Biomedical subjects

L S Adair

Publications and source records attributed to L S Adair.

At least 19 recordsLinked to original sources

PubMed2007

Cross-sectional comparison of physical activity and inactivity patterns in Chinese and Filipino youth.

BACKGROUND: To compare and contrast youth physical activity (PA) and inactivity patterns in two developing Asian countries: the Philippines and China. METHODS: Comparative analysis of 1997-1999 Cebu Longitudinal Health and Nutrition Survey and the 1997 China Health and Nutrition Survey, large-scale surveys that included questions on type, frequency and duration of: commuting mode to school, sports/exercise in and outside of school, select sedentary activities and chores. RESULTS: Filipino data included 760 males and 872 females aged 14-16 years. The comparable Chinese sample consisted of 202 males and 197 females. Active commuting is proportionately high in both countries (70-71% in the Philippines vs. 77-90% in China), although commuting by bicycling is rare in the Philippines (<1%) vs. China ( approximately 35%). Patterns of school sport/exercise participation differ between countries by gender; more Filipino males report school sport/exercise than females (63 vs. 49%) vs. China, where more females participate than males (75 vs. 69%). Sport/exercise outside of school is proportionately low (6-12%) for youth from both countries with a single exception: 74% of Filipino males participate in extra-curricular sport/exercise. Although a higher percentage of Filipino youth report watching television >4 h/day (<10%) vs. Chinese youth (<1%), both are lower than comparable US reports. CONCLUSION: In the Philippines, continued modernization augurs a decrease in local primary PA sources (chores and active commuting). In China, where youth already are not expected to perform chores, shifts to more passive commuting modes (i.e. increased motorized transportation) are anticipated.

Activities of Daily Living↗

PubMed2005

The dual burden household and the nutrition transition paradox.

OBJECTIVE: The purpose of this study is to document the prevalence of households with underweight and overweight persons (henceforth referred to as dual burden households) and their association with income and urban residence. The explorations by urban residence and income will test whether dual burden households differ from 'underweight only' and 'overweight only' households, respectively. These comparisons are relevant to differentiating or adapting nutrition-related interventions wherever obesity and undernutrition cluster at the household level. POPULATION: Data analysis is based on national surveys conducted in Brazil, China, Indonesia, the Kyrgyz Republic, Russia, Vietnam and the United States. METHODS: All persons were first classified into categories for underweight and overweight, using body mass index (BMI) cutoffs, and then all households were categorized into four types: dual burden, overweight, underweight and normal. Income and urban residence were explored as key risk factors for being a dual burden household, with the effects modeled separately for each country. Multiple logistic regression was used to explore income and urban risk factors, controlling for household size, region of residence and either urban residence or income, as appropriate. RESULTS: In six of the countries studied, 22-66% of households with an underweight person also had an overweight person. Countries with the highest prevalence of dual burden households were those in the middle range of gross national product (GNP). The dual burden household is easily distinguished from the 'underweight only' households in Brazil, China, Indonesia, the United States and Vietnam. In these five countries dual burden households were more likely to be urban and more likely to be among the highest income tertile. There were no significant differences between dual burden and 'underweight only' households in Russia and the Kyrgyz Republic. In contrast, dual burden households were not easily distinguished from the 'overweight only' households in China, Indonesia, the Kyrgyz Republic, the United States and Vietnam. In Brazil and Russia dual burden households were more likely to be lower income and urban than 'overweight only' households. CONCLUSION: The prevalence of dual burden households presents a significant public health concern, particularly for those countries in the middle range of GNP. In some countries (China, Indonesia, the Kyrgyz Republic, the United States and Vietnam), dual burden households share sociodemographic profiles with overweight households, raising concerns for underweight individuals who may inadvertently become the focus of obesity prevention initiatives. For this reason, obesity prevention efforts should focus on messages that are beneficial to the good health of all, such as increasing fruit and vegetable intake, improving overall diet quality and increasing physical activity.

Adolescent↗

PubMed2005

Do protein and energy intakes explain long-term changes in body composition?

BACKGROUND: Despite evidence that profiles of protein and energy intake can determine short-term (< 1 y) change in both lean and fat compartments,the role of diet in longer-term, age-related changes in body composition remains unclear. OBJECTIVE: This paper tests for long-term counterparts to the well-established short-term relationships between protein and energy intake and changes in body composition. DESIGN: Using longitudinal data on 608 healthy, non-obese Chinese (50-69 y)from the 1993 and 1997 China Health and Nutrition Surveys, sex-specific regression models were created to determine if 3-day mean protein (%of energy) and energy (kJ) intakes at baseline predicted change in mid arm muscle area (MAMA) and waist circumference (WC). RESULTS: Although sex-specific U-shaped associations were observed,higher energy intakes were associated with greater gain in WC and less loss of MAMA, and higher protein intakes with less loss of MAMA than lower intakes for both sexes, adjusting for baseline age, height, weight, MAMA, WC, smoking status, activity level, income and urban residence. For males, energy intake be low 95%of the Chinese RDA was associated with significantly smaller gains in WC and greater loss of MAMA than energy intake between 95-125% RDA. For both sexes, protein intake be low 10.4% of energy was associated with significantly greater loss of MAMA than intake between 10.4-12.1% of energy. For females, energy intake above 125% RDA was associated with significantly greater gains in body fat than intake between 95-125% RDA. CONCLUSION: The results suggest that diet may play an important role in age-related change in body composition.

Adipose Tissue↗

PubMed2004

A supply-demand model of fetal energy sufficiency predicts lipid profiles in male but not female Filipino adolescents.

OBJECTIVE: To test the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply during pregnancy will predict lipid profiles in offspring measured in adolescence. SUBJECTS AND METHODS: A total of 296 male and 307 female Filipino offspring (aged 14-16 y) and mothers enrolled in a longitudinal birth cohort study (begun in 1983-84) had lipid profiles measured. Data on maternal height (as a proxy for offspring growth potential and thus fetal nutritional demand) and third trimester maternal arm fat area (as a proxy for maternal supply) were used to create four groups hypothesized to reflect a gradient of fetal energy sufficiency. RESULTS: As fetal energy sufficiency increased among males, there was a decrease in total cholesterol (TC) (P<0.05 for trend), low-density lipoprotein cholesterol (LDL-C), and the ratios of TC/HDL-C cholesterol and LDL-C/HDL-C (all P<0.001), while HDL-C increased (P<0.05). Similar associations were identified when lipid levels were modeled as dichotomous 'high-risk' cut-points used in cardiovascular disease prevention in adolescents. These relationships were stronger, or only present, among offspring of mothers in the lower half of the third trimester energy intake distribution, and were independent of the child's current adiposity, dietary energy and fat intake, maturity, household income, and birth weight. In females, the supply-demand model did not predict any lipid outcome or clinical risk criteria. CONCLUSIONS: Our findings in males support the hypothesis that the balance between fetal nutritional demand and maternal nutritional supply has implications for future lipid profiles. The lack of significant associations in females adds to mounting evidence for sex differences in lipid metabolism programming, and may reflect sex differences in fetal nutritional demand. SPONSORSHIP: The National Science Foundation, the Mellon Foundation, the Nestle Foundation, and the Emory University Internationalization Program.

Adaptation, Physiological↗

PubMed2004

Prenatal and early postnatal environments are significant predictors of total immunoglobulin E concentration in Filipino adolescents.

BACKGROUND: Recent evidence suggests that atopic disease may in part be mediated by fetal growth, as well as exposure to infectious disease early in life. Few studies have been able to evaluate these associations simultaneously, or to investigate prospectively the long-term effects of early environments while adequately controlling for potentially confounding variables. OBJECTIVE: To examine how prenatal growth and infectious disease in infancy are related to total IgE production in adolescence. METHODS: Ninety-nine adolescents (aged 14-15 years) were selected from a larger cohort study according to the following criteria: full-term birth, currently healthy, and small-for-gestational age (N=53) or appropriate-for-gestational age (N=46). Plasma total IgE was measured with ELISA, and analysed in relation to anthropometric, nutritional, and environmental quality data collected prospectively beginning in the third trimester prior to birth. RESULTS: Each episode of infectious morbidity recorded at bimonthly intervals in the first 6 months of life was associated with a 0.12 log IU/mL reduction in total IgE in adolescence (P=0.004). Prenatal undernutrition was associated with increased adolescent IgE, but only under conditions of an unsanitary household environment (P=0.002). Each additional kilogram gained per month in the first 6 months of life was associated with an increase in adolescent IgE of 0.74 log IU/mL (P=0.03). Each quartile increase in weekly household income at the time of blood sampling was associated with a 0.10 log IU/mL reduction in total IgE (P=0.02). CONCLUSION: Infectious disease in infancy, as well as interactions between prenatal and postnatal environments, appear to have long-term effects on adolescent total IgE production. Future research should investigate the mechanisms behind these effects, and their implications for symptoms of atopic disease.

Adolescent↗

PubMed2003

Physical activity and inactivity in Chinese school-aged youth: the China Health and Nutrition Survey.

OBJECTIVE: To describe physical activity (PA) and inactivity levels and patterns in Chinese school children (aged 6-18 y). DESIGN: PA and inactivity were assessed in a youth cohort enrolled in the China Health and Nutrition Survey (CHNS) in 1997. SUBJECTS: A total of 1423 males (11.5+/-3.2 y) and 1252 females (11.5+/-3.3 y). MEASUREMENTS: PA and inactivity were assessed by self-reported usual activity (questionnaire). Children under 10 y were assisted by parents. RESULTS: Approximately 84% of Chinese youth actively commute to school for a median of 100-150 min/week. A total of 72% engage in in-school moderate/vigorous (MOD/VIG) PA for a median of 90-110 min/week. Relatively few children ( approximately 8%) participate in any MOD/VIG PA outside of school. A total of 72% engage in study-related activities outside of school for a median of 420 min/week. Only 8% of Chinese school children, regardless of gender, watch television > or =2 h/day; less than 1% watch > or =4 h/day. Chores related to housework are not a part of life for Chinese school children; fewer than 20% performed these tasks. CONCLUSION: Chinese youth are unique compared to those in other developing countries because they do not perform household chores. Instead, they are under pressure to achieve scholastically. Participation in MOD/VIG PA outside of school is almost nonexistent. Current television watching habits are relatively low compared to developed countries and walking/biking is a common form of commuting. The descriptive analysis herein represents the foundation upon which future longitudinal studies of PA in this population will be based.

Adolescent↗

PubMed2003

Physical activity in Filipino youth: the Cebu Longitudinal Health and Nutrition Survey.

OBJECTIVE: To describe physical activity (PA) and inactivity levels of Filipino youth aged 14-16 y. DESIGN: PA type and patterns were assessed in an adolescent cohort enrolled in the Cebu Longitudinal Health and Nutrition Survey. SUBJECTS: A total of 1053 males (aged 15.6+/-0.5 y; body mass index (BMI)=18.6+/-2.6 kg/m(2)) and 990 females (aged 14.6+/-0.5 y; BMI=18.8+/-2.4 kg/m(2)). MEASUREMENTS: PA was assessed by (1) self-reported usual PA (questionnaire); (2) 24-h objective monitoring (Caltrac accelerometer); and (3) 24 h recalls of PA during the objectively monitored time frame. RESULTS: As measured by Caltrac, males expended 378.0+/-164.5 kcal and females 271.0+/-105.4 kcal. The measurement approaches employed agreed in expected ways, given the limitations of each. Together the approaches used indicated that the primary sources of PA for this population are chores and active commuting. In all, 40% of the sample walked to school, less than 1% rode a bicycle, 22% rode in/on motorized transport, and 37% used some combination of walking and motorized transport. Further, gender differences exist for type, frequency, and duration of physical activities performed by Filipino youth. Specifically, females report engaging in few leisure-time physical activities and more household chores. In total, 48% of Filipino youth report watching > or =2 h/day of television; relatively few youth (7%) report watching >4 h/day at this time. An 18% of males report no vigorous activities compared to 87% of females. CONCLUSION: Clear gender differences in PA patterns and levels exist in Filipino adolescents. Nonsport/exercise type activities (eg chores and active commuting) currently provide a large proportion of daily activity for both males and females, however. It is anticipated that as modernization and technological advancement continue in this developing country, these primary sources of PA will decrease.

Activities of Daily Living↗

PubMed2001

Maternal energy stores and diet composition during pregnancy program adolescent blood pressure.

BACKGROUND: Fetal undernutrition is hypothesized to program blood pressure (BP) later in life. Human epidemiological studies that use birth weight as a proxy for fetal malnutrition fail to identify specific aspects of maternal nutrition responsible for programming. METHODS AND RESULTS: We examined how maternal nutrition during pregnancy and infant birth weight relate to systolic and diastolic BP (SBP and DBP) in 2026 Filipino adolescents. Data were collected prospectively during the Cebu (Philippines) Longitudinal Health and Nutrition Survey. Women were assessed at approximately 30 weeks gestation, and children were followed from birth through adolescence. Regression models were used to examine how the mothers' total energy intake, percentage of energy from protein and fat, triceps skinfold thickness during pregnancy, and infant birth weight relate to adolescent BP, controlling for current age, height, and body mass index and other potential confounders. Maternal triceps skinfold thickness was significantly inversely related to SBP among boys and to DBP in boys and girls. Maternal nutrition variables attenuated but did not eliminate an inverse birth weight-SBP relationship in boys. SBP was significantly inversely related to the mothers' percent of dietary energy from protein in boys. Among girls, SBP and DBP were inversely related to the mothers' percentage of calories from fat. There was no evidence of confounding of these relationships by current diet, maturation status, physical activity, or socioeconomic status. CONCLUSIONS: Maternal diet composition and energy stores in the form of subcutaneous fat have long-term effects on offspring BP in adolescence.

Adolescent↗

PubMed2001

Defining the "urban" in urbanization and health: a factor analysis approach.

Urban environments have been linked to a range of human health issues, and as the pace of urbanization accelerates, new challenges arise to characterize these environments, and to understand their positive and negative implications for health. We seek to contribute to future studies of urbanization and health by exploring multiple definitions of urbanicity in the Philippines, using data from an ongoing, longitudinal study. We use factor analysis to identify meaningful clusters of household- and community-level variables, and to generate factor scores that summarize each household's position with respect to access to infrastructure and health services, and level of affluence. Factor scores are considered for 1983 and 1994 to assess the type and pace of change that has occurred in the Philippines, and scores are compared across urban and rural areas, and across six different settlement types, to explore household- and community-level markers of urbanicity. This analysis demonstrates the heterogeneity of environments within urban and rural areas, and emphasizes the need for a finer level of investigation in future studies of urbanization and health.

Cluster Analysis↗

PubMed2001

Prenatal undernutrition, postnatal environments, and antibody response to vaccination in adolescence.

BACKGROUND: Recently, researchers have considered the fetal and infant origins of several adult cardiovascular and metabolic diseases, but the implications of early events for immune function and infectious disease are unclear. OBJECTIVE: We investigated the association between prenatal undernutrition and immunocompetence in adolescence and hypothesized that intrauterine growth retardation is associated with a lower likelihood of mounting an adequate antibody response later in life. DESIGN: A subsample of one hundred three 14-15-y-olds was recruited from an ongoing longitudinal study in which data collection began while participants were in utero. A typhoid vaccine was given, and anti-typhoid antibodies were measured 2 wk and 3 mo later as a functional marker of immunocompetence. The likelihood of mounting an adequate antibody response was compared for adolescents who were small for gestational age or appropriate for gestational age at birth while controlling for a range of postnatal exposures. RESULTS: The predicted probability of mounting a positive antibody response for adolescents who were prenatally and currently undernourished was 0.32, compared with probabilities of 0.49-0.70 for adequately nourished adolescents (P = 0.023). Diarrhea in the first year of life (P = 0.009) and fast weight gain during the first 6 mo (P = 0.003) were also associated with a higher probability of response. CONCLUSIONS: These findings extend the concept of fetal and early infant programming of adult diseases to the immune system and suggest that early environments may have long-term implications for immunocompetence and infectious disease risk, particularly in developing countries.

Adolescent↗

PubMed2001

Prenatal undernutrition and postnatal growth are associated with adolescent thymic function.

The fetal and early infant origins of a number of adult cardiovascular and metabolic diseases have received considerable attention, but the long-term consequences of early environments for human immune function have not been reported. We investigated the effects of pre- and postnatal environments on thymic hormone production in adolescents participating in an ongoing longitudinal study in the Philippines. Prospective data collected at birth, during y 1 of life, in childhood and in adolescence were used to predict plasma thymopoietin concentration in 14- to 15-y-old adolescents (n = 103). Thymopoietin concentration was compared for small-for-gestational-age and appropriate-for-gestational-age individuals while controlling for a range of postnatal exposures. Prenatal undernutrition was significantly associated with reduced thymopoietin production in interaction with the duration of exclusive breast-feeding (P = 0.006). Growth in length during y 1 of life was positively associated with adolescent thymopoietin production (P = 0.002). These associations remained significant after adjusting for a range of potentially confounding variables. These findings provide support for the importance of fetal and early infant programming of thymic function, and suggest that early environments may have long-term implications for immunocompetence and adult disease risk.

Adolescent↗

PubMed2001

Full breast-feeding for at least four months has differential effects on growth before and after six months of age among children in a Mexican community.

This study examines the relationship between breast-feeding and growth from 0 to 6 and 6 to 20 mo among 185 children in a Mexican community. Infants from a previous 6-mo longitudinal study were followed up for additional anthropometric measurements at a mean age of 19.9 mo. Size at 6 mo and at follow-up were modeled as outcomes of whether infants were fully breast-fed (exclusively or predominantly breast-fed) for at least 4 mo, controlling for size at birth and 6 mo, respectively, and potential confounders. From birth to 6 mo, fully breast-fed infants had ponderal index increments of 0.07 units larger (P = 0.04) than comparison infants. There were no differences in weight. For length, an interaction between full breast-feeding and socioeconomic status (SES) was found, with fully breast-fed infants of low SES growing more than comparison infants, whereas the opposite was seen at upper SES levels. From 6 to 20 mo, fully breast-fed infants had weight and length increments of 0.53 cm (P < 0.001) and 0.72 kg (P = 0.01) smaller than those of comparison infants. For ponderal index, an interaction between mother's education and breast-feeding revealed an inverted U-shaped response across levels of education. Additionally, logistic regressions of monthly breast-feeding on lagged measurements revealed that relatively heavier infants had higher odds of being fully breast-fed at 2 and 3 mo. Our findings indicate that the benefits of full breast-feeding on growth may be most pronounced early in life. Further research of unmeasured confounders may explain the association of full breast-feeding with slower growth beyond 6 mo.

Body Weight↗

PubMed2001

Size at birth predicts age at menarche.

OBJECTIVE: This study examines the relationship of intrauterine growth, measured by size and maturity at birth, to age at menarche, while also considering a wide range of other factors that may affect maturation. The research is motivated by the current debate about the importance of the prenatal environment as a determinant of later disease risk. METHODS: Data were collected during the Cebu Longitudinal Health and Nutrition Survey. This community-based study has followed a cohort of several thousand Filipino infants since their birth in 1983 to 1984. Participants live in urban and rural communities of Metro Cebu, the second largest metropolitan area of the Philippines. The analysis sample includes 997 girls 14 to 15 years of age. The main outcome measure is age at menarche, determined from girls' self-report of the month and year of first menses. Factors that influenced age at menarche were identified using Weibull parametric survival time models. The main exposure variables of interest included weight and length (measured by trained field staff) and gestational age (assessed from mother's reported date of last menstrual period, augmented by clinical assessments at birth). The analysis also takes into account a wide range of other factors that are likely to affect age at menarche. These include the girls' early postnatal growth rates, premenarcheal body composition (body mass index and skinfold thicknesses measured at 8 years), current diet (measured by two 24-hour dietary recalls), and socioeconomic conditions of the household in which they live. We also assessed the contribution of maternal characteristics, including age at menarche, height, and nutritional status while pregnant with the study child. RESULTS: The median age at menarche calculated from the hazard model is 13.1 years, with 50% of girls attaining menarche between 12.4 and 13.9 years. Earlier menarche is characteristic of girls who live in urban, higher socioeconomic status households, as indicated by higher maternal education, better housing quality, and possession of assets, such as a TV or refrigerator. Age at menarche is significantly associated with birth characteristics. Although birth weight alone was not significantly related to age at menarche, girls who were relatively long and thin at birth (>49 cm, <3 kg) attained menarche ~6 months earlier than did girls who were short and light (<49 cm, <3 kg). This effect of thinness at birth is most pronounced among girls with greater than average growth increments in 6 months of life. The effects of birth size are not modified when body mass index and skinfold thicknesses at 8 years are taken into account. Effects of birth size on age at menarche also remain significant when maternal nutritional status during pregnancy and the girl's current diet and socioeconomic indicators are taken into account. CONCLUSIONS: The study provides additional evidence of fetal programming of later health outcomes by showing that future growth and maturation trajectories are established in utero. Furthermore, rapid postnatal growth potentiates the effects of size at birth and is related independently to earlier pubertal maturation.

Adolescent↗

PubMed2001

Maturational timing and overweight prevalence in US adolescent girls.

OBJECTIVES: This study examined the relation of age at menarche to overweight in US adolescent girls. METHODS: Effects of age at menarche and race/ethnicity on overweight were estimated via logistic regression, after adjustment for sociodemographic characteristics, in a sample of 6507 Hispanic, Black, White, and Asian American girls who participated in wave 2 of the National Longitudinal Study of Adolescent Health. RESULTS: Overweight prevalence rates were significantly higher in early maturing adolescents of all racial/ethnic groups but highest (57.5%) among early maturing Black girls. Early maturation nearly doubled the odds of being overweight (body mass index at or above the 85th percentile). CONCLUSIONS: Greater public health attention should be focused on the high prevalence of overweight, particularly among minority female adolescents.

Adolescent↗

PubMed2000

Overweight and underweight coexist within households in Brazil, China and Russia.

The possibility that underweight and overweight coexist within households and understanding such an occurrence have not been studied sufficiently. In fact, underweight and overweight are thought of as resulting from very different environmental, behavioral and individual risk factors. This study identified households in which overweight and underweight coexist and explored household-level associations such as urban residence and income. Using three large national surveys from Brazil, China and Russia, the prevalence of such households ranged from 8% in China and Russia to 11% in Brazil. Even more important from the public health perspective is the finding that these under/over households accounted for a high proportion of all households with an underweight member in China (23%), Brazil (45%), and Russia (58%). The prevalence of the underweight/overweight household was highest in the urban environment in all three countries. There was no clear pattern in the prevalence of the underweight/overweight household type by income. Multivariable logistic regression was used to test the significance of the association of household type with urban residence and income while controlling for household size and household demographics by gender. Further analysis was done to consider the age relationships within the underweight/overweight pair. The underweight child coexisting with an overweight nonelderly adult was the predominant pair combination in all three countries. These findings illustrate the need for public health programs that are able to address underweight and overweight simultaneously.

Age Factors↗

PubMed1999

Sex difference in measures of body fatness and the possible difference in the effect of dietary fat on body fatness in men and women.

OBJECTIVES: To examine the sex difference in anthropometric measures of body fatness and to explore the possibility that diet may have differential effects on body fatness in men and women. DESIGN: Prospective study design. SETTING: The first and second China Health and Nutrition Survey conducted in 1989 and 1991, respectively. SUBJECTS: 1449 men and 1683 women age 20-35 y at the baseline (1989) survey. METHODS: Anthropometric measures of body fatness in men and women were compared. Statistical methods were used to explore the potential difference in the effect of dietary fat on body fatness in men and women. RESULTS: Measures of body fatness, especially peripheral fatness, differed markedly between men and women in this study sample. Statistical analysis suggested that the effect of dietary fat on body fatness may be different in men compared to women. CONCLUSIONS: Sexual dimorphism in body fatness has important implications for both clinical and epidemiologic research of obesity. The possibility that diet may have differential effect on body fatness in men and women needs to be investigated.

Adipose Tissue↗

PubMed1999

Filipino children exhibit catch-Up growth from age 2 to 12 years.

Potential for catch-up growth among stunted children is thought to be limited after age 2 y, particularly when they remain in poor environments. We explored the extent to which there were improvements in height status from age 2 to 12 y in a cohort of >2, 000 children from the Cebu (The Philippines) Longitudinal Health and Nutrition Survey. At age 2 y, about 63% of sample children were stunted as defined by height-for-age (HAZ) <-2 based on the WHO reference. Of children stunted at age 2, 30% were no longer stunted at 8.5 y, and 32.5% were no longer stunted at 12 y. The mean increase in HAZ among those with such improvements was 1.14 units. The likelihood that children stunted at age 2 y would no longer be stunted at 8.5 y was estimated using logistic regression. Low birth weight, which was associated with more severe stunting in the first 2 y of life, significantly reduced likelihood of catch-up growth in later childhood. In contrast, children with taller mothers, who were first born, longer at birth, less severely stunted in early infancy and those with fewer siblings were more likely to increase HAZ from <-2 to >-2 between ages 2 and 8.5 y. Similar factors predicted the improvement in linear growth from 8.5 to 12 y. These results suggest that there is a large potential for catch-up growth in children into the preadolescent years.

Aging↗

PubMed1999

Severity and timing of stunting in the first two years of life affect performance on cognitive tests in late childhood.

Undernutrition in infancy and early childhood is thought to adversely affect cognitive development, although evidence of lasting effects is not well established. With the use of data from the Cebu Longitudinal Health and Nutrition Study, we assesshere the relationship between stunting in the first 2 y of life and later cognitive development, focusing on the significance of severity, timing and persistence of early stunting. The sample included > 2000 Filipino children administered a cognitive ability test at ages 8 and 11 y. Stunting status was determined on the basis of anthropometric data collected prospectively between birth and age 2 y. Children stunted between birth and age 2 y had significantly lower test scores than nonstunted children, especially when stunting was severe. The shortfall in test scores among children stunted in the first 2 y was strongly related to reduced schooling, which was the result of a substantial delay in initial enrollment as well as higher absenteeism and repetition of school years among stunted children. Interactions between stunting and schooling were not significant, indicating that stunted and nonstunted children benefitted similarly from additional schooling. After multivariate adjustment, severe stunting at age 2 y remained significantly associated with later deficits in cognitive ability. The timing of stunting was also related to test performance, largely because children stunted very early also tended to be severely stunted (chi(2) P = 0.000). Deficits in children's scores were smaller at age 11 y than at age 8 y, suggesting that adverse effects may decline over time. Results emphasize the need to prevent early stunting and to provide adequate schooling to disadvantaged children.

Child↗