Persistence of growth stunting in a Peruvian high altitude community, 1964-1999.

The growth of children living in Nuñoa, a Peruvian high-altitude community, was studied over a 35-year period using data collected in 1964 and 1999. There had been evidence of a secular trend in growth in the mid-1980s, but this was before a period of sociopolitical upheaval lasting until the late 1990s partly linked to the activities of the Shining Path group and the Peruvian government's response. Anthropometric data for 576 children examined in 1964-1966 were compared with data from 361 children examined in 1999. Data were converted to Z Scores using NCHS/WHO reference standards. Compared with the 1964 cohort, boys in 1999 had marginally greater height Z Scores, but among females, the trend was reversed. Stunting prevalence had decreased from 1964 levels, but still approached 60% in both sexes, among the highest rates recorded for a modern world population. The prevalence of low weight for height was less than expected, possibly because of the compensatory effect of enlarged chest diameter. This anatomical feature may represent the effect of chronic hypoxic stress, causing growth of the chest cavity at the expense of growth in height. In view of modest improvements during the late 1980s in this population, we believe that the relatively poor growth status of children a decade later may result from food disruption associated with later political instability. Compared with children in a nearby community, which benefits from the socioeconomic infrastructure associated with a large copper mine, Nuñoa children continue to fare relatively poorly.