Abstract
Objective:
To assess the coexistence of maternal adiposity and child stunting (CS) in Mexico, estimate its national prevalence and identify the associated socio-demographic factors.
Methods:
A secondary analysis from the Mexican Nutrition Survey 1999, a nationally representative survey, was conducted. Mother and children subsamples were matched and a total of 6225 mother/child pairs were obtained. Stunting was defined as height-for-age z-scores <−2.0. Maternal body mass index (BMI) was classified according to World Health Organization recommended cutoff points. Waist-to-hip ratio (WHR) was calculated by dividing waist by hip circumferences. Logistic regression models were fitted to explore the coexistence of CS and maternal central adiposity (MCA) (WHR⩾0.85) while controlling for biological and socio-demographic factors.
Results:
A total of 5974 pairs had complete information. MCA coexisted with CS in 6.2% of the mother/child pairs. The phenomenon was more prevalent in rural locations, in the south region and among indigenous families (14.5, 12.5 and 23.9%). After controlling for child age and maternal BMI, a 78% increase in the likelihood of CS was related to maternal WHR ⩾0.85 (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.53, 2.10). After controlling for maternal height, the magnitude of the OR decreased (OR=1.33, 95%CI=1.13, 1.57), but remained significant. Therefore, it is suggested that women with a WHR ∼1 have had twice the probability of having a stunted child as those with a WHR of 0.65.
Conclusion:
Although MCA and CS are two conditions frequently regarded as result of opposite determinants, our observation suggests that this is not necessarily the case, particularly in populations undergoing the nutrition transition. MCA was associated not only to chronic diseases, but also to child stunting.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
References
Popkin B, Richards M, Monteiro C . Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 1996; 126: 3009–3016.
Garret J, Ruel M . Stunted Children–overweight Mother Pairs: An Emerging Policy Concern?. International Food Policy Research Institute: Washington DC, 2003, pp. 1–22.
Sawaya A, Dallal G, Solymos G, de SM, Ventura M, Roberts S et al. Obesity and malnutrition in a Shantytown population in the city of Sao Paulo, Brazil. Obes Res 1995; 3 (Suppl 2): 107s–115s.
Omran AR . The epidemiologic transition. A theory of the epidemiology of population change. Milbank Meml Fund Q 1971; 49: 509–538.
Anonymous. The epidemiologic transition theory. A preliminary update. J Trop Pediatr 1983; 29: 305–316.
Popkin B . Understanding the nutrition transition. Urban Health Newslett 1996; 30: 3–19.
Anonymous. Nutrition transition and obesity in the developing world. J Nutr 2001; 131: 871S–873S.
Doak C, Adair L, Monteiro C, Popkin B . Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr 2000; 130: 2965–2971.
Peña M, Bacallao J . Obesity among the Poor: An Emerging problem in Latin America. In: Peña M, Bacallao J (eds). Obesity and Poverty. A New Public Health Challenge. PAHO: Washington, DC, 2000, pp 3–11.
Monteiro C, Moura E, Conde W, Popkin B . Socioeconomic status and obesity in adult populations of developing countries: a review. Bull WHO 2004; 82: 940–946.
Barker DJ . Intrauterine programming of adult disease. Mol Med Today 1995; 1: 418–423.
Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM . Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 1993; 36: 62–67.
Barker DJ, Osmond C, Simmonds SJ, Wield GA . The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ 1993; 306: 422–426.
Hales CN, Barker DJ . Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 1992; 35: 595–601.
Phillips DI, Barker DJ, Hales CN, Hirst S, Osmond C . Thinness at birth and insulin resistance in adult life. Diabetologia 1994; 37: 150–154.
Hoffman D, Roberts S, Verreschi I, Martins P, de NC, Tucker K et al. Regulation of energy intake may be impaired in nutritionally stunted children from the shantytowns of Sao Paulo, Brazil. J Nutr 2000; 130: 2265–2270.
Sawaya A, Roberts S . Stunting and future risk of obesity: principal physiological mechanisms. Cad Saude Publica 2003; 19 (Suppl 1): S21–S28.
Rivera-Dommarco JA, Monterrubio EA, González-Cossío T, García-Feregrino R, García-Guerra A, Sepúlveda-Amor J . Nutritional status of indigenous children younger than five years of age in Mexico: results of a national probabilistic survey. Salud Pública de Mexico 2003; 45: s466–s476.
Rivera J, Barquera S, Gonzalez-Cossio T, Olaiz G, Sepulveda J . Nutrition transition in Mexico and other Latin American countries. Nutr Rev 2004; 62: s1–s9.
Rivera-Dommarco J, Barquera S, Campirano F, Campos-Nonato I, Safdie M, Tovar V . The epidemiological and nutritional transition in mexico: rapid increase of non-communicable chronic diseases and obesity. Publ Health Nutr 2002; 14: 113–122.
Rivera J, Shamah T, Villalpando S, Gonzalez-Cossio T, Hernandez B, Sepulveda J . Encuesta Nacional de Nutrición 1999: Estado nutricio de niños y mujeres en México. Instituto Nacional de Salud Pública, Secretaría de Salud., Cuernavaca, Morelos 2000.
Olaiz G, Rojas R, Barquera S, Shamah T, Aguilar C, Cravioto P et al. Encuesta Nacional de Salud 2000. Tomo 2. La salud de los adultos. Instituto Nacional de Salud Pública (ISBN 968-6502-72-6), Cuernavaca, Mor. 2003.
Hernandez-Diaz S, Peterson K, Dixit S, Hernandez B, Parra S, Barquera S et al. Association of maternal short stature with stunting in Mexican children: common genes vs common environment. Eur J Clin Nutr 1999; 53: 938–945.
Sawaya A, Martins P, Hoffman D, Roberts S . The link between childhood undernutrition and risk of chronic diseases in adulthood: a case study of Brazil. Nutr Rev 2003; 61: 168–175.
Monteiro C, Conde W, Popkin B . Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil. Pub Health Nutr 2002; 5: 105–112.
Popkin B . The shift in stages of the nutrition transition in the developing world differs from past experiences!. Pub Health Nutr 2002; 5: 205–214.
Colditz G, Willett W, Rotnitzky A, Manson J . Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995; 122: 481–486.
Brook R, Bard R, Rubenfire M, Ridker P, Rajagopalan S . Usefulness of visceral obesity (waist/hip ratio) in predicting vascular endothelial function in healthy overweight adults. Am J Cardiol 2001; 88: 1264–1269.
Dalton M, Cameron A, Zimmet P, Shaw J, Jolley D, Dunstan D et al. Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med 2003; 254: 555–563.
Yajnik CS . The lifecycle effects of nutrition and body size on adult adiposity, diabetes and cardiovascular disease. Obes Rev 2002; 3: 217–224.
Martorell R, Stein A, Schroeder D . Early nutrition and later adiposity. J Nutr 2001; 131: 874S–880S.
Habicht J, Martorell R, Yarbrought C, Malina R, Klein R . Height and weight standards for pre-school children. Lancet 1974; 2: 611.
Resano-Perez E, Mendez-Ramirez I, Shamah-Levy T, Rivera J, Sepulveda-Amor J . Methods of the National Nutrition Survey 1999. Salud Publica Mex 2003; 45 (Suppl 4): S558–S564.
Lohman T, Roche A, Martorell R . Anthropometric Standardization Reference Manual. Human Kinetics Books: Champaign, IL, 1988.
NCHS. NCHS Growth Curves for Children Birth–18y. National Center for Health Statistics, Centers for Disease Control – US Government Printing Office: Washington, DC, 1978.
Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R et al. Centers for disease control and prevention 2000 Growth charts for the United States: Improvements to the 1977 National Center for Health Statistics Version. Pediatrics 2002; 109: 45–60.
World Health Organization. An evaluation of infant growth: the use and interpretation of antropometry in infants. Bull WHO 1995; 73: 165–174.
Anonymous. Physical Status: The Use and Interpretation of Anthropometry. World Health Organization: Geneva, 1995.
Hodge AM, Zimmet PZ . The epidemiology of obesity. Bailliere Clin Endocrinol Metab 1994; 8: 577–599.
Seidell J, Kahn H, Williamson D, Lissner L, Valdez R . Report from a Centers for Disease Control and Prevention workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr 2001; 73: 123–126.
Berber A, Gómez-Santos R, Fanghänel G, Sánchez-Reyes L . Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dislipidaemia in a Mexican population. Int J Obes Relat Metab Disord 2001; 25: 1794–1799.
Rivera J, Monterrubio E, Gonzalez-Cossio T, Garcia-Feregrino R, Garcia-Guerra A, Sepulveda-Amor J . Nutritional status of indigenous children younger than five years of age in Mexico: results of a national probabilistic survey. Salud Publica Mex 2003; 45 (Suppl 4): S466–S476.
Rivera J, Sepulveda AJ . Conclusions from the Mexican National Nutrition Survey 1999: translating results into nutrition policy. Salud Publica Mex 2003; 45 (Suppl 4): S565–S575.
Diggle P, Liang K, Zeger S . Analysis of Longitudinal Data. Oxford University Press: New York, 1994.
Kleinbaum D, Kupper L, Muller K, Nizam A . Applied Regression Analysis and Other Multivariable Methods, 3rd edn. Brooks/Cole Publishing Company: Pacific Grove, CA, 1998.
SPSS. SPSS for Windows. Release 10.0.0. SPSS Inc: Chicago, 1999.
Stata Corp. Stata Reference Manual. Release 7. Stata Press: College Station, TX, 2001.
Martins I, Marinho S . The potential of central obesity antropometric indicators as diagnostic tools. Rev Saude Publica 2003; 37: 760–767.
Doll S, Paccaud F, Bovet P, Burnier M, Wietlisbach V . Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries. Int J Obes Relat Metab Disord 2002; 26: 48–57.
Ko G, Chan J, Woo J, Lau E, Yeung V, Chow C et al. Simple anthropometric indexes and cardiovascular risk factors in Chinese. Int J Obes Relat Metab Disord 1997; 21: 995–1001.
Ito H, Nakasuga K, Ohshima A, Maruyama T, Kaji Y, Harada M et al. Detection of cardiovascular risk factors by indices of obesity obtained from anthropometry and dual-energy X-ray absorptiometry in Japanese individuals. Int J Obes Relat Metab Desord 2003; 27: 232–237.
Ghosh A, Bose K, Chakravarti S, Chaudhuri A, Chattopadhyay J, Dasgupta G et al. Central obesity and coronary risk factors. J Roy Soc Health 2004; 124: 86–90.
Silventoinen K, Jousilahti P, Vartiainen E, Toumilehto J . Appropriateness of anthropometric obesity indicators in assessment of coronary heart disease risk among Finnish men and women. Scand J Pub Health 2003; 31: 283–290.
Barquera S, Tovar-Guzman V, Campos-Nonato I, Gonzalez-Villalpando C, Rivera-Dommarco J . Geography of diabetes mellitus mortality in Mexico: an epidemiologic transition analysis. Arch Med Res 2003; 34: 407–414.
Reeder B, Senthilselvan A, Despres J, Angel A, Liu L, Wang H et al. The association of cardiovascular disease risk factors with abdominal obesity in Canada. Can Med Assoc J 1997; 157: s39–s45.
Jia W, Lu J, Xiang K, Bao Y, Lu H, Chen L . Prediction of abdominal visceral obesity from body mass index, waist circumference and waist-hip ratio in Chinese adults: receiver operating characteristic curves analysis. Biomed Environ Sci 2003; 16: 206–211.
Chien L, Liou Y, Chen J . Association between indices of obesity and fasting hyperglycemia in Taiwan. Int J Obes Relat Metab Disord 2004; 28: 690–696.
Ho S, Chen Y, Woo J, Leung S, Lam T, Janus E . Association between simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat Metab Disord 2001; 25: 1689–1697.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Barquera, S., Peterson, K., Must, A. et al. Coexistence of maternal central adiposity and child stunting in Mexico. Int J Obes 31, 601–607 (2007). https://doi.org/10.1038/sj.ijo.0803529
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0803529
Keywords
This article is cited by
-
Examining the relationship between socioeconomic status and the double burden of maternal over and child under-nutrition in Bangladesh
European Journal of Clinical Nutrition (2019)
-
Transition of the BMI distribution in India: evidence from a distributional decomposition analysis
Journal of Bioeconomics (2019)
-
Association of the Familial Coexistence of Child Stunting and Maternal Overweight with Indigenous Women in Guatemala
Maternal and Child Health Journal (2017)
-
The nutrition transition in Colombia over a decade: a novel household classification system of anthropometric measures
Archives of Public Health (2015)
-
Caloric beverage consumption patterns in Mexican children
Nutrition Journal (2010)