The document summarizes research on the nutritional status of the Maya people from Mexico. It finds that the Maya now experience a "dual burden" of malnutrition, with high rates of both stunting (chronic undernutrition) and overweight/obesity. A three-generation study showed stunting and obesity rates were highest in grandmothers, lower in mothers, and lowest but still significant in children. This suggests negative intergenerational effects, where the poor nutritional status of grandmothers and mothers impacts the growth of the current generation of children. The causes require more investigation but could involve factors like micronutrient intake, dietary fat consumption, metabolic pathways, and physical activity levels.

1. Growing short and fat:
The Maya from Mexico are now a dual-burden
group
Dr Inês Varela-Silva
Centre for Global Health
and Human Development
Loughborough University, UK
M.I.O.Varela-Silva@lboro.ac.uk
Twitter: @inesvarelasilva
(with F Dickinson, H Wilson,
H Azcorra, PL Griffiths and B Bogin)

3. Developed
countries
Growth
status
Immigrants in
developed countries
Developing
countries
Normal/tall
Fat
Normal/short
Fatter
Stunted
Fat
Micronutrients and dietary fat
Excessive intake of vitamins?
Excessive caloric comsumption
Common
factors
EE / P. Act
levels
Very
low
Probably
low
Not
known
Metabolic
pathways
High fat
oxidation & low
carb oxidation
Probably reduced fat
oxidation
Energy conserving
mechanisms
Discordant
information
Positive growth
Interof mothers &
generational
grandmothers:
and early
positive lasting
life effects
effect on current
generation
(Probably)...Negative growth of mothers &
grandmothers: negative lasting effect on
current generation

4. The Maya in Mérida, Mexico

6. Intergenerational effects

7. Nutritional status
based on growth data
Height-for-age
Stunting (chronic malnutrition)
Weight-for-age
Underweight
Weight-for-height
Wasting (acute malnutrition)
BMI-for-age
Overweight
Obesity

8. Saturday, January 11, 2014

9. Anthropometric classification: physical growth & nutritional status
(Adapted from Frisancho, 2008; www.cdc.gov/growthcharts , www.who.org)
Indices
Categories
Height-for-age
Weight-for-age
Weight-forheight
BMI-for-age
< 5.0 percentile
Z< -1.650
Stunting
Underweight
Wasting
Low
5.0-15 percentile
-1.645 <Z< -1.040
Below the
mean
Below the
mean
Below the
mean
Below the
mean
15.1-85 percentile
-1.036 <Z< +1.030
Healthy range
Healthy range
Healthy range
Healthy range
85.1-95 percentile
+1.036 <Z< +1.640
Above the
mean
Above the
mean
Above the
mean
Overweight
95.1-100 percentile
Z> +1.645
Tall
Excessive
Heavy for
height
Obese
Saturday, January 11, 2014
(not reliable)

11. Children
Mothers
WHO CDC
IOTF
p-value
WHO
CDC
p-value
Stunting
15.5
31.0
N/A
<0.001
55.2
81.0
<0.001
Underweight
1.7
5.2
6.9
Ns
0.0
N/A
Overweight
8.6
12.1
17.2
<0.001
51.7
N/A
Obesity
0.0
15.5
10.3
<0.001
39.7
N/A

12. Cut-off points selection

14. Body composition, energy expenditure
and physical activity
• Lean mass (muscle): strongest
predictor of energy expenditure
• The shorter the stature, the lower
the levels of activity energy
expenditure
• Girls and stunted children: lowest level of physical activity
However
• Children: overall highly active, above the guidelines
Inactivity doesn’t seem to explain the high levels of OW/OB
Wilson et al (2012)

15. Developed
countries
Growth
status
Immigrants in
developed countries
Maya in
Merida
Normal/tall
Fat
Normal/short
Fatter
Dual-burden
Micronutrients and vitamins
Excessive intake of dietary fat
Excessive Unknown – needs testing
caloric comsumption
Common
factors
EE / P. Act
levels
Very
low
Probably low, but needs
testing
High
Metabolic
pathways
High fat
oxidation & low
carb oxidation
Probably reduced fat
oxidation, but needs
testing
Not known
(Probably)...Negative
growth of mothers &
grandmothers: negative
lasting effect on current
generation
Negative
growth of
mothers,
negative effect
on children.
Positive growth
Interof mothers &
generational
grandmothers:
and early
positive lasting
life effects
effect on
children
Grandmothers
being tested

16. Three-generation study 2012
Grandmothers
Mothers
Children
p
Stunting
88.75%
68.75%
7.50%
0.001
Underweight
2.50%
0.0%
0.0%
N/A
Overweight
28.75%
42.50%
26.25%
0.061
Obesity
63.75%
42.50%
7.50%
0.001
OW/OB
92.50%
85.0%
33.75%
0.001
NDB*
81.25%
58.75%
0.0%
0.001
* Nutritional individual dual-burden (stunting+ OW/OB)

17. Thank you