Intergenerational factors that shape nutritional status of urban Maya households in Merida, Mexico.

A 3-generations study

Centre for Global Health & Human Development

Hugo AzcorraDr Maria Ines Varela-Silva

Dr Federico Dickinson

The Maya and their historical background

• Pre-colonial period: state-level societies -architecture, food production, astronomy, literature (Thompson, 1954; Coe, 2005).

• Colonial period: the Maya were maintained in a subordinate position (Bracamonte, 2007).

• Recent period: several factors have led to the Maya to move into low paid employment in urban centers.

Merida City became during the last decades an important destination of rural-to-urban Maya migrants.

Place of research: Merida city

Intergenerational influences

• By 1986 Emanuel (1986, pg. 27) defined intergenerational factors ‘as those factors, conditions, exposures, and environments experienced by one generation that relate to the health, growth, and development of the next generation’.

Kuzawa (2005) suggest:

a) The growth of a child depend not only on the conditions experienced in utero, but also is influenced by factors that trace the chronic nutritional history of the mother, including her nutrition in utero and early years of life.

Research approach

Grandmothers (F1)

Mothers (F2) Children (F3)

Including 3 generations give us a better understanding on how collective nutritional experiences of recent matrilineal ancestors (F1 – F2) shape nutritional and growth status of children (F3).

Environmental conditions during childhood

Environmental conditions during childhood

Anthropometric traits

Anthropometric traits Nutritional status

General Aims

1. To assess the nutritional status of participants and the nutritional dual burden prevalence

2. To identify antenatal and socioeconomic factors that shape nutritional status of children

3. To assess the intergenerational effects on the growth of the participants, specifically

Grandmothers MothersGrandmothers + Mothers Children

Methods - Sample

MINA – Migration, Nutrition & Aging in Bangladeshi Mothers and Daughters

Intergenerational andtransnational correlates of health

• Sample size: 107 triads of Maya children, their mothers and grandmothers residents on the south/west/east of Merida.

• Inclusion criteria was based on: 1) the presence of a 6.0-to-8.99 years old child attending a public school 2) that the grandmothers and mothers were the biological mothers of the daughters and children3) at least maternal Maya surname needed to be present in each generation

• We got anthropometric, body composition and SES data on 3 generations.

Results – Nutritional status of participants

Children:

Mothers and grandmothers:

Stunting, short legs and trunk: <5th percentile of reference for height-for-age, LL-for-age, SH-for age.

Overweight (OW)/Obesity (OB) and high waist circumference (WC): >85th percentile of reference for BMI-for-age and WC-for-age.

Nutritional dual burden (NDB): coexistence of stunting and OW/OB

Short stature Short legs High WC NDB

Mothers 71% 54% 55% 36%

Grandmothers 90% 69% 83% 72%

Short stature and legs: <5th percentile of reference for height-for-age and LL-for-age; High waist circumference: >88cm, NDB: coexistence of short stature and high WC.

Results – Correlations between F1/F2 and F3

Variables Mothers (F2) Grandmothers (F1)r Partial r r Partial r

Height 0.2097* 0.2020* 0.0583 -0.0095Sitting height 0.1013 0.1066 -0.0125 -0.0356Leg length 0.2376* 0.2136* 0.1109 0.0315Knee height 0.2661* 0.2209* 0.1855 0.1071Z-Height 0.3987** 0.3838** 0.1176 -0.0114Z-Sitting height 0.2141* 0.1994* 0.0866 0.0346Z-Leg length 0.3558** 0.3554** 0.0637 0.0611SHR 0.2554* 0.2428* 0.0818 0.0078

Linear growth variables

*p<0.05; **p<0.001

Variables Mothers (F2) Grandmothers (F1)

r Partial r r Partial r

Weight 0.2551* 0.2265* 0.3008* 0.2777*

Body mass index 0.3115* 0.2591* 0.3332** 0.2856*

Waist circumference 0.3066* 0.2602* 0.3053* 0.2587*

Hip circumference 0.2171* 0.1744 0.3660* 0.3446**

Sum of skinfolds 0.2663* 0.2118* 0.2671* 0.2129*

Fat free mass 0.1567 0.1478 0.1395 0.1293Fat mass 0.2778* 0.2330 0.3000* 0.2596*

Body mass and body composition variables

Results – Path analysis (linear growth)

  β = 0.32 *

Grandmothers

Mothers Children

β = -0.01 (ns)

β = 0.40 **

e1=0.94 e2=0.91

-Indirect effect of grandmothers: 0.32 x 0.40 = 0.13-Total effect of grandmothers: -0.01 + 0.13 = 0.12

Z-score of height

  β = 0.33 **

Grandmothers

Mothers Children

β = -0.06 (ns)

β = 0.38 **

e1=0.94 e2=0.93

-Indirect effect of grandmothers: 0.33 x 0.38 = 0.13-Total effect of grandmothers: -0.06 + 0.13 = 0.07

Z-Score of leg length*p<0.05; **p<0.001

*p<0.05; **p<0.001

Results – Path analysis (BMI & fat mass)

  β = 0.22 *

Grandmothers

Mothers Children

β = 0.26 *

β = 0.23 *

e1=0.97 e2=0.92

-Indirect effect of grandmothers: 0.22 x 0.23 = 0.05-Total effect of grandmothers: 0.26 + 0.05 = 0.31

Z-score of BMI

  β = 0.20 *

Grandmothers

Mothers Children

β = 0.25 *

β = 0.23 *

e1=0.97 e2=0.93

-Indirect effect of grandmothers: 0.20 x 0.23 = 0.05-Total effect of grandmothers: 0.25 + 0.05 = 0.30

Fat mass*p<0.05

*p<0.05

Results – Children’s z-score of height

aHousehold Maya type: palm leaf roof, wooden walls and ground floor; n = 109; R2 = 0.290; Shapiro-Wilk residual normality test: w = 0.98, p = 0.126; Breusch-Pagan/Cook-Weisberg homocedasticity test: X2

(1) = 0.04, p = 0.840; Mean VIF = 1.08

Results – Children’s z-score of leg length

aHousehold Maya type: palm leaf roof, wooden walls and ground floor; n = 106, R2 = 0.337; Shapiro-Wilk residual normality test: w = 0.99, p = 0.693; Breusch-Pagan/Cook-Weisberg homocedasticity test: X2

(1) = 0.19, p = 0.660; Mean VIF = 1.09

Results – Children z-score of BMI

a Household Maya type: palm leaf roof, wooden walls and ground floor; n = 109; R2 = 0.317; Shapiro-Wilk residual normality test: w = 0.98, p = 0.188; Breusch-Pagan/Cook-Weisberg homocedasticity test: X2

(1) = 2.90, p = 0.090; Mean VIF = 1.09.

Results – Children’s z-score of sum of skinfolds (skf)