Childhood growth and chronic disease: evidence from countries undergoing the nutrition transition

Abstract

Evidence is accumulating that the pattern of growth in childhood is associated with development of cardiovascular disease in adulthood, but such evidence comes mostly from developed countries. We conducted a review of studies from countries undergoing the nutrition transition. Five birth cohorts with measures of child growth and outcomes through adolescence were identified, from China, India, Guatemala, Brazil and the Philippines. Across studies there are major differences in data availability and in statistical approaches to modelling child growth and its effects. Nevertheless, generally consistent associations of growth failure in early childhood and development of overweight in later childhood with the risk of elevated blood pressure, glucose, and serum lipids in adulthood were observed. As these cohorts mature they will provide a wealth of critical information on the relation between early life factors and later disease risk, and efforts should be made to ensure ongoing follow-up using standardized approaches and more comprehensive assessments.

Figure 1

Data collection through age 20 years in five birth cohort studies, by month of age. Each mark denotes a scheduled data collection point, although not all variables were collected at each age, and some data collection instruments were only administered to a sample of the original birth cohort. In the Oriente, Guatemala study, there was a single wave of data collection in 1988–89, at which time the birth cohort was 11–20 years old. See text for sources.