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Community and International Nutrition

Height for Age Increased While Body Mass Index for Age Remained Stable between 1968 and 2007 among Guatemalan Children^1,2

³ Hubert Department of Global Health, Rollins School of Public Health and ⁴ Department of Sociology, Emory University, Atlanta, GA 30322; ⁵ Division of Nutrition and Food Consumption, International Food Policy Research Institute, Washington DC 20006; and ⁶ Institute of Nutrition of Central America and Panama, 01011 Guatemala City, Guatemala

Promotion of optimal growth while preventing the emergence of obesity in childhood requires an understanding of the dynamics over time of linear growth and weight for height. To assess long-term secular trends in height-for-age and BMI for age in children <6 y old, we analyzed a series of cross-sectional surveys conducted between 1968 and 2007 in 4 villages in eastern Guatemala. We used height and weight of children <6 y old (n = 507, 606, 627, 704, 526, and 502 for survey years 1968, 1972, 1977, 1988, 1997, and 2005–7, respectively) to compute height-for-age Z-score (HAZ) and BMI-for-age Z-score (BMIZ) based on WHO growth standards. HAZ was –2.73 ± 1.12 (mean ± SD) in 1968 and –1.16 ± 1.16 in 2005–7 (P < 0.001). The prevalence of stunting (HAZ <–2.0) was 73.0% in 1968 and 23.1% in 2005–7 (P < 0.001). Among children 57–63 mo old, HAZ in 2005–7 was 1.20 (95% CI, 0.79, 1.62) SD units higher than in 1968, corresponding to 5.6 cm in boys and 5.7 cm in girls. For all survey years except 2007, BMIZ increased through age 36 mo, then declined; for the 2005–7 sample, BMIZ did not vary by age. The prevalence of BMIZ >1.00 was 21.1% in 1968 and 19.6% in 2005–7 (P > 0.05); for BMI <–1.00, the respective prevalences were 7.9% and 5.2% (P > 0.05). There have been long-term improvements in child growth, as measured by HAZ, without concurrent increases in BMI over successive generations of children.

^* To whom correspondence should be addressed. E-mail: aryeh.stein{at}emory.edu.

Manuscript received 13 August 2008. Initial review completed 19 September 2008. Revision accepted 15 November 2008.

Published online 12 December 2008.