Abstract
BackgroundPrior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare – all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured by the leg length index, LLI) and measures of adiposity – based on body mass index (BMI) and waist circumference (WC) – in a population of recent Mexican immigrant women to the New York City Area.MethodsThe analysis was based on a cross-sectional survey of 200 Mexican immigrant women aged 18 to 70 years, whose data were collected between April and November 2008; although for purposes of the current study we restricted the sample to those aged 18 to 59 years. The dependent variables were BMI and WC, both transformed into categorical variables. The main independent variable was LLI, and other correlates were controlled for (i.e. age, education, having had children, characteristics of the community of origin, acculturation, chronic conditions, sedentary behaviors, access to fresh fruits and vegetables). Two probit models were estimated: the first one analyzed the effect of LLI on BMI categories and the second one estimated the effect of LLI on WC.ResultsThe probit assessing the effect of LLI on overweight/obesity suggested that having a short LLI increased the probability of overweight/obesity by 21 percentage points. Results from the probit model estimating the effect of LLI on WC indicated that having a short LLI increased the probability of having abdominal adiposity by 39 percentage points. Both results were statistically significant at p < 0.05.ConclusionThe study found an association between having shorter legs relative to one’s height and increased risk of overweight/obesity and abdominal adiposity. Findings support the epidemiological evidence regarding the association between short leg length, early life socioeconomic conditions (i.e. limited access to basic rights), and increased risk of adverse health effects later in life.
Highlights
In order to achieve the United Nation’s (UN’s) Sustainable Development Goals (SDGs), the world requires healthy and productive individuals that have the skills and motivation needed to implement future policies aimed at achieving social and economic development among countries [1]
There is evidence that stunting and enteric infections in malnourished children are associated with the development of obesity, hypertension, diabetes, and other non-communicable diseases in later stages of life, which, in turn, are associated with growing healthcare expenditures that contribute to poverty in vicious cycles [3]
Considering the evidence on the relationship between relative leg length and childhood nutritional environments, the purpose of this study is to determine whether differences in proxy measures of adult adiposity are associated with relative leg length among a sample of Mexican-born adult immigrant women in the United States (U.S.) The advantage of selecting this sample lies on the fact that in middle-income countries like Mexico, as well as in groups of immigrants of low socioeconomic status in highincome countries, overweight and obesity have been reported to co-exist with short stature and undernutrition [12, 14]
Summary
In order to achieve the United Nation’s (UN’s) Sustainable Development Goals (SDGs), the world requires healthy and productive individuals that have the skills and motivation needed to implement future policies aimed at achieving social and economic development among countries [1]. Guerrant et al argue that, mainly as a consequence of lack of sanitation and lack of healthcare access, poor children are frequently afflicted by long-lasting enteric infections during their first years 2– 3 years of life. The occurrence of these infections, along with the economic barriers that their families face to access healthy foods, predispose poor children to malnutrition and stunted growth. There is evidence that stunting and enteric infections in malnourished children are associated with the development of obesity, hypertension, diabetes, and other non-communicable diseases in later stages of life, which, in turn, are associated with growing healthcare expenditures that contribute to poverty in vicious cycles [3]. Our objective was to examine the association between relative leg length (as measured by the leg length index, LLI) and measures of adiposity – based on body mass index (BMI) and waist circumference (WC) – in a population of recent Mexican immigrant women to the New York City Area
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