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Glass DJ, Godwin J, Bez E, Corley MK, Valeggia CR, Martin MA. Longitudinal analysis of cortisol changes during pubertal development in indigenous Qom girls. Am J Hum Biol 2024:e24133. [PMID: 39034658 DOI: 10.1002/ajhb.24133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/09/2024] [Accepted: 06/28/2024] [Indexed: 07/23/2024] Open
Abstract
Pubertal research has primarily focused on hypothalamic-pituitary-gonadal axis (HPG) regulation of puberty, though the hypothalamic-pituitary-adrenal axis (HPA) is increasingly considered critical. Heightened HPA function proxied by increasing cortisol levels may play a role in accelerated pubertal timing. However, the extent to which cortisol varies across ages and its relation to pubertal changes in linear growth are less well substantiated. We explored relationships between age, linear growth, adiposity, C-peptide (proxy for insulin), and cortisol across puberty, and we tested whether higher cortisol levels are associated with earlier ages at menarche and peak height velocity. We utilize longitudinal data (n = 777 urine samples) from Qom females ages 7-14 (n = 46) and test our pre-registered analysis using Bayesian longitudinal mixed effects models and joint modeling techniques. We find limited evidence supporting the overarching hypothesis that HPA upregulation is associated with pubertal maturation or timing. We find some evidence that HPA upregulation, as proxied by cortisol, may be more clearly related to differences in relative linear growth at early-mid puberty, as measured by height-for-age z-scores. Transdisciplinary perspectives on puberty, including the assumption that stressors acting via cortisol accelerate pubertal development, are discussed.
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Affiliation(s)
- Delaney J Glass
- Department of Anthropology, University of Washington, Seattle, Washington, USA
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, USA
| | - Jessica Godwin
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, USA
| | - Eleanna Bez
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Margaret K Corley
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut, USA
| | - Claudia R Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
| | - Melanie A Martin
- Department of Anthropology, University of Washington, Seattle, Washington, USA
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, USA
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Rached V, Diogenes MEL, Donangelo CM, Bezerra FF. Calcium plus vitamin D supplementation during pregnancy reduces postpartum fat mass in adolescents: A randomized trial. Am J Hum Biol 2023; 35:e23911. [PMID: 37166151 DOI: 10.1002/ajhb.23911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Pregnancy during adolescence may increase the risk of overweight/obesity. There is evidence that increasing calcium intake, alone or vitamin D-combined, may favor loss of weight and/or fat mass. OBJECTIVES We hypothesized that calcium supplementation during pregnancy reduces excessive fat accumulation during postpartum period. We aimed to investigate the effect of calcium plus vitamin D supplementation during pregnancy on body composition measurements throughout 1 year postpartum in Brazilian adolescents with habitually low calcium intake (~600 mg/day). METHODS Adolescents (14-19 years) were randomly assigned to receive a daily supplement (600 mg of calcium plus 200 UI of cholecalciferol, n = 30) or a placebo (n = 26) from 26 weeks of gestation until parturition. Body composition was determined at 5, 20, and 56 weeks postpartum by dual-energy x-ray absorptiometry. The effects of intervention group, time point, as well as their interaction were assessed using repeated measures mixed-effects models. RESULTS In the adjusted analysis, those supplemented showed lower total body mass [mean difference = -3.32 kg; confidence interval (CI) 95% -6.12 to -0.52 kg], trunk (-1.25 kg; CI 95% -2.34 to -0.15 kg), android (-0.29 kg; CI 95% -0.53 to -0.04 kg) and subcutaneous (-0.23 kg; CI 95% -0.43 to -0.03 kg) fat masses. In the supplemented group, BMI and postpartum weight retention significantly decreased from 5 to 20 weeks (-0.90 kg/m2 and -1.76 kg, respectively; p < .05). At 56 weeks, BMI was still lower (-1.22 kg/m2 ; p < .05) than 5 weeks. CONCLUSIONS Our findings suggest that increasing calcium intake through supplementation in combination with vitamin D contributes to a more pronounced reduction in total body mass overtime, mostly as a consequence of fat mass reductions in central body regions. This trial was registered at clinicaltrials.gov as NCT01732328.
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Affiliation(s)
- Verônica Rached
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Maria Eduarda Leão Diogenes
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Brazilian National Cancer Institute José Alencar Gomes da Silva, Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
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Pujia R, Maurotti S, Coppola A, Romeo S, Pujia A, Montalcini T. The Potential Role of C-peptide in Sexual and Reproductive Functions in Type 1 Diabetes Mellitus: An Update. Curr Diabetes Rev 2022; 18:e051021196983. [PMID: 34636302 DOI: 10.2174/1573399817666211005093434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 07/09/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although hyperglycaemia is known to be the leading cause of diabetic complications, the beneficial effect of optimal glucose control in preventing diabetic complications is still far from being proven. In fact, such complications may not be related to glycaemic control alone. OBJECTIVE This review summarizes several studies that suggest that a C-peptide deficiency could be new and common pathophysiology for complications in type 1 diabetes, including sexual and reproductive dysfunction. METHODS We reviewed in vitro, in vivo, and human studies on the association between C-peptide deficiency or C-peptide replacement therapy and complications in type 1 diabetes. It seems that Cpeptide replacement therapy may interrupt the connection between diabetes and sexual/reproductive dysfunction. RESULTS The Diabetes Control and Complications Trial suggested that maintaining C-peptide secretion is associated with a reduced incidence of retinopathy, nephropathy, and hypoglycaemia. Risk of vascular, hormonal, and neurologic damage in the structures supplying blood to the penis increases with increasing levels of HbA1. However, several human studies have suggested an association between C-peptide production and hypothalamic/pituitary functions. When exposed to C-peptide, cavernosal smooth muscle cells increase the production of nitric oxide. C-peptide in diabetic rats improves sperm count, sperm motility, testosterone levels, and nerve conduction compared to non-treated diabetic rats. CONCLUSION C-peptide deficiency may be involved, at least partially, in the development of several pathological features associated with type 1 diabetes, including sexual/reproductive dysfunction. Preliminary studies have reported that C-peptide administration protects against diabetic microand macrovascular damages as well as sexual/reproductive dysfunction. Therefore, further studies are needed to confirm these promising findings.
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Affiliation(s)
- Roberta Pujia
- Department of Health Science, University Magna Grecia, Catanzaro,Italy
| | - Samantha Maurotti
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,Italy
| | | | - Stefano Romeo
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,Italy
| | - Tiziana Montalcini
- Department of Experimental and Clinical Medicine, Clinical Nutrition Unit, University Magna Græcia of Catanzaro, Catanzaro,Italy
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Nepomnaschy PA, Rowlands A, Prescivalli Costa AP, Salvante KG. Socio-Ecological Challenges as Modulators of Women's Reproductive Trajectories. ANNUAL REVIEW OF ANTHROPOLOGY 2020. [DOI: 10.1146/annurev-anthro-102317-045930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Amenorrhea, anovulatory cycles, miscarriages, and other reproductive outcomes are often seen as pathological. Life history theory, in contrast, treats those outcomes as adaptations that helped women optimize the timing of reproductive ventures across our evolutionary history. Women's bodies adjust their reproductive strategies in response to socio-ecological conditions, a process mediated by the hypothalamic-pituitary-adrenal axis (HPAA). Here, we review the links between socio-ecological conditions, HPAA activity, and the pace of women's reproductive transitions such as puberty, age at first birth, interbirth interval, and perimenopause. We also discuss the HPAA's role as a modulator of reproductive function: It not only suppresses it but may also prime women's bodies for future reproductive ventures. We conclude by reviewing challenges and opportunities within our subfield, including the need for transdisciplinary teams to develop longitudinal studies to improve our understanding of women's reproductive trajectories and outcomes from the moment they are conceived.
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Affiliation(s)
- Pablo A. Nepomnaschy
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Amanda Rowlands
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Ana Paula Prescivalli Costa
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
| | - Katrina G. Salvante
- Maternal and Child Health Laboratory, Faculty of Health Sciences; and Crawford Laboratory of Evolutionary Studies, Department of Biological Sciences, Faculty of Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;, , ,
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Veile A, Valeggia C, Kramer KL. Cesarean birth and the growth of Yucatec Maya and Toba/Qom children. Am J Hum Biol 2019; 31:e23228. [PMID: 30815932 DOI: 10.1002/ajhb.23228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post-birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri-urban Latin American indigenous populations, and test predictions developed using life history theory. METHODS Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1-48 months (2007-2014, 3812 observations). Random-effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders. RESULTS Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean-delivered children had significantly greater weight gain (but similar height grain) compared to vaginally-delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight-for-age compared to vaginally-delivered children from their own sex and population. CONCLUSIONS This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity-inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Purdue University, West Lafayette, Indiana
| | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah
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Martin MA, Veile AJ, Valeggia CR. Birth mode and infectious morbidity risks in Qom children of Argentina. Am J Hum Biol 2019; 31:e23200. [PMID: 30565345 DOI: 10.1002/ajhb.23200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/01/2018] [Accepted: 10/23/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Cesarean delivery may increase childhood infectious morbidity risks via altered birth exposures and subsequent immune, microbial, and epigenetic development. Many Latin American indigenous populations experience dual burdens of infectious and chronic diseases, and are particularly vulnerable to rising rates of cesarean delivery and associated adverse outcomes. The Qom/Toba are an indigenous population in Argentina experiencing rapid lifestyle transitions. We hypothesized that cesarean delivery would be associated with increased risk of infectious symptoms in Qom children after adjusting for gestational and nutritional factors. METHODS We conducted a secondary analysis of birth records and monthly anthropometric and illness data collected previously from 90 Qom children (aged 1-55 months). We tested for additive effects of birth mode on risk of gastrointestinal (GI) and respiratory illness (RI) in mixed-effects logistic regression models adjusting for child weight-for-age (WAZ), weaning, and gestational and maternal age. RESULTS Cesarean deliveries accounted for 46% of births and were associated with maternal age < 20 and ≥ 30 years, gestational age < 39 weeks, and prenatal complications. GI and RI risks were reduced in association with cesarean delivery, greater WAZ, weaning, maternal age ≥ 30 years, and gestational age < 39 weeks. CONCLUSIONS The relationship between cesarean delivery and reduced infectious risks may reflect statistical confounding with relatively rapid postnatal growth and greater adiposity. Postnatal growth trajectories may be important mediators of long-term morbidity risks associated with cesarean delivery. The frequency of cesarean deliveries among the Qom remains concerning given traditionally high rates of fertility and adolescent pregnancy.
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Affiliation(s)
- Melanie A Martin
- Department of Anthropology, University of Washington, Seattle, Washington.,Department of Anthropology, Yale University, New Haven, Connecticut
| | - Amanda J Veile
- Department of Anthropology, Purdue University, West Lafayette, Indiana
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Klein LD, Huang J, Quinn EA, Martin MA, Breakey AA, Gurven M, Kaplan H, Valeggia C, Jasienska G, Scelza B, Lebrilla CB, Hinde K. Variation among populations in the immune protein composition of mother's milk reflects subsistence pattern. Evol Med Public Health 2018; 2018:230-245. [PMID: 30430010 PMCID: PMC6222208 DOI: 10.1093/emph/eoy031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/25/2018] [Indexed: 12/29/2022] Open
Abstract
LAY SUMMARY Adaptive immune proteins in mothers' milk are more variable than innate immune proteins across populations and subsistence strategies. These results suggest that the immune defenses in milk are shaped by a mother's environment throughout her life. BACKGROUND AND OBJECTIVES Mother's milk contains immune proteins that play critical roles in protecting the infant from infection and priming the infant's developing immune system during early life. The composition of these molecules in milk, particularly the acquired immune proteins, is thought to reflect a mother's immunological exposures throughout her life. In this study, we examine the composition of innate and acquired immune proteins in milk across seven populations with diverse disease and cultural ecologies. METHODOLOGY Milk samples (n = 164) were collected in Argentina, Bolivia, Nepal, Namibia, Philippines, Poland and the USA. Populations were classified as having one of four subsistence patterns: urban-industrialism, rural-shop, horticulturalist-forager or agro-pastoralism. Milk innate (lactalbumin, lactoferrin and lysozyme) and acquired (Secretory IgA, IgG and IgM) protein concentrations were determined using triple-quadrupole mass spectrometry. RESULTS Both innate and acquired immune protein composition in milk varied among populations, though the acquired immune protein composition of milk differed more among populations. Populations living in closer geographic proximity or having similar subsistence strategies (e.g. agro-pastoralists from Nepal and Namibia) had more similar milk immune protein compositions. Agro-pastoralists had different milk innate immune protein composition from horticulturalist-foragers and urban-industrialists. Acquired immune protein composition differed among all subsistence strategies except horticulturist-foragers and rural-shop. CONCLUSIONS AND IMPLICATIONS Our results reveal fundamental variation in milk composition that has not been previously explored in human milk research. Further study is needed to understand what specific aspects of the local environment influence milk composition and the effects this variation may have on infant health outcomes.
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Affiliation(s)
- Laura D Klein
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, USA
- Department of Anthropology, University of Illinois at Chicago, 1007 West Harrison Street, Chicago IL, USA
| | - Jincui Huang
- Chemistry Department, University of California Davis, 2465 Chemistry Annex, One Shields Avenue, Davis, CA, USA
| | - Elizabeth A Quinn
- Department of Anthropology, Washington University in St Louis, Campus Box 1114, One Brookings Drive, St Louis, MO, USA
| | - Melanie A Martin
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA, USA
| | - Alicia A Breakey
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, USA
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Hillard Kaplan
- Department of Anthropology, University of New Mexico, MSC01-1040, 1 University of New Mexico, Albuquerque, NM, USA
| | - Claudia Valeggia
- Department of Anthropology, Yale University, 10 Sachem Street, New Haven, CT, USA
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, ul. Grzegorzecka 20, Krakow, Poland
| | - Brooke Scelza
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, Box 951553, Los Angeles, CA, USA
| | - Carlito B Lebrilla
- Chemistry Department, University of California Davis, 2465 Chemistry Annex, One Shields Avenue, Davis, CA, USA
| | - Katie Hinde
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, USA
- School of Human Evolution and Social Change
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
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Martin MA, Valeggia C. Timing of pubertal growth and menarche in indigenous Qom girls of Argentina. Ann Hum Biol 2018; 45:321-329. [PMID: 30033762 DOI: 10.1080/03014460.2018.1486455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pubertal timing is in part mediated by environmental factors, with greater energy availability often associated with earlier or more rapid development. Many indigenous populations are undergoing socioeconomic change that may affect pubertal development and related health risks, necessitating fundamental longitudinal research on growth and development in these populations. AIM Growth velocity and time to menarche among peri-urban indigenous Qom (Toba) girls in Argentina are described. SUBJECTS AND METHODS From 2011-2015, monthly anthropometrics and menstrual status were collected from 61 Qom girls aged 7-14. Growth velocity curves were generated using the 'Super-imposition by translation and rotation' (SITAR) method. Median time to menarche was estimated by Kaplan-Meier survival analysis. RESULTS Mean ages at peak height, weight and BMI velocity were estimated at 10.8, 10.5 and 10.7 years and median age at menarche at 11.6 years (95% CI = 11.4-11.9). At menarche, 45% of girls were overweight or obese and only one participant was short-statured by international standards. CONCLUSION Qom participants in this study exhibit relatively fast pubertal development as compared to other Latin American indigenous populations studied previously by others. Genetic and environmental factors influencing body size, diet and/or activity levels should be investigated further in this population.
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Affiliation(s)
- Melanie A Martin
- a Department of Anthropology , Yale University , New Haven , CT , USA
| | - Claudia Valeggia
- a Department of Anthropology , Yale University , New Haven , CT , USA.,b Department of Anthropology , University of Pennsylvania , Philadelphia , PA , USA
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Bender RL, Williams HS, Dufour DL. No change in energy efficiency in lactation: Insights from a longitudinal study. Am J Hum Biol 2017; 29. [PMID: 28816374 DOI: 10.1002/ajhb.23051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/28/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Lactation is the most energy-demanding phase of reproduction for human females, but it is still unclear how women in different environments are able to meet this additional energy demand. Previous studies have investigated whether changes in metabolism could have an energy-sparing effect in lactation, with conflicting results. Here, we asked whether increased energy efficiency in physical activity serves as an energy-sparing mechanism in lactation. METHODS We used a longitudinal design with a control group. Participants were 33 well-nourished, exclusively breastfeeding women and 29 non-pregnant, non-lactating (NPNL) controls aged 32 ± 4 years. Lactating women were measured at peak- and post-lactation. NPNL controls completed a baseline measurement and a follow-up visit. Energy efficiency in physical activity was assessed using a graded submaximal exercise test and calculated as delta efficiency (change in work accomplished over change in energy expended) and gross efficiency (work accomplished over energy expended). RESULTS There was no significant change in either delta efficiency or gross efficiency from peak to post lactation in lactating women, and no significant difference in delta efficiency between lactating women and NPNL controls at any time period. However, lactating women showed greater between-visit variation in delta efficiency than the NPNL controls. Additionally, 79% of lactating participants lost weight between visits (mean weight loss -3.6 ± 2.3kg), consistent with a mobilization of body tissues to support lactation. CONCLUSION We found no support for the idea that lactating women undergo an increase in energy efficiency to support the energy costs of lactation.
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Affiliation(s)
- Richard L Bender
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado 80309
| | - Heather S Williams
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado 80309
| | - Darna L Dufour
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado 80309
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Klein LD, Breakey AA, Scelza B, Valeggia C, Jasienska G, Hinde K. Concentrations of trace elements in human milk: Comparisons among women in Argentina, Namibia, Poland, and the United States. PLoS One 2017; 12:e0183367. [PMID: 28817665 PMCID: PMC5560670 DOI: 10.1371/journal.pone.0183367] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022] Open
Abstract
Human milk contains essential micronutrients for growth and development during early life. Environmental pollutants, such as potentially toxic metals, can also be transferred to the infant through human milk. These elements have been well-studied, but changing diets and environments and advances in laboratory technology require re-examining these elements in a variety of settings. The aim of this study was to characterize the concentrations of essential and toxic metals in human milk from four diverse populations. Human milk samples (n = 70) were collected in Argentina (n = 21), Namibia (n = 6), Poland (n = 23), and the United States (n = 20) using a standardized mid-feed collection procedure. Milk concentrations of calcium, zinc, iron, copper, manganese, lead, arsenic, and cadmium were determined using inductively coupled plasma mass spectrometry (ICP-MS). We used standard multiple linear regression models to evaluate differences among populations, while including infant age, infant sex, and maternal parity status (multiparous or primiparous) as covariates. Concentrations of all elements, except zinc, varied across populations after controlling for infant age, infant sex, and maternal parity. Calcium and magnesium showed more differences across populations than iron or copper. There were no significant differences among population in zinc concentrations. Mean concentrations of lead, but not arsenic, were low compared to recently published values from other populations. The concentrations of trace elements in human milk are variable among populations. Limitations due to small sample sizes and environmental contamination of some samples prevent us from drawing robust conclusions about the causes of these differences.
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Affiliation(s)
- Laura D. Klein
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Alicia A. Breakey
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Brooke Scelza
- Department of Anthropology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut, United States of America
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Katie Hinde
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, United States of America
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, United States of America
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Ellison PT. Endocrinology, energetics, and human life history: A synthetic model. Horm Behav 2017; 91:97-106. [PMID: 27650355 DOI: 10.1016/j.yhbeh.2016.09.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/14/2016] [Accepted: 09/16/2016] [Indexed: 02/06/2023]
Abstract
Human life histories are shaped by the allocation of metabolic energy to competing physiological domains. A model framework of the pathways of energy allocation is described and hormonal regulators of allocation along the pathways of the framework are discussed in the light of evidence from field studies of the endocrinology of human energetics. The framework is then used to generate simple models of two important life history transitions in humans, puberty and the postpartum return to full fecundity in females. The results of the models correspond very closely to observations made in the field.
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Affiliation(s)
- Peter T Ellison
- Department of Human Evolutionary Biology, Harvard University, United States
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Goetz TG, Valeggia C. The ecology of anemia: Anemia prevalence and correlated factors in adult indigenous women in Argentina. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.22947] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/31/2016] [Accepted: 11/16/2016] [Indexed: 01/02/2023] Open
Affiliation(s)
- Teddy G. Goetz
- Department of Molecular Biophysics & BiochemistryYale UniversityNew Haven Connecticut05611
| | - Claudia Valeggia
- Department of AnthropologyYale UniversityNew Haven Connecticut05611
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Nepomnaschy PA, Salvante KG, Zeng L, Pyles C, Ma H, Blais JC, Wen L, Barha CK. Variation in maternal urinary cortisol profiles across the peri-conceptional period: a longitudinal description and evaluation of potential functions. Hum Reprod 2015; 30:1460-72. [PMID: 25904636 DOI: 10.1093/humrep/dev086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/25/2015] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION How do women's first morning urinary cortisol levels, a marker of stress axis activity, vary during the peri-conceptional period (the 12 weeks around conception)? SUMMARY ANSWER First morning urinary cortisol follows an overall increasing trajectory across the peri-conceptional period, interrupted by 2 week-long decreases during the week preceding conception and the fifth week following conception. WHAT IS KNOWN ALREADY Later gestational stages (i.e. second and third trimesters) are characterized by increasing levels of circulating cortisol. This increase is hypothesized to constitute a response to the energy demands imposed by fetal growth, and the development of energy reserves in preparation for nursing and performing regular activities while carrying pregnancy's extra weight and volume. STUDY DESIGN, SIZE, DURATION This study is based on a data set collected as part of a longitudinal, naturalistic investigation into the interactions between the stress (hypothalamic-pituitary-adrenal axis (HPAA)) and reproductive (hypothalamic-pituitary-gonadal axis (HPGA)) axes. Biomarkers of HPAA and HPGA function were quantified in first morning urinary specimens collected every other day from 22 healthy women who conceived a pregnancy during the study. We analyzed the longitudinal within- and between-individual variation in first morning urinary cortisol levels across the 12-week peri-conceptional period. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were recruited from two rural, aboriginal, neighboring communities in Guatemala. Cortisol, estradiol and progesterone metabolites (estrone-3-glucuronide and pregnanediol glucuronide, respectively) and hCG levels were quantified in first morning urinary specimens using immunoassays to determine time of conception and confirm pregnancy maintenance. Linear mixed-effects models with regression splines were used to evaluate the magnitude and significance of changes in cortisol trajectories. MAIN RESULTS AND THE ROLE OF CHANCE Overall, maternal first morning urinary cortisol increased from 6 weeks prior to conception (geometric mean ± SD = 58.14 ± 36.00 ng/ml) to 6 weeks post-conception (89.29 ± 46.76 ng/ml). The magnitude of the increase between the pre- and post-conception periods varied significantly between women (likelihood ratio test statistic = 8.0017, P = 0.005). The peri-conceptional period is characterized by an increasing cortisol trajectory (+1.36% per day; P = 0.007) interrupted by a week-long decline immediately prior to conception (-4.02% per day; P = 0.0013). After conception cortisol increased again (+1.73% per day; P = 0.0008) for 4 weeks, fell in the fifth week (-6.60% per day; P = 0.0002) and increased again in post-conceptional week 6 (+8.86% per day; P = 0.002). Maternal urinary cortisol levels varied with sex of the gestating embryo. During gestational week 2, mothers carrying female embryos (N = 10) had higher mean cortisol levels than those carrying male embryos (N = 9) (t(17) = 2.28, P = 0.04). LIMITATIONS, REASONS FOR CAUTION Our results are based on a relatively small sample (n = 22) of women. However, our repeated-measures design with an average of 27 ± 8 (mean ± SD) data points per woman strengthens the precision of estimates resulting in high statistical power. Additionally, our study population's high degree of ethnic and cultural homogeneity reduces the effects of confounders compared with those found in industrialized populations. This higher level of homogeneity also increases our statistical power. However, since there may be small differences in absolute cortisol values among ethnic groups, the social and biological background of our sample may affect the generalizability of our results. General patterns of HPAA activity, however, are expected to be universal across women. Finally, as there is, to the best of our knowledge, no evidence to the contrary, we assumed that urinary cortisol levels reflect HPAA activity and that changes in gonadal steroids across the menstrual cycle do not affect the levels of free cortisol measured in urine. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the first longitudinal profile of basal maternal HPAA activity across the peri-conceptional period. A basic understanding of the normative (basal as opposed to stress-induced) changes in HPAA activity across this period is needed to accurately assess women's stress at this juncture. Importantly, changes in HPAA activity are likely to play a critical role in ovulation, fertilization, implantation, placentation and embryonic programing. Thus, this novel information should aid in the development of interventions aimed at preventing or moderating undesired effects of maternal physiological stress during the peri-conceptional period on reproductive outcomes as well as embryonic development. STUDY FUNDING/COMPETING INTERESTS This research was funded by a CIHR IGH Open Operating grant (CIHR 106705) to P.A.N. and L.Z.; a Simon Fraser University (SFU) President's Start-up grant, a Community Trust Endowment Fund grant through SFU's Human Evolutionary Studies Program and a Michael Smith Foundation for Health Research Career Investigator Scholar Award to P.A.N.; an NSERC Discovery grant to L.Z.; a CIHR Post-Doctoral Fellowship to C.K.B. and an NSERC Undergraduate Student Research Award to H.M. and J.C.B. The funding agencies had no role in the design, analysis, interpretation or reporting of the findings. There are no competing interests. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- P A Nepomnaschy
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Human Evolutionary Studies Program, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6
| | - K G Salvante
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Human Evolutionary Studies Program, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6
| | - L Zeng
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - C Pyles
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Human Evolutionary Studies Program, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6
| | - H Ma
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - J C Blais
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - L Wen
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - C K Barha
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Human Evolutionary Studies Program, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6
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Abstract
OBJECTIVE Weight gained during pregnancy and postpartum weight retention might contribute to obesity in women of childbearing age. Whether breast-feeding (BF) may decrease postpartum weight retention (PPWR) is still controversial. The purpose of our systematic review and meta-analysis was to investigate the relationship between BF and PPWR. DESIGN Three databases were systematically reviewed and the reference lists of relevant articles were checked. Meta-analysis was performed to quantify the pooled standardized mean differences (SMD) of BF on PPWR by using a random-effect model. Heterogeneity was tested using the χ 2 test and I 2 statistics. Publication bias was estimated from Egger's test (linear regression method) or Begg's test (rank correlation method). RESULTS Among 349 search hits, eleven studies met the inclusion criteria for the meta-analysis. Seven studies were conducted in the USA, one in Brazil, one in France, one in Georgia and one in Croatia. Compared with formula-feeding, BF for 3 to ≤6 months seemed to have a negative influence on PPWR and if BF continued for >6 months had little or no influence on PPWR. In a subgroup meta-analysis, the results did not change substantially after the analysis had been classified by available confounding factors. There was no indication of a publication bias from the result of either Egger's test or Begg's test. CONCLUSIONS Although the available evidence held belief that BF decreases PPWR, more robust studies are needed to reliably assess the impact of patterns and duration of BF on PPWR.
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Abstract
All over Latin America, indigenous populations are rapidly changing their lifestyle. This work elaborates on the complex experience of indigenous people in transition. Poverty, discrimination, marginalization, and endurance are defining characteristics of their everyday life. Global health programs represent excellent opportunities for addressing these issues. These initiatives, however, are at risk of being short-sighted, ethnocentric, and paradigmcentric. Global health programs would be increasingly more successful if they break disciplinary boundaries and invite actors with different perspectives to a dialogue that does not emphasize biology over culture or academic over community expertise.
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Affiliation(s)
- Claudia Valeggia
- a Department of Anthropology , Yale University , New Haven , Connecticut , USA
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16
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Lagranja ES, Phojanakong P, Navarro A, Valeggia CR. Indigenous populations in transition: an evaluation of metabolic syndrome and its associated factors among the Toba of northern Argentina. Ann Hum Biol 2014; 42:84-90. [PMID: 25004443 DOI: 10.3109/03014460.2014.932008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The health problems associated with rapidly changing lifestyles in indigenous populations, e.g. cardiovascular disease, are becoming a public health concern. AIM The objective of this study was to evaluate the prevalence of metabolic syndrome and analyse the metabolic conditions that define this syndrome, in an indigenous Toba community of northern Argentina. SUBJECTS AND METHODS A total of 275 adults participated in this study. Anthropometric (BMI, body fat percentage, waist circumference) and clinical measures (blood pressure, cholesterol, glucose and triglycerides) were taken. Pearson and logistic regressions were used in the statistical analysis of risk factors for metabolic syndrome by sex and by reproductive status in women. RESULTS The overall prevalence of metabolic syndrome was 38%. Nearly a third (31%) of the population was overweight and 45% obese. Men had significantly higher blood pressure and levels of triglycerides than women, while women had higher percentages of body fat. BMI was significantly associated with most of the risk factors for metabolic syndrome. Menopausal women had a higher prevalence of metabolic syndrome than women of reproductive age. CONCLUSION Metabolic syndrome was highly prevalent in this indigenous community, which places them at an increased risk for cardiovascular disease.
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Affiliation(s)
- Elena Sofía Lagranja
- Doctoral Program in Nutrition, Faculty of Medical Sciences, National University of Córdoba , Argentina
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17
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Zeng W, Eisenberg DTA, Jovel KR, Undurraga EA, Nyberg C, Tanner S, Reyes-García V, Leonard WR, Castaño J, Huanca T, McDade TW, Godoy R. Adult obesity: panel study from native Amazonians. ECONOMICS AND HUMAN BIOLOGY 2013; 11:227-235. [PMID: 22591954 DOI: 10.1016/j.ehb.2012.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 01/29/2012] [Accepted: 01/30/2012] [Indexed: 05/31/2023]
Abstract
This paper examines three morphological indicators measuring obesity among a native Amazonian population of foragers-farmers in Bolivia (Tsimane') and estimates the associations between them and standard covariates of obesity (e.g., socioeconomic status [SES]). We collected annual data from 350 non-pregnant women and 385 men ≥20 years of age from all 311 households in 13 villages during five consecutive years (2002-2006). We used three indicators to measure obesity: body-mass index (BMI), waist circumference (WC), and body fat using bioelectrical impedance analysis (BF-BIA). We ran separate individual random-effect panel multiple regressions for women and men with wealth, acculturation, health, and household food availability as key covariates, and controlled for village and year fixed effects and village×year interaction effects. Although BMI increases by a statistically significant annual growth rate of 0.64% among women and 0.37% among men over the five years, the increase does not yield significant biological meanings. Neither do we find consistent and biologically meaningful covariates associated with adult obesity.
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Affiliation(s)
- Wu Zeng
- Heller School, Brandeis University, Waltham, MA 02454, USA.
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18
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Caire-Juvera G, Casanueva E, Bolaños-Villar AV, De Regil LM, De la barca AMC. No changes in weight and body fat in lactating adolescent and adult women from Mexico. Am J Hum Biol 2012; 24:425-31. [DOI: 10.1002/ajhb.22234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 11/25/2011] [Accepted: 12/17/2011] [Indexed: 11/06/2022] Open
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Wells JCK. Ecogeographical associations between climate and human body composition: analyses based on anthropometry and skinfolds. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2011; 147:169-86. [PMID: 22212891 DOI: 10.1002/ajpa.21591] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 06/27/2011] [Indexed: 11/07/2022]
Abstract
In the 19th century, two "ecogeographical rules" were proposed hypothesizing associations of climate with mammalian body size and proportions. Data on human body weight and relative leg length support these rules; however, it is unknown whether such associations are attributable to lean tissue (the heat-producing component) or fat (energy stores). Data on weight, height, and two skinfold thickness were obtained from the literature for 137 nonindustrialized populations, providing 145 male and 115 female individual samples. A variety of indices of adiposity and lean mass were analyzed. Preliminary analyses indicated secular increases in skinfolds in men but not women, and associations of age and height with lean mass in both sexes. Decreasing annual temperature was associated with increasing body mass index (BMI), and increasing triceps but not subscapular skinfold. After adjusting for skinfolds, decreasing temperature remained associated with increasing BMI. These results indicate that colder environments favor both greater peripheral energy stores, and greater lean mass. Contrasting results for triceps and subscapular skinfolds might be due to adaptive strategies either constraining central adiposity in cold environments to reduce cardiovascular risk, or favoring central adiposity in warmer environments to maintain energetic support of the immune system. Polynesian populations were analyzed separately and contradicted all of the climate trends, indicating support for the hypothesis that they are cold-adapted despite occupying a tropical region. It is unclear whether such associations emerge through natural selection or through trans-generational and life-course plasticity. These findings nevertheless aid understanding of the wide variability in human physique and adiposity.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Center, UCL Institute of Child Health, University College London, 30 Guilford Street, London, UK.
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20
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Rebelo F, Castro MBT, Dutra CL, Schlussel MM, Kac G. Fatores associados à retenção de peso pós-parto em uma coorte de mulheres, 2005-2007. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2010. [DOI: 10.1590/s1519-38292010000200009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: investigar fatores associados à retenção de peso pós-parto. MÉTODOS: estudo de coorte com 104 gestantes recrutadas em uma Unidade Básica de Saúde no município do Rio de Janeiro, da 8ª a 13ª semana de gestação e acompanhadas até aproximadamente 55 dias pós-parto. As variáveis incluíram informações sócio-demográficas, econômicas, bioquímicas, antropométricas e reprodutivas. A retenção de peso pós-parto (diferença entre o peso pós-parto e o peso pré-gestacional) foi utilizada como variável dependente. RESULTADOS: a média de peso retido foi 3,2 kg ± 3,7 kg. As mulheres com ganho de peso gestacional (GPG) excessivo retiveram 5,0 kg ± 3,9 em comparação a 3,6 kg ± 3,0 em mulheres com GPG adequado e 1,4 kg ± 3,1 para as com GPG insuficiente. O GPG e o Índice de Massa corporal (IMC) pré-gestacional mantiveram associação significativa com a retenção de peso no modelo final. Observou-se que a cada quilo de peso ganho na gestação, quase 50% ficaram retidos no pós-parto (β = 0,494; p<0,001) e a cada 1,0 kg/m² a menos no IMC pré-gestacional correspondeu a uma retenção de aproximadamente 150g (β = -0,149;p<0,05). CONCLUSÃO: o GPG está positivamente e o IMC pré-gestacional inversamente associado à retenção de peso pós-parto. Orientações nutricionais sobre o controle do ganho ponderal podem ajudar a minimizar a incidência de obesidade entre mulheres no pós-parto.
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21
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Valeggia CR, Burke KM, Fernandez-Duque E. Nutritional status and socioeconomic change among Toba and Wichí populations of the Argentinean Chaco. ECONOMICS AND HUMAN BIOLOGY 2010; 8:100-10. [PMID: 19959406 PMCID: PMC3470426 DOI: 10.1016/j.ehb.2009.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 11/06/2009] [Accepted: 11/06/2009] [Indexed: 05/25/2023]
Abstract
The prevalence of overweight and obesity is growing at an accelerated pace in disadvantaged populations. Indigenous populations all over the world, whose lifestyle is changing rapidly and drastically, seem to be particularly prone to show an increased prevalence of overweight and its co-morbidities among adults. The aim of this study was to evaluate the association between socioeconomic and nutritional statuses in adults of two indigenous populations of the Argentine Gran Chaco: the Toba and Wichí of the province of Formosa. Originally hunter-gatherers, they are now more settled and engage in temporary wage labor and local political positions. A total of 541 adults (>20 years old) participated in the study. Almost 50% of the adult Toba and 34% of the adult Wichí were overweight and 10% of adults in both populations were obese. Socioeconomic status was positively associated with body mass index in both populations. Furthermore, political connectedness with the non-indigenous sector, as in the case of community leaders, was highly correlated with obesity. Differences within and between groups can be explained by biocultural factors that include gender, diet (foraged vs store-bought), lifestyle (sedentary vs more active), and history of political power. Our study highlights the interactions among social, cultural, and political economic variables, such as political hierarchies within the group or degree of social connectedness with community leaders. By making these variables an integral part of our analysis and interpretation, we hope to improve our understanding of the situation of indigenous populations in transition.
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Affiliation(s)
- Claudia R. Valeggia
- Department of Anthropology, University of Pennsylvania, 3260 South St., Philadelphia, PA 19104-6398, USA
- Reproductive Ecology Laboratory, University of Pennsylvania, 3260 South St., Philadelphia, PA 19104-6398, USA
| | - Kevin M. Burke
- Reproductive Ecology Laboratory, University of Pennsylvania, 3260 South St., Philadelphia, PA 19104-6398, USA
| | - Eduardo Fernandez-Duque
- Department of Anthropology, University of Pennsylvania, 3260 South St., Philadelphia, PA 19104-6398, USA
- Centro de Ecología Aplicada del Litoral, CONICET, Corrientes, Argentina
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22
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Valeggia C, Ellison PT. Interactions between metabolic and reproductive functions in the resumption of postpartum fecundity. Am J Hum Biol 2009; 21:559-66. [PMID: 19298003 PMCID: PMC3305908 DOI: 10.1002/ajhb.20907] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Lactation has long been recognized as a major determinant of interbirth intervals. The temporal pattern of nursing has been proposed as the mechanism behind lactational amenorrhea. We present a new model of the dynamic regulation of lactational amenorrhea that identifies maternal energy availability as the main determinant of ovarian resumption. Variation in the intensity of lactation remains a component of the model as a determinant of the absolute energetic cost of milk production. However, maternal energy supply determines net energy availability; a larger energy supply leaves a greater net energy surplus than a smaller energy supply (lactation costs being equal). We characterize the hormonal postpartum profile of 70 lactating Toba women of Argentina. We use C-peptide, which reflects maternal insulin production, as a measure of energy availability. Initially low, insulin production rises as the postpartum period progresses, reflecting the declining metabolic load of lactation. A short period of supernormal insulin production precedes menstrual resumption. The high levels of insulin may play a role in stimulating the resumption of ovarian activity, which in turn may help to resolve the transient period of insulin resistance. The dynamics of insulin sensitivity during lactation would aid in synchronizing the resumption of ovarian function with a reduction in the energy demands of milk production. This hypothesis is supported by the sustained weight gain experienced by lactating women during the months preceding the first postpartum menses. The link between fecundity and energy balance could serve as a mechanism for adjusting the duration of lactational amenorrhea to the relative metabolic load of lactation.
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Affiliation(s)
- Claudia Valeggia
- Department of Anthropology, University of Pennsylvania, Philadelphia, 19104, USA.
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23
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Jasienska G. Reproduction and lifespan: Trade-offs, overall energy budgets, intergenerational costs, and costs neglected by research. Am J Hum Biol 2009; 21:524-32. [DOI: 10.1002/ajhb.20931] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Jehn M, Brewis A. Paradoxical malnutrition in mother-child pairs: untangling the phenomenon of over- and under-nutrition in underdeveloped economies. ECONOMICS AND HUMAN BIOLOGY 2009; 7:28-35. [PMID: 19246260 DOI: 10.1016/j.ehb.2009.01.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Revised: 01/22/2009] [Accepted: 01/22/2009] [Indexed: 05/27/2023]
Abstract
As economic development and urbanization proceed globally, the coexistence of under- and over-nutrition within the same household, sometimes termed 'paradoxical' or 'dual burden' malnutrition is increasingly being reported. We used Demographic and Health Survey data sets from 18 lower and middle income countries to explore paradoxical forms of malnutrition (maternal overweight with child underweight or stunting) in mother-child pairs. Multinomial logistic regression was used to estimate the odds of discordant pairs after adjusting for a number of important covariates. Several factors were significantly associated with an increased relative odds of discordant mother-child pairs, including working in subsistence agriculture, low levels of maternal education, more siblings in the household, and relative household poverty. However, many of these factors also predicted other combinations of poor nutritional status in mother-child pairs. We conclude that it is difficult to identify any specific factors that elevate risk above and beyond those that predict risk of maternal over-nutrition or child under-nutrition. Based on these analyses, it appears that paradoxical weight status between mothers and children can be best understood as a consequence of rapid secular increases in maternal weight, rather than a distinct nutritional condition with a discrete etiology.
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Affiliation(s)
- Megan Jehn
- School of Health Management & Policy, Arizona State University, Tempe, AZ 85287-4506, United States
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25
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Abstract
For maternal metabolism, pregnancy ends not with delivery, but with weaning. In several recent epidemiological studies, authors have reported an association between duration of breast-feeding and reduced maternal risk of metabolic disease. These findings parallel data from animal models showing favorable changes in metabolism associated with lactation. During gestation, visceral fat accumulates, and insulin resistance and lipid and triglyceride levels increase. These changes appear to reverse more quickly, and more completely, with lactation. In this article, we review animal and human studies regarding the effects of lactation on adiposity, lipid, and glucose homeostasis. We hypothesize that lactation plays an important role in "resetting" maternal metabolism after pregnancy.
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Affiliation(s)
- Alison M Stuebe
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina 27599-7516, USA.
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Villegas R, Gao YT, Yang G, Li HL, Elasy T, Zheng W, Shu XO. Duration of breast-feeding and the incidence of type 2 diabetes mellitus in the Shanghai Women's Health Study. Diabetologia 2008; 51:258-66. [PMID: 18040660 PMCID: PMC2170456 DOI: 10.1007/s00125-007-0885-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Accepted: 10/22/2007] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to examine the association between lifetime breast-feeding and the incidence of type 2 diabetes mellitus in a large population-based cohort study of middle-aged women. METHODS This was a prospective study of 62,095 middle-aged parous women in Shanghai, China, who had no prior history of type 2 diabetes mellitus, cancer or cardiovascular disease at study recruitment. Breast-feeding history, dietary intake, physical activity and anthropometric measurements were assessed by in-person interviews. The Cox regression model was employed to evaluate the association between breast-feeding and the risk of type 2 diabetes mellitus. RESULTS After 4.6 years of follow-up, 1,561 women were diagnosed with type 2 diabetes mellitus. Women who had breastfed their children tended to have a lower risk of diabetes mellitus than those who had never breastfed [relative risk (RR)=0.88; 95% CI, 0.76-1.02; p=0.08]. Increasing duration of breast-feeding was associated with a reduced risk of type 2 diabetes mellitus. The fully adjusted RRs for lifetime breast-feeding duration were 1.00, 0.88, 0.89, 0.88, 0.75 and 0.68 (p trend=0.01) for 0, >0 to 0.99, >0.99 to 1.99, >1.99 to 2.99, >2.99 to 3.99 and >or=4 years in analyses adjusted for age, daily energy intake, BMI, WHR, smoking, alcohol intake, physical activity, occupation, income level, education level, number of live births and presence of hypertension at baseline. CONCLUSIONS/INTERPRETATION Breast-feeding may protect parous women from developing type 2 diabetes mellitus later in life.
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Affiliation(s)
- R. Villegas
- Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37232-1738 USA
| | - Y.-T. Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People’s Republic of China
| | - G. Yang
- Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37232-1738 USA
| | - H. L. Li
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People’s Republic of China
| | - T. Elasy
- Diabetes Research and Training Center, Vanderbilt University Medical Center, Nashville, TN USA
| | - W. Zheng
- Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37232-1738 USA
| | - X.-O. Shu
- Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37232-1738 USA
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Nuss H, Freeland-Graves J, Clarke K, Klohe-Lehman D, Milani TJ. Greater nutrition knowledge is associated with lower 1-year postpartum weight retention in low-income women. ACTA ACUST UNITED AC 2007; 107:1801-6. [PMID: 17904941 DOI: 10.1016/j.jada.2007.07.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to assess nutrition knowledge during early and late postpartum in a sample of low-income and minority women, and to determine if that knowledge had any relationship to weight retention at 1-year postpartum. A questionnaire was developed and validated in a sample of 151 low-income new mothers. This instrument was then administered to a separate sample of mothers (n=140) of similar demographics to assess nutrition knowledge at 0 to 1 days and 12 months postpartum. In addition, a survey of nutrition information sources was administered at both time points. Nutrition knowledge was compared with 12-month postpartum weight retention and demographic variables. Women who retained less than 5% of weight gained during pregnancy had greater knowledge of nutrition at 0 months (53% vs 49%, P<0.05) and 12 months (55% vs 51%, P<0.05) than those who retained 5% or more of weight gained during pregnancy. Whites had higher nutrition knowledge scores than non-Hispanic blacks and Hispanics. Women who lactated 6 months or more had more knowledge than those who lactated less than 6 months. Higher knowledge test scores were observed among women who used the Internet and books/magazines as their source for information. These results indicate that assessment of nutrition knowledge in early postpartum can identify women at risk for significant weight retention.
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Piperata BA, Dufour DL. Diet, energy expenditure, and body composition of lactating Ribeirinha women in the Brazilian Amazon. Am J Hum Biol 2007; 19:722-34. [PMID: 17657725 DOI: 10.1002/ajhb.20628] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Lactation is the most energetically demanding part of human reproduction; yet, compared with pregnancy, we know little about the strategies women in different settings employ to cope with these increased energy demands. This paper takes a biocultural approach and reports longitudinal data on the anthropometry, dietary intakes and energy expenditure of a sample of 23 rural, lactating Ribeirinha women living in subsistence-based communities in the eastern Amazon. The dietary intakes of these lactating women were insufficient to meet their lactating energy needs and were least sufficient during resguardo, a 40-day period in the immediate postpartum when the women observed a series of food taboos and work restrictions. Instead, the women in this study met the increased energy demands of lactation by drawing on their energy reserves and reducing their energy expenditure in physical activity. The women showed a significant reduction in weight (P<0.001), BMI (P<0.001) and in circumferences (hip, P=0.01; waist, P=0.03) and skinfolds (thigh, P=0.03) in the gluteal femoral region. Total daily energy expenditure (TDEE) was lowest during resguardo and increased as lactation progressed (P=0.01). While the practice of resguardo reduced maternal energy expenditure and allowed women more time to spend with their newborn infants, it came at a cost (low dietary intake), which appears to be related to the loss of the adult woman from subsistence activities. By taking a biocultural approach this study illustrates the role the social environment plays in shaping the experience of lactating women.
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Affiliation(s)
- Barbara A Piperata
- Department of Anthropology, The Ohio State University, Columbus, Ohio 43210-1364, USA.
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Lacerda EMDA, Leal MDC. Fatores associados com a retenção e o ganho de peso pós-parto: uma revisão sistemática. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2004. [DOI: 10.1590/s1415-790x2004000200008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: A retenção de peso após o parto é um dos determinantes da obesidade em mulheres. Seu desenvolvimento está relacionado com o ganho de peso gestacional, paridade, idade, situação marital, consumo energético, atividade física e lactação, mas as associações encontradas têm se mostrado inconclusivas e contraditórias. Objetivos: Avaliar estudos que identificaram fatores preditores da retenção e ganho de peso após o parto. MATERIAL E MÉTODOS: Foi realizada uma revisão de literatura na Base de Dados LILACS e MEDLINE, referente aos anos de 1993 a 2003. RESULTADOS: Vinte e oito artigos foram identificados, sendo 23 estudos de coorte, quatro estudos transversais e um estudo caso-controle. A maioria dos estudos foi realizada nos EUA e o tempo de acompanhamento após o parto ocorreu principalmente entre seis semanas e 24 meses. Cerca de 25% dos estudos apresentaram perdas superiores a 30%, 61% incluíram adolescentes na amostra e 75% não aferiram o peso pré-gestacional. Sete estudos foram considerados de melhor qualidade, pois utilizaram o peso pré-gestacional medido, incluíram grupo de comparação, excluíram adolescentes, apresentaram perdas de seguimento inferiores a 30% e controlaram para variáveis de confundimento. CONCLUSÃO: Ganho de peso gestacional, raça negra e paridade estão associados positivamente com a retenção de peso pós-parto. As evidências são contraditórias para a variável lactação e insuficientes para as variáveis consumo alimentar e atividade física. São necessários estudos cuidadosamente desenhados para esclarecer estas questões.
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