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Working with the Maya in Yucatan: Behavioural,
environmental, metabolic and intergenerational factors
impacting on the health of the families

Dr Inês Varela-Silva, PhD
Centre for Global Health
and Human Development
Loughborough University, UK
M.I.O.Varela-Silva@lboro.ac.uk

(with F Dickinson, H Wilson,
H Azcorra, PL Griffiths and B Bogin)
Summary
• Working with the Maya
• Biocultural facts
• The Maya of Merida
• Research, training and
intervention
• Impact
• What’s next?
Working with the Maya
• Guatemala 1976-present (Bogin)
• Maya migrants to Los Angeles and
Florida 1992 (Bogin, Loucky)
• Maya migrants to Florida 1999present (Bogin, Varela-Silva, Smith,
Loucky)
• Maya in Yucatan 2005-present
(Varela-Silva, Azcorra, Dickinson,
Wilson, Griffiths, Bogin, Frisancho)
Basic biocultural facts
The Maya are:
•One of the major ethnic groups of
Guatemala, Mexico and Belize (Maya
Culture Area or Mundo Maya)
(Montejo 1999)
•Long history of social, economic,
and political repression (Coe 2005)
•Historically, socially, biologically
(genetically) related to each other
(Cucina & Tiesler 2004, Scherer
2007, Ibarra-Rivera et al 2008)
Biocultural facts

• The pattern of human growth
reflect the social, political and
economic conditions of a society
• Height is a reliable indicator of
the quality of the environment
(e.g. Tanner 1989, Bogin 1999)
Biocultural facts
Developed
countries
Growth
status

Immigrants in
developed countries

Developing
countries

Normal/tall
Fat

Normal/short
Fatter

Stunted
Fat

Excessive intake of dietary fat
Excessive caloric comsumption

Common
factors
EE / P. Act
levels

Very
low

Probably
low

Not
known

Metabolic
pathways

High fat
oxidation & low
carb oxidation

Probably reduced fat
oxidation
Energy conserving
mechanisms

Discordant
information

Positive growth

Interof mothers &
generational
grandmothers:
and early
positive lasting
life effects

effect on current
generation

(Probably)...Negative growth of mothers &
grandmothers: negative lasting effect on
current generation
Nutrition transition?
Yes
igh fibre, low fat foods Low fibre, high fat foods

raditional diets)

High prevalence of
infectious diseases

(globalized diets)

Nutritional
dual-burden

High prevalence of
non-communicable
diseases

Epidemiological transition?

Yes

Very short and fat

Behavioural transition? We don’t know
Active lifestyle

Sedentary lifestyle
The Maya in Mérida, Mexico
The Maya: a dual burden population
(Varela-Silva et al. 2009)

• N=206, 4-6 year old Maya
21.8% stunted
33.0% overweight
2.4 % dual-burden children

• N= 201, Maya mothers
70% are below the 5th percentile for
height - below 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 children

Intergenerational effects…
Research aims: Project 2010
• To identify long-and-short
term causes of the dualburden of stunting in height
and overweight among Maya
families
• To identify intergenerational
and early life biocultural
factors that shape nutritional
status outcomes during
childhood
Methods
• Anthropometric assessment of mother-child pairs
• Body composition assessment (Bioelectric impedance)
• Estimation of energy expenditure (free living)
• Culture-specific food frequency questionnaire
• Interviews: prenatal & birthing
care, birth outcomes, food
security, maternal education,
woman’s status, access to safe
water, sanitation, and SES
The Actiheart

Combined heart rate &
activity monitor
Sample (2010)

Children

N

Mean age
(years)

Std. Deviation

Min

Max

Boys

31

8.29

.84

6.82

9.95

Girls

27

8.56

.72

6.95

9.95

Total

58

8.42

.79

6.82

9.95

Mothers

58

34.30

6.28

22.52

49.42
Children

Mothers

WHO CDC

IOTF

p-value

WHO

CDC

p-value

Stunting

15.5

31.0

N/A

<0.001

55.2

81.0

<0.001

Underweight

1.7

5.2

6.9

Ns

0.0

N/A

Overweight

8.6

12.1

17.2

<0.001

91.4

N/A

Obesity

0.0

15.5

10.3

<0.001

39.7

N/A
Body composition, energy expenditure
and physical activity
• Lean mass (muscle): strongest predictor of energy
expenditure
• The shorter the stature, the lower the levels of activity
energy expenditure
However
• Children: overall highly active, above the guidelines.
• Girls and stunted children: lowest level of physical
activity

Wilson et al (submitted AHB)
Developed
countries
Growth
status

Immigrants in
developed countries

Maya in
Merida

Normal/tall
Fat

Normal/short
Fatter

Dual-burden

Excessive intake of dietary fat
Excessive caloric comsumption

Common
factors
EE / P. Act
levels

Very
low

Probably
low

High

Metabolic
pathways

High fat
oxidation & low
carb oxidation

Probably reduced fat
oxidation
Energy conserving
mechanisms

Discordant
information

(Probably)...Negative
growth of mothers &
grandmothers: negative
lasting effect on current
generation

Negative
growth of
mothers &
grandmothers:
negative effect
on children

Positive growth

Interof mothers &
generational
grandmothers:
and early
positive lasting
life effects

effect on
children
Training component
 Open to graduate students and staff from CINVESTAV
Three modules:

• Assessment of energy
expenditure (MIVS):
• Biocultural theory and
application for the
assessment of health and
nutritional status (BB)
• Ecological and
anthropological research in
Mexico (FD)
Intervention in the communities
• Nutritional guidance to the
mothers
• “Use what is growing in your
backyard”
• “Stay away from fast foods and
fizzy drinks”
• Basic nutritional status
information for mothers and
children
• Encourage children to stay
active and play outside
The Becker model: Indicators of Impact

https://becker.wustl.edu/impact-assessment
Research outputs & activities
• International and transdisciplinary collaboration
involving universities and communities
• Peer-reviewed articles
• Conferences, meetings, symposia and lectures
• Data available upon request
• Media releases/interviews
• Public presentations (outside academia)
• Social media usage (FB, Twitter and blog)
• Training materials
• Trainees and scholars
Social Media
Twitter: @inesvarelasilva
LinkedIn
ResearchGate.net

http://bemicelu.blogspot.co.uk/
Advancement of knowledge
• Change in understanding and awareness
• Our publications are cited by others
• Conference themes around the topic
• Research study findings are cited in others
presentations
• On-going research collaboration and expanding
beyond grants
• Re-use of data
Advancement of knowledge
• Mass media
• Developing research methodologies
• New studies being generated from initial study
• Research study cited in a review
• Trainees and scholars continue in a different
institution
Community benefit

• Awareness and identification of risk factors
• Health promotion within the community
• Measurement instruments generated by
project
Future plans
• Answer further research questions
• Development of measurement instruments and
techniques
• Advance research methodologies
• Website development – not just a blog
• Continue training sessions
• Develop partnership with NGOs
• Reinforce partnership in the communities
• Translate research into legislation and policy
• Economic benefit???
Thank you

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Working with the Maya in Yucatan: Behavioural, environmental, metabolic and intergenerational factors impacting health

  • 1. Working with the Maya in Yucatan: Behavioural, environmental, metabolic and intergenerational factors impacting on the health of the families Dr Inês Varela-Silva, PhD Centre for Global Health and Human Development Loughborough University, UK M.I.O.Varela-Silva@lboro.ac.uk (with F Dickinson, H Wilson, H Azcorra, PL Griffiths and B Bogin)
  • 2. Summary • Working with the Maya • Biocultural facts • The Maya of Merida • Research, training and intervention • Impact • What’s next?
  • 3. Working with the Maya • Guatemala 1976-present (Bogin) • Maya migrants to Los Angeles and Florida 1992 (Bogin, Loucky) • Maya migrants to Florida 1999present (Bogin, Varela-Silva, Smith, Loucky) • Maya in Yucatan 2005-present (Varela-Silva, Azcorra, Dickinson, Wilson, Griffiths, Bogin, Frisancho)
  • 4. Basic biocultural facts The Maya are: •One of the major ethnic groups of Guatemala, Mexico and Belize (Maya Culture Area or Mundo Maya) (Montejo 1999) •Long history of social, economic, and political repression (Coe 2005) •Historically, socially, biologically (genetically) related to each other (Cucina & Tiesler 2004, Scherer 2007, Ibarra-Rivera et al 2008)
  • 5. Biocultural facts • The pattern of human growth reflect the social, political and economic conditions of a society • Height is a reliable indicator of the quality of the environment (e.g. Tanner 1989, Bogin 1999)
  • 7. Developed countries Growth status Immigrants in developed countries Developing countries Normal/tall Fat Normal/short Fatter Stunted Fat Excessive intake of dietary fat Excessive caloric comsumption Common factors EE / P. Act levels Very low Probably low Not known Metabolic pathways High fat oxidation & low carb oxidation Probably reduced fat oxidation Energy conserving mechanisms Discordant information Positive growth Interof mothers & generational grandmothers: and early positive lasting life effects effect on current generation (Probably)...Negative growth of mothers & grandmothers: negative lasting effect on current generation
  • 8. Nutrition transition? Yes igh fibre, low fat foods Low fibre, high fat foods raditional diets) High prevalence of infectious diseases (globalized diets) Nutritional dual-burden High prevalence of non-communicable diseases Epidemiological transition? Yes Very short and fat Behavioural transition? We don’t know Active lifestyle Sedentary lifestyle
  • 9. The Maya in Mérida, Mexico
  • 10. The Maya: a dual burden population (Varela-Silva et al. 2009) • N=206, 4-6 year old Maya 21.8% stunted 33.0% overweight 2.4 % dual-burden children • N= 201, Maya mothers 70% are below the 5th percentile for height - below 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 children Intergenerational effects…
  • 11. Research aims: Project 2010 • To identify long-and-short term causes of the dualburden of stunting in height and overweight among Maya families • To identify intergenerational and early life biocultural factors that shape nutritional status outcomes during childhood
  • 12. Methods • Anthropometric assessment of mother-child pairs • Body composition assessment (Bioelectric impedance) • Estimation of energy expenditure (free living) • Culture-specific food frequency questionnaire • Interviews: prenatal & birthing care, birth outcomes, food security, maternal education, woman’s status, access to safe water, sanitation, and SES
  • 13. The Actiheart Combined heart rate & activity monitor
  • 14. Sample (2010) Children N Mean age (years) Std. Deviation Min Max Boys 31 8.29 .84 6.82 9.95 Girls 27 8.56 .72 6.95 9.95 Total 58 8.42 .79 6.82 9.95 Mothers 58 34.30 6.28 22.52 49.42
  • 16. Body composition, energy expenditure and physical activity • Lean mass (muscle): strongest predictor of energy expenditure • The shorter the stature, the lower the levels of activity energy expenditure However • Children: overall highly active, above the guidelines. • Girls and stunted children: lowest level of physical activity Wilson et al (submitted AHB)
  • 17. Developed countries Growth status Immigrants in developed countries Maya in Merida Normal/tall Fat Normal/short Fatter Dual-burden Excessive intake of dietary fat Excessive caloric comsumption Common factors EE / P. Act levels Very low Probably low High Metabolic pathways High fat oxidation & low carb oxidation Probably reduced fat oxidation Energy conserving mechanisms Discordant information (Probably)...Negative growth of mothers & grandmothers: negative lasting effect on current generation Negative growth of mothers & grandmothers: negative effect on children Positive growth Interof mothers & generational grandmothers: and early positive lasting life effects effect on children
  • 18. Training component  Open to graduate students and staff from CINVESTAV Three modules: • Assessment of energy expenditure (MIVS): • Biocultural theory and application for the assessment of health and nutritional status (BB) • Ecological and anthropological research in Mexico (FD)
  • 19. Intervention in the communities • Nutritional guidance to the mothers • “Use what is growing in your backyard” • “Stay away from fast foods and fizzy drinks” • Basic nutritional status information for mothers and children • Encourage children to stay active and play outside
  • 20. The Becker model: Indicators of Impact https://becker.wustl.edu/impact-assessment
  • 21. Research outputs & activities • International and transdisciplinary collaboration involving universities and communities • Peer-reviewed articles • Conferences, meetings, symposia and lectures • Data available upon request • Media releases/interviews • Public presentations (outside academia) • Social media usage (FB, Twitter and blog) • Training materials • Trainees and scholars
  • 23. Advancement of knowledge • Change in understanding and awareness • Our publications are cited by others • Conference themes around the topic • Research study findings are cited in others presentations • On-going research collaboration and expanding beyond grants • Re-use of data
  • 24. Advancement of knowledge • Mass media • Developing research methodologies • New studies being generated from initial study • Research study cited in a review • Trainees and scholars continue in a different institution
  • 25. Community benefit • Awareness and identification of risk factors • Health promotion within the community • Measurement instruments generated by project
  • 26. Future plans • Answer further research questions • Development of measurement instruments and techniques • Advance research methodologies • Website development – not just a blog • Continue training sessions • Develop partnership with NGOs • Reinforce partnership in the communities • Translate research into legislation and policy • Economic benefit???

Editor's Notes

  • #5: The Maya have a long history of social, economic, and political repression at the hands of European colonists and, more recently, from the Guatemalan and Mexican political regimes.(113) The Maya of these regions in Mexico and Guatemala are historically, socially, and biologically related to each other.(114) The political boundary between Mexico and Guatemala artificially divides what is commonly referred to as the Maya Culture Area (Guatemala, the Yucatan peninsula, in Mexico and Belize). The current social, economic, and political situation for the Maya of Guatemala makes fieldwork in that country difficult and dangerous. For these reasons we will work with the Maya of the Yucatan. Cultural descendants of the pre-Conquest Maya Speak Maya dialects and Spanish Wear traditional clothing Eat specific food Geneticaly similar within the Mundo Maya – different from other Latin groups