Implications of market integration for cardiovascular and metabolic health among an indigenous Amazonian Ecuadorian population

Melissa A. Liebert, J. Josh Snodgrass, Felicia C. Madimenos, Tara J. Cepon, Aaron D. Blackwell, Lawrence S. Sugiyama

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Background: Market integration (MI), the suite of social and cultural changes that occur with economic development, has been associated with negative health outcomes such as cardiovascular disease; however, key questions remain about how this transition manifests at the local level. Aim: The present paper investigates the effects of MI on health among Shuar, an indigenous lowland Ecuadorian population, with the goal of better understanding the mechanisms responsible for this health transition. Subjects and methods: This study examines associations between measures of MI and several dimensions of cardiovascular and metabolic health (fasting glucose, lipids [LDL, HDL and total cholesterol; triglycerides] and blood pressure) among 348 adults. Results: Overall, Shuar males and females have relatively favourable cardiovascular and metabolic health. Shuar who live closer to town have higher total (p < 0.001) and HDL cholesterol (p < 0.001), while Shuar in more remote regions have higher diastolic blood pressure (p = 0.007). HDL cholesterol is positively associated with consumption of market foods (r = 0.140; p = 0.045) and ownership of consumer products (r = 0.184; p = 0.029). Conclusions: This study provides evidence that MI among Shuar is not a uniformly negative process but instead produces complex cardiovascular and metabolic health outcomes.

Original languageEnglish (US)
Pages (from-to)228-242
Number of pages15
JournalAnnals of Human Biology
Issue number3
StatePublished - May 2013
Externally publishedYes


  • Amazonia
  • Cardiovascular disease
  • Market integration
  • Metabolic disorders

ASJC Scopus subject areas

  • Epidemiology
  • Physiology
  • Aging
  • Genetics
  • Public Health, Environmental and Occupational Health


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