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.     

Reducing child malnutrition in Tanzania. Combined effects of income growth and program interventions.

Malnutrition is associated with an inadequate diet, poor health and sanitation services and inadequate care for young children. A combination of income growth and nutrition interventions are therefore suggested to adequately tackle this issue [Haddad, L., Alderman, H., Appleton, S., Song, L., Yohannes, Y., 2003. Reducing child malnutrition: how far does income growth take us? World Bank Econ. Rev., 17, 107-131.], yet evidence to support this claim is often not available, especially for African settings. This paper evaluates the joint contribution of income growth and nutrition interventions towards the reduction of malnutrition. Using a four round panel data set from northwestern Tanzania we estimate the determinants of a child's nutritional status, including household income and the presence of nutrition interventions in the community. The results show that better nutrition is associated with higher income, and that nutrition interventions have a substantial beneficial effect. Policy simulations make clear that if one intends to halve malnutrition rates by 2015 (the MDG objective), income growth will have to be complemented by large scale program interventions.     

Nutritional status of adults in rural Mali.

An anthropometric assessment was conducted of 441 adults from six rural villages in southern Mali. As is typical for human populations, females are shorter and lighter than males. Both females (N = 320) and males (N = 121) are shorter and lighter than their U.S. counterparts. Mean weight in the sample is 53.4 +/- 8.5 kilos for females and 58.8 +/- 6.5 kilos for males. Mean height is 160.4 +/- 5.7 cm for females and 171.3 +/- 6.6 cm for males. The data for height in males are very similar to those reported from other surveys in Mali, and show no evidence for a positive secular trend in height. Mean body mass index (BMI) is 20.8 for females and 20.0 for males. These are lower than U.S. averages, but well above suggested cutoff points for malnutrition in adults. Average arm circumference is 26.5 cm for females and 26.4 cm for males. Females have relatively large arm circumferences due, in part, to the heavy manual labor they perform. Average head circumference is 53.0 cm for females and 54.8 cm for males. For both sexes, these values are more than 1 standard deviation (SD) below the U.S. means. Adult values for anthropometric measurements reflect childhood stresses of malnutrition and disease, and a lifetime of accommodation to a high-carbohydrate, low-protein diet, and hard physical labor. Females are significantly closer to the U.S. standards than males for weight, height, BMI, and arm circumference; these findings support the idea that females are buffered from environmental stresses relative to males. In addition, females exhibit significantly more variability than males for weight, arm circumference, and head circumference, but not for height, suggesting that variability in adult height does not reflect the presence or absence of female buffering or the level of environmental adversity.     

Determinants of malnutrition in Senegal: Individual, household, community variables, and their interaction

The relationship between poverty and nutrition is a two-sided one: on the one hand, economic growth (which is generally associated with an eradication of poverty) leads to reduced malnutrition. On the other hand, nutrition is one of the key ingredients for human capital formation, which in turn represents one of the fundamental factors of growth. There are numerous studies that show the correlates of malnutrition using both household- and community-level variables. However, few of these studies allow for the potential endogeneity of community infrastructure or indicate their interplay with characteristics of the mother. The current study considers the socio-economic determinants of child malnutrition and investigates how programs compensate for the increased risks facing young mothers and their children or substitute for a low social status of the mother in the household. The empirical results show that children of mothers giving birth at a young age are disadvantaged in terms of their anthropometric status. Interaction effects of the presence of a non-governmental organization (NGO) or a health post in the village with characteristics of the mother stress the important role played by these institutions in helping disadvantaged mothers overcome their difficulties. These findings have implications for efficient program design and represent a further step towards gaining an improved understanding of the complex determinants of child (mal)nutrition.     

Children’s growth and socio-economic status in Hungary

The Hungarian National Growth Study comprises data on 39,035 children and youth aged 3-18 years. We examine the relationship between 15 body measurements and nine family background variables in this data set. After multiple regression analysis which removed curvilinear age effects, family size and population size of the place of residence showed consistent associations with the body measurements. Children from larger families tended to be shorter on average, and have lower weight and skinfold thicknesses whereas children from Budapest were, on average, taller and heavier than children from elsewhere with bigger chest and calf circumferences and lower skinfold thicknesses. Paternal age, mother's profession and birth order showed few associations with body measurements in both sexes and father's profession did not associate significantly with any of the measurements in boys.     

Urban land rights and child nutritional status in Peru, 2004

Advocates of land-titling programs in developing countries posit that these programs lead to a multitude of benefits, including health improvements. This paper presents the results of a child health survey of several Lima communities after various time exposures to Peru's urban land-titling program. The results provide suggestive evidence that improved property rights increase children's weight but not their height, which is consistent with previous work on the topic. However, titles also appear to raise children's risk of being overweight or obese, implying that the observed weight gain is not necessarily an improvement in nutritional status.     

Infant mortality and child health in Brazil

Child health is a central issue in the public policy agenda of developing countries. Several policies aimed at improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have triggered a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high compared to international standards. Moreover, there is considerable imbalance across Brazilian municipalities suggesting that various policies should be adopted. We investigate the determinants of infant mortality at the municipal level and provide an analysis of the factors affecting child health at the individual level. To analyze the mortality rate, we estimate static and dynamic panel data models using four censuses covering the period from 1970 to 2000. The demand for child health, on the other hand, is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results obtained indicate that a rise in sanitation, education and per capita income contributed to the decline of infant mortality in Brazil, with stronger impacts in the long run than in the short run. The fixed effects associated with county characteristics explain the observed dispersion in child mortality rates. The results from the decision model are confirmed by the findings of the mortality model: education, sanitation and poverty are the most important causes of poor child health in Brazil.     

Child health in rural Colombia: determinants and policy interventions

We study the determinants of child anthropometrics on a sample of poor Colombian children living in small municipalities. We focus on the influence of household consumption, and public infrastructure, taking into account the endogeneity of household consumption using two different sets of instruments: household assets and municipality average wage. We find that both household consumption and public infrastructure are important determinants of child health. We have also found that the coverage of the piped water network positively influenced child health if the parents have some education.     

Height, health, and income in the US, 1984–2005

Height has been associated with better physical health when outcomes such as diabetes, heart disease, and obesity are considered, yet stature is rarely used in predicting comorbidities or as a proxy for physical health when analyzing outcomes such as income. Since height is a more exogenous measure than variables likely to be affected by lifestyle changes, such as obesity, observing labor market outcomes based on height may be revealing. In addition, gender and racial differences must be taken into account when analyzing the effects of height on physical health and labor market outcomes. This study utilizes the 1984--2005 samples of the Behavioral Risk Factor Surveillance System in estimating trends in height over time by gender and race, and in analyzing the relationship between height and physical health and labor market outcomes in the United States. Trends show that height has not changed substantially at a time when physical health, as indicated by the incidence of obesity, Type II diabetes, and cholesterol, has deteriorated, and earnings disparities across racial gaps persist. Results at mean values for males indicate that being 10cm taller is associated with a 14-47% increase in obesity, an 8-13% reduction in cholesterol prevalence, and a $1874-2306 income premium. For females, results indicate that being 10cm taller is associated with an 8-18% reduction in cholesterol, a 14% reduction in diabetes for white females, and an $891-2243 earnings premium.     

Institutions,Biophysical Factors and History: An Integrative Analysis of Private and Common Property Forests in Guatemala and Honduras

Attention to institutional arrangements has become integral to research on forest management and conservation. While strong institutions typically are associated with better forest conditions, few institutional studies have evaluated the influence of underlying biophysical factors on forest conditions. Our research compared institutional arrangements and forest conditions across nine forests in Guatemala and Honduras while accounting for biophysical characteristics. Statistical analyses found that soil nitrogen concentration, annual temperature, and annual rainfall were positively correlated with better forest conditions. Better forest conditions were in turn associated with stronger institutions. In part, the results suggest that the biophysical characteristics most favorable for high productivity, given the socioeconomic context, constitute an incentive for strong institutions. One common-property forest presented strong institutions with very good forest conditions, but stronger institutions and better forest conditions in this region typically occur with private property. The situation reflects historical contexts that have supported private property and undermined common property. The findings indicate that efforts to improve natural resource management should recognize the biophysical factors and historical contexts that facilitate or constrain strong institutions.     

Poverty, health infrastructure and the nutrition of Peruvian children

This paper offers empirical evidence on the impact of the expansion in health infrastructure of the 1990s upon child nutrition in Peru, as measured by the height for age z-score. Using a pooled sample of three rounds of the Peruvian DHS, I have controlled for biases in the allocation of public investments by using a district fixed effects model. The econometric analysis shows a positive effect of the expansion of the last decade in urban areas, but not in rural areas. Furthermore, the effect for urban children is highly non-linear and has a pro-poor bias, in the sense that the estimated effect is larger for children of less educated mothers. These findings support the idea that reducing distance and waiting time barriers is necessary to improve child health and nutrition in developing countries, but that we need more explicitly inclusive policies to improve the health of the rural poor, especially indigenous groups, that are caught in this type of poverty trap.     

Recent growth of children in the two Koreas: A meta-analysis

Height differences between the two Koreas were injected into the U.S. presidential debate. The purpose of this article is to report briefly the height, weight, and body mass index (BMI) differences between North and South Korean children by using previous sources and new data. This study employs South Korean data published by the Korean Research Institute for Standards and Science in 1997 and by the Korean Agency for Technology and Standards in 2004, comparing them to North Korean data stemming from the 1997 and 2002 nutritional surveys conducted by the United Nations. Furthermore, this article makes use of anthropometric measurements of North Korean refugee children immigrating to South Korea from 2000 to 2007. In 1997, South Korean preschool children were found on average to be 6-7 cm (2-3 in.) taller and about 3 kg (6.6 pounds) heavier than their Northern counterparts; in 2002, the average gap was about 8 cm (3 in.) and 3 kg (6.6 pounds), and the BMI gap was about 1. North Korean boys and girls escaping to South Korea were also found to be on average about 3-4 cm (1-1.6 in.) shorter and 1 kg (2.2 pounds) lighter than their Southern peers.     

Cross-sectional growth of young Shipibo Indian children in eastern Peru

This paper reports measurements of weight and recumbent length for a cross-sectional sample of 149 Shipibo infants and children between birth and 35.99 months of age from eight villages in the Peruvian Amazon Basin. The Shipibo are an Amerindian population experiencing a period of local environmental disruption and rapid cultural change. Compared with the National Center for Health Statistics (NCHS) references values, Shipibo children are smaller and shorter than American children. The differences are least at birth. Deficits in linear growth begin between 3 and 6 months of age and continue through 35.99 months of age. Weight-for-length ratios are generally adequate compared to the NCHS values in all age groups. This pattern of growth is similar to that reported for non-Amerindians in many developing countries and is assumed to represent a pattern of growth under mild-to-moderate undernutrition. High infant mortality rates suggest that an interaction of suboptimal nutrition and infectious diseases is contributing to the pattern of growth retardation seen; however, genetic differences cannot yet be discounted.     

Obesity and its socioeconomic determinants in Iran

ObjectiveTo investigate the socioeconomic inequality of obesity and its determinants in Iran.MethodsData was from Iran's surveillance system for risk factors of non-communicable diseases which was conducted on 89,400 individuals aged 15–64 years in 2005. Principal component analysis was used to create a new variable for defining socioeconomic status of participants. We assessed inequality by calculating a slop index of inequality and concentration index for obesity. Oaxaca-Blinder decomposition analysis was used to determine the determinants of inequality.ResultsThe slop index of inequality and concentration index for obesity was −13.1 (95% Confidence Intervals [CI]: −16.3 to −9.8) percentage points and −0.123, respectively. The level of inequality varied widely between different provinces in Iran and was more severe in women and urban population. Obesity persisted in 20.2% (95% CI: 19.4–20.9) of the low-socioeconomic group and 11.0% (95% CI: 10.5–11.6) of the high-socioeconomic group. More than 90% of this gap was due to differences of independent variables (mainly age, gender and marital status) in two socioeconomic status groups.ConclusionsA pro-rich inequality existed in the obesity in Iran. Older age, female gender and rural residency contributed most to the economic inequality of obesity.     

The environmental quality and social justice implications of shrimp mariculture development in Honduras

Development schemes aimed at reducing Central America's social and economic problems historically have stressed intensified exploitation of the region's natural resources through augmented exports of agricultural commodities and forest products, enhanced agricultural productivity, and expanded industrial fisheries. There is plentiful evidence documenting how succeeding waves of export expansion have displaced small farmers from their lands often initiating cycles of repression and violence while also generating or intensifying environmental destruction. This paper explores the environmental quality and social justice implications of the current prevailing development strategy in the region, the promotion of so-called nontraditional exports. Focusing on the expansion of shrimp mariculture in coastal zones along the Gulf of Fonseca, Honduras, it uses political ecological analysis to examine the interconnections among the dominant export-led development model, the policies and actions of the state, the competition among various classes and interest groups, and the survival strategies of an increasingly impoverished population. Analysis suggests that problems of social justice and environmental quality cannot be understood apart from the underlying social structure of the region.     

Growth differences between children of highland and coastal Ecuador

This study examines patterns of growth in height and weight among children (<60 months) of highland and coastal agricultural communities of Ecuador. Highland children are significantly shorter, but not significantly lighter than their coastal peers. Linear growth rates (cm/6 months) are comparable between the two samples. Growth rates for body weight (kg/6 m) are similar in highland and coastal boys, whereas highland girls display larger weight gains than their coastal counterparts. In both regions, linear growth is compromised to a much greater extent than growth in body weight, and growth faltering for both height and weight is most pronounced between birth and 24 months of age. The similarity in growth rates between the highland and coastal samples suggests that high altitude hypoxia plays a relatively small role in shaping growth during the first five years after birth. Rather, it appears that most of the disparity in height between the two samples can be attributed to differences established by 6 months of age. The pattern of growth retardation seen in both regions during the first 24 postnatal months is similar to that observed among impoverished populations throughout the world and is likely associated with the influence of nutritional and disease stressors. After 2 years of age, little or no “catch up” growth is seen in height, whereas improvements in weight gain are more pronounced, especially among highland girls. Ongoing research is investigating the nutritional and socio-economic correlates of growth within each region. © Wiley-Liss, Inc.     

Human capital, wealth, and nutrition in the Bolivian Amazon

We analyze anthropometric variables of a society of forager-horticulturalists in the Bolivian Amazon (Tsimane') in 2001-2002. Community variables (e.g., inequality, social capital) explain little of the variance in anthropometric indices of nutritional status, but individual-level variables (schooling, wealth) are positively correlated with nutritional status. Dietary quality (foods high in animal proteins), access to foraging technology, and traditional knowledge of medicinal plants are related to better anthropometric indices.     

Gene flow and variation in stature and craniofacial dimensions among indigenous populations of southern Mexico, Guatemala, and Honduras

Populations with histories of outbreeding tend to be taller even in the face of seemingly unchanged health and nutritional circumstances, while inbreeding generally results in a negative correlation between body dimensions and level of inbreeding. Populations that have experienced a positive secular trend in stature and maturation typically have histories of higher outbreeding rates in combination with improved nutritional, health, and economic conditions, suggesting a genetic-environment interaction. In general, Middle American Indians have not experienced a secular trend in stature, nor a substantial increase in their standard of living, but they have experienced varying degrees of admixture with Spanish and African populations since the Spanish Conquest. The relationship between estimated gene flow and variation in several anthropometric dimensions is thus considered in indigenous Mesoamerican populations. Available data on height, sitting height, craniofacial dimensions, and admixture rate of Indian populations from southern Mexico, Guatemala, and Honduras were assembled from the literature. The population mean data on 3,371 adults from 23 populations for males and 18 for females were analyzed by regression with anthropometry as the dependent variable, and log10 of admixture as the independent variable. Admixture was less than or equal to 28.9% in this study and is suggestive of a primarily traditional Indian cultural and economic base. The results suggest that populations with higher admixture tend to be taller, and that the increase in stature is due to greater subischial length in both sexes. A decrease in nasion-menton height, and an increase in nasal breadth, nasal height, and the nasal index is suggested for the dimensions of the craniofacial complex.(ABSTRACT TRUNCATED AT 250 WORDS)     

鄂西青少年体质发育初步研究

目前,研究青少年体质发育的方法较多,作者试图用逐步回归分析法对此作些研究。 按照我国正常儿童青少年体格发育调查研究实施方案(儿童体格发育调查研究工作学习班,1976)和活体测量方法(黄新美,1983)的有关规定,对鄂西7—17岁的1533名青少年(男863人,女670人)进行了直接测量:1.身高;2.体重;3.上肢长;4.下肢长(由地面至大转子尖的距离)(靳仕信,1981);5.上半身长(身高—下肢长);6.上半身长与下肢长的比值。以上各项均值和标准差见表1.另外,还计算了下肢长指数（下肢长/身高×100）和上半身长指数（上半身长/身高×100）。将以上数据按性别、年龄逐个输入AppleII电子计算机（Basic语言）,对数据进行分析处理,用回归分析法（上海第二医学院数学教研室,1979;杨树勤,1985）分析青少年体重的变化与年龄、身高等七个因素的相关关系（见表2）,并对已进入方程式中的各项指标进行反复检查,最后,建立了推算青少年体重变化与年龄、身高的多元回归方程。