Socioeconomic change and patterns of growth in the Andes.

Changes in the pattern of growth over a 20-year period are described for a combined rural and semi-urban population in the District of Nuñoa (Puno) in southern Peruvian Andes. Over the past two decades, Andean regions have experienced many socioeconomic changes, including the implementation of agrarian reform policies and increased integration into a market economy. Local changes in Nuñoa have included improved transportation networks, new markets, an expanded public school system, and improved health care facilities. Secular trends in stature and weight have been found to be associated with social and economic development throughout the developing world, including Peru. The purpose of this paper is to present the findings from a re-study of growth in the Nuñoan population, and to assess whether changing conditions in Nuñoa have resulted in secular increases in growth. A cross-sectional sample of 1,466 children and adults and mixed-longitudinal sample of 404 children (age 3-22), measured between 1983 and 1984, are compared to similar samples collected from the same location between 1964 and 1966. Adolescents are taller, heavier, and somewhat fatter in the present population, although these differences diminish or disappear in adulthood. Age of maturation, peak growth velocities, and cessation of growth may come 1 to 2 years earlier than in the 1960s. As was found in earlier studies, growth velocities are low, the adolescent growth spurt is small, and sexual dimorphism is delayed. No secular trends in adult stature were found. Thus, the effects of social and economic change on nutrition, health, and growth in the population are uneven and generally unclear. This points to inequalities in access to the benefits of change throughout the region.