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Article

Regulation of Energy Intake May Be Impaired in Nutritionally Stunted Children from the Shantytowns of São Paulo, Brazil¹

The Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil and ^* The Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111

³To whom correspondence should be addressed.

We tested the hypothesis that nutritionally stunted children have impaired regulation of energy intake (EI), a factor that could help explain the increased risk of obesity associated with stunting in developing countries. A 3-d residency study was conducted in 56 prepubertal boys and girls aged 8–11 y from the shantytowns of Sao Paulo, Brazil. Twenty-seven of the subjects were stunted and 29 were not stunted; weight-for-height Z-scores were not significantly different between the groups. Parents of the two groups had equivalent heights and body mass indices. Measurements were made of voluntary EI from a self-selection menu, resting energy expenditure (REE) and body composition. In addition, a 753-kJ yogurt supplement was administered at breakfast on one study day (with an equal number of children receiving the supplement on each of the 3 study days) and its effect on daily EI assessed. There was no change in EI over time in either group (P = 0.957), and no significant difference in EI between stunted and nonstunted children, even though the stunted children weighed 10% less. Energy intake per kilogram body weight was significantly higher in the stunted children (278 ± 89 (SD), vs. 333 ± 67 kJ/kg, P < 0.05) and EI/REE was also significantly higher (1.91 ± 0.34 vs. 1.68 ± 0.38, P < 0.05). However, the relationship between EI and body weight was not significantly influenced by stunting (P = 0.12). There was no significant effect of the breakfast supplement on daily EI in either group although the absolute difference in EI between supplement and control days was greater in stunted than in nonstunted children (EI: +460 ± 1574 vs. -103 ± 1916 kJ/d, P = 0.25). These data provide preliminary evidence consistent with the suggestion that stunted children tend to overeat opportunistically, but further studies are required to confirm these results in a larger study.

KEY WORDS: • humans • energy intake • malnutrition • hunger • satiety

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