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      Childhood stunting and the metabolic syndrome components in young adults from a Brazilian birth cohort study

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          Abstract

          Background/Objectives:

          The aim of this study was to investigate the association between stunting in the second year of life and metabolic syndrome components in early adulthood among subjects who have been prospectively followed-up since birth, in a city in Southern Brazil.

          Subjects/Methods:

          In 1984, we attempted to follow-up the entire cohort; the subjects were examined and their mothers interviewed. Stunting was defined by a length-for-age Z-score 2 s.d. or more below the mean, in accordance with the World Health Organization reference. Between 2004 and 2005, we again tried to follow the entire cohort; during this period the subjects were evaluated for the following metabolic syndrome components: high-density lipoprotein (HDL) cholesterol, triglycerides, random blood glucose, waist circumference and systolic and diastolic blood pressure. Family income at the time of the baby's birth, asset index, mother's education, mother's smoking during pregnancy and duration of breastfeeding were considered possible confounders. Linear regression was used in the unadjusted and adjusted analyses.

          Results:

          Among men, stunting was inversely associated with triglycerides ( β=−11.90, confidence interval (CI)=−22.33 to −1.48) and waist circumference ( β=−4.29, CI=−5.62 to −2.97), whereas for women stunting was negatively related to HDL-cholesterol ( β=−4.50, CI=−6.47 to −2.52), triglycerides ( β=−9.61, CI=−17.66 to −1.56) and waist circumference ( β=−1.14, CI=−4.22 to −1.02). However, after controlling for confounding variables, these associations vanished.

          Conclusions:

          The findings suggest that stunting in childhood is not associated with metabolic syndrome components in young adults.

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          Most cited references22

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Association of weight gain in infancy and early childhood with metabolic risk in young adults.

            Early postnatal life has been suggested as an important window during which risks for long-term health may be influenced. The aim of this study was to examine the independent associations between weight gain during infancy (0-6 months) and early childhood (3-6 yr) with components of the metabolic syndrome in young adults. This was a prospective cohort study (The Stockholm Weight Development Study). The study was conducted in a general community. Subjects included 128 (54 males) singletons, followed from birth to 17 yr. None of these young adults met the full criteria for the metabolic syndrome. We therefore calculated a continuous clustered metabolic risk score by averaging the standardized values of the following components: waist circumference, blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, glucose, and insulin level. Clustered metabolic risk at age 17 yr was predicted by weight gain during infancy (standardized beta = 0.16; P < 0.0001) but not during early childhood (standardized beta = 0.10; P = 0.23), adjusted for birth weight, gestational age, current height, maternal fat mass, and socioeconomic status at age 17 yr. Further adjustment for current fat mass and weight gain during childhood did not alter the significant association between infancy weight gain with the metabolic risk score (standardized beta = 0.20; P = 0.007). Rapid weight gain during infancy (0-6 months) but not during early childhood (3-6 yr) predicted clustered metabolic risk at age 17 yr. Early interventions to moderate rapid weight gain even at very young ages may help to reduce adult cardiovascular disease risks.
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              Stunted children gain less lean body mass and more fat mass than their non-stunted counterparts: a prospective study.

              The aim of the present study was to analyse the changes in body composition of stunted children during a follow-up period and to test the hypothesis of a tendency to accumulate body fat as a consequence of undernutrition early in life. We selected fifty boys and girls aged 11 to 15, who were residents of slums in Sao Paulo, Brazil. Twenty were stunted (S) and thirty had normal stature (NS). The children's nutritional status and body composition were assessed through anthropometry and dual-energy X-ray absorptiometry, at the beginning of the present study and after 3 years, and changes in lean mass (LM and LM%) and fat mass (FM and FM%) were calculated. Stunted boys accumulated more body fat (FM%: S=1.62%, NS=-3.40%; P=0.003) and gained less lean mass (LM%: S=-1.46, NS=3.21%; P=0.004). Stunted girls gained less lean mass (S=7.87 kg, NS=11.96 kg; P=0.032) and had significantly higher values of FM% at follow-up when compared with their baseline values (P=0.008), whereas non-stunted girls had a non-significant difference in FM% over time (P=0.386). These findings are important to understand the factors involved in the increased prevalence of overweight and obesity among poor populations, which appear to be associated with hunger during infancy and/or childhood.
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                Author and article information

                Journal
                Eur J Clin Nutr
                Eur J Clin Nutr
                European Journal of Clinical Nutrition
                Nature Publishing Group
                0954-3007
                1476-5640
                May 2016
                06 January 2016
                : 70
                : 5
                : 548-553
                Affiliations
                [1 ]Departament of Nutrition, Vale of Itajaí University , Itajaí, Santa Catarina, Brazil
                [2 ]Epidemiological Research Center, Epidemiology Postgraduate Program, Federal University of Pelotas , Rio Grande do Sul, Brazil
                [3 ]Departament of Nutrition, Federal University of Pelotas , Rio Grande do Sul, Brazil
                Author notes
                [* ]Nutrition, Vale of Itajaí University, Uruguai Street, 458 , Setor F, Bloco 6, Itajaí, Santa Catarina 88302-202, Brazil. E-mail: grillo@ 123456univali.br
                Article
                ejcn2015220
                10.1038/ejcn.2015.220
                4858756
                26733042
                1c141f9e-84a5-4616-a17b-2897fe7fe963
                Copyright © 2016 Macmillan Publishers Limited

                This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                : 24 May 2015
                : 02 November 2015
                : 18 November 2015
                Categories
                Original Article

                Nutrition & Dietetics
                Nutrition & Dietetics

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