|Effects of Improved Nutrition in Early Childhood : The institute of Nutrition of Central America and Panama (INCAP) Follow-up Study; Proceedings of an IDECG workshop, July 1990, Bellagio, Italy, Supplement of The Journal of Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)|
|Patterns of linear growth in rural Guatemalan adolescents and children(¹,²)|
REYNALDO MARTORREL*³ DIRK G. SCHROEDER,* JUAN A. RIVERA AND HALEY J. KAPLOWITZ
*Department of International Health, The Rollins
School of Public Health of Emory University, Atlanta, CA 30322, Centro de
Investigaciones en Salud Pública, Instituto Nacional de Salud Pública 62508
Cuernavaca, Morelos, México, Genentech, Inc., South San Francisco, CA
¹ Published as a supplement to The Journal of Nutrition. Guest editors for this supplemental publication were Reynaldo Martorell, The Rollins School of Public Health of Emory University, Atlanta, GA, and Nevin Scrimshaw, The United Nations University, Boston, MA.
² Data collection and analyses were supported by NIH grant HD22440 and by the International Center for Research on Women (ICRW), Contract # IC-75/03.
³ To whom correspondence should be sent: Department of International Health, The Rollins School of Public Health of Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322.
Length and weight data from a longitudinal study of rural Guatemalan subjects birth to 7 y of age and height and weight data from a cross-sectional study of the same subjects when they were 11-24.9 y old are compared to reference data for the USA general population and for Mexican-Americans. At birth, the median length of Guatemalan children is at ~ the 16th percentile of the USA reference or ~2 cm shorter. By 6 mo of age, Cuatemalan children are shorter, on average, than the 5th percentile of the reference curves and, in absolute terms, are ~5 cm below the median; by 3 y, the difference increases to ~10 cm. As adults, Cuatemalans have about the same absolute level of deficit (~13 cm) as they did at age 3 y. If the general USA population is used for comparison, Cuatemalans can be said to grow as expected during adolescence, neither recuperating the growth retardation of early childhood nor falling further behind in size. If the Mexican-American sample is selected instead, it would appear that some catch-up in growth occurs in Cuatemalan adolescents. Regardless of the choice of reference population, growth is markedly retarded only in early childhood; adolescence is not a period when growth is significantly constrained. J. Nutr. 125: 1060S-1067S, 1995.
INDEXING KEY WORDS:
While much is known in developing countries about growth in early childhood and the factors that shape its course, knowledge about growth during later childhood and adolescence is limited. Research to date indicates that growth failure and nutritional stress in poor children from developing countries are greatest in the first 2-3 y of life (Beaton et al. 1990). Growth during later childhood and adolescence in these same societies appears to be considerably less constrained, if at all (Martorell et al. 1994). Some argue that adolescence is a time when the growth retardation produced in early childhood may be recuperated (Delgado et al. 1987). However, the research to support the claim that catch-up growth can occur to a significant degree during adolescence is weak (Martorell et al. 1994). The objective of this paper is to compare patterns of growth of poor Guatemalans during childhood and adolescence to both a racially similar population of Mexican Americans and a general USA reference. Several key questions guide the analyses: what are the periods in life in rural Guatemala when significant growth failure occurs? Specifically, is adolescence a time of constrained growth or instead, is it a period when some of the growth failure of earlier childhood is overcome by compensatory growth?