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1. Cesarean birth and the growth of Yucatec Maya and Toba/Qom children

   https://doi.org/10.1002/ajhb.23228  

   Veile, Amanda ; Valeggia, Claudia ; Kramer, Karen L. ( February 2019 , American Journal of Human Biology)

   Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post‐birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri‐urban Latin American indigenous populations, and test predictions developed using life history theory.

   Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1‐48 months (2007‐2014, 3812 observations). Random‐effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders.

   Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean‐delivered children had significantly greater weight gain (but similar height grain) compared to vaginally‐delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight‐for‐age compared to vaginally‐delivered children from their own sex and population.

   This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity‐inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.

    

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2. Adiposity and pathogen exposure: An investigation of response to iron supplementation and hypothesized predictors in anemic pre‐school‐aged children living in a dual burden environment

   https://doi.org/10.1002/ajpa.24287  

   Dorsey, Achsah F. ; Penny, Mary E. ; Thompson, Amanda L. ( April 2021 , American Journal of Physical Anthropology)

   Peruvians are experiencing rapid dietary and lifestyle changes, resulting in a phenomenon known as the “dual burden of disease.” A common manifestation of the dual burden in individuals is the co‐occurrence of overweight and anemia. Despite recent initiatives introduced to address these concerns, rates continue to be public health concerns. This study investigates the relationship between immune activation and lack of response to iron supplementation after 1 month of treatment and explores variation in body fat stores as a potential moderator between immune function and response to treatment.

   Data come from children, aged 2–5 years (n = 50) from a peri‐urban community in Lima, Peru. Multivariate logistic regression models were used to explore the associations between response to treatment (Hb > =11.0 g/dl) after 1 month of treatment), markers of immune activation (C‐reactive protein [CRP] and reported morbidity symptoms), and measures of body fat (waist‐to‐height ratio, triceps skinfold thickness, and body mass index [BMI]).

   We found that high CRP is associated with a lack of response to iron supplementation after 1 month of treatment and that BMI z‐score may moderate this association. Generally, larger body size is associated with response to iron supplementation whether or not the children in this sample have high immune activation. However, the probability of anemic children responding to iron supplementation treatment differed across adiposity measures.

   Our finding suggesting that adiposity and CRP influence response to iron supplementation, furthers our understanding of the relationship between inflammation and anemia treatment in children and has both theoretical and public health implications.

    

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3. Child stunting is associated with weaker human capital among native Amazonians

   https://doi.org/10.1002/ajhb.23059  

   Undurraga, Eduardo A. ; Behrman, Jere R. ; Emmett, Susan D. ; Kidd, Celeste ; Leonard, William R. ; Piantadosi, Steven T. ; Reyes‐García, Victoria ; Sharma, Abhishek ; Zhang, Rebecca ; Godoy, Ricardo A. ( September 2017 , American Journal of Human Biology)

   We assessed associations between child stunting, recovery, and faltering with schooling and human capital skills in a native Amazonian society of horticulturalists‐foragers (Tsimane').

   We used cross‐sectional data (2008) from 1262 children aged 6 to 16 years in 53 villages to assess contemporaneous associations between three height categories: stunted (height‐for‐age Z score, HAZ<–2), moderately stunted (–2 ≤ HAZ≤–1), and nonstunted (HAZ>–1), and three categories of human capital: completed grades of schooling, test‐based academic skills (math, reading, writing), and local plant knowledge. We used annual longitudinal data (2002–2010) from all children (n = 853) in 13 villages to estimate the association between changes in height categories between the first and last years of measure and schooling and academic skills.

   Stunting was associated with 0.4 fewer completed grades of schooling (∼24% less) and with 13–15% lower probability of showing any writing or math skills. Moderate stunting was associated with ∼20% lower scores in local plant knowledge and 9% lower probability of showing writing skills, but was not associated with schooling or math and writing skills. Compared with nonstunted children, children who became stunted had 18–21% and 15–21% lower probabilities of showing math and writing skills, and stunted children had 0.4 fewer completed grades of schooling. Stunted children who recovered showed human capital outcomes that were indistinguishable from nonstunted children.

   The results confirm adverse associations between child stunting and human capital skills. Predictors of growth recovery and faltering can affect human capital outcomes, even in a remote, economically self‐sufficient society.

    

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4. Environmental Enteric Dysfunction Is Associated With Poor Linear Growth and Can Be Identified by Host Fecal mRNAs

   https://doi.org/10.1097/MPG.0000000000001315  

   Ordiz, Maria Isabel ; Shaikh, Nurmohammad ; Trehan, Indi ; Maleta, Ken ; Stauber, Jennifer ; Shulman, Robert ; Devaraj, Sridevi ; Tarr, Phillip I. ; Manary, Mark J. ( November 2016 , Journal of Pediatric Gastroenterology and Nutrition)

   Environmental enteric dysfunction (EED) can be assessed by the lactulose:mannitol (L:M) test. Our objective was to determine if selected host fecal transcripts were correlated with EED, and whether transcripts and clinical characteristics could be used to predict EED in rural African children.

   Demographic and sanitation characteristics, along with L:M testing and host fecal transcript analyses from 798 asymptomatic Malawian children aged 12 to 61 months were compared with linear growth over the subsequent 3 months. Fecal host mRNA analysis included quantification of expression of 18 transcripts associated with L:M. Permeability was categorized as normal (L:M ⩽ 0.15), moderate (0.15

   L:M was inversely correlated with linear growth over the subsequent 3 months (r= −0.32,P< 0.001) and severe EED was associated with stunting (P< 0.0001). Age younger than 24 months, weight‐for‐heightzscore <0, domesticated animals in the child's sleep environment, lack of a pit latrine combined with a potentially contaminated water source, and a recent history of diarrhea were associated with severe EED. A random forest model using CD53, HLA‐DRA, MUC12, and TNF was 84% sensitive for severe EED and 83% sensitive for no EED.

   Selected host fecal transcripts can be used in a random forest model as a noninvasive biomarker for categories of EED in rural African children.

    

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5. Food systems and rural-urban linkages in African secondary cities

   https://doi.org/10.1186/s42854-022-00042-8  

   Zimmer, Andrew ; Guido, Zack ; Davies, Julia ; Joshi, Nupur ; Chilenga, Allan ; Evans, Tom ( August 2022 , Urban Transformations)

   Urban populations globally are expected to increase by approximately 2.5 billion by 2050. Much of this growth is taking place in African cities, where about 40% of Africans live in urban areas with populations of less than 250,000. In many of these cities, rapid urban growth has outpaced economic and social development, resulting in high levels of urban poverty and widespread food insecurity. As one response strategy, urban households may leverage their linkages with rural areas and other towns or cities to supplement their food consumption, for example through food remittances or food purchases from remote retailers. While this strategy has been found to occur among inhabitants of large cities where existing research on urban food systems and urban food linkages with other areas has focused, the dynamics in smaller cities are likely different. In this paper, we draw on data from 837 surveys collected in 2021 to investigate household food sourcing strategies across 14 urban areas in Zambia with populations less than 100,000. We find that rural-urban food linkages are dominated by grains while urban-urban food linkages are predominantly composed of higher value foods. Our data further suggest that urban area characteristics explain more of the variability in food sourcing behaviors than household level characteristics, and that urban food purchasing preferences in secondary urban areas are sensitive to the food retail landscape available to households. These relationships highlight the disparate role that rural and urban linkages play across cities of different sizes. They suggest a need for food-related policies to consider diverse urban food systems among smaller cities.

    

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