ArticleThe Journal of nutrition2021
Wasting and Stunting in Infants and Young Children as Risk Factors for Subsequent Stunting or Mortality: Longitudinal Analysis of Data from Malawi, South Africa, and Pakistan.
Article in The Journal of nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Effect of prenatal multiple micronutrient supplementation compared with iron and folic acid supplementation on size at birth and subsequent growth through 24 mo of age: a systematic review and meta-analysis.The American journal of clinical nutrition · 2025Pooled it
- Malaria Incidence, Growth, and their Relationship among a Cohort of Malawian Children.The American journal of tropical medicine and hygiene · 2026Article
- Undernutrition in Infants Aged Under Six Months: A Multi-Center Cross-Sectional Study in Two Governorates in Yemen.Nutrients · 2026Article
- The Paradox of Stunting: Differences in the Perception of Health Workers in Community Health Centers and Experts in Hospitals on Low Birth Weight and Stunting Data.Journal of multidisciplinary healthcare · 2026Article
- Experiences, barriers, and enablers of infant and young child feeding among adolescent mothers in Sub-Saharan Africa: a scoping review protocol.Systematic reviews · 2025Article
- Impact of Stunting on Outcomes of Severely Wasted Children (6 Months to 5 Years) Admitted for Inpatient Treatment: A Cross-Sectional Study in an Ethiopian Referral Hospital.Children (Basel, Switzerland) · 2025Article
- Acceptability of a Microbiome-Directed Food for the Management of Children with Uncomplicated Acute Malnutrition in Maradi, Niger: Two Randomized Crossover Trials.Current developments in nutrition · 2025Article
- Sociodemographic factors associated with concurrent stunting and wasting among children experiencing extreme poverty in the Philippines: A cross-sectional study.Nutrition and health · 2025Article
- Article
- Global and Chinese growth failure disease burden analysis and projections for adolescents and children, 1990-2021.Frontiers in public health · 2025Article
- Factors associated with childhood undernutrition in poor Ethiopian households: Implications for public health interventions.PloS one · 2025Article
- Weight Velocity in Addition to Latest Weight Does Not Improve the Identification of Wasting or the Prediction of Stunting and Mortality: A Longitudinal Analysis Using Data from Malawi, South Africa, and Pakistan.The Journal of nutrition · 2024Article
- Child stunting starts in utero: Growth trajectories and determinants in Ugandan infants.Maternal & child nutrition · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundFew studies have had sufficient longitudinal data to track how different malnourished states relate to mortality at different ages and interrelate over time.
objectivesThis study aims to describe the RRs and proportions of mortality associated with wasting and stunting and the pathways into and out of these nutritional states.
methodsLongitudinal growth data sets collected for children ages 0-24 months from Malawi, South Africa, and Pakistan were combined (n = 5088). Children were classified as deceased, wasted (weight for height < -2 SD; 1-4%), stunted (length < -2SD; 20-47%), or wasted and stunted (WaSt; 2-5%) at ages 3, 6, 9, 12, 18, and 24 months. Mixed-effects Cox models were used to study the association between nutritional status and mortality.
resultsBy age 3 months, 20% of children were already stunted, rising to 49% by 24 months, while wasting (4.2% and 2.2% at 3 months, respectively) and WaSt (0.9% and 3.7% at 24 months, respectively) were less common. The HR for mortality in WaSt was 9.5 (95% CI, 5.9-15), but 60% of WaSt-associated mortality occurred at 3-6 months. Wasting or WaSt was associated with 10-23% of deaths beyond 6 months, but in the second year over half of deaths occurred in stunted, nonwasted children. Stunting persisted in 82% of children and wasting persisted in 44%. Wasted children were more likely than nonwasted, nonstunted children to become stunted (RR, 1.93; 95% CI, 1.7-2.2), but 94% of children who progressed to stunting had not been wasted in the prior period.
conclusionsWaSt greatly increased the risk of death, particularly in very young infants, but more deaths overall were associated with stunting. Most stunting appeared to be either intrauterine in origin or arose in children without prior wasting. Either stunting and wasting represent alternative responses to restricted nutrition, or stunting also has other, nonnutritional causes.
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