TY - JOUR
T1 - Associations between Stunting, Wasting and Body Composition
T2 - A Longitudinal Study in 6- to 15-Month-Old Kenyan Children
AU - Konyole, Silvenus O.
AU - Omollo, Selina A.
AU - Kinyuru, John N.
AU - Owuor, Bethwell O.
AU - Estambale, Benson B.
AU - Ritz, Christian
AU - Michaelsen, Kim F.
AU - Filteau, Suzanne M.
AU - Wells, Jonathan C.
AU - Roos, Nanna
AU - Friis, Henrik
AU - Owino, Victor O.
AU - Grenov, Benedikte
PY - 2023/4
Y1 - 2023/4
N2 - Background: Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life. Objectives: We assessed stunting and wasting as correlates of body composition in young Kenyan children. Methods: Nested in a randomized controlled nutrition trial, this longitudinal study assessed fat and fat-free mass (FM, FFM) using deuterium dilution technique among children at age 6 and 15 months. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models. Results: Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P < 0.001) lower FFM at 6 mo and increased to 1.59 kg (95% CI: 1.25, 1.94; P < 0.001) at 15 mo, corresponding to differences of 18% and 17%, respectively. When analyzing FFMI, the deficit in FFM tended to be less than proportional to children's height at 6 mo (P ≤ 0.060) but not at 15 mo (P > 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time. Conclusions: Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences.
AB - Background: Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life. Objectives: We assessed stunting and wasting as correlates of body composition in young Kenyan children. Methods: Nested in a randomized controlled nutrition trial, this longitudinal study assessed fat and fat-free mass (FM, FFM) using deuterium dilution technique among children at age 6 and 15 months. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models. Results: Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P < 0.001) lower FFM at 6 mo and increased to 1.59 kg (95% CI: 1.25, 1.94; P < 0.001) at 15 mo, corresponding to differences of 18% and 17%, respectively. When analyzing FFMI, the deficit in FFM tended to be less than proportional to children's height at 6 mo (P ≤ 0.060) but not at 15 mo (P > 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time. Conclusions: Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences.
KW - body composition
KW - child growth
KW - fat mass
KW - fat-free mass
KW - infancy and childhood
KW - infant growth
KW - malnutrition
KW - Body Mass Index
KW - Body Composition
KW - Cross-Sectional Studies
KW - Humans
KW - Kenya/epidemiology
KW - Infant
KW - Growth Disorders/epidemiology
KW - Adipose Tissue/metabolism
KW - Female
KW - Cachexia/metabolism
KW - Child
KW - Longitudinal Studies
U2 - 10.1016/j.tjnut.2023.02.014
DO - 10.1016/j.tjnut.2023.02.014
M3 - Journal article
C2 - 36796480
AN - SCOPUS:85150360329
SN - 0022-3166
VL - 153
SP - 970
EP - 978
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 4
ER -