title: Nutritional transition in children under five years and women of reproductive age: a 15-years trend analysis in Peru.
abstract: BACKGROUND
  Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement.
  
  
  METHODS
  Trend analyses of anthropometric measures in children of preschool age and women between 15-49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5 y. We employed the WHO BMI-age standardized curves for teenagers between 15-19 y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively.
  
  
  RESULTS
  We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5 y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15-19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19 y.
  
  
  CONCLUSIONS
  Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions--undernutrition/stunting, overweight/obesity and anemia--considering age and place of residence in rapid developing societies like Peru.
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors.forename: Christian
authors.initials: C
authors.lastname: Loret de Mola
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; CONEVID Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Renato
authors.initials: R
authors.lastname: Quispe
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Giancarlo A
authors.initials: GA
authors.lastname: Valle
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Poterico
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D005523:Food Supply; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D050177:Overweight / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult