Growth faltering and recovery in children aged 1-8 years in four low- and middle-income countries: Young Lives.
OBJECTIVE
We characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting.


METHODS
Data came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries.


METHODS
We analysed length/height measurements for children at ages 1, 5 and 8 years.


METHODS
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.
1Nutrition and Health Sciences,Graduate Division of Biological and Biomedical Sciences,Emory University,Atlanta,GA,USA.
Elizabeth A
EA
Lundeen
2Economics,Sociology and Population Studies Center,University of Pennsylvania,Philadelphia,PA,USA.
Jere R
JR
Behrman
3Department of Health Science,Brigham Young University,Provo,UT,USA.
Benjamin T
BT
Crookston
4Department of International Health and Center for Global Health and Development,Boston University,Boston,MA,USA.
Kirk A
KA
Dearden
6Department of Psychology and Child Development,Cal Poly State University,San Luis Obispo,CA,USA.
Patrice
P
Engle
7Young Lives Study,Department of International Development,University of Oxford,Oxford,UK.
Andreas
A
Georgiadis
8Instituto de Investigación Nutricional,Lima,Peru and Massachusetts General Hospital for Children,Harvard Medical School,Boston,MA,USA.
Mary E
ME
Penny
9Hubert Department of Global Health and Department of Epidemiology,Rollins School of Public Health,Emory University,Mailstop 1518-002-7BB,Atlanta,GA 30322,USA.
Aryeh D
AD
Stein
D001827:Body Height; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology; D010568:Peru / Q000453:epidemiology; D011204:Poverty Areas; D015995:Prevalence; D014744:Vietnam / Q000453:epidemiology