Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia

Abstract

Background: Childhood growth stunting is negatively associated with cognitive and health outcomes, and is claimed to be irreversible after age 2.

Aim: To estimate growth rates for children aged 2–7 who were stunted (sex-age standardised z-score [HAZ] <−2), marginally-stunted (−2 ≤ HAZ ≤−1) or not-stunted (HAZ >−1) at baseline and tracked annually until age 11; frequency of movement among height categories; and variation in height predicted by early childhood height.

Subjects and methods: This study used a 9-year annual panel (2002–2010) from a native Amazonian society of horticulturalists–foragers (Tsimane’; n = 174 girls; 179 boys at baseline). Descriptive statistics and random-effect regressions were used.

Results: This study found some evidence of catch-up growth in HAZ, but persistent height deficits. Children stunted at baseline improved 1 HAZ unit by age 11 and had higher annual growth rates than non-stunted children. Marginally-stunted boys had a 0.1 HAZ units higher annual growth rate than non-stunted boys. Despite some catch up, ∼ 80% of marginally-stunted children at baseline remained marginally-stunted by age 11. The height deficit increased from age 2 to 11. Modest year-to-year movement was found between height categories.

Conclusions: The prevalence of growth faltering among the Tsimane’ has declined, but hurdles still substantially lock children into height categories.

Keywords:

• Growth faltering
• public health
• social epidemiology
• stunting
• Tsimane’

Acknowledgements

The views expressed in this article do not necessarily represent the views of the Federal Reserve Board or the US. We thank the following institutions for grant support: (1) Cultural Anthropology Program of the USA National Science Foundation (BCS: 0650378, 0552296, 0200767, 0111905), (2) Bill & Melinda Gates Foundation (Global Health Grant OPP1032713), (3) Eunice Shriver Kennedy National Institute of Child Health and Development (Grant R01 HD070993) and (4) Grand Challenges Canada (Grant 0072-03). The study received IRB approval from Northwestern University (Study 00007) and the Consejo Tsimane’ (governing body of the Tsimane’). We would also like to thank the Consejo Tsimane’ for continuous support and two AHB referees for helpful comments on earlier drafts.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.