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The stunting syndrome in developing countries

Published on Nov 1, 2014in Paediatrics and International Child Health1.362
· DOI :10.1179/2046905514Y.0000000158
Andrew J. Prendergast33
Estimated H-index: 33
(Johns Hopkins University),
Jean H Humphrey ScD39
Estimated H-index: 39
(Johns Hopkins University)
Sources
Abstract
AbstractLinear growth failure is the most common form of undernutrition globally. With an estimated 165 million children below 5 years of age affected, stunting has been identified as a major public health priority, and there are ambitious targets to reduce the prevalence of stunting by 40% between 2010 and 2025. We view this condition as a ‘stunting syndrome’ in which multiple pathological changes marked by linear growth retardation in early life are associated with increased morbidity and mortality, reduced physical, neurodevelopmental and economic capacity and an elevated risk of metabolic disease into adulthood. Stunting is a cyclical process because women who were themselves stunted in childhood tend to have stunted offspring, creating an intergenerational cycle of poverty and reduced human capital that is difficult to break. In this review, the mechanisms underlying linear growth failure at different ages are described, the short-, medium- and long-term consequences of stunting are discussed, and th...
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References266
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#1Luz Maria De-Regil (Micronutrient Initiative)H-Index: 20
#2Cristina Palacios (UPR: University of Puerto Rico)H-Index: 18
Last. Juan Pablo Peña-Rosas (WHO: World Health Organization)H-Index: 17
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BACKGROUND: Vitamin D deficiency or insufficiency is thought to be common among pregnant women. Vitamin D supplementation during pregnancy has been suggested as an intervention to protect against adverse pregnancy outcomes. OBJECTIVES: To examine whether oral supplements with vitamin D alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes. METHODS: Search methods: We searched the Cochrane Pregnancy an...
37 CitationsSource
#1Charles Mangani (UNIMA: University of Malawi)H-Index: 9
#2Kenneth Maleta (UNIMA: University of Malawi)H-Index: 36
Last. Per Ashorn (UTA: University of Tampere)H-Index: 41
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Low nutritional value of complementary foods is associated with high incidence of childhood growth stunting in low-income countries. This study was done to test a hypothesis that dietary complementation with lipid-based nutrient supplements (LNS) promotes linear growth and reduces the incidence of severe stunting among at-risk infants. A total of 840 6-month-old healthy infants in rural Malawi were enrolled to a randomised assessor- blinded trial. The participants received 12-month supplementati...
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#2Rintaro MoriH-Index: 47
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Background It has been suggested that low serum zinc levels may be associated with suboptimal outcomes of pregnancy such as prolonged labour, atonic postpartum haemorrhage, pregnancy-induced hypertension, preterm labour and post-term pregnancies, although many of these associations have not yet been established. Objectives To assess the effects of zinc supplementation in pregnancy on maternal, fetal, neonatal and infant outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth G...
174 CitationsSource
#1Patwari Ak (Hamdard University)H-Index: 19
#2Sanjay Kumar (United Nations Population Fund)H-Index: 1
Last. Jennifer Beard (BU: Boston University)H-Index: 8
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In India most childhood nutrition recommendations and interventions are still not focused on infants under 6 months. Secondary data analyses of National Family Health Survey-3 data from India were analysed to compare the prevalence of wasting stunting and underweight in infants less than 6 months and 6-59 months. Our results revealed that wasting was higher (31%) in infants less than 6 months (P < 0.05) as compared with children between 6 and 59 months. Thirteen per cent of infants less than 6 m...
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The Sackler Institute for Nutrition Science and the World Health Organization (WHO) have worked together to formulate a research agenda for nutrition science. Undernutrition of children has profound effects on health, development, and achievement of full human capacity. Undernutrition is not simply caused by a lack of food, but results from a complex interplay of intra- and intergenerational factors. Representative preclinical models and comprehensive well-controlled longitudinal clinical studie...
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#1John Mason (Tulane University)H-Index: 21
#2Roger Shrimpton (Tulane University)H-Index: 20
Last. Reynaldo Martorell (Emory University)H-Index: 54
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BackgroundFrom conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months – about 500 days – is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here.Objective and designThis paper aims to summarize research on policies and programs to prote...
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#1Bruno F Sunguya (UTokyo: University of Tokyo)H-Index: 27
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Nutrition transition necessitates low and middle-income countries (LAMICs) to scale up their efforts in addressing the burdens of undernutrition and overweight/obesity. Magnitudes of undernutrition and overweight are high in LAMICs, but no study has reviewed the existence of nutrition policies to address it. No evidence is also available on the effect of nutrition policies and governance on the undernutrition and overweight/obesity patterns in such countries. We conducted a policy review to exam...
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#1Ingunn Marie S. Engebretsen (University of Bergen)H-Index: 17
#2Debra Jackson (UWC: University of the Western Cape)H-Index: 32
Last. Thorkild Tylleskär (University of Bergen)H-Index: 38
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Background: In this multi-country cluster-randomized behavioural intervention trial promoting exclusive breastfeeding (EBF) in Africa, we compared growth of infants up to 6 months of age living in communities where peer counsellors promoted EBF with growth in those infants living in control communities. Methods: A total of 82 clusters in Burkina Faso, Uganda and South Africa were randomised to either the intervention or the control arm. Feeding data and anthropometric measurements were collected...
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Background A large literature in developing countries finds a strong association between stunting in early childhood and educational attainment and/or cognitive performance among children of school-going age. We contribute to the literature on the effects of stunting in childhood by exploring the links between linear growth retardation and measures of development among preschool-aged children. Methods We analyse the association between stunting (height-for-age z-score <−2) at age 2 years and chi...
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Background & Aims Environmental enteropathy (EE) is a subclinical condition among children in the developing world, characterized by T-cell infiltration of the small-bowel mucosa and diffuse villous atrophy. EE leads to macronutrient and micronutrient malabsorption and stunting, with a resultant increased risk for infection and reduced cognitive development. We tested the hypothesis that zinc and albendazole treatments would reduce the severity of EE in rural African children. Methods In a rando...
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Cited By205
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Last. Nurdiana
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Background: Every student has the potential to do well in school. Failing to provide good nutrition puts them at risk for missing out on meeting that potential and leads to long-term irreversible damage to cognitive development. However, taking action today to provide healthier choices in schools can help set students up for a successful future full of possibilities. So, this study is aimed at assessing the effect of nutritional status on academic performance of school-aged children. Methods: A ...
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#1María Fernanda Rivadeneira (Pontificia Universidad Católica del Ecuador)H-Index: 1
#1María F. Rivadeneira (Pontificia Universidad Católica del Ecuador)
Last. Mario J. Grijalva (Heritage College of Osteopathic Medicine)H-Index: 19
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Objectives Chronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador.
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#2Zacharie Tsala Dimbuene (UNIKIN: University of Kinshasa)H-Index: 11
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This study examined the socio-demographic factors associated with normal linear growth among pre-school children living in better-off households, using survey data from Ghana, Kenya, Nigeria, Mozambique and Democratic Republic of Congo (DRC). The primary outcome variable was child height-for-age z-scores (HAZ), categorised into HAZ>/=-2SD (normal growth/not stunted) and HAZ<-2 (stunted). Using logistic regression, we estimated adjusted odds ratios (aORs) of the factors associated with normal gro...
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#1Joseph Hackman (UofU: University of Utah)H-Index: 6
#2Daniel J. Hruschka (ASU: Arizona State University)H-Index: 25
OBJECTIVES: Current standards for comparing stunting across human populations assume a universal model of child growth. Such comparisons ignore population differences that are independent of deprivation and health outcomes. This article partitions variation in height-for-age that is specifically associated with deprivation and health outcomes to provide a basis for cross-population comparisons. MATERIALS AND METHODS: Using a multilevel model with a sigmoid relationship of resources and growth, w...
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WHO documents characterize stunting as, “…impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.” The equation of stunting with malnutrition is common. This contrasts with historic and modern observations indicating that growth in height is largely independent of the extent and nature of the diet. We measured 1716 Indonesian children, aged 6.0–13.2 years, from urban Kupang/West-Timor and rural Soe/West-Timor, urb...
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BACKGROUND: Developing countries bear the burden of childhood stunting but lack resources for cohort studies to develop preventive strategies. To enable future prospective studies, we designed and tested the Child Electronic Growth Monitoring System (CEGROMS) using a readily available electronic data capture platform, the Research Electronic Data Capture (REDCap). OBJECTIVES: To demonstrate the feasibility of using CEGROMS for data collection for a pilot study for the Kaduna Infant Development (...
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