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Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia.

ABSTRACT: BACKGROUND:Childhood growth stunting is negatively associated with cognitive and health outcomes, and is claimed to be irreversible after age 2. AIM:To estimate growth rates for children aged 2-7 who were stunted (sex-age standardised z-score [HAZ] <-2), marginally-stunted (-2 ? HAZ ?-1) or not-stunted (HAZ >-1) at baseline and tracked annually until age 11; frequency of movement among height categories; and variation in height predicted by early childhood height. SUBJECTS AND METHODS:This study used a 9-year annual panel (2002-2010) from a native Amazonian society of horticulturalists-foragers (Tsimane'; n?=?174 girls; 179 boys at baseline). Descriptive statistics and random-effect regressions were used. RESULTS:This study found some evidence of catch-up growth in HAZ, but persistent height deficits. Children stunted at baseline improved 1 HAZ unit by age 11 and had higher annual growth rates than non-stunted children. Marginally-stunted boys had a 0.1 HAZ units higher annual growth rate than non-stunted boys. Despite some catch up, ? 80% of marginally-stunted children at baseline remained marginally-stunted by age 11. The height deficit increased from age 2 to 11. Modest year-to-year movement was found between height categories. CONCLUSIONS:The prevalence of growth faltering among the Tsimane' has declined, but hurdles still substantially lock children into height categories.

SUBMITTER: Zhang R

PROVIDER: S-EPMC5392255 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia.

Zhang Rebecca R Undurraga Eduardo A EA Zeng Wu W Reyes-García Victoria V Tanner Susan S Leonard William R WR Behrman Jere R JR Godoy Ricardo A RA

Annals of human biology 20160629 4

<h4>Background</h4>Childhood growth stunting is negatively associated with cognitive and health outcomes, and is claimed to be irreversible after age 2.<h4>Aim</h4>To estimate growth rates for children aged 2-7 who were stunted (sex-age standardised z-score [HAZ] <-2), marginally-stunted (-2 ≤ HAZ ≤-1) or not-stunted (HAZ >-1) at baseline and tracked annually until age 11; frequency of movement among height categories; and variation in height predicted by early childhood height.<h4>Subjects and ...[more]

PMID: 27251215

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Project description:Mounting evidence suggests that income inequality is associated with worse individual health. But does the visibility of inequality matter? Using data from a horticultural-foraging society of native Amazonians in Bolivia (Tsimane'), we examined whether village inequality in resources and behaviors with greater cultural visibility is more likely to bear a negative association with health than village inequality in less conspicuous resources. We draw on a nine-year annual panel (2002-2010) from 13 Tsimane' villages for our main analysis, and an additional survey to gauge the cultural visibility of resources. We measured inequality using the Gini coefficient. We tested the robustness of our results using a shorter two-year annual panel (2008-2009) in another 40 Tsimane' villages and an additional measure of inequality (coefficient of variation, CV). Behaviors with low cultural visibility (e.g., household farm area planted with staples) were less likely to be associated with individual health, compared to more conspicuous behaviors (e.g., expenditures in durable goods, consumption of domesticated animals). We find some evidence that property rights and access to resources matter, with inequality of privately-owned resources showing a larger effect on health. More inequality was associated with improved perceived health - maybe due to improved health prospects from increasing wealth - and worse anthropometric indicators. For example, a unit increase in the Gini coefficient of expenditures in durable goods was associated with 0.24 fewer episodes of stress and a six percentage-point lower probability of reporting illness. A one-point increase in the CV of village inequality in meat consumption was associated with a 4 and 3 percentage-point lower probability of reporting illness and being in bed due to illness, and a 0.05 SD decrease in age-sex standardized arm-muscle area. In small-scale, rural societies at the periphery of market economies, nominal economic inequality in resources bore an association with individual health, but did not necessarily harm perceived health. Economic inequalities in small-scale societies apparently matter, but a thick cultural tapestry of reciprocity norms and kinship ties makes their effects less predictable than in industrial societies.

Project description:In developed countries, children with intrauterine growth restriction (IUGR) or born preterm (PT) tend to achieve catch-up growth. There is little information about height catch-up in developing countries and about height catch-down in both developed and developing countries. We studied the effect of IUGR and PT birth on height catch-up and catch-down growth of children from two cohorts of liveborn singletons. Data from 1,463 children was collected at birth and at school age in Ribeirão Preto (RP), a more developed city, and in São Luís (SL), a less developed city. A change in z-score between schoolchild height z-score and birth length z-score ≥ 0.67 was considered catch-up; a change in z-score ≤ -0.67 indicated catch-down growth. The explanatory variables were: appropriate weight for gestational age/PT birth in four categories: term children without IUGR (normal), IUGR only (term with IUGR), PT only (preterm without IUGR) and preterm with IUGR; infant's sex; maternal parity, age, schooling and marital status; occupation of family head; family income and neonatal ponderal index (PI). The risk ratio for catch-up and catch-down was estimated by multinomial logistic regression for each city. In RP, preterms without IUGR (RR = 4.13) and thin children (PI<10(th) percentile, RR = 14.39) had a higher risk of catch-down; catch-up was higher among terms with IUGR (RR = 5.53), preterms with IUGR (RR = 5.36) and children born to primiparous mothers (RR = 1.83). In SL, catch-down was higher among preterms without IUGR (RR = 5.19), girls (RR = 1.52) and children from low-income families (RR = 2.74); the lowest risk of catch-down (RR = 0.27) and the highest risk of catch-up (RR = 3.77) were observed among terms with IUGR. In both cities, terms with IUGR presented height catch-up growth whereas preterms with IUGR only had height catch-up growth in the more affluent setting. Preterms without IUGR presented height catch-down growth, suggesting that a better socioeconomic situation facilitates height catch-up and prevents height catch-down growth.

Dataset Information

Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia.

Publications

Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia.

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