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Abdominal Circumference Contributes to Absence of Wasting in Brazilian Children^1,2,

Juraci A. César³, Cesar G. Victora^*, Saul S. Morris^*,, and Cora A. Post^*

Departamento Materno-Infantil, Universidade do Rio Grande, 96202-900 Rio Grande RS, Brazil ^* Departamento de Medicina Social, Universidade Federal de Pelotas, 96030-002 Pelotas RS, Brazil Maternal and Child Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK

A number of population groups in Latin America show high prevalences of stunting (low height-for-age) despite very low rates of wasting (weight-for-height deficits). One possible explanation for this phenomenon is an increase in abdominal circumference, which would affect children's weights but not their heights. This study was designed to describe the abdominal circumferences of a group of poor children from Northeast Brazil, and to relate these to their weight-for-weight z-score. Children (n = 252) participating in a government growth monitoring program were studied. The prevalence of stunting (below -2 SD) was 26.2%, but only 1.2% were wasted. Abdominal circumferences increased with age up to 36 mo, followed by a slight decline after 48 mo. Abdominal circumference was the anthropometric measurement most closely associated with weight-for-height, with a coefficient of determination of 41%. Even after adjusting for arm circumference, abdominal circumference continued to explain 16% of the variation in weight-for-height. Despite slight differences in measurement techniques, the study children had consistently larger abdominal girths than a sample of North American children. These findings must be verified by replication but highlight a possible contribution of abdominal circumference in the determination of levels of wasting.

KEY WORDS: • abdominal circumference • malnutrition • wasting • preschool children • Brazil

¹ Financial support for this study was provided by UNICEF, Brazil.

² The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

³ To whom correspondence should be addressed.

Manuscript received 3 April 1996. Revision accepted 2 July 1996.