Long run height and education implications of early life growth faltering: a synthetic panel analysis of 425 birth cohorts in 21 low- and middle-income countries

Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health.

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Growth faltering and recovery in children aged 1–8 years in four low- and middle-income countries: Young Lives

Public Health Nutrition ◽

10.1017/s1368980013003017 ◽

2013 ◽

Vol 17 (9) ◽

pp. 2131-2137 ◽

Cited By ~ 54

Author(s):

Elizabeth A Lundeen ◽

Jere R Behrman ◽

Benjamin T Crookston ◽

Kirk A Dearden ◽

Patrice Engle ◽

...

Keyword(s):

Child Growth ◽

Growth Patterns ◽

The Other ◽

Middle Income ◽

Childhood Poverty ◽

Middle Income Countries ◽

Percentage Points ◽

Growth Faltering ◽

Low And Middle Income ◽

Young Lives

AbstractObjectiveWe characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting.DesignData came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries.SettingWe analysed length/height measurements for children at ages 1, 5 and 8 years.SubjectsChildren (n 7171) in Ethiopia, India, Peru and Vietnam.ResultsMean height-for-age Z-score (HAZ) at age 1 year ranged from −1·51 (Ethiopia) to −1·08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0·27 in Ethiopia (P < 0·001) and decreased among the other cohorts (range: −0·19 (Peru) to −0·32 (India); all P < 0·001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0·19 (India) to 0·38 (Peru); all P < 0·001). Prevalence of stunting (HAZ<−2·0) at 1 year ranged from 21 % (Vietnam) to 46 % (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15·1 percentage points in Ethiopia (P < 0·001) and increased in the other cohorts (range: 3·0 percentage points (Vietnam) to 5·3 percentage points (India); all P ≤ 0·001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5·0 percentage points (Vietnam) to 12·7 percentage points (Peru); all P < 0·001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11 % (Vietnam) to 22 % (India); between ages 5 to 8 years, it ranged from 3 % (Peru) to 6 % (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27 % (Vietnam) to 53 % (Ethiopia); between ages 5 and 8 years, it ranged from 30 % (India) to 47 % (Ethiopia).ConclusionsWe found substantial recovery from early stunting among children in four low- and middle-income countries.

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Patterns of growth in childhood in relation to adult schooling attainment and IQ in 6 birth cohorts in low and middle-income countries: evidence from COHORTS

10.1101/2020.06.16.20133074 ◽

2020 ◽

Author(s):

Natalia E Poveda ◽

Fernando P Hartwig ◽

Cesar G Victora ◽

Linda S Adair ◽

Fernando C Barros ◽

...

Keyword(s):

Human Capital ◽

Early Childhood ◽

Early Life ◽

Linear Growth ◽

Relative Weight ◽

Childhood And Adolescence ◽

Birth Cohorts ◽

Middle Income ◽

Middle Income Countries ◽

School Attainment

SummaryBackgroundGrowth faltering has been associated with poor intellectual performance. The relative strengths of associations between growth in early and in later childhood remain underexplored. We examined the association between growth in childhood and adolescence and adult human capital in five low- or middle-income countries (LMICs).MethodsWe analyzed data from six prospective birth cohorts of five LMICs (Brazil, Guatemala, India, the Philippines, and South Africa). We assessed the associations of measures of height and relative weight at four ages (birth, at around age 2 years, mid-childhood (MC), adulthood), with two dimension of adult human capital (schooling attainment and IQ).FindingsIn site- and sex-pooled analyses, size at birth and linear growth from birth to around 2 years of age were positively associated with schooling attainment and adult IQ. Linear growth from age 2 years to MC and from MC to adulthood was not associated with higher school attainment or IQ. Change in relative weight in early childhood was not associated with either outcome. Relative weight in MC and in adulthood were inversely associated with schooling attainment but were not associated with adult IQ.InterpretationLinear growth in the first 1,000 days is a predictor of schooling attainment and IQ in adulthood in LMICs. Linear growth in later periods was not associated with either of these outcomes. Changes in relative weight had inconsistent association with schooling and IQ in adulthood.FundingBill and Melinda Gates Foundation (OPP1164115)Research in contextEvidence before this studyEarly life growth faltering has been associated with poor cognitive and intellectual performance in childhood and poorer schooling outcomes in children and adults. There is a paucity of data about how growth in specific age intervals over the course of childhood and adolescence relates to attained schooling and adult cognitive performance.We conducted a literature search using the terms (growth [Title/Abstract]) AND ((school [Title/Abstract] OR schooling [Title/Abstract]) AND (intelligence [Title/Abstract] OR IQ [Title/Abstract]) OR (human capital [Title/Abstract]) in Pubmed. The search yielded 536 publications from 1965 to 2020. We screened titles and selected 31 publications that included linear growth and our outcomes of interest, namely school attainment and intelligence quotient (IQ). Additionally, we checked reference lists of selected articles and identified eleven papers that were not displayed in the initial electronic query. We therefore reviewed 42 abstracts and identified 24 unique studies conducted in low and middle-income countries (LMICs). Fourteen of them investigated the association of birth size and/or early-life size with schooling or IQ, or with both outcomes during childhood. Three studies investigated the association between linear growth in early childhood and schooling and intelligence in adults, one studied the association between early-life undernutrition and IQ in early adulthood and another six publications investigated the association between growth and school attainment in adults. Economists have also studied the relationship between stunting or linear growth and schooling in LMICs, but to our knowledge not the relative importance of growth during specific age intervals.Added value of this studyThis is an analysis of the associations between child and adolescent growth and two dimensions of human capital (schooling attainment and IQ) in adulthood in six birth cohorts from five LMICs. The evidence of long-term associations of linear growth with adult IQ is scarce and the few published studies have analyzed data from a single country. In the present study, we found that size at birth and linear growth from birth to around 2 years of age were positively associated with both schooling and IQ in adulthood. Linear growth between early and mid-childhood (MC)was not associated with higher school attainment or IQ in adjusted models. Linear growth from MC to adulthood was not associated with IQ in men or women, and was inversely associated with schooling attainment in women only. Change in relative weight in early childhood was positively associated with schooling attainment only in minimally adjusted models. Relative weight measures in MC and adulthood were inversely associated with schooling attainment. Change in relative weight between MC and adulthood was not associated with adult IQ.Implications of all the available evidenceWe confirmed in multiple cohorts that birth size and linear growth from birth to age 2 years are predictors of schooling attainment and adult IQ. Linear growth in early life was the strongest predictor of these two human capital dimensions in adulthood among individuals in LMICs. We did not find evidence that supports the notion that linear growth in adolescence contributes to a better cognitive performance in adulthood. Thus, our results inform the more effective timing of nutritional and other interventions to improve linear growth and human capital in the long-term.

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Estimation of Tobacco Products Price and Income Elasticity using Aggregate Data

Economic Analysis ◽

10.28934/ea.18.51.34.pp81-94 ◽

2018 ◽

Vol 51 (3-4) ◽

pp. 81-94 ◽

Cited By ~ 1

Author(s):

Olivera Jovanovic ◽

Jovan Zubović ◽

Marko Vladisavljević ◽

Duško Bodrož ◽

Isidora Ljumović ◽

...

Keyword(s):

Income Elasticity ◽

Demand Elasticity ◽

Aggregate Level ◽

Tobacco Products ◽

Middle Income ◽

Middle Income Countries ◽

Inelastic Analysis ◽

Long Run ◽

Level Data ◽

Low And Middle Income

In order to estimate elasticity of demand for tobacco products authors of this paper used aggregate level data. Research among low and middle income countries over the world empirically showed that demand for tobacco products is usually inelastic. Analysis conducted in the Republic of Serbia showed that price elasticity ranged between -0.76 and -0.62 while income elasticity ranged between 0.34 and 0.39. The main aim of this paper is to estimate long run and short run demand elasticity based on aggregate level data for period 2002-2016 using Error Correction model. This research is unique in the SEE countries, while research conducted in other low and middle income countries in Western Balkan region showed similar results.

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Early-life exposure to ambient fine particulate air pollution and infant mortality: pooled evidence from 43 low- and middle-income countries

International Journal of Epidemiology ◽

10.1093/ije/dyz090 ◽

2019 ◽

Vol 48 (4) ◽

pp. 1125-1141 ◽

Cited By ~ 9

Author(s):

Nihit Goyal ◽

Mahesh Karra ◽

David Canning

Keyword(s):

Air Pollution ◽

Infant Mortality ◽

Neonatal Mortality ◽

Early Life ◽

Middle Income ◽

Middle Income Countries ◽

Particulate Air Pollution ◽

Fine Particulate ◽

Early Life Exposure ◽

Low And Middle Income

Abstract Background Many low- and middle-income countries are experiencing high and increasing exposure to ambient fine particulate air pollution (PM2.5). The effect of PM2.5 on infant and child mortality is usually modelled using concentration response curves extrapolated from studies conducted in settings with low ambient air pollution, which may not capture its full effect. Methods We pool data on more than half a million births from 69 nationally representative Demographic and Health Surveys that were conducted in 43 low- and middle-income countries between 1998 and 2014, and we calculate early-life exposure (exposure in utero and post partum) to ambient PM2.5 using high-resolution calibrated satellite data matched to the child’s place of residence. We estimate the association between the log of early-life PM2.5 exposure, both overall and separated by type, and the odds of neonatal and infant mortality, adjusting for child-level, parent-level and household-level characteristics. Results We find little evidence that early-life exposure to overall PM2.5 is associated with higher odds of mortality relative to low exposure to PM2.5. However, about half of PM2.5 is naturally occurring dust and sea-salt whereas half is from other sources, comprising mainly carbon-based compounds, which are mostly due to human activity. We find a very strong association between exposure to carbonaceous PM2.5 and infant mortality, particularly neonatal mortality, i.e. mortality in the first 28 days after birth. We estimate that, at the mean level of exposure in the sample to carbonaceous PM2.5—10.9 µg/m3—the odds of neonatal mortality are over 50% higher than in the absence of pollution. Conclusion Our results suggest that the current World Health Organization guideline of limiting the overall ambient PM2.5 level to less than 10 µg/m³ should be augmented with a lower limit for harmful carbonaceous PM2.5.

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Weight Gain in the First Two Years of Life Is an Important Predictor of Schooling Outcomes in Pooled Analyses from Five Birth Cohorts from Low- and Middle-Income Countries

Journal of Nutrition ◽

10.3945/jn.109.112300 ◽

2009 ◽

Vol 140 (2) ◽

pp. 348-354 ◽

Cited By ~ 154

Author(s):

◽

Reynaldo Martorell ◽

Bernardo L. Horta ◽

Linda S. Adair ◽

Aryeh D. Stein ◽

...

Keyword(s):

Weight Gain ◽

Important Predictor ◽

Birth Cohorts ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income ◽

Schooling Outcomes

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DOHaD in low- and middle-income countries: a systematic review exploring gaps in DOHaD population studies

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420000276 ◽

2020 ◽

Vol 11 (6) ◽

pp. 557-563

Author(s):

Siobhan Tu’akoi ◽

Mark H. Vickers ◽

Jacquie L. Bay

Keyword(s):

Low Income ◽

Early Life ◽

Western Europe ◽

Later Life ◽

Research Capacity ◽

Low Income Countries ◽

Middle Income ◽

Middle Income Countries ◽

Incidence Risk ◽

Low And Middle Income

AbstractLow- and middle-income countries (LMICs) are disproportionately affected by non-communicable diseases (NCDs), accounting for more than 80% of NCD-related deaths globally. Research into early-life influences on these diseases via the developmental origins of health and disease (DOHaD) paradigm has informed health promotion interventions and policies focused on optimising early-life health. However, little is known about where this research occurs and whether it reaches and reflects the countries most affected by NCDs. This review searched for DOHaD studies that investigated relationships between factors during pregnancy and at birth, with later-life NCD incidence, risk and related mortality. The aim of this review was to identify where DOHaD research has been conducted and whether this focus is appropriate and relevant, given the differential burden of NCDs. Embase, MEDLINE and Scopus were searched, and eligibility screening processes identified 136 final articles. This review found that 49.7% of DOHaD research was conducted on populations within Western Europe, 15.9% in East Asia, 12.7% in North America, 8.3% in Latin America and the Caribbean, and fewer in Australasia, South Asia, the Middle East, the Africas, and Central Asia. When categorised by income, this review found that 76.4% of studies were based in high-income countries, 19.1% in upper-middle-income and 4.5% in lower-middle-income countries. No studies were based in low-income countries. There is therefore a marked disconnect between where DOHaD research is undertaken and where the greatest NCD disease burden exists. Increasing DOHaD research capacity in LMICs is crucial to informing local strategies that can contribute to reducing the incidence of NCDs.

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