The low prevalence of weight-for-height deficits in Brazilian children is related to body proportions

Compared with children from other regions Latin American children living in poverty have much lower prevalences of weight-for-height deficits than would be expected given the observed rates of stunting. This study was aimed at investigating whether variations in body proportions, particularly abdominal circumference, could explain this paradoxical finding. In a cross-sectional study, children aged 12-35 mo (n = 197) were studied in Southern Brazil. Half of these children were from a high socioeconomic status (SES) group whose growth closely resembled that of the National Center for Health Statistics (NCHS)/WHO reference; the other half were from low income families. The following 11 anthropometric measurements were collected: weight, height, sitting height/crown-rump length, head, chest, upper arm and abdominal circumference, triceps, biceps, subscapular and suprailiac skinfolds. These measures were compared between the two groups of children and with values for North American children [mostly from Second National Health and Nutrition Examination Survey (NHANES II)]. For nearly all measures, low SES Brazilian children tended to be smaller than both high SES and North American children. However, when body proportionality was assessed by dividing the measurements by the child's height, these differences tended to disappear or even to change direction, as was the case for head, chest and abdominal circumferences. Mean abdominal circumference was virtually identical between low and high SES children, and the former had larger abdomens for a given height. Despite slight differences in measuring techniques, Brazilian children had larger abdomens than North Americans. These findings may explain in part why deprived Latin American children have higher weights for their height compared with the NCHS/WHO reference.