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Vaidyanathan S, Menon V. Research on feeding and eating disorders in India: A narrative review. Indian J Psychiatry 2024; 66:9-25. [PMID: 38419929 PMCID: PMC10898522 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_782_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Despite growing evidence of their prevalence, research on feeding and eating disorders (FEDs) in India has been sporadic. This narrative review aimed to summarize the research on FED in India and set priorities for future research and translation of evidence. An electronic search was conducted in the MEDLINE, PsycINFO, and Google Scholar databases to identify relevant English peer-reviewed articles from April 1967 to July 2023. The extracted data from these studies included author names, publication year, research location, type of intervention (for interventional studies), nature of comparator treatments, and main outcomes or findings. We found a rising trend in the prevalence of EDs in India. Adolescent age group, female sex, higher socioeconomic status, family history of mental illness or disordered eating, and borderline personality pattern were risk factors for EDs. For feeding disorders (FDs), childhood age group, malnutrition, pregnancy, psychosis, intellectual disability (ID), and obsessive-compulsive disorder (OCD) were putative risk factors. Both physical and psychiatric comorbidities were common in FEDs. Culture appears to exert a pathoplastic effect on symptom presentation in FEDs; an illustrative example is the documented nonfat phobic variant of anorexia nervosa (AN) in India. Research on management has focused on using assessment tools, investigations to rule out medical comorbidities, psychosocial and family-based psychotherapies, nutritional rehabilitation, pharmacotherapy, and neuromodulation approaches. Whereas the publication output on FEDs in India has increased over the last decade, it remains an under-researched area, with a striking paucity of original research. Future research priorities in FEDs include conducting country-wide registry-based studies to offer real-world insights, longitudinal research to identify culturally relevant risk factors, and developing brief, culturally sensitive diagnostic instruments for FEDs in the Indian context. This will help generate locally relevant epidemiological data on FEDs and inform treatment and prevention strategies.
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Affiliation(s)
- Sivapriya Vaidyanathan
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Davies TC. Current status of research and gaps in knowledge of geophagic practices in Africa. Front Nutr 2023; 9:1084589. [PMID: 36890865 PMCID: PMC9987423 DOI: 10.3389/fnut.2022.1084589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/29/2022] [Indexed: 02/22/2023] Open
Abstract
This article synthesises current knowledge and identifies research gaps on the still intriguing aspects of the subject of geophagy as practised in Africa. Despite the voluminous research literature that exists on the subject, geophagy in Africa is still a largely misunderstood phenomenon. Although the practice is not confined to any particular age group, race, gender, or geographical region, in Africa it is most commonly recorded among pregnant women and children. Till now, the precise aetiology of geophagy remains obscure; but the practice is thought to have both beneficial effects such as having a role as a nutrient supplement, as well as several demerits. An updated critical review of human geophagy in Africa - with a section on (other) animal geophagy -, highlights several aspects of the practice that need further research. A comprehensive bibliography is assembled, comprising some of the more pertinent and recently published papers (mostly post-dating the year 2005), as well as older seminal works, providing a baseline and robust framework for aiding the search process of Medical Geology researchers and those from allied fields wanting to explore the still poorly understood aspects of geophagy in Africa.
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Affiliation(s)
- Theophilus C. Davies
- Faculty of Natural Sciences, Mangosuthu University of Technology, Umlazi, KwaZulu-Natal, South Africa
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Placek C, Mohanty S, Bhoi GK, Joshi A, Rollins L. Religion, Fetal Protection, and Fasting during Pregnancy in Three Subcultures. HUMAN NATURE (HAWTHORNE, N.Y.) 2022; 33:329-348. [PMID: 36214964 DOI: 10.1007/s12110-022-09433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/07/2022]
Abstract
Fasting during pregnancy is an enigma: why would a woman restrict her food intake during a period of increased nutritional need? Relative to the costs to healthy individuals who are not pregnant, the physiological costs of fasting in pregnancy are amplified, with intrauterine death being one possible outcome. Given these physiological costs, the question arises as to the socioecological factors that give rise to fasting during pregnancy. There has been little formal research regarding the emic perceptions and socioecological factors associated with such fasting. This study therefore took an emic approach and investigated the types of fasts that are common in pregnancy, women's perceptions of the consequences of fasting, and the socioecological models of pregnancy fasting in three Indian communities. This cross-sectional study took place in Bhubaneshwar, Odisha state, and Mysore, Karnataka state, among two populations of Hindu women and one population of Muslim women (N = 85). In total, 64% of women fasted in prior pregnancies. Findings revealed variation in the number and types of fasts that are common in pregnancy across the three communities. Each community reported differences in positive and negative consequences of fasting, with varied emphasis on reproductive health, religiosity, and general health and well-being. Finally, quantitative analyses indicated that the best-fitting model for fasting during pregnancy was religiosity, and the poorest-fitting models were resource scarcity and general health. This study provides insight into motivations for such fasting and highlights the need to investigate the relationship between supernatural beliefs and maternal-fetal protection further, as well as social functions of pregnancy fasting within the family and community.
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Affiliation(s)
- Caitlyn Placek
- Department of Anthropology, Ball State University, Muncie, IN, 47306, USA.
| | | | | | - Apoorva Joshi
- Sri Jayachamarajendra College of Engineering, Mysore, Karnataka, India
| | - Lynn Rollins
- Department of Telecommunications, Ball State University, Muncie, IN, USA
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The influence of pica practice on nutritional status, stress and anxiety of pregnant women. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bruce RM, Crandall PG, Atungulu GG, O'Bryan CA. Uncooked Rice Consumption: Causes, Implications, Regulation, and Interventions. Cereal Chem 2022. [DOI: 10.1002/cche.10580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rebecca M. Bruce
- Department of Food ScienceUniversity of ArkansasFayettevilleAR72704
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Kibr G. A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia. ScientificWorldJournal 2021; 2021:5580039. [PMID: 34248425 PMCID: PMC8236338 DOI: 10.1155/2021/5580039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
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Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, P. O. Box: 38, Shambu, Ethiopia
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Placek CD, Jaykrishna P, Srinivas V, Madhivanan P. Pregnancy Fasting in Ramadan: Toward a Biocultural Framework. Ecol Food Nutr 2021; 60:785-809. [PMID: 33890529 DOI: 10.1080/03670244.2021.1913584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Pregnancy fasting poses a paradox: why would a woman restrict her diet during a period of increased nutritional need? This qualitative, cross-sectional study applied biological and cultural evolutionary theories of pregnancy diet to emic models of fasting with the aim of establishing a testable biocultural framework of pregnancy fasting. The research took place with Muslim women residing in Mysore, India. In-depth interviews were conducted with pregnant women who have experience and knowledge of fasting during during the holy month of Ramadan. Our findings indicate that pregnancy fasting is socially acquired via multiple modes of transmission and that women do not fast according to mainstream evolutionary theories of pregnancy diet, but perhaps to gain moral capital.
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Affiliation(s)
- Caitlyn D Placek
- Department of Anthropology, Ball State University, Muncie, Indiana, USA
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India.,Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health University of Arizona, Tucson, Arizona, USA.,Division of Infectious Diseases, College of Medicine, University of Arizona, Tucson, Arizona, USA.,University of Arizona, Tucson, Arizona, USA
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Traugott MT, Singh M, Raj DK, Kutalek R. Geophagy in India: a qualitative exploratory study on motivation and perception of female consumers. Trans R Soc Trop Med Hyg 2020; 113:123-130. [PMID: 30476287 DOI: 10.1093/trstmh/try123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/28/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Geophagy, the consumption of soil, is well documented in Africa and other continents, but is rarely investigated in Asia and even less so in India. The main aim of this exploratory qualitative study was therefore to understand the motivation for clay consumption, the social perception of the habit, the mode and quantity of consumption, as well as subjectively perceived effects of clay consumption in Himachal Pradesh, North India. METHODS We conducted semi-structured interviews with 27 female geophagists aged 18-80 years. RESULTS We could show that geophagy exists across all ages and social groups. The main type of consumed soil is yellow clay used for house wall plastering. Geophagy is usually practised because of a craving for soil despite various fears of negative health effects. It is normally done secretly and under-reported to local doctors. The most common self-reported positive effect of geophagy was the feeling of relief. Geophagy was generally considered as harmful to health and various complaints were associated with it. It is not practised because of food shortages or as a remedy. On the contrary, it is generally seen as an addiction detrimental to health. CONCLUSIONS Awareness of geophagy has to be ameliorated in the Indian population and specifically among health workers to improve support for affected individuals. Geophagy should be routinely included in national antenatal care guidelines.
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Affiliation(s)
- Marianna T Traugott
- Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria
| | - Mitasha Singh
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Tatui Tanda (District Kangra), Himachal Pradesh, India
| | - Des K Raj
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Tatui Tanda (District Kangra), Himachal Pradesh, India
| | - Ruth Kutalek
- Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria
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Yamamoto SS, Premji SS, Nyanza EC, Jahanpour O. Investigating the association between stress. Anxiety and geophagy among pregnant women in mwanza, Tanzania. Appetite 2019; 142:104328. [PMID: 31238080 DOI: 10.1016/j.appet.2019.104328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 11/05/2018] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
Geophagy, the craving and intentional consumption of soil, is common especially among pregnant women in some low- and middle-income settings. Soils may contain a variety of non-nutritive components such as heavy metals and microbes or substances that interfere with gastrointestinal absorptive processes, posing health risks to pregnant women. Several hypotheses regarding the practice have been proposed but very few have examined the role of maternal stress. The practice of geophagy may help to alleviate stress or anxiety during gestation from perceived dietary or other pregnancy-related concerns. In this study, we evaluated several measures of maternal stress (general anxiety, Pregnancy-Related Anxiety Scores (10-item revised), and Perceived Stress Scores) and other covariates in relation to geophagic behaviour in early pregnancy in 227 women (12-19 weeks gestation) recruited from two hospitals in the Nyamagana district of Mwanza City, Tanzania. Geophagy was reported by 24.7% of the pregnant women. Using LASSO regression, self-reported treatment of nausea or vomiting during pregnancy (adjusted OR = 3.12, 95%CI: 1.43 to 6.83), paternal education level (adjusted OR = 2.79, 95%CI: 1.32 to 5.87 for primary or lower education level), antenatal hospital site (adjusted OR = 3.71, 95%CI: 1.78 to 7.75), prescription drug use prior to pregnancy (adjusted OR = 1.76, 95%CI: 0.87 to 3.56) and general anxiety (feeling worried, tense or anxious in the past four weeks) (adjusted OR = 1.81, 95%CI: 0.88 to 3.72) were associated with geophagic behaviour. Given that relatively little has been done to examine geophagy in relation to the public health risk it may pose to pregnant women, these findings suggest the need for further investigations regarding maternal stress.
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Affiliation(s)
- Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton Clinic Health Academy, 11405-87Ave, Edmonton, Alberta, T6G 1C9, Canada.
| | - Shahirose S Premji
- School of Nursing, Faculty of Health, York University, 313 HNES Building, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
| | - Elias C Nyanza
- Department of Environmental and Occupational Health, School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando Area, Mwanza, Tanzania.
| | - Ola Jahanpour
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, P.O. Box 2240, Tanzania.
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10
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Forsyth JE, Weaver KL, Maher K, Islam MS, Raqib R, Rahman M, Fendorf S, Luby SP. Sources of Blood Lead Exposure in Rural Bangladesh. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:11429-11436. [PMID: 31525910 PMCID: PMC7705119 DOI: 10.1021/acs.est.9b00744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 05/29/2023]
Abstract
Lead (Pb) exposure is a major public health problem worldwide. Although high levels of Pb in blood in Bangladesh have been documented, the dominant Pb sources contributing to human exposure in rural Bangladesh have not been determined. Here, we first obtained blood from pregnant women from three rural Bangladeshi districts who were previously assessed by a case-control and sampling study, and we then conducted semistructured in-depth interviews to understand Pb exposure behavior and finally collected samples of the suspected Pb sources. We measured the Pb isotopic composition of both potential Pb sources and 45 blood samples in order to understand which of three sources predominate: (1) food from Pb-soldered cans, (2) turmeric, or (3) geophagous materials (clay, soil, or ash). The Pb isotope ratios of the three sources are distinct (p = 0.0001) and blood isotope ratios are most similar to turmeric. Elevated lead and chromium (Cr) concentrations in turmeric and a yellow pigment used in turmeric processing are consistent with reported consumption behavior that indicated turmeric as a primary contributor to blood Pb. The Pb isotopic composition analyses combined with a case-control and sampling approach provides evidence that turmeric adulterated with the yellow Pb-bearing pigment is the main Pb exposure source in these districts and illustrates the need to assess drivers and practices of turmeric adulteration, as well as the prevalence of adulteration across South Asia.
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Affiliation(s)
| | | | | | | | | | - Mahbubur Rahman
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh
| | | | - Stephen P Luby
- Stanford Center for Innovation in Global Health, and
- Stanford Woods Institute for the Environment, Stanford University, Stanford, California 94305, United States
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Chung EO, Mattah B, Hickey MD, Salmen CR, Milner EM, Bukusi EA, Brashares JS, Young SL, Fernald LCH, Fiorella KJ. Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2510. [PMID: 31337101 PMCID: PMC6679355 DOI: 10.3390/ijerph16142510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/16/2022]
Abstract
Background: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described the prevalence of pica among women on Mfangano Island, Kenya, and examined sociodemographic and health correlates. Methods: Our cross-sectional study included 299 pregnant or postpartum women in 2012. We used a 24-h recall to assess pica, defined as consumption of earth (geophagy), charcoal/ash, or raw starches (amylophagy) and built multivariable logistic regression models to examine sociodemographic and health correlates of pica. Results: Eighty-one women (27.1%) engaged in pica in the previous 24 h, with 59.3% reporting amylophagy and 56.8% reporting geophagy, charcoal, and/or ash consumption. The most common substances consumed were raw cassava (n = 30, 36.6%), odowa, a chalky, soft rock-like earth (n = 21, 25.6%), and soil (n = 17, 20.7%). Geophagy, charcoal, and/or ash consumption was negatively associated with breastfeeding (OR = 0.38, 95% CI: 0.18-0.81), and amylophagy was associated with pregnancy (OR = 4.31, 95% CI: 1.24-14.96). Pica was more common within one of six study regions (OR = 3.64, 95% CI: 1.39-9.51). We found no evidence of an association between food insecurity and pica. Conclusion: Pica was a common behavior among women, and the prevalence underscores the need to uncover its dietary, environmental, and cultural etiologies.
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Affiliation(s)
- Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA.
| | - Brian Mattah
- Ekialo Kiona Research Dept, Organic Health Response, Mbita, P.O. Box 224-40305, Kenya
| | - Matthew D Hickey
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, UCSF, 1001 Potrero Ave, San Francisco, CA 94110, USA
| | - Charles R Salmen
- Ekialo Kiona Research Dept, Organic Health Response, Mbita, P.O. Box 224-40305, Kenya
- Department of Family Medicine and Community Health, University of Minnesota, 5516 Delaware St SE, Minneapolis, MN 55455, USA
| | - Erin M Milner
- Bureau for Global Health, USAID, Washington, DC 20001, USA
| | - Elizabeth A Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Hospital Road, Nairobi 00100, Kenya
| | - Justin S Brashares
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, 130 Mulford Hall #3114, Berkeley, CA 94720, USA
| | - Sera L Young
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA 94720-7360, USA
| | - Kathryn J Fiorella
- Master of Public Health Program, Department of Population Medicine and Diagnostic Sciences, Cornell University, S2-004 Shurman Hall, Ithaca, NY 14853, USA
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Placek CD, Nishimura H, Hudanick N, Stephens D, Madhivanan P. Reframing HIV Stigma and Fear : Considerations from Social-ecological and Evolutionary Theories of Reproduction. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2019; 30:1-22. [PMID: 30661161 DOI: 10.1007/s12110-018-09335-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
HIV stigma and fears surrounding the disease pose a challenge for public health interventions, particularly those that target pregnant women. In order to reduce stigma and improve the lives of vulnerable populations, researchers have recognized a need to integrate different types of support at various levels. To better inform HIV interventions, the current study draws on social-ecological and evolutionary theories of reproduction to predict stigma and fear of contracting HIV among pregnant women in South India. The aims of this study were twofold: compare the social-ecological model to a modified maternal-fetal protection model and test a combined model that included strong predictors from each model. The study took place in 2008-2011 in Mysore District, Karnataka, India. Using data from a cross-sectional survey and biological indicators of health, we statistically modeled social-ecological variables representing individual, interpersonal, and community/institutional levels. Participants were 645 pregnant women. The social-ecological and combined models were the best-fitting models for HIV-related stigma, and the combined model was the best fit for HIV-related fear. Our findings suggest that combining reproductive life history factors along with individual, interpersonal, and community/institutional factors are significant indicators of HIV-related stigma and fear. Results of this study support a multifaceted approach to intervention development for HIV-related stigma and fear. The combined model in this study can be used as a predictive model for future research focused on HIV stigma and fear, with the intent that dual consideration of social-ecological and evolutionary theories will improve public health communication efforts.
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Affiliation(s)
- Caitlyn D Placek
- Department of Anthropology, Ball State University, Muncie, IN, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.,Public Health Research Institute of India, Mysore, Karnataka, India
| | - Holly Nishimura
- School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Natalie Hudanick
- Department of Anthropology, Ball State University, Muncie, IN, USA
| | - Dionne Stephens
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA. .,Public Health Research Institute of India, Mysore, Karnataka, India.
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Placek C. A test of four evolutionary hypotheses of pregnancy food cravings: evidence for the social bargaining model. ROYAL SOCIETY OPEN SCIENCE 2017; 4:170243. [PMID: 29134058 PMCID: PMC5666241 DOI: 10.1098/rsos.170243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/18/2017] [Indexed: 05/04/2023]
Abstract
The onset of cravings for items not typically desired is often considered a hallmark of pregnancy. Given the ubiquity of cravings, this phenomenon remains surprisingly understudied. The current study tested four hypotheses of pregnancy food cravings: behavioural immune system, nutrient seeking, resource scarcity and social bargaining. The research took place in Tamil Nadu, South India, with pregnant women residing in rural villages (N = 94). Methods included structured interviews and anthropometric measures. Findings revealed that unripe mango and unripe tamarind were the two most frequently mentioned food cravings among this population, but were not sufficiently supported by the a priori models. Results confirmed that the social bargaining model was the best explanation for the etic category of toxic/pathogenic food items, suggesting that pregnant women crave dangerous foods when experiencing heightened social pressures. Finally, toxicity/pathogenicity was a confounding factor for the nutrient seeking and resource scarcity models, calling into question the validity of these models in adverse environments. Overall, these findings present important implications for research on pregnancy food cravings, such that in resource-scarce and pathogen-dense environments, cravings might target teratogenic items that signal a need for increased social support.
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Placek CD, Madhivanan P, Hagen EH. Innate food aversions and culturally transmitted food taboos in pregnant women in rural southwest India: separate systems to protect the fetus? EVOL HUM BEHAV 2017; 38:714-728. [PMID: 29333059 DOI: 10.1016/j.evolhumbehav.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pregnancy increases women's nutritional requirements, yet causes aversions to nutritious foods. Most societies further restrict pregnant women's diet with food taboos. Pregnancy food aversions are theorized to protect mothers and fetuses from teratogens and pathogens or increase dietary diversity in response to resource scarcity. Tests of these hypotheses have had mixed results, perhaps because many studies are in Westernized populations with reliable access to food and low exposure to pathogens. If pregnancy food aversions are adaptations, however, then they likely evolved in environments with uncertain access to food and high exposure to pathogens. Pregnancy food taboos, on the other hand, have been theorized to limit resource consumption, mark social identity, or also protect mothers and fetuses from dangerous foods. There have been few tests of evolutionary theories of culturally transmitted food taboos. We investigated these and other theories of psychophysiological food aversions and culturally transmitted food taboos among two non-Western populations of pregnant women in Mysore, India, that vary in food insecurity and exposure to infectious disease. The first was a mixed caste rural farming population (N = 72), and the second was the Jenu Kurubas, a resettled population of former hunter-gatherers (N = 30). Women rated their aversions to photos of 31 foods and completed structured interviews that assessed aversions and socially learned avoidances of foods, pathogen exposure, food insecurity, sources of culturally acquired dietary advice, and basic sociodemographic information. Aversions to spicy foods were associated with early trimester and nausea and vomiting, supporting a protective role against plant teratogens. Variation in exposure to pathogens did not explain variation in meat aversions or avoidances, however, raising some doubts about the importance of pathogen avoidance. Aversions to staple foods were common, but were not associated with resource stress, providing mixed support for the role of dietary diversification. Avoided foods outnumbered aversive foods, were believed to be abortifacients or otherwise harmful to the fetus, influenced diet throughout pregnancy, and were largely distinct from aversive foods. These results suggest that aversions target foods with cues of toxicity early in pregnancy, and taboos target suspected abortifacients throughout pregnancy.
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Affiliation(s)
- Caitlyn D Placek
- The Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, AHC5 505, Miami, FL 33199.,Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, India 570020.,Department of Anthropology, Washington State University, 14204 NE Salmon Creek Avenue, Vancouver, WA 98686-9600
| | - Purnima Madhivanan
- The Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, AHC5 505, Miami, FL 33199.,Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, India 570020
| | - Edward H Hagen
- Department of Anthropology, Washington State University, 14204 NE Salmon Creek Avenue, Vancouver, WA 98686-9600
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15
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Placek CD. Ethnomedical and Sociocultural Factors of Pica Substances in Rural South India. Ecol Food Nutr 2017; 56:238-255. [DOI: 10.1080/03670244.2017.1311255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Caitlyn D. Placek
- Department of Epidemiology, Florida International University, Miami, Florida, USA
- Department of Anthropology, Washington State University, Pullman, Washington, USA
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16
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Placek CD, Hagen EH. Fetal Protection : The Roles of Social Learning and Innate Food Aversions in South India. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2016; 26:255-76. [PMID: 26286435 DOI: 10.1007/s12110-015-9239-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pregnancy involves puzzling aversions to nutritious foods. Although studies generally support the hypotheses that such aversions are evolved mechanisms to protect the fetus from toxins and/or pathogens, other factors, such as resource scarcity and psychological distress, have not been investigated as often. In addition, many studies have focused on populations with high-quality diets and low infectious disease burden, conditions that diverge from the putative evolutionary environment favoring fetal protection mechanisms. This study tests the fetal protection, resource scarcity, and psychological distress hypotheses of food aversions in a resource-constrained population with high infectious disease burden. The role of culture is also explored. In the first of two studies in Tamil Nadu, India, we investigated cultural explanations of pregnancy diet among non-pregnant women (N = 54). In the second study, we conducted structured interviews with pregnant women (N = 94) to determine their cravings and aversions, resource scarcity, indices of pathogen exposure, immune activation, psychological distress, and emic causes of aversions. Study 1 found that fruits were the most commonly reported food that pregnant women should avoid because of their harmful effects on infants. Study 2 found modest support for the fetal protection hypothesis for food aversions. It also found that pregnant women most commonly avoided fruits as well as "black" and "hot" foods. Aversions were primarily acquired through learning and focused on protecting the infant from harm. Our findings provide modest support for the fetal protection hypothesis and surprisingly strong support for the influence of cultural norms and learning on dietary aversions in pregnancy.
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Affiliation(s)
- Caitlyn D Placek
- Department of Anthropology, Washington State University, PO Box 644910, Pullman, WA, 99163, USA,
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17
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Miller EM. The reproductive ecology of iron in women. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 159:S172-95. [PMID: 26808104 DOI: 10.1002/ajpa.22907] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Reproductive ecology focuses on the sensitivity of human reproduction to environmental variation. While reproductive ecology has historically focused on the relationship between energy status and reproductive outcomes, iron status is equally critical to women's reproductive health, given the wide-ranging detrimental effects of iron-deficiency anemia on maternal and infant well-being. This review interprets the vast literature on iron status and women's reproduction through an evolutionary framework. First, it will critique the evidence for iron deficiency caused by blood loss during menstruation, reinterpreting the available data as ecological variation in menses within and between populations of women. Second, it will highlight the scant but growing evidence that iron status is implicated in fertility, a relationship that has deep evolutionary roots. Third, this review proposes a new hypothesis for the transfer of iron from mother to infant via pregnancy and breastfeeding: reproductive iron withholding. In this hypothesis, mothers transfer iron to infants in a manner that helps infants avoid iron-mediated infection and oxidative stress, but trades off with potential risk of maternal and infant iron deficiency. Finally, this review explores two main factors that can modify the relationship between iron status and the gestation-lactation cycle: (1) the relationship between long-term reproductive effort (parity) and iron status and (2) supplementation schemes before and during pregnancy. The review concludes by suggesting continued research into iron homeostasis in women using evolutionary, ecological, and biocultural frameworks.
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Affiliation(s)
- Elizabeth M Miller
- Department of Anthropology, University of South Florida, Tampa, FL, 33620
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18
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Wiley AS, Cullin JM. What Do Anthropologists Mean When They Use the TermBiocultural? AMERICAN ANTHROPOLOGIST 2016. [DOI: 10.1111/aman.12608] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea S. Wiley
- Department of Anthropology; Indiana University; Bloomington IN 47405
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19
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Ezzeddin N, Zavoshy R, Noroozi M, Jahanihashemi H, Riseh SH. Prevalence and risk factors for pica during pregnancy in Tehran, Iran. Eat Weight Disord 2015; 20:457-63. [PMID: 26143570 DOI: 10.1007/s40519-015-0198-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Pica is an eating disorder characterized by the persistent ingestion of substances that the consumer does not define as food. The exact cause of pica is often unknown. The purpose of this study was to determine the prevalence of pica during pregnancy and its related risk factors. METHOD This cross-sectional study was carried out in health care centers in west of Tehran. Three hundred women were selected by stratified sampling method from the population. Demographic information and characteristics of pica during pregnancy, such as the kind, the onset, duration, frequency and the reasons, and also iron supplementation status before and during pregnancy and kind of infant feeding were collected via interview and questionnaire. The data were analyzed by chi square test and logistic regression in SPSS 16. RESULTS The prevalence of pica among the studied population was 8.33%, and pagophagia (ice and freezer frost) was the most common form of pica which is characterized by the ingestion of non-food substance (76%). Sixty-four percent of women reported practicing pica regularly on a daily basis. In this study, there was significant association between pica practice and education, unwanted pregnancy, pregnancy complications, the levels of economic satisfaction, iron supplementation during pregnancy, kind of infant feeding, and type of delivery. However, there was no significant association between pica and age, employment, pregnancy ranks, the history of abortions or stillbirths, infant sex, and iron supplementation before pregnancy. CONCLUSIONS Iron supplementation during pregnancy should be more considered. Also women with low education should be asked concerning pregnancy pica.
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Affiliation(s)
- Neda Ezzeddin
- Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rosa Zavoshy
- Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mostafa Noroozi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Hassan Jahanihashemi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shaghayegh Hadizadeh Riseh
- Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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Premji SS, Yim IS, Dosani (Mawji) A, Kanji Z, Sulaiman S, Musana JW, Samia P, Shaikh K, Letourneau N, MiGHT Group. Psychobiobehavioral Model for Preterm Birth in Pregnant Women in Low- and Middle-Income Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:450309. [PMID: 26413524 PMCID: PMC4564601 DOI: 10.1155/2015/450309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/03/2015] [Indexed: 12/19/2022]
Abstract
Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in stress responses leading to PTB and explain the basis of this approach. We discuss ethical considerations for a psychosocial, biological, and behavioral screening tool to predict PTB from a LMI country perspective.
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Affiliation(s)
- Shahirose S. Premji
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6
- Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1
- O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, Canada T2N 4Z6
| | - Ilona S. Yim
- Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Aliyah Dosani (Mawji)
- School of Nursing and Midwifery, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, Canada T3E 6K6
| | - Zeenatkhanu Kanji
- School of Nursing and Midwifery, Aga Khan University-East Africa, Opposite Aga Khan Primary School Plot (9/11), Colonel Muammar Gaddafi Road, P.O. Box 8842, Kampala, Uganda
| | - Salima Sulaiman
- School of Nursing and Midwifery, Aga Khan University-Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Joseph W. Musana
- Department of Obstetrics & Gynecology, Faculty of Health Sciences, Aga Khan University-Nairobi, 3rd Parklands Avenue off Limuru Road, P.O. Box 30270, Nairobi 00100, Kenya
| | - Pauline Samia
- Department of Pediatrics, Aga Khan University-Nairobi, 2nd Parklands Avenue, East Tower Block, Room 505, Nairobi 00100, Kenya
| | - Kiran Shaikh
- School of Nursing and Midwifery, Aga Khan University-Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Nicole Letourneau
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1
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