Life history and the early origins of health differentials

Qualitative development of the PROMIS(R) pediatric stress response item banks

OBJECTIVE

To describe the qualitative development of the Patient-Reported Outcome Measurement Information System (PROMIS®) Pediatric Stress Response item banks.

METHODS

Stress response concepts were specified through a literature review and interviews with content experts, children, and parents. A library comprising 2,677 items derived from 71 instruments was developed. Items were classified into conceptual categories; new items were written and redundant items were removed. Items were then revised based on cognitive interviews (n = 39 children), readability analyses, and translatability reviews.

RESULTS

2 pediatric Stress Response sub-domains were identified: somatic experiences (43 items) and psychological experiences (64 items). Final item pools cover the full range of children's stress experiences. Items are comprehensible among children aged ≥8 years and ready for translation.

CONCLUSIONS

Child- and parent-report versions of the item banks assess children's somatic and psychological states when demands tax their adaptive capabilities.

Infant and fetal mortality among a high fertility and mortality population in the Bolivian Amazon

Indigenous populations experience higher rates of poverty, disease and mortality than non-indigenous populations. To gauge current and future risks among Tsimane Amerindians of Bolivia, I assess mortality rates and growth early in life, and changes in risks due to modernization, based on demographic interviews conducted Sept. 2002-July 2005. Tsimane have high fertility (total fertility rate = 9) and infant mortality (13%). Infections are the leading cause of infant death (55%). Infant mortality is greatest among women who are young, monolingual, space births close together, and live far from town. Infant mortality declined during the period 1990-2002, and a higher rate of reported miscarriages occurred during the 1950-1989 period. Infant deaths are more frequent among those born in the wet season. Infant stunting, underweight and wasting are common (34%, 15% and 12%, respectively) and greatest for low-weight mothers and high parity infants. Regression analysis of infant growth shows minimal regional differences in anthropometrics but greater stunting and underweight during the first two years of life. Males are more likely to be underweight, wasted, and spontaneously aborted. Whereas morbidity and stunting are prevalent in infancy, greater food availability later in life has not yet resulted in chronic diseases (e.g. hypertension, atherosclerosis and diabetes) in adulthood due to the relatively traditional Tsimane lifestyle.

Diurnal cortisol rhythms in Tsimane' Amazonian foragers: new insights into ecological HPA axis research

Although a growing body of research has documented important pathways by which the HPA axis mediates the interface between the psychosocial world and individual health, there is a paucity of data from nonwestern populations, particularly from those populations with distinct nutritional and infectious disease ecologies. The specific objectives of this study are: (1) to document variation in diurnal cortisol rhythms among the Tsimane', a remote population in the Bolivian Amazon, (2) to explore this variation by age and by gender, and (3) to compare diurnal rhythms from this study to other population based studies of cortisol conducted in industrialized nations. Salivary cortisol samples were collected twice daily, immediately upon waking and before bed, for three consecutive days from 303 participants (age 1.6-82 years, 1564 samples) in conjunction with the Tsimane' Amazonian Panel Study (TAPS). Cortisol rhythms showed strong age effects across the developmental span, with basal levels and slopes increasing into adulthood, although individuals older than 60 years demonstrated a precipitous flattening of the diurnal slope. Cortisol profiles were elevated in adult females compared to their age-matched male counterparts, and diurnal slopes, as well as mean cortisol concentrations among the Tsimane' were the lowest reported in any population based study of HPA axis function. Although the within-population variation in cortisol profiles was consistent with the established correlates of time of day, age, and sex, the between-population comparisons revealed dramatically lower levels of HPA activity among the Tsimane'. This study provides a benchmark against which to reference cortisol levels from industrialized populations, and expands the range of documented variation in HPA axis function in a nonwestern context.

An integrated scientific framework for child survival and early childhood development

Building a strong foundation for healthy development in the early years of life is a prerequisite for individual well-being, economic productivity, and harmonious societies around the world. Growing scientific evidence also demonstrates that social and physical environments that threaten human development (because of scarcity, stress, or instability) can lead to short-term physiologic and psychological adjustments that are necessary for immediate survival and adaptation, but which may come at a significant cost to long-term outcomes in learning, behavior, health, and longevity. Generally speaking, ministries of health prioritize child survival and physical well-being, ministries of education focus on schooling, ministries of finance promote economic development, and ministries of welfare address breakdowns across multiple domains of function. Advances in the biological and social sciences offer a unifying framework for generating significant societal benefits by catalyzing greater synergy across these policy sectors. This synergy could inform more effective and efficient investments both to increase the survival of children born under adverse circumstances and to improve life outcomes for those who live beyond the early childhood period yet face high risks for diminished life prospects.

Trade-offs underlying maternal breastfeeding decisions: a conceptual model

This paper presents a new conceptual model that generates predictions about breastfeeding decisions and identifies interactions that affect outcomes. We offer a contextual approach to infant feeding that models multi-directional influences by expanding on the evolutionary parent-offspring conflict and situation-specific breastfeeding theories. The main hypothesis generated from our framework suggests that simultaneously addressing breastfeeding costs and benefits, in relation to how they are interpreted by mothers, will be most effective. Our approach focuses on contributors to the attitudes and commitment underlying breastfeeding outcomes, beginning in the prenatal period. We conclude that some maternal-offspring conflict is inherent with the dynamic infant feeding relationship. Guidance that anticipates and addresses family trade-offs over time can be incorporated into breastfeeding support for families.

The influence of mortality and socioeconomic status on risk and delayed rewards: a life history theory approach

Why do some people take risks and live for the present, whereas others avoid risks and save for the future? The evolutionary framework of life history theory predicts that preferences for risk and delay in gratification should be influenced by mortality and resource scarcity. A series of experiments examined how mortality cues influenced decisions involving risk preference (e.g., $10 for sure vs. 50% chance of $20) and temporal discounting (e.g., $5 now vs. $10 later). The effect of mortality depended critically on whether people grew up in a relatively resource-scarce or resource-plentiful environment. For individuals who grew up relatively poor, mortality cues led them to value the present and gamble for big immediate rewards. Conversely, for individuals who grew up relatively wealthy, mortality cues led them to value the future and avoid risky gambles. Overall, mortality cues appear to propel individuals toward diverging life history strategies as a function of childhood socioeconomic status, suggesting important implications for how environmental factors influence economic decisions and risky behaviors.

Transgenerational effects of infantile adversity and enrichment in male and female rats

To discover whether the accumulation of life's experiences, adverse and enriching, inform, and serve the following generation by inheritance we examine whether stress to a weanling female will influence her future offspring, whether prereproductive enrichment to the dam, or postweaning enrichment to the offspring, can reverse the transgenerational effects of stress, and whether, like adversity, enrichment might have transgenerational effects. Female rats were exposed to stressors when they were 27-29 days old. Half of these females and their controls were then raised in an enriched environment from weaning until mating at 60 days to examine whether preproduction enrichment reverses the effects of preproduction stress on offspring. Half of the offspring of each group were raised in an enriched environment after weaning, to see whether it reverses the effects of preproduction stress and buttresses prereproductive enrichment. Behavior was examined in 625 adult offspring in 16 groups covering all permutations of the experimental variables (preproduction weanling stress (PS), preproduction enrichment (PE), offspring enrichment (OE), sex). Exploration, avoidance learning, startle, and social interaction were tested. Results reveal that very early prereproductive experience in females, adverse or enriching, will transgenerationally influence their future offspring, depending on the behavior tested and sex. Our finding that enrichment, whether to the parent or offspring generation, can ameliorate the transgenerational impact of adversity, has novel implications for the malleability of transgenerational inheritance, and its individual, social, and therapeutic impact.

Environmental contingency in life history strategies: the influence of mortality and socioeconomic status on reproductive timing

Why do some people have children early, whereas others delay reproduction? By considering the trade-offs between using one's resources for reproduction versus other tasks, the evolutionary framework of life history theory predicts that reproductive timing should be influenced by mortality and resource scarcity. A series of experiments examined how mortality cues influenced the desire to have children sooner rather than later. The effects of mortality depended critically on whether people grew up in a relatively resource-scarce or resource-plentiful environment. For individuals growing up relatively poor, mortality cues produced a desire to reproduce sooner--to want children now, even at the cost of furthering one's education or career. Conversely, for individuals growing up relatively wealthy, mortality cues produced a desire to delay reproduction--to further one's education or career before starting a family. Overall, mortality cues appear to shift individuals into different life history strategies as a function of childhood socioeconomic status, suggesting important implications for how environmental factors can influence fertility and family size.

Prenatal programming of postnatal plasticity?

Evidence indicates that maternal prenatal distress predicts problematic health and behavioral outcomes in children as well as infant/child cortisol levels and negative emotionality as reviewed here. Evidence that these physiological and behavioral characteristics themselves moderate environmental effects on development in a "for better and for worse" manner consistent with Belsky's differential susceptibility hypothesis and Boyce and Ellis' notions of biological sensitivity to context raises the prospect that susceptibility to rearing is a function of nurture (i.e., fetal environment), consistent with Boyce and Ellis' proposal that plasticity can be shaped by developmental experience. This hypothesis is supported by new findings from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development showing that low birth weight, a marker for an adverse prenatal environment, predicts infant difficult temperament, which is a susceptibility factor that we previously showed as moderating, in a for better and for worse manner, the effects of parenting and child care quality on socioemotional functioning. Moreover, recent Gene × Environment interaction research raises the prospect that some fetuses may be more susceptible to such "prenatal programming of postnatal plasticity" as a result of their genetic makeup. If this proves true, it will be consistent with the conclusion that early developmental plasticity is a function of both nature and nurture and may be evolutionarily adaptive, a further possibility considered in the discussion.

Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective

If a mother is stressed or anxious while pregnant her child is more likely to show a range of symptoms such as those of attention deficit hyperactivity disorder, conduct disorder, aggression or anxiety. While there remains some debate about what proportion of these effects are due to the prenatal or the postnatal environment, and the role of genetics, there is good evidence that prenatal stress exposure can increase the risk for later psychopathology. Why should this be? In our evolutionary history it is possible that some increase in these characteristics in some individuals was adaptive in a stressful environment, and that this type of fetal programming prepared the child or group for the environment in which they were going to find themselves. Anxiety may have been associated with increased vigilance, distractible attention with more perception of danger, impulsivity with more exploration, conduct disorder with a willingness to break rules, and aggression with the ability to fight intruders or predators. This adaptation for a future dangerous environment may explain why stress and anxiety, rather than depression, seem to have these programming effects; why there is a dose-response relationship with prenatal stress from moderate to severe and it is not only toxic stress that has consequences; why not all children are affected and why individual children are affected in different ways; and why the outcomes affected can depend on the sex of the offspring. An evolutionary perspective may give a different understanding of children in our society with these symptoms, and suggest new directions for research. For example, there is some evidence that the type of cognitive deficits observed after prenatal stress have specific characteristics; these may be those which were adaptive in a past environment.

The Adaptive Calibration Model of stress responsivity

This paper presents the Adaptive Calibration Model (ACM), an evolutionary-developmental theory of individual differences in the functioning of the stress response system. The stress response system has three main biological functions: (1) to coordinate the organism's allostatic response to physical and psychosocial challenges; (2) to encode and filter information about the organism's social and physical environment, mediating the organism's openness to environmental inputs; and (3) to regulate the organism's physiology and behavior in a broad range of fitness-relevant areas including defensive behaviors, competitive risk-taking, learning, attachment, affiliation and reproductive functioning. The information encoded by the system during development feeds back on the long-term calibration of the system itself, resulting in adaptive patterns of responsivity and individual differences in behavior. Drawing on evolutionary life history theory, we build a model of the development of stress responsivity across life stages, describe four prototypical responsivity patterns, and discuss the emergence and meaning of sex differences. The ACM extends the theory of biological sensitivity to context (BSC) and provides an integrative framework for future research in the field.

Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study

OBJECTIVE

To study in a large-scale cohort with prospective data the associations of psychosocial adversities during pregnancy with length of gestation and offspring size at birth.

METHODS

We defined a priori two types of psychosocial adversity during pregnancy: life stress (perceived burdens in major areas of life) and emotional symptoms (e.g. anxiety). Measures of offspring size at birth, including body weight, body length, abdominal and head circumference, were obtained from a national medical birth registry. We included in the analyses gestational age and offspring size at birth controlled for length of gestation; the latter was calculated by gestational-age-specific z scores (ZS) reported in 10(-3). We conducted multiple regression analyses adjusted for potential confounders to estimate the association between exposures and birth outcomes (n = 78017 pregnancies).

RESULTS

Life stress (per score increase by 1; range, 0-18) was associated with shorter length of gestation (days; B, -0.14; 95% confidence interval (CI), -0.19, -0.10), increased offspring body weight (ZS; B, 9.14; 95% CI, 4.99, 13.28), body length (ZS; B, 6.58; 95% CI, 2.39, 10.77), abdominal circumference (ZS; B, 9.96; 95% CI, 5.77, 14.16), and head circumference (ZS; B, 6.13; 95% CI, 1.95, 10.30). Emotional symptoms were associated with shorter length of gestation (days; B, -0.04; 95% CI, -0.07, -0.004) and decreased body length (ZS; B, -4.44; 95% CI, -7.57, -1.32) only.

CONCLUSIONS

Life stress and emotional symptoms both predicted a shorter length of gestation, while only life stress predicted an increased offspring size at birth controlled for length of gestation; yet, the associations were rather small. The fetoplacental-maternal unit may regulate fetal growth according to the type of psychosocial adversity and even increase fetal growth in response to maternal stress in major areas of life. This potentially reflects a basic principle of intrauterine human development in response to stress.

Reproductive development and parental investment during pregnancy: moderating influence of mother's early environment

The association between a woman's age at menarche and the birth weight of her children is highly variable across human populations. Life history theory proposes that a woman's early environment may moderate this association and thus account for some of the variation between populations. According to one life history theory model, for individuals who develop in a childhood environment of high local mortality rates (experienced subjectively as psychosocial stress), it can be adaptive to mature earlier, have more offspring during their reproductive lifetime, and reduce investment in each offspring. In an environment of low psychosocial stress, however, it may be adaptive to mature later, have fewer offspring, and invest more in each. In this study, birth weight and proportionate birth weight (neonate's birth weight as a percentage of its mother's prepregnancy weight) were used as measures of parental investment during pregnancy. In a sample of 580 first-time mothers, we tested the hypothesis that the psychosocial stress experienced as a child would moderate the association between age at menarche and investment during pregnancy. We found that earlier menarche in those women who experienced stressful life events before 15 years of age was associated with a lower birth weight and proportionate birth weight. Conversely, in those who reported no childhood stressors, earlier menarche was associated with increased birth weight and proportionate birth weight. Our data suggest that the moderating influence of the childhood psychosocial environment on the association between age at menarche and parental investment throughout gestation operates in a dose-dependent manner.

The Ecology of Human Development: Evolving Models for Cultural Psychology

The Whiting model aimed to provide a blueprint for psychocultural research by generating testable hypotheses about the dynamic relationships of a culture with the psychology and behavior of its members. This analysis identifies reasons why the model was so effective at generating hypotheses borne out in empirical research, including its foundational insight that integrated nature and nurture, its reconceptualization of the significance of early environments, and its attention to biopsychocultural dynamics active in those environments. Implications and the evolution of the ecological paradigm are tracked through presentations of three current models (developmental niche, ecocultural theory, bioecocultural microniche) and discussion of their related empirical literatures. Findings from these literatures converge to demonstrate the power of a developmental, cultural, ecological framework for explaining within- and between-population variation in cultural psychology.

Fetal origins of mental health: evidence and mechanisms

The concept of fetal programming states that changes in the fetal environment during sensitive periods of organ development may cause long-lasting changes in the structure and functioning of these organs later in life and influence the risk for chronic diseases such as coronary heart disease and type 2 diabetes. Fetal growth is a summary marker of the fetal environment and is reflected by relatively easy-to-obtain measures of size at birth such as birth weight. In the last two decades, a body of evidence emerged linking fetal growth with behavioural and mental health outcomes later in life. Cognitive functioning and behavioural problems in childhood, in particular inattention/hyperactivity, have been shown to be inversely related to fetal growth. Although results are mixed, risk for personality disorders and schizophrenia seems to be linked with fetal growth and adversity, while the evidence for mood disorders is weak. Vulnerability for psychopathology may also be influenced by prenatal adversity. There is evidence for associations of fetal growth with temperament in childhood as well as stress reactivity and distress. The associations of fetal growth with mental health later in life are potentially caused by specific prenatal factors such as maternal smoking, alcohol, toxins/drugs, nutrition, psychosocial stress and infection during pregnancy. The mechanisms likely involve changes in neurodevelopment and in the set point of neuroendocrine systems, and there is evidence that prenatal adversity interacts with genetic and postnatal environmental factors. Future studies should examine the effects of specific prenatal factors and attempt to disentangle genetic and prenatal environmental effects.

Extreme maternal underweight and feto-infant morbidity outcomes: a population-based study

OBJECTIVE

We sought to estimate the association between severity of maternal pre-pregnancy underweight and feto-infant morbidity outcomes.

METHODS

Missouri maternally linked cohort records from 1989 to 1997 inclusive were analysed. Using pre-pregnancy maternal body mass index (BMI), we classified study participants into: Normal (18.5-24.9) [referent group], mild thinness (17.0-18.5), moderate thinness (16.0-16.9) and severe thinness (<16.0). We estimated the association between pre-pregnancy underweight, underweight subtypes and feto-infant morbidity outcomes using adjusted odds ratios to approximate relative risks with correction for intra-cluster correlations.

RESULTS

Fetal growth curve trajectories for the two groups became divergent as from 30 gestational weeks. Underweight mothers were at increased risk for low birthweight (OR = 1.82; 95% CI = 1.77-1.88), very low birthweight (OR = 1.41; 95% CI = 1.31-1.51), small for gestational age (OR = 1.80; 95% CI = 1.76-1.84), preterm (OR = 1.37; 95% CI = 1.33-1.40) and very preterm (OR = 1.42; 95% CI = 1.34-1.50). These risk estimates increased in a dose-effect fashion with increasing severity of underweight status except for very preterm (p for trend < 0.01).

CONCLUSION

Pre-pregnancy underweight is a risk factor for a spectrum of feto-infant morbidity outcomes, with risk estimates being most pronounced among extremely underweight mothers.

Tracking biocultural pathways in population health: the value of biomarkers

BACKGROUND

Cultural factors and biomarkers are emerging emphases in social epidemiology that readily ally with human biology and anthropology. Persistent health challenges and disparities have established biocultural roots, and environment plays an integral role in physical development and function that form the bases of population health. Biomarkers have proven to be valuable tools for investigating biocultural bases of health disparities.

AIMS

We apply recent insights from biology to consider how culture gets under the skin and evaluate the construct of embodiment. We analyse contrasting biomarker models and applications, and propose an integrated model for biomarkers. Three examples from the Great Smoky Mountains Study (GSMS) illustrate these points.

SUBJECTS AND METHODS

The longitudinal developmental epidemiological GSMS comprises a population-based sample of 1420 children with repeated measures including mental and physical health, life events, household conditions, and biomarkers for pubertal development and allostatic load.

RESULTS

Analyses using biomarkers resolved competing explanations for links between puberty and depression, identified gender differences in stress at puberty, and revealed interactive effects of birthweight and postnatal adversity on risk for depression at puberty in girls.

CONCLUSION

An integrated biomarker model can both enrich epidemiology and illuminate biocultural pathways in population health.

Association of adult height and leg length with fasting plasma cortisol concentrations: evidence for an effect of normal variation in adrenocortical activity on growth

We have evaluated the relationship between activity of the hypothalamic-pituitary-adrenal (HPA) axis and adult height in adults recruited from the UK Hertfordshire Cohort Study. In a sample of 1,354 individuals, we found that height fell by 0.67 cm (95% CI 0.34-1.0) per SD (114 nmol/l) increase in fasting plasma cortisol concentrations. The association was continuous across the range of cortisol concentrations and was independent of the levels of corticosteroid binding globulin. It was of similar magnitude in men and women. In a subsample of the study available data on standing and sitting height was used to estimate trunk and leg length. Fasting plasma cortisol concentrations were found to have a much greater impact on leg length than trunk length. These findings suggest that physiological variations in adrenocortical glucocorticoid secretion in humans affect adult height. They also raise the possibility that the HPA axis may be involved in mediating resource allocation decisions and trade-offs during development perhaps by limiting physical growth to enable other competing processes.

Culture and the socialization of child cardiovascular regulation at school entry in the US

The measurement of cardiovascular functioning targets an important bridge between social conditions and differential well-being. Nevertheless, the biocultural, psychosocial processes that link human ecology to cardiovascular function in children remain inadequately characterized. Childrearing practices shaped by parents' cultural beliefs should moderate children's affective responses to daily experience, and hence their psychophysiology. The present study concerns interactions among family ecology, the normative social challenge of entry into kindergarten, and parasympathetic (vagal) cardiac regulation in US middle-class children (N = 30). Although parents believed children must be protected from overscheduling to reduce stress and improve socio-emotional adaptation, maternal rather than child schedules predicted parasympathetic regulation during a nonthreatening social engagement task following school entry. Children of busier married mothers, but less busy single mothers, showed the context-appropriate pattern of parasympathetic regulation, low respiratory sinus arrhythmia (RSA). These findings are expected if: maternal and family functioning, rather than the scheduling of the child's daily life, principally drive young children's cardiovascular responsiveness to a normative challenge; and busy schedules represent high family functioning with married mothers, but not under single-parent conditions wherein adult staffing is uniquely constrained. Family ecology is shaped by culture, and in turn shapes the development of children's cardiovascular responses. Appropriately fine-grained analysis of daily experience can illustrate how culturally driven parenting practices may have unintended consequences for child biological outcomes that vary by family structure.

The relationship between obstetric complications and temperament in eating disorders: a mediation hypothesis

OBJECTIVE

Recent studies have hypothesized that perinatal complications might increase the risk of developing eating disorders. However, it is unclear which pathways might link obstetric complications and eating disorders. The present study aimed at exploring the relationship between obstetric complications and temperament in eating disordered subjects.

METHODS

The sample was selected among subjects who took part in a prevalence study carried out on a representative sample of the general population and from among people with anorexia and bulimia nervosa referred to an outpatient specialist unit. Subjects who were born in the two obstetric wards of Padua Hospital between 1971 and 1979 and who completed the Tridimensional Personality Questionnaire were included. A blind analysis of the obstetric records of the whole sample was performed. The final sample was composed of 66 anorexia nervosa, 44 bulimia nervosa, and 257 control subjects.

RESULTS

Among the different groups of obstetric complications, only the group that included preterm birth and other signs of neonatal immaturity or dysmaturity displayed a significant relationship with harm avoidance. The use of a mediation path analytic model revealed a significant, but incomplete, mediation effect of harm avoidance in explaining the link between neonatal dysmaturity and the development of eating disorders. Maternal weight gain during pregnancy seemed to have a protective effect on harm avoidance.

CONCLUSIONS

The presence of signs of neonatal dysmaturity at birth seems to influence the development of high levels of harm avoidance in eating disorders.

Developmental origins of adult health and disease: the role of periconceptional and foetal nutrition

The 'developmental origins of adult health and disease' hypothesis stated that environmental factors, particularly maternal undernutrition, act in early life to programme the risks for adverse health outcomes, such as cardiovascular disease, obesity and the metabolic syndrome in adult life. Early physiological tradeoffs, including activation of the foetal hypothalamo-pituitary-adrenal (HPA) axis, confer an early fitness advantage such as foetal survival, while incurring delayed health costs. We review the evidence that such tradeoffs are anticipated from conception and that the periconceptional nutritional environment can programme the developmental trajectory of the stress axis and the systems that maintain and regulate arterial blood pressure. There is also evidence that restriction of placental growth and function, results in an increased dependence of the maintenance of arterial blood pressure on the sequential recruitment of the sympathetic nervous system and HPA axis. While the 'early origins of adult disease' hypothesis has focussed on the impact of maternal undernutrition, an increase in maternal nutritional intake and in maternal body mass intake has become more prevalent in developed countries. Exposure to overnutrition in foetal life results in a series of central and peripheral neuroendocrine responses that in turn programme development of the fat cell and of the central appetite regulatory system. While the physiological responses to foetal undernutrition result in the physiological trade off between foetal survival and poor health outcomes that emerge after reproductive senescence, exposure to early overnutrition results in poor health outcomes that emerge in childhood and adolescence. Thus, the effects of early overnutrition can directly impact on reproductive fitness and on the health of the next generation. In this context, the physiological responses to relative overnutrition in early life may directly contribute to an intergenerational cycle of obesity.

The sex ratio and age-specific male mortality: evidence for culling in utero

While adverse conditions early in life reportedly predispose individuals to increased mortality in adulthood, controversy remains as to whether exogenous insults in utero, especially among male fetuses, induce similar cohort "damage" in populations. A rival theory postulates that exogenous stressors in gestation may "cull" frail male members of the cohort before birth, leaving a smaller but hardier cohort with improved survival. Recent tests, which use the sex ratio (i.e., the odds of a male live birth) as a gauge of insults inflicted upon cohorts in gestation, support the culled cohort argument. These tests, however, examined only aggregate male lifespan, thereby obscuring potential heterogeneity of both damaged and culled cohorts at specific ages over the life course. Using time-series methods, we explore associations between the sex ratio and cohort male mortality in infancy (before age 1), childhood (1-4 years), youth (5-19 years), adulthood (20-54 years), and old-age (55-79 years). We examine males born in Sweden (1751-1913), Denmark (1835-1913), and England and Wales (1841-1912). Our findings generally support culled cohorts in that male mortality across all ages fell below its expected value among cohorts in which the sex ratio dropped below its expected level. These findings suggest that exogenous shocks to gestation, as measured by a lower than expected sex ratio, may cull males in utero, leaving behind a less frail cohort over the entire life course.

Is there an elephant in the room? Addressing rival approaches to the interpretation of growth perturbations and small size

Two interpretations of growth perturbation and small size are commonly applied in human biology: an adaptationist approach in which small size is considered to be an a relatively beneficial adjustment to environmental stressors, and a biomedical approach in which small size is considered nonadaptive, a sign of dysfunction or pathology. These two interpretations conflict, but are used without acknowledging or addressing the conflict. This article reviews the strengths and weaknesses of the two. This exercise does not prove the indisputable superiority of either approach. Considerations of epistemology show that biologists will never be faced with a decisive test of either, much as they might like such clear cut evidence. Nevertheless, it is possible that a gradual decrease in the productivity of one approach will become a sufficient reason to abandon it. Alternatively, if specific areas of application can be distinguished, each approach might continue to be productive in its own domain.

Evolution of Infant and Young Child Feeding: Implications for Contemporary Public Health

Evolutionary anthropological and ethnographic studies are used to develop a general conceptual framework for understanding prehistoric, historic, and contemporary variation in human lactation and complementary feeding patterns. Comparison of similarities and differences in human and nonhuman primate lactation biology suggests humans have evolved an unusually flexible strategy for feeding young. Several lines of indirect evidence are consistent with a hypothesis that complementary feeding evolved as a facultative strategy that provided a unique adaptation for resolving tradeoffs between maternal costs of lactation and risk of poor infant outcomes. This evolved flexibility may have been adaptive in the environments in which humans evolved, but it creates potential for mismatch between optimal and actual feeding practices in many contemporary populations.

Stress responsiveness in adult life: influence of mother's diet in late pregnancy

CONTEXT

Men and women whose mothers ate an unbalanced high-protein, low-carbohydrate diet in late pregnancy have raised blood pressure. We recently showed that they also have raised fasting plasma cortisol concentrations. Because raised fasting cortisol concentrations probably reflect a greater response to the stress of fasting and venesection, we suspected that this diet may have led to increased stress responsiveness in the adult offspring.

OBJECTIVE

The aim was to determine whether an unbalanced high-protein diet during pregnancy is associated with increased cortisol secretion in response to psychological stress in the offspring.

DESIGN AND PARTICIPANTS

Salivary cortisol concentrations were measured during a modified Trier Social Stress Test in 70 men and women aged 36.3 yr whose mothers had taken part in a dietary intervention in which they were advised to eat 1 pound (0.45 kg) of red meat daily during pregnancy and to avoid carbohydrate-rich foods.

RESULTS

The offspring of women who reported greater consumption of meat and fish in the second half of pregnancy had higher cortisol concentrations during the Trier Test. Compared with the offspring of mothers who had reported eating no more than 13 meat/fish portions per week, the average cortisol concentrations were raised by 22% (95% confidence interval, 13 to 71%) and 46% (5 to 103%) in the offspring of those eating 14-16 and at least 17 portions per week, respectively.

CONCLUSIONS

These findings provide the first human evidence that an unbalanced high protein maternal diet during late pregnancy leads to increased cortisol secretion in response to psychological stress in the offspring.

Programming of the stress response: a fundamental mechanism underlying the long-term effects of the fetal environment?

There is a large body of evidence which suggests that an adverse fetal environment results in a heightened biobehavioral response to stress, with increased activity of the classical mediators of the stress response, including the hypothalamic-pituitary adrenal axis and autonomic nervous system. Although this has been amply demonstrated in animal experiments, several recent studies suggest that the same processes operate in human populations and may have important consequences for health. The evidence suggests that an adverse early environment or markers of an adverse environment such as low birth weight are linked with long-term alterations in these neuroendocrine systems. However, these studies also demonstrate that there is a considerable degree of heterogeneity in the responses observed which appear to depend on a variety of factors such as the nature or timing of the adverse exposure as well as the gender of the offspring. The mediators of these classical neuroendocrine responses such as cortisol and catecholamines are biologically potent and may directly influence disease susceptibility by means of their effects on metabolism and the vasculature. However, lifelong changes in the set point of these neuroendocrine systems in response to the early environment may also direct the course of development during fetal life, infancy and childhood towards the generation of a phenotype adapted for the adult environment predicted by the clues available during fetal life. This has biological advantages if the actual adult environment turns out to be appropriate for the phenotype. However, ill health may occur if the phenotype is not well matched to the actual environment encountered in adult life.

The predictive adaptive response and metabolic syndrome: challenges for the hypothesis

In humans and other mammals, maternal undernutrition or stress during gestation results in small offspring with permanently altered metabolism and tissue composition. It has been suggested that such responses might exist because in utero conditions provide a reliable 'prediction' of the environmental conditions that foetuses will eventually be exposed to during adulthood. Thus, some developmental responses to the early environment might improve an individual's evolutionary success in a similar future environment.

Secondary sex ratio variation during stressful times: the impact of the French revolutionary wars on a German parish (1787-1802)

The observation that declines in the human secondary sex ratio (SSR) may be linked to stressful periconceptional periods has received considerable attention (Catalano [2003] Hum Reprod 18:1972-1975; Catalano et al. [2005] Int J Epidemiol 34:944-948, [2005] Hum Reprod 20:1221-1227, [2005] Paediatr Perinat Epidemiol 19:413-420). For the purpose of testing the external validity of this phenomenon, birth records from four German village genealogies (N = 1,048) were analyzed to study the impact of the French Revolutionary Wars (1787-1802) on the proportion of male births. All births were subdivided into three cohorts (prewar, 1787-1792; war, 1792-1797; and postwar, 1797-1802). Differences in SSR between cohorts achieved statistical significance (chi2= 7.695; df = 2; P = 0.021). In addition, changes in SSR before, during, and after the wars were monitored by risk analysis. Using the SSR of the prewar period as a control, the results of the war cohort failed to achieve statistical significance (regression coefficient, -0.257; ExpB= 0.773; P = 0.118), while the odds reduction of 32.3% in the postwar period proved to be statistically significant (regression coefficient, -0.390; ExpB= 0.677; P = 0.006). It is hypothesized that the experience of postwar economic hardship (attributable to lowered food availability paired with dietary changes) represents the most likely proximate cause. The study also finds evidence of a parental sex ratio manipulation strategy meant to offset the female-biased SSR after the wars. It is argued that from an evolutionary perspective both the decline in SSR in response to stress as well as parental manipulation of the tertiary sex ratio convey reproductive advantages.

Maternal age and the size of White, Black, Hispanic, and mixed infants

OBJECTIVE

To clarify the interaction between maternal age and race in the prediction of infant size at birth.

METHODS

Birth certificate data was used to study the relationship between maternal age, race/ethnicity, and the size of term, singleton infants born to 91,061 healthy, non-smoking, non-substance using, primigravidas.

RESULTS

Maternal race/ethnicity (Black race: OR: 1.95, 95% CI: 1.49-2.56; Hispanic ethnicity: OR: 1.38, 95% CI: 1.19-1.61) and the interaction term, maternal age x race/ethnicity (OR: 1.06, 95% CI: 1.01-1.11) predicted small-for-gestational age (SGA) birth. The strength of the association between Black race and SGA delivery increased and the strength of the association between Hispanic ethnicity and SGA delivery decreased with age (P < 0.001 for trend). Thus, Black and Hispanic teenagers were more likely to have SGA babies than White teenagers (1.7% and 1.6%, respectively compared to 1.2%; P = 0.003). However, Black women who postponed childbearing until their mid-twenties were more likely to have SGA babies than their Hispanic and White counterparts (2.6% compared to 1.2%, and 1.0%, respectively; P < 0.0001).

CONCLUSION

The findings suggest that acquired maternal characteristic(s) cause the reproductive health of Black primigravidas to deteriorate and Hispanic primigravidas to improve with age.

High ponderal index at birth predicts high estradiol levels in adult women

Inter-individual variation in levels of sex hormones results from differences in genetic, developmental, and environmental factors. We tested a hypothesis that programming of the fetal neuroendocrine axis may predispose some women to produce higher levels of steroid hormones during their menstrual cycles as adults. One hundred forty-five regularly menstruating 24- to 36- year-old women collected daily saliva samples for one menstrual cycle. Data on women's birth weights and birth lengths were obtained from medical records. A positive relationship was observed between ponderal index at birth (an indicator of nutritional status, calculated as birth weight/(birth length)(3)) and levels of estradiol (E2) in menstrual cycles, after controlling for potential confounding factors. Mean E2 was 16.4 pmol/l in the low ponderal index tertile, 17.3 pmol/l in the moderate ponderal index tertile, and 19.6 pmol/l in the high ponderal index tertile (the high ponderal index group had significantly higher E2 than both low and moderate ponderal index groups, P=0.0001). This study shows a positive association between ponderal index recorded for women at birth and levels of E2 measured during their menstrual cycles as adults. This suggests that conditions during fetal life influence adult production of reproductive hormones and may contribute to inter-individual variation in reproductive function. In addition, because large size at birth is one of the factors linked with an increased risk of breast cancer, our findings provide a physiological link for the observed positive relationship between indicators of energetic conditions during fetal growth and breast cancer in women.