Background AAPA 2013 Charles Darwin Award Recipient Prof Roberto Frisancho Nutritional dual-burden Under-and-overnutrition Coexistence of stunting & overweight/obesity Intergenerational factors The Maya in Mexico
Developed Immigrants in Developing countries developed countries countriesGrowth Normal/tall Normal/short Stuntedstatus Fat Fatter FatCommon Excessive intake of dietary fatfactors Excessive caloric comsumptionEE / P. Act Very Probably Notlevels low low knownMetabolic High fat Probably reduced fat Discordantpathways oxidation & low oxidation information carb oxidation Energy conserving mechanisms Positive growthInter-generational of mothers &and early grandmothers: (Probably)...Negative growth of mothers &life effects positive lasting grandmothers: negative lasting effect on effect on current current generation generation
Varela-Silva et al (2009). AJHB, 21: 657-663 • N=206, 4-6 year old Maya 21.8% stunted 33.0% overweight/obese • N= 201, Maya mothers 70% below the 5th perc/height <150cm • Birthweight < 3,000 gr less likely to be OW/OB more likely to be stunted as children • Mother < 150 cm 3.6 times more likely of having stunted childrenPhysical activity/energy expenditure?
Objective measurement of PA - Actiheart Wilson et al (2011). AJHB, 23: 426-428 • Actiheart® very accurate in estimating EE and PAL • Well tolerated by children (7days, free-living) • EKG pads didn’t hold under hot & humid conditions • Fieldwork conditions more demanding than lab’s • Several Actihearts damaged/lost
Varela-Silva et al (2012). Coll. Antropol, 36: 39-45 Children Mothers WHO CDC IOTF p-value WHO CDC p-valueStunting 15.5 31.0 N/A <0.001 55.2 81.0 <0.001Underweight 1.7 5.2 6.9 Ns 0.0 N/AOverweight 8.6 12.1 17.2 <0.001 91.4 N/AObesity 0.0 15.5 10.3 <0.001 39.7 N/A
Body composition, energy expenditure & PAWilson et al (2012). AHB, Vol. 39 (5): 432-439• Lean mass (muscle): strongest predictor of energy expenditure• The shorter the stature, the lower the levels of activity energy expenditure------------------------------------------------------• Children: overall highly active, above the guidelines (60 min/day MVPA)• Girls and stunted children: lowest level of PA• PA independent of nutritional status
Developed Immigrants in Maya in countries developed countries MeridaGrowth Normal/tall Normal/short Dual-burdenstatus Fat FatterCommon Excessive intake of dietary fatfactors Excessive caloric comsumptionEE / P. Act Very Probably Highlevels low lowMetabolic High fat Probably reduced fat Discordantpathways oxidation & low oxidation information carb oxidation Energy conserving mechanisms Positive growth (Probably)...Negative NegativeInter-generational of mothers & growth of mothers & growth ofand early grandmothers: grandmothers: negative mothers &life effects positive lasting lasting effect on current grandmothers: effect on negative effect generation children on children
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