Malnutrition and Catch-Up Growth during Childhood and Puberty

Stunting and wasting are the result of poor nutrient intake and/or disease. Children suffering from stunting may never attain their full genetic height. Children suffering from stunting and/or wasting also suffer from weakened immunity, increased risk of mortality and death, and are susceptible to long-term developmental delays [1]. According to the 2021 edition of the UNICEF, WHO, and World Bank report [1], the rates of children with malnutrition remain alarmingly high, and this condition is still far from being eliminated. According to this report, in 2020, about 149.2 million children aged under 5 years suffered from stunting, and 45.4 million children under 5 years were affected by wasting, of whom 13.6 million were severely wasted. These numbers may increase due to limitations in accessing nutritious diets and nutrition services during the COVID-19 pandemic [1]. Malnutrition can be prevented by various strategies, including adequate maternal nutrition before and during pregnancy and while breastfeeding; optimal breastfeeding during the first 2 years of life; nutritious, diverse, and safe foods in early childhood; and a healthy
environment [1]. Many of these strategies are under threat, including due to the COVID-19 pandemic, and have the potential to attenuate the progress towards reaching the global targets of reducing the global rate of malnutrition in all its forms. More intensive efforts will be required to achieve global targets of reducing the number of children with stunting to 104 million by 2025 and to 87 million by 2030 [1].This chapter reviews the most recent data on childhood malnutrition and catch-up growth, published between July 1, 2020 and June 30, 2021, and addresses several topics:
a. The changing face of global stunting (Vaivada et al. and NCD-RisC collaboration)
b. New suggested biomarkers for malnutrition in children (Scheffer et al.)
c. Association between nutritional components and growth indices: vitamin D (Song et al.)
d. COVID-19 and malnutrition (Akseer et al.)
e. Outcomes of malnutrition (Villar et al., Martínez-Oca et al.)
f. Outcome of malnutrition in unique populations: children adopted internationally
(Ivey et al.), female adolescents with anorexia nervosa (Modan-Moses et al.)
g. Outcomes of different intervention strategies to treat malnutrition and under nutrition
(Keats et al., Huey et al., Bhutta et al.)

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline
Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA
Am J Clin Nutr 2020;112(Suppl 2):777–91S
Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2,181 population-based studies with 65 million participants
NCD Risk Factor Collaboration (NCD-RisC) Lancet 2020;396(10261):1511–1524
Catch-up growth is a better indicator of undernutrition than thresholds for stunting
Scheffler C, Bogin B, Hermanussen M
Public Health Nutr 2021;24:52–61
Association between vitamin D status and undernutrition indices in children: a systematic review and meta-analysis of observational studies
Song C, Sun H, Wang B, Song C, Lu H
Front Pediatr 2021;9:665749
COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition
Akseer N, Kandru G, Keats EC, Bhutta ZA
Am J Clin Nutr 2020;112:251–256
Fetal cranial growth trajectories are associated with growth and neurodevelopment at 2 years of age: INTERBIO-21st Fetal Study
Villar J, Gunier RB, Tshivuila-Matala COO, Rauch SA, Nosten F, Ochieng R, Restrepo-Méndez MC,
McGready R, Barros FC, Fernandes M, Carrara VI, Victora CG, Munim S, Craik R, Barsosio HC,
Carvalho M, Berkley JA, Cheikh Ismail L, Norris SA, Ohuma EO, Stein A, Lambert A, Winsey A,
Uauy R, Eskenazi B, Bhutta ZA, Papageorghiou AT, Kennedy SH
Nat Med 2021;27:647–652
Gut DYSBIOSIS and altered barrier function precedes the appearance of metabolic syndrome in a rat model of nutrient-induced catch-up growth
Martínez-Oca P, Robles-Vera I, Sánchez-Roncero A, Escrivá F, Pérez-Vizcaíno F, Duarte J, Álvarez C, Fernández-Millán E
J Nutr Biochem 2020;81:108383
The nutritional status of individuals adopted internationally as children: a systematic review
Ivey R, Kerac M, Quiring M, Dam TTH, Doig S, DeLacey E
Nutrients 2021;13:245
Prospective longitudinal assessment of linear growth and adult height in female adolescents with anorexia nervosa
Modan-Moses D1,3, Yaroslavsky A2, Pinhas-Hamiel O, Levy-Shraga Y, Kochavi B, Iron-Segev S,
Enoch-Levy A, Toledano A, Stein D
J Clin Endocrinol Metab 2021;106:e1–10
Effective interventions to address maternal and child malnutrition: an update of the evidence
Keats EC, Das JK, Salam RA, Lassi ZS, Imdad A, Black RE, Bhutta ZA
Lancet Child Adolesc Health 2021;5:367–384
Effects of oral vitamin D supplementation on linear growth and other health outcomes among children under five years of age
Huey SL, Acharya N, Silver A, Sheni R, Yu EA, Peña-Rosas JP, Mehta S
Cochrane Database Syst Rev 2020;12:CD012875
How countries can reduce child stunting at scale: lessons from exemplar countries
Bhutta ZA, Akseer N, Keats EC, Vaivada T, Baker S, Horton SE, Katz J, Menon P, Piwoz E, Shekar M,
Victora C, Black R
Am J Clin Nutr 2020;112(Suppl 2):894–904S