Abstract
To examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria. Trend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991-2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban-rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights). Peru. Children aged 0-59 months surveyed in 1991-92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007-08 (n 8232) and 2011 (n 8186). Child stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991-2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020). The 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.
Highlights
The present study aimed to examine 20-year trends (1991–2011) in stunting and overweight in children aged 0–59 months in Peru, using a study design intended to overcome the limitations described above
Study design and sample The study used cross-sectional data from Demographic and Health Surveys (DHS) in Peru collected at five time points: 1991–92, 1996, 2000, 2007–08 and 2011
Over the 20-year period examined, the present study found a statistically significant decrease in overall child stunting and no overall change in the level of child overweight in Peru
Summary
The currently recommended WHO child growth standards[24] give higher estimates for both stunting and overweight compared with the earlier standards of the US National Center for Health Statistics[25] and the US Centers for Disease Control and Prevention[26], and this poses serious problems concerning comparison of studies using the various standards. The following research question was addressed: what are the nationallevel sex-specific trends in child stunting and overweight in Peru and in subgroups defined by (i) age, (ii) geographic region, (iii) urban/rural split, (iv) maternal education level and (v) household wealth?
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