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PEDIATRICS Vol. 113 No. 3 March 2004, pp. e270-e275

ELECTRONIC ARTICLE

Comparison of Linear Growth Patterns in the First Three Years of Life Across Two Generations in Guatemala

Aryeh D. Stein, MPH, PhD*, Huiman X. Barnhart, PhD{ddagger}, Meng Wang, MD*, Moshe B. Hoshen, PhD§, Karen Ologoudou, BS||, Usha Ramakrishnan, PhD*, Ruben Grajeda, MD, MPH, Manuel Ramirez-Zea, MD, PhD and Reynaldo Martorell, PhD*

* Department of International Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
{ddagger} Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
§ Liverpool School of Tropical Medicine, Liverpool, United Kingdom
|| Graduate Program in Nutrition and Health Sciences, Emory University, Atlanta, Georgia
Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala

Objective. The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is not known whether these improvements have an impact on the growth of subsequent generations. Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother’s early childhood.

Methods. We studied 283 mother–child pairs (mothers born 1969–1977; children born 1996–1999). The mothers had received nutritional supplementation—either atole (enhanced protein-energy) or fresco (moderate energy, no protein), with both containing vitamins and minerals—prenatally and up to age 7 y as part of a community trial conducted in 4 villages in Guatemala. Length was measured on repeated occasions to 36 months of age in both mothers and children. Growth was modeled as a fractional polynomial.

Results. Children grew faster than their mothers. Children of mothers who received atole grew faster than children of women who received fresco. In both groups, lengths of individual children were positively correlated with lengths of their own mothers at the same ages. Correlations were generally stronger when the mothers had received atole in early life.

Conclusion. We have confirmed a secular trend in growth of children in a developing country setting. The rate of child growth reflects, in part, the growth pattern of the mother, including improvements to that pattern resulting from nutritional supplementation.

Key Words: children • energy • Guatemala • growth • intergenerational effects • nutrition • protein • supplementation

Abbreviations: SD, standard deviation

Received for publication Jul 14, 2003; Accepted Dec 1, 2003.




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