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Piperata BA, Dufour DL. Food Insecurity, Nutritional Inequality, and Maternal–Child Health: A Role for Biocultural Scholarship in Filling Knowledge Gaps. ANNUAL REVIEW OF ANTHROPOLOGY 2021. [DOI: 10.1146/annurev-anthro-101819-110317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Food insecurity, a significant contributor to nutritional inequality, disproportionately affects women and children in low- and middle-income countries. The magnitude of the problem has inspired research on its impacts on health, especially on nutritional status and, more recently, mental well-being. Current research is dominated by surveillance-type studies that emphasize access, one of food security's four dimensions. Findings are inconclusive regarding the association between food insecurity and women and children's nutritional status, but some evidence indicates that it is a key contributor to mental distress in women. To understand these inconsistent findings, we emphasize the need for research on the strategies that people use to cope with inadequate access to food. We contend that biocultural approaches that recognize the importance of local contexts and the role of broader political-economic factors in shaping them are well suited for addressing current knowledge gaps.
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Affiliation(s)
- Barbara A. Piperata
- Department of Anthropology, The Ohio State University, Columbus, Ohio 43210, USA
| | - Darna L. Dufour
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado 80309, USA
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Wutich A. Water insecurity: An agenda for research and call to action for human biology. Am J Hum Biol 2019; 32:e23345. [PMID: 31697009 DOI: 10.1002/ajhb.23345] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/28/2019] [Accepted: 09/30/2019] [Indexed: 12/21/2022] Open
Abstract
Water insecurity-the lack of adequate and safe water for a healthy and productive life-is one of the greatest threats facing humans in the coming century. By 2030, half of the world is expected to be living in water-stressed conditions, given current climate change scenarios. A key goal of the UN Water Action Decade and Sustainable Development Goal 6 is to improve water security for the three billion people globally affected, but the future looks grim. For many communities, from Cape Town, South Africa to Flint, United States, the imagined dystopian future of severe water shortages has already arrived-shaped not so much by lack of water, but by aging infrastructure, underfunded utilities, social exclusion, politicized commodification, and environmental racism. Stepping off from my biocultural research in Cochabamba, Bolivia, I discuss how recent research is dramatically advancing our understanding of water insecurity, such as new findings around the biocultural causes and consequences of dehydration, contamination, and water stress. But, much more needs be done to support local communities in creating fair and just water systems. I discuss how human biologists can make crucial contributions toward the advancement of a much-needed science of water insecurity, while highlighting some practical and ethical challenges to advancing a core mission of providing safe, sufficient water to all.
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Affiliation(s)
- Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
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Guerrón-Montero C, Moreno-Black G. Household Structure and Dietary Patterns in the Afro-Ecuadorian Highlands. Food Nutr Bull 2016. [DOI: 10.1177/156482650102200105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dietary patterns in contemporary societies have been a primary focus of nutritional and anthropological research. Class, occupation, income, and gender have been studied when analyzing dietary patterns and the roots of malnutrition and hunger; however, the effects of household structure have received less attention. The main purpose of our study was to obtain information on the diet of a highland Afro-Ecuadorian community and examine the relationship between household structure and dietary patterns. Survey questionnaires, in-depth questionnaires, and participant observation were utilized to examine how women in female-headed households compare with women in male-headed households in meeting the dietary needs of their families. There was no significant difference in food-acquisition patterns. Weekly expenditures for food in the two types of households were similar, despite different income levels. However, female-headed households had higher food-group scores and consumed more meals per day.
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Vellema W, Desiere S, D'Haese M. Verifying Validity of the Household Dietary Diversity Score: An Application of Rasch Modeling. Food Nutr Bull 2015; 37:27-41. [PMID: 26683281 DOI: 10.1177/0379572115620966] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Household Dietary Diversity Score (HDDS) was developed to measure household food access, one of the levels of food security. Previous research has shown dietary diversity is related to food security. However, the validity of the HDDS in the form developed by the Food and Nutrition Technical Assistance (FANTA) project-12 food groups, 24-hour recall-and most frequently used by development organizations and nongovernmental organizations has never been verified. OBJECTIVE To verify the construct validity of the HDDS. METHODS A Rasch model was used to test the extent to which the HDDS meets the criteria required for interval scale measurement, using data from 1015 households in Colombia and Ecuador. RESULTS Different dietary patterns between Colombia and Ecuador and 2 cultural groups within Ecuador required data to be split into 3 subgroups. For each subgroup, the food groups meeting the criteria and their difficulty ranking were different. Refined indices, containing only those food groups meeting the criteria, contained 7 items in Colombia, 10 for Kichwa households in Ecuador, and 9 for migrant households. CONCLUSION The indicator in its current form does not meet all criteria. Even when analyzing culturally homogenous subgroups within a small region, the components of the indicator do not form a reliable way of measuring household-level food access.
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Affiliation(s)
- Wytse Vellema
- Ghent University, Ghent, Belgium International Centre for Tropical Agriculture (CIAT), Cali, Colombia
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Bender RL, Dufour DL, Valenzuela LO, Cerling TE, Sponheimer M, Reina JC, Ehleringer JR. Stable isotopes (carbon, nitrogen, sulfur), diet, and anthropometry in urban Colombian women: Investigating socioeconomic differences. Am J Hum Biol 2014; 27:207-18. [DOI: 10.1002/ajhb.22640] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 09/16/2014] [Accepted: 09/18/2014] [Indexed: 12/31/2022] Open
Affiliation(s)
- Richard L. Bender
- Department of Anthropology; University of Colorado; Boulder Colorado
| | - Darna L. Dufour
- Department of Anthropology; University of Colorado; Boulder Colorado
| | - Luciano O. Valenzuela
- Department of Biology; University of Utah; Salt Lake City Utah
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Laboratorio de Ecología Evolutiva Humana; Unidad de Enseñanza Universitaria Quequen, Universidad Nacional del Centro de la Provincia de Buenos Aires; Buenos Aires Argentina
| | | | - Matt Sponheimer
- Department of Anthropology; University of Colorado; Boulder Colorado
| | - Julio C. Reina
- Departmento de Pediatría; Universidad del Valle and Centro Médico Imbanaco; Cali Colombia
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Vercellotti G, Piperata BA, Agnew AM, Wilson WM, Dufour DL, Reina JC, Boano R, Justus HM, Larsen CS, Stout SD, Sciulli PW. Exploring the multidimensionality of stature variation in the past through comparisons of archaeological and living populations. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 155:229-42. [PMID: 24894916 PMCID: PMC7424595 DOI: 10.1002/ajpa.22552] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/23/2014] [Indexed: 11/11/2022]
Abstract
Adult stature variation is commonly attributed to differential stress-levels during development. However, due to selective mortality and heterogeneous frailty, a population's tall stature may be more indicative of high selective pressures than of positive life conditions. This article examines stature in a biocultural context and draws parallels between bioarchaeological and living populations to explore the multidimensionality of stature variation in the past. This study investigates: 1) stature differences between archaeological populations exposed to low or high stress (inferred from skeletal indicators); 2) similarities in growth retardation patterns between archaeological and living groups; and 3) the apportionment of variance in growth outcomes at the regional level in archaeological and living populations. Anatomical stature estimates were examined in relation to skeletal stress indicators (cribra orbitalia, porotic hyperostosis, linear enamel hypoplasia) in two medieval bioarchaeological populations. Stature and biocultural information were gathered for comparative living samples from South America. Results indicate 1) significant (P < 0.01) differences in stature between groups exposed to different levels of skeletal stress; 2) greater prevalence of stunting among living groups, with similar patterns in socially stratified archaeological and modern groups; and 3) a degree of regional variance in growth outcomes consistent with that observed for highly selected traits. The relationship between early stress and growth is confounded by several factors-including catch-up growth, cultural buffering, and social inequality. The interpretations of early life conditions based on the relationship between stress and stature should be advanced with caution.
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Affiliation(s)
| | | | - Amanda M. Agnew
- Department of Anthropology, The Ohio State University, Columbus, OH 43210
- Division of Anatomy, The Ohio State University, Columbus, OH 43210
| | - Warren M. Wilson
- Department of Archaeology, University of Calgary, Calgary, Alberta AB T2N 1N4
| | - Darna L. Dufour
- Department of Anthropology, University of Colorado, Boulder, CO 80309
| | - Julio C. Reina
- Departamento de Pediatría, Universidad del Valle and Centro Médico Imbanaco de Cali, Colombia
| | - Rosa Boano
- Dipartimento di Biologia Animale e dell’Uomo, Università di Torino, Torino, Italy 10123
| | - Hedy M. Justus
- Department of Anthropology, The Ohio State University, Columbus, OH 43210
| | | | - Sam D. Stout
- Department of Anthropology, The Ohio State University, Columbus, OH 43210
| | - Paul W. Sciulli
- Department of Anthropology, The Ohio State University, Columbus, OH 43210
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Dufour DL, Bender RL, Reina JC. Local trends in diet in urban Colombia, 1990-1995 to 2008: Little evidence of a nutrition transition among low-income women. Am J Hum Biol 2014; 27:106-15. [DOI: 10.1002/ajhb.22621] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 07/18/2014] [Accepted: 08/20/2014] [Indexed: 12/11/2022] Open
Affiliation(s)
- Darna L. Dufour
- Department of Anthropology; University of Colorado; Boulder Colorado 80309-0233
| | - Richard L. Bender
- Department of Anthropology; University of Colorado; Boulder Colorado 80309-0233
| | - Julio C. Reina
- Departamento de Pediatría; Universidad del Valle and Centro Médico Imbanaco de Cali; Colombia
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Hicks K. Instrumental social support and women's body composition in El Alto, Bolivia. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 152:51-7. [PMID: 23913665 DOI: 10.1002/ajpa.22327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 06/06/2013] [Indexed: 11/10/2022]
Abstract
Instrumental social support, or aid in the form of labor or money, may exert a positive influence on economic welfare and food security. Several investigators have found a positive relationship between social support and nutritional status, while others have found a negative association between social support and central adiposity. In the rural Andes, extra-household economic cooperation has long been an important adaptive strategy, and the breakdown of these relationships is one reason for high rates of rural-to-urban migration, including to the Bolivian city of El Alto. This research investigates the influence of instrumental support on women's body composition. Information was collected on individual perception of instrumental support and anthropometric indicators of nutritional status including percent body fat (bioelectrical impedance analysis (BIA)), BMI, and distribution of fat on trunk relative to limbs (Ratio of subscapular to triceps skinfold (STR)), and multiple linear regression analysis used to test the prediction that instrumental social support is positively related to body fat stores. Controlling for age and household socioeconomic status, perceived access to one or more sources of instrumental support was positively and significantly related to overall levels of adiposity. There is no evidence that STR mediates the relationship between instrumental social support and body composition. This analysis offers support for the prediction that economic social support has direct effects on women's energy stores. The interpretation of these results is somewhat ambiguous given the high levels of overweight and obesity in this population.
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Affiliation(s)
- Kathryn Hicks
- University of Memphis, Department of Anthropology, 316 Manning Hall, Memphis, TN, 38152
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Hadley C, Crooks DL. Coping and the biosocial consequences of food insecurity in the 21st century. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2012; 149 Suppl 55:72-94. [DOI: 10.1002/ajpa.22161] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 09/07/2012] [Indexed: 11/10/2022]
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Benefice E, Lévi P, Banouvong P. Progressive growth deterioration in a context of nutritional transition: a case study from Vientiane (Lao PDR). Ann Hum Biol 2012; 39:239-46. [PMID: 22574680 DOI: 10.3109/03014460.2012.681803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The high rates of rapid urban and economic growth occurring in Asia are bringing about parallel changes in both food consumption patterns and nutritional status. AIM The aim of this study is to examine the impact of these changes on the nutritional and health status of mothers and their offspring in Vientiane, Lao PDR. METHODOLOGY Over 2 consecutive years, a follow-up study of 150 infant-mother pairs living at three different levels of urbanization was performed in Vientiane. The mothers completed a questionnaire on their eating habits. Clinical examinations and anthropometric measurements were also carried out. RESULTS The results showed that, in general, the dietary energy content was low (providing only 83% of the energy requirement) and there were deficiencies in calcium, vitamin A, Folate and iron. The main energy source was rice (providing 40.9%), while 40% of the protein provided by meat and fish provided 19.8%. The differences observed in the food contribution to energy intakes and in food diversity varied with the level of urbanization. The prevalence of stunting (13.9%; CI 10.0 ∼ 18.6%) was less than that reported at the country level. Stunting was related to age, the sex of the child and the mother's physique and varied according to the level of urbanization. CONCLUSION The level of urbanization in Vientiane influences the pace of the ongoing process of nutritional transition.
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Affiliation(s)
- Eric Benefice
- IRD, Institut de Recherche pour le développement, France.
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Gartin M. Food deserts and nutritional risk in Paraguay. Am J Hum Biol 2012; 24:296-301. [PMID: 22450869 DOI: 10.1002/ajhb.22270] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The purpose of this case study in San Lorenzo, Paraguay is to identify a food desert in a developing context and to test if food deserts shape residential obesity risk. This article reviews some of the debate surrounding whether food deserts really exist; and, if so, what are the dietary implications of living in a food desert. METHODS The research is an exploratory/explanatory design. The author mapped the downtown food retail district and the neighborhood food environment to identify what stores/markets. The author assessed each type of food store using an adapted version of the Nutrition Environment Measure Survey for Stores (NEMS-S) for Paraguay. Body mass index and household characteristics were collected with 68 households in a small neighborhood; and, the author matched the NEMS-S scores to the store reported by households as their primary grocery store for regression tests. RESULTS The results suggest that a tradeoff exists in the local food environment between food stores which negatively impact obesity risk for local residents. Exposure to this tradeoff appears to worsen as people live longer in the food desert. Thus, the results support the location of a food desert finding in Paraguay. CONCLUSIONS The underlying factors of a food desert extend beyond food access to focus on the issues of justice. A way to improve upon future research to build scholarship on the relationship between deprivation and obesity requires that sample sizes are either large or representative of the population and that the research should be based on multiple neighborhood and city sites.
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Affiliation(s)
- Meredith Gartin
- School of Human Evolution and Social Change, Arizona State University, Tempe, USA.
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Piperata BA, Spence JE, Da-Gloria P, Hubbe M. The nutrition transition in amazonia: rapid economic change and its impact on growth and development in Ribeirinhos. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2012; 146:1-13. [PMID: 21541919 DOI: 10.1002/ajpa.21459] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The goal of this longitudinal study was to assess the impact of economic change and increased market integration on subsistence strategies, living conditions, growth, and nutritional status of Ribeirinhos living in the rural Amazon, Brazil. Data on weight, height, skinfolds, and circumferences, as well as data on economic strategies and living conditions were collected from 469 individuals in 2002 and 429 in 2009. Of these, 204 individuals were measured on both occasions. Independent and paired t-tests were used to identify changes in nutritional status over time in the larger sample and smaller, longitudinal subsample, respectively. Multiple linear regressions were used to examine the relationship between changes in economic/living conditions and nutritional status in the longitudinal subsample. Results indicate modest improvements in linear growth (HAZ) and among male children the observed increase was related to enrollment in the Brazilian conditional cash transfer program, Bolsa Família (P = 0.03). In terms of short-term measures of nutritional status, we found a significant increase in ZTSF and a reduction in ZUMA in most age/sex groups. Among subadults, there was a negative relationship between ZUMA and access to electricity (P = 0.01) and positive relationship between ZUMA and the sale of the açaí fruit (P = 0.04). Significant changes in weight and BMI (P < 0.01) were found among adult females and both were negatively related to household cash income (P = 0.02 and P = 0.03, respectively). Despite significant changes in economic strategies and lifestyle, changes in nutritional status were modest which may be explained by increased food insecurity documented during this early stage of transition.
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Affiliation(s)
- Barbara A Piperata
- Department of Anthropology, The Ohio State University, Columbus, OH 43210, USA.
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Stansbury JP. Recovering from Hurricane Mitch: Household and Place in Predicting Honduran Child Nutritional Status. Ecol Food Nutr 2007. [DOI: 10.1080/03670240701486685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Biocultural approaches recognize the pervasiveness and dynamism of interactions between biological and cultural phenomena, and they explicitly strive to integrate biological, sociocultural, environmental, and other kinds of data. They have been part of human biology at least since 1958, when Frank Livingstone so elegantly explained the linkages among population growth, subsistence strategy, and the distribution of the sickle cell gene in West Africa. These approaches developed further with the advent of human adaptability studies in the 1960s as part of the Human Biological Program and have become increasingly focused on understanding the impacts of everyday life on human biological variation. Biocultural approaches generate explanations that are intuitively appealing to many because they offer a kind of holistic view. They can, however, be very challenging approaches to implement, perhaps in part because we are more experienced in measuring the biological than the cultural. Some of the challenges include (1) defining precisely what we mean by constructs like socioeconomic status, poverty, rural, and urban; (2) operationalizing key variables so that they can be measured in ways that are ethnographically valid as well as replicable; (3) defining and measuring multiple causal pathways. In this paper, I briefly review the history of biocultural approaches and then illustrate some of the challenges that these approaches present with examples from my own research on nutrition and energetics as well as that of other practitioners.
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Affiliation(s)
- Darna L Dufour
- Department of Anthropology, University of Colorado, Boulder, Colorado 80309-0233, USA.
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Leslie PW, Little MA. Human Biology and Ecology: Variation in Nature and the Nature of Variation. AMERICAN ANTHROPOLOGIST 2003. [DOI: 10.1525/aa.2003.105.1.28] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dufour DL, Reina JC, Spurr GB. Energy intake and expenditure of free-living, lactating Colombian women in an urban setting. Eur J Clin Nutr 2002; 56:205-13. [PMID: 11960295 DOI: 10.1038/sj.ejcn.1601302] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2000] [Revised: 06/29/2001] [Accepted: 07/03/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the components of energy balance during lactation in a population of economically disadvantaged women in an urban developing country setting in order to better understand the metabolic response to lactation. DESIGN Cross-sectional comparison of lactating (LACT) and non-pregnant non-lactating (NPNL) women. Body size and composition were assessed via anthropometry, energy intake was measured using estimated diet records and energy expenditure using indirect calorimetry and the Flex-Heart Rate method. SETTING Low-income neighborhoods of Cali, Colombia. SUBJECTS Lactating women (n=15) studied at 2.4+/-0.8, 5.5+/-0.8 and 8.9+/-1.2 months postpartum, and NPNL women (n=48) studied in three measurement rounds at 0, 3.5+/-0.6 and 7.1+/-1.0 months. RESULTS There were no significant differences between LACT and NPNL women in anthropometric dimensions, but LACT women showed decreases in waist-hip ratio, lean body mass and increases in mid-arm circumference and percentage body fat with time. Energy intake was higher in LACT women (P=0.04), but there were no significant between-group differences in energy expenditure variables. CONCLUSION This group of women met the cost of lactation principally via increased energy intake.
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Affiliation(s)
- D L Dufour
- Department of Anthropology, University of Colorado, Boulder, Colorado, USA.
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Barnett R. Coping with the costs of primary care? Household and locational variations in the survival strategies of the urban poor. Health Place 2001; 7:141-57. [PMID: 11470227 DOI: 10.1016/s1353-8292(01)00013-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper examines the 'survival' strategies adopted by lower income groups seeking to cope with the costs of primary care. Two surveys, one of the health and health service concerns of clients of an inner city voluntary welfare agency, and another of how 114 general practitioner (GP) surgeries in Christchurch, New Zealand aided patients in financial distress, were conducted in October-December, 1997. Patients adopted a variety of strategies, both active and passive, with delays in obtaining medications and seeking financial help from GPs being the most common. Although less important, high rates of switching GPs occurred. There was evidence of geographical variation in the strategies adopted by patients and practices as well as of the effects of such strategies given that considerable levels of unmet need remain. I conclude that more attention should be paid to the gatekeeper role of GPs and how their actions in different social contexts may result in inequalities in service provision to low income patients and outcomes of care.
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Affiliation(s)
- R Barnett
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch, New Zealand.
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Fouéré T, Maire B, Delpeuch F, Martin-Prével Y, Tchibindat F, Adoua-Oyila G. Dietary changes in African urban households in response to currency devaluation: foreseeable risks for health and nutrition. Public Health Nutr 2000; 3:293-301. [PMID: 10979149 DOI: 10.1017/s1368980000000331] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the effects of currency devaluation on dietary change and nutritional vulnerability of poor households in two African capital cities. DESIGN A qualitative study based on 120 semistructured individual interviews and four focus group discussions in each city. SETTING Dakar, Senegal (western Africa) and Brazzaville, Congo (central Africa). SUBJECTS All of the subjects were randomly selected women from modest or poor households, who spoke the local common language and were responsible for household meal preparation. Only those likely to restrict the dynamic of focus group discussions (because of language, age or education) were excluded. RESULTS Changes were found in meal preparation characteristics (frequency, sharing pattern) and meal composition. There was frequent depletion of fat and vegetable contents in meals, frequent elimination of desserts and even the elimination of one daily meal. These changes specifically affected economically disadvantaged and socially isolated households, and those headed by women. Other changes were the reduction in the size of consumption units and the development of neighbourhood-specific street food - which has been a growing trend in Brazzaville since the outset of the economic crisis but is more recent in Dakar. CONCLUSIONS If lasting, these changes pose a dual health risk, i.e. reducing dietary diversity and altering the bacteriological quality of prepared meals. In addition, attempts to reduce the consumption units were found to upset community ties that bind these societies.
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Affiliation(s)
- T Fouéré
- Nutrition Unit, WHO Collaborating Centre for Nutrition, Institut de Recherche pour le Développement, 911 Avenue d'Agropolis, 34032, Montpellier Cedex 1, France
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Osrin D, de L Costello AM. Maternal nutrition and fetal growth: practical issues in international health. SEMINARS IN NEONATOLOGY : SN 2000; 5:209-19. [PMID: 10956446 DOI: 10.1053/siny.2000.0024] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The relationship between maternal nutrition and fetal growth is more complex than might be at first assumed. Low birthweight (LBW) increases the risk of early mortality and later morbidity, and attempts to improve fetal outcome in developing countries need to address the problem of compromised fetal growth. This paper examines the links between birthweight and women's nutritional status in both biomedical and programmatic contexts.
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Affiliation(s)
- D Osrin
- Centre for International Child Health, Institute of Child Health, University College, London, UK
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Abstract
The objective of this article is to assess changes in diet composition, defined in terms of macronutrient intake and types of foods consumed, in pregnancy in poor urban women in Colombia. The subjects were 20 pregnant and 20 matched nonpregnant, nonlactating (NPNL) women 19 to 35 years of age. The pregnant women were studied in three measurement rounds at 14.0 +/- 3.6, 27 +/- 2.2, and 35 +/- 1.7 weeks gestation, and the NPNL women in three measurement rounds approximately 3 months apart. Dietary intake was obtained from estimated food records and macronutrient composition from published sources. Types of foods consumed were aggregated into 16 groups: alcohol; breads; candy; coffee, chocolate; juices; fruit; legumes; meat, fish, offal; dairy; vegetable dishes; other; rice, pasta; tubers, plantains; salads; soft drinks; and soups. Macronutrient intakes showed nonsignificant increases in pregnancy. There were no significant differences between pregnant and NPNL women, except for carbohydrate intake in late pregnancy (P = 0.03). Carbohydrate, fat, and protein provided 74%, 17%, and 12% of dietary energy, respectively, in pregnant women at baseline, and did not change significantly. Except for a decrease in fruits, the types of foods consumed did not change significantly in pregnancy. There were no between-group differences in types of foods consumed except for the greater number of fruits consumed by pregnant women at baseline (P = 0.004). We conclude that in this population there were no changes in diet composition in pregnancy, except for an increase in fruit consumption in Round 1. Am. J. Hum. Biol. 11:753-762, 1999. Copyright 1999 Wiley-Liss, Inc.
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Affiliation(s)
- Darna L. Dufour
- Department of Anthropology, University of Colorado, Boulder, Colorado
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Dufour DL, Reina JC, Spurr G. Energy intake and expenditure of free-living, pregnant Colombian women in an urban setting. Am J Clin Nutr 1999; 70:269-76. [PMID: 10426705 DOI: 10.1093/ajcn.70.2.269] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study examined the components of energy balance in poor, free-living pregnant women living in an urban setting of a developing country. OBJECTIVES We tested the following hypotheses: 1) energy intake increases in pregnancy and is greater than when nonpregnant and nonlactating (NPNL), 2) basal metabolic rate (BMR) increases in pregnancy and the increase is positively correlated with prepregnancy fatness, and 3) energy expenditure in activity decreases in pregnancy and is lower than in NPNL women. DESIGN Pregnant women were studied at 14.8 +/- 3.4 (n = 40), 25.0 +/- 3.2 (n = 54), and 34.9 +/- 2.4 (n = 43) wk gestation, and NPNL women at baseline (n = 114) and at 3 (n = 103) and 6 (n = 93) mo. Energy intake was measured by using estimated diet records and energy expenditure by using the flex heart rate method. Time allocation in physical activity was assessed by observation. RESULTS In pregnant women, body weight, BMR, and energy intake increased but total daily energy expenditure (TDEE) did not change significantly. There were no significant changes in time allocation to selected activities except for lying down. In comparison with NPNL control subjects, women in late pregnancy had higher energy intakes and BMRs. Values for TDEE were not significantly different, but pregnant women expended less energy in activity and allocated more time to 2 energy-saving activities and less time to 2 energy-demanding activities. CONCLUSION A decrease in energy expenditure in activity and changes in time allocation are important ways in which pregnant women meet the energy demands of pregnancy.
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Affiliation(s)
- D L Dufour
- Department of Anthropology, University of Colorado, Boulder, 80309-0233, USA.
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Dufour DL, Staten LK, Waslien CI, Reina JC, Spurr GB. Estimating energy intake of urban women in Colombia: comparison of diet records and recalls. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1999; 108:53-63. [PMID: 9915301 DOI: 10.1002/(sici)1096-8644(199901)108:1<53::aid-ajpa3>3.0.co;2-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
As part of a larger study of energy-nutrition, we compared the performance of 24 h diet recalls with estimated diet records kept by trained observers. The subjects were economically disadvantaged women (n = 85) in the city of Cali, Colombia. A 24 h recall and an estimated diet record were collected for each woman at 0 and approximately 3 and 6 months. Energy intake obtained from the estimated dietary records was validated against energy expenditure and used as the reference method. Energy and macronutrient intake were calculated from published food composition tables and proximate analyses of common foods. The number of food items consumed per woman per day, total and in each of 16 food groups, was tabulated. Energy and macronutrient intakes were 11-13% lower in the 24 h recalls. The discrepancy energy could be largely accounted for by the lower number of food items in the recalls. The number of food items in eight of 16 food groups was significantly lower in the recalls compared to the records. Underreporting on the recalls was a general tendency in these subjects and not clearly related to average energy intake. We conclude that 24 h diet recalls underestimate energy and nutrient intake in this population and are not suitable for studies of human energetics.
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Affiliation(s)
- D L Dufour
- Department of Anthropology, University of Colorado, Boulder 80309-0233, USA.
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Jaramillo E. Pulmonary tuberculosis and health-seeking behaviour: how to get a delayed diagnosis in Cali, Colombia. Trop Med Int Health 1998; 3:138-44. [PMID: 9537276 DOI: 10.1046/j.1365-3156.1998.00202.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Tuberculosis is a heavy burden in the developing countries. Early diagnosis and adherence to treatment are difficult to achieve by patients. Our qualitative research looked at the paths followed and the barriers experienced by patients at the health care services of Cali, Colombia, while seeking help for pulmonary tuberculosis symptoms. Results show that the cultural-based explanation patients give to the symptoms, the stigma attached to the disease, and the poor quality of health care services (communication skills, organizational structure, attitudes, and knowledge of the tuberculosis control strategy of health care workers) are strong barriers to early diagnosis.
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Affiliation(s)
- E Jaramillo
- School of Public Health, Universidad del Valle and Fundación CIDEIM, Cali, Colombia
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Staten LK, Dufour DL, Reina JC, Spurr GB. Household headship and nutritional status: Female-headed versus male/dual-headed households. Am J Hum Biol 1998; 10:699-709. [PMID: 28561416 DOI: 10.1002/(sici)1520-6300(1998)10:6<699::aid-ajhb2>3.0.co;2-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/1997] [Accepted: 09/10/1997] [Indexed: 11/11/2022] Open
Abstract
Approximately one-third of all poor urban households in Latin America are headed by females. This study compares the nutritional status of women and children from female-headed (FHH) and male/dual headed (MHH/DHH) households in economically disadvantaged neighborhoods in Cali, Colombia. Data collected included socioeconomic indicators, anthropometric dimensions, dietary intake, and interviews documenting household composition. Classification of household headship was based on the acknowledged head and the primary economic provider of the household. Of the households in this study, 81 (80%) were from MHH/DHHs and 20 (20%) from FHHs. FHHs had fewer material possessions and lived in houses made of less expensive materials compared to MHH/DHHs. However, there were no significant differences in the nutritional status of women or children in FHHs vs MHH/DHHs. Most women had BMIs within the normal range (19-29 kg/m2 ). The majority of children (95%) had weight-for-height z-scores within ±2 of the NCHS references. These results suggest that while FHHs in Cali were economically poorer, the women studied appeared to have had access to sufficient food sources for themselves and their children. Am. J. Hum. Biol. 10:699-709, 1998. © 1998 Wiley-Liss, Inc.
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Affiliation(s)
- Lisa K Staten
- Arizona Prevention Center, University of Arizona, Tucson, Arizona
| | - Darna L Dufour
- Department of Anthropology, University of Colorado, Boulder, Colorado.,Department of Physiological Sciences, Universidad del Valle, Cali, Colombia
| | - Julio C Reina
- Department of Pediatrics, Universidad del Valle, Cali, Colombia
| | - G B Spurr
- Department of Physiological Sciences, Universidad del Valle, Cali, Colombia.,Department of Physiology, Medical College of Wisconsin and Research Service, VA Medical Center, Milwaukee, Wisconsin
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Spurr GB, Dufour DL, Reina JC, Haught TA. Daily energy expenditure of women by factorial and heart rate methods. Med Sci Sports Exerc 1997; 29:1255-62. [PMID: 9309639 DOI: 10.1097/00005768-199709000-00020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To compare the minute-by-minute heart rate (Flex-HR) reference method with the factorial method, total daily energy expenditure (TDEE) and the pattern of daily energy expenditure (EE) were measured in nonpregnant, nonlactating women 19-40 yr of age, working at their household chores (at home, N = 20) or for remuneration in various kinds of employment (at work, N = 28). The factorial method used three data sets described in the compendium of Ainsworth et al. (CMD), FAO/WHO/UNU (FAO), and James and Schofield (J&S). Measurements were repeated on three rounds separated by 3 months. The TDEE by Flex-HR method, by round, was 9.0 +/- 2.6, 8.9 +/- 1.4, and 10.3 +/- 3.4 MJ.d-1 in the women at home and 9.7 +/- 2.3, 11.4 +/- 3.2, and 11.3 +/- 3.6 MJ.d-1 in the women at work. Values using the CMD data set were not significantly different from Flex-HR in either group in any round, but FAO and J&S data sets gave significantly lower values than both of the former methods in all rounds. The same statistical results were obtained for the patterns of activity. Since the timing of activities by the observers was the same, it is concluded that the major source of error in applying the factorial method is in the values for energy expenditure assigned to the various activities and the ability of investigators to properly judge EE from available data sets.
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Affiliation(s)
- G B Spurr
- Department of Physiology, Medical College of Wisconsin, Milwaukee, USA
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