Anthropometric measurements are standard tools for population monitoring of both overnutrition and undernutrition globally. However, such measures confound differences in nutrition with well-established population differences in body form that are unrelated to recent nutrition transitions. Using reliable population estimates for basal body form derived from Demographic and Health Survey data (n=281,953 women, men, and children) across three world regions (sub-Saharan Africa, Asia, and South America), we show dramatic and consistent between-population variation ranging over 4.5 kg/m2 in basal body mass among adults and over 1 SD in basal weight-for-height z-scores among children. Mapping these population differences in body form at the country subdistrict level can reveal important information about regions where we would expect current anthropometric standards to fail to identify undernutrition (e.g., Lesotho and parts of South America) or overnutrition (South Asia and Southeast Asia). We also show remarkable variation within some countries (e.g., between Terai and Himalayan regions in Nepal and the north and south of Egypt). We discuss the implications of these findings for current monitoring efforts, and propose ways to incorporate this information into assessments of over- and undernutrition.
Daniel Hruschka is an Associate Professor of Anthropology and Global Health at Arizona State University. Trained as an anthropologist and epidemiologist, he studies how cultural, social, and economic factors shape human health and biology, with a particular focus on recent global increases in obesity. He has also worked for the past eight years with collaborators at LAMB Hospital (Bangladesh) and the International Center for Diarrhoeal Disease Research, Bangladesh, on interventions aimed at improving maternal and child health. He received his AB in mathematics from Harvard College and his MPH in epidemiology and PhD in anthropology from Emory University. Before starting at Arizona State University, he was an Omidyar Fellow at the Santa Fe Institute.