TY - JOUR

T1 - Associations between stunting, wasting and body composition: 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

N1 - Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.

PY - 2023

Y1 - 2023

N2 - Background: Early growth and body composition may influence risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life.Objective: 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. Cross-sectional and longitudinal associations between z-score categories of length-for-age Z (LAZ) or weight-for-length Z (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 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32% and wasting remained at 2-3% between 6 and 15 months. Compared to LAZ >0, stunted children had 1.12 (95% CI: 0.88;1.36, P <0.001) kg lower FFM at 6 months increasing to 1.59 (95% CI: 1.25;1.94, P <0.001) kg at 15 months, corresponding to differences of 18% and 17%, respectively. When analysing FFMI, the deficit in FFM tended to be less than proportional to children's height at 6 months (P ≤0.060), but not at 15 months (P >0.40). Stunting was associated with 0.28 (95% CI: 0.09;0.47, P =0.004) kg lower FM at 6 months. The difference lost significance at 15 months, and stunting was not associated with FMI at any time point. Lower WLZ was generally associated with lower FM, FFM, FMI and FFMI at 6 and 15 months. Differences in FFM, but not FM, increased with time, while FFMI differences did not change and FMI differences generally decreased with time.Conclusions: Overall, low LAZ and WHZ among young Kenyan children is associated with reduced lean tissue, which may have long-term health consequences.Trial registration: ISRCTN30012997.

AB - Background: Early growth and body composition may influence risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life.Objective: 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. Cross-sectional and longitudinal associations between z-score categories of length-for-age Z (LAZ) or weight-for-length Z (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 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32% and wasting remained at 2-3% between 6 and 15 months. Compared to LAZ >0, stunted children had 1.12 (95% CI: 0.88;1.36, P <0.001) kg lower FFM at 6 months increasing to 1.59 (95% CI: 1.25;1.94, P <0.001) kg at 15 months, corresponding to differences of 18% and 17%, respectively. When analysing FFMI, the deficit in FFM tended to be less than proportional to children's height at 6 months (P ≤0.060), but not at 15 months (P >0.40). Stunting was associated with 0.28 (95% CI: 0.09;0.47, P =0.004) kg lower FM at 6 months. The difference lost significance at 15 months, and stunting was not associated with FMI at any time point. Lower WLZ was generally associated with lower FM, FFM, FMI and FFMI at 6 and 15 months. Differences in FFM, but not FM, increased with time, while FFMI differences did not change and FMI differences generally decreased with time.Conclusions: Overall, low LAZ and WHZ among young Kenyan children is associated with reduced lean tissue, which may have long-term health consequences.Trial registration: ISRCTN30012997.

KW - Faculty of Science

KW - Body composition

KW - Malnutrition

KW - Infancy and childhood

KW - Fat-free mass

KW - Fat mass

KW - Infant growth

KW - Child growth

U2 - 10.1016/j.tjnut.2023.02.014

DO - 10.1016/j.tjnut.2023.02.014

M3 - Journal article

C2 - 36796480

VL - 153

SP - 970

EP - 978

JO - Journal of Nutrition

JF - Journal of Nutrition

SN - 0022-3166

IS - 4

ER -