TY - JOUR
T1 - Childhood Daily Energy Expenditure Does Not Decrease with Market Integration and Is Not Related to Adiposity in Amazonia
AU - Urlacher, Samuel S.
AU - Snodgrass, J. Josh
AU - Dugas, Lara R.
AU - Madimenos, Felicia C.
AU - Sugiyama, Lawrence S.
AU - Liebert, Melissa A.
AU - Joyce, Cara J.
AU - Terán, Enrique
AU - Pontzer, Herman
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Background: Childhood overweight and obesity (OW/OB) is increasingly centered in low- and middle-income countries (LMICs) as rural populations experience market integration and lifeway change. Most explanatory studies have relied on imprecise estimates of children's energy expenditure, restricting understanding of the relative effects of changes in diet and energy expenditure on the development of OW/OB in transitioning contexts. Objectives: This study used gold-standard measurements of children's energy expenditure to investigate the changes that underlie OW/OB and the nutrition/epidemiologic transition. Methods: Cross-sectional data were collected from "rural"(n = 43) Shuar forager-horticulturalist children and their "peri-urban"(n = 34) Shuar counterparts (age 4-12 y) in Amazonian Ecuador. Doubly labeled water measurements of total energy expenditure (TEE; kcal/d), respirometry measurements of resting energy expenditure (REE; kcal/d), and measures of diet, physical activity, immune activity, and market integration were analyzed primarily using regression models. Results: Peri-urban children had higher body fat percentage (+8.1%, P < 0.001), greater consumption of market-acquired foods (multiple P < 0.001), lower concentrations of immune activity biomarkers (multiple P < 0.05), and lower REE (-108 kcal/d, P = 0.002) than rural children. Despite these differences, peri-urban children's TEE was indistinguishable from that of rural children (P = 0.499). Moreover, although sample-wide IgG concentrations and household incomes predicted REE (both P < 0.05), no examined household, immune activity, or physical activity measures were related to children's overall TEE (all P > 0.09). Diet and energy expenditure associations with adiposity demonstrate that only reported consumption of market-acquired "protein"and "carbohydrate"foods predicted children's body fat levels (multiple P < 0.05). Conclusions: Despite underlying patterns in REE, Shuar children's TEE is not reliably related to market integration and - unlike dietary measures - does not predict adiposity. These findings suggest a leading role of changing dietary intake in transitions to OW/OB in LMICs.
AB - Background: Childhood overweight and obesity (OW/OB) is increasingly centered in low- and middle-income countries (LMICs) as rural populations experience market integration and lifeway change. Most explanatory studies have relied on imprecise estimates of children's energy expenditure, restricting understanding of the relative effects of changes in diet and energy expenditure on the development of OW/OB in transitioning contexts. Objectives: This study used gold-standard measurements of children's energy expenditure to investigate the changes that underlie OW/OB and the nutrition/epidemiologic transition. Methods: Cross-sectional data were collected from "rural"(n = 43) Shuar forager-horticulturalist children and their "peri-urban"(n = 34) Shuar counterparts (age 4-12 y) in Amazonian Ecuador. Doubly labeled water measurements of total energy expenditure (TEE; kcal/d), respirometry measurements of resting energy expenditure (REE; kcal/d), and measures of diet, physical activity, immune activity, and market integration were analyzed primarily using regression models. Results: Peri-urban children had higher body fat percentage (+8.1%, P < 0.001), greater consumption of market-acquired foods (multiple P < 0.001), lower concentrations of immune activity biomarkers (multiple P < 0.05), and lower REE (-108 kcal/d, P = 0.002) than rural children. Despite these differences, peri-urban children's TEE was indistinguishable from that of rural children (P = 0.499). Moreover, although sample-wide IgG concentrations and household incomes predicted REE (both P < 0.05), no examined household, immune activity, or physical activity measures were related to children's overall TEE (all P > 0.09). Diet and energy expenditure associations with adiposity demonstrate that only reported consumption of market-acquired "protein"and "carbohydrate"foods predicted children's body fat levels (multiple P < 0.05). Conclusions: Despite underlying patterns in REE, Shuar children's TEE is not reliably related to market integration and - unlike dietary measures - does not predict adiposity. These findings suggest a leading role of changing dietary intake in transitions to OW/OB in LMICs.
KW - Ecuador
KW - doubly labeled water
KW - economic development
KW - nutrition transition
KW - obesity
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U2 - 10.1093/jn/nxaa361
DO - 10.1093/jn/nxaa361
M3 - Article
C2 - 33454748
AN - SCOPUS:85101523590
SN - 0022-3166
VL - 151
SP - 695
EP - 704
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 3
ER -