Child growth under adverse conditions: an ecological investigation of the community, household and individual-level influences on the growth trajectories of rural East Timorese children

Child growth in Timor-Leste is well below international standards. Children experience seasonal food shortages, high disease burden, and requisite high activity levels. In addition to being small. rural Timorese children (especially boys) have growth trajectories that differ in shape from those of well-fed children. Timorese children's growth is associated with individual. household and geospatial factors. Girls' growth exceeds that of boys but activity levels are similar. Trade-offs in energy allocations relative to resource levels begin in utero with boys showing effects of exposure to seasonal food shortage. lntergenerational effects on growth explain continued growth deficits despite national development.