Living at high altitudes increases stunting in children

Recent research sheds light on a significant health challenge in India: the increased risk of stunting associated with children living at higher altitudes.

The study was focused on children residing 2,000 meters or more above sea level, who were found to have a 40% greater risk of stunted growth compared to their counterparts living below 1,000 meters.

What is stunting?

Stunting, a chronic condition marked by inadequate height in children, reflects prolonged undernutrition during key developmental stages, primarily from conception to age two. This condition emerges not just from insufficient nutrient intake but also from factors like recurrent infections, particularly gastrointestinal ones, which impair nutrient absorption and increase nutrient losses.

Poor maternal nutrition before and during pregnancy significantly contributes to stunting, affecting fetal growth and increasing stunting risks in infants. Additionally, improper infant feeding practices – such as non-exclusive breastfeeding during the first six months and inappropriate timing and diversity of complementary foods – can exacerbate the situation.

Impact of stunting

The consequences of stunting extend beyond height, adversely affecting cognitive development, which in turn impacts educational performance and future economic productivity. Moreover, stunted individuals face higher risks of developing chronic health issues such as obesity, diabetes, and cardiovascular diseases later in life due to metabolic adaptations during undernourishment.

Addressing stunting requires multifaceted approaches, including improving maternal nutrition, advocating for exclusive breastfeeding, ensuring adequate nutritional intake during early childhood, and enhancing overall socioeconomic conditions. By implementing these strategies, communities and governments can mitigate the long-term impacts of stunting on individuals and societies.

High altitudes and children stunting

The researchers analyzed data from the 2015-16 National Family Health Survey (NFHS-4), which included a substantial sample of 167,555 children under the age of five from across India.

The majority of these children lived at altitudes less than 1,000 meters above sea level. However, a notable minority resided higher up, where they experienced significantly higher rates of stunting – chronic malnutrition that leads to reduced growth.

This vulnerability was particularly severe in rural areas, leading researchers to advocate for prioritized nutritional programs in the country’s mountainous regions.

Despite various national efforts to address malnutrition, stunting still affects over a third of young children in India, especially those between 18 and 59 months of age.

Altitude effect behind children stunting

The study highlighted several factors that influence stunting rates. Notably, maternal education significantly impacts these rates. Children of mothers without any schooling suffer higher rates of stunting compared to those whose mothers have higher educational achievements.

Moreover, aspects of antenatal care, including clinic visits, tetanus vaccinations, and supplements of iron and folic acid, serve as protective factors against stunting.

Children born later in birth order or those smaller at birth also showed higher stunting rates, illustrating the complex nature of malnutrition that goes beyond just altitude.

Overcoming the high-altitude and children stunting hurdle

The researchers suggest that high altitude directly challenges health by reducing appetite, restricting oxygen delivery to tissues, and limiting nutrient absorption.

Environmental hardships, such as lower crop yields and harsher climates, compound these physiological barriers, escalating food insecurity at higher elevations.

Additionally, the provision and access to healthcare become more problematic in these regions, further complicating the implementation of effective nutritional programs.

Solutions for the multifaceted problem

The study calls for a multipronged approach to combat stunting, recommending a blend of reproductive health initiatives, women’s nutrition programs, infant and young child feeding interventions, and food security measures. It underscores the importance of ongoing research, monitoring, and evaluation to inform evidence-based policies and ensure targeted actions.

Professor Sumantra Ray from the NNEdPro Global Institute for Food, Nutrition and Health notes that although public health interventions in India have successfully tackled issues like iodine deficiency, understanding the complexities of malnutrition deeper requires examining its various determinants – heredity, environment, lifestyle, and socioeconomic factors.

Rising above stunting

This study not only identifies the heightened risk of stunting among children living at higher altitudes but also serves as a critical reminder of the broader impacts of geographic and socioeconomic factors on health.

By tailoring health and nutrition strategies to the needs of vulnerable populations in challenging environments, India can make significant strides toward ensuring all children have the opportunity to achieve healthy growth and development.

The study is published in the journal BMJ Nutrition Prevention & Health.

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