Childhood stunting (height-for-age z-score < −2 SD) remains a global developmental health burden. Traditional interventions centered on nutrition and infection have reached a bottleneck. Emerging evidence identifies chronic low-dose dietary environmental toxins as an independent, modifiable risk factor for early-life growth restriction.
This review synthesizes cohort studies, meta-analyses, and in vivo toxicological models published over the past decade to characterize exposures to mycotoxins, toxic heavy metals, and food-borne endocrine disruptors that are closely associated with stunting.
Multi-layered mechanisms are elucidated, including environmental enteric dysfunction (EED), intestinal barrier disruption, persistent subclinical inflammation, GH-IGF-1 axis disturbance, gut microbiota dysbiosis, oxidative stress, and epigenetic alterations, which collectively impair linear growth. Critical surveillance gaps are identified, and integrated environment–nutrition–infection intervention strategies aligned with public health practice are proposed.
Dietary environmental toxins cause irreversible developmental deficits by damaging intestinal function and disrupting endocrine regulation. Strengthening developmental toxicology-oriented monitoring and source control will support precise prevention of early childhood stunting within the critical first 1000-day window.



