Where will they grow from here? Association between height at 24 months and adult attained height in a population with a high prevalence of linear growth restriction.

This was a longitudinal observational cohort study to investigate the association of stunting at 24 months of age and attained adult height. A cohort of 104 Peruvian males (n=47) and females (n=57) was studied from 24 months to after puberty in a rural community in the Peruvian Amazon located 15 km southeast from the urban center of Iquitos. Anthropometric measures were made at 24 months and after puberty. Height for Age Z (HAZ) Scores were calculated and compared to assess the association of HAZ score at 24 months and adult height. 67.7% of males and 54.1% of females who were stunted at 24 m (HAZ<-2.0) recovered (HAZ>-2.0) after puberty, whereas 6.25% of males and 6.06% of females who were not stunted at 24 m (HAZ>-2.0) became stunted (HAZ<-2.0) after puberty. The first 1000 days are not the only critical window for growth promotion. Global and national initiatives to reduce stunting should not exclusively focus on the first two years of life, but also work to promote the nutritional initiatives to promote optimal nutrition and growth throughout childhood and adolescence.