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.     

Are changes in body dimensions of adult females from Italy (Sardinia and Latium) related to secular trend?

This paper presents secular changes in height, weight, sitting height, relative sitting height, BMI and estimated lower limb length in two samples of Italian adult females from Sardinia (Cagliari) and Latium (Rieti). The samples consist of 579 healthy women from the province of Cagliari and 138 from the town of Rieti, aged 20.0-39.9 years, measured in the period 2003-2006. The women were divided into four 5-year age groups. The anthropometric variables were considered according to different socioeconomic status (SES) in the Cagliari sample, while the Rieti sample was considered as a whole, as the SES was homogeneous. ANOVA results suggest that the secular trend was very slow or had come to a halt in the Rieti sample but continues in the Cagliari sample, as shown by the statistically significant differences for estimated lower limb length (p≤0.02), and relative sitting height (p≤0.05). However, these differences disappear after ANCOVA with sibship size and socioeconomic status controlled for, suggesting that they depend mainly on the composition of the Cagliari sample in terms of SES. Therefore, it can be hypothesised that the secular trend might be very slow or has stopped in the Cagliari subsamples homogeneous for SES.     

Physical growth of St. Lawrence Island Eskimos: Body size,proportion, and composition

Growth patterns of body size, proportion, and composition were analyzed in 57 male and 56 female Eskimos from St. Lawrence Island in the Bering Sea, ranging in age from 1.23 through 19.82 years. Age-groups means for whites and blacks of the U.S. Health Examination Survey served as reference data. Relative to HES data, the Eskimo sample were shorter with lower values for leg length, while there were no differences from the reference values for sitting height. The Eskimos also had higher values of Quetelet's Index, the sitting height/height ratio, and the upper arm muscle circumference, while there were no differences in body weight or triceps skinfold thickness. Differences from the reference data were more pronounced in males than in females. The growth patterns for size and body proportion are in conformity with known relationships between morphology and climate.     

Cross-Location Analysis of the Impact of Household Socioeconomic Status on Participation in Urban and Peri-Urban Agriculture in West Africa

This study explores the relation between household socioeconomic status (SES) and participation in urban and periurban agriculture (UPA) in three West African cities. We used a structured questionnaire to survey 700 randomly selected households: 250 in Kano, Nigeria, 250 in Bobo Dioulasso, Burkina Faso, and 200 in Sikasso, Mali. Multiple correspondence analysis was applied on household asset variables to create an index of assets which was used as a proxy for household SES. The results showed no significant differences in households’ rate of participation in UPA across socioeconomic groups. Participation in UPA was rather significantly (P < 0.001) and positively related to household size. Interestingly, the analysis revealed that field crop cultivation and gardening were more common among households in the low and medium SES groups while those in the high SES group were more likely to keep livestock.     

Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors

Age at menarche is regarded as a sensitive indicator of physical, biological, and psychosocial environment. The aim of this study was to determine the age at menarche and its association with biological and socioeconomic factors in girls from Santa Rosa (La Pampa, Argentina). An observational cross-sectional study was carried out on 1,221 schoolgirls aged 9-15 years. Menarche data were obtained by the status-quo method. Height, sitting height, weight, arm circumference, tricipital and subscapular skinfolds were measured. We also calculated body mass index, measures of body composition and proportions, and fat distribution. To assess socioeconomic factors, parents completed a self-administered questionnaire about their occupation and education, family size, household, and other family characteristics. The median age at menarche - estimated by the logit method--was 12.84 years (95% CI: 12.71, 12.97). Compared with their premenarcheal age peers, postmenarcheal girls had greater anthropometric dimensions through age 12. After this age, only height was higher in the latter group. Data were processed by fitting two logistic regressions, both including age. The first model included anthropometric variables and birth weight, while the second model included the socioeconomic variables. The significant variables derived from each model were incorporated into a new regression: height, sitting height ratio (first model), and maternal education (second model). These three variables remained significantly associated with menarche. The results suggest a relationship between linear growth and menarche and agree with those found in other populations where the advancement of menarche is associated with improved living conditions. In relatively uniform urban contexts, maternal education may be a good proxy for the standard of living.     

Socioeconomic transition and physical growth of Tupí-Mondê Amerindian children of the Aripuan? Park, Brazilian Amazon

Anthropometric assessment of nutritional status is reported for three Tupí-Mondê-speaking groups from Rond?nia and Mato Grosso, Brazil. This region of the Amazon basin is experiencing rapid development through government-oriented colonization. The Gavi?o, Suruí, and Zoró had their first contacts with Brazilian national society at different times, and the nature and degree of their participation in regional markets varies. Height, weight, sitting height, subischial leg length, upper arm circumference, triceps skin-fold thickness, and upper arm muscle and fat areas are reported for children 0-10.9 years of age. Like other Amazonian Amerindians, Tupí-Mondê children are short for their age but normal or above normal in weight for height with respect to the National Center for Health Statistics reference. Hence stunting levels are high (55.4%) and wasting levels are low (0.8%). There are also deficits in body composition parameters, especially in upper arm circumference and estimated muscle and fat areas. We interpret the results as evidence of suboptimal nutritional status, reflecting the interaction between poor diet and infectious and parasitic diseases. The Gavi?o, with the longest period of contact, present the lowest level of stunting. This finding is attributed to the use of cash income from rubber tapping and nut gathering to purchase of food items and health care. Differences in height between the three groups are mostly due to leg length, instead of sitting height, reinforcing the idea that environmental conditions can alter body proportions.     

Increased heterozygosity and child growth in an isolated subsistence agricultural community in the valley of Oaxaca, Mexico

Gene flow and rate of inbreeding (delta F) were calculated from demographic data for a community previously reported to be isolated from outside genetic influences of immigration. Significant child growth differences caused by gene flow among children born to native parents (n = 287) and offspring of native-immigrant matings (n = 38) were found in fatness (triceps skinfold), body proportions (sitting height ratio), and size (leg length). No differences were found between the two groups in height, weight, sitting height, and arm circumference. Variation in absolute and relative leg length in this population parallels previously reported differences in adult body size and proportion associated with increased heterozygosity caused by gene flow in other populations in southern Mexico.     

BMI may overestimate the prevalence of obesity among women of lower socioeconomic status

Objective: Our objective was to examine gender differences in height and weight associated with socioeconomic status (SES) and the consequent effect on body mass index in a multiethnic society. Research Methods and Procedures: A cross‐sectional study, the First Israeli National Health and Nutrition Survey, was performed on a representative population sample of 3246 adults 25 to 64 years of age, between the years 1999 to 2001. Height and weight were measured, and BMI and other weight‐height indices were calculated. SES was assessed by income and education. Results: Age‐adjusted height was significantly lower at lower levels of SES among both women and men (p < 0.001). As opposed to men, women of lower SES were heavier than those of higher SES, and the mean age‐adjusted weight was 4.6 kg higher among those of lower SES (p < 0.001). Thus, using the standard index of BMI, the prevalence of obesity was significantly higher among shorter women. Discussion: In this group of Israeli adults, the unfavorable effect of low SES on BMI was evident among women, partly due to their decreased height combined with increased weight common in this socioeconomic sector. Since BMI is only partly independent of height, it may overestimate the prevalence of obesity among women of lower SES. Alternative measures for classifying obesity in the lower SES groups that put less emphasis on height may be considered and studied.     

The shape of things to come? household dependency ratio and adolescent nutritional status in rural and urban Ethiopia

Several related demographic trends are occurring in developing countries: youth comprise a large portion of populations, fertility rates are declining, and urban dwellers are increasing. As fertility rates decline and populations age, the decline in the ratio of young dependents to working age adults is expected to free up household resources, which can be invested in human capital, including youth nutritional wellbeing. We test this hypothesis in a sample of youth (n = 1,934) in Southwestern Ethiopia. Multiple measures of achieved growth and nutritional status are explored (weight, height, mid-upper arm circumference (MUAC), body mass index (BMI) and body mass index for age z-score (BMIZ), weight for age z-score (WAZ), and height for age z-score (HAZ)). In multivariable models controlling for the effects of income, age, gender, and youth workloads, youth living in rural settings had significantly lower weight (1.24 kg lighter), MUAC (0.67 cm lower), BMI (0.45 BMI lower), BMIZ (0.27 lower), HAZ (0.14 HAZ lower), and WAZ (0.3 WAZ lower) than urban youth (all P < 0.01). Compared with youth in the lowest dependency ratio households, results show that youth in households with the highest dependency ratios were estimated to be 1.3 kg lighter, have 0.67 cm smaller MUAC, and BMI that was 0.59 lower (all P<0.01). Similar results were found for WAZ (0.21 lower) and BMIZ (0.36 lower). Youth height and HAZ were not associated with household dependency. These results may point toward increasing levels of human capital investments in Ethiopian youth as fertility levels decline and populations urbanize.     

Trends in sibling correlations for height and weight: the effect of age changes (0-24 months) and spacing between siblings (0-10 years)

Familial correlations were studied in a sample of 618 sibships from a western neighborhood of Jerusalem, whose height (H) and weight (W) were measured longitudinally at the same age, from birth to 3 years of age. Covariate adjustments were applied to correct for change in mean of H and W with the sex of child and age of mother and for the effect of origin, education, and socioeconomic status of the mother, parity, and calendar year at birth. The highest sibling correlations were observed at birth or 1 month later (r = 0.45-0.46). Pooled sibling correlations were lower 6 months later (r = 0.33; r = 0.26 for H and W, respectively) and tended to increase again 12-18 months after birth. A clear trend of decline in sib-sib correlation for H and W measured 3 and 12 months after birth with increased spacing between siblings was observed. Our data provide evidence for transient environmental factors as possible sources of the observed temporal variation in sibling correlation for height and weight.     

Secular change in growth of native children and adolescents at high altitude I. Puno,Peru (3800 meters)

A cross sectional sample of 969 native males from Puno (Peru), altitude 3800 m, ranging in age from 7–20 years, and studied for body height, weight, sitting height, leg length, and chest circumference in 1980, were compared, from the point of view of secular trend, with another cross sectional sample of 992 native males from the same place, which were investigated in 1945. In addition, similar observations were carried out in 1980, in a group of 112 females. The data indicate that in Puno there has been no secular increment in the adult body size. However for all ages between 7 and 19 years, body weight and height were significantly greater in 1980 than in 1945. This may be due to earlier sexual maturation in the present generation.     

Trends in Child Overweight Rates and Energy Intake in France From 1999 to 2007: Relationships With Socioeconomic Status

Our objectives were (i) to assess the current prevalence of childhood overweight (including obesity) (OWOB) in France and its relationship with comprehensive socioeconomic status (SES) indicators and (ii) to examine trends in OWOB prevalence and changes in energy intake (EI) and sedentary behavior (SED) based on the previous INCA 1 (Individuelle Nationale des Consommations Alimentaires) data (1998–1999). A representative sample of children aged 3–14 (n = 1,030) was taken from the 2006–2007 cross‐sectional INCA 2 food consumption survey. Weight and height were measured. The prevalence of OWOB was estimated according to the IOTF (International Obesity Task Force) definition. Average daily EI was evaluated using a 7‐day food record. SED (screen time) and SES were reported by answering questionnaires. SES indicators included the occupation and level of education of the head of the household (HH), and variables describing household wealth. Composite indices of SES were computed by correspondence analysis, and relationships with OWOB were explored by logistic regression analysis. In total, 14.5% (95% CI: 12.1–17.0) of the children were OWOB. All SES indicators were inversely correlated to OWOB. Average EI was equal to 1,739 kcal/day. Daily, children spent 113.5 min watching television, and 38.5 min playing video games or using a computer. Compared to the INCA 1 study, OWOB prevalence was not significantly different, EI was lower, and SED was higher. These trends were the same across all occupational categories of heads of household. Although overall rates of childhood OWOB are currently stabilizing, no change was observed in the strong inverse socioeconomic gradient of OWOB between the two studies.     

Familial aggregation of blood pressure and anthropometric variables in patrilocal households

Fifty-three households in a small Indian fishing community were surveyed for blood pressure, pulse rate, and anthropometric measurements (height, weight, and three skinfolds). In addition to nuclear family relationships, correlations for extended family members and in-laws living within a common household were estimated by maximum likelihood. Based on likelihood ratio tests, the hypothesis that correlations among genetically unrelated pairs from the same household are zero is rejected for systolic blood pressure. Among genetically related individuals, the degree of relationship does not affect the magnitude of the blood pressure correlations. For the anthropometric measurements, family resemblance is significant only for first-degree relatives, except that the correlation for uncle-child pairs is significant for subscapular skinfold, and brother-in-law-sister-in-law pairs resemble each other for height and weight. The results suggest that common household environment is a significant determinant of blood pressure but not fatness in this population.     

Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria

Objective

There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups.

Methods

The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care.

Results

The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme.

Conclusion

The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms.     

Phenotypic relationships of scrotal circumference to frame size and body weight in performance-tested bulls

The objective of this study was to determine if frame size (height) is related to scrotal circumference. A total of 695 bulls (425 Angus, 65 Hereford, 70 Charolais, 135 Simmentals) were tested for postweaning gain in five stations over a period of 1 to 3 years. Variables examined included hip height, weight and scrotal circumference at beginning and completion of a 140-d feeding period. Correlations among these traits, adjusted for age (7 to 10 months at entry), year, station and management were estimated for each breed. Both height and weight were correlated positively with scrotal circumference at the start and the end of the test period in all four breeds. When height and scrotal circumference were adjusted for weight, correlations were negligible, with the exception of end-of-test values for Charolais bulls (-0.26). Negative correlations were obtained between the scrotal circumference at the start of the test and the change in height during the test after adjustment for weight in Angus bulls (-0.18) and in Charolais bulls (-0.15). These small negative phenotypic relationships indicate that a bull's fertility is not seriously reduced by large frame size at the completion of a feedlot performance test. For maximum fertility in bulls, scrotal circumference needs to be evaluated independently of frame size.     

Assessment of body cell mass at bedside in critically ill patients

Critical illness affects body composition profoundly, especially body cell mass (BCM). BCM loss reflects lean tissue wasting and could be a nutritional marker in critically ill patients. However, BCM assessment with usual isotopic or tracer methods is impractical in intensive care units (ICUs). We aimed to modelize the BCM of critically ill patients using variables available at bedside. Fat-free mass (FFM), bone mineral (Mo), and extracellular water (ECW) of 49 critically ill patients were measured prospectively by dual-energy X-ray absorptiometry and multifrequency bioimpedance. BCM was estimated according to the four-compartment cellular level: BCM = FFM - (ECW/0.98) - (0.73 × Mo). Variables that might influence the BCM were assessed, and multivariable analysis using fractional polynomials was conducted to determine the relations between BCM and these data. Bootstrap resampling was then used to estimate the most stable model predicting BCM. BCM was 22.7 ± 5.4 kg. The most frequent model included height (cm), leg circumference (cm), weight shift (Δ) between ICU admission and body composition assessment (kg), and trunk length (cm) as a linear function: BCM (kg) = 0.266 × height + 0.287 × leg circumference + 0.305 × Δweight - 0.406 × trunk length - 13.52. The fraction of variance explained by this model (adjusted r(2)) was 46%. Including bioelectrical impedance analysis variables in the model did not improve BCM prediction. In summary, our results suggest that BCM can be estimated at bedside, with an error lower than ±20% in 90% subjects, on the basis of static (height, trunk length), less stable (leg circumference), and dynamic biometric variables (Δweight) for critically ill patients.     

Relative lower extremity length in Mexican American and in American black and white youth

Stature, sitting height, estimated leg (subischial) length and the sitting height/stature ratio are compared in Mexican American, American White and American Black boys 9 through 14 years of age and girls 12 through 17 years of age. Mexican American youth are shorter in stature and have absolutely shorter lower extremities. The sitting height of Mexican American youth is similar to that of Black youth and shorter than that of White youth. The sitting height/stature ratio is virtually identical in Mexican American and White youth, indicating similar proportions of lower extremities to stature. In contrast, Black youth have absolutely and relatively longer lower extremities than Mexican American and White youth. These results would thus seem to suggest that reference data for the body mass index (BMI) based on American White youth can be used with Mexican American youth, while race-specific values may be necessary for American Black youth. However, ethnic variation in physique, perhaps frame size, may be a factor which should be more systematically considered in evaluating the utility of the body mass index.     

Associations between household and neighbourhood socioeconomic status and systolic blood pressure among urban South African adolescents

Factors resulting in high risk for cardiovascular disease have been well studied in high income countries, but have been less well researched in low/middle income countries. This is despite robust theoretical evidence of environmental transitions in such countries which could result in biological adaptations that lead to increased hypertension and cardiovascular disease risk. Data from the South African Birth to Twenty cohort, Bone Health sub-sample (n = 358, 47% female), were used to model associations between household socioeconomic status (SES) in infancy, household/neighbourhood SES at age 16 years, and systolic blood pressure (multivariate linear regression) and risk for systolic pre-hypertension (binary logistic regression). Bivariate analyses revealed household/neighbourhood SES measures that were significantly associated with increased systolic blood pressure. These significant associations included improved household sanitation in infancy/16 years, caregiver owning the house in infancy and being in a higher tertile (higher SES) of indices measuring school problems/environment or neighbourhood services/problems/crime at 16 years of age. Multivariate analyses adjusted for sex, maternal age, birth weight, parity, smoking, term birth, height/body mass index at 16 years. In adjusted analyses, only one SES variable remained significant for females: those in the middle tertile of the crime prevention index had higher systolic blood pressure (β = 3.52, SE = 1.61) compared with the highest tertile (i.e. those with the highest crime prevention). In adjusted analyses, no SES variables were significantly associated with the systolic blood pressure of boys, or with the risk of systolic pre-hypertension in either sex. The lack of association between SES and systolic blood pressure/systolic pre-hypertension at age 16 years is consistent with other studies showing an equalization of adolescent health inequalities. Further testing of the association between SES and systolic blood pressure would be recommended in adulthood to see whether the lack of association persists.     

Assessing the Impacts of Agrobiodiversity Maintenance on Food Security Among Farming Households in Sri Lanka’s Dry Zone

Farmers’ maintenance of agrobiodiversity is fundamental to global food security, particularly in a world increasingly affected by climate change. Biodiversity helps to buffer agroecosystems from stresses like climatic variability, and the crop genetic diversity conserved with biodiverse agroecosystems is critical for plant breeding both locally and globally. Yet, despite these benefits, few studies have directly assessed the implications of household–level agrobiodiversity maintenance on household food security. Drawing on survey data collected in Sri Lanka’s Hambantota District, we evaluated the plant diversity maintained by small–scale farming households in both homegardens and crop fields and determined the relationships between this diversity and their households’ food security. We also considered how a suite of additional demographic, household, community, and farm characteristics relate to both the plant diversity maintained by a household and their food security. Similar to previous studies, the age of the agricultural decision-maker and the age and size of households’ homegardens positively correlated with the overall species richness of farming systems. Older homegardens were also identified to be more evenly distributed in their species abundance, and market–oriented households had significantly higher species richness but lower Shannon Indices. Most notably, household socioeconomic status and material wealth were important to both agrobiodiversity maintenance and household food security, while no significant relationships between species richness and food security measures were detected. These findings suggest that effort aiming to increase the food security of small–scale farming households in Sri Lanka, and elsewhere, should target those farming households with a paucity of socioeconomic assets, as these households lack both agroecological and economic resources to overcome shocks, such as those associated with climate change.     

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.