It is commonly argued that unless under nutrition is addressed in the first 2-3 years of life, the window of opportunity for improving both growth and cognitive development of children, adolescents and adults is severely limited. However, many children who experience linear growth retardation in their first 2-3 years of life experience growth recovery later in childhood. In Peru, for example, 37% of children who were stunted at age 12 (16) mo were not stunted at age 5 y. Further, the cognitive achievement of children who recovered from stunting was no different from the cognitive achievement of children who were not stunted at either time point. The causality of this association has not been determined, and the determinants of early life growth recovery are not known. The objective of this study is to understand (1) what determines recovery from early growth failure (physically stunted at 1 year of age but not at 5 years of age), and (2) how recovery from early growth failure affects (a) schooling (b) cognitive development, and (c) academic achievement through age 12 y. We propose innovative systematic analyses of recent, very rich longitudinal data on children from four low and middle income countries on three continents. We will conduct secondary analysis of the Young Lives (YL) database. YL is the largest cross-national cohort dataset on poverty and child well-being in the developing world and is ideally placed to permit examination of the long-term impact of nutritional recovery on schooling, cognitive development and academic achievement among children growing up in the 21st century over a very significant period of their lives in a range of diverse, developing country contexts. We will analyze data from all four YL countries: Ethiopia, India, Peru and Vietnam. We will examine data for each of the four rounds of data collection (when children were 1, 5, 8 and 12 years of age). The four diverse settings and large sample sizes permit an examination of consistency across countries and an exploration of the additional burdens posed by disparities within countries in class/caste, sex, race, ethnicity, level of poverty, parental schooling and region of residence. This research is highly relevant to policies regarding children's health and education. Findings will (1) improve understanding of age patterns in growth faltering and recovery in relation to schooling and outcomes in diverse contexts, and (2) inform other long-term studies on nutritional recovery including work that tests the impact of clinic-, school- and community-based interventions on cognitive function and academic achievement.

Public Health Relevance

Many children who experience linear growth retardation in their first 2-3 years of life experience growth recovery later in childhood. The objective of this study is to understand (1) what determines recovery from early growth failure between 1 and 5 years of age and (2) how recovery from early growth failure affects schooling, cognitive development and academic achievement through age 12 years. We will conduct secondary analysis of the Young Lives database which includes information about four cohorts of children living in Ethiopia, India, Peru and Vietnam. Findings will (1) improve understanding of age patterns in growth faltering and recovery in relation to schooling and outcomes in diverse contexts, and (2) inform other long-term studies on nutritional recovery, schooling, cognition and academic achievement.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD070993-01
Application #
8221361
Study Section
Special Emphasis Panel (ZRG1-SSPS-H (09))
Program Officer
Bures, Regina M
Project Start
2012-06-15
Project End
2016-05-31
Budget Start
2012-06-15
Budget End
2013-05-31
Support Year
1
Fiscal Year
2012
Total Cost
$378,022
Indirect Cost
$110,230
Name
Boston University
Department
Type
Schools of Public Health
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Woldehanna, Tassew; Behrman, Jere R; Araya, Mesele W (2017) The effect of early childhood stunting on children's cognitive achievements: Evidence from young lives Ethiopia. Ethiop J Health Dev 31:75-84
Dearden, Kirk A; Brennan, Alana T; Behrman, Jere R et al. (2017) Does household access to improved water and sanitation in infancy and childhood predict better vocabulary test performance in Ethiopian, Indian, Peruvian and Vietnamese cohort studies? BMJ Open 7:e013201
Humphries, Debbie L; Dearden, Kirk A; Crookston, Benjamin T et al. (2017) Household food group expenditure patterns are associated with child anthropometry at ages 5, 8 and 12 years in Ethiopia, India, Peru and Vietnam. Econ Hum Biol 26:30-41
Georgiadis, Andreas; Benny, Liza; Duc, Le Thuc et al. (2017) Growth recovery and faltering through early adolescence in low- and middle-income countries: Determinants and implications for cognitive development. Soc Sci Med 179:81-90
Aurino, Elisabetta; Schott, Whitney; Penny, Mary E et al. (2017) Birth weight and prepubertal body size predict menarcheal age in India, Peru, and Vietnam. Ann N Y Acad Sci :
Abufhele, Alejandra; Behrman, Jere; Bravo, David (2017) Parental preferences and allocations of investments in children's learning and health within families. Soc Sci Med 194:76-86
Alderman, Harold; Behrman, Jere R; Puett, Chloe (2017) Big Numbers about Small Children: Estimating the Economic Benefits of Addressing Undernutrition. World Bank Res Obs 32:107-125
Duc, Le Thuc; Behrman, Jere R (2017) Heterogeneity in predictive power of early childhood nutritional indicators for mid-childhood outcomes: Evidence from Vietnam. Econ Hum Biol 26:86-95
Dearden, Kirk A; Schott, Whitney; Crookston, Benjamin T et al. (2017) Children with access to improved sanitation but not improved water are at lower risk of stunting compared to children without access: a cohort study in Ethiopia, India, Peru, and Vietnam. BMC Public Health 17:110
Schott, Whitney; Aurino, Elisabetta; Penny, Mary E et al. (2017) Adolescent mothers' anthropometrics and grandmothers' schooling predict infant anthropometrics in Ethiopia, India, Peru, and Vietnam. Ann N Y Acad Sci :

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