The influence of indigenous status and community indigenous composition on obesity and diabetes among Mexican adults

Santa Clara County Public Health Department, San Jose, CA, USA.
Social Science [?] Medicine (Impact Factor: 2.89). 12/2011; 73(11):1635-43. DOI: 10.1016/j.socscimed.2011.09.006
Source: PubMed


In many high-income countries, indigenous populations bear a higher burden of obesity and diabetes than non-indigenous populations. Less is known about these patterns in lower- and middle-income countries. We assessed the hypothesis that obesity and diabetes were less prevalent among indigenous than non-indigenous adults in Mexico, home to the largest indigenous population in Latin America. We investigated socioeconomic explanations for differences. In a related line of inquiry, we examine whether adults in communities with higher versus lower percentages of indigenous residents were buffered against these conditions. We assessed whether differences were partially explained by lower development in higher-indigenous communities.

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Available from: Margaret A Handley, Apr 21, 2014
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    • "This relationship of a lower prevalence of obesity and indigenous status has also been identified in Mexico.[38], [39]. "
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    ABSTRACT: In Central America, there has been a marked increase in obesity in the last 30 years. Over this time frame, in Panama, there have been lifestyle changes associated with economic development and urbanization that may have facilitated increases in body weight. The aim of the study is to describe the change in the prevalence of obesity in the country since 1982 and to analyze the association of obesity with gender, place of residence and socioeconomic factors. We analyzed three nationally representative cross-sectional studies and one sub-national study of Panamanian adults that evaluated anthropometric and socioeconomic variables; ENPA-1982 (n = 11 611), ENV-II 2003 (n = 14 737), ENV-III 2008 (n = 15 484), PREFREC-2010 (n = 3 590). We also evaluated one nationally representative study that evaluated people's perception of their body weight, ENSCAVI-2007 (n = 25 748). In 1982, the prevalence in males of a body mass index (BMI) ≥ 30 kg/m2 was 3.8% (3.3 - 4.2) and in females 7.6% (6.9 - 8.2). In 2003, the prevalence in males increased to 14.4% (13.6 - 15.2) and in females to 21.8% (20.8 - 22.7). In 2008, the prevalence in males was 16.9% (16.0 - 17.7) and in females it was 23.8% (22.8 - 24.7). Nevertheless, in 2007, the national perception of being obese was only 4% among males and 6.7% among females. The highest prevalence of obesity was noted in urban areas. Female gender and higher income were found to be positively associated with obesity. Income level was positively associated with abdominal obesity in men but not in women. There has been a marked increase of obesity in Panama in the last 3 decades. Initiatives to control this problem will have to take into consideration the observed gender difference and the lifestyle changes that have contributed to the rise of this problem.
    Full-text · Article · Mar 2014 · PLoS ONE
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    • "According to the 2012 National Health and Nutrition Survey in the Mexican population, the prevalence of overweight and obesity is 71.2% in adults aged above 20 years and 34.4% in children [2]. Moreover, according to the 2002 Mexican Family Life survey, 59% of indigenous Mexican individuals are overweight or obese [3]. Hereditability of obesity has been estimated as high as 70% [4]. "
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    ABSTRACT: Several studies have identified multiple obesity-associated loci mainly in European populations. However, their contribution to obesity in other ethnicities such as Mexicans is largely unknown. The aim of this study was to examine 26 obesity-associated single-nucleotide polymorphisms (SNP) in a sample of Mexican mestizos. 9 SNPs in biological candidate genes showing replications (PPARG, ADRB3, ADRB2, LEPR, GNB3, UCP3, ADIPOQ, UCP2, and NR3C1), and 17 SNPs in or near genes associated with obesity in first, second and third wave GWAS (INSIG2, FTO, MC4R, TMEM18, FAIM2/BCDIN3, BDNF, SH2B1, GNPDA2, NEGR1, KCTD15, SEC16B/RASAL2, NPC1, SFRF10/ETV5, MAF, PRL, MTCH2, and PTER) were genotyped in 1,156 unrelated Mexican-Mestizos including 683 cases (441 obese class I/II and 242 obese class III) and 473 normal-weight controls. In a second stage we selected 12 of the SNPs showing nominal associations with obesity, to seek associations with quantitative obesity-related traits in 3 cohorts including 1,218 Mexican Mestizo children, 945 Mexican Mestizo adults, and 543 Indigenous Mexican adults. After adjusting for age, sex and admixture, significant associations with obesity were found for 6 genes in the case-control study (ADIPOQ, FTO, TMEM18, INSIG2, FAIM2/BCDIN3 and BDNF). In addition, SH2B1 was associated only with class I/II obesity and MC4R only with class III obesity. SNPs located at or near FAIM2/BCDIN3, TMEM18, INSIG2, GNPDA2 and SEC16B/RASAL2 were significantly associated with BMI and/or WC in the combined analysis of Mexican-mestizo children and adults, and FTO locus was significantly associated with increased BMI in Indigenous Mexican populations. Our findings replicate the association of 8 obesity-related SNPs with obesity risk in Mexican adults, and confirm the role of some of these SNPs in BMI in Mexican adults and children.
    Full-text · Article · Aug 2013 · PLoS ONE
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    ABSTRACT: Indigenous populations worldwide who are shifting to a westernized lifestyle experience high rates of type 2 diabetes and obesity. These conditions are commonly the result of genetic predisposition and environmental factors that promote excess energy intake and decreased energy expenditure. The purpose of this study was to examine changes in the food environment, specifically looking at retail and subsistence-food availability, and food-acquisition behaviors in the rural Mexican town of Maycoba and surrounding communities between 1995 and 2010. The population in this area includes indigenous Pima, genetically-related to the Pima Indians in Arizona who have the highest documented rates of diabetes, and non-Pima Mexican (ie non indigenous and other indigenous). An initial study in 1995 compared the prevalence of diabetes and obesity in the Maycoba population with that of Pima Indians of Arizona and found a dramatically lower type 2 diabetes prevalence in the Maycoba region due to the protective effect of a traditional lifestyle despite a genetic predisposition to diabetes. The 2010 follow-up study was undertaken to determine the prevalence of obesity and type 2 diabetes as well as to examine lifestyle changes over the 15 year time span, following changes to housing and the local environment. This study focused on the food environment, examining changes in food acquisition behaviors in the retail and subsistence aspects. The study included a household survey ( n =71), two focus group discussions, and participant-observation. To determine changes in retail food availability, seven stores throughout the study region were audited. The main findings were an increasing presence and use of retail stores for food: an expansion in the selection of processed foods, their prominent placement, and refrigeration allowing more perishable foods to be available to the local population. Subsistence activities remained significant, although some aspects of specific subsistence activities are in decline, such as the area allocated to home gardens and a reduction in the variety of crops cultivated in them. Although there have been a number of changes in the food environment during the 15 year period, a traditional subsistence-based lifestyle prevails.
    No preview · Article · Sep 2013 · Rural and remote health
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