Review of obesity/stunting literature (last 5 years only)
Compiled November 2009
Malina et al (2009). Socioeconomic variation in the growth status of urban school children 6-13 years in Oaxaca, Mexico, in 1972 and 2000. Am J Hum Biol 21:805.
Stunting declines while obesity increases over time. This effect is more pronounced in middle SES than in low SES.
Leonard et al (2009). Reduced fat oxidation and obesity risks among the Buryat of Southern Siberia. Am J Hum Biol 21:664
Stunted adult population (Buryat, Siberia). Shorter women (compared to taller women) have reduced rates of lipid oxidation and are fatter and heavier and have higher serum lipid levels.
Varela-Silva et al (2009). Influence of maternal stature, pregnancy age, and infant birth weight on growth during childhood in Yucatan, Mexico: a test of the intergenerational effects hypothesis. Am J Hum Biol 21:657.
Yucatec Maya from Merida, MX. Explores the intergenerational hypothesis. Nice review of this literature. Maternal short stature predicts stunting in the second generation.
Santos et al (2009). Influence of stunting on nutrition disorders in adolescents and pre-adolescents. Rev de Nutr 22:187.
Stunting predicts overweight in an adolescent female cohort but not in males.
Ferreira et al (2009). Short stature of mothers from an area endemic for undernutrition is associated with obesity, hypertension and stunted children: a population-based study in the semi-arid region of Alagoas, Northeast Brazil. Brit J Nutr 101:1239.
Alagoas, Brazil. Short maternal stature predicts maternal obesity, HTN, and central adiposity. It also predicts LBW and stunting in offspring.
El Taguri et al (2009). Stunting is a major risk factor for overweight: results from national surveys in 5 Arab countries. East Mediterr Health J 15:549.
Stunting is a major risk factor for overweight, as high as RR of >7 in severely stunted children from Libya.
Sawaya et al (2009). Malnutrition, long-term health and the effect of nutritional recovery. Nestle Nutr Workshop Ser Pediatric Prog 63:95.
Important review article summarizing the physiology and biology of the stunting – obesity/insulin resistance connection with special reference to the authors’ work in Brazilian slums.
Jehn and Brewis. (2009). Paradoxical malnutrition in mother-child pairs: Untangling the phenomenon of over- and under-nutrition in underdeveloped economies. Econ Hum Biol 7:28.
Wrong headed analysis which attributes the paradox to “rapid secular increases” in the weight of mothers.
Stein et al (2009). Height for Age Increased While Body Mass Index for Age Remained Stable between 1968 and 2007 among Guatemalan Children. J Nutr. 139:365.
Study is getting a lot of attention. It is another followup of the INCAP trial. Shows dramatic reductions in stunting since the 1960s. Importantly the INCAP study was conducted only in nonindigenous villages.
Delisle (2008). Poverty - The double burden of malnutrition in mothers and the intergenerational impact. Ann NY Acad Sci. 1136:172.
Nice review detailing in part the effects of maternal undernutrition on subsequent offspring (obesity, HTN, etc).
Gopalan (2008). Growth retardation in early childhood: long term implications. NFI Bull 29:6.
Reviews evidence on maternal undernutrition and IUGR on long term consequences for offspring (insulin resistance, etc) in India.
Vieira et al. (2007). Stunting: its relation to overweight, global or localized adiposity and risk factors for chronic non-communicable diseases. Rev Brasil Saud Mat Infant 7:365.
Nice review of the links between undernutrition/stunting in childhood and the development of chronic noncommunicable diseases.
Mamabolo et al (2007). Association between insulin-like growth factor-1, insulin-like growth factorbinding protein-1 and leptin levels with nutritional status in 1-3-year-old children, residing in the central region of Limpopo Province, South Africa. Brit J Nutr 98:762
As the title says.
Hoffman et al (2007). Body fat distribution in stunted compared with normal-height children from the shantytowns of Sao Paulo, Brazil. Nutr. 23:640.
Brazil: Stunted children are more likely to deposit fat centrally when entering puberty.
Fernald and Neufeld (2007). Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors. Eur J Clin Nutr. 61:623.
Among stunted children, maternal obesity is associated with obesity.
Barquera et al (2007). Coexistence of maternal central adiposity and child stunting in Mexico. Int J Obesity 31:601.
Women with a WHR of 1 have twice the probability of having a stunted child as those with a WHR of 0.65
Martins and Sawaya (2006). Evidence for impaired insulin production and higher sensitivity in stunted children living in slums. Brit J Nutr 95:996.
As it says.
Eboh and Boye (2006). Investigation of body composition of normal and malnourished rural children (3-11 years) in the Niger-Delta region of Nigeria. Pak J Nutr. 4:418.
Percentage body fat is higher in stunted children.
Grillo et al (2005). Lower resting metabolic rate and higher velocity of weight gain in a prospective study of stunted vs nonstunted girls living in the shantytowns of Sao Paulo, Brazil. Eur J Clin Nutr 59:835.
As it says.
Garrett and Ruel (2005). The coexistence of child undernutrition and maternal overweight: prevalence, hypotheses, and programme and policy implications. Mat Child Nutr 1:185.
Review of the phenomenon of stunted child and an overweight mother.
Sawaya et al (2005). Association between chronic undernutrition and hypertension. Mat Child Nutr 1:155.
As it says. Summarizes data from Brazil.
Hoffman and Lee (2005). The prevalence of wasting, but not stunting, has improved in the Democratic People's Republic of Korea. J Nutr 135:452.
Sounds like Guatemala.
Tuesday, November 10, 2009
Journal Club
Arnold B et al (2009). Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala. Int J Epidemiol (Advance Access).
Luby SP et al (2008). Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78:382-7.
These two interesting articles highlight some of the difficulties of implementing point-of-use water treatment and public water quality educational programs in Guatemala.
The first article details the results of a Caritas/Catholic Relief Services/SODIS intervention in Camotán a Ch’orti’-speaking region of Guatemala bordering Honduras. The intervention under study involved the training of health promoters and rural education campaigns on point-of-use water treatment (boiling, solar disinfection, or chlorine) and hand-washing. The evaluation reported in this article shows that the rate of confirmed POU water treatment was quite low (9%) and that there was no observable effect on child wellness. It is difficult to assess what factors contributed to the intervention’s lack of effect. For example, there are no data on the degree of community integration of the program, language used by health promoters, etc. Therefore we cannot speculate on the interpersonal and cultural dynamics of the program. Additionally, a major omission is any discussion of how POU remedies were subsidized. Where families responsible for purchases these, or were they provided free-of-charge in a sustained fashion.
This latter point is emphasized by the second article, an odd study of the market penetration of Procter and Gamble’s attempt to roll out a proprietary flocculant in San Juan Sacatepéquez, a Kaqchikel-speaking town. In this study less than 5% of households in the town used the product consistently. The most commonly cited reason for not using the product was cost.
Luby SP et al (2008). Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78:382-7.
These two interesting articles highlight some of the difficulties of implementing point-of-use water treatment and public water quality educational programs in Guatemala.
The first article details the results of a Caritas/Catholic Relief Services/SODIS intervention in Camotán a Ch’orti’-speaking region of Guatemala bordering Honduras. The intervention under study involved the training of health promoters and rural education campaigns on point-of-use water treatment (boiling, solar disinfection, or chlorine) and hand-washing. The evaluation reported in this article shows that the rate of confirmed POU water treatment was quite low (9%) and that there was no observable effect on child wellness. It is difficult to assess what factors contributed to the intervention’s lack of effect. For example, there are no data on the degree of community integration of the program, language used by health promoters, etc. Therefore we cannot speculate on the interpersonal and cultural dynamics of the program. Additionally, a major omission is any discussion of how POU remedies were subsidized. Where families responsible for purchases these, or were they provided free-of-charge in a sustained fashion.
This latter point is emphasized by the second article, an odd study of the market penetration of Procter and Gamble’s attempt to roll out a proprietary flocculant in San Juan Sacatepéquez, a Kaqchikel-speaking town. In this study less than 5% of households in the town used the product consistently. The most commonly cited reason for not using the product was cost.
Wednesday, October 21, 2009
Pieta
After one thousand days of sun
The streets breathed yellow dust
that licked in at open doors
and lay in ribbons along the walls
And yellow dogs wagged thin air
down yellow alleys thick with stones
Tripping tourists rushed to leave
before the last drop ran out
There were stones on the ground
the night that Maria came home
smelling of stones, covered in sorrow
and lathered in thin yellow drink
The streets breathed yellow dust
that licked in at open doors
and lay in ribbons along the walls
And yellow dogs wagged thin air
down yellow alleys thick with stones
Tripping tourists rushed to leave
before the last drop ran out
There were stones on the ground
the night that Maria came home
smelling of stones, covered in sorrow
and lathered in thin yellow drink
Saturday, May 30, 2009
Journal Club - Medical Anthropology
Harvey TS (2008). Where there is no patient: An anthropological treatment of a biomedical category. Cult Med Psychiatry 32:577-606.
This article continues the dubious tradition in medical anthropology of essentializing both indigenous communities and biomedicine. Drawing mostly on the author’s PhD research among K’ichee’ Maya, it belabors the point that non-Western views of wellness and healing are often at odds with Western models.
It begins by comparing the dynamics of encounters with ethnomedical healers and allopathic practioners. These case studies are used to make the point that Maya models of healing involve a communal body and collaborative notions of wellness (multiple patients or family members attending a single consultation, family members standing in for a patient physically absent) while allopathic models require the presence of a disarticulated, theoretically mandated Western individual.
The author essentializes his own Western culture, theoretically demanding that all Westerners adhere to his model of individualism. Data from pediatrics (collaborative consultations with parents) and the terminally ill (therapeutic interactions with extended families) are ignored, as are Northern spiritual healing traditions (e.g. Pentecostal healing prayer), which would be much better comparisons to the data he compiles among the K’ichee’. Furthermore, it essentializes indigenous communities, denying them a priori the capacity or desire to interact with allopathic medicine in ways that are locally productive.
In the end, he perpetuates one of the most common theoretical fallacies in medical anthropology. What the author manages to criticize effectively is ‘bad doctoring’—but he conflates ‘bad doctoring’ with allopathic practice per se, thereby shutting the door on any analysis of how to engage in effective, cross-cultural allopathic practice.
Finally, the article is deficient in parsimonious political economic or materialist analysis. Does the fact that multiple members of a family attend a consultation really say something about their wellness model, or does it rather imply that their lack of facility in Spanish requires that an entire family’s combined linguistic ability be employed in order to understand what the doctor is saying? Does the fact that a relative stands in for a physically absent patient imply a collective body, or does it implicate a lack of job security and labor protection that does not allow individuals time off from work in order to attend a medical consultation?
This article continues the dubious tradition in medical anthropology of essentializing both indigenous communities and biomedicine. Drawing mostly on the author’s PhD research among K’ichee’ Maya, it belabors the point that non-Western views of wellness and healing are often at odds with Western models.
It begins by comparing the dynamics of encounters with ethnomedical healers and allopathic practioners. These case studies are used to make the point that Maya models of healing involve a communal body and collaborative notions of wellness (multiple patients or family members attending a single consultation, family members standing in for a patient physically absent) while allopathic models require the presence of a disarticulated, theoretically mandated Western individual.
The author essentializes his own Western culture, theoretically demanding that all Westerners adhere to his model of individualism. Data from pediatrics (collaborative consultations with parents) and the terminally ill (therapeutic interactions with extended families) are ignored, as are Northern spiritual healing traditions (e.g. Pentecostal healing prayer), which would be much better comparisons to the data he compiles among the K’ichee’. Furthermore, it essentializes indigenous communities, denying them a priori the capacity or desire to interact with allopathic medicine in ways that are locally productive.
In the end, he perpetuates one of the most common theoretical fallacies in medical anthropology. What the author manages to criticize effectively is ‘bad doctoring’—but he conflates ‘bad doctoring’ with allopathic practice per se, thereby shutting the door on any analysis of how to engage in effective, cross-cultural allopathic practice.
Finally, the article is deficient in parsimonious political economic or materialist analysis. Does the fact that multiple members of a family attend a consultation really say something about their wellness model, or does it rather imply that their lack of facility in Spanish requires that an entire family’s combined linguistic ability be employed in order to understand what the doctor is saying? Does the fact that a relative stands in for a physically absent patient imply a collective body, or does it implicate a lack of job security and labor protection that does not allow individuals time off from work in order to attend a medical consultation?
Sunday, May 03, 2009
"Your being over there tonight..."
Paul Celan - "Dein Hinübersein heute Nacht..." translated by John Felstiner.
Your being over there tonight.
I fetched you back with words, here you are,
all things are true and a waiting
for trueness.
The beanstalk climbs
at our window: think
who's growing up near us and
watches it.
God, so we've read, is
one part and a second, dispersed:
in the death
of all who've been reaped
he grows whole.
Our gaze
leads us there,
it's this
half
we deal with.
Tuesday, April 21, 2009
Assisi - Paul Celan
Umbrische Nacht.
Umbrische Nacht mit dem Silber von Glocke und Ölblatt.
Umbrische Nacht mit dem Stein, den du hertrugst.
Umbrische Nacht mit dem Stein.
Stumm, was ins Leben stieg, stumm.
Füll die Krüge um.
Irdener Krug.
Irdener Krug, dran die Töpferhand festwuchs.
Irdener Krug, den die Hand eines Schattens für immer verschloss.
Irdener Krug mit dem Siegel des Schattens.
Stein, wo du hinsiehst, Stein.
Lass das Grautier ein.
Trottendes Tier.
Trottendes Tier im Schnee, den die nackteste Hand streut.
Trottendes Tier vor dem Wort, das ins Schloss fiel.
Trottendes Tier, das den Schlaf aus der Hand frisst.
Glanz, der nicht trösten will, Glanz.
Die Toten - sie betteln noch, Franz.
Umbrische Nacht mit dem Silber von Glocke und Ölblatt.
Umbrische Nacht mit dem Stein, den du hertrugst.
Umbrische Nacht mit dem Stein.
Stumm, was ins Leben stieg, stumm.
Füll die Krüge um.
Irdener Krug.
Irdener Krug, dran die Töpferhand festwuchs.
Irdener Krug, den die Hand eines Schattens für immer verschloss.
Irdener Krug mit dem Siegel des Schattens.
Stein, wo du hinsiehst, Stein.
Lass das Grautier ein.
Trottendes Tier.
Trottendes Tier im Schnee, den die nackteste Hand streut.
Trottendes Tier vor dem Wort, das ins Schloss fiel.
Trottendes Tier, das den Schlaf aus der Hand frisst.
Glanz, der nicht trösten will, Glanz.
Die Toten - sie betteln noch, Franz.
Current Reading List
Things I have been reading in the last few weeks.
1. Robert Pinsky (1996). The Figured Wheel: New and Collected Poems 1966-1996. The Noonday Press: New York.
2. Martin Buber (1953). For the Sake of Heaven. Meridian Books: New York.
3. Carmen Martinez Novo (2006). Who Defines Indigenous? Identities, Development, Intellectuals, and the State in Northern Mexico. Rutgers University Press.
4. Ernesto Cardenal (2007). Poesía Completa: Tomo 1. Editora Patria Grande: Buenos Aires.
5. Jacques Lacan (1999). Écrits. Norton: New York.
From 'A Love of Death'
A small excerpt from my favorite Robert Pinsky volume, An Explanation of America (1979).
None of this happens precisely as I try
To imagine that it does, in the empty plains,
And yet it happens in the imagination
Of part of the country: not in any place
More than another, on the map, but rather
Like a place, where you and I have never been
And need to try to imagine--place like a prairie
Where immigrants, in the obliterating strangeness,
Thirst for the wide contagion of the shadow
Or prairie--where you and I, with our other ways,
More like the cities or the hills or trees,
Less like the clear blank space with their potential,
Are like strangers in a place we must imagine.
Sunday, March 01, 2009
Tenebrae
This incredible poem by Paul Celan, first in German and then an ok English translation by John Felstiner.
Nah sind wir, Herr,
nahe und greifbar.
Gegriffen schon, Herr,
ineinander verkrallt, als wär
der Leib eines jeden von uns
dein Leib, Herr.
Bete, Herr,
bete zun uns,
wir sind nah.
Windschief gingen wir hin,
gingen wir hin, uns zu bücken
nach Mulde und Maar.
Zur Tränke gingen wir, Herr.
Es war Blut, es war,
was du vergossen, Herr.
Es glänzte.
Es warf uns dein Bild in die Augen, Herr.
Augen und Mund stehn so offen und leer, Herr.
Wir haben getrunken, Herr.
Das Blut und das Bild, das im Blut war, Herr.
Bete, Herr.
Wir sind nah.
Near are we, Lord,
near and graspable.
Grasped already, Lord,
clawed into each other, as if
each of our bodies were
your body, Lord.
Pray, Lord,
pray to us,
we are near.
Wind-skewed we went there,
went there to bend
over pit and crater.
Went to the water-trough, Lord.
It was blood, it was
what you shed, Lord.
It shined.
It cast your image into our eyes, Lord.
Eyes and mouth stand so open and void, Lord.
We have drunk, Lord.
The blood and the image that was in the blood, Lord.
Pray, Lord.
We are near.
Nah sind wir, Herr,
nahe und greifbar.
Gegriffen schon, Herr,
ineinander verkrallt, als wär
der Leib eines jeden von uns
dein Leib, Herr.
Bete, Herr,
bete zun uns,
wir sind nah.
Windschief gingen wir hin,
gingen wir hin, uns zu bücken
nach Mulde und Maar.
Zur Tränke gingen wir, Herr.
Es war Blut, es war,
was du vergossen, Herr.
Es glänzte.
Es warf uns dein Bild in die Augen, Herr.
Augen und Mund stehn so offen und leer, Herr.
Wir haben getrunken, Herr.
Das Blut und das Bild, das im Blut war, Herr.
Bete, Herr.
Wir sind nah.
Near are we, Lord,
near and graspable.
Grasped already, Lord,
clawed into each other, as if
each of our bodies were
your body, Lord.
Pray, Lord,
pray to us,
we are near.
Wind-skewed we went there,
went there to bend
over pit and crater.
Went to the water-trough, Lord.
It was blood, it was
what you shed, Lord.
It shined.
It cast your image into our eyes, Lord.
Eyes and mouth stand so open and void, Lord.
We have drunk, Lord.
The blood and the image that was in the blood, Lord.
Pray, Lord.
We are near.
Sunday, February 01, 2009
Bartleby's Books
Amazing book store day. Tripping around Georgetown enjoying the sun and pop my head into this Americana bookstore where, much to my suprise, I find three books that I have been hunting down for ages:
Adrián Recinos and Delia Goetz. The Annals of the Cakchiquels. 1953.
Sandra Orellana. Indian Medicine in Highland Guatemala. 1987.
Lilly de Jongh Osborne. Indian Crafts of Guatemala and El Salvador. 1965.
Adrián Recinos and Delia Goetz. The Annals of the Cakchiquels. 1953.
Sandra Orellana. Indian Medicine in Highland Guatemala. 1987.
Lilly de Jongh Osborne. Indian Crafts of Guatemala and El Salvador. 1965.
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