Socioeconomic status, sex, age, and ethnicity as determinants of body fat distribution for Guatemalan children

The distribution of subcutaneous fat at the triceps and subscapular skinfold sites is described for four groups of children living in Guatemala. These groups are high socioeconomic status (SES) children of Ladino (mixed Spanish and Indian) ancestry, high SES children of European ancestry, low SES Ladino children, and very low SES Indian children. The method of Healy and Tanner (1981) is used, employing regression and principal components analysis of log transformed skinfold values to divide "fatness" into two uncorrelated variables: size (amount of fat) and shape (fat pattern). Significant differences exist between groups in size, with lower SES groups having less fat than higher SES groups. No significant difference in fat pattern exists between the high SES Ladino and high SES European children. Significant differences do exist between the high SES groups and the low SES groups. The relative amount of subscapular fat increases from the high SES Ladinos and high SES Europeans, to the low SES Ladinos, to the very low SES Indians. In the high SES European and high SES Ladino samples, girls have significantly more arm fat than boys. There is no significant difference in fat patterning between boys and girls in the two low SES samples. Finally, the relative amount of subscapular fat tends to increase with age in all four samples. These results indicate that fatness and fat patterning are independent anatomical characteristics, SES influences fat patterning; low SES children of both Ladino and Indian ancestry show greater reductions in arm fat than in trunk fat compared to high SES children, sexual dimorphism in fat patterning is SES dependent.(ABSTRACT TRUNCATED AT 250 WORDS)     

Growth status of disadvantaged urban Guatemalan children of a resettled community

This paper reports the physical growth and body composition from the first year of longitudinal study of 519 Guatemalan children, and their families, from a disadvantaged urban community consisting largely of refugees of the 1976 earthquake. Four cohorts are described, composed of children of 1,3,5, and 7 years at examination. The children are smaller, weigh less, and have reduced fat stores compared either to NCHS reference data or to upper SES Guatemalan children. Stature (or length) and head circumference deviate more from reference data than do triceps or upper arm muscle circumference. Greater deviations are found in the linear dimensions of males than of females. These children are the smallest yet described from Guatemala City, though they are slightly larger than available rural samples. This suggests a continuum of environmental effects acting upon the growth of children of differing socioeconomic levels.     

Genetic and environmental effects on growth of children from a subsistence agricultural community in southern Mexico

Sibling correlations for size attained in height, weight, sitting height, estimated leg length, the triceps skinfold, arm circumference, and estimated midarm muscle circumference were compared in 6- through 13-year-old schoolchildren grouped by household socioeconomic status. The children were residents of a Zapotec-speaking, subsistence agricultural community in the Valley of Oaxaca in southern Mexico. Sibling pairs were classified as being from high and low socioeconomic status (SES) households, and sibling correlations were computed within each SES group controlling for environmental effects derived from a factor analysis of information on household demography and land and livestock holdings. Like-sex siblings from lower SES households have significantly different correlations in four instances. Correlations are higher for leg length in lower SES brothers and higher for sitting height and weight in lower SES sisters, while the correlation for sitting height is higher in upper SES brothers. The sibling correlation results are not entirely consistent with observations on growth status by SES, particularly if the power and similarity of a common environment is the only cause of higher sibling correlations. Reduced body size under poorer socioeconomic and presumably nutritional circumstances is apparent, but it is not possible in this analysis to distinguish whether genotypic (developmental) plasticity or genetic adaptation, or both, are involved.     

Age-related Patterns of Upper Arm Muscle and Fat Area in Turkish Children and Assessment of Nutritional Status

Anthropometric estimation of midarm muscularity and fatness was employed as a general index of nutritional status in developing countries. The present study attempts to evaluate the sex- and age-related pattern of regional muscle and fat area characteristics in Turkish children. A cross-sectional study was carried out on 1,068 10- to 14-year-old children (583 boys and 485 girls) from junior high schools in Ankara, the capital city of Turkey. According to general anthropometric protocols, weight, height, triceps skinfold thickness, and midarm circumference measurements were taken and socioeconomic data were collected. Arm muscle area (AMA) and arm fat area (AFA) were calculated and centile curves were evaluated using least median squares method. Results showed significant sexual dimorphism in muscle and fat patterning. AFA was found to be higher among girls and AMA among boys. The present findings suggest that the different levels of socioeconomic status (SES) appeared to be more prevalent on muscularity among boys (p < 0.05) and adiposity among girls (p < 0.001).     

Socioeconomic variation in the growth status of children in a subsistence agricultural community

Socioeconomic variation in the growth status of 293 children, 6 through 13 years of age, from a rural subsistence agricultural community in southern Mexico was considered. Socioeconomic status was based on an index developed from landholdings, household goods, and occupation, and households were classified as high and low status. Growth measurements included weight, stature, sitting height, estimated leg length, arm and estimated arm muscle circumferences, triceps skinfold, and right gripping strength. The growth status of boys showed a clear socioeconomic differential, while that of girls did not. The results are consistent with the generalization that males are more influenced by environmental stresses than females, including, of course, the favorable stress of improved socioeconomic circumstances, even within seemingly single-class rural communities.     

Parental education and living environmental influence on physical development, nutritional habits as well as level of physical activity in Polish children and adolescents

The aim of this work was to evaluate the physical development and nutritional status, the nutrition habits as well as level of physical activity of boys and girls in relation to the socio-economic status of their families. The study was conducted on a group of 529 boys and 535 girls aged 7-16 years from Swietokrzyskie Province in Poland. Boys and girls from high SES families had the greatest body height, BMI, upper arm muscle area, as well as upper arm fat tissue area, while the lowest values of these features occurred among those studied coming from families of a low SES. The higher the family SES, the higher habitual frequency of consuming vegetables and fruit as well as fish. The diet of children coming from higher SES families was also linked with a higher total protein content as well as animal protein, all analysed minerals and some vitamins, but there were no significant differences of energetic value in daily food rations as well as fat content. The longer time spent on some sedentary activities was connected with a higher family SES. The girls coming from a high status families also declared a higher level of physical activity, whereas such relationship was not observed among boys. A more rational set of nutritional habits observed among children from a higher SES families can be the basic reason for their higher advancement in development. A shorter time devoted to sedentary activities is assumed to be the main cause of a smaller relative body mass and less obesity among girls and boys from low SES families.     

Growth of specific muscle strength between 6 and 18 years in contrasting socioeconomic conditions

The influence of sex, age, and socioeconomic conditions on specific grip strength of 6-18-year-old individuals was studied among 1,704 males and 1,956 females belonging to the so-called "Cape Coloured" community in the western part of South Africa. Half of the participants of both sexes came from communities in the Greater Cape Town area where living conditions are comparable to those of middle-class First World communities (high SES). The other half came from the poorest rural communities of Klein Karoo (low SES). Arm circumferences, triceps skinfold thickness, and grip strength of the right and of the left hand were greater in individuals from high SES at all ages. Females within each SES group had skinfolds thicker than males, especially at older ages, and were weaker. Specific grip strength (SS), estimated as grip strength per unit area of cross section of the fat-free arm, increased with age in each group, was greater in males, and was significantly lower in low SES groups, than in the high SES ones, especially during and after puberty. It seems that SES difference in SS will persist into adulthood. Sexual differences in SS can be attributed to hormonal differences; while the SS increase with age and the difference between SES groups find no clear explanation in current theories of muscle growth and development. Since the speed of neuromuscular reaction observed in our participants is slower among low SES individuals, it seems that the difference in neuromuscular control of strength may be responsible for our findings. Differences in muscle metabolism and hormonal regulation must also be considered.     

Standards of arm muscle by stature for the assessment of nutritional status of children

This study is based on a sample of 9,134 children ranging in age from 2 to 17 years from which the excessively lean and fat children by skinfold thickness were excluded. This sample was derived from the combined data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and II) of 1971-1974 and 1976-1980. Means and percentiles of upper arm muscle area were calculated for 3 cm increments in stature from 84 to 184 cm for boys and from 84 to 176 cm for girls. Based on means, Z-score units, and percentile ranges of upper arm muscle area by stature, five operational categories of nutritional status have been established. It is recommended that these standards and this classification system be used to supplement current standards of weight for age and weight for height in order to obtain a more complete assessment of body composition and nutritional status.     

Somatic growth of a school-aged population from Mozambique: trend and biosocial meaning

A cross-sectional study of children and adolescents from Maputo, Mozambique, was carried out in order to (1) describe the current growth status of children and adolescents from Maputo, (2) evaluate the relative status of the growth and development of youth from Maputo compared to WHO international standards, (3) assess the relationship between socioeconomic status and growth and development, and (4) assess the impact that the civil war (1980-1992) had on the health status of children and adolescents living in Maputo. The sample is composed of 2,271 subjects (1,098 boys and 1,173 girls), age 6 to 17 years. Somatic measures included height, weight, and skinfold thicknesses from which nutritional indicators were calculated and plotted against WHO norms. Subjects were divided into three groups according to their socioeconomic status. Data from a cross-sectional study done in the same areas in 1992 was used to analyze the impact of war. Beginning at 11 years, Maputo students are always shorter and weigh less than the WHO standards. BMI in boys from 11 years and in girls from 12 years is somewhat lower than the WHO norms. A social gradient is evident, favoring those students with higher socioeconomic status. Height, weight, BMI, fat mass, and lean body mass are always higher in the 1999 sample than in the 1992 study. We conclude that (1) there is a substantial difference in height and weight values of Maputo children and adolescents compared to WHO standards; (2) there is a clear advantage of being of higher socioeconomic status; (3) socioeconomic status, hygiene, and sanitation are the main factors responsible for the greater values of the 1999 sample; and (4) differences between the stature of students with higher socioeconomic status and the WHO norms are almost irrelevant. This last aspect reveals the importance of socioeconomic factors in determining the growth process, implying its importance in facilitating the "expression" of the genotypes available in the population.     

Ethnic differences in anthropometric characteristics of young children and their parents

The distribution of body fat, or fat patterning, is an important risk factor for cardiovascular disease and diabetes, independent of obesity. Furthermore, the incidence of cardiovascular disease and diabetes varies by ethnicity. We documented ethnic differences in anthropometric characteristics and body fat distribution between Anglo, Black, and Mexican American men (n = 101), women (n = 245), boys (n = 111), and girls (n = 111). We used aggregates of skinfold measures to examine ethnic differences in the deposition of fat in body compartments (body, trunk, leg, and arm) and analyzed trunk-extremity skinfold ratios to determine which best reflected ethnic differences in fat distribution. The results show that Mexican American mothers have larger skinfold ratios and more body fat (as determined by skinfold aggregates) than either Anglo or Black American mothers, whereas Black American mothers have larger ratios than Anglo American mothers. Mexican American fathers also have larger skinfold ratios but not more body fat (skinfold aggregates) than Anglo American fathers. Mexican American fathers have more body fat than Black American fathers, but we found no differences between skinfold ratios. The ethnic differences among children in skinfold ratios and aggregates are similar to those found among fathers, with more differences among girls than boys. Fat patterning differences do exist among the three ethnicities, with greater trunk fat among Mexican and Black Americans. Those ethnicities are known to be at higher risk for cardiovascular disease and diabetes.     

Plasma lipids in Turkish children: impact of puberty, socioeconomic status, and nutrition on plasma cholesterol and HDL.

In Turkish adults, HDL cholesterol (HDL-C) levels are 10-15 mg/dl lower than those of adults in western Europe and the United States. In this study, we determined whether HDL-C levels in Turks are low from birth to adulthood and assessed the effect of socioeconomic status (SES) on plasma lipids and lipoproteins. Analyses of cord blood from 105 Turkish newborns showed low levels of plasma cholesterol ( approximately 60 mg/dl) and HDL-C (approximately 30 mg/dl), consistent with results from other Western ethnic groups. Prepubescent 8- to 10-year-old Turkish boys and girls of upper (n = 82) and lower (n = 143) SES had high HDL-C levels (50-60 mg/dl) similar to those of western European children. However, the cholesterol (154-158 mg/dl) and HDL-C (55-58 mg/dl) levels of upper SES children were approximately 25 and approximately 12 mg/dl higher, respectively, than those of lower SES children. Height, weight, skinfold thickness, and estimated body fat were greater in the upper SES children and appeared to reflect dietary differences. Upper SES children consumed more total fat (approximately 35% vs. 25% of total calories), including more saturated fat of animal origin, and less carbohydrate (approximately 50% vs. 62% of total calories), consistent with their elevated plasma cholesterol levels. Carbohydrate intake correlated inversely with the HDL-C level. The HDL-C levels in the prepubescent children, especially those of higher SES, who consumed diets more like western Europeans, decreased markedly to adult levels, with males exhibiting a approximately 20 mg/dl decrease (from 58 to 37 mg/dl) and females a approximately 13 mg/dl decrease (from 55 to 42 mg/dl). SES did not affect HDL-C levels in adults. The profound decrease may reflect alterations in androgen/estrogen balance in Turks at puberty and a modulation of hepatic lipase affecting HDL-C levels.     

Childhood malnutrition and growth in a rural area of Western Kenya

An anthropometric survey was carried out on 1,383 school students aged 5-17 years in Suba district (a rural area of western Kenya). Body size and proportion were computed from height, weight, sitting height, arm circumference, and skinfolds. The aim of the study was to evaluate patterns of growth and nutritional status of the Luo population by assessment of the prevalence and trends of malnutrition among children and adolescents. Very few age-groups show significant sex differences for height, body weight, and arm muscle area. However, there are several differences in skinfold thicknesses and arm circumference, always with higher mean values in girls. Analysis of the nutritional status (weight-for-age, height-for-age, and BMI-for-age) shows significant differences among the age-groups in both sexes. Boys present lower Z-scores than girls and there are higher percentages of malnourished subjects (stunted and underweight) among the males. The Luo data were compared with those of other African populations. Their body dimensions, nutritional status, and growth are similar to those of the other sub-Saharan samples. In conclusion, the Luo children are generally undernourished at the older ages: adolescents (11-16 years of age) show the most severe undernutrition and the highest percentages of undernourished subjects. In addition to the higher risk of undernutrition in teenagers, an emerging problem of over-nutrition is evident among the younger age-groups, with a higher prevalence in females. These findings are discussed in light of sexual dimorphism in sensitivity to adverse environmental conditions.     

Interaction of nutritional and socioeconomic status as determinants of cognitive development in disadvantaged urban Guatemalan children

The relationship between nutritional status, measured by height for age, and cognition, measured by WISC full-scale IQ, was studied in a longitudinal sample of 459 urban Guatemalan children, aged 4-9 years, from a disadvantage community of the fringe of Guatemala City, examined annually over a 3 year period. Socioeconomic status (SES) was controlled by developing a composite index for each home. The mean IQ differed significantly from the lowest to the highest quartiles of stature, the difference between the two extreme quartiles being approximately 0.3 SD of IQ. There was a significant interaction between SES and stature in their effects on IQ. Whereas nutritional status and SES affected IQ in an additive fashion in the upper three SES quartiles, there was no difference in IQ attributible to stature among children from the most disadvantaged homes. This analysis indicates that the mild-to-moderate protein-energy malnutrition (defined by height for age) that is prevalent among children from disadvantaged environments in developing countries is significantly related to cognitive development. However, in the poorest homes, SES is seen as a more important determinant of cognitive development than stature.     

Differences in nutritional status between rural and urban Yucatec Maya children: The importance of early life conditions

Early-life conditions shape childhood growth and are affected by urbanization and the nutritional transition. To investigate how early-life conditions (across the “first” and “second” 1000 days) are associated with rural and urban children's nutritional status, we analyzed anthropometric data from Maya children in Yucatan, Mexico. We collected weight, height and triceps skinfold measures, then computed body mass and fat mass indices (BMI/FMI), in a cross-sectional sample of 6-year-olds (urban n = 72, rural n = 66). Demographic, socioeconomic and early-life variables (birthweight/mode, rural/urban residence, household crowding) were collected by maternal interview. We statistically analyzed rural-urban differences in demographic, socioeconomic, early-life, and anthropometric variables, then created linear mixed models to evaluate associations between early-life variables and child anthropometric outcomes. Two-way interactions were tested between early-life variables and child sex, and between early-life variables and rural-urban residence. Results showed that rural children were shorter-statured, with lower overweight/obesity and cesarean delivery rates, compared to urban children. Household crowding was a negative predictor of anthropometric outcomes; the strongest effect was in boys and in urban children. Birthweight positively predicted anthropometric outcomes, especially weight/BMI. Birth mode was positively (not statistically) associated with any anthropometric outcome. Cesarean delivery was more common in boys than in girls, and predicted increased height in urban boys. In conclusion, urbanization and household crowding were the most powerful predictors of Maya 6-year-old anthropometry. The negative effects of crowding may disproportionately affect Maya boys versus girls and urban versus rural children. Early-life conditions shape Maya children's nutritional status both in the “first” and “second” 1000 days.     

Short and plump physique of Mexican-American children

Mexican-American children are shorter but relatively heavier than non-Hispanic whites and blacks. The objectives of this paper are to assess the extent to which this "short and plump" physique occurs in data collected in two national surveys (HANES I and II); to determine variations by age, sex, and socioeconomic status; and to investigate the anthropometric characteristics that may account for the overweight. Three groups, defined on the basis of reported ancestry and observed race, are studied: Mexican-Americans (MEXAME), non-Hispanic Whites, (EURAME), and blacks (BLACK). Short stature was clearly associated with the poverty index (PI) in all three groups. MEXAMEs with a PI greater than 1.6 were similar in stature to EURAMEs at the same income level at ages 1-11 years but not at 12-17 years. On the other hand, MEXAMEs were shorter than BLACKs at all ages and income levels. The body mass index (kg/cm2) and poverty were unrelated. With respect to the anthropometric characteristics examined that are related to the body mass index, MEXAMEs and EURAMEs were similar in sitting height as a proportion of total height, arm muscle and fat areas, and triceps skinfold but different in the following ways: MEXAMEs had narrower elbow but broader bitrochanteric breadths and larger chest circumferences and subscapular skinfolds. Greater upper body dimensions and fatfolds seem to best describe the physique of MEXAMEs. However, in multiple regressions, these anthropometric characteristics failed to account fully for the greater relative weight of MEXAMEs as compared to EURAMEs.     

The question of differences in body dimensions between children from endogamic and exogamic matings: a study in Sardinia

The aim of this study is to investigate whether there are differences in body dimensions between children of the same sex from endogamic and exogamic matings. The cross-sectional sample consisted of 285 children, 136 males and 149 females, 6 to 10 years old, attending elementary schools in Tortolí, a town in east-central Sardinia. The children of each sex were divided into two groups: endogamic and exogamic, the first including children from parents born in the same Sardinian village, the latter children from parents born in two different places. For each sex, ANCOVA with age as covariate revealed no significant differences between the two groups of children for the 35 anthropometric variables considered. Moreover, for each sex, there were no significant differences between the two groups of children for some anthropometric variables considered to be indicators of nutritional status: sums of skinfold thicknesses, waist/hip ratio, body mass index, total upper arm area, upper muscle arm area, upper arm fat area. We conclude that when Sardinian children of endogamous and exogamous unions are in similar nutritional conditions, they do not differ in body dimensions.     

Growth and malnutrition of rural Zimbabwean children (6-17 years of age)

The rural environment is an important factor in delayed growth in developing countries. The aim of this study was to investigate the effects of poor rural living conditions on the growth of a Shona sample in Zimbabwe. In total, 982 subjects aged 6-17 years were analyzed. Mean values of height, weight, skinfolds (triceps, subscapular, suprailiac, biceps, medial calf), cormic index, body mass index (BMI), arm composition (total upper arm area, upper arm muscle area, arm fat area, and arm fat index), fat percentage (%F), centripetal fat ratio (CFR), and the contribution of each skinfold to the adiposity of the trunk and upper limbs are presented. Weight, height, BMI, cormic index, SSCP, TRCP, arm circumference, and arm composition are compared with NHANES percentiles. Boys and girls showed stunting and underweight at ages 11-15 and 8-15, respectively; boys presented particularly severe malnutrition and their means of height and weight were below the 10th percentile. The means of arm circumference, UMA, UFA, and TRCP were below the 15th percentile in both sexes. The contribution of the skinfolds generally showed an overall prevalence of TRCP in both sexes; the contribution of SSCP was prevalent only for the 16- to 17-year-old boys. Males presented a higher CFR than girls after 14 years while females showed an irregular pattern. There was a high incidence of brachycormia and mesocormia in females and males, respectively. Height, weight, and BMI were similar to the values observed in other sub-Saharan countries, although body size was slightly larger than in South Africa and smaller than in Tanzania. The results provide a useful database for future comparisons.     

Skinfold thickness, body measurements and age changes in Trio and Wajana Indians of Surinam

The nutritional status of Trio and Wajana is representative of a group living under primitive conditions in a favourable environment. In adults, skinfold thickness remains constant throughout life. The folds of females are thicker than those of males, the difference being most marked over the triceps and least at the subscapular. In children, skinfold thickness at the subscapular and suprailiac sites decreases from the 3–4 to the 5–6 age group, after which there is a rapid increase towards adult values. Age changes over the triceps are less marked, especially in males. Other measurements included arm and calf circumference, bone dimensions at the wrist, elbow, ankle and knee, weight, stature, leg and arm length and biacromial breadth. The two tribes differ significantly in several measurements. The Wajana are heavier but they tend to be shorter in stature, with shorter legs but broader elbows and wrists. Shoulder breadth and the circumference of the upper arm are greater in Wajana males but females do not show these differences. The Wajana have longer and broader heads, but the cephalic index is similar. The tribes also differ in hair texture.     

Influence of maternal nutritional status on prenatal growth in a Peruvian urban population

Anthropometric measurements were made on 4,952 mothers and their neonates from a Peruvian urban population. Based on age-specific percentiles, the mothers were separated into categories of short and tall stature, high and low fat, and high and low muscle. The study indicates that: (1) tall and short mothers characterized by similar subcutaneous fat and upper arm muscle area (whether high or low) had newborns with similar birth weight and recumbent length; (2) mothers characterized by high subcutaneous fat had heavier and fatter, but not longer, newborns than mothers with low subcutaneous fat; (3) mothers characterized by high upper arm muscle area had heavier, leaner and longer newborns than mothers with low upper arm muscle area; (4) mothers characterized by high muscle and high fat had heavier and longer newborns than mothers with high muscle and low fat; but (5) mothers characterized by high muscle and low fat had heavier and longer newborns than mothers with low muscle and high fat. Considering that subcutaneous fat and arm muscle area reflect calorie and protein reserves respectively, it is concluded that an increase in maternal calorie reserves results in increased infant fatness, but a lesser increase in linear growth. In contrast, an increase in maternal protein reserves does enhance both birth weight and prenatal linear growth.     

A Comparative Study on Nutritional Status and Body Composition of Urban and Rural Schoolchildren from Brandsen District (Argentina)

The purpose of this study was to analyze whether nutritional status and body composition varies according to the environment of residence (urban or rural) of children in the Brandsen district (Argentina). Weight, height, arm circumference and tricipital and subscapular skinfolds were performed in 1368 schoolchildren aged 3 to 14. NHANES III reference was used to estimate nutritional status -underweight, stunting, wasting, overweight, and obesity- and to evaluate body composition -deficit and excess of adipose (DA, EA) and muscular (DM, EM) tissues of the arm-. Central fat distribution (CFD) was estimated using the subscapular-tricipital index. A structured questionnaire was implemented to evaluate socio-environmental characteristics. Nutritional categories based on body size and body composition were compared between urban and rural areas of residence using Chi-squared tests (χ2). The results indicated for the total sample: 1.1% underweight, 6.9% stunting, 0.4% wasting, 12.1% overweight, 9.7% obesity, 22.0% DM, 2.5% EM, 0.1% DA, 17.6% EA, and 8.5% CFD. Significant differences between urban and rural areas were found only for CFD. The socio-environmental analysis showed that while access to public services and housing quality was significantly better in the urban area, a considerable number of city households lived under deficient conditions, lacked health insurance and had low socioeconomic level. Fifty-three percent of the undernourished children had DM without urban-rural significant differences, and none of them showed DA. In the overweight plus obesity group, 62.8% presented EA, 6.4% EM, 4.7% DM, and 22.8% CFD. The highest percentages of DM and CFD were recorded in rural areas (p = 0.00). We conclude that the child population shows the “double burden” of malnutrition. The environment of residence does not promote any differentiation in the nutritional status. Nevertheless, the increment of central adiposity and, in some cases of muscle deficit in rural children, suggests a consumption of unbalanced diet.