Evidence map›Paper›PMID 30801614›Full record

ReviewAdvances in nutrition (Bethesda, Md.)2019

Perspective: What Does Stunting Really Mean? A Critical Review of the Evidence.

Jef L Leroy, Edward A Frongillo

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Advances in nutrition (Bethesda, Md.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 163 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
163citing papers in PubMed, 10 pooled it
17.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

163 citing papers in PubMed, 10 syntheses or guidelines pooled it, 370 citations in OpenAlex.

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  7. Drivers of stunting reduction in Ethiopia: a country case study.The American journal of clinical nutrition · 2020
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  8. Drivers of stunting reduction in Nepal: a country case study.The American journal of clinical nutrition · 2020
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103 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Jef L LeroyPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC.
Edward A FrongilloDepartment of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC.
International Food Policy Research Institute · USUniversity of South Carolina · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The past decade has seen an unprecedented increase in attention to undernutrition, and drastically reducing child stunting has become a global development objective. The strong focus on linear growth retardation and stunting has enabled successful advocacy for nutrition, but with this focus has come some confusion and misunderstanding about the meaning of linear growth retardation and stunting among researchers, donors, and agencies active in nutrition. Motivated by the belief that a sharp focus will further accelerate progress in reducing undernutrition, we critically reviewed the evidence. The global attention to stunting is based on the premise that any intervention aimed at improving linear growth will subsequently lead to improvements in the correlates of linear growth retardation and stunting. Current evidence and understanding of mechanisms does not support this causal thinking, with 2 exceptions: linear growth retardation is a cause of difficult births and poor birth outcomes. Linear growth retardation is associated with (but does not cause) delayed child development, reduced earnings in adulthood, and chronic diseases. We thus propose distinguishing 2 distinctly different meanings of linear growth retardation and stunting. First, the association between linear growth retardation (or stunting) and other outcomes makes it a useful marker. Second, the causal links with difficult births and poor birth outcomes make linear growth retardation and stunting outcomes of intrinsic value. In many cases a focus on linear growth retardation and stunting is not necessary to improve the well-being of children; in many other cases, it is not sufficient to reach that goal; and for some outcomes, promoting linear growth is not the most cost-efficient strategy. We appeal to donors, program planners, and researchers to be specific in selecting nutrition outcomes and to target those outcomes directly.

Indexed as

ChildChild DevelopmentChild Nutritional Physiological PhenomenaChild, PreschoolFemaleGlobal HealthGrowth DisordersHumansInfantMaleNutritional Statusbirth outcomescausalitychild developmentchronic diseaseearningsglobal development objectivelinear growth retardationmarkerstuntingundernutrition

Identifiers

PMID30801614
PMCPMC6416038
OpenAlexW2915590742

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.