PT - JOURNAL ARTICLE AU - Jemie Walrod AU - Erica Seccareccia AU - Iván Sarmiento AU - Juan Pablo Pimentel AU - Shivali Misra AU - Juana Morales AU - Alison Doucet AU - Neil Andersson TI - Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador AID - 10.1136/bmjopen-2017-020760 DP - 2018 Jul 01 TA - BMJ Open PG - e020760 VI - 8 IP - 7 4099 - http://bmjopen.bmj.com/content/8/7/e020760.short 4100 - http://bmjopen.bmj.com/content/8/7/e020760.full SO - BMJ Open2018 Jul 01; 8 AB - Objectives We aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people.Design We used mixed methods including household questionnaires, discussion groups with respondents of the questionnaires and anthropometric measurement of children (6 months to 12 years) from surveyed households.Setting The study involved four Andean indigenous communities transitioning from traditional to Western lifestyles. They subsist mainly on small-scale agriculture and have a rich cultural heritage including their traditional language.Participants Anthropometric data were collected from 298 children from 139 households in four communities; all households completed the questionnaire. We held five discussion groups (6–10 participants each): three composed of mothers and two of farmers.Primary and secondary outcome measures Primary outcomes were stunting, overweight, food insecurity and their relationship with demographics, dietary habits and agricultural habits.Results Of 298 children, 48.6% were stunted and 43.3% overweight for age. Stunted children were more likely to live in households that sold livestock (ORa 1.77, 95% CIa 1.06 to 2.95) and with illiterate primary caretakers (ORa 1.81, 95% CIa 1.07 to 3.06), but were less likely to live in households with irrigation (ORa 0.47, 95% CIa 0.27 to 0.81). Overweight children were more likely to be male (ORa 1.87, 95% CIa 1.02 to 3.43) and live in a household that sold livestock (ORa 2.14, 95% CIa 1.14 to 4.02). Some 67.8% of children lived in a household with food insecurity, more frequently in those earning below minimum wage (ORa 2.90, 95% CIa 1.56 to 5.41) and less frequently in those that ate quinoa in the past 24 hours (ORa 0.17, 95% CIa 0.06 to 0.48). Discussion groups identified irrigation and loss of agricultural and dietary traditions as important causes of poor childhood nutrition.Conclusion Many indigenous communities face tumultuous cultural, nutritional and epidemiological transitions. Community-based interventions on factors identified here could mitigate negative health outcomes.