Stunting at 2 years in relation to body composition at 9 years in African urban children

Objective: To determine whether African urban children who were stunted at 2 years of age demonstrated an altered body composition by the end of childhood, before entering puberty, at 9 years of age. Research Methods and Procedures: This was a mixed-longitudinal study of 330 prepubertal African children (182 boys) from Soweto-Johannesburg, South Africa. Anthropometric data at 2 years of age were compared with anthropometric, DXA-determined body composition and fat patterning in late childhood (7 to 9 years). Results: Children who had been stunted at 2 years were significantly shorter and lighter than non-stunted children at 7 to 9 years, but there were no differences in their BMI or centralization of body fat. Previously stunted status significantly predicted reduced weight and height at 7 to 9 years but did not predict BMI, body composition, or fat patterning after controlling for potential confounding factors. The odds ratio for stunting at 2 years as a predictor of overweight at 7 to 9 years was not significant at 1.09 (95% confidence limits: 0.30, 3.98). Discussion: Greater BMI in stunted infants does not demonstrate a tendency toward overweight or obesity but is a reflection of the greater reduction in height rather than weight in stunted children. Stunted children may be programmed to accumulate greater body fat at central sites during adolescence, but we have been unable to show that these changes are evident before the initiation of pubertal development.