Filipino Children Exhibit Catch-Up Growth from Age 2 to 12 Years

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Abstract
Potential for catch-up growth among stunted children is thought to be limited after age 2 y, particularly when they remain in poor environments. We explored the extent to which there were improvements in height status from age 2 to 12 y in a cohort of >2,000 children from the Cebu (The Philippines) Longitudinal Health and Nutrition Survey. At age 2 y, about 63% of sample children were stunted as defined by height-for-age (HAZ) <−2 based on the WHO reference. Of children stunted at age 2, 30% were no longer stunted at 8.5 y, and 32.5% were no longer stunted at 12 y. The mean increase in HAZ among those with such improvements was 1.14 units. The likelihood that children stunted at age 2 y would no longer be stunted at 8.5 y was estimated using logistic regression. Low birth weight, which was associated with more severe stunting in the first 2 y of life, significantly reduced likelihood of catch-up growth in later childhood. In contrast, children with taller mothers, who were first born, longer at birth, less severely stunted in early infancy and those with fewer siblings were more likely to increase HAZ from <−2 to >−2 between ages 2 and 8.5 y. Similar factors predicted the improvement in linear growth from 8.5 to 12 y. These results suggest that there is a large potential for catch-up growth in children into the preadolescent years.