Poor fetal growth or stunting in the first two years of life leads to irreversible damage, including shorter adult height, lower attained schooling, reduced adult income and decreased offspring birthweight for women. These are the conclusions of Professor Caroline Fall, Medical Research Council Epidemiology Resource Centre, University of Southampton, UK, and Professor Cesar Victora, Universidade Federal de Pelotas, Brazil, and colleagues, authors of the second paper in The Lancet's Series on Maternal and Child Undernutrition.
The authors analysed the association between child and maternal undernutrition with human capital and risk of adult diseases in low- and middle-income countries (LMICs), focussing on five long-standing studies in Brazil, Guatemala, India, the Philippines, and South Africa. They showed that indicators of undernutrition, (maternal height, birthweight, fetal growth restriction, and the child’s weight, height, and body-mass index (BMI)) at age two years were related to adult outcomes (height, schooling, income/assets, offspring birthweight, BMI, glucose concentrations, blood pressure). The strongest associations with undernutrition were found for shorter adult height, lower levels of schooling, and reduced economic productivity, and, for women, lower offspring birthweight.
Further, the authors found that children who are undernourished in the first two years of life, and who put on weight rapidly later in childhood and in adolescence are at high risk of chronic diseases related to nutrition, such as high glucose concentrations, hypertension and increased levels of harmful fats in their blood. But they found no evidence that rapid weight gain or height gain in the first two years of life increases the risk of chronic disease, even in children with poor fetal growth. Height for age at two years was the best predictor of the child’s future economic productivity (human capital).
The authors say: “We conclude that damage suffered in early life leads to permanent impairment, and might also affect future generations. Its prevention will probably bring about important health, educational, and economic benefits. Chronic diseases are especially common in undernourished children who experience rapid weight gain after infancy….at the same time as investments are made against undernutrition, middle-income countries undergoing the nutrition transition should also address the negative consequences of rapid weight-gain, especially in later childhood.”
Professor Caroline Fall, Medical Research Council Epidemiology Resource Centre, University of Southampton, UK T) +44 (0) 2380 777624 / +44 (0) 7885 478453 E) chdf@mrc.soton.ac.uk
Professor Cesar Victora, Universidade Federal de Pelotas, Brazil T) +55 53 3284 1300 E) cvictora@terra.com.br
The paper associated with this release can be viewed at
http://www.eurekalert.org/jrnls/lance/undernutrition2.pdf.
Journal
The Lancet