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 (ß=-11.90, confidence interval (CI)=-22.33 to -1.48) and waist circumference (ß=-4.29, CI=-5.62 to -2.97), whereas for women stunting was negatively related to HDL-cholesterol (ß=-4.50, CI=-6.47 to -2.52), triglycerides (ß=-9.61, CI=-17.66 to -1.56) and waist circumference (ß=-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.
Subject(s)
Growth Disorders/blood , Metabolic Syndrome/blood , Blood Pressure , Brazil , Child, Preschool , Cholesterol, HDL/blood , Cohort Studies , Female , Follow-Up Studies , Growth Disorders/complications , Growth Disorders/physiopathology , Humans , Linear Models , Male , Metabolic Syndrome/etiology , Metabolic Syndrome/physiopathology , Sex Factors , Triglycerides/blood , Waist Circumference , Young AdultABSTRACT
PURPOSE: A cross-sectional study was carried out to characterize the alterations in the resting metabolic rate (RMR), and socioeconomic conditions of 15 stunted (DP= height/age < 95% and 110% (3) weight/height >90%) and 15 nonstunted (EU= height/age > 95% and 110% (3) weight/height >90%) school girls living in shantytowns of São Paulo. METHODS: Resting metabolic rate was measured using indirect calorimetry. Socioeconomic data was collected during home visits by administration of a questionnaire. RESULTS: The mildly stunted group had a higher RMR when expressed as Kcal/kg body weight (EU= 40,5 Kcal/kg/day; DP=44,4 Kcal/kg/day; p<0.05) and lean body mass (EU= 49, 2 Kcal/kg/day; DP=52,5 Kcal/kg/day; p<0.05). Stunting was associated with maternal illiteracy (EU= 13,3%; DP=57,1%; p<0.05), income per capita (EU=US$107,14; DP=US$54,40; p< 0.05), number of parasites per child (EU=0; DP=1; p<0.05), birth order (EU=2; DP=4; p< 0.05), and number of siblings (EU=4; DP=6; p<0.01). Stunting was best predicted by income per capita and maternal illiteracy by using multiple logistic regression. CONCLUSIONS: Although the two groups had normal weight/height, the group with mild stunting showed socioeconomic and metabolic alterations, typical of a malnourished condition.
Subject(s)
Child Nutrition Disorders/metabolism , Energy Metabolism , Poverty Areas , Rest , Body Height , Body Weight , Brazil/epidemiology , Child , Child Nutrition Disorders/epidemiology , Child Nutrition Disorders/parasitology , Cross-Sectional Studies , Female , Humans , Regression Analysis , Socioeconomic FactorsABSTRACT
OBJETIVOS: Realizou-se um estudo transversal para avaliar a taxa de metabolismo de repouso (TMR) e condições socioeconômicas em 15 crianças escolares do sexo feminino; eutróficas (EU= estatura/idade > ou = 95 por cento e peso/idade entre 90-110por cento) e 15 com desnutrição pregressa (DP= estatura/idade < 95 por cento e peso/estatura entre 90-110 por cento) moradoras em favelas no município de São Paulo. MÉTODOS: Avaliou-se a TMR por calorimetria indireta, e a situação socioeconômica por entrevista domiciliar. RESULTADOS: O grupo DP apresentou TMR mais alta quando expressa por unidade de peso corpóreo (EU= 40,5 Kcal/kg/dia; DP=44,4 Kcal/kg/dia, p<0,05) e por quilograma de massa magra (EU= 49,2 Kcal/kg/dia; DP=52,5 Kcal/kg/dia, p<0,05); e diferenças significantes para renda per capita, analfabetismo materno, número de parasitas por criança, número de ordem entre os filhos e número de irmãos. Em análise multivariada as variáveis associadas à desnutrição foram renda per capita e analfabetismo materno. CONCLUSÕES: Embora os dois grupos tenham peso/estatura normais, a presença de baixa estatura leve foi acompanhada por alterações metabólicas e socioeconômicas típicas de um quadro de desnutrição.
Subject(s)
Humans , Female , Child , Rest , Child Nutrition Disorders/metabolism , Poverty Areas , Protein-Energy Malnutrition/metabolism , Energy Metabolism , Socioeconomic Factors , Body Height , Body Weight , Brazil , Child Nutrition Disorders/parasitology , Child Nutrition Disorders/epidemiology , Cross-Sectional Studies , Regression Analysis , Protein-Energy Malnutrition/parasitology , Protein-Energy Malnutrition/epidemiologyABSTRACT
Previous studies by our group and others have suggested that nutritional stunting may increase the risk of obesity. To investigate mechanisms that could explain a link between stunting and obesity, a 22-mo follow-up study was conducted in two groups of shantytowns school girls (7-11 y old) in São Paulo, Brazil. One group (n = 15) had mild stunting (defined using a cutoff of -1.4 Z-scores of height-for-age) but normal weight-for-height; the control group (n = 15) had normal weight and height. Similar energy intake, dietary macronutrient composition and energy expenditure were observed in the two groups. Both groups showed comparable levels of IGF-1 that were below the normal range. A significant and positive association between baseline IGF-1 and the change in height-for-age during follow-up was found in all subjects combined (P = 0.044). A significant association was found between the baseline percentage of dietary energy supplied by fat and the gain in weight-for-height during follow-up in girls with mild stunting (P = 0.048), but not in the nonstunted control girls (P = 0.245); however, the slopes of these relationships were not significantly different. This study raises the question of whether a diet high in fat may increase the susceptibility to excess body fat gain in children who are mildly stunted. Further studies are need to explore this issue and to examine the possible etiological role of low levels of IGF-1.
