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Title: Intergenerational factors that shape the nutritional status of urban Maya households in Merida, Mexico. A 3-generations study.
Authors: Azcorra, Hugo
Keywords: Maya
Intergenerational influences
Nutritional dual burden
Issue Date: 2014
Publisher: © Hugo Santiago Azcorra-Perez
Abstract: Background. The Maya are one of the largest Mesoamerican groups. The decline of the classic Maya society, the subsequent Colonial domination and the current national economic policies has had a severe biological and social impact on the Maya across several generations. Accumulated evidence suggests that conditions and environments experienced by one generation can affect the health, growth and development of the next generation (Emanuel, 1986). Historical evidence of political, educational and socioeconomic deprivation suffered by the Maya from Yucatan, Mexico, provides us with the opportunity to test the intergenerational influence hypothesis and ascertain the impact of the biosocial background of urban Maya grandmothers (first generation) and mothers (second generation) on the growth and nutritional status of their children (third generation). Aims. The main objective is to assess the impact of socioeconomic and intergenerational factors on the growth of Maya children, in a sample of children, their mothers and maternal grandmothers. The specific objectives are: 1) to assess the nutritional status and nutritional dual burden prevalence in participants, 2) to identify the pre and postnatal biosocial and economic factors that relate to the nutritional status of the children, and 3) to assess the intergenerational influences on the growth of participants: from grandmothers to mothers and from grandmothers and mothers to children. Methods. The sample is composed of 109 triads of Maya children (6-8 years old), their mothers and their maternal grandmothers from the city of Merida, Yucatan, Mexico. From September 2011 to June 2012 we collected anthropometric, body composition and socioeconomic data on the three generations. We also assessed parameters about living conditions of maternal and grand-maternal childhood. Nutritional status was assessed by comparing the participants against the Comprehensive Growth References published by Frisancho (2008) and based on the NHANES III. Pre and postnatal biosocial and economic factors were analysed through multiple regression models. Intergenerational influences were assessed through: 1) bivariate and partial correlations in anthropometric and derived variables between participants, 2) path analysis to identify the direction and magnitude of direct and indirect causal effects between the three generations, and 3) multiple regression models to identify the effect of anthropometric and socioeconomic intergenerational factors on the growth of mothers and children. Results. Eleven percent of the children were categorized as stunted and 36% met the criteria of risk for abdominal obesity. Only 1% of children exhibited the combination of stunting and abdominal obesity. Mothers and grandmothers showed very low average heights and high levels of abdominal obesity. The combination of maternal abdominal obesity and child stunting was present in the 6% of mother-child dyads. It was found that preeclampsia and cigarette smoke exposure during pregnancy and household overcrowding impacted negatively the linear growth of the children. Maternal education and the presence of grandmothers at home predicted healthier values of BMI, waist circumference, body fat and body lean mass percentages on children. Maternal height and leg length (LL = height sitting height) were positively associated with the linear growth of children. These associations were not modified by the grand-maternal size, in terms of very short stature. In contrast, associations in weight, body mass index, sum of skinfolds and fat mass were stronger in grandmother-child pairs than in mother-child pairs. The birth weight of the children was positively associated with maternal head circumference and negatively associated with the absence of a toilet at home during maternal childhood (i.e. when the mother was growing up). Grand-maternal intergenerational predictors of children s height, leg length, body mass index, waist circumference and skinfolds were: index of household characteristics, family size and school attendance during childhood. Family size and paternal job loss during maternal childhood were the maternal intergenerational factors that influenced significantly the body mass index, waist circumference and skinfolds of children. Conclusions. Growth and nutritional status of the children, mothers and grandmothers reflect the effects of chronic deprivation and poverty that are a constant among the Maya in the Yucatan. Under and-overnutrition coexisted in this sample of three generations. Pre-and-postnatal biosocial and economic factors impacted the growth and nutritional status of children. Harsh living conditions experienced by mothers and grandmothers during their childhood influenced the prenatal and postnatal growth of children. We suggest that disadvantaged conditions experienced by mothers and grandmothers during their first years of life impacted their own growth and this in turn is influencing the growth of children of the third generation. Substantial reductions in poverty levels and increase educational levels of the mothers are required to overcome the intergenerational traces on the future generations.
Description: A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.
Sponsor: Consejo Nacional de Ciencia y Tecnología de México
URI: https://dspace.lboro.ac.uk/2134/14159
Appears in Collections:PhD Theses (Sport, Exercise and Health Sciences)

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