TY - JOUR
T1 - Relationship between growth and illness, enteropathogens and dietary intakes in the first 2 years of life
T2 - Findings from the MAL-ED birth cohort study
AU - MAL-ED Network Investigators
AU - Acosta, Angel Mendez
AU - De Burga, Rosa Rios
AU - Chavez, Cesar Banda
AU - Flores, Julian Torres
AU - Olotegui, Maribel Paredes
AU - Pinedo, Silvia Rengifo
AU - Salas, Mery Siguas
AU - Trigoso, Dixner Rengifo
AU - Vasquez, Angel Orbe
AU - Ahmed, Imran
AU - Alam, Didar
AU - Ali, Asad
AU - Bhutta, Zulfiqar A.
AU - Qureshi, Shahida
AU - Rasheed, Muneera
AU - Soofi, Sajid
AU - Turab, Ali
AU - Zaidi, Anita K.M.
AU - Bodhidatta, Ladaporn
AU - Mason, Carl J.
AU - Babji, Sudhir
AU - Bose, Anuradha
AU - George, Ajila T.
AU - Hariraju, Dinesh
AU - Steffi Jennifer, M.
AU - John, Sushil
AU - Kaki, Shiny
AU - Kang, Gagandeep
AU - Karunakaran, Priyadarshani
AU - Koshy, Beena
AU - Lazarus, Robin P.
AU - Muliyil, Jayaprakash
AU - Raghava, Mohan Venkata
AU - Raju, Sophy
AU - Ramachandran, Anup
AU - Ramadas, Rakhi
AU - Ramanujam, Karthikeyan
AU - Bose, Anuradha
AU - Roshan, Reeba
AU - Sharma, Srujan L.
AU - Shanmuga Sundaram, E.
AU - Thomas, Rahul J.
AU - Pan, William K.
AU - Ambikapathi, Ramya
AU - Daniel Carreon, J.
AU - Charu, Vivek
AU - Doan, Viyada
AU - Murray-Kolb, Laura E.
AU - Catharine Ross, A.
AU - Schaefer, Barbara
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Background Dietary and illness factors affect risk of growth faltering; the role of enteropathogens is less clear. As part of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study, we quantify the effects of enteropathogen infection, diarrhoea and diet on child growth. Methods Newborns were enrolled and followed until 24 months. Length and weight were assessed monthly. Illnesses and breastfeeding practices were documented biweekly; from 9 to 24 months, non-breast milk intakes were quantified monthly. Routinely collected non-diarrhoeal stools were analysed for a broad array of enteropathogens. A linear piecewise spline model was used to quantify associations of each factor with growth velocity in seven of eight MAL-ED sites; cumulative effects on attained size at 24 months were estimated for mean, low (10th percentile) and high (90th percentile) exposure levels. Additionally, the six most prevalent enteropathogens were evaluated for their effects on growth. results Diarrhoea did not have a statistically significant effect on growth. Children with high enteropathogen exposure were estimated to be 1.21±0.33 cm (p<0.001; 0.39 length for age (LAZ)) shorter and 0.08±0.15 kg (p=0.60; 0.08 weight-for-age (WAZ)) lighter at 24 months, on average, than children with low exposure. Campylobacter and enteroaggregativeEscherichia coli detections were associated with deficits of 0.83±0.33 and 0.85±0.31 cm in length (p=0.011 and 0.001) and 0.22±0.15 and 0.09±0.14 kg in weight (p=0.14 and 0.52), respectively. Children with low energy intakes and protein density were estimated to be 1.39±0.33 cm (p<0.001; 0.42 LAZ) shorter and 0.81±0.15 kg (p<0.001; 0.65 WAZ) lighter at 24 months than those with high intakes. conclusions Reducing enteropathogen burden and improving energy and protein density of complementary foods could reduce stunting.
AB - Background Dietary and illness factors affect risk of growth faltering; the role of enteropathogens is less clear. As part of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study, we quantify the effects of enteropathogen infection, diarrhoea and diet on child growth. Methods Newborns were enrolled and followed until 24 months. Length and weight were assessed monthly. Illnesses and breastfeeding practices were documented biweekly; from 9 to 24 months, non-breast milk intakes were quantified monthly. Routinely collected non-diarrhoeal stools were analysed for a broad array of enteropathogens. A linear piecewise spline model was used to quantify associations of each factor with growth velocity in seven of eight MAL-ED sites; cumulative effects on attained size at 24 months were estimated for mean, low (10th percentile) and high (90th percentile) exposure levels. Additionally, the six most prevalent enteropathogens were evaluated for their effects on growth. results Diarrhoea did not have a statistically significant effect on growth. Children with high enteropathogen exposure were estimated to be 1.21±0.33 cm (p<0.001; 0.39 length for age (LAZ)) shorter and 0.08±0.15 kg (p=0.60; 0.08 weight-for-age (WAZ)) lighter at 24 months, on average, than children with low exposure. Campylobacter and enteroaggregativeEscherichia coli detections were associated with deficits of 0.83±0.33 and 0.85±0.31 cm in length (p=0.011 and 0.001) and 0.22±0.15 and 0.09±0.14 kg in weight (p=0.14 and 0.52), respectively. Children with low energy intakes and protein density were estimated to be 1.39±0.33 cm (p<0.001; 0.42 LAZ) shorter and 0.81±0.15 kg (p<0.001; 0.65 WAZ) lighter at 24 months than those with high intakes. conclusions Reducing enteropathogen burden and improving energy and protein density of complementary foods could reduce stunting.
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U2 - 10.1136/bmjgh-2017-000370
DO - 10.1136/bmjgh-2017-000370
M3 - Article
AN - SCOPUS:85055284665
SN - 2059-7908
VL - 2
JO - BMJ Global Health
JF - BMJ Global Health
IS - 4
M1 - e000370
ER -