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Little B, Escobedo J, Pena Reyes ME, Shakib SH, O'Brien L, Kerber R, Velasco X, Lopez MC, Tillquist C. Environment driven changes in type 2 diabetes, overweight and obesity in an isolated Mixe community in the Valley of Oaxaca, southern Mexico. Am J Hum Biol 2024; 36:e24119. [PMID: 39010757 DOI: 10.1002/ajhb.24119] [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: 08/17/2023] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico. OBJECTIVE This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence. METHODS AND MATERIALS Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829). RESULTS T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017. CONCLUSIONS An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.
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Affiliation(s)
- Bert Little
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Anthropology, University of Louisville, Louisville, Kentucky, USA
| | - Jorge Escobedo
- Clinical Epidemiology Research Unit, IMMS, Mexico City, Mexico
| | - Maria Eugenia Pena Reyes
- Posgrado en Antropología Física de la Escuela Nacional de Antropología e Historia (ENAH), National School of Anthropology and History, Mexico City, Mexico
| | - Shaminul Hoque Shakib
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Liz O'Brien
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Rich Kerber
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Xochitl Velasco
- Clinical Chemistry, Tlacolula Rural Hospital, IMMS, Tlacolula, Oaxaca, Mexico
| | - Miguel Cruz Lopez
- Medical Research Unit in Biochemistry, Specialty Hospital, National Medical Center of the Twenty-First Century, Mexican Institute of Social Security, Mexico City, Mexico
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Little BB, Peña Reyes ME, Malina RM. Tracking anthropometric dimensions and grip strength among children, adolescents and adults in an indigenous community of southern Mexico: 1968-1978-2000. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024:e25017. [PMID: 39254402 DOI: 10.1002/ajpa.25017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 07/06/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024]
Abstract
PURPOSE To track body size and proportions, arm dimensions and grip strength in children, adolescents, and adults resident in an indigenous community in Oaxaca who were measured on two or three occasions across surveys in 1968, 1978, and 2000. METHODS The three cross-sectional surveys included measures of height, weight, sitting height, arm circumference, triceps skinfold, and grip strength in surveys of schoolchildren in 1968 and of schoolchildren, adolescents and adults in 1978 and 2000. Cross-checks of surnames, forenames and ages/dates of birth of participants in the three surveys identified three samples of individuals measured on two occasions (1968-1978, two age groups in 1978-2000) and a subsample of individuals measured in the three surveys. Partial correlations controlling for age at each observation were calculated for each variable in the three sex-specific samples measured on two occasions, and for the subsamples of males and females measured on three occasions. RESULTS Allowing for variation in age among subsamples, inter-age correlations were moderate to high for stature, moderate for sitting height and estimated leg length, and low to moderate for weight, BMI, arm and estimated arm muscle circumference, triceps skinfold, and grip strength. CONCLUSION Allowing for the relatively broad chronological age intervals, the inter-age correlations for height, weight and BMI were at the low end, while those for grip strength and for strength per unit body weight for males (though not females) were generally in the range of correlations noted in studies of European samples. Likely associated with improved health, nutritional, and sanitation conditions, obesity and overweight were emerging among adults by 2000. Obesity and overweight in adults paralleled the introduction of mechanized agriculture that reduced routine physical work. Among children, the association of obesity and overweight is likely with increased nutritional availability, but poor choices in diet.
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Affiliation(s)
- Bertis B Little
- Department of Health Management and Systems Sciences, Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, Louisville, Kentucky, USA
| | | | - Robert M Malina
- Department of Kinesiology, University of Texas, Austin, USA
- Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, USA
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Malina RM, Little BB, Peña Reyes ME. Secular trends are associated with the demographic and epidemiologic transitions in an indigenous community in Oaxaca, Southern Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 165:47-64. [PMID: 29072304 DOI: 10.1002/ajpa.23326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To test the hypothesis that secular changes in body size and age at menarche are related to the demographic and epidemiologic transitions in an indigenous community in Oaxaca, southern Mexico. METHODS Data were derived from surveys of a Zapotec-speaking community conducted between 1968 and 2000. Segmented linear regressions of height, weight, BMI and recalled age at menarche on year of birth in cohorts of adults born before and after the demographic transition were used to evaluate secular changes. Corresponding comparisons of body size (MANCOVA controlling for age) and age at menarche (status quo, probit analysis) were done for samples of children and adolescents born before and after the epidemiological transition. RESULTS Height and weight increased in adults born after the demographic transition (mid-1950s), and especially in children and adolescents born after the epidemiological transition (mid-1980s). Age at menarche also decreased significantly in women born after the demographic transition, but at a more rapid estimated rate in adolescents born after the epidemiological transition. Secular gains in body weight were proportional to those for height among children and adolescents, but adults, males more so than females, gained proportionally more weight. CONCLUSIONS The secular trend in height in adults of both sexes was associated with the decade of the demographic transition in the mid-1950s. Significant secular gains in size attained and age at menarche occurred in children and youth born after the epidemiologic transition which likely reflected improved health and nutritional conditions since the mid-1980s.
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Affiliation(s)
- Robert M Malina
- Professor Emeritus, Department of Kinesiology and Health Education, The University of Texas at Austin, and Adjunct Professor, School of Public Health and Information Sciences and Department of Anthropology, University of Louisville, Louisville, Kentucky
| | - Bertis B Little
- Department of Health Management and Systems Sciences, School of Public Health and Information Sciences and Department of Anthropology, University of Louisville, Louisville, Kentucky
| | - Maria Eugenia Peña Reyes
- Posgrado en Antropología Física, Escuela Nacional de Antropología e Historia, Ciudad de Mexico, Mexico
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Little BB, Peña Reyes ME, Malina RM. Natural selection and type 2 diabetes‐associated mortality in an isolated indigenous community in the valley of Oaxaca, southern Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 162:561-572. [DOI: 10.1002/ajpa.23139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 10/25/2016] [Accepted: 11/15/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Bertis B. Little
- Department of Health Management and Systems SciencesSchool of Public Health and Information Sciences, and Department of AnthropologyUniversity of LouisvilleLouisville Kentucky
| | - Maria Eugenia Peña Reyes
- Posgrado en Antropología FísicaFisica, Escuela National de Antroplogia e HistoriaMexico City Mexico D.F
| | - Robert M. Malina
- Department of Kinesiology and Health EducationThe University of Texas at AustinAustin Texas
- Department of Health Management and Systems SciencesSchool of Public Health and Information Sciences, and Department of Anthropology, University of LouisvilleLouisville Kentucky
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Santosa A, Wall S, Fottrell E, Högberg U, Byass P. The development and experience of epidemiological transition theory over four decades: a systematic review. Glob Health Action 2014; 7:23574. [PMID: 24848657 PMCID: PMC4038769 DOI: 10.3402/gha.v7.23574] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 03/12/2014] [Accepted: 03/29/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Epidemiological transition (ET) theory, first postulated in 1971, has developed alongside changes in population structures over time. However, understandings of mortality transitions and associated epidemiological changes remain poorly defined for public health practitioners. Here, we review the concept and development of ET theory, contextualising this in empirical evidence, which variously supports and contradicts the original theoretical propositions. DESIGN A Medline literature search covering publications over four decades, from 1971 to 2013, was conducted. Studies were included if they assessed human populations, were original articles, focused on mortality and health or demographic or ET and were in English. The reference lists of the selected articles were checked for additional sources. RESULTS We found that there were changes in emphasis in the research field over the four decades. There was an increasing tendency to study wide-ranging aspects of the determinants of mortality, including risk factors, lifestyle changes, socio-economics, and macro factors such as climate change. Research on ET has focused increasingly on low- and middle-income countries rather than industrialised countries, despite its origins in industrialised countries. Countries have experienced different levels of progress in ET in terms of time, pace, and underlying mechanisms. Elements of ET are described for many countries, but observed transitions have not always followed pathways described in the original theory. CONCLUSIONS The classic ET theory largely neglected the critical role of social determinants, being largely a theoretical generalisation of mortality experience in some countries. This review shows increasing interest in ET all over the world but only partial concordance between established theory and empirical evidence. Empirical evidence suggests that some unconsidered aspects of social determinants contributed to deviations from classic theoretical pathways. A better-constructed, revised ET theory, with a stronger basis in evidence, is needed.
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Affiliation(s)
- Ailiana Santosa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden;
| | - Stig Wall
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Edward Fottrell
- Institute for Global Health, University College London, London, UK
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Peter Byass
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Little BB, Malina RM. Marriage patterns in a Mesoamerican peasant community are biologically adaptive. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2010; 143:501-11. [DOI: 10.1002/ajpa.21333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Malina RM, Reyes MEP, Tan SK, Little BB. Secular change in muscular strength of indigenous rural youth 6–17 years in Oaxaca, southern Mexico: 1968–2000. Ann Hum Biol 2010; 37:168-84. [DOI: 10.3109/03014460903325193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Malina RM, Peña Reyes ME, Little BB. Secular change in heights of indigenous adults from a Zapotec-speaking community in Oaxaca, southern Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2009; 141:463-75. [DOI: 10.1002/ajpa.21167] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Malina RM, Reyes MEP, Tan SK, Little BB. Physical activity in youth from a subsistence agriculture community in the Valley of Oaxaca, southern Mexico. Appl Physiol Nutr Metab 2008; 33:819-30. [PMID: 18641730 DOI: 10.1139/h08-043] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Observations of activities of contemporary subsistence agricultural communities may provide insights into the lifestyle of youth of 2 to 3 generations ago. The purpose of this study was to document age- and sex-associated variation in household activities and daily steps walking to school of youth 9-17 years in an indigenous subsistence agricultural community in Oaxaca, southern Mexico. Activities during leisure were also considered. A cross-sectional survey of a rural Zapotec-speaking community was undertaken, and respondents included 118 boys and 152 girls, aged 8.7-17.9 years. Household and leisure activities were documented by questionnaire and subsequent interview. Household activities were classified by estimated intensity for before and after school and on the weekend, and an estimate of METS per day accumulated while doing chores was derived. Number of steps from home to school was estimated. Contingency table analysis and MANCOVA controlling for age was used to evaluate results. Household activities tended to cluster at light and moderate intensities in girls and at moderate to moderate-to-vigorous intensities in boys. Estimated METS per day in approximately 2 h of chores differed significantly by sex. Secondary school girls expended significantly more METS per day in chores than primary school girls, but there was no difference by school level in boys. The daily round trip from home to school was approximately 2400 steps for primary students and approximately 2700 and approximately 3100 steps for secondary boys and girls, respectively. Television viewing and participation in sports were major leisure activities for boys and girls. Daily household chores, walking, and leisure activities suggest moderately active and moderately-to-vigorously active lifestyles in girls and boys, respectively, in this indigenous subsistence agricultural community.
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Affiliation(s)
- Robert M Malina
- Department of Kinesiology and Health Education, University of Texas at Austin, TX, USA.
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Malina RM, Peña Reyes ME, Little BB. Epidemiologic transition in an isolated indigenous community in the Valley of Oaxaca, Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2008; 137:69-81. [PMID: 18446853 DOI: 10.1002/ajpa.20847] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objective of the present study is to analyze age-specific mortality in a rural indigenous community in the throes of a secular increase in size in the Valley of Oaxaca, southern Mexico, over 30 years, 1970-1999. Variation in mortality by age group was analyzed over time for evidence of an epidemiological transition. The seasonal rain pattern in the Valley of Oaxaca (83% from May through September) was evaluated for its relationship with mortality in wet and dry months. Mortality and causes of death changed markedly over the 30-year interval. Infant and preschool mortality, overall mortality, and causes of death changed from the 1970s through the 1990s. Prereproductive deaths (<15 years) predominated in the 1970s and were largely due to gastrointestinal and respiratory diseases, with periodic outbreaks of measles. Deaths of adults 65+ years predominated in the 1990s and were largely due to degenerative diseases usually associated with aging. The marked changes in age and causes of death over the three decades (epidemiologic transition from Stage I to Stage II) occurred concurrently with significant secular increases in body size in children, adolescents, and young adults, highlighting improved health and nutritional conditions in the community which is in early Stage II of the demographic transition. The demographic transition to Stage II is a leading indicator (15-25 years lag) for the onset of the secular trend, while the epidemiologic transition to Stage II is a predictor that the secular increase is in process in the study community.
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Affiliation(s)
- Robert M Malina
- Department of Kinesiology and Health Education, University of Texas at Austin, TX 76402-0010, USA.
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