Nutrition and Health Science Program, Laney Graduate School, Emory University, Atlanta, GA, USA.
Division of Nutritional Sciences and Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, USA.
J Nutr. 2021 Jan 4;151(1):206-213. doi: 10.1093/jn/nxaa337.
Growth faltering in early childhood is associated with poor human capital attainment, but associations of linear growth in childhood with executive and socioemotional functioning in adulthood are understudied.
In a Guatemalan cohort, we identified distinct trajectories of linear growth in early childhood, assessed their predictors, and examined associations between growth trajectories and neurodevelopmental outcomes in adulthood. We also assessed the mediating role of schooling on the association of growth trajectories with adult cognitive outcomes.
In 2017-2019, we prospectively followed 1499 Guatemalan adults who participated in a food supplementation trial in early childhood (1969-1977). We derived height-for-age sex-specific growth trajectories from birth to 84 mo using latent class growth analysis.
We identified 3 growth trajectories (low, intermediate, high) with parallel slopes and intercepts already differentiated at birth in both sexes. Children of taller mothers were more likely to belong to the high and intermediate trajectories [relative risk ratio (RRR): 1.21; 95% CI: 1.15, 1.26, and RRR: 1.11; 95% CI: 1.07, 1.15, per 1-cm increase in height, respectively] compared with the low trajectory. Children in the wealthiest compared with the poorest socioeconomic tertile were more likely to belong to the high trajectory compared with the low trajectory (RRR: 2.24; 95% CI: 1.29, 3.88). In males, membership in the high compared with low trajectory was positively associated with nonverbal fluid intelligence, working memory, inhibitory control, and cognitive flexibility at ages 40-57 y. Sex-adjusted results showed that membership in the high compared with low trajectory was positively associated with meaning and purpose scores at ages 40-57 y. Associations of intermediate compared with low growth trajectories with study outcomes were also positive but of lesser magnitude. Schooling partially mediated the associations between high and intermediate growth trajectories and measures of cognitive ability in adulthood.
Modifiable and nonmodifiable risk factors predicted growth throughout childhood. Membership in the high and intermediate growth trajectories was positively associated with adult cognitive and socioemotional functioning.
儿童早期生长迟缓与人力资本获得不良有关，但儿童线性生长与成年后执行功能和社会情感功能之间的关联研究较少。
在危地马拉队列中，我们确定了儿童早期线性生长的不同轨迹，评估了它们的预测因素，并研究了生长轨迹与成年后神经发育结果之间的关系。我们还评估了学校教育对生长轨迹与成人认知结果之间关联的中介作用。
在 2017-2019 年，我们前瞻性地随访了 1499 名参加过儿童早期（1969-1977 年）食品补充试验的危地马拉成年人。我们使用潜在类别增长分析从出生到 84 个月导出身高年龄性别特定的增长轨迹。
我们在两性中发现了 3 种生长轨迹（低、中、高），其斜率和截距在出生时已经不同。母亲较高的孩子更有可能属于高和中轨迹[相对风险比（RRR）：1.21；95%置信区间（CI）：1.15，1.26 和 RRR：1.11；95%CI：1.07，1.15，每增加 1 厘米身高]，而不是低轨迹。与最贫穷的社会经济三分位相比，最富裕的儿童更有可能属于高轨迹，而不是低轨迹（RRR：2.24；95%CI：1.29，3.88）。在男性中，与低轨迹相比，属于高轨迹与非言语流体智力、工作记忆、抑制控制和认知灵活性在 40-57 岁时呈正相关。调整性别后的结果表明，与低轨迹相比，属于高轨迹与 40-57 岁时的意义和目的评分呈正相关。中间轨迹与低生长轨迹相比，与研究结果呈正相关，但幅度较小。高和中间生长轨迹与成年后认知能力的关联部分通过学校教育来介导。
可改变和不可改变的风险因素预测了整个儿童时期的生长。属于高和中生长轨迹与成年后的认知和社会情感功能呈正相关。
