Stratification of BMI categories among older adults within and across countries.

OBJECTIVE: Within- and across-country nutritional disparities were examined among older adults in six different countries at varying levels of development. DESIGN: Cross-sectional study. PARTICIPANTS: Older adults (aged 50 years or over) in China, Ghana, India, Mexico, Russia and South Africa using the Study on global AGEing and adult health (SAGE). RESULTS: While the distribution of BMI categories varied by country, development-related characteristics were generally related to BMI category in a similar way: urban-living, educated and wealthier individuals were typically more likely to be in a higher BMI category. However, there were some exceptions that corroborate findings in more developed countries. Indeed, a pooled partial proportional odds model which included gross domestic product per capita interactions made the case for intertwining processes of development and the nutrition transition. CONCLUSIONS: Population segments to be targeted by nutrition policy and programme implementation might need to change over the course of development.

FROM BIRTH TO ADULTHOOD: ANTHROPOMETRIC TRAJECTORIES AND THEIR IMPLICATIONS FOR CHRONIC DISEASES IN GUATEMALA.

The objective of this paper was to study nutritional status and growth, as measured by height and weight, over the life course and their connection with chronic diseases in Guatemala, a country with high levels of child undernutrition and adult overnutrition, using data from the Institute of Nutrition of Central America and Panama (INCAP) Nutrition Trial Cohort study. The study sample comprised a birth cohort of 1570 individuals who had data in the original 1969-1977 survey as well as the 2002-2004 follow-up, allowing for an analysis of the nutritional transition from childhood to adulthood. The associations between childhood and adulthood anthropometrics were analysed, and the links of these with chronic disease indicators were assessed using multiple regression analysis and structural equation modelling. Moving upwards in nutritional status from childhood to adulthood was observed frequently in the study population. Unlike sex and place of residence, early anthropometrics were not generally found to be associated with adult body mass index (BMI). However, direct relationships were found between childhood nutritional status and growth and adulthood high-density lipoprotein (HDL) cholesterol, triglycerides and fasting blood glucose. Furthermore, these relationships were not mediated by BMI. The findings were not sensitive to the metric of childhood anthropometrics, as the use of length-for-age, weight-for-age and weight-for-length all resulted in similar conclusions. These relationships demonstrate the importance of early childhood conditions for later-life outcomes. However, the lack of such relationships for blood pressure suggests that the biological links between childhood anthropometrics and various chronic diseases might vary.