The determinants of child stunting and shifts in the growth pattern of children: a long-run, global review

This article explores how child growth has changed over the past 150 years and links changes in child growth to the recent decline in child stunting in low and middle income countries (LMICs). The article begins by defining the four characteristics of the growth pattern in height: size at birth, size at adulthood, the timing of the pubertal growth spurt and the speed of maturation. It then shows how these characteristics have changed over time and links these characteristics to child stunting, children who are too short for their age relative to healthy standards, the most common indicator used to measure malnutrition in LMICs today. The article then surveys the literature on the causes of changes in the growth pattern and reductions in child stunting, comparing research on current LMICs with historical research on current high income countries (HICs) in the past. To limit the scope of the contemporary literature, I focus on explanations of the so-called ‘Indian enigma’: why Indian children are shorter than sub-Saharan African children despite India’s lead in many indicators of economic development. The article closes with ideas for what historical and contemporary researchers can learn from one another.