Lelijveld, Natasha;
Cox, Sioned;
Anujuo, Kenneth;
Amoah, Abena S;
Opondo, Charles;
Cole, Tim J;
Wells, Jonathan C;
... CHANGE study collaborators group, .; + view all
(2023)
Post-malnutrition growth and its associations with child survival and non-communicable disease risk: A secondary analysis of the Malawi 'ChroSAM' cohort.
Public Health Nutrition
, 26
(8)
pp. 1658-1670.
10.1017/S1368980023000411.
Preview |
Text
Cole_post-malnutrition-growth-and-its-associations-with-child-survival-and-non-communicable-disease-risk-a-secondary-analysis-of-the-ma.pdf Download (1MB) | Preview |
Abstract
OBJECTIVE: Explore patterns of post-malnutrition growth (PMGr) during and after treatment for severe malnutrition, and describe associations with survival and non-communicable disease (NCD) risk seven years post-treatment. DESIGN: Six indicators of PMGr were derived based on a variety of timepoints, weight, weight-for-age z-score (WAZ) and height-for-age z-score (HAZ). Three categorisation methods included: no categorisation, quintiles, and latent class analysis (LCA). Associations with mortality risk, and seven NCD indicators were analysed. SETTING: Secondary data from Blantyre, Malawi between 2006 and 2014. PARTICIPANTS: A cohort of 1024 children treated for severe malnutrition (weight-for-length z-score <70% median and/or MUAC<110 mm and/or bilateral oedema) at aged 5 to 168 months. RESULTS: Faster weight gain during treatment (g/day) and after treatment (g/kg/day) were associated with lower risk of death (aOR 0.99, 95%CI 0.99 to 1.00; and aOR 0.91, 95% CI 0.87 to 0.94 respectively). In survivors (mean age 9 years), it was associated with greater hand grip strength (0.02, 95%CI 0.00 to 0.03) and larger HAZ (6.62, 95%CI 1.31 to 11.9), both indicators of better health. However, faster weight gain was also associated with increased waist:hip ratio (0.02, 95%CI 0.01 to 0.03), an indicator of later life NCD risk. The clearest patterns of association were seen when defining PMGr based on weight gain in g/day during treatment and using the LCA method to describe growth patterns. Weight deficit at admission was a major confounder. CONCLUSIONS: A complex pattern of benefits and risks is associated with faster PMGr. Both initial weight deficit and rate of weight gain have important implications for future health.
| Type: | Article |
|---|---|
| Title: | Post-malnutrition growth and its associations with child survival and non-communicable disease risk: A secondary analysis of the Malawi 'ChroSAM' cohort |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1017/S1368980023000411 |
| Publisher version: | https://doi.org/10.1017/S1368980023000411 |
| Language: | English |
| Additional information: | Copyright © The Author(s), 2023. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
| Keywords: | DOHaD, Malawi, catch-up growth, non-communicable diseases, rapid weight gain, severe acute malnutrition |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10166216 |
Archive Staff Only
 |
View Item |
