Influence of dietary quality on the growth of highland and coastal Ecuadorian children.

Abstract

This study examines variation in dietary patterns and its influence on physical growth among children under 60 months of age from rural households of highland and coastal Ecuador. Differences in subsistence ecology between the regions appear to influence infant and early childhood feeding patterns. Coastal children are weaned significantly earlier than their highland counterparts (median +/- SE = 15.9 +/- 1.7 vs. 24.7 +/- 3.4 months) and have a weaning/supplemental diet that contains significantly more animal foods. In both regions, growth retardation is most severe among infants (<12 months), with growth rates being poorer in the highlands than on the coast. Linear growth rates among coastal infants are positively correlated with intakes of animal energy and animal protein, whereas among highland children energy intake from supplemental/weaning foods is negatively correlated with linear growth. These divergent patterns appear to be a consequence of the differences in nutrient density of the weaning/supplemental diets. Among the coastal infants, higher quality, nutrient dense foods augment breast milk and contribute to better growth rates. In contrast, among the highland infants the more filling, less nutrient dense foods appear to be replacing breast milk, and thus compromising growth status. In the older cohorts (i.e., "weaning age" children: 12.0-35.9 months, and completely weaned children: 36.0-59.9 months), linear growth rates stabilize with little evidence of "catch up" growth in either region. Improved weight gain, however, is seen among the highland children, and is correlated with the nutritional intake (i.e., energy, total protein, and animal protein) from weaning foods. Overall, marked growth stunting is seen in both regions, but is more pronounced in the highland children. These high levels of stunting are largely established in the first 12 months of life. Greater growth retardation among the highland children appears to reflect the influence of hypoxia as well as the lower nutrient density of weaning foods in that region. Am. J. Hum. Biol. 12:825-837, 2000. Copyright 2000 Wiley-Liss Inc.