Intergenerational factors that shape the nutritional status of urban Maya households in Merida, Mexico. A 3-generations study.

Background. The Maya are one of the largest Mesoamerican groups. The decline of the classic Maya society, the subsequent Colonial domination and the current national economic policies has had a severe biological and social impact on the Maya across several generations. Accumulated evidence suggests that conditions and environments experienced by one generation can affect the health, growth and development of the next generation (Emanuel, 1986). Historical evidence of political, educational and socioeconomic deprivation suffered by the Maya from Yucatan, Mexico, provides us with the opportunity to test the intergenerational influence hypothesis and ascertain the impact of the biosocial background of urban Maya grandmothers (first generation) and mothers (second generation) on the growth and nutritional status of their children (third generation). Aims. The main objective is to assess the impact of socioeconomic and intergenerational factors on the growth of Maya children, in a sample of children, their mothers and maternal grandmothers. The specific objectives are: 1) to assess the nutritional status and nutritional dual burden prevalence in participants, 2) to identify the pre and postnatal biosocial and economic factors that relate to the nutritional status of the children, and 3) to assess the intergenerational influences on the growth of participants: from grandmothers to mothers and from grandmothers and mothers to children. Methods. The sample is composed of 109 triads of Maya children (6-8 years old), their mothers and their maternal grandmothers from the city of Merida, Yucatan, Mexico. From September 2011 to June 2012 we collected anthropometric, body composition and socioeconomic data on the three generations. We also assessed parameters about living conditions of maternal and grand-maternal childhood. Nutritional status was assessed by comparing the participants against the Comprehensive Growth References published by Frisancho (2008) and based on the NHANES III. Pre and postnatal biosocial and economic factors were analysed through multiple regression models. Intergenerational influences were assessed through: 1) bivariate and partial correlations in anthropometric and derived variables between participants, 2) path analysis to identify the direction and magnitude of direct and indirect causal effects between the three generations, and 3) multiple regression models to identify the effect of anthropometric and socioeconomic intergenerational factors on the growth of mothers and children. Results. Eleven percent of the children were categorized as stunted and 36% met the criteria of risk for abdominal obesity. Only 1% of children exhibited the combination of stunting and abdominal obesity. Mothers and grandmothers showed very low average heights and high levels of abdominal obesity. The combination of maternal abdominal obesity and child stunting was present in the 6% of mother-child dyads. It was found that preeclampsia and cigarette smoke exposure during pregnancy and household overcrowding impacted negatively the linear growth of the children. Maternal education and the presence of grandmothers at home predicted healthier values of BMI, waist circumference, body fat and body lean mass percentages on children. Maternal height and leg length (LL = height sitting height) were positively associated with the linear growth of children. These associations were not modified by the grand-maternal size, in terms of very short stature. In contrast, associations in weight, body mass index, sum of skinfolds and fat mass were stronger in grandmother-child pairs than in mother-child pairs. The birth weight of the children was positively associated with maternal head circumference and negatively associated with the absence of a toilet at home during maternal childhood (i.e. when the mother was growing up). Grand-maternal intergenerational predictors of children s height, leg length, body mass index, waist circumference and skinfolds were: index of household characteristics, family size and school attendance during childhood. Family size and paternal job loss during maternal childhood were the maternal intergenerational factors that influenced significantly the body mass index, waist circumference and skinfolds of children. Conclusions. Growth and nutritional status of the children, mothers and grandmothers reflect the effects of chronic deprivation and poverty that are a constant among the Maya in the Yucatan. Under and-overnutrition coexisted in this sample of three generations. Pre-and-postnatal biosocial and economic factors impacted the growth and nutritional status of children. Harsh living conditions experienced by mothers and grandmothers during their childhood influenced the prenatal and postnatal growth of children. We suggest that disadvantaged conditions experienced by mothers and grandmothers during their first years of life impacted their own growth and this in turn is influencing the growth of children of the third generation. Substantial reductions in poverty levels and increase educational levels of the mothers are required to overcome the intergenerational traces on the future generations

Caesarean birth and adiposity parameters in 6- to 8-year-old urban Maya children from two cities of Yucatan, Mexico

Objectives The purpose of this study was to analyze the association between birth mode and fat mass index (FMI = fat mass [kg]/height [m]2), and z‐score values of waist circumference (WCZ) and sum of triceps and subscapular skinfolds (SumSkfZ) in a sample of 256 6‐ to 8‐year‐old urban Maya children from the cities of Merida and Motul in Yucatan, Mexico. Methods From September 2011 to January 2014, we measured height, weight, waist circumference and skinfolds in children, and height and weight in their mothers. Body composition was estimated in both generations through bioelectrical impedance analysis. Data on children's birth mode and birth weight were obtained from birth certificates. A pre‐validated questionnaire for mothers was used regarding household living conditions. Multiple regression models were used to analyze the association between birth mode and adiposity parameters, adjusting for the effect of place of residence, household crowding index, children's birth weight, and maternal fat mass. Separate regression models were run for boys and girls. Results Caesarean‐born children comprised 43% of the entire sample. Caesarean section (CS) was found to be associated with higher values of body adiposity in girls, but not in boys. Specifically, our models predicted that girls born by CS had an increased value of 0.817 kg/m2 in FMI and showed higher SDs values for WCZ and SumskfZ (0.29 and 0.32 SD, respectively) than girls who were delivered vaginally. Discussion Our results support the hypothesis that CS is associated with increased levels of adiposity in childhood, but only in girls

Body mass index in mother and child dyads and its association with household size and parents’ education in 2 urban settings of Yucatan, Mexico

Background: Overweight/obesity (OW/OB) coexists in mother-child dyads. However, dearth of evidence on the factors associated with this phenomenon calls for research. Objective: To analyze the association of sociodemographic factors with OW/OB in a sample of 260 Maya mother-child dyads from Yucatan, Mexico. Methods: During 2011-2014 we measured height and weight in children and their mothers and calculated their body mass index (BMI). The OW/OB cut-off points were defined, for mothers, as having a BMI >25kg/m2 and, for children, as having a BMI-for-age >2SD of the World Health Organization references. Mother-child dyads were grouped according to their BMI status: 1) normal weight mother and child, 2) normal weight mother and OW/OB child, 3) OW/OB mother and normal weight child, and 4) OW/OB mother and child. A multinomial logistic regression model was used to analyze the interrelationships among BMI status in mother-child dyads, household size and parental education. Results: OW/OB coexisted in 40% of dyads. Compared to normal weight dyads (1), each unit increase in household size and in years of maternal education decreased the risks for the coexistence of OW/OB in motherchild dyads (OR=0.72, 95% IC 0.55-0.94, P=0.015; OR=0.70, 95% IC 0.52-0.94, P=0.019, respectively). Conversely, each year increase in paternal education increased the risk for OW/OB in dyads (OR=1.47, 95% CI 1.08-1.99, P=0.015). Conclusions: Results suggest that household size and parental education contribute to shape BMI-based nutritional status in this sample of mother-child dyads. A higher level of maternal education acts as a protective factor against OW/OB in mothers and children

Caesarean birth and adiposity parameters in 6‐to 8 year‐old urban Maya children from two cities of Yucatan, Mexico [Abstract]

Caesarean birth and adiposity parameters in 6‐to 8 year‐old urban Maya children from two cities of Yucatan, Mexico [Abstract

The effects of short-stature-for-age on cardiovascular and metabolic health in children: a systematic review.

Short stature has been associated with coronary heart disease in adults (Paajanen et al, 2010), but similar effects have not been established in children. We aim to identify cardiovascular and metabolic health indicators that are associated with height-for-age in children. These consist of any measures of cardiovascular health and metabolic syndrome such as, but not limited to: abdominal obesity; atherogenic dyslipidaemia; hypertension; hyperglycaemia; insulin resistance; body-mass-index, height-adjusted fat mass, pulse rate, insulin-resistance, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and structural and electrical cardiac dysfunction

Globalization and children’s diets: the case of Maya of Mexico and Central America

Globalization is, in part, an economic force to bring about a closer integration of national economies. Globalization is also a biological, social and ideological process of change. Globalization results in powerful multinational corporations imposing their products on new markets. Food globalization brings about nutritional transitions, the most common being a shift from a locally-grown diet with minimally refined foods, to the modern diet of highly processed foods, high in saturated fat, animal products and sugar, and low in fiber. This paper will examine the influences of food globalization using the Maya of Mexico as a case study. The Maya people of Mexico are a poignant case. Maya health and culture has deteriorated as a result, with highly processed foods affecting physical growth and health of Maya children and their families. The case of the Maya is not isolated and we must come to terms with food globalization if we are to translate research into better child health and well-being

Effects of stunting on body composition, biological age, and muscle strength of Maya and Ladino children in Guatemala [Poster]

Effects of stunting on body composition, biological age, and muscle strength of Maya and Ladino children in Guatemala [Poster

Birth weight and body composition in 6-to-8 years old Maya children

Objective: To test the hypothesis that fetal growth, indexed by birth weight (BW), induce metabolic adjustments in the fetus that will be reflected in differences in body composition in a sample of 6-to 8-years old urban Maya children from Yucatan, Mexico.Methods: We measured height (cm), weight (kg) and triceps skinfold (mm) in 260 children (boys: 132, girls: 128), and height (cm) and weight (kg) in their mothers. Body composition was estimated in children through bioelectrical impedance analysis. Outcome variables were fat free-mass index (FFMI= fat-free mass [kg]/height [m]2) and fat mass index (FMI= fat mass [kg]/height [m]2). The main independent variable was BW z-scores. Multiple linear regression models were used to analyze the association between BW z-scores and outcome variables measured during childhood. Separate analyses were done for boys and girls. Complementary models were run using outcomes as z-scores. Models were adjusted for location, children’s and mothers’ age, mother’s body mass index and household overcrowding index. Results: BW in boys was positively associated with FFMI and FMI. FFMI increase 0.34 kg/m2 per 1-SD increase in BW and FMI increase 0.40 kg/m2 per 1-SD increase in BW. When outcomes were used as z-scores, FFMI increase 0.24 SD and FMI increase 0.18 SD per 1-SD increase in BW, respectively. Conclusion Our results are in contrast with previous findings that birth weight is more consistently associated with subsequent lean mass than with fat mass. Associations, detected only in boys, may be explained by sex differences in sensitivity to early life environments. </div

Maternal grandmothers’ household residency, children’s growth, and body composition are not related in urban Maya families from Yucatan

Purpose: To analyze the influence of grandmothers’ household residency on the presence of low height-for-age and excessive fat mass index (FMI=fat mass [kg]/height [m]2), waist circumference-for-age and sum of triceps and subscapular skinfold-for age of grandchildren in a sample of 247 6 to 8-year-old urban Maya children from Yucatan, Mexico.Methods: From September 2011 to January 2014, we obtained anthropometric and body composition data from children and mothers, as well as socioeconomic characteristics of participants and households. Place of residence of grandmothers was used to define the geographical proximity between them and their grandchildren and was set into two categories: 1) households with grandmothers at home (n=71), 2) and households without grandmothers at home (n=176). Multiple logistic regression models were used to analyze the association between grandmothers’ household residency and outcome variables. Models were adjusted for maternal anthropometric characteristics and socioeconomic variables: family size, location, maternal education, monthly family income and household crowding status.Results: Models showed that the presence of grandmothers’ at their grandchildren’s household was not associated with any of the outcome variables. In contrast, larger family size, overcrowding in the household and lower family income predicted low height-for-age in children. Larger family size decreased the risk for overweight based on the three parameters of body composition, but overcrowding in the household increased the risk for greater skinfolds thickness, while low family income increased the risk for greater fat mass index. Conclusion: The residency of grandmothers to their adult daughters’ household is not significantly associated with the outcome variables in this sample of urban Maya families. Instead, maternal anthropometric characteristics and socioeconomic conditions of the family have a greater influence on the overall growth of children.</div

Intergenerational influences on the growth of Maya children: The effect of living conditions experienced by mothers and maternal grandmothers during their childhood

Objectives: To test the hypothesis that living conditions experienced by maternal grandmothers (F1 generation) and mothers (F2 generation) during their childhood are related to height and leg length (LL: height2sitting height) of their 6-to-8 year old children (F3 generation). Methods: From September 2011 to June 2012 we obtained height and LL, and calculated z-score values of these measurements for 109 triads (F1, F2, F3) who are Maya living in Merida, Yucatan, Mexico. Multiple regression models were adjusted to examine the relation of anthropometric and intergenerational socioeconomic parameters of F1 (house index and family size during childhood) and F2 (paternal job loss during childhood) with the z-score values of height and LL of F3. Results: Children’s height and LL were positively associated with maternal height and LL. This association was relatively stronger in LL. Better categories of grand-maternal house index were significantly associated with higher values of height and LL in grandchildren. Grand-maternal family size was positively related with LL, but not with height. Conclusions: Our findings partially support the hypothesis that living conditions experienced by recent maternal ancestors (F1 and F2) during their growth period influence the growth of descendants (F3). Results suggest that LL is more sensitive to intergenerational influences than is total height and that the transition from a traditional rural lifestyle to urban conditions results in new exposures for risk in human physical growth