Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6 ± 10.7 months in the indigenous group and 146.6 ± 10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.     

Nutritional status of adolescent girls of a slum community of Varanasi

In order to assess nutritional status of adolescent girls of a slum community of Varanasi and factors influencing them, this study was carried out on 70 girls belonging to the age group 13 to 18 years. The study subjects were selected from Sunderpur, an urban community of Varanasi, by adopting appropriate sampling methodology. The approach adopted for the study was a cross sectional one. The tools in the study were pre-designed and pre-tested schedule, weighing scale, steel anthoropometric rod and measuring tape. The techniques of the study included interview method, clinical examination and anthropometry. In all, 70.0% adolescent girls had BMI < 20%; 51.43% study subjects were suffering from Chronic Energy Deficiency (CED). Stunting (Height for age alpha 90%) was present in 10% of adolescent girls. Their average Weight, Height, MAC were 83.45%, 93.08% and 82.05% of the corresponding estimated reference values. Significant association of common parameters (viz., age, caste, income, type of family, working and literacy status) with nutritional status of study subjects was not observed in this study. However, lesser undernutrition in large families (> 6) indicated role of familial support in prevention of undernutrition in adolescent girls.     

Correlation of body mass index levels with menarche in adolescent girls in Shaanxi,China: a cross sectional study

Background

Menarche is a milestone for adolescent girls. The timing of menarche is influenced by genetics, social status and nutritional status (e.g., height, weight and body mass index [BMI]) and impacts future health (e.g., obesity and breast cancer). There have been many studies on trends in age at menarche among adolescent girls in China, but few have investigated associations between growth status and the timing of menarche. This study examined the association between age at menarche and growth status among adolescent girls in Western China.

Methods

The participants in this cross sectional study came from three geographical regions of Shaanxi Province. A total of 533 adolescent girls from urban and rural areas were randomly selected. Trained investigators administered a standard questionnaire to each participant during a face-to-face interview and carried out anthropometric measurements.

Results

The average age at menarche was 13.3 years. There were statistically significant differences in BMI z-scores between pre-menarcheal and post-menarcheal girls of the same age and these differences were related to socioeconomic factors. Girls who had reached menarche, in particular those aged 13–14 years, were significantly taller (P?<?0.01) and had higher BMI (P?<?0.01) than girls in the same age group who had not reached menarche.

Conclusions

BMI is associated with the timing of menarche but socioeconomic factors are also important.

     

The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: results from an urban city cross-sectional survey

Lower age of menarche has been associated with increased mental distress among adolescent girls. The association might be mediated via body image, as girls with early menarche tend to have higher weight than those with late onset menarche. Many of the existing studies of menarche and mental distress are based on samples of white, western girls. The aim of the study was to analyze the association between age of menarche and mental distress among Norwegian girls and girls from different immigrant groups, and to study the effect of body mass index (BMI) and the difference between current and desired weight, on the relationship between age of menarche and mental distress. The study was a cross-sectional population-based self-report survey of all 10th grade pupils in Oslo for two consecutive years. A total of 3694 girls (91%) participated, one quarter of which were first or second generation immigrants. The Hopkins Symptom Checklist-10 was used to measure mental distress. An inverse, linear association between age of menarche and mental distress was found for both Norwegian girls and girls from all the immigrant groups. Regardless of immigrant status, girls with early onset menarche had higher BMI and higher difference in current and desired weight than those with late onset menarche. In linear regression, the difference in current and desired weight was more strongly associated with mental distress both among the Norwegian girls and girls from immigrant groups than age of menarche and BMI when controlling for social and behavioral factors. Early age of menarche might serve as a predictor for psychopathology in Norwegians girls as well as in girls from different immigrant groups. The association between age of menarche and mental distress might be mediated via differences in current and desired weight.     

Body mass index in adolescence and number of children in adulthood

BACKGROUND: Body weight is associated with reproduction and related behaviors, but it is unknown whether it has significance for fertility differences in the general population. We examined whether adolescent body mass index (BMI; kg/m) predicted the number of children in adulthood 21 years later. METHODS: The participants were 1298 Finnish women and men (ages 12, 15, and 18 years at baseline) followed in a prospective population-based cohort study (the Cardiovascular Risk in Young Finns) from year 1980 to 2001. RESULTS: There was an inverted J-shaped association between BMI and the number of children, such that underweight adolescents had 10-16% fewer children in adulthood, overweight adolescents 4-8% fewer, and obese adolescents 32-38% fewer than individuals with normal adolescent weight. This association was similar in women and men, and independent of age, education, urbanicity of residence, and timing of menarche (in women). Adolescents with low or high BMI were less likely to have lived with a partner in adulthood, which partly accounted for their decreased number of children. The influence of adolescent BMI was independent of adulthood BMI in women but not in men. Age at menarche also predicted the number of children, such that women with early or late menarche had more children than those with average age at menarche. CONCLUSION: Underweight and especially obesity may have a negative impact on fertility in the general population. The increasing prevalence of obesity in children and adolescents may represent a concern for future reproductive health.     

Nutritional factors affecting the menarcheal state of adolescent school girls in Alexandria

The nutritional status of adolescents plays a dominant role in determining the maturation status. The aim of the present work was to assess the mean age of menarche and the main nutritional factors affecting it. A cross-sectional study of 1606 girls was conducted in primary and preparatory schools in Alexandria. Every girl was subjected to anthropometric assessment including weight, height, mid upper arm circumference (MUAC), waist circumference, hip circumference and triceps skin-fold thickness. BMI and body fat percentage were calculated. A 24 hours diet recall method was used to assess the dietary intake. The mean age of menarche was 11.98+/-0.96 years. The mean MUAC, triceps skin-fold thickness, waist circumference and hip circumference were significantly higher among menstruating girls as compared to non-menstruating. (p<0.01). Only 7.5% of the females less than the 5th percentile of BMI (thinness) were menstruating, while the corresponding figure for those at or more than 85th percentile (overweight) was 65.6% and this was statistically significant (X 2 (2) =102.8, P<0.001). Girls who attained menstruation demonstrated a higher significant mean percent of body fat (43.40+/-10.0) as compared to non menstruating ones (35.41+/-7.87), ( t=17.09, P<0.001). The oldest age at menarche was noted when the protein, iron and caloric intake was less than 80% of the RDAs. However after adjustment of other variables direct relation was detected between age of girls and their age of menarche and those in private school had earlier age of menarche than those in governmental one. The nutritional status of the adolescents had a significant association with the onset of menstruation and the age at menarche.     

Epidemiology of overweight and obesity among school children and adolescents in three provinces of central Italy, 1993-2001: study of potential influencing variables

OBJECTIVE: The prevalence of overweight and obesity was estimated among the school children and adolescents of three provinces of central Italy, and the role of several possible influencing factors was analysed. DESIGN, SUBJECTS AND MEASUREMENTS: Body mass index (BMI) was measured in 44 231 subjects, age 3-17.5 y, and a household questionnaire was filled out by the parents of 12 143 subjects to collect the following data: subjects, only child or firstborn status, prematurity, birth weight, type of feeding until the fifth month, menarche status in girls; parents, age at the time of the subject's birth; BMI (mean of the two parents) at the time the subject was measured, mother's age of menarche, socioeconomic status. BMI was measured in a subgroup of 10 795 subjects 1 y later to study the yearly sex- and age-related variations from the categories of normal weight to overweight or obesity and vice versa. All females aged 11-14 y were asked if they had their menarche. RESULTS: Striking differences in the proportions of overweight and obesity resulted from the use of two different criteria for defining cutoff points. The overall prevalence of overweight was 13.2 and 20.7% in males, and 13.7 and 18.6% in females, and the overall prevalence of obesity varied between 24.2 and 6.3% in males, and between 22.9 and 6.1% in females, respectively. Parents' BMI, birth weight, firstborn status and post-menarche status in girls showed a significant association with overweight and/or obesity in logistic regression models. CONCLUSIONS: A large prevalence of overweight and obesity was observed in school subjects from three provinces of central Italy. From the comparisons of the prevalence rate, the new internationally agreed criteria seem more appropriate for epidemiological studies in this population. SPONSOR: University of Perugia, Region of Umbria, Commune of Perugia.     

Ability of young women to recall past body size and age at menarche

OBJECTIVE: The ability of young women (n = 132, average age 17 years) to recall body size and age at menarche was examined. The use of body silhouettes to assist women in recalling their body size at menarche and to represent their current body size was also evaluated. RESEARCH METHODS AND PROCEDURES: Subjects, who previously participated in a cohort study, were asked to recall height and weight at the time of menarche, to select body silhouettes that best reflected their body shape at the time of menarche and their current body shape, and to recall age at menarche. Two sets of body silhouettes were developed, one representative of an adult body shape and another representative of an adolescent body shape. RESULTS: Pearson correlation coefficients between the adult and adolescent body figures and actual body mass index (BMI; kg/m(2)) at the time of menarche were not significantly different (r = 0.82 for adult figures vs. r = 0.72 for adolescent figures, p > 0.05). The correlation between actual BMI at the time of menarche and body silhouette (r = 0.77, all subjects) was similar to the correlation between actual and recalled BMI at the time of menarche (r = 0.83) as well as the correlation between current BMI and current body silhouette (r = 0.75). Recalled and actual ages at menarche were highly correlated (r = 0.83). DISCUSSION: The recall of body shape was considered to be a less precise measure of body size than asking about height and weight, but use of body silhouettes may offer advantages in certain situations.     

Relationship Between Body Mass Index and Early Menarche of Adolescent Girls in Seoul

Objectives

The object of this study was to determine the relationship between body mass index (BMI) and early menarche in adolescent girls in Seoul.

Methods

A retrospective study was conducted with 144 middle school students in Seoul who provided informed consent. We measured their body composition, and used the questionnaire survey method for data collection from November to December 2008. Past elemental body composition data were collected from elementary school health records of first year of middle school.

Results

The early menarcheal group was taller and heavier than the late menarcheal group (p<0.05 from 8-12 years old). The body fat percentage (%), BMI were higher in the early menarcheal girls than the late-menarcheal girls (p<0.05, age at 13). In the result of multiple logistic regression, the BMI at the age of 8 and 9 was associated with early menarche after adjusting for birth weight, breast feeding and age at menarche of the mother (BMI at the age of 8: p for trend=0.01, BMI at the age of 9: p for trend=0.04). An increase in BMI from 7 to 8 year was associated with early menarche after adjusting for birth weight, breast feeding, age at menarche of the mother (p for trend=0.048).

Conclusions

The BMI at the age of 8 and 9 was associated with the early menarche of girls and increase in BMI from 7 to 8 year was associated with the early menarche of girls. These results suggest that BMI and increase in BMI before menarche cause early menarche. Although this study does not represent all Korean adolescent girls, it is one of the few studies that have investigated the temporal relationship between BMI and early menarche.     

Age at menarche and adult BMI in the Aberdeen children of the 1950s cohort study

BACKGROUND: Few studies have examined whether the inverse association of age at menarche with adult body mass index (BMI) is due to the tendency of BMI to track between childhood and adult life, with childhood BMI playing a causal role in determining age at menarche. OBJECTIVE: The objective was to investigate whether the association of younger age at menarche with a high BMI and increased likelihood of obesity in middle age is due to confounding with early childhood BMI. DESIGN: In a historical cohort of 3743 Scottish females born between 1950 and 1955, height and weight were measured in early childhood, and age at menarche and height and weight in middle age were obtained by questionnaire. RESULTS: The age-adjusted change in mean adult BMI per additional year of age at menarche was -0.64 (95% CI: -0.78, -0.50). Adjustment for childhood BMI measured between 4 and 6 y reduced this value to -0.57 (-0.71, -0.43). Adjustment for childhood and adult social class, parity, smoking, and alcohol intake had little effect. The odds ratio for being obese compared with not being obese in adulthood was 0.82 (0.76, 0.86) per 1-y increase in age at menarche and was unchanged by adjustment for childhood BMI and other covariates. CONCLUSIONS: The inverse association of age at menarche with BMI and obesity in middle age is not explained by confounding by early childhood BMI. Instead, age at menarche may simply be a proxy marker for the pace of sexual maturation, which itself leads to differences in adiposity (and BMI) in the peripubertal period that track into adult life.     

Nutritional status and menarche in a rural community in the Philippines

To examine the relationship between nutritional status and onset of menarche, anthropometric measurements and information on age at menarche were obtained from 1844 females aged 6-17 years in a rural community in the Philippines. The mean age at the initiation of the growth spurt in height was 13.5 years, while the spurt in weight occurred at the age of 11.5 years. 25.2% of respondents had attained menarche by age 11.5 years, 43.6% by age 13.5 years, 88.2% by age 14.5 years, and 96.6% by age 15.5 years. This contrasts with data from Bangladesh, where only 3.5% of girls attain menarche by age 13.5 years and only 35.1% reach this point by age 15.5 years. Further analysis indicated that both age and weight are related to the proportion achieving menarche. The effect of height is not as marked as that of body weight. A minimum level of fatness (about 17% of body weight) is associated with the onset of menstruation and its continued maintenance. Malnutrition results in a shorter reproductive span, later age at menarche, and early menopause. Since improvements in nutritional status in developing countries can be expected to result in a pattern of early menarche, late menopause, short birth intervals, and shorter periods of adolescent subfecundity, increasing attention must be given to family planning counseling of adolescents.     

A nested case-control study of the correlates of early menarche

Age at menarche, an early determinant of breast cancer risk, shows both a downward secular trend and marked differences by socioeconomic status, both presumably the reflection of dietary variations. A cohort study is being conducted in the Quebec City, Canada, area to assess the relation between diet, physical activities, and menarche. In the fall of 1986, 3,022 fifth-grade girls (mean age, 10.7 years) agreed to participate in the study. All of the girls' parents provided information on health, familial, and socioeconomic variables. A 3-day dietary record and a 7-day physical activity recall were provided by 95.8% of the girls. All dietary information was verified with each girl by a dietician. Body weight and height and two skinfold thickness measurements were also recorded for 98% of the subjects. At the beginning of the study, 107 girls had already experienced menarche. In the fall of 1987, letters were sent to the mothers of the remaining 2,915 girls; 2,854 (97.9%) responded. In the preceding year, 352 girls had reached menarche. Of these, 333 (94.6%) had provided baseline dietary data. A case-control analysis was conducted in which these 333 girls were compared with 333 age-matched premenarcheal girls. There was a weak association between energy intake, energy expenditure, and early menarche. Weight, height, skinfold thickness, mother's age at menarche, and participation in a dance, ballet, gymnastics, or figure skating club were also associated with the early onset of menstruation.     

The factors affecting the relation between the menarcheal age of mother and daughter

BACKGROUND: Menarche is one of the most important biologic signals in the life of a woman. Menarche is a biological variable which has a significant genotypic component in girls. In recent years, many studies reporting the earlier onset of menarche owing to the improvement of socio-economic conditions have been published. DESIGN: We asked some questions about menarche to 1017 female students studying in the high schools of Manisa region in order to determine the menarcheal age and the correlation of menarcheal age between the mothers and daughters in our region. RESULTS: The mean age at menarche for the girls was 12.82+/-1.07 years and for the mothers was 13.6+/-1.39 years. The mean menarcheal age of the mothers was higher than the mean menarcheal age of the girls (P<0.001). This difference persisted independent of the socio-economic status, nutritional state and physical activity of the girls. There was a significant correlation between the menarcheal age of the girls and their mothers (r=0.262, P<0.001). This correlation existed in all the girls with different socio-economic status, nutritional state and physical activity. However, this correlation disappeared in girls with body mass index (BMI)>25 (r=0.04, P=0.813). In girls with BMI<25, there was a correlation between the menarcheal age of the girls and mothers (r=0.282, P<0.001). CONCLUSION: These results suggest that the menarche occurs earlier in the daughters than their mothers. The correlation between the menarcheal age of the girls and their mothers persists under all circumstances except in obesity. The mother's menarcheal age is a good predictor of the daughter's menarcheal age in non-obese girls and the BMI is an important factor.     

Nutrition and fertility in Bangladesh: nutritional status of nonpregnant women

In October 1975 a longitudinal study of over 2000 married women was initiated in Matlab, Bangladesh, to determine the association of fertility with nutritional status. This paper reports the results on nutritional status among nonpregnant women. The average weight and height of the study women was 40.4 kg and 147.9 cm. Weight fluctuated throughout the 2 1/2 yr study period corresponding to seasonal food shortages. Maternal weight (controlling for height) was consistently lower for older, higher parity women, illustrating the negative impact of increasing numbers of births on the mother's nutrient stores. Older women were also shorter than younger women, due to greater deficits in growth during childhood. Older, higher parity women had slightly lower hematocrits than younger women with an overall mean of 35%. Education level was associated positively with height, weight, and hematocrit. Muslims were taller and heavier than Hindus, reflecting their generally higher socioeconomic status. The seasonal pattern of nutritional status is discussed in relation to the seasonality of food availability, activity patterns, and incidence of infectious disease.     

Exposures to Endocrine-Disrupting Chemicals and Age of Menarche in Adolescent Girls in NHANES (2003–2008)

Background: The observed age of menarche has fallen, which may have important adverse social and health consequences. Increased exposure to endocrine-disrupting compounds (EDCs) has been associated with adverse reproductive outcomes.Objective: Our objective was to assess the relationship between EDC exposure and the age of menarche in adolescent girls.Methods: We used data from female participants 12–16 years of age who had completed the reproductive health questionnaire and laboratory examination for the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey (NHANES) for years 2003–2008 (2005–2008 for analyses of phthalates and parabens). Exposures were assessed based on creatinine-corrected natural log urine concentrations of selected environmental chemicals and metabolites found in at least 75% of samples in our study sample. We used Cox proportional hazards analysis in SAS 9.2 survey procedures to estimate associations after accounting for censored data among participants who had not reached menarche. We evaluated body mass index (BMI; kilograms per meter squared), family income-to-poverty ratio, race/ethnicity, mother’s smoking status during pregnancy, and birth weight as potential confounders.Results: The weighted mean age of menarche was 12.0 years of age. Among 440 girls with both reproductive health and laboratory data, after accounting for BMI and race/ethnicity, we found that 2,5-dichlorophenol (2,5-DCP) and summed environmental phenols (2,5-DCP and 2,4-DCP) were inversely associated with age of menarche [hazard ratios of 1.10; 95% confidence interval (CI): 1.01, 1.19 and 1.09; 95% CI: 1.01, 1.19, respectively]. Other exposures (total parabens, bisphenol A, triclosan, benzophenone-3, total phthalates, and 2,4-DCP) were not significantly associated with age of menarche.Conclusions: Our findings suggest an association between 2,5-DCP, a potential EDC, and earlier age of menarche in the general U.S. population.     

Depression and Anxiety in Adolescent Females: The Impact of Sleep Preference and Body Mass Index

PurposeTo examine the differences in depressive symptoms and anxiety between (a) normal weight and overweight, and (b) morning type and evening type (sleep chronotype) adolescent girls. The interaction of sleep chronotype and weight and depressive symptoms and anxiety were also examined.MethodThe design consisted of a cross-sectional study of 264 adolescent females (mean age = 14.9 ± 2.2, range 11–17 years). Sleep chronotype, depressive symptoms, and anxiety were obtained by self-report questionnaire. The mean of three measurements of height and weight was used to calculate the body mass index (BMI). BMI was plotted on the CDC BMI-for-age growth charts to obtain percentile ranking. Participants were categorized into two groups according to BMI percentile: normal weight (<85th percentile) and overweight (≥85th percentile).ResultsCompared with normal-weight females, overweight females were more likely to be non-Caucasian, lower socioeconomic status, have more advanced pubic hair and breast stages, and earlier age at menarche. No differences were observed with respect to sleep chronotype, depressive symptoms, and trait anxiety between normal weight and overweight females. Evening chronotype was associated with more depressive symptoms (β = ?.65, p < .01) and higher trait anxiety (β = ?.22, p < .05). Evening chronotype was associated with more depressive symptoms in both normal-weight and overweight females. However, the association was stronger in overweight females.ConclusionsIndividually, sleep and weight impact physical and mental health during adolescence. The combination of evening chronotype and overweight appears to have the strongest association on the emotional health of adolescent females. Further investigations are needed to provide potential biological mechanisms for this relationship.     

南阳市10~15岁月经来潮与未来潮女生体成分比较及相关因素分析

  目的  了解南阳市10~15岁月经来潮与未来潮女生体成分的年龄变化特点,预测月经初潮时间,为及时开展青春期的卫生保健工作提供可靠依据。  方法  于2020年8—12月及2021年3—10月,对南阳市13个县市区采取抽签法随机整群抽样抽取1 523名女生,先通过问卷调查获取研究对象基本情况,然后利用日本百利达MC-180体成分分析仪对研究对象进行体成分测定。  结果  南阳市10~15岁女生体质量指数(BMI)、脂肪率、躯干脂肪率、肌肉量、骨量随着年龄的增长而逐渐增加,体内水分率随着年龄的增长逐渐减少。来潮女生的BMI、脂肪率、躯干脂肪率、肌肉量、骨量均高于未来潮女生,体内水分率低于未来潮女生。其中11~15岁已来潮女生与未来潮女生之间BMI差异均有统计学意义(t值分别为2.07,2.03,2.43,2.45,2.52,P值均 < 0.05);12~15岁已来潮女生与未来潮女生之间脂肪率、躯干脂肪率、肌肉量、骨量差异均有统计学意义(P值均 < 0.05);10,14,15岁未来潮女生与已来潮女生间体内水分率差异均有统计学意义(t值分别为2.75,2.35,2.37,P值均 < 0.05);10,11,14岁同年龄组农村女生和城市女生月经来潮率差异有统计学意义(χ2值分别为4.34,3.45,6.73,P值均 < 0.05)。  结论  女生月经初潮前后BMI、脂肪率、躯干脂肪率、肌肉量、骨量、体内水分率等体成分年龄变化特点有助于月经初潮的预判,月经初潮年龄与营养状况、BMI、体育锻炼、零食及饮料摄入等因素有关。     

Body size,fat distribution,menarcheal age and blood pressure in 14-year-old girls

Background: The relationships between body size and fatness and blood pressure are generally acknowledged. The majority of the few studies that have examined the effect of fat distribution and maturation rate on blood pressure have used secondary sex characteristics as the measure of maturity. The aim of the present study is to examine the associations between blood pressure and relative weight, fat distribution, recalled menarcheal age and occurrence of menstruation (yes/no) in a sample comprising of 1149 14-year-old girls. Methods: Systolic and diastolic blood pressure (DBP), height, weight and body circumferences were measured using standard protocols. Fatness was expressed as body mass index (BMI, kg/m²), whereas fat distribution was estimated by using waist-to-hip ratio. The girls' maturity status was assessed from exact recalled date of menarche. One-way analysis of covariance and multiple linear regression analyses were used to determine the strength of association among systolic blood pressure (SBP), DBP and BMI, menarcheal age and indices of fat distribution. Results and conclusion: Height and BMI are significantly associated with SBP. Relative weight is the most important factor related to SBP independently of chronological age and maturity status. Height and age at menarche are significantly associated with DBP. Height of 14-year-old girls shows the same strength of association with SBP and DBP, whereas maturity status negatively correlates with DBP. Fat distribution shows no effect on the level of DBP in girls.     

Women's education can improve child nutrition in India

Child malnutrition has long been recognized as a serious problem in India, but national-level data on levels and causes of malnutrition have been scarce. Hence, during 1992-93, a National Family Health Survey was carried out to examine the levels and determinants of child malnutrition in the country. More specifically, this survey estimated the levels of child malnutrition and examined the effects of mother's education and other demographic and socioeconomic factors on the nutritional status of children in India. Based on standards developed by the WHO, 52% of children under age 4 years are stunted, 17% are wasted, and 54% are underweight. Maternal education has the strongest independent influence on child malnutrition. Children whose mothers have little or no education tend to have a lower nutritional status than do children of more-educated mothers, even after controlling potentially confounding demographic and socioeconomic variables. The age of the child, birth order, and household economic status all have independent effects on nutritional status. Considering the very strong impact of maternal education on child nutrition, women's education and literacy programs could play an important role in improving the nutritional status of children.