Stunting, wasting and breast-feeding as correlates of body composition in Cambodian children at 6 and 15 months of age

Br J Nutr. 2019 Mar;121(6):688-698. doi: 10.1017/S0007114518003884. Epub 2019 Jan 23.

Abstract

The study aimed at assessing stunting, wasting and breast-feeding as correlates of body composition in Cambodian children. As part of a nutrition trial (ISRCTN19918531), fat mass (FM) and fat-free mass (FFM) were measured using 2H dilution at 6 and 15 months of age. Of 419 infants enrolled, 98 % were breastfed, 15 % stunted and 4 % wasted at 6 months. At 15 months, 78 % were breastfed, 24 % stunted and 11 % wasted. Those not breastfed had lower FMI at 6 months but not at 15 months. Stunted children had lower FM at 6 months and lower FFM at 6 and 15 months compared with children with length-for-age z ≥0. Stunting was not associated with height-adjusted indexes fat mass index (FMI) or fat-free mass index (FFMI). Wasted children had lower FM, FFM, FMI and FFMI at 6 and 15 months compared with children with weight-for-length z (WLZ) ≥0. Generally, FFM and FFMI deficits increased with age, whereas FM and FMI deficits decreased, reflecting interactions between age and WLZ. For example, the FFM deficits were -0·99 (95 % CI -1·26, -0·72) kg at 6 months and -1·44 (95 % CI -1·69; -1·19) kg at 15 months (interaction, P<0·05), while the FMI deficits were -2·12 (95 % CI -2·53, -1·72) kg/m2 at 6 months and -1·32 (95 % CI -1·77, -0·87) kg/m2 at 15 months (interaction, P<0·05). This indicates that undernourished children preserve body fat at the detriment of fat-free tissue, which may have long-term consequences for health and working capacity.

Keywords: FFM fat-free mass; FFMI fat-free mass index; FM fat mass; FMI fat mass index; LAZ length-for-age z score; SAM severe acute malnutrition; TBW total body water; WLZ weight-for-length z score; Body composition; Childhood; Fat mass; Fat-free mass; Infancy; Stunting; Wasting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue
  • Body Composition*
  • Body Mass Index
  • Breast Feeding*
  • Cambodia
  • Female
  • Growth Disorders / etiology
  • Growth Disorders / physiopathology*
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena*
  • Male
  • Nutritional Status
  • Wasting Syndrome / etiology
  • Wasting Syndrome / physiopathology*