Therefore, it is important to limit

the potential for erroneous results that may arise due to the use of statistical techniques that are less than robust for longitudinal analyses. One potential technique would be the use of “life course” analyses.21 An important feature of life course techniques is that measures of different variables over a period of time (e.g. birth weight and body composition), mTOR inhibitor as well as repeated measures of the same variables (e.g. body weight, lipid profiles, or height), are appropriately modeled in the analyses. Simply, factors that are more distant to the outcome (e.g. birth weight) are not treated independently, but rather as modifiers of factors that are close to the outcome (e.g. body composition). Incorporating the collection of additional data and using advanced statistical analyses will ensure that solid conclusions can be made from studies of the kind presented. The implications of the article by Alves et al.2 are vast and important, given that approximately 171 million children in the world are stunted.22 The fact that most stunted children do not recover height is secondary SCH727965 concentration to the observations that stunting is a risk factor for chronic metabolic diseases later in life. This reality is complicated as the initial nutritional, social, and economic factors that influence a child’s

growth (e.g. inadequate diet, poor maternal education, low income, or poor sanitation) are in turn positively associated with the degree of poor growth (e.g. poor cognition, decreased physical capacity, and continued poverty). This vicious cycle of stunting and poverty is often intergenerational,23

and may be perceived as a “nutrition trap” from which a person or family Fossariinae cannot escape without broad structural changes that include improved sanitation, real educational opportunities, and comprehensive health care, essentially fundamental human rights. If human rights are not strong enough motivators, then economic productivity should be considered, since the segment of a society most at risk for stunting is also the segment that will serve the growing service and manufacturing sectors of many countries.24 Thus, for transitional economies, hosting a population of adults who are at risk for chronic and costly diseases is both a health and an economic issue. In conclusion, scientists who study DOHaD are still far from any real consensus regarding the precise mechanisms that explain the relationship between poor growth and chronic disease. Alves et al2 present important data that advances the field by exploring changes in lipid profiles of stunted children following treatment for undernutrition. Moreover, these data complement existing studies by expanding the possible realm in which poor growth may alter normal metabolic processes that increase the risk for chronic diseases later in life.