title: Growth references for Tsimane forager-horticulturalists of the Bolivian Amazon.
abstract: OBJECTIVE
  Growth standards and references currently used to assess population and individual health are derived primarily from urban populations, including few individuals from indigenous or subsistence groups. Given environmental and genetic differences, growth may vary in these populations. Thus, there is a need to assess whether international standards are appropriate for all populations, and to produce population specific references if growth differs. Here we present and assess growth references for the Tsimane, an indigenous population of Bolivian forager-horticulturalists.
  
  
  METHODS
  Mixed cross-sectional/longitudinal anthropometrics (9,614 individuals; 30,118 observations; ages 0-29 years) were used to generate centile curves and Lambda-Mu-Sigma (LMS) tables for height-for-age, weight-for-age, body mass index (BMI)-for-age, and weight-for-height (WFH) using Generalized Additive Models for Location Shape and Scale (GAMLSS). Velocity curves were generated using SuperImposition by Translation and Rotation (SITAR). Tsimane ≤5 years were compared to World Health Organization (WHO) standards while those >5 years were compared to WHO school age references. All ages were compared to published references for Shuar forager-horticulturalists of the Ecuadorian Amazon.
  
  
  RESULTS
  Tsimane growth differs from WHO values in height and weight, but is similar for BMI and WFH. Tsimane growth is characterized by slow height velocity in childhood and early adolescent peak height velocity at 11.3 and 13.2 years for girls and boys. Tsimane growth patterns are similar to Shuar, suggesting shared features of growth among indigenous South Americans.
  
  
  CONCLUSIONS
  International references for BMI-for-age and WFH are likely appropriate for Tsimane, but differences in height-for-age and weight-for-age suggest Tsimane specific references may be useful for these measures.
authors.affiliation: Department of Anthropology, University of California Santa Barbara, California.|Tsimane Health and Life History Project, San Borja, Bolivia.
authors.forename: Aaron D
authors.identifier: http://orcid.org/0000-0002-5871-9865
authors.initials: AD
authors.lastname: Blackwell
authors.affiliation: Department of Anthropology, Hunter College, City University of New York, New York.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Urlacher
authors.affiliation: Tsimane Health and Life History Project, San Borja, Bolivia.|Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.|Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Bret
authors.initials: B
authors.lastname: Beheim
authors.affiliation: Tsimane Health and Life History Project, San Borja, Bolivia.|Jepson School of Leadership Studies, University of Richmond, Richmond, Virginia.
authors.forename: Christopher
authors.initials: C
authors.lastname: von Rueden
authors.affiliation: Tsimane Health and Life History Project, San Borja, Bolivia.|Department of Anthropology, Emory University, Atlanta, Georgia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Jaeggi
authors.affiliation: Tsimane Health and Life History Project, San Borja, Bolivia.|Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.|Institute for Advanced Study in Toulouse, Toulouse, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stieglitz
authors.affiliation: Department of Anthropology, University of California Santa Barbara, California.|Tsimane Health and Life History Project, San Borja, Bolivia.|Center for Evolution and Medicine, Arizona State University, Tempe, Arizona.|School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona.
authors.forename: Benjamin C
authors.identifier: http://orcid.org/0000-0003-3201-0628
authors.initials: BC
authors.lastname: Trumble
authors.affiliation: Department of Anthropology, University of California Santa Barbara, California.|Tsimane Health and Life History Project, San Borja, Bolivia.
authors.forename: Michael
authors.initials: M
authors.lastname: Gurven
authors.affiliation: Tsimane Health and Life History Project, San Borja, Bolivia.|Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Hillard
authors.initials: H
authors.lastname: Kaplan
mesh_terms: D000293:Adolescent; D000328:Adult; D000885:Anthropology, Physical; D000886:Anthropometry; D001827:Body Height / Q000208:ethnology*; D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology*; D001838:Bolivia; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D006801:Humans; D007199:Indians, South American / Q000208:ethnology* / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values; D055815:Young Adult
keywords: Amazonians; BMI; GAMLSS; Tsimane; growth; growth velocity; height; indigenous South Americans; weight