# Early childhood height is a determinant of young adult stature in rural Nepal

## TL;DR

This study shows that early childhood height in rural Nepal is a strong predictor of adult height, even in undernourished populations.

## Contribution

The study provides new evidence on the long-term impact of early childhood growth on adult stature in a chronically undernourished setting.

## Key findings

- Children with normal preschool height achieved 69–74% of their adult height by age 6.
- Stunted children were 4–7% shorter as adults compared to those with normal growth.
- Preschool height predicted adult height more strongly for girls than boys.

## Abstract

Does preschool height predict adult stature in undernourished settings? The extent to which preschool length or height forecasts young adult stature is unclear in chronically undernourished populations.

In 2006-8, we assessed height in a cohort of 2074 young adults, aged 16–23 years, in rural Nepal who, as preschoolers (≤ 4 year), were measured at baseline and again 16 months later during a vitamin A supplementation trial in 1989-91. We assessed by linear regression the ability of preschool length (L, measured < 24 mo) or height (Ht, 24–59 mo), at each year of age to predict 16–23 year old height, adjusted for month of young adult age, interval duration (in months), caste, preschool weight-for-height z-score and, in young women, time since menarche, marriage status and pregnancy history.

Young women were a mean of 0.81, 1.11, 0.82, 0.24, 0.44 cm taller (all p < 0.01) and young men, 0.84, 1.18, 0.74, 0.64 and 0.48 cm taller (all p < 0.001) per cm of attained L/Ht at each successive preschool year of age and, overall, were 2.04 and 2.40 cm taller for each unit increase in preschool L/Ht z-score (L/HAZ) (both p < 0.001). Coefficients were generally larger for 16-month follow-up measurements. The percent of young adult height attained by children with normal L/HAZ (>-1) increased from 38–40% mid-infancy to ∼ 69–74% by 6 years of age. By 3–6 years of age heights of stunted children (L/HAZ<-2) were consistently ∼ 4–7% lower in their young adult height versus normal statured children. There was no effect of preschool vitamin A receipt.

Shorter young children become shorter adults but predictive effects can vary by sex, age assessed, and may be influenced by year or season of measurement.

The online version contains supplementary material available at 10.1186/s12889-024-19469-8.