Publications by authors named "Stanley Ulijaszek"

44 Publications

How active can preschoolers be at home? Parents' and grandparents' perceptions of children's day-to-day activity, with implications for physical activity policy.

Soc Sci Med 2022 Jan 6;292:114557. Epub 2021 Nov 6.

Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.

Background: The importance of physical activity in early childhood for establishing long-term health is well understood, yet with the exception of recent WHO guidelines, public health initiatives rarely focus on children below school age. Moreover, little is known about how domestic spaces and day-to-day caring activities influence preschool-age children's physical activity. To examine this, we explore caregivers' perceptions of young children's activities within and outside the home, and we consider how lived experiences of caregiving align (or not) with current physical activity policy.

Methods: Semi-structured interviews with 49 parents and grandparents from 16 families were conducted in Oregon, USA; each family had a child aged 3-5 years. Questions focused on caregivers' perceptions of and involvement with children's body weights, activities, and food practices. The interviews were analysed using thematic analysis. Our analysis drew on a materialities framework, attending to relationships between children, caregivers, spaces in and around the home, and everyday activities.

Results: Four themes were developed: appropriateness of outside versus inside spaces for physical activity; making accommodations for physical activity in the home; active spaces of care, referring to relationships among space, activity type, and caregiver attention; and mundane movement, or the low-intensity movement of everyday life. Together, the results highlight that children's day-to-day activities cut across a spectrum of movement, mediated by available spaces and caregiving affordances.

Conclusions: Attending to the full spectrum of children's movements highlights how children's activities interlink with family routines, available indoor and outdoor spaces, and the intended uses of these spaces. These interplays between space, care, and physical activity enacted at the household level should inform an integrated, systems-level public health approach to increasing health and well-being for preschool-age children. Suggestions for improvement include coordinating policy development across multiple fields (e.g., housing design, urban planning) that structure the activities of children and their caregivers across 'home' and 'outside' spaces.
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http://dx.doi.org/10.1016/j.socscimed.2021.114557DOI Listing
January 2022

Pregnancy-related interventions in mothers at risk for gestational diabetes in Asian India and low and middle-income countries (PRIMORDIAL study): protocol for a randomised controlled trial.

BMJ Open 2021 02 17;11(2):e042069. Epub 2021 Feb 17.

Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, Oxfordshire, UK

Introduction: Lifestyle modification is the mainstay of gestational diabetes mellitus (GDM) prevention. However, clinical trials evaluating the safety and efficacy of diet or physical activity (PA) in low-income and middle-income settings such as Africa and India are lacking. This trial aims to evaluate the efficacy of yoghurt consumption and increased PA (daily walking) in reducing GDM incidence in high-risk pregnant women.

Methods And Analysis: The study is a 2×2 factorial, open-labelled, multicentre randomised controlled trial to be conducted in Vellore, South India and The Gambia, West Africa. 'High-risk' pregnant women (n=1856) aged ≥18 years and ≤16 weeks of gestational age, with at least one risk factor for developing GDM, will be randomised to either (1) yoghurt (2) PA (3) yoghurt +PA or (4) standard antenatal care. Participants will be followed until 32 weeks of gestation with total active intervention lasting for a minimum of 16 weeks. The primary endpoint is GDM incidence at 26-28 weeks diagnosed using International Association of the Diabetes and Pregnancy Study Groups criteria or elevated fasting glucose (≥5.1 mmol/L) at 32 weeks. Secondary endpoints include absolute values of fasting plasma glucose concentration at 32 weeks gestation, maternal blood pressure, gestational weight gain, intrapartum and neonatal outcomes. Analysis will be both by intention to treat and per-protocol. Continuous outcome measurements will be analysed using multiple linear regression and binary variables by logistic regression.

Ethics And Dissemination: The study is approved by Oxford Tropical Research Ethics Committee (44-18), ethics committees of the Christian Medical College, Vellore (IRB 11367) and MRCG Scientific Coordinating Committee (SCC 1645) and The Gambia Government/MRCG joint ethics committee (L2020.E15). Findings of the study will be published in peer-reviewed scientific journals and presented in conferences.

Trial Registration Number: ISRCTN18467720.
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http://dx.doi.org/10.1136/bmjopen-2020-042069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893661PMC
February 2021

Health and medicine cannot solve COVID-19.

Lancet 2020 08;396(10251):599-600

Institute of Social and Cultural Anthropology, University of Oxford, Oxford OX2 6PE, UK.

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http://dx.doi.org/10.1016/S0140-6736(20)31796-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831468PMC
August 2020

Ecological Sensing Through Taste and Chemosensation Mediates Inflammation: A Biological Anthropological Approach.

Adv Nutr 2020 11;11(6):1671-1685

School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom.

Ecological sensing and inflammation have evolved to ensure optima between organism survival and reproductive success in different and changing environments. At the molecular level, ecological sensing consists of many types of receptors located in different tissues that orchestrate integrated responses (immune, neuroendocrine systems) to external and internal stimuli. This review describes emerging data on taste and chemosensory receptors, proposing them as broad ecological sensors and providing evidence that taste perception is shaped not only according to sense epitopes from nutrients but also in response to highly diverse external and internal stimuli. We apply a biological anthropological approach to examine how ecological sensing has been shaped by these stimuli through human evolution for complex interkingdom communication between a host and pathological and symbiotic bacteria, focusing on population-specific genetic diversity. We then focus on how these sensory receptors play a major role in inflammatory processes that form the basis of many modern common metabolic diseases such as obesity, type 2 diabetes, and aging. The impacts of human niche construction and cultural evolution in shaping environments are described with emphasis on consequent biological responsiveness.
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http://dx.doi.org/10.1093/advances/nmaa078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666896PMC
November 2020

Productive simplification in the use of anthropometric nutritional status.

Eur J Clin Nutr 2020 03 31;74(3):359-361. Epub 2020 Jan 31.

Unit for Biocultural Variation and Obesity, School of Anthropology, University of Oxford, Oxford, UK.

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http://dx.doi.org/10.1038/s41430-020-0572-0DOI Listing
March 2020

How does psychosocial stress affect the relationship between socioeconomic disadvantage and overweight and obesity? Examining Hemmingsson's model with data from a Danish longitudinal study.

BMC Public Health 2019 Nov 7;19(1):1475. Epub 2019 Nov 7.

Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.

Background: Chronic stress in childhood may increase the risk of overweight and obesity in young people. Erik Hemmingsson has suggested a new obesity causation model which focuses on psychosocial stress. The aim was to examine the associations between socioeconomic disadvantage and overweight and obesity and examine if these associations attenuate, when the effect of the different domains from Eric Hemmingsson's obesity causation model were taken into account.

Methods: A longitudinal study using data from The West Jutland Cohort Study (N = 2879). Outcome was overweight and obesity combined derived from self-reported weight and height at age 15, 18, 21 and 28 years. Exposure variables were equivalised household income, educational level and labour market participation of the mother derived from registers and psychosocial variables derived from questionnaires. A three-step adjustment model using logistic regression and stratified by gender was applied.

Results: Mother's low educational level was associated with a 3-fold increased odds of obesity in 18 year-old-girls, which attenuated when adjusting for the domains adult distress, disharmonious family environment and offspring distress. In 28 year-old girls, a 2.5-fold increased odds of obesity was observed, which attenuated when mutual adjusted for other socioeconomic variables and attenuated even further when adjusting for all the domains. In 18-year-old boys, a 3-fold increased odds of obesity was observed which attenuated after adjustments for adult distress, disharmonious family environment and offspring distress. In 21-year old boys, a four-fold increased odds of obesity was observed that attenuated after adjustments. At age 28 years, a three-fold increased odds of obesity was observed, which vanished in the fully adjusted model.

Conclusions: Our study confirms to some extent that the associations between socioeconomic disadvantage and overweight and obesity can be explained by the domains included in Erik Hemmingsson's model, although our results should be interpreted with caution. Adult distress, disharmonious family environment and offspring distress accounted for some of the association in girls, whereas in boys it was primarily offspring distress, which had the greatest impact. Young people's educational attainment can act as a buffer in the relationship between mother's lower educational level and obesity at age 28 years.
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http://dx.doi.org/10.1186/s12889-019-7699-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839153PMC
November 2019

Last Word on Viewpoint: Rejuvenation of the term sarcopenia.

J Appl Physiol (1985) 2019 01;126(1):263

Department of Biomedical Sciences, University of Copenhagen , Denmark.

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http://dx.doi.org/10.1152/japplphysiol.00815.2018DOI Listing
January 2019

Identifying notions of environment in obesity research using a mixed-methods approach.

Obes Rev 2019 04 14;20(4):621-630. Epub 2018 Dec 14.

Copenhagen Centre for Health Research in the Humanities, The Saxo Institute, University of Copenhagen, Copenhagen, Denmark.

The recent rise of computation-based methods in social science has opened new opportunities for exploring qualitative questions through analysis of large amounts of text. This article uses a mixed-methods design that incorporates machine reading, network analysis, semantic analysis, and qualitative analysis of 414 highly cited publications on obesogenic environments between 2001 and 2015. The method produces an elaborate network map exhibiting five distinct notions of environment, all of which are currently active in the field of obesity research. The five notions are institutional, built, food, family, and bodily environments. The network map is proposed as a navigational tool both for policy actors who wish to coordinate efforts between a variety of stakeholders and for researchers who wish to understand their own research and research plans in light of different positions in the field. The final part of the article explores how the network map may also initiate a broader set of reflections on the configuration, differentiation, and coherence of the field of obesity research.
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http://dx.doi.org/10.1111/obr.12807DOI Listing
April 2019

Rejuvenation of the term sarcopenia.

J Appl Physiol (1985) 2019 01 12;126(1):255-256. Epub 2018 Jul 12.

Department of Biomedical Sciences, University of Copenhagen , Denmark.

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http://dx.doi.org/10.1152/japplphysiol.00400.2018DOI Listing
January 2019

Beware the medicalisation of loneliness.

Lancet 2018 04;391(10129):1480

Institute of Social and Cultural Anthropology, University of Oxford, Oxford OX2 6PF, UK.

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http://dx.doi.org/10.1016/S0140-6736(18)30577-4DOI Listing
April 2018

The 'who' and 'what' of #diabetes on Twitter.

Digit Health 2017 Jan-Dec;3:2055207616688841. Epub 2017 Jan 1.

School of Anthropology and Museum Ethnography, University of Oxford, UK.

Social media are being increasingly used for health promotion, yet the landscape of users, messages and interactions in such fora is poorly understood. Studies of social media and diabetes have focused mostly on patients, or public agencies addressing it, but have not looked broadly at all of the participants or the diversity of content they contribute. We study Twitter conversations about diabetes through the systematic analysis of 2.5 million tweets collected over 8 months and the interactions between their authors. We address three questions. (1) What themes arise in these tweets? (2) Who are the most influential users? (3) Which type of users contribute to which themes? We answer these questions using a mixed-methods approach, integrating techniques from anthropology, network science and information retrieval such as thematic coding, temporal network analysis and community and topic detection. Diabetes-related tweets fall within broad thematic groups: health information, news, social interaction and commercial. At the same time, humorous messages and references to popular culture appear consistently, more than any other type of tweet. We classify authors according to their temporal 'hub' and 'authority' scores. Whereas the hub landscape is diffuse and fluid over time, top authorities are highly persistent across time and comprise bloggers, advocacy groups and NGOs related to diabetes, as well as for-profit entities without specific diabetes expertise. Top authorities fall into seven interest communities as derived from their Twitter follower network. Our findings have implications for public health professionals and policy makers who seek to use social media as an engagement tool and to inform policy design.
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http://dx.doi.org/10.1177/2055207616688841DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6001201PMC
January 2017

Framing obesity in UK policy from the Blair years, 1997-2015: the persistence of individualistic approaches despite overwhelming evidence of societal and economic factors, and the need for collective responsibility.

Obes Rev 2016 May;17(5):397-411

School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.

Since 1997, and despite several political changes, obesity policy in the UK has overwhelmingly framed obesity as a problem of individual responsibility. Reports, policies and interventions have emphasized that it is the responsibility of individual consumers to make personal changes to reduce obesity. The Foresight Report 'Tackling Obesities: Future Choices' (2007) attempted to reframe obesity as a complex problem that required multiple sites of intervention well beyond the range of personal responsibility. This framing formed the basis for policy and coincided with increasing acknowledgement of the complex nature of obesity in obesity research. Yet policy and interventions developed following Foresight, such as the Change4Life social marketing campaign, targeted individual consumer behaviour. With the Conservative-Liberal Democrat government of 2011, intervention shifted to corporate and individual responsibility, making corporations voluntarily responsible for motivating individual consumers to change. This article examines shifts in the framing of obesity from a problem of individual responsibility, towards collective responsibility, and back to the individual in UK government reports, policies and interventions between 1997 and 2015. We show that UK obesity policies reflect the landscape of policymakers, advisors, political pressures and values, as much as, if not more than, the landscape of evidence. The view that the individual should be the central site for obesity prevention and intervention has remained central to the political framing of population-level obesity, despite strong evidence contrary to this. Power dynamics in obesity governance processes have remained unchallenged by the UK government, and individualistic framing of obesity policy continues to offer the path of least resistance.
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http://dx.doi.org/10.1111/obr.12386DOI Listing
May 2016

Obesity emergence in the Pacific islands: why understanding colonial history and social change is important.

Public Health Nutr 2015 Jun 29;18(8):1499-505. Epub 2014 Aug 29.

School of Anthropology and Museum Ethnography,University of Oxford,51/53 Banbury Road,Oxford OX2 6PE,UK.

Objective: Between 1980 and 2008, two Pacific island nations - Nauru and the Cook Islands - experienced the fastest rates of increasing BMI in the world. Rates were over four times higher than the mean global BMI increase. The aim of the present paper is to examine why these populations have been so prone to obesity increases in recent times.

Design: Three explanatory frames that apply to both countries are presented: (i) geographic isolation and genetic predisposition; (ii) small population and low food production capacity; and (iii) social change under colonial influence. These are compared with social changes documented by anthropologists during the colonial and post-colonial periods.

Setting: Nauru and the Cook Islands.

Results: While islands are isolated, islanders are interconnected. Similarly, islands are small, but land use is socially determined. While obesity affects individuals, islanders are interdependent. New social values, which were rapidly propagated through institutions such as the colonial system of education and the cash economy, are today reflected in all aspects of islander life, including diet. Such historical social changes may predispose societies to obesity.

Conclusions: Colonial processes may have put in place the conditions for subsequent rapidly escalating obesity. Of the three frameworks discussed, social change under colonial influence is not immutable to further change in the future and could take place rapidly. In theorising obesity emergence in the Pacific islands, there is a need to incorporate the idea of obesity being a product of interdependence and interconnectedness, rather than independence and individual choice.
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http://dx.doi.org/10.1017/S136898001400175XDOI Listing
June 2015

Do adult obesity rates in England vary by insecurity as well as by inequality? An ecological cross-sectional study.

BMJ Open 2014 May 13;4(5):e004430. Epub 2014 May 13.

Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.

Objective: Geographical variations in adult obesity rates have been attributed in part to variations in social and economic inequalities. Insecurity is associated with obesity at the cross-national level, but there is little empirical evidence to show that insecurity contributes to the structuring of adult obesity rates at the subnational level. This is examined in this study across local authorities in England, using a recently developed social classification for the British population.

Setting: Modelled obesity rates from the Health Survey for England 2006-2008 were related to social class (as estimated from the BBC's Great British Class Survey of 2011 and a nationally representative sample survey), across 320 local authorities in England.

Primary And Secondary Outcome Measures: Comparisons of mean obesity rates across Z score categories for seven latent social classes were carried out using one-way analysis of variance. Pooled ordinary least square regression analyses of obesity rates by local authorities according to the proportion of different social classes within each of them were performed to determine the extent of geographical variations in obesity rates among the classes that were more greatly based on insecurity (emergent service workers, precariat), and those more closely based on inequality (elite, established middle class, technical middle class, new affluent workers, traditional working class).

Results: Adult obesity rates vary negatively across local authorities according to the proportion of people in the elite (F=39.06, p<0.001) and technical middle class (F=8.10, p<0.001) and positively with respect to the proportion of people of the established middle class (F=26.36, p<0.001), new affluent workers (F=73.03, p<0.001), traditional working class (F=23.00, p<0.001) and precariat (F=13.13, p<0.001). Social classes more closely based on inequality show greater association with adult obesity rates across local authorities than social classes more closely based on insecurity.

Conclusions: Both insecurity and inequality are associated with the geographical patterning of adult obesity rates across England.
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http://dx.doi.org/10.1136/bmjopen-2013-004430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025464PMC
May 2014

Concluding remarks: what's in a name? "Negritos" in the context of the human prehistory of Southeast Asia.

Hum Biol 2013 Feb-Jun;85(1-3):495-xx

School of Anthropology, University of Oxford and St. Cross College, Oxford, UK.

The "negrito" hypothesis posits that various indigenous groups throughout Island and Mainland Southeast Asia have a shared phenotype due to common descent from a putative ancestral population, representing a pre-agricultural substrate of humanity in the region. This has been examined and tested many times in the past, with no clear resolution. With many new resources to hand, the articles in this volume reexamine this hypothesis in a range of different ways. The evidence presented in this double issue of Human Biology speaks more against the category of "negrito" than for it. While populations with the negrito phenotype form a small proportion of all contemporary populations in this region, they have remained a persistent presence. And without a fascination about their origins, there would not be such a depth of knowledge about the human biology of this region more broadly as there is now.
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http://dx.doi.org/10.3378/027.085.0323DOI Listing
April 2015

Relative fat distribution in relation to menarcheal status among Bengalee Hindu girls of West Bengal, India.

J Nat Sci Biol Med 2013 Jul;4(2):369-73

Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India.

Background: Menarche seems be related to the relative distribution rather than the total amount of body fat. Previous studies showed that the ratio between lower-body vs. upper-body fat was associated with the timing of menarche.

Aim: To compare the relative distribution of subcutaneous fat among Bengali Hindu pre- and post-menarcheal girls.

Materials And Methods: The participants were 234 Bengali Hindu girls aged 11-14 years: 111 pre-menarcheal and 123 post-menarcheal girls, randomly selected from a secondary school from a suburb of Kolkata, West Bengal, India. Triceps, abdominal, sub-scapular, and calf skinfolds were measured. For each skinfold site, ratio was calculated as follows: Log (one skinfold/sum of skinfolds). Principal components (PC) analysis was performed to derive components which express the maximum contrast among the log of ratios. T-test was employed to assess differences between individual scores of components between pre- and post-menarcheal girls.

Results: The three identified PC suggested extremities-trunk, lower trunk-upper trunk, and an upper extremity-lower extremity contrasts, respectively. Scores for second and third components showed significant differences between pre- and post-menarcheal groups of girls.

Conclusion: The attainment of menarche by Bengali girls aged 11-14 years was associated with characteristically more relative subcutaneous fat distribution in the upper trunk and in the lower limbs, in contrast to lower trunk and upper limbs, respectively.
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http://dx.doi.org/10.4103/0976-9668.116997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783782PMC
July 2013

Predicting adult obesity from measures in earlier life.

J Epidemiol Community Health 2013 Dec 18;67(12):1032-7. Epub 2013 Sep 18.

Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, , Oxford, UK.

Background: As most obese adults were not overweight as children, the prediction of adult obesity from childhood body size alone is limited. We constructed a two-way, multifactor risk assessment framework for predicting adult obesity during childhood using the Foresight Obesity System Map and tested it against longitudinal data from the 1958 National Child Development Study.

Methods: The framework divided study participants according to two categories of risk: 'conditioning factors' (past/fixed events and conditions) and 'intervention factors' (present and modifiable). At the age of 11 years, conditioning factors were 'low/high birth weight' and 'absence of breastfeeding', and intervention factors were 'low childhood activity level' and 'having at least one obese parent'. From a composite score of all four variables, study participants were assigned to one of the four risk groups: low risk, past 'conditioning' risk only, present 'intervention' risk only and high combined risk. ORs and relative risks for the development of future overweight/obesity at ages 23, 33 and 42 years were calculated for each risk group.

Results: Those identified in the highest risk category at the age of 11 were around twice as likely to become overweight (body mass index (BMI)≥25 kg/m(2)) by the age of 23 years, and obese (BMI≥30 kg/m(2)) by ages 33 and 42 years, in comparison to their low-risk peers (total sample, N=11 752). Increased prevalence of future obesity was also observed for high-risk children who were not already overweight at the age of 11 (filtered sample, N=9549).

Conclusions: This framework identifies a greater proportion of the population that is at risk for future obesity than does childhood weight assessment alone.
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http://dx.doi.org/10.1136/jech-2012-201978DOI Listing
December 2013

Variation in height and BMI of adult Indians.

J Biosoc Sci 2014 Jan 27;46(1):47-65. Epub 2013 Mar 27.

* Indian Statistical Institute, Kolkata, India.

It is well known that height and weight are interrelated, and that both are related to socioeconomic variables. The objective of this study was to assess the effect of socioeconomic variables on the heights and weights of different groups of people, formed according to different levels of heights and weights, and to see whether there are sex differences in the variations in heights and weights. Data for adults aged 15-49 years were taken from the India National Family Health Survey-3 and descriptive studies and multiple linear regression analyses carried out. A clear positive association was found for height and BMI with economic level (except for overweight females in the case of BMI). In the case of BMI, it is age that seems to be the most influential factor. Surprisingly, the observed changes in height and BMI are not as expected for short and tall or underweight and overweight people; these sometimes behave in the opposite directions to that of normal height and weight people. The basic assumption of multivariate normality is not valid due to changing relations at different height and BMI levels.
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http://dx.doi.org/10.1017/S002193201300014XDOI Listing
January 2014

Results of epidemiological studies of blood pressure are biased by continuous variation in arm size related to body mass.

Hum Biol 2012 Aug;84(4):437-44

UBVO, Institute of Social and Cultural Anthropology, University of Oxford, Oxford.

In cross-sectional epidemiological studies, blood pressure (BP) is often found to be positively correlated with fatness. Usually sphygmomanometers with only one cuff size for adults are used to measure BP while arm circumference (AC) influences BP readings. We have studied cross-sectional anthropometric and BP data of adult men and women from three populations: Cook Islanders (n = 259), Papua New Guinean: Purari (n = 295), and Ok Tedi (n = 274). These were selected because of their diverse socio-economic, anthropometric, and BP characteristics. Partial correlations and regressions were used to analyze these data. Systolic and diastolic pressures (SBP, DBP) showed dependence on AC, body mass index (BMI), and skinfold thickness. Stature had some effect on SBP and DBP, independent of BMI and AC. When effects of AC and stature were statistically controlled, BMI did not correlate with either SBP or DBP. People of larger body mass have greater AC, and this biases BP readings. Average values of SBP and DBP in groups of underweight, normal, overweight, and obese people predicted by AC (sex, age, and BMI being statistically controlled) closely matched observed SBP and DBP averages in those groups. Out of 24 pairwise comparisons (3 samples from different populations × 4 groups of BMI × 2 pressure readings) of predicted and actual BP, only two produced statistically significant differences while 21 of the differences were 5 mm Hg or less. Correlations between BP and obesity found in epidemiological studies may be severely biased by effects of variation in AC. Sphygmomanometric measurements of BP should be corrected for continuous variation in AC.
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http://dx.doi.org/10.3378/027.084.0406DOI Listing
August 2012

High fructose corn syrup and diabetes prevalence: a global perspective.

Glob Public Health 2013 27;8(1):55-64. Epub 2012 Nov 27.

Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.

The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.
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http://dx.doi.org/10.1080/17441692.2012.736257DOI Listing
August 2013

One reason why waist-to-height ratio is usually better related to chronic disease risk and outcome than body mass index.

Int J Food Sci Nutr 2013 May 16;64(3):269-73. Epub 2012 Oct 16.

Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford OX2 6PF, UK.

The waist-to-height ratio (wtHR) has been proposed as an alternative to body mass index (BMI) as a simple anthropometric measure of body fatness. Both measures retain residual correlations with height, which causes them to over- or under-adjust for height (and thus misestimate nutritional state) when relating these measures to chronic disease risk, morbidity or mortality. The possibility that BMI has greater misadjustment than wtHR relative to waist/height (p) and weight/height (p) (where p is the optimal exponent for each population and sex group) is examined here. Analysis of anthropometric data for groups in Thailand, Papua New Guinea and Australia shows that this is the case, especially over-adjustment. This may contribute to the weaker relationships of chronic disease markers and outcomes with BMI than with wtHR.
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http://dx.doi.org/10.3109/09637486.2012.734291DOI Listing
May 2013

Intercontinental differences in overweight of adopted Koreans in the United States and Europe.

Econ Hum Biol 2013 Jul 23;11(3):345-50. Epub 2012 Sep 23.

Institute of Social and Cultural Anthropology, University of Oxford, United Kingdom.

A greater proportion of the United States (US) population is overweight or obese (with BMI over 25kg/m(2)) relative to all Western European populations, and it might be expected that migrants to either the US or Western Europe would develop patterns of overweight and obesity that reflect this difference. This paper examines the effects of obesogenic environments on Asians by reporting differences in rates of overweight (which is taken to include obesity in this analysis) among 261 adult South Koreans, which had been adopted in early-life into white middle class families living in the US and in Western European Nations. Data collected during an international adoption survey carried out for the Korean government in 2008 were analyzed. The prevalence of overweight of adopted Koreans raised in the US significantly exceeds the level among adopted Koreans in Europe by 11.3%. These intercontinental differences are statistically significant after controlling for sex, current age, age of adoption, and education. This paper supports the view that life-style factors are more detrimental for the weight status of people in the US than in Western Europe.
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http://dx.doi.org/10.1016/j.ehb.2012.09.001DOI Listing
July 2013

Socio-economic status, forms of capital and obesity.

J Gastrointest Cancer 2012 Mar;43(1):3-7

Institute of Social and Cultural Anthropology, University of Oxford, Oxford OX2 6PF, UK.

Introduction: While the relationships among socio-economic status (SES) and obesity are powerful and synergistic, the SES construct is insufficient to describe some of the cultural influences on status production in society, and therefore on obesity production. Socio-economic status has two closely related dimensions. The economic one is represented by financial wealth while the social one can incorporate education, occupational prestige, authority and community standing. These are, however, incomplete explanations for the relationships between societal inequalities and obesity.

Discussion: Cultural factors associated with SES and obesity are examined here by using Bourdieu and Boltanski's theory of practice, which links economic, social and cultural forms of capital (or value) in an overarching category of symbolic capital. These represent categories through which power relationships within society are negotiated. This construct permits a more complete examination of societal stratification and its human biological consequences and amplifiers, since it incorporates the notion of cultural value in different groups of, for example, preferences in body size and shape. The focus is primarily on the USA, although it draws on literature from elsewhere in the industrialized world where appropriate. Differences in obesity rates across major ethnic groups are discussed, because this is an area in which forms of capital differ, and may offer new insights into obesity and factors that predispose to it, as forms of symbolic capital.
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http://dx.doi.org/10.1007/s12029-012-9366-5DOI Listing
March 2012

Waist-to-hip ratio and woman's education level as predictors of breastfeeding duration.

Coll Antropol 2011 Jun;35(2):313-8

University of Wroclaw, Department of Anthropology, Wroclaw, Poland.

The possible existence of a relationship between breastfeeding duration, educational status and waist-hip ratio (WHR) as a measure of fertility and biological fitness in a sample of the Polish population is examined in this article. Data on age, height, weight, waist and hip circumferences, educational level (as a proxy for socio-economic status), and duration of breast feeding were collected for women using questionnaires in 11 outpatients' surgeries for healthy children, and in 5 general practices in three districts of Wroclaw, Poland. An ordinal multinominal linear model with logit link was used to determine the extent to which duration of lactation was influenced by maternal WHR and level of education. The best single predictor for the duration of lactation was WHR. While WHR decreases according to increasing duration of lactation for mothers with university or high school education, no such differences were observed among women at the lowest level of education. This study confirms the greater biological fitness of women with low WHR in the Polish population, and shows that this is mediated by level of educational attainment of the women.
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June 2011

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

Econ Hum Biol 2010 Dec 27;8(3):297-308. Epub 2010 Jul 27.

All Souls College, University of Oxford, High Street, Oxford, OX1 4AL, UK.

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.
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http://dx.doi.org/10.1016/j.ehb.2010.07.002DOI Listing
December 2010

Body frame dimensions are related to obesity and fatness: Lean trunk size, skinfolds, and body mass index.

Am J Hum Biol 2010 Jan-Feb;22(1):83-91

University of Adelaide, SA, Australia.

We explore relationships between BMI and skinfolds and anthropometric variables reflecting variation in lean body frame. Data on the middle class adult Australian women (n = 1260) collected in 2002 during a National Body Size and Shape Survey were used. Standard measurements of stature, weight, skeletal dimensions (shoulder width, hip width, chest width, and depth, limb lengths), circumferences of head, trunk, limbs and triceps, subscapular and abdominal skinfolds were taken. Techniques for measurements of skeletal frame minimized the inclusion of adipose tissue thickness. Analysis of variance and parametric and nonparametric correlations were used. Vertical dimensions show weak correlations with fatness, while body frame circumferences and transverse dimensions are consistently, significantly, and substantially correlated with fatness, each explaining from 3 to 44% of variation in skinfold thickness. Skeletal dimensions explain up to 50% of variation in skinfold thickness (multiple regression). Especially high correlations with skinfold thickness occur for chest width, depth, and hip width (r range from 0.42 to 0.66). Body frame dimensions reflect largely trunk volume and the trunk/limb proportions. Larger lean trunk size is associated with greater fatness. Since the size of the abdominal cavity, and thus the gastrointestinal system (GI), is reflected in the trunk size, we speculate that larger frame may predispose to obesity in two ways: (1) larger stomachs require greater bulk of food to produce feeling of satiety as mediated through antral distension, (2) larger GIs may absorb more nutrients. Frame size may help to detect the risk of obesity among young adults.
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http://dx.doi.org/10.1002/ajhb.20957DOI Listing
January 2010

Seven models of population obesity.

Angiology 2008 Apr-May;59(2 Suppl):34S-8S. Epub 2008 Jul 15.

Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.

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.
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http://dx.doi.org/10.1177/0003319708320763DOI Listing
October 2008

Nutrition transition and dietary energy availability in Eastern Europe after the collapse of communism.

Econ Hum Biol 2007 Dec 7;5(3):359-69. Epub 2007 Sep 7.

Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, 51 Banbury Road, Oxford OX2 6PF, UK.

After the economic transition of the late 1980s and early 1990s there was a rapid increase in overweight and obesity in many countries of Eastern Europe. This article describes changing availability of dietary energy from major dietary components since the transition to free-market economic systems among Eastern European nations, using food balance data obtained at national level for the years 1990-92 and 2005 from the FAOSTAT-Nutrition database. Dietary energy available to the East European nations satellite to the former Soviet Union (henceforth, Eastern Europe) was greater than in the nations of the former Soviet Union. Among the latter, the Western nations of the former Soviet Union had greater dietary energy availability than the Eastern and Southern nations of the former Soviet Union. The higher energy availability in Eastern Europe relative to the nations of the former Soviet Union consists mostly of high-protein foods. There has been no significant change in overall dietary energy availability to any category of East European nation between 1990-1992 and 2005, indicating that, at the macro-level, increasing rates of obesity in Eastern European countries cannot be attributed to increased dietary energy availability. The most plausible macro-level explanations for the obesity patterns observed in East European nations are declines in physical activity, increased real income, and increased consumption of goods that contribute to physical activity decline: cars, televisions and computers.
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http://dx.doi.org/10.1016/j.ehb.2007.08.007DOI Listing
December 2007

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

Econ Hum Biol 2007 Dec 4;5(3):443-57. Epub 2007 Sep 4.

Institute of Social and Cultural Anthropology, Unit for Biocultural Variation and Obesity, University of Oxford, 51 Banbury Road, Oxford OX2 6PF, UK.

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.
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http://dx.doi.org/10.1016/j.ehb.2007.08.006DOI Listing
December 2007

The effects of fatness and fat distribution on respiratory functions.

Ann Hum Biol 2007 Jan-Feb;34(1):123-31

Institute of Anthropology, Polish Academy of Sciences, Kuznicza 35, 50-951 Wroclaw, Poland.

Background: Inverse relationships between respiratory function and indices of obesity and fat distribution have been reported, but it remains unclear which measure of obesity shows the strongest relationship with lung function.

Aim: The study assessed the effect of fatness and fat distribution on respiratory function.

Subjects And Methods: A sample of 423 males and 509 females aged 40-50 years were examined in the Silesian Centre for Preventive Medicine, DOLMED, in Wrocław in 1995. The strength of influence of height, body mass index (BMI), wait-to-hip ratio (WHR) and abdominal and subscapular skinfolds upon forced vital capacity (FVC) and forced expiratory volume in a 1-s expiration (FEV1) was assessed by multiple regression analysis.

Results: In males, FVC was strongly positively associated with height and BMI, but negatively associated with subscapular and abdominal skinfolds, WHR, and smoking. FEV1 showed a positive relationship with height, BMI and WHR. In females, both FVC and FEV1 showed significant positive associations with height, negative ones with subscapular skinfold, and no association with either WHR or abdominal skinfold. In males, respiratory function is affected to a similar extent by fat in the abdominal region and by fatness of the chest. In females, fatness of the thorax has the strongest relationship with respiratory function.

Conclusion: Fatness tends to impair respiratory function in both sexes but these effects show a different pattern in males and females. In males, respiratory functions are significantly, and to a similar extant, affected by fatness in the abdominal region, both subcutaneous and visceral, and by fatness on the chest. In females, it is primarily subcutaneous fat on the upper thorax that affects respiratory functions, while visceral and subcutaneous abdominal fatness play little or no role.
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http://dx.doi.org/10.1080/03014460601121795DOI Listing
June 2007
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