Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants.

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Abstract

Child stunting remains a poorly understood, prevalent public health problem. Environmental enteric dysfunction (EED) is hypothesized to be an important underlying cause.

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Most cited references 90

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Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

Zulfiqar A Bhutta, Jai K Das, Arjumand Rizvi … (2013)

The Lancet, 382(9890), 452-477

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Maternal and child undernutrition: consequences for adult health and human capital

Cesar Victora, Linda S Adair, Caroline Fall … (2008)

Summary In this paper we review the associations between maternal and child undernutrition with human capital and risk of adult diseases in low-income and middle-income countries. We analysed data from five long-standing prospective cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa and noted that indices of maternal and child undernutrition (maternal height, birthweight, intrauterine growth restriction, and weight, height, and body-mass index at 2 years according to the new WHO growth standards) were related to adult outcomes (height, schooling, income or assets, offspring birthweight, body-mass index, glucose concentrations, blood pressure). We undertook systematic reviews of studies from low-income and middle-income countries for these outcomes and for indicators related to blood lipids, cardiovascular disease, lung and immune function, cancers, osteoporosis, and mental illness. Undernutrition was strongly associated, both in the review of published work and in new analyses, with shorter adult height, less schooling, reduced economic productivity, and—for women—lower offspring birthweight. Associations with adult disease indicators were not so clear-cut. Increased size at birth and in childhood were positively associated with adult body-mass index and to a lesser extent with blood pressure values, but not with blood glucose concentrations. In our new analyses and in published work, lower birthweight and undernutrition in childhood were risk factors for high glucose concentrations, blood pressure, and harmful lipid profiles once adult body-mass index and height were adjusted for, suggesting that rapid postnatal weight gain—especially after infancy—is linked to these conditions. The review of published works indicates that there is insufficient information about long-term changes in immune function, blood lipids, or osteoporosis indicators. Birthweight is positively associated with lung function and with the incidence of some cancers, and undernutrition could be associated with mental illness. We noted that height-for-age at 2 years was the best predictor of human capital and that undernutrition is associated with lower human capital. 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.

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Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee.

M. de Onis, J P Habicht (1996)

The World Health Organization (WHO) convened an Expert Committee to reevaluate the use of anthropometry at different ages for assessing health, nutrition, and social wellbeing. The Committee's task included identifying reference data for anthropometric indexes when appropriate, and providing guidelines on how the data should be used. For fetal growth, the Committee recommended an existing sex-specific multiracial reference. In view of the significant technical drawbacks of the current National Center for Health Statistics (NCHS)/WHO reference and its inadequacy for assessing the growth of breast-fed infants, the Committee recommended the development of a new reference concerning weight and length/height for infants and children, which will be a complex and costly undertaking. Proper interpretation of midupper arm circumference for preschoolers requires age-specific reference data. To evaluate adolescent height-for-age, the Committee recommended the current NCHS/WHO reference. Use of the NCHS body mass index (BMI) data, with their upper percentile elevations and skewness, is undesirable for setting health goals; however, these data were provisionally recommended for defining obesity based on a combination of elevated BMI and high subcutaneous fat. The NCHS values were provisionally recommended as reference data for subscapular and triceps skinfold thicknesses. Guidelines were also provided for adjusting adolescent anthropometric comparisons for maturational status. Currently, there is no need for adult reference data for BMI; interpretation should be based on pragmatic BMI cutoffs. Finally, the Committee noted that few normative anthropometric data exist for the elderly, especially for those > 80 y of age. Proper definitions of health status, function, and biologic age remain to be developed for this group.

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Author and article information

Journal

Journal ID (iso-abbrev): Am J Clin Nutr

Title: The American journal of clinical nutrition

Publisher: Oxford University Press (OUP)

ISSN (Electronic): 1938-3207

ISSN (Print): 0002-9165

Publication date (Electronic): May 08 2021

Volume: 113

Issue: 5

Affiliations

[1 ] Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.

[2 ] Global Alliance for Improved Nutrition, Washington, DC, USA.

[3 ] Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.

[4 ] Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

[5 ] Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.

[6 ] School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.

[7 ] Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.

[8 ] Blizard Institute, Queen Mary University of London, London, United Kingdom.

Article

Publisher Item ID: 6178925

DOI: 10.1093/ajcn/nqaa416

PMC ID: 8106752

PubMed ID: 33740052

SO-VID: 5f90c7ca-fe0a-42b8-abcc-e9346161a9c8

History

Keywords: biomarkers,Zimbabwe,stunting,environmental enteric dysfunction,child growth

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Keywords: biomarkers, Zimbabwe, stunting, environmental enteric dysfunction, child growth

Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants.

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Abstract

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Journal of Circulating Biomarkers

Most cited references 90

Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

Maternal and child undernutrition: consequences for adult health and human capital

Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee.

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