Inequalities in adiposity trends between 1979 and 1999 in Guatemalan children

William Johnson*, Liina Mansukoski, J. Andres Galvez-Sobral, Luis Furlán, Barry Bogin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Guatemala suffered from civil war and high levels of inequality and childhood stunting in the second half of the 20th century, but little is known about inequalities in secular trends in adiposity.

OBJECTIVES: To investigate differences in childhood body mass index (BMI) and skinfold thickness trajectories from 1979 to 1999 between three groups of children: High socioeconomic position (SEP) Ladino, Low SEP Ladino, and Low SEP Indigenous Maya.

METHODS: The sample comprised 19 346 children aged 7-17 years with 54 638 observations. The outcomes were height, BMI, triceps skinfold thickness (TST), and subscapular skinfold thickness (SST) Z-scores according to the Centers for Disease Control and Prevention (CDC) references. Sex-specific multilevel models were used to estimate and compare mean trajectories from 1979 to 1999 between the three groups.

RESULTS: Mean Z-scores were always highest for High SEP Ladino children and lowest for Low SEP Maya children. Despite their very short stature, the Low SEP groups had SST trajectories that were above the 50th centile. The BMI trajectories were relatively flat and within one major centile band of the CDC median, with differences between the three groups that were small (0.2-0.3 Z-scores) and did not attenuate over time. Conversely, the TST Z-score trajectories demonstrated larger positive secular trends (e.g., from -1.25 in 1979 to -0.06 in 1999 for Low SEP Maya boys), with differences between the three groups that were large (0.5-1.2 Z-scores) and did attenuate over time (in boys). Secular trends and between-group difference in the SST Z-score trajectories were less pronounced, but again we found stronger evidence in boys that the estimated inequalities attenuated over time.

CONCLUSIONS: Secular trends and inequalities in skinfolds differ from those for BMI in Guatemalan children. Differences between groups in skinfolds attenuated over time, at least in boys, but whether this is good news is questionable given the very short stature yet relatively large subscapular skinfolds of the Low SEP groups.

Original languageEnglish
Article numbere24031
Number of pages13
JournalAmerican Journal of Human Biology
Early online date26 Dec 2023
Publication statusE-pub ahead of print - 26 Dec 2023

Bibliographical note

Funding Information:
The authors thank Rosa Amalia Camacho de Paz for coordination and data collection for the original Longitudinal Study and for her assistance with recent reacquisition of data. We further thank the team at Centro de Investigaciones Educativas (CIE) at Universidad del Valle de Guatemala for their assistance in locating study materials. This work was funded by a British Academy and Leverhulme Small Research Grant (SRG1920\100415). Digitization of the UVG Study data records was supported by both the Universidad del Valle de Guatemala and the Healthy Birth, Growth and Development knowledge integration (HBGDki) program of the Bill & Melinda Gates Foundation (contract OPP1125811) awarded to BB. WJ is supported by the NIHR Leicester Biomedical Research Centre.

Publisher Copyright:
© 2023 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.

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