99: The Double Threat of Childhood Obesity and Stunting in Rural Indigenous Ecuador

Abstract

Overweight and obesity are a major health threat in middle and low-income countries and mark a new evolution in the nutritional situation of impoverished populations. Indigenous populations face additional risk factors for malnutrition such as food insecurity and low food diversity. It is estimated that in Ecuador, the rate of stunting in children <5 years of age is 23%, and 6% are overweight. In our study we present stunting and overweight data in an indigenous population in Ecuador and identify risk factors in this population. To examine anthropomorphic measures in children 0 to 12 years old, household food security, dietary diversity, and demographic variables in a rural community in the Andean mountains of Ecuador. Child nutritional status of children in a single isolated indigenous community were assessed according World Health Organization (WHO) criteria for stunting (low height-for-age), wasting (low weight-for-age) and overweight (BMI >25) and obesity (BMI >30). Escala Latina Americana de Seguridad Alimentaria (ELCSA) survey was used to assess household food security, locally designed dietary diversity score questionnaire measuring the number of food categories consumed by household. Sixty households (63% indigenous) and 88 children were included in our study. Overall, 40 (46%) of children were stunted, 25 (28%) were overweight, and three (3%) were obese. The concurrent prevalence of stunting and overweight or obesity was 17%. Nine (10%) children were wasted or severely wasted. Only two (2%) of households were food secure, with 28 (43%), 34 (39%) and 14(16%) being mild, moderately, and severely food insecure respectively. Indigenous children were more likely to be stunted than non-indigenous (P=0.01), and increasing number of children per household, and absence of primary education correlated with worsening food security (P=0.02, P=0.01). Regression analysis revealed dietary diversity scores correlated with education (P<0.001). We document that concurrent childhood stunting and overweight or obesity is an important health issue for indigenous children in Ecuador. Furthermore, we identify low education and having more than two children per family as risk factors for food insecurity.