Abstract
BACKGROUND: Stunting, also known as growth retardation, is a prominent health challenge for Mayan children, stemming from the complex interaction of malnutrition, inflammation, limited healthcare access, poverty, and food insecurity. Diet plays a key role in early childhood growth. A monotonous diet may lack essential nutrients, potentially affecting growth and developmental trajectories. Our objective was to explore the dietary patterns of Guatemalan Mayan children, comparing stunted children to those with typical growth. METHODS: We conducted a cross-sectional study involving 155 Mayan children aged 2 to 5 years in Guatemala. Dietary intake was assessed using three 24-hour recalls. A questionnaire assessed WASH (water, sanitation, and hygiene) service availability and household food insecurity via the Household Food Insecurity Access Scale (HFIAS). Additionally, we measured weight, height, age, body composition, and recent common childhood communicable diseases (CCCD). The dietary data was analyzed based on two approaches: The nutrient approach yields the prevalence of inadequacy, and A-posteriori approach using K-means cluster analysis informed about the dietary pattern of the sample, including types of foods, and their energy contribution to the diet. RESULTS: Stunting affected 53.5% of the children, and nearly half of the children (49.7%) had experienced one or more recent CCCD. The majority resided in food-insecure households (81.9%), with more than half located in rural areas (61.6%). They had a low intake of omega-3, omega-6 fatty calcium and choline. We found two distinct dietary patterns: the grain-based diet, represented by high intakes of cereal-based drinks and corn-based meals. The second was a dairy, poultry, and corn dietary pattern; distinguished by higher consumption of dairy products and poultry. CONCLUSION: Significantly more children living in severely food insecure households consumed a grain-based dietary pattern. The stunted children on the grain-based diet consumed more calories from grain-based drinks than any other food group. Beyond dietary monotony and poor nutritional quality, additional factors likely contribute to the high stunting rate, requiring further investigation.