Understanding Stunting in Nutrition

Understanding Stunting in Nutrition

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Why Your Child's Height Matters for Healthy Growth?

A child’s height in early childhood is a strong marker of healthy growth. It is also closely linked with the development of the brain and language skills. In fact, children who fall short of the minimum height standards for their age are considered to suffer from a serious condition called stunting.1

Children who are stunted may not be deficient in calories but may be undernourished due to their unwillingness to eat or lack of balanced nutrition.

Did you know that ~22% children globally below the age of 5, are stunted!2

  • In Philippines, 1 in 3 children is stunted2

Stunting is an issue that affects the child the entire life. It goes beyond just being short, numerous studies have shown the health consequences and forced choices a child has to make in adulthood due to stunted growth.3  

But the good news is that stunting can be prevented. The first step is to MEASURE and compare your child’s height vs. WHO global averages.

Your child’s height is the best indicator of his/her physical and mental health

Use this tool to see if your child’s growth is on track:

What is stunting?

A child is said to be stunted when they are too short for their age. It is a consequence of inadequate nutrition during the most critical period of growth and development.2

Can stunting be measured?

WHO has developed the global standards based on data from 6 countries to create a height chart for every age.4  

Let’s look at this chart, where we compare the height of a normal 3-year-old girl and boy versus a stunted 3-year-old boy and girl. Do you observe the height difference in the two sets of children?5,6  

This is a simple way to diagnose stunting. All you need to do is just measure your child’s height and compare it with the WHO’s pre-determined range.  

If your child’s height is above the normal range (on or above the green), it means your child is growing well. If not, and may be at a risk of stunting.  Consult your paediatrician to find the causes.5,6  

What can cause stunting?

One of the major causes of stunting is nutrition…. 

Inadequate Nutrition:

When it comes to food intake, the quality as well as quantity of food matters. An imbalance in the amount and type of a particular nutrient can impact growth of the child.  Each nutrient has their own unique role to play in the growth and development of the child. For example., carbohydrates are needed to produce energy, proteins for muscle building and strength, vitamins and minerals for the various body functions like immunity, digestion, vision, bone building, etc.

Proteins can be categorised based on their quality i.e., how well they meet the body’s requirement. It is important that your child’s diet should have good quality protein (milk, milk products, eggs, legumes, meat, fish). Lack of good quality protein in the diet can cause stunting.7,8

Inadequate use of nutrients in the body:

Nutrients that are consumed should also be appropriately absorbed and used in the body. For example, once the calcium from the food source is consumed, it requires Vitamin K2 to convert into a form that can be deposited into the bones and result in growth.

The bacteria in the intestine (gut) play an essential role to achieve proper absorption and utilization of nutrients in the body. They help in absorbing nutrients from food and also play a role in providing immunity from diseases.

An imbalance or lack of good bacteria in the intestine can lead to inadequate nutrient absorption and use, causing stunting.9-11

Insufficient intake of vitamins and minerals:

 Vitamins and minerals have important functions in the body such as strengthening the bones, fighting infections, wound healing, etc. Vitamin and minerals are required for the body to work properly and stay healthy. If your child’s diet lacks in these important nutrients, like vitamin D, minerals like zinc, iron, calcium, etc., it may result in stunting.8

In addition – link to UNICEF or WHO and check with doctor to rule out any serious medical conditions…..

MYTH: Genetics plays a large role in Stunting

Many people believe that if the parents are short, then their kids will be short as well.  But that’s not true!

Research has shown that environmental factors, including nutrition, have a greater influence on height during early childhood than genetics, highlighting the critical role of addressing stunting in nutrition

Did you know, 80% of a child’s height is determined by factors like nutrition and only 20% by genetics?1

The impact of stunting

Stunting is a problem with early beginnings and lasting consequences. It can lead to irreversible, long-lasting impact on physical and mental development of the child.1,3

Poor Performance in school

Deficiency of nutrients can lead to inadequate brain development, resulting in lower IQ, reduced learning capacity, difficultly in focusing and problems with memory recall.13,14

Is your child picky and eats very little?

Inadequate or deficiency in nutrients can lead to a weakened immune system, resulting in a child falling sick, often; which impacts growth.1,14

Reduced Physical Fitness

Stunted children may not be as physically fit as normal children. They also have lesser range of motion, reducing their success in sports like basketball, volley ball, swimming, athletics and rowing.15,16

Grow up to be Stunted adults

A study among adults showed that stunted children who grow up remain 6-9 cms shorter.17

Lower income

A study showed that tall adults are more likely to get managerial jobs as they are perceived to have leadership qualities.18,19

High risk of lifestyle diseases

Stunted children are at a high risk of developing lifestyle diseases and cancer as adults.1

How to prevent stunting? Here's what you can do.

  • Inadequate nutrition is one of the most significant causes of stunting. Hence, it is important for children to consume balanced healthy diet, along with adequate intake of high-quality protein. Good nutrition should include the following:
    • Balanced diet: A healthy, balanced diet is not about calories alone, you need the right proportion of carbohydrates (whole grain), protein (meat or legumes), vegetables, fruit and dairy.8
    • Good quality protein from sources like dairy, legumes, meat and fish is also important to preventing stunting.8
    • Vitamins and minerals: These are micronutrients that help the body digest and use the nutrition we eat.8
  • If your child is a picky eater or you are worried that he is eating insufficient food or an imbalanced meal or falls sick too often, consider a child nutritional supplement. 

  • Ensure your child is getting enough exercise regularly. Children who get enough physical activity grow taller since exercise stimulates the production of growth hormones.15 

  • Ensure your child is getting enough rest. Growth hormones are released at night and children who get adequate sleep are known to grow better than those who dont.21 

  • Research has shown that providing a complete, balanced child nutritional supplement (CNS) as part of the diet of children at risk can help to improve their nutrient intakes.20 

In a study conducted among stunted children in Vietnam, about 4 in 10 children recovered from stunting after 6 months of daily Consumption of oral nutrition supplement.20 

Early intervention can get your child’s growth back on track

A child cannot recover height in the same way they can regain weight later. To address stunting in nutrition, you need to make changes to your child’s diet immediately. If left untreated, your child will most likely grow up to be a shorter adult.

Take action as early as possible to provide good nutrition for your child and help unlock his or her full growth potential!

Make sure to also measure and monitor your child’s growth regularly.

Learn more about how Pediasure Complete Nutritional Supplement can help your child grow well! 

Consult a healthcare professional if you have concerns regarding your child’s growth, and their specific nutritional needs.  

References:

  1. WHO Departmental News. Stunting in a nutshell. Available [Online] at: https://www.who.int/news/item/19-11-2015-stunting-in-a-nutshell Accessed on 3 Nov 2022.
  2. Levels and trends in child malnutrition: UNICEF/WHO/The World Bank Group joint child malnutrition estimates: Key findings of the 2021 edition. Available [Online] at: https://www.who.int/publications/i/item/9789240025257 Accessed on 2 Nov 2022.
  3. Soliman A, et al. Acta Biomed 2021; Vol. 92, N. 1: e2021168 DOI: 10.23750/abm.v92i1.11346
  4. de Onis M and Branca F. Maternal & Child Nutrition. 2016;12(Suppl.1):12–26
  5. WHO. Height-for-age. Boys. Available [Online] at: https://cdn.who.int/media/docs/default-source/child-growth/child-growth-standards/indicators/length-height-for-age/sft_lhfa_boys_z_2_5.pdf?sfvrsn=e70e3a87_7 Accessed 3 Nov 2022.
  6. WHO. Height-for-age. Girls. Available [Online] at: https://cdn.who.int/media/docs/default-source/child-growth/child-growth-standards/indicators/length-height-for-age/sft_lhfa_girls_z_2_5.pdf?sfvrsn=72bff814_9 Accessed 3 Nov 22.
  7. Maulidiana AR and Sutjiati E. Journal of Public Health Research 2021;10:2161.
  8. Milward J. Nutrition Research Reviews. 2017;30:50-72.
  9. Vonaesch P, et al. PNAS. 2018;115(36):E8489–E8498.
  10. Iddrisu I, et al. Nutrients 2021, 13, 2727. DOI: 10.3390/nu13082727.
  11. Cahyawati PN and Sujaya N. BAJ 2021;4(1):1-4.
  12. Wu H, et al. Front. Nutr. 8:650976. DOI: 10.3389/fnut.2021.650976.
  13. Aurora WID, et al. Advances in Engineering Research. 2015. DOI: 10.2991/aer.k.210825.032
  14. Alam A, et al. PlosOne. 2020;15(1):e0227839. DOI: 10.1371/journal.pone.0227839
  15. Torun B and Viteri FE. Available [Online] at: https://archive.unu.edu/unupress/food2/UID06E/UID06E18.HTM Accessed on 3 Nov 2022.
  16. Bhadra C and Singh S. IOSR Journal of Sports and Physical Education. 2016;3(1):27-29.
  17. Coly AN, et al. Journal of Nutrition. 2006;136: 2412–2420.
  18. Judge TA. Journal of Applied Psychology. 2004;89(3):428-441.
  19. Schick A and Steckel RH. Journal of human capital. 2015;9(1):94-115.
  20. Pham DT, et al. Op NutrJ. 2019;13:43-52.
  21. Gulliford MC, et al. Archives of Disease in Childhood 1990; 65: 119-122

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