and faltering through early adolescence in low-and middle-income countries: Determinants and implications for cognitive development. Soc Sci Med 2017; 179: 81-90.
26. Georgiadis A. The Sooner the Better but it's Never Too Late: The Impact of Nutrition at Different Periods of Childhood on Cognitive Development. Young LivesWorking Paper 159. Oxford, UK; 2017.
27. Crookston BT, Schott W, Cueto S, Dearden KA, Engle P, Georgiadis A, Lundeen EA, Penny ME, Stein AD, Behrman JR. Postinfancy growth, schooling, and cognitive achievement: young lives. Am J Clin Nutr 2013; 98 (6): 1555-63.
28. Crookston BT, Penny ME, Alder SC, Dickerson TT, Merrill RM, Stanford JB, Porucznik CA, Dearden KA. Children who recover from early stunting and children who are not stunted demonstrate similar levels of cognition. J Nutr 2010; 140: 1996-2001.
29. Lamble L. Surviving without thriving-but all is not lost for the world's "stunted" children. The Guardian 7 sep 2017.
30. Prentice AM, Ward KA, Goldberg GR, Jarjou LM, Moore SE, Fulford AJ, Prentice A. Critical windows for nutritional interventions against stunting. Am J Clin Nutr 2013; 97: 911-8.
31. Aboud FE, Yousafzai AK. Global health and development in early childhood. Annu Rev Psychol 2015; 66: 433-57.
32. Pollitt E. A developmental view of the undernourished child: background and purpose of the study in Pangalengan, Indonesia. Eur J Clin Nutr 2000; 54: S2-10.
33. Larson LM, YousafzaiAK. Ameta-analysis of nutrition interventions on mental development of children under-two in low-and middle-income countries. Matern Child Nutr 2017; 13.
34. Engle PL, Black MM, Behrman JR, Cabral de Mello M, Gertler PJ, Kapiriri L, Martorell R, Young ME. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet 2007; 369: 229-42.
35. Behrman JR, Hoddinott J, Maluccio JA, Martorell R. Brains versus brawn: labor market returns to intellectual and physical human capital in a poor developing country. MiddleburyCollegeWorking Paper Series 0907, Middlebury College, Department of Economics; 2013.
36. Hanson MA, Gluckman PD. Early developmental conditioning of later health and disease: physiology or pathophysiology? Physiol Rev 2014; 94: 1027-76.
37. Martin-Gronert MS, Ozanne SE. Mechanisms underlying the developmental origins of disease. Rev Endocr Metab Disord 2012; 13: 85-92.
38. Adair LS, Fall CHD, Osmond C, Stein AD, Martorell R, Ramirez-Zea M, Sachdev HS, Dahly DL, Bas I, Norris SA, et al. Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of lowand middle income: findings fromfive birth cohort studies. Lancet 2013; 382: 525-34.
39. Hanson SK, Munthali RJ, Lundeen EA, Richter LM, Norris SA, Stein AD. Stunting at 24 months is not related to incidence of overweight through young adulthood in an urban SouthAfrican birth cohort. JNutr 2018; 148: 967-73.
40. Andersen CT, Stein AD, Reynolds SA, Behrman JR, Crookston BT, Dearden KA, Penny ME, Schott W, Fernald LC. Stunting in infancy is associated with decreased risk of high body mass index for age at 8 and 12 years of age. J Nutr 2016; 146: 2296-303.
41. Dujardin B, Van CutsemR, Lambrechts T. The value ofmaternal height as a risk factor of dystocia: a meta-analysis. Trop Med Int Health 1996; 1: 510-21.
42. Wells JCK. The new"obstetrical dilemma": stunting, obesity and the risk of obstructed labour. Anat Rec (Hoboken) 2017; 300: 716-31.
43. Fischer B, Mitteroecker P. Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma. Proc Natl Acad Sci U S A 2015; 112: 5655-60.
44. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: aWHO systematic analysis. Lancet Glob Heal 2014; 2: e323-33.
45. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1211-59.
46. Kozuki N, Katz J, Lee ACC, Vogel JP, Silveira MF, Sania A, Stevens GA, Cousens S, Caulfield LE, Christian P, et al. Short maternal stature increases risk of small-for-gestational-age and preterm births in low-and middle-income countries: individual participant data meta-analysis and population attributable fraction. J Nutr 2015; 145: 2542-50.
47. Christian P, Lee SE, Donahue Angel M, Adair LS, Arifeen SE, Ashorn P, Barros FC, Fall CH, Fawzi WW, Hao W, et al. Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low-and middle-income countries. Int J Epidemiol 2013; 42: 1340-55.
48. Lee AC, Kozuki N, Cousens S, Stevens GA, Blencowe H, Silveira MF, Sania A, Rosen HE, Schmiegelow C, Adair LS, et al. Estimates of burden and consequences of infants born small for gestational age in lowand middle-income countries with INTERGROWTH-21st standard: analysis of CHERG datasets. BMJ 2017; 358: j3677.
49. Dewey KG, Begum K. Long-termconsequences of stunting in early life. Matern Child Nutr 2011; 7 (Suppl 3): 5-18.
50. Gates B, Gates M. The stories behind the data. Case Study-Stunting: Peru [Internet]. 2017. Available from: http://stash. globalgoals. org/goalkeepers/datareport/case-studies/stunting-peru/.
51. Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet 2007; 369: 60-70.
52. Hoddinott J, Behrman JR, Maluccio JA, Melgar P, Quisumbing AR, Ramirez-ZeaM, Stein AD, Yount KM, Martorell R. Adult consequences of growth failure in early childhood. Am J Clin Nutr 2013; 98: 1170-8.
53. Rawat R, Nguyen PH, Tran LM, Hajeebhoy N, Nguyen H Van, Baker J, Frongillo EA, Ruel MT, Menon P. Social franchising and a nationwide mass media campaign increased the prevalence of adequate complementary feeding in Vietnam: a cluster-randomized program evaluation. J Nutr 2017; 147: 670-9.
54. Menon P, Nguyen PH, Saha KK, Khaled A, Sanghvi T, Baker J, Kaosar A, Haque R, Frongillo EA, RuelMT, et al. Combining intensive counseling by frontline workers with a nationwide mass media campaign has large differential impacts on complementary feeding practices but not on child growth: results of a cluster-randomized program evaluation in Bangladesh. J Nutr 2016; 146 (10): 2075-84.
55. VictoraCG, de Onis M, Hallal PC, BlössnerM, Shrimpton R. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 2010; 125: e473-80.
56. Ruel MT. The Oriente Study: program and policy impacts. J Nutr 2010; 140: 415-8.
57. Leroy JL, Ruel M, Habicht J-P, Frongillo EA. Linear growth deficit continues to accumulate beyond the first 1000 days in low-andmiddleincome countries: global evidence from 51 national surveys. J Nutr 2014; 144: 1460-6.
58. Thompson RA, Nelson CA. Developmental science and the media. Early brain development. Am Psychol 2001; 56: 5-15.
59. Roberts JL, Stein AD. The impact of nutritional interventions beyond the first 2 years of life on linear growth: a systematic review and metaanalysis. Adv Nutr 2017; 8: 323-36.
60. Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 2013; 382 (9891): 536-51.
61. Ruel MT, Quisumbing AR, Balagamwala M. Nutrition-sensitive agriculture: what have we learned so far? Glob Food Sec 2018; 17: 128-53.
62. Perumal N, Bassani DG, Roth DE. Use and misuse of stunting as a measure of child health. J Nutr 2018; 148: 311-5.
63. Leroy JL, Olney D, Ruel M. Tubaramure, a food-assisted integrated health and nutrition program, reduces child stunting in Burundi: a cluster-randomized controlled intervention trial. J Nutr 2018; 148: 445-52.