The Association Between Stunting and Overweight in Latin American and Caribbean Preschool Children

Nutrition and Diabetes Unit, P de Elizalde Children's Hospital, School of Public Health, University of Buenos Aires, Buenos Aires, Argentina.
Food and nutrition bulletin (Impact Factor: 1.15). 01/2007; 27(4):300-5. DOI: 10.1177/156482650602700403
Source: PubMed


Although some segments of the population continue to suffer from undernutrition, other groups exhibit excess weight gain, resulting in the coexistence of undernutrition and obesity and leading to a dual nutritional burden.
To explore the association between stunting and overweight in preschool children from Latin American and Caribbean countries.
We analyzed cross-sectional data from children 0 to 5 years of age from 79 nationally representative surveys, compiled by the World Health Organization (WHO) Global Database on Child Growth and Malnutrition. This database defines stunting as low height-for-age and overweight as high weight-for-height. These variables were explored with the use of simple and multiple regression models.
There were significant differences between subregions in the prevalence of stunting: the prevalence was 7.4% in the Caribbean, 11.3% in South America, and 20.4% in Central America (p < .001). In contrast, the estimated prevalence of overweight was similar between subregions. The overall prevalence rates of stunting and overweight in Latin America and the Caribbean in the year 2000 were 13.7% and 4.3%, respectively. We found an inverse relationship (r = -0.3) between the prevalence rates of overweight and stunting, overall and within subregions. South America exhibited the highest slope and intercept on the regression of overweight on stunting.
Different subregions of Latin America and the Caribbean have different prevalence rates of childhood stunting but similar prevalence rates of overweight. There is an inverse relationship between stunting and overweight. The South American subregion had the highest increase and prevalence of overweight of the Latin American region.

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Available from: Pablo Duran, Mar 05, 2015
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    • "Understanding the circumstances under which the dual burden is observed in individual children will help elucidate its etiology and the conditions under which children are most at risk, and is critical for designing appropriate interventions to alleviate stunting without exposing already vulnerable populations to increased chronic disease in adulthood (Duran et al., 2006; Popkin et al., 1996; Varela-Silva et al., 2012; Victora, 2009). This study therefore has two objectives. "
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    ABSTRACT: Background The causes of the “dual burden” of stunting and obesity remain unclear, and its existence at the individual level varies between populations. We investigate whether the individual dual burden differentially affects low socioeconomic status Peruvian children from contrasting environments (urban lowlands and rural highlands), and whether tibia length can discount the possible autocorrelation between adiposity proxies and height due to height measurement error.Methods Stature, tibia length, weight, and waist circumference were measured in children aged 3–8.5 years (n = 201). Height and body mass index (BMI) z scores were calculated using international reference data. Age-sex-specific centile curves were also calculated for height, BMI, and tibia length. Adiposity proxies (BMI z score, waist circumference-height ratio (WCHtR)) were regressed on height and also on tibia length z scores.ResultsRegression model interaction terms between site (highland vs. lowland) and height indicate that relationships between adiposity and linear growth measures differed significantly between samples (P < 0.001). Height was positively associated with BMI among urban lowland children, and more weakly with WCHtR. Among rural highland children, height was negatively associated with WCHtR but unrelated to BMI. Similar results using tibia length rather than stature indicate that stature measurement error was not a major concern.Conclusions Lowland and rural highland children differ in their patterns of stunting, BMI, and WCHtR. These contrasts likely reflect environmental differences and overall environmental stress exposure. Tibia length or knee height can be used to assess the influence of measurement error in height on the relationship between stature and BMI or WCHtR. Am. J. Hum. Biol., 2014. © 2014 Wiley Periodicals, Inc.
    Full-text · Article · Jul 2014 · American Journal of Human Biology
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    • "This phenomenon is characterized as the nutritional dual burden( 1 ). Latin America is no exception to this emerging manifestation of malnutrition( 1 , 3 – 6 ). The dual burden may be manifest at various levels; the population level, the household level and the individual level( 1 ). "
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