Critical windows for nutrition interventions against stunting

Andrew M Prentice et al. Am J Clin Nutr. May 2013; 97(5): 911–918

An analysis of early growth patterns in children from54 resource-poor countries in Africa and Southeast Asia shows a rapid fall off in the height-for-age z-score during the first two years of life and no recovery until children are five years or older. This finding has focused attention on the period of conception to 24 months as a “window of opportunity” for interventions against stunting and has gained considerable political backing for investment targeted at the first 1000 days. A view has emerged that inter- ventions outside this window are unlikely to have any effects.

While supporting the importance of the 1000 days and interventions to address undernutrition during this period, this paper presents analysis showing that there are other windows of opportunity to address stunting that should not be overlooked and might well offer additional points for intervention. The authors argue that adolescence represents an additional window during which growth-promoting interventions might yield substantial life cycle and intergenerational effects.