Contributions of nutrition versus hypoxia to growth in rural Andean populations.

Previous research on diet and nutrition among peasant agriculturalists in the Andes has produced inconsistent results. As a consequence it has been difficult to determine the extent to which nutritional factors contribute to the slowed, prolonged growth and resultant small adult body size that is characteristic of these highland populations. The study examines patterns of diet and growth in the rural highland community of Nuñoa, Peru (elevation 4,000 m), and compares them to similar data collected on this community during the 1960s. Additional data from other locations in the Andes are then evaluated to discern critical determinants of growth variation. Analyses of the Nuñoan data indicate that nutritional factors have played a significant role in shaping statural growth at this location. Comparisons of other growth surveys indicate that Nuñoans remain among the smallest of all Andean populations. Additionally, urban/rural differences in growth are quite evident in the highlands, with the magnitude of this difference being greater than in other regions (i.e., coastal or jungle). It appears that income level and access to land strongly interact to direct and constrain food consumption patterns. The resulting differences in nutrition, in turn, appear to be strong predictors of growth variation. Consequently, studies that consider 1) dietary intake, 2) level of variability in diet, and 3) relative contributions of purchased and home-produced food to diet should contribute to furthering our understanding of growth variation in the Andes.