Epidemiological insights on malnutrition: some resurrected, others restructured, a few retired

Food, sanitation, and the socioeconomic determinants of child growth in Colombia

To describe the causes of growth failure in a developing country, we studied family food availability, anthropometric measurements of preschool children, and family and neighborhood socioeconomic conditions in a stratified random sample of Cali, Colombia families. The influences on preschool child growth of food availability, neighborhood socioeconomic conditions, and family socioeconomic conditions were separated statistically. Neither food availability nor other family factors were related directly to growth, but neighborhood factors did have a strong relationship to growth. Children decreased progressively from 97.5 percent of expected weight in the top one-sixth of neighborhoods we studied to 89 per cent in the botton one-sixth. Food availability, although not related to growth, was strongly related to family factors. The top one-sixth of families had 115 percent of FAO (Food and Agricultural Organization) protein allowances, while the bottom one-sixth had only 75 per cent. These finding are inconsistent with food availability or family factors being the prinicipal causes of growth retardation. They are consistent with neighborhood determined factors, possibly enteric infections, being the principal cause of growth retardation in preschool children in Cali.