Study: Risks and Benefits of Weight Gain in Children With Undernutrition (DOI: 10.1001/jamanetworkopen.2025.14289)
In children with undernutrition, increasing weight in a child's first decade of life can lead to significantly taller adults-with no increase in the risk of obesity or high blood pressure later in life, according to a new University of Michigan study.
The findings, published in JAMA Network Open this month, are key for children facing undernutrition, offering the opportunity to positively shape their long-term health and development, especially in undernourished settings.
"Previous research suggested that interventions to reduce undernutrition in children after age 2 might not be beneficial. The concern was that weight gain in childhood might lead to higher blood pressure and obesity in adulthood," said lead author Beverly Strassmann, U-M professor of anthropology and faculty associate at the Institute for Social Research.
"This previous recommendation neglected to consider the importance of weight gain for helping children to achieve their full height potential as adults. Taller women are less likely to die in childbirth, so it's important to consider the association between childhood nutrition and adult height."
The study investigated whether weight gain in childhood would positively impact adult height and if it would also be linked to an elevated risk of adult obesity and high blood pressure.
"Our findings are significant because they show that improved growth from age 1 to 10 years led to taller stature in adulthood and the increased risk for obesity and hypertension was negligible," Strassmann said.
Her research team followed 1,348 participants with repeated follow-up visits for 21 years in central Mali. The findings indicate that weight gain between ages 1 and 10 was significantly associated with gains in adult stature for both females and males by age 21.
According to Strassmann, the research employed a longitudinal design, allowing them to follow children from an average age of 1.6 years to 21 years, which is "rare for low-income countries in Africa."
"Our study is unique in that we considered not only the risks of childhood weight gain for higher blood pressure and BMI in adulthood but also the benefits for increased adult stature," she said. "It is hard to overestimate the health benefits of being taller in a population that is impacted by undernutrition. It is known that taller women are less likely to die in childbirth, for example.
The research went against the widespread view that nutritional interventions for children should stop at age 2.
"Not all children are reached in the first 1,000 days of life, which is the time from conception to age 2 years," Strassmann said.
The findings show that in undernourished settings, weight gain after age 2 can support growth in stature and lead to taller adults who are not obese or hypertensive. Policy for undernourished settings needs to take into account the importance of reducing undernutrition throughout childhood, Strassman said.
