Regulation of energy intake may be impaired in nutritionally stunted children from the shantytowns of Sao Paulo, Brazil

We tested the hypothesis that nutritionally stunted children have impaired regulation of energy intake (EI), a factor that could help explain the incr eased 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 s ignificantly different between the groups. Parents of the two groups had eq uivalent heights and body mass indices. Measurements were made of voluntary EI from a self-selection menu, resting energy expenditure (REE) and body c omposition. In addition, a 753-kJ yogurt supplement was administered at bre akfast on one study day (with an equal number of children receiving the sup plement on each of the 3 study days) and its effect on daily EI assessed. T here was no change in EI over time in either group (P = 0.957), and no sign ificant difference in EI between stunted and nonstunted children, even thou gh the stunted children weighed 10% less. Energy intake per kilogram body w eight was significantly higher n the stunted children (278 +/- 89 (so), 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 E I 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 (Delta EI: +460 +/- 1574 vs. -103 +/- 1916 kJ/d, P = 0.25). These data provide prelimi nary evidence consistent with the suggestion that stunted children tend to overeat opportunistically, but further studies are required to confirm thes e results in a larger study.