Stunting in Infancy Is Associated with Decreased Risk of High Body Mass Index for Age at 8 and 12 Years of Age.
BACKGROUND
Effects of early-life stunting on adiposity development later in childhood are not well understood, specifically with respect to age in the onset of overweight and obesity.


OBJECTIVE
We analyzed associations of infant stunting with prevalence of, incidence of, and reversion from high body mass index-for-age z score (BMIZ) later in life. We then estimated whether associations of infant stunting with BMIZ varied by sex, indigenous status, and rural or urban residence.


METHODS
Data were collected from 1942 Peruvian children in the Young Lives cohort study at ages 1, 5, 8, and 12 y. Multivariable generalized linear models estimated associations of stunting (height-for-age z score <-2) at age 1 y with risk of BMIZ > 1 and BMIZ > 2 prevalence, incidence (moving above a BMIZ threshold between ages), and reversion (moving below a BMIZ threshold between ages) at later ages.


RESULTS
After adjustment for covariates, stunting at age 1 y was associated with a lower prevalence of BMIZ > 1 at age 8 y (RR: 0.81; 95% CI: 0.66, 1.00; P = 0.049) and 12 y (RR: 0.75; 95% CI: 0.61, 0.91; P = 0.004), as well as a lower prevalence of BMIZ > 2 at age 8 y. Stunting was not associated with incident risk of BMIZ > 1 or BMIZ > 2. Stunting was positively associated at age 5 y with risk of reversion from BMIZ > 1 (RR: 1.22; 95% CI: 1.05, 1.42; P = 0.008) and BMIZ > 2. We found evidence that the association of stunting with prevalent and incident BMIZ > 1 was stronger for urban children at ages 5 and 8 y, and for nonindigenous children at age 8 y.


CONCLUSIONS
Stunting predicted a lower risk of prevalent BMIZ > 1 and BMIZ > 2, even after controlling for potential confounders. This finding may be driven in part by a higher risk of reversion from BMIZ > 1 by age 5 y. Our results contribute to an understanding of how nutritional stunting in infancy is associated with BMIZ later in life.
Division of Epidemiology and chrisandersen@berkeley.edu.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Christopher T
http://orcid.org/0000-0001-5599-6130
CT
Andersen
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
Aryeh D
AD
Stein
Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, CA.
Sarah A
SA
Reynolds
Department of Economics.|Department of Sociology, and.|Population Studies Center, University of Pennsylvania, Philadelphia, PA.
Jere R
JR
Behrman
Department of Health Science, Brigham Young University, Provo, UT.
Benjamin T
BT
Crookston
IMA World Health, Dar es Salaam, Tanzania; and.
Kirk A
KA
Dearden
Nutrition Research Institute, Lima, Peru.
Mary E
ME
Penny
Population Studies Center, University of Pennsylvania, Philadelphia, PA.
Whitney
W
Schott
Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, CA.
Lia Ch
http://orcid.org/0000-0003-1555-4607
LC
Fernald
D015992:Body Mass Index; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D006130:Growth Disorders; D006801:Humans; D007223:Infant
Peru; body mass index; children; cohort study; stunting
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