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Institute
Plasticity of human growth
(2020)
Background:
This systematic review aimed at collecting, analyzing and summarizing scientific studies focusing on psychosocial factors that influence linear growth among humans.
Methods:
The online database "PubMed" was used in order to acquire suitable scientific studies. These studies were evaluated based on clearly defined criteria that determine whether a study was to be excluded or included in the literature review. In the end, a total sum of 36 studies remained, which were carefully analyzed and used to generate an overview of the association between psychosocial factors and linear growth.
Results:
In the 36 reviewed studies, different social and psychological factors, such as socioeconomic status, parental education or emotional deprivation were set in relation to physical growth among humans. The studies were listed and summarized, depending on the investigated psychosocial factor. A clear association between psychosocial factors and growth could be observed in most of the reviewed studies. Discussion: Based on the results of the reviewed studies it could be concluded that the regulation of linear growth is also subject to different psychosocial factors. The way in which the developing human and the specific social environment interact seemed to have a major impact on linear growth. Statusspecific stress was discussed as one possible explanation for the regulating mechanism of human linear growth.
Objective:
Stunting (height-for-age < −2 SD) is one of the forms of undernutrition and is frequent among children of low- and middle-income countries. But stunting perSe is not a synonym of undernutrition. We investigated association between body height and indicators of energetic undernutrition at three critical thresholds for thinness used in public health: (1) BMI SDS < −2; (2) mid-upper arm circumference divided by height (MUAC (mm) × 10/height (cm) < 1·36) and (3) mean skinfold thickness (SF) < 7 mm and to question the reliability of thresholds as indicators of undernutrition.
Design:
Cross-sectional study; breakpoint analysis.
Setting:
Rural and urban regions of Indonesia and Guatemala – different socio-economic status (SES).
Participants:
1716 Indonesian children (6·0–13·2 years) and 3838 Guatemalan children (4·0–18·9 years) with up to 50 % stunted children.
Results:
When separating the regression of BMI, MUAC or SF, on height into distinguishable segments (breakpoint analysis), we failed to detect relevant associations between height, and BMI, MUAC or SF, even in the thinnest and shortest children. For BMI and SF, the breakpoint analysis either failed to reach statistical significance or distinguished at breakpoints above critical thresholds. For MUAC, the breakpoint analysis yielded negative associations between MUAC/h and height in thin individuals. Only in high SES Guatemalan children, SF and height appeared mildly associated with R2 = 0·017.
Conclusions:
Currently used lower thresholds of height-for-age (stunting) do not show relevant associations with anthropometric indicators of energetic undernutrition. We recommend using the catch-up growth spurt during early re-feeding instead as immediate and sensitive indicator of past undernourishment. We discuss the primacy of education and social-economic-political-emotional circumstances as responsible factors for stunting.