Catch-Up Growth Occurs after Diarrhea in Early Childhood
Open Access
- 1 June 2014
- journal article
- Published by Elsevier BV in Journal of Nutrition
- Vol. 144 (6), 965-971
- https://doi.org/10.3945/jn.113.187161
Abstract
Diarrhea and linear growth faltering continue to burden low-income countries and are among the most important contributors to poor health during early childhood. Diarrhea is thought to adversely affect linear growth, but catch-up growth can occur if no additional insults are experienced. We sought to characterize catch-up growth in relation to diarrhea burden in a multisite dataset of 1007 children. Using longitudinal anthropometry and diarrheal surveillance data from 7 cohort studies in 4 countries, we examined the relation between diarrhea prevalence and growth in 3- to 6-mo periods using linear mixed-effect models. Growth during each period was calculated as a function of age using linear splines. We incorporated the longitudinal prevalence of diarrhea in both current and previous periods into the model. Diarrhea during the current period was associated with slower linear and ponderal growth. Faster (catch-up) growth in length was observed in children with no diarrhea in age groups immediately after an age group in which diarrhea was experienced [age group >6–12 mo: 0.03 mm/mo for each percentage diarrhea prevalence in the previous period (95% CI: 0.007, 0.06) relative to 11.3 mm/mo mean growth rate; age group >12–18 mo: 0.04 mm/mo (95% CI: 0.02, 0.06) relative to 8.9 mm/mo mean growth rate; age group >18–24 mo: 0.04 mm/mo (95% CI: 0.003, 0.09) relative to 7.9 mm/mo mean growth rate]. The associations were stronger in boys than in girls when separate models were run. Similar results were observed when weight was the outcome variable. When diarrheal episodes are followed by diarrhea-free periods in the first 2 y of life, catch-up growth is observed that may allow children to regain their original trajectories. The finding of a greater effect of diarrhea on linear growth in boys than in girls was unexpected and requires additional study. Diarrhea burdens are high throughout the first 2 y of life in these study sites, therefore reducing the likelihood of catch-up growth. Extending diarrhea-free periods may increase the likelihood of catch-up growth and decrease the prevalence of stunting.Keywords
This publication has 40 references indexed in Scilit:
- Fecal Markers of Intestinal Inflammation and Permeability Associated with the Subsequent Acquisition of Linear Growth Deficits in InfantsThe American Journal of Tropical Medicine and Hygiene, 2013
- Revisiting the Relationship of Weight and Height in Early ChildhoodAdvances in Nutrition: An International Review Journal, 2012
- Comparative effects of vivax malaria, fever and diarrhoea on child growthInternational Journal of Epidemiology, 2012
- Sex differences in statural growth impairment in Crohnʼs disease: Role of IGF-1Inflammatory Bowel Diseases, 2011
- Multi-country analysis of the effects of diarrhoea on childhood stuntingInternational Journal of Epidemiology, 2008
- Plasticity of Growth in Height, Weight, and Head Circumference: Meta-analytic Evidence of Massive Catch-up After International AdoptionJournal of Developmental & Behavioral Pediatrics, 2007
- Etiologic agents in acute vs persistent diarrhea in children under three years of age in peri‐urban Lima, PerúActa Paediatrica, 1992
- Would Control of Childhood Infectious Diseases Reduce Malnutrition?Acta Paediatrica, 1991
- Diarrhoea and catch-up growthThe Lancet, 1990
- ARE DIARRHOEA CONTROL PROGRAMMES LIKELY TO REDUCE CHILDHOOD MALNUTRITION? OBSERVATIONS FROM RURAL BANGLADESHThe Lancet, 1989