Body‐Segment Profile in Mid‐Life Women Residents in Quetzaltenango, Guatemala: A Perspective on Stunting in Adulthood
Authors: Gopal Mallika , Escobar Marta , García‐Meza Rosario , Solomons Noel W , Bermudez Odilia I 
Published: November 2023

Background

Stunting is highly prevalent in the Guatemalan population and presents many health issues. In regards to growing children, stunting is defined by the WHO Child Growth Standards (2006) as a length or height below 2 SD of the median of the reference growth curve. Guatemala has highest prevalence of stunting in the Americas, with under‐5yo children having rates of 49.8% in a 2009 survey and falling to 46.5% in the 2015 follow‐up, with an even higher proportion in the indigenous children (63.7%). It is associated with poverty, food insecurity, neglect and infection, with effects extending to health, social, and gender disparities. Stunting during childhood is the most common correlate of adult stunting, the latter defined as less than 145 cm in women and 150 cm in men. Humans develop in a cephalocaudal fashion – as extension of the lower part of the anatomy is delayed, body proportions are representative of childhood environment. A high torso‐to‐stature ratio is indicative of higher risk of cardiac arterial disease, liver disorders, and certain cancers. Segmental analysis, as in the NHANES, is conventionally assessed using sitting‐height to indicate the torso, which is confounded by gluteal thickness. Body posture photographs have been shown to be a promising tool with high inter‐rater reliability in calculating torso‐to‐height ratio in children.

Objective

This study aims to assess photography as an anthropometric tool to measure body proportions in Guatemalan women between the ages of 35–59 years, living in the city of Quetzaltenango, and to analyze the contribution of the torso‐to‐height ratio as a function of height (i.e. the effect that stunting has on segmental ratios).

Methods

Photographs and anthropometric measurements in a total of 105 women within the age criteria were collected. Their iliac crest was palpated and marked, representing their iliac height. Photographs were taken – with their right side facing the lens on a digital camera Samsung WB150F propped vertically on a tripod and positioned at about 5 feet from the objective. On the developed photo print, the distances on the page‐printed paper from the bottom of the feet to the iliac‐crest mark (leg), from the mark to the crown of the head (torso), and then the sole‐to‐crown (height) were registered. Segmental ratios were calculated from the measurements taken in millimeters. Total height (cm) was measured on a wall stadiometer.

Results

The median age of study participants was 47yo and standing height was 148 cm. 31 (29.5%) women were stunted and 74 (71.5%) were non‐stunted. Their respective torso‐to‐height ratios were 0.57 and 0.51 (p=0.011). In a continuous‐variable context, the ratio vs height Spearman correlation coefficient was −0.240 (p=0.014).

Conclusion

The photo‐image method appears to be an effective tool for assessing body proportions in adults. The significantly different body proportions in the stunted versus non‐stunted individuals may be indicative of growth disparities during the participants' childhood.