The Influence of Markets on the Nutrition Transition of Hunter-Gatherers: Lessons from the Western Amazon

Alcohol consumption, life history and extinction risk among Raute hunter-gatherers from Nepal

Hunter-gatherer populations underwent a mass extinction in the Neolithic, and in present times face challenges such as explicit sedentarisation policies. An exception is in Nepal, where the nomadic Raute people receive monthly governmental individual payments. One consequence of the money transfers has been a significant increase in alcohol consumption, with nearly all individuals drinking industrially produced alcohol. Here we investigate the Raute demography based on a full census of 144 individuals. We show that the Raute exhibit the short life expectancies typical of other hunter-gatherer populations from Africa, Asia and America. Bayesian survival trajectory analysis demonstrated that heavy drinking by either parent substantially reduces offspring survival to age 15. Bayesian regressions revealed a significant effect of heavy drinking on maternal fertility by decreasing the number of living children and reducing the proportion of live children at the end of maternal reproductive life. Although the absence of data prior to monetary support precludes a direct assessment of long-term demographic trends, relatively stable population sizes over the last decades and a fertility rate close to the replacement rate rule out an imminent population crash. Further studies are required to elucidate the Rautes' origins and relationship with other nomadic people in the region.

Influence path of work-family conflict on primary care physicians' resignation intention: Data from a Chinese cross-sectional survey

BACKGROUND

Primary care physicians and their teams are the leading force in constructing primary medical services, undertaking the critical responsibility of residents' essential health, and also related to realizing the national health goal. However, primary care physicians generally have a high turnover rate due to problems such as high work pressure, low salary levels, and limited career development. Therefore, exploring primary care physicians' resignation intentions plays a vital role in promoting the construction of primary care physicians' health service system.

OBJECTIVE

This study explores the factors influencing the resignation intentions of primary care physicians, specifically examining the roles of work-family conflict, job satisfaction, professional identity, and emotional exhaustion. By understanding these dynamics, the research aims to inform strategies that can enhance the stability and effectiveness of primary care services, ultimately contributing to the improvement of public health infrastructure and achieving national health goals. This investigation will utilize structural equation modeling to analyze the interrelationships among the identified variables, thereby providing a comprehensive framework for addressing the high turnover rates among primary care physicians.

METHODS

This study uses the work-family conflict, job satisfaction, professional identity, and emotional exhaustion scales. The data comes from a cross-sectional survey in Zhejiang Province, China, in 2022. Using SPSS 27 and Mplus8.3 software to analyze 1205 primary care physicians and their team members, the selected cases all answered the relevant questions of resignation intention. The potential relationship among work-family conflict, job satisfaction, professional identity, emotional exhaustion, and family doctor resignation intention was explored by constructing structural equations.

RESULTS

Work-family conflict can directly and positively affect primary care physicians' resignation intention (β = -0.546, p < 0.001). The results of the mediation model found that job satisfaction, professional identity, and emotional exhaustion were significantly related to work-family conflict, and primary care physicians' resignation intention has a significant mediating effect. It mainly includes six intermediary approaches: one is through the independent intermediary effect of job satisfaction; the second is through the independent intermediary effect of professional identity; the third is through the chain intermediary effect between Job satisfaction and professional identity; the fourth is through the intermediary effect of Job satisfaction and emotional exhaustion chain intermediary; fifth is through the chain intermediary of professional identity and emotional exhaustion; sixth is through the complex chain intermediary of job satisfaction, professional identity, and emotional exhaustion.

CONCLUSION

Primary care physicians have a high score in resignation intention, which deserves continuous attention. Relevant department can help primary care physicians balance work and family roles, provide them with appropriate resources and rewards, as well as a good working environment and career development opportunities, to improve their job satisfaction and professional identity and reduce emotional exhaustion, thereby reducing the risk of resignation intention.

Changes in weight status among "Ju/'hoansi" San hunter-gatherers between 1968/69 and 1987-The effects of nutritional transition, sex and age

BACKGROUND

Changes in lifestyle and dietary habits that hunter-gatherer populations have undergone in recent decades have often led to rising obesity rates with disastrous consequences for their health.

OBJECTIVES

The associations between dietary habits and weight status were studied in 238 "Ju/'hoansi" San (93 women and 145 men) aged between 18 and 65 years in northern Namibia in 1987. Weight status was estimated based on the World Health Organization body mass index (BMI) categories, and dietary habits were recorded using food recall methods. Anthropometrics and weight status were compared with those of a sex- and age-matched sample of "Ju/'hoansi" San people collected by Nancy Howell in 1968/69.

RESULTS

Body weight had increased significantly among "Ju/'hoansi" San people from 1968/69 to 1987. The number of underweight people decreased from 1968/69 to 1987. In 1987, most participants (60.9%) were of normal weight. Overweight was found in 1.3% of the women, but not among men. No participants were obese. Less than 4% of the women and less than 2% of the men consumed exclusively traditional hunter-gatherer food. Westernized food products were significantly (p < 0.001) more common among men and younger people. Dietary patterns were significantly associated with weight status. The less traditional the diet, the higher the BMI (p < 0.001).

CONCLUSION

The transition to domestic agricultural and westernized foods was positively associated with increasing BMI. Overweight, however, was still an extremely rare condition in this population in 1987.

Hunter-gatherer diets and activity as a model for health promotion: Challenges, responses, and confirmations

Beginning in 1985, we and others presented estimates of hunter-gatherer (and ultimately ancestral) diet and physical activity, hoping to provide a model for health promotion. The Hunter-Gatherer Model was designed to offset the apparent mismatch between our genes and the current Western-type lifestyle, a mismatch that arguably affects prevalence of many chronic degenerative diseases. The effort has always been controversial and subject to both scientific and popular critiques. The present article (1) addresses eight such challenges, presenting for each how the model has been modified in response, or how the criticism can be rebutted; (2) reviews new epidemiological and experimental evidence (including especially randomized controlled clinical trials); and (3) shows how official recommendations put forth by governments and health authorities have converged toward the model. Such convergence suggests that evolutionary anthropology can make significant contributions to human health.

Arterial hypertension and its covariates among nomadic Raute hunter-gatherers of Western Nepal: a mixed-method study

OBJECTIVES

To determine the prevalence of, and understand the factors associated with, hypertension among the nomadic Raute hunter-gatherers of Western Nepal.

DESIGN

A mixed-method study.

SETTING

The study was carried out at Raute temporary campsites in the Surkhet District of Karnali Province between May and September 2021.

PARTICIPANTS

The questionnaire-based survey included all males and non-pregnant females of the nomadic Raute group aged 15 years and above. In-depth interviews were conducted among purposively selected 15 Raute participants and four non-Raute key informants to help explain and enrich the quantitative findings.

OUTCOME MEASURES

The prevalence of hypertension (defined as brachial artery blood pressure of systolic ≥140 mm Hg and/or diastolic ≥90 mm Hg) and its sociodemographic, anthropometric and behavioural covariates.

RESULTS

Of the 85 eligible participants, 81 (median age 35 years (IQR: 26-51), 46.9% female) were included in the final analysis. Hypertension was found in 10.5% of females, 48.8% of males and 30.9% of the total population. Current alcohol and tobacco use were high (91.4% and 70.4%, respectively), with concerning high rates among youths. Males, older people, current drinkers and current tobacco users were more likely to have hypertension. Our qualitative analysis suggests that the traditional forest-based Raute economy is gradually transitioning into a cash-based one that heavily relies on government incentives. Consumption of commercial foods, drinks and tobacco products is increasing as their market involvement grows.

CONCLUSION

This study found a high burden of hypertension, alcohol and tobacco use among nomadic Raute hunter-gatherers facing socioeconomic and dietary transitions. Further research is needed to assess the long-term impact of these changes on their health. This study is expected to help appraise concerned policymakers of an emerging health concern and formulate context-specific and culturally sensitive interventions to limit hypertension-related morbidities and mortalities in this endangered population.

Amazonian fruits with potential effects on COVID-19 by inflammaging modulation: A narrative review

The COVID-19 pandemic had a great impact on the mortality of older adults and, chronic non- transmissible diseases (CNTDs) patients, likely previous inflammaging condition that is common in these subjects. It is possible that functional foods could attenuate viral infection conditions such as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the causal agent of COVID-19 pandemic. Previous evidence suggested that some fruits consumed by Amazonian Diet from Pre-Colombian times could present relevant proprieties to decrease of COVID-19 complications such as oxidative-cytokine storm. In this narrative review we identified five potential Amazonian fruits: açai berry (Euterpe oleracea), camu-camu (Myrciaria dubia), cocoa (Theobroma cacao), Brazil nuts (Bertholletia excelsa), and guaraná (Paullinia cupana). Data showed that these Amazonian fruits present antioxidant, anti-inflammatory and other immunomodulatory activities that could attenuate the impact of inflammaging states that potentially decrease the evolution of COVID-19 complications. The evidence compiled here supports the complementary experimental and clinical studies exploring these fruits as nutritional supplement during COVID-19 infection. PRACTICAL APPLICATIONS: These fruits, in their natural form, are often limited to their region, or exported to other places in the form of frozen pulp or powder. But there are already some companies producing food supplements in the form of capsules, in the form of oils and even functional foods enriched with these fruits. This practice is common in Brazil and tends to expand to the international market.

Consumption and Preferences for Wild and Domestic Meat in Indigenous Communities in the Brazilian Atlantic Forest

Wild animals have traditionally been the main sources of protein available, if not the only, to numerous indigenous populations worldwide. However, greater access to markets, reduced availability or access to wildlife, and policies in support of agricultural development, have shifted food habits toward domestic and industrial sources of protein. In this study, we evaluated consumption patterns and preferences/avoidances for wild animals (wildmeat, crustaceans, and fish) in comparison to domestic sources of protein among the Potiguara living on the Brazilian coast. Using data from 843 semi-structured interviews applied to students from 28 indigenous villages, we found that domestic meats were more consumed and preferred as compared to wild animals (aquatic and game animals), despite the high abundance of fish and crustacean resources in the surveyed area. Consumption and preference for game were higher among male students while avoidance was higher among female students. The avoidance of domestic meats and fish was low for both genders. The occupation of the fathers affected students’ food habits, in those nature-related occupations (farmer, fisherman/woman, sugarcane worker) conditioned greater consumption of wildmeat and fish, while non-nature related occupations lead to greater consumption of protein from domestic sources. The consumption of protein from all sources increased with the distance between villages and a protected area. Our results indicate that the younger generation of Potiguaras does not regularly consume wildmeat and fish and their preference for domestic sources of protein is shaped by the socio-environmental context, access to different types of meat, and taste preferences.

The impact of neoliberal generative mechanisms on Indigenous health: a critical realist scoping review

The pervasive nature and colonial foundations of neoliberalism has significant ramifications for Indigenous health, globally. Not only does neoliberalism undermine Indigenous collectivist values by emphasising personal autonomy, but the exploitation of natural resources has unique implications for Indigenous wellbeing. Therefore, this scoping review aims to synthesise evidence that articulates the impacts of neoliberalism on global Indigenous health inequities. Two reviewers searched PubMed, Embase, Scopus, Web of Science, and ProQuest Central to identify records eligible for inclusion. The search was not restricted by geographic location or language. Using principles of qualitative meta-aggregation, generative mechanism summaries and illustrations were extracted from each of the included articles, synthesised into broader categories, then considered in the context of neoliberal ideologies. The systematic search identified 9952 unique records, of which 38 fully satisfied the inclusion criteria. Findings represented 23 Indigenous communities across 12 countries and considered the impacts of neoliberalism across 16 health outcomes. Eighty-eight generative mechanisms of neoliberalism and 12 generative mechanisms of resistance were extracted from the included articles and mapped against four core principles of neoliberalism: competitive and private markets, reduced public expenditure on infrastructure, personal autonomy, and deregulation that facilitates economic activity. Overwhelmingly, neoliberalism has manifest impacts, through various pathways, on poor health outcomes and experiences for Indigenous communities included in this review. Importantly, Indigenous communities continue to resist the impacts of neoliberalism through advocacy, reclamation of traditional practices, and opposition to industrial development. Consideration and investigation of neoliberal structures and ideologies must become common practice in health equity scholarship. Actors within neoliberal societies must resist dominant epistemological, ontological, and praxiological stances that reinforce the supremacy of colonial values and subalternation of Indigenous ways of knowing, being, and doing to begin effectively addressing Indigenous health inequities.

Sustainability Dimensions Assessment in Four Traditional Agricultural Systems in the Amazon

Although traditional agriculture carried out by ethnic groups is considered for its high biodiversity and important for food security and sovereignty, few studies have investigated the potential of these systems in the interest of promoting a sustainable agricultural development policy according to United Nations Sustainable Development Goals. Using the FAO's Sustainability Assessment of Food and Agriculture (SAFA) methodology, this study analyzed the sustainability of four traditional agricultural systems, three indigenous (Waorani, Shuar, and Kichwa) and one migrant settler populations in the Yasuní Biosphere Reserve (YBR) and identified synergies and trade-offs among the dimensions of sustainability. The results showed different dynamics in all dimensions of sustainability-specifically, trade-offs in the dimensions of good governance with environmental integrity and social well-being, economic resilience, and social well-being. It was identified that the differences in terms of sustainability are narrowing between the indigenous Shuar people's traditional agricultural systems and those of migrant settlers, which provides policymakers with specific information to design sustainable development policies and rescue traditional agricultural systems in the Amazon region.

Adherence to the Mediterranean Diet and Its Association With Sleep Quality and Chronotype Among Youth: A Cross-Sectional Study

Background

Evidence indicates that many university students have poor adherence to a healthy diet accompanied by unhealthy lifestyle behaviors. Chrono-nutrition is an emerging field of research that examines the pattern of optimum daily activity in relation to the human's dietary patterns, and their reflections of variable health indicators such as sleep quality. However, there is a scarcity of research that examines the relationship between adherence to the healthy eating pattern, like the Mediterranean diet (MD), with sleep quality and chronotype among university students.

Methods

A cross-sectional study was conducted, and convenience sampling was used. Participants were assessed for adherence to the MD using the Mediterranean Diet Quality Index (KIDMED), for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and for chronotype using the Morningness-Eveningness questionnaire (MEQ).

Results

The study included 503 university students, most of them (81.5%) were females. Only 15.1 and 16.9% reported morningness chronotype and good sleep quality, respectively. About half of the students showed medium and high adherence to the KIMED. In-depth analysis revealed that students with good adherence to the MD were more likely to have a good sleep quality (OR = 0.35; 95%CI: 0.21–0.59; P < 0.001) even after adjustment for age and sex (OR = 0.36; 95%CI: 0.21–0.62; P < 0.001). The regression analysis also showed that those with good adherence to the MD had a significant association with better subjective sleep quality, less sleep latency, sleep disturbance, and daytime dysfunction even after adjustment for age and sex. Those with morningness chronotype had about a six-fold higher chance to have good adherence to the MD (OR = 5.67; 95%CI: 2.86–11.26; P < 0.001, respectively).

Conclusions

Good adherence to the healthy diet presented in the MD among university students is associated with morningness chronotype and with improved overall sleep quality and sleep components. Long-term, controlled intervention research works are warranted for more elaboration on the impact of chronotype and dietary habits on sleep quality and other important aspects such as mental health and academic achievement.