title: Physical growth of the shuar: Height, Weight, and BMI references for an indigenous amazonian population.
abstract: OBJECTIVE
  Information concerning physical growth among small-scale populations remains limited, yet such data are critical to local health efforts and to foster basic understandings of human life history and variation in childhood development. Using a large dataset and robust modeling methods, this study aims to describe growth from birth to adulthood among the indigenous Shuar of Amazonian Ecuador.
  
  
  METHODS
  Mixed-longitudinal measures of height, weight, and body mass index (BMI) were collected from Shuar participants (n = 2,463; age: 0-29 years). Centile growth curves and tables were created for each anthropometric variable of interest using Generalized Additive Models for Location, Scale, and Shape (GAMLSS). Pseudo-velocity and Lambda-Mu-Sigma curves were generated to further investigate Shuar patterns of growth and to facilitate comparison with United States Center for Disease Control and Prevention and multinational World Health Organization growth references.
  
  
  RESULTS
  The Shuar are small throughout life and exhibit complex patterns of growth that differ substantially from those of international references. Similar to other Amazonians, Shuar growth in weight compares more favorably to references than growth in height, resulting in BMI curves that approximate international medians. Several additional characteristics of Shuar development are noteworthy, including large observed variation in body size early in life, significant infant growth faltering, extended male growth into adulthood, and a markedly early female pubertal growth spurt in height. Phenotypic plasticity and genetic selection in response to local environmental factors may explain many of these patterns.
  
  
  CONCLUSIONS
  Providing a detailed reference of growth for the Shuar and other Amazonian populations, this study possesses direct clinical application and affords valuable insight into childhood health and the ecology of human growth.
authors.affiliation: Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, 02138.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Urlacher
authors.affiliation: Department of Anthropology, University of California, Santa Barbara, California, 93106.|Broom Center for Demography, University of California, Santa Barbara, California, 93106.|Center for Evolutionary Psychology, , University of California, Santa Barbara, California, 93106.
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Blackwell
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.|Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Liebert
authors.affiliation: Department of Anthropology, Queens College, Flushing, New York, 11367.
authors.forename: Felicia C
authors.initials: FC
authors.lastname: Madimenos
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.|Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403.
authors.forename: Tara J
authors.initials: TJ
authors.lastname: Cepon-Robins
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.|Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403.
authors.forename: Theresa E
authors.initials: TE
authors.lastname: Gildner
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.|Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403.
authors.forename: J Josh
authors.initials: JJ
authors.lastname: Snodgrass
authors.affiliation: Broom Center for Demography, University of California, Santa Barbara, California, 93106.|Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.|Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Sugiyama
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004484:Ecuador; D005260:Female; D006801:Humans; D007199:Indians, South American; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values; D055815:Young Adult