Nutritional anthropology in the world

Nutritional anthropology is the study of human subsistence, diet and nutrition in comparative social and evolutionary perspective. Many factors influence the nutritional health and well-being of populations, including evolutionary, ecological, social, cultural and historical ones. Most usually, biocultural approaches are used in nutritional anthropology, incorporating methods and theory from social science as well as nutritional and evolutionary science. This review describes approaches used in the nutritional anthropology of past and present-day societies. Issues of concern for nutritional anthropology in the world now include: understanding how undernutrition and food insecurity are produced at local, regional and international levels; how food systems are constructed using social, biological and biocultural perspectives; and obesity from a biocultural viewpoint. By critiquing framings of present-day diet in an evolutionary context, nutritional anthropology asks 'what should be eaten?', rather than 'what can be eaten?', and 'how cheaply can people be fed?'.

Bergmann’s rule is a “just-so” story of human body size

Carl Bergmann was an astute naturalist and physiologist. His ideas about animal size and shape were important advances in the pre-Darwinian nineteenth century. Bergmann’s rule claims that that in cold climates, large body mass increases the ratio of volume-to-surface area and provides for maximum metabolic heat retention in mammals and birds. Conversely, in warmer temperatures, smaller body mass increases surface area relative to volume and allows for greater heat loss. For humans, we now know that body size and shape are regulated more by social-economic-political-emotional (SEPE) factors as well as nutrition-infection interactions. Temperature has virtually no effect. Bergmann’s rule is a “just-so” story and should be relegated to teaching and scholarship about the history of science. That “rule” is no longer acceptable science and has nothing to tell us about physiological anthropology.

Context matters: Leveraging anthropology within one health

Anthropologists develop long-term engagements with communities, animals, and the ecosystems they all share. This approach can provide important context that is necessary for One Health research, which may otherwise overlook the perspectives and lived experiences of community members. This paper presents two case studies that illustrate the importance of leveraging long-term, holistic, engagements with communities in moving the One Health concept forward. The first illustrates the complexity of understanding the health of people and animals within the context of environmental change in South India. The second provides insights into how the conservation of endangered species requires considering the entanglements of people, domestic animals, and the landscapes they share with wildlife in Madagascar. We demonstrate the value of integrating anthropological perspectives within interdisciplinary One Health research and interventions to better understand the complexity of systems.

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One Health research should incorporate anthropologists and/or social scientists.

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Anthropology provides unique approaches to improve One Health research.

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Long-term engagements with communities will improve One Health research.

Children's longitudinal bodyweight in Australia: Influence of migrant mothers' long-term residency, attachment to, and level of childhood overweight in country-of-birth

Immigration creates opportunities and imposes constraints associated with acculturation. We used the Australian national longitudinal survey of children aged 2 to 17 to evaluate the influence of mothers' long-term residency in Australia, mothers' attachment to country-of-birth, and macro indicators of childhood overweight environment at mothers' country-of-birth on children's longitudinal bodyweight. Both mothers' long-term exposure to the Australian environment and attachment to country-of-birth were associated with increased children's bodyweight z-scores. The childhood overweight environment in mothers' country-of-birth continued to influence their children's bodyweight after immigration. A better understanding of factors related to mothers' migration and children's bodyweight status is necessary to identify risk factors and migrant sub-groups needing extra support.

Toward an Affective Political Ecology of Obesity

This article argues for an affective approach to obesity that destabilizes the conceptual boundaries between the biological and the social aspects of food, eating, and fatness. Its approach foregrounds visceral experience, attends to food both inside and outside the body, and explores how bodies labeled “obese” consume their political, economic, and material environments. This approach is termed affective political ecology. The authors’ aim is to draw attention to how the entanglements between the physiological and social aspects of eating tend to be absented from antiobesity public health rhetoric. By exploring a range of ethnographic examples in high-income countries, they illuminate how such interventions often fail to account for the complex interplays between subjective corporeal experience and political economic relations and contend that overlooking an individual’s visceral relationship with food counterproductively augments social stigma, stresses, and painful emotions. They demonstrate, then, how an approach that draws together political economic and biomedical perspectives better reflects the lived experience of eating. In so doing, the authors aim to indicate how attending to affective political ecologies can further our understanding of the consumption practices of those in precarious and stressful social contexts, and they offer additional insight into how the entanglement of the biological and the social is experienced in everyday life.

Obesity epidemic in urban Tanzania: a public health calamity in an already overwhelmed and fragmented health system

BACKGROUND

Worldwide, the epidemiological and demographic transitions have resulted in nutrition shift characterized by an increased consumption of high energy fast food products. In just over 3 decades, overweight and obesity rates have nearly tripled to currently affecting over a third of the global population. Notwithstanding the ever present under-nutrition burden, sub Saharan Africa (SSA) is witnessing a drastic escalation of overweight and obesity. We aimed to explore the prevalence and associated factors for obesity among residents of Dar es Salaam city in Tanzania.

METHODS

Participants from this study were recruited in a community screening conducted during the Dar es Salaam International Trade Fair. Sociodemographic and clinical data were gathered using a structured questionnaire during enrollment. Dietary habits and anthropometric measurements were assessed using standard methods. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student's T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with BMI ≥ 25. All tests were 2-sided and p < 0.05 was used to denote a statistical significance.

RESULTS

A total of 6691 participants were enrolled. The mean age was 43.1 years and males constituted 54.2% of all participants. Over two-thirds of participants were alcohol consumers and 6.9% had a positive smoking history. 88.3% of participants were physically inactive, 4.7% had a history of diabetes mellitus and 18.1% were known to have elevated blood pressure. Overweight and obesity were observed in 34.8 and 32.4% of participants respectively. Among overweight and obese participants, 32.8% had a misperception of having a healthy weight. Age ≥ 40, female gender, a current working status, habitual breakfast skipping, poor water intake, high soft drink consumption, regular fast food intake, low vegetable and fruit consumption, alcohol consumption and hypertension were found to be independent associated factors for obesity.

CONCLUSION

Amidst the ever present undernutrition in SSA, a significant proportion of participants had excess body weight. Concomitantly, the rates of physical inactivity and unhealthy eating are disproportionately high in Dar es Salaam. In view of this, community-based and multilevel public health strategies to promote and maintain healthy eating and physical activity require an urgent step-up in urban Tanzania.

Health impact of the Anthropocene: the complex relationship between gut microbiota, epigenetics, and human health, using obesity as an example

The growing prevalence of obesity worldwide poses a public health challenge in the current geological epoch, the Anthropocene. Global changes caused by urbanisation, loss of biodiversity, industrialisation, and land-use are happening alongside microbiota dysbiosis and increasing obesity prevalence. How alterations of the gut microbiota are associated with obesity and the epigenetic mechanism mediating this and other health outcome associations are in the process of being unveiled. Epigenetics is emerging as a key mechanism mediating the interaction between human body and the environment in producing disease. Evidence suggests that the gut microbiota plays a role in obesity as it contributes to different mechanisms, such as metabolism, body weight and composition, inflammatory responses, insulin signalling, and energy extraction from food. Consistently, obese people tend to have a different epigenetic profile compared to non-obese. However, evidence is usually scattered and there is a growing need for a structured framework to conceptualise this complexity and to help shaping complex solutions. In this paper, we propose a framework to analyse the observed associations between the alterations of microbiota and health outcomes and the role of epigenetic mechanisms underlying them using obesity as an example, in the current context of global changes within the Anthropocene.

Biocultural determinants of overweight and obesity in the context of nutrition transition in Senegal: a holistic anthropological approach

Senegal is experiencing a rising obesity epidemic, due to the nutrition transition occurring in most African countries, and driven by sedentary behaviour and high-calorie dietary intake. In addition, the anthropological local drivers of the social valorization of processed high-calorie food and large body sizes could expose the population to obesity risk. This study aimed to determine the impact of these biocultural factors on the nutritional status of Senegalese adults. A mixed methods approach was used, including qualitative and quantitative studies. Between 2011 and 2013, fourteen focus group discussions (n=84) and a cross-sectional quantitative survey (n=313 women;n=284 men) of adults in three different socio-ecological areas of Senegal (rural:n=204; suburban:n=206; urban:n=187) were conducted. Dietary intake (Dietary Diversity Scores), physical activity (International Physical Activity Questionnaire), body weight norms (Body Size Scale), weight and health statuses (anthropometric measures and blood pressure) were measured. Middle-aged and older Senegalese women were found to value overweight/obesity more than younger Senegalese in all regions. In addition, young urban/suburban adults had a tendency for daily snacking whilst urban/suburban adults tended to be less physically active and had higher anthropometric means. A binary logistic regression model showed that being female, older, living in urban/suburban areas and valuing larger body size were independently associated with being overweight/obese, but not high-calorie diet. Univariate analyses showed that lower physical activity and higher socioeconomic status were associated with being overweight/obese. Finally, overweight/obesity, which is low in men, is associated with hypertension in the total sample. The nutrition transition is currently underway in Senegal’s urban/suburban areas, with older women being more affected. Since several specific biocultural factors jointly contribute to this phenomenon, the study’s findings suggest the need for local public health interventions that target women and which account for the anthropological specificities of the Senegalese population.

Body size perceptions and preferences favor overweight in adult Saharawi refugees

Background

Culture affects body image and body size perceptions from an early age and in many African countries, overweight has been associated with richness, health, strength, and fertility. The present study investigated body size perceptions and preferences in an African refugee population.

Methods

The cross-sectional study was comprised of 180 and 175 randomly selected Saharawi women and men, respectively, between 18 and 80 years. Stunkard’s body figure scale was used to identify self-perceived body size, desired body size and desired body size in the opposite gender.

Results

Approximately half of the participants had a correct self-perceived body size; among them 70% did not have a desire to have a smaller body size. Among women who preferred a body size corresponding to overweight in men, 77% also had a desired body size corresponding to overweight; compared to 43% for men. The youngest participants (18–25 years) were the least likely to overestimate their body size in comparison to the older participants (26–45 years and 46–80 years).

Conclusion

We found an overall preference for an overweight body size, and a significant difference in body size perception associated with age.

Gut Microbiome of Coexisting BaAka Pygmies and Bantu Reflects Gradients of Traditional Subsistence Patterns

To understand how the gut microbiome is impacted by human adaptation to varying environments, we explored gut bacterial communities in the BaAka rainforest hunter-gatherers and their agriculturalist Bantu neighbors in the Central African Republic. Although the microbiome of both groups is compositionally similar, hunter-gatherers harbor increased abundance of Prevotellaceae, Treponema, and Clostridiaceae, while the Bantu gut microbiome is dominated by Firmicutes. Comparisons with US Americans reveal microbiome differences between Africans and westerners but show western-like features in the Bantu, including an increased abundance of predictive carbohydrate and xenobiotic metabolic pathways. In contrast, the hunter-gatherer gut shows increased abundance of predicted virulence, amino acid, and vitamin metabolism functions, as well as dominance of lipid and amino-acid-derived metabolites, as determined through metabolomics. Our results demonstrate gradients of traditional subsistence patterns in two neighboring African groups and highlight the adaptability of the microbiome in response to host ecology.

An Emerging Epidemic of Noncommunicable Diseases in Developing Populations Due to a Triple Evolutionary Mismatch

With their transition from adverse to affluent environments, developing populations experience a rapid increase in the number of individuals with noncommunicable diseases. Here, we emphasize that developing populations are more susceptible than western populations to acquire these chronic diseases, because their genetic, cultural, and epigenetic characteristics do not match with the eagerly awaited affluent environments. In regard to this, there is an urgent need for public health organizations to reorganize current environments in developing populations so as to fit their inherited characteristics. Unfortunately, this need is neglected as an essential part of the Sustainable Development Goals that form the core of the United Nations' Post-2015 Development Agenda. Only through global collaborative efforts can the environments in developing populations be reorganized and, thereby, the emerging epidemic of noncommunicable diseases be stalled.

Are neighborhoods causal? Complications arising from the 'stickiness' of ZNA

Are neighborhoods causal? The answer remains elusive. Armed with new multilevel methods, enthusiasm for neighborhoods research surged at the turn of the century. However, a wave of skepticism has arisen based on the difficulty of drawing causal inferences from observational studies in which selection to neighborhoods is non-random. Researchers have sought answers from experimental and quasi-experimental studies of movers vs. stayers. We develop two related concepts in this essay in the hopes of shedding light on this problem. First, the inceptive environment into which persons are born (which we term ZNA for Zip code Nativity Area) exerts a potentially powerful causal impact on health. Detecting that causal effect is challenging for reasons similar that obtain in other fields (including genetics). Second, we explicate the problem of neighborhood 'stickiness' in terms of the persistence of neighborhood treatment assignment, and argue that under-appreciation of stickiness has led to systematic bias in causal estimates of neighborhoods proportional to the degree of stickiness. In sticky contexts, failure to account for the lasting influences of ZNA by adjusting for intermediate individual socioeconomic and health variables on the causal pathway can result in neighborhood effects estimates that are biased toward the null. We follow with an example drawn from evidence of neighborhood 'stickiness' and obesity. The stickiness of ZNA cautions us that experimental evidence may be insufficient or misleading as a solution to causal inference problems in neighborhood research.

Ambient Temperature and Prevalence of Obesity: A Nationwide Population-Based Study in Korea

Background

Recent studies have suggested a possible association between outdoor or indoor temperature and obesity. We aimed to examine whether ambient temperature is associated with the prevalence of obesity or abdominal obesity in the Korean population.

Methods

Data on anthropometric, socio-demographic, laboratory and lifestyle factors were retrieved from National Health Insurance System data obtained in 2009–2010. Thirty years (1981 to 2010) of meteorological parameters for 71 observation areas were acquired from the Korea Meteorological Administration. Included in this analysis were 124,354 individuals. A body mass index (BMI) ≥ 25 kg/m² and a waist circumference (WC) ≥ 90 cm (men) or 85 cm (women) were considered to represent obesity and abdominal obesity, respectively.

Results

The mean annual temperature (MAT) ranged from 6.6°C to 16.6°C, and BMI was positively correlated with MAT (r = 0.0078, P = 0.0065). WC was positively correlated with MAT (r = 0.0165, P < 0.0001) and negatively correlated with the number of days with mean temperature < 0°C (DMT0; r = –0.0129, P = 0.0002). After adjusting for age, sex, smoking status, alcohol consumption, exercise, income, residential area and altitude, the odds ratios (95% CI) for obesity and abdominal obesity in the highest quintile MAT group were 1.045 (1.010, 1.081) and 1.082 (1.042, 1.124), respectively, compared with the lower four quintiles of the MAT group. Similarly, subjects in the area of the lowest quintile of DMT0 had significantly higher odds of abdominal obesity compared with the higher four quintile groups of DMT0.

Conclusion

This study finds an association between ambient temperature and prevalence of obesity in the Korean population when controlling for several confounding factors. Adaptive thermogenesis might be a possible explanation for this phenomenon.

Local Spatial Analysis and Dynamic Simulation of Childhood Obesity and Neighbourhood Walkability in a Major Canadian City

Body weight is an important indicator of current and future health and it is even more critical in children, who are tomorrow's adults. This paper analyzes the relationship between childhood obesity and neighbourhood walkability in Calgary, Canada. A multivariate analytical framework recognizes that childhood obesity is also associated with many factors, including socioeconomic status, foodscapes, and environmental factors, as well as less measurable factors, such as individual preferences, that could not be included in this analysis. In contrast with more conventional global analysis, this research employs localized analysis and assesses need-based interventions. The one-size-fit-all strategy may not effectively control obesity rates, since each neighbourhood has unique characteristics that need to be addressed individually. This paper presents an innovative framework combining local analysis with simulation modeling to analyze childhood obesity. Spatial models generally do not deal with simulation over time, making it cumbersome for health planners and policy makers to effectively design and implement interventions and to quantify their impact over time. This research fills this gap by integrating geographically weighted regression (GWR), which identifies vulnerable neighbourhoods and critical factors for childhood obesity, with simulation modeling, which evaluates the impact of the suggested interventions on the targeted neighbourhoods. Neighbourhood walkability was chosen as a potential target for localized interventions, owing to the crucial role of walking in developing a healthy lifestyle, as well as because increasing walkability is relatively more feasible and less expensive then modifying other factors, such as income. Simulation results suggest that local walkability interventions can achieve measurable declines in childhood obesity rates. The results are encouraging, as improvements are likely to compound over time. The results demonstrate that the integration of GWR and simulation modeling is effective, and the proposed framework can assist in designing local interventions to control and prevent childhood obesity.

FACTORS ASSOCIATED WITH CHILDREN'S HEIGHT AND BODY MASS INDEX IN LITHUANIA, 1990-2008

The aim of the study was to reveal the ethnic and socioeconomic factors associated with height and body mass index (BMI) of children during the period of political and social transition in Lithuania in 1990-2008. Data were derived from the personal health records of 1491 children (762 boys and 729 girls) born in 1990 in Vilnius city and region. Height and BMI from birth up to the age of 18 years were investigated. Children were divided into groups according to their ethnicity, place of residence, father's and mother's occupation and birth order. Height and BMI were compared between the groups; a Bonferroni correction was applied. A multiple linear regression model was used to measure the effects of the independent variables on height and BMI. Girls living in Vilnius city were significantly taller in later life at the ages of 8 and 11 years. Sons of mothers employed as office workers appeared to be significantly taller at the ages of 7, 12, 14 and 15 years compared with the sons of labourers. First-born girls were taller at the age of 7 years than later-born girls of the same age (124.48±5.11 cm and 122.92±5.14 cm, respectively, p<0.001). Later-born children of both sexes had higher BMIs at birth compared with first-borns; however, first-born girls had higher BMIs at the age of 11 years compared with their later-born peers (17.78±2.87 kg/m² and 16.79±2.14 kg/m² respectively, p<0.001). In the multiple linear regression model, the five tested independent variables explained only up to 18% of total variability. Boys were more sensitive to ethnic and socioeconomic factors: ethnicity appeared to be a significant predictor of boys' height at the age of 5 years (p<0.001), while birth order (p<0.001) predicted boys' BMI at birth. In general, ethnicity, place of residence, father's and mother's occupation and birth order were not associated with children's height and BMI in most age groups.

Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: clinical characteristics and outcomes

Obesity is an important public health problem that may influence the outcomes of hematopoietic cell transplantation (HCT). We studied 898 children and adults receiving first-time allogeneic hematopoietic SCTs between 2004 and 2012. Pretransplant body mass index (BMI) was classified as underweight, normal weight, overweight or obese using the WHO classification or age-adjusted BMI percentiles for children. The study population was predominantly Caucasian, and the median age was 51 years (5 months-73 years). The cumulative 3-year incidence of nonrelapse mortality (NRM) in underweight, normal weight, overweight and obese patients was 20%, 19%, 20% and 33%, respectively. Major causes of NRM were acute and chronic GVHD. The corresponding incidence of relapse was 30%, 41%, 37% and 30%, respectively. Three-year OS was 59%, 48%, 47% and 43%, respectively. Multivariate analysis showed that obesity was associated with higher NRM (hazard ratio (HR) 1.43, P=0.04) and lower relapse (HR 0.65, P=0.002). Pretransplant plasma levels of ST2 and TNFR1 biomarkers were significantly higher in obese compared with normal weight patients (P=0.04 and P=0.05, respectively). The increase in NRM observed in obese patients was partially offset by a lower incidence of relapse with no difference in OS.

Disentangling basal and accumulated body mass for cross-population comparisons

Measures of human body mass confound 1) well-established population differences in body form and 2) exposure to obesogenic environments, posing challenges for using body mass index (BMI) in cross-population studies of body form, energy reserves, and obesity-linked disease risk. We propose a method for decomposing population BMI by estimating basal BMI (bBMI) among young adults living in extremely poor, rural households where excess body mass accumulation is uncommon. We test this method with nationally representative, cross-sectional Demographic and Health Surveys (DHS) collected from 69,916 rural women (20-24 years) in 47 low-income countries. Predicting BMI by household wealth, we estimate country-level bBMI as the average BMI of young women (20-24 years) living in rural households with total assets <400 USD per capita. Above 400 USD per capita, BMI increases with both wealth and age. Below this point, BMI hits a baseline floor showing little effect of either age or wealth. Between-country variation in bBMI (range of 4.3 kg m(-2) ) is reliable across decades and age groups (R(2)  = 0.83-0.88). Country-level estimates of bBMI show no relation to diabetes prevalence or country-level GDP (R(2)  < 0.05), supporting its independence from excess body mass. Residual BMI (average BMI minus bBMI) shows better fit with both country-level GDP (R(2)  = 0.55 vs. 0.40) and diabetes prevalence (R(2)  = 0.23 vs. 0.17) than does conventional BMI. This method produces reliable estimates of bBMI across a wide range of nationally representative samples, providing a new approach to investigating population variation in body mass.

Plantando, colhendo, vendendo, mas não comendo: práticas alimentares e de trabalho associadas à obesidade em agricultores familiares do Bonfim, Petrópolis, RJ

OBJETIVO: verificar a prevalência de obesidade entre adultos das 86 famílias agricultoras de um bairro de Petrópolis, RJ, e analisar seus determinantes socioculturais. MÉTODOS: estudo quantitativo e qualitativo sobre nutrição, práticas alimentares e de trabalho realizado em 2008. Dados antropométricos foram coletados por inquérito nutricional domiciliar e o material qualitativo por observação participante e entrevistas. RESULTADOS: a prevalência de obesidade foi baixa (9,3%) entre os homens, mas bastante elevada entre as mulheres (29,9%). A prática agrícola local implica em atividade física leve para mulheres e intensa para homens. Essa diferença não é acompanhada na dieta, semelhante para homens e mulheres, com predomínio de alimentos de alto valor calórico. A produção familiar objetiva essencialmente a venda. A agricultura mercantil e a decorrente especialização dos cultivos favorecem comprar alimentos no mercado em vez de produzir para autoconsumo. CONCLUSÃO: os aspectos socioculturais e ocupacionais estudados podem ter contribuído para elevar a prevalência de obesidade nas mulheres e podem ser úteis no estudo de outros grupos com características semelhantes. Esta pesquisa ratifica a importância de estudar a obesidade em nível local, integrando abordagens quantitativas e qualitativas para identificar possíveis limitações e portas de entrada para ações de intervenção localmente relevantes.

Hispanic immigrant women's perspective on healthy foods and the New York City retail food environment: A mixed-method study

Much has been written about the role of dietary acculturation in the epidemic of obesity among Hispanic immigrants in the United States. Yet little is known about the role of beliefs and preferences in immigrants' dietary practices and their relationship to the retail food environment in which the practices occur. We conducted a mixed-methods convergence study of these issues. Twenty-eight foreign-born Hispanic adult women, recruited from families enrolled in a childhood asthma study and mainly living in New York City took part in 60-90 min, semi-structured interviews regarding their dietary beliefs, preferences, and practices. The findings were then used to formulate hypotheses for analyses of food frequency questionnaire (FFQ) data collected from the 345 New York Hispanic women enrolled in the asthma study. Generalized estimating equations were used to determine whether characteristics of the retail food environment within 0.5 km of the home predicted diet, adjusting for individual and neighborhood socio-demographic characteristics. In the interviews, healthy food was rarely discussed in terms of nutritional content. Instead, considerations of freshness, as indicated by time since harvest or slaughter and thus local sourcing; purity, as indicated by the absence of preservatives and processing; and naturalness, as indicated by chemical free farming practices, were the primary axes around which healthy food was defined. Quantitative results were consistent with the qualitative findings: 1) the presence of a farmers' market within the home neighborhood was associated with consumption of more total servings per day of fruit, vegetables, and juice, and 2) the presence of a farmers' market and/or a livestock market was associated with consumption of more servings per day of meat. Proximity to supermarkets or medium-sized grocery stores was not associated with consumption. The results suggest that the availability of fresh produce and meat from local farms may influence diet among Hispanic women in urban neighborhoods.

Nutritional vulnerability in Mbyá-Guaraní adolescents and adults from Misiones, Argentina

OBJECTIVES

The aim of this study was to evaluate the nutritional status and body composition in Mbyá-Guaraní adolescents and adults from three communities in the Province of Misiones, in northern Argentina.

METHODS

Anthropometric parameters were analyzed in 45 individuals (aged 14-60). Data were transformed to z-scores using NHANES I and II.

RESULTS

Ninety-three percent of the sample showed some kind of malnutrition (undernutrition and/or excess of weight). Stunting and overweight reached the highest prevalences (85.0 and 10.0%, respectively). The most Mbyá people were found to have low arm muscle and fat areas. They also tended to have shorter than normal lower limbs. Centralized obesity was evident in both sexes and in all the age intervals.

CONCLUSIONS

Extreme poverty, together with changes in life habits and diet composition, resulted in decrease of body size and changes in body proportions and composition. Although these changes could be considered as an adaptive response to the chronic exposure of these populations to adverse environmental conditions, they would favor the co-occurrence of malnutrition and overweight in a single scenario, and consequently increase the risk of infectious and nontransmissible diseases.

Obesity under affluence varies by welfare regimes: the effect of fast food, insecurity, and inequality

Among affluent countries, those with market-liberal welfare regimes (which are also English-speaking) tend to have the highest prevalence of obesity. The impact of cheap, accessible high-energy food is often invoked in explanation. An alternative approach is that overeating is a response to stress, and that competition, uncertainty, and inequality make market-liberal societies more stressful. This ecological regression meta-study pools 96 body-weight surveys from 11 countries c. 1994-2004. The fast-food 'shock' impact is found to work most strongly in market-liberal countries. Economic insecurity, measured in several different ways, was almost twice as powerful, while the impact of inequality was weak, and went in the opposite direction.

Growth of school children in different urban environments in Argentina

BACKGROUND

Nutritional transition has been described in various countries, each showing inherent characteristics. Furthermore, different patterns also appear within the same country.

AIM

To compare the nutritional status of schoolchildren, of both sexes, living in two Argentine cities with different urban and environment characteristics, from the perspective of nutritional transition.

SUBJECTS AND METHODS

The sample comprised 5355 children (6-13 years) living in Puerto Madryn (Chubut) and General Alvear (Mendoza), Argentina. Weight and height were transformed into Z-scores according to NHANES I- II; underweight, stunting and wasting defined by - 2 SD and overweight and obesity calculated according the cut-off proposed by IOTF. Prevalences of nutritional status were estimated.

RESULTS

Comparison of the two cities revealed significant χ² values for the indicators of nutritional status analysed. Puerto Madryn had higher prevalences of overweight and obesity. General Alvear exhibited higher stunting and underweight values.

CONCLUSIONS

The cities studied are in different stages of nutritional transition. Puerto Madryn is undergoing growing industrialization and urbanization and thus exhibits characteristics typical of an 'obesogenic' environment. General Alvear, a less complex urban centre, where some cultural patterns related to an agrarian way of life appear to have been retained, is situated at a less advanced stage.

Oral health and frailty in the medieval English cemetery of St Mary Graces

The analysis of oral pathologies is routinely a part of bioarcheological and paleopathological investigations. Oral health, while certainly interesting by itself, is also potentially informative about general or systemic health. Numerous studies within modern populations have shown associations between oral pathologies and other diseases, such as cardiovascular disease, certain types of cancer, and pulmonary infections. This article addresses the question of how oral health was associated with general health in past populations by examining the relationship between two oral pathologies (periodontal disease and dental caries) and the risk of mortality in a cemetery sample from medieval England. The effects of periodontitis and dental caries on risk of death were assessed using a sample of 190 individuals from the St Mary Graces cemetery, London, dating to approximately AD 1350-1538. The results suggest that the oral pathologies are associated with elevated risks of mortality in the St Mary Graces cemetery such that individuals with periodontitis and dental caries were more likely to die than their peers without such pathologies. The results shown here suggest that these oral pathologies can be used as informative indicators of general health in past populations.

The "childhood obesity epidemic": health crisis or social construction?

There has been a meteoric rise over the past two decades in the medical research and media coverage of the so-called global childhood obesity epidemic. Recently, in response to this phenomenon, there has been a spate of books and articles in the fields of critical sociology and cultural studies that have argued that this "epidemic" is socially constructed, what Natalie Boero (2007) dubs a "postmodern epidemic." As an anthropologist who has studied child nutrition and obesity in relation to poverty and the school environment, I am concerned about both the lack of reflexivity among medical researchers as well as critical scholars' treatment of the problem as entirely socially constructed. In this article I present both sides of this debate and then discuss how wee can attempt to navigate a middle course that recognizes this health issue but also offers alternative approaches to those set by the biomedical agenda.

Is thermogenesis a significant causal factor in preventing the "globesity" epidemic?

During the last four decades the world has experienced an epidemic of overweight individuals in affluent as well as developing countries. The WHO has predicted a "globesity epidemic" with more than 1 billion adults being overweight and at least 300 million of these being clinically obese. Obesity among children and adolescents is of great significance. From a global population perspective, this epidemic in weight gain and its sequelae are the largest public health problems identified to date and have very significant adverse implications for population health, and have by now almost reached the proportion of a pandemic. While genetic changes have been discussed as a cause of the epidemic, there has been too little time since its start to enable enough genetic adaptation to take place for this to provide a valid explanation. Traditionally positive energy balance and sedentary life style have been regarded as the primary causal factors; however, these factors have so far failed to provide explanations for the entire problem. For these reasons it seems warranted to investigate other possible co-factors contributing to the "globesity epidemic" and to find efficient strategies to counteract further increases in the size and nature of the epidemic. The purpose of this paper is to discuss a potential preventive co-factor, thermogenesis. Special attention has been paid to the influence of ambient temperature as a grossly neglected factor in the debate. As most people today live and work at ambient temperatures close to their body temperature (the thermal neutral point), we hypothesise that this is an important causal co-factor in the "globesity" epidemic. The hypothesis: The null hypothesis that adaptive thermogenesis in brown adipose tissue in adult humans is not significant for weight loss is rejected. We propose the hypothesis that homoeothermic living conditions close to the thermogenic neutral level is an important causal co-factor in the "Globesity" Epidemic.

Cultural and social influences on food consumption in dutch residents of Turkish and moroccan origin: a qualitative study

OBJECTIVE

To explore the social and cultural influences on food intake in 2 non-Western migrant origin groups. The authors were particularly interested in the influence of the traditional culture and its relevance within the context of migration and associated changes in social, economic and cultural context, including acculturation.

DESIGN

Qualitative focus group discussions.

SETTING

City of Amsterdam, the Netherlands.

PARTICIPANTS

Young adults of Turkish and Moroccan migrant origin.

PHENOMENON OF INTEREST

Social and cultural influences on food intake.

ANALYSIS

Focus groups were recorded, transcribed, and analyzed using framework analysis.

RESULTS

A dominant theme that emerged is that of hospitality and the central role of food herein. Hospitality is rooted within the cultural and religious tradition of both groups. Additional themes that emerged were: cultural identity; migration and lifestyle change; and acculturation.

CONCLUSIONS AND IMPLICATIONS

Among Dutch residents of Turkish and Moroccan migrant origin, the central role of food in culture coupled with the changes that come about as a result of migration create an environment of abundance that can lead to overeating, which may impact energy balance and overweight development. These results indicate that younger members of migrant origin populations continue to value their traditional food cultures, underpinning the need for interventions to be culturally sensitive.

Dietary intake, overweight status, and perceptions of food insecurity among homeless Minnesotan youth

Youth, 9-18 years (n = 202), living in homeless shelters in Minneapolis, Minnesota, were assessed for height, weight, dietary intake, and perceptions of food insecurity. Perceptions of food security were measured by asking youth to respond to the statements (1) "There are times when we do not have enough food in the house," (2) "I go to bed hungry at night," (3) "I do not get enough to eat at home," and (4) "Have you ever had to miss a meal (or not been able to eat) because there was no food at home?" Additionally, questions evaluated coping mechanisms used by children to ward off hunger. Fifty-five percent of the children reported not enough food in the house and 25% reported going to bed hungry. Youth had inadequate intakes of vitamin D, calcium, and potassium and the majority consumed less than the estimated average requirements (EAR) for vitamins A, C, and E, phosphorus, folate, and zinc. Fruits, vegetables, and dairy were also consumed below recommended levels. Forty-five percent of boys and 50% of girls were at risk-for-overweight or were overweight. Overeating, eating anything, eating disliked foods, and eating at the homes of family and friends were identified as strategies to cope with food insecurity. Overeating when food is available may explain why we see a hunger-obesity paradigm to the magnitude that we do among the poorest Americans. These strategies protect children from the immediate negative associations of poverty and hunger, but they may contribute to long-term weight problems currently found in the US.

Body mass index, waist to hip ratio and waist/height in adult Polish women in relation to their education, place of residence, smoking and alcohol consumption

Obesity is a complex, multifactorial disorder that develops from genotype and environmental interactions. The aim of this study is to describe the variability of body mass index (BMI), waist to hip ratio (WHR) and waist to height (W/Ht) in adult Polish women, and to determine relationships between these variables and factors such as education, place of residence, smoking and alcohol drinking. The tested group consisted of 10,254 women aged 25-95 years, who voluntarily filled in questionnaires and participated in anthropometric measurements (body height and mass, waist and hip circumferences). The BMI, WHR and W/Ht values were calculated based on these measurements. The participants were differentiated in terms of education, residence and lifestyle (smoking, alcohol drinking). Chi-squared test, product-moment correlations, ANOVA, multiple correspondence analysis (MCA) and logistic regression with backward elimination were used to evaluate associations between social and lifestyle factors and BMI, WHR and W/Ht. The results confirm (1) the relationship between low social status and the risk of overweight and obesity as observed in developed countries; (2) higher susceptibility to environmental factors such as education, place of residence, smoking and alcohol drinking in younger (premenopausal) women; (3) the usefulness of simple and practical anthropometric indicators such as WHR and W/Ht for the identification of the higher risk of future metabolic diseases in obese people and those with a normal body mass.

Seven models of population obesity

Obesity is new in human evolutionary history, having become possible at the population level with increased food security. As with any phenotype, obesity is at base an outcome of gene-environment interactions. However, different disciplines working in obesity research have identified different facets of the problem and developed different models of population obesity. These include those of thrifty genotypes, obesogenic behavior, obesogenic environments, nutrition transition, obesogenic culture, and biocultural interactions of genetics, environment, behavior, and culture. Although there is an overlap between various of these models, there remains a lack of consensus concerning obesity causation at the population level. This is a major problem in study of, and intervention in, obesity among populations.

Evolutionary origins of obesity

Although it appeared relatively suddenly, the current obesity epidemic - largely manifest in industrialized societies but now spreading to the rest of the world - is the result of interaction between human biology and human culture over the long period of human evolution. As mammals and primates, humans have the capacity to store body fat when opportunities to consume excess energy arise. But during the millions of years of human evolution such opportunities were rare and transient. More commonly ancestral hominins and modern humans were confronted with food scarcity and had to engage in high levels of physical activity. In tandem with encephalization, humans evolved elaborate and complex genetic and physiological systems to protect against starvation and defend stored body fat. They also devised technological aids for increasing energy consumption and reducing physical effort. In the last century, industrialization provided access to great quantities of mass-produced, high-calorie foods and many labour-saving and transportation devices, virtually abolishing starvation and heavy manual work. In the modern obesogenic environment, individuals possessing the appropriate combination of ancestral energy-conserving genes are at greater risk for overweight and obesity and associated chronic diseases.

Frameworks of population obesity and the use of cultural consensus modeling in the study of environments contributing to obesity

Obesity in Eastern Europe has been linked to privilege and status prior to the collapse of communism, and to exposure to free-market economics after it. Neither formulation is a complete explanation, and it is useful to examine the potential value of other models of population obesity for the understanding of this phenomenon. These include those of: thrifty genotypes; obesogenic behaviour; obesogenic environments; nutrition transition; obesogenic culture; and biocultural interactions of genetics, environment, behaviour and culture. At the broadest level, obesity emerges from the interaction of thrifty genotype with obesogenic environment. However, defining obesogenic environments remains problematic, especially in relation to sociocultural factors. Furthermore, since different identity groups may share different values concerning the obesogenicity of the environment, a priori assumptions about group homogeneity may lead to flawed interpretations of the importance of sociocultural factors in obesogenic environments. A new way to identify cultural coherence of groups and populations in relation to environments contributing to obesity is put forward here, that of cultural consensus modeling.

Intense sweetness surpasses cocaine reward

Background

Refined sugars (e.g., sucrose, fructose) were absent in the diet of most people until very recently in human history. Today overconsumption of diets rich in sugars contributes together with other factors to drive the current obesity epidemic. Overconsumption of sugar-dense foods or beverages is initially motivated by the pleasure of sweet taste and is often compared to drug addiction. Though there are many biological commonalities between sweetened diets and drugs of abuse, the addictive potential of the former relative to the latter is currently unknown.

Methodology/Principal findings

Here we report that when rats were allowed to choose mutually-exclusively between water sweetened with saccharin–an intense calorie-free sweetener–and intravenous cocaine–a highly addictive and harmful substance–the large majority of animals (94%) preferred the sweet taste of saccharin. The preference for saccharin was not attributable to its unnatural ability to induce sweetness without calories because the same preference was also observed with sucrose, a natural sugar. Finally, the preference for saccharin was not surmountable by increasing doses of cocaine and was observed despite either cocaine intoxication, sensitization or intake escalation–the latter being a hallmark of drug addiction.

Conclusions

Our findings clearly demonstrate that intense sweetness can surpass cocaine reward, even in drug-sensitized and -addicted individuals. We speculate that the addictive potential of intense sweetness results from an inborn hypersensitivity to sweet tastants. In most mammals, including rats and humans, sweet receptors evolved in ancestral environments poor in sugars and are thus not adapted to high concentrations of sweet tastants. The supranormal stimulation of these receptors by sugar-rich diets, such as those now widely available in modern societies, would generate a supranormal reward signal in the brain, with the potential to override self-control mechanisms and thus to lead to addiction.