Professor Stanley Ulijaszek: List of publications

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Using a new socioepidemiological questionnaire to analyse associations between intergenerational upward social mobility and body fat distribution: A pilot study with the Oxford BioBank cohort

September 2020

Journal article

Journal of Epidemiology and Community Health

Background: As measured through body mass index (BMI), obesity is more prevalent among upwardly mobile adults than among adults born into middle-class families. Although BMI reflects general adiposity, health risks are more strongly associated with abdominal adiposity. It is therefore important to investigate associations between upward mobility and fat distribution. Methods: A socioepidemiological questionnaire was developed, qualitatively validated and piloted with Oxford BioBank participants. Sex-specific analyses of variance (ANOVA) investigated associations between participant occupational class and adiposity, paternal occupational class and adiposity, and upward occupational mobility and adiposity. The main aim was to observe whether the expected directional effect of adiposity in relation to paternal occupational class would emerge. Results: 280 participants (166 women, 114 men; age 32–67 years) completed the questionnaire. Men with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and android-to-gynoid fat mass ratio than men with fathers of occupational class 1. Women with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and gynoid fat mass than women with fathers of occupational class 1. Among men, upward mobility was not associated with adiposity. Among women, upward mobility was associated with higher total body fat percentage, android fat mass and gynoid fat mass. Conclusion: The expected directional effect was found, thereby supporting the questionnaire’s use. Upward mobility did not appear to change associations between paternal occupational class and participant adiposity. Future research using the socioepidemiological questionnaire should investigate associations between gender, educational mobility, adiposity and health.

FFR

Mobile activism, material imaginings, and the ethics of the edible: Framing political engagement through the Buycott app

June 2016

Journal article

Geoforum

In this article, we explore the discursive constructions of Buycott, a free mobile app that provides a platform for user-generated ethical consumption campaigns. Unlike other ethical consumption apps, Buycott’s mode of knowledge production positions the app itself as neutral, with app users generating activist campaigns and providing both data and judgment. Although Buycott is not a dedicated food activism app, food features centrally in its campaigns, and the app seems to provide a mobile means of extending, and perhaps expanding, alternative food network (AFN) action across geographies and constituencies. Thus, as a case study, Buycott unveils contemporary possibilities for citizen participation and the formation of activist consumer communities, both local and transnational, through mobile technologies. Our analysis shows, however, that despite the app’s user-generated format, the forms of activism it enables are constrained by the app’s binary construction of action as consumption or non-consumption and its ethos of ‘voting with your wallet’. Grounded in texts concerning Buycott’s two largest campaigns (Demand GMO Labeling and Long live Palestine boycott Israel), our analysis delineates how Buycott, its campaigns, and its modes of action take shape in user, media, and app developer discourses. We find that, as discursively framed, Buycott campaigns are commodity-centric, invoking an ‘ethics of care’ to be enacted by atomized consumers, in corporate spaces and through mainstream, barcode-bearing, retail products. In user discourses, this corporate spatiality translates into the imagined materializing of issues in products, investing commodities with the substance of an otherwise ethereal cause. This individualized, commodity-centric activism reinforces tenets of the neoliberal market, ultimately turning individual users into consumers not only of products, but also of the app itself. Thus, we suggest, the activist habitus constructed through Buycott is a neoliberal, consumer habitus.

mobile apps, ethical consumption, boycott, political consumerism, consumer activism, food citizenship

Do adult obesity rates in England vary by insecurity as well as by inequality? An ecological cross-sectional study

May 2014

Journal article

BMJ open

Geographical variations in adult obesity rates have been attributed in part to variations in social and economic inequalities. Insecurity is associated with obesity at the cross-national level, but there is little empirical evidence to show that insecurity contributes to the structuring of adult obesity rates at the subnational level. This is examined in this study across local authorities in England, using a recently developed social classification for the British population.Modelled obesity rates from the Health Survey for England 2006-2008 were related to social class (as estimated from the BBC's Great British Class Survey of 2011 and a nationally representative sample survey), across 320 local authorities in England.Comparisons of mean obesity rates across Z score categories for seven latent social classes were carried out using one-way analysis of variance. Pooled ordinary least square regression analyses of obesity rates by local authorities according to the proportion of different social classes within each of them were performed to determine the extent of geographical variations in obesity rates among the classes that were more greatly based on insecurity (emergent service workers, precariat), and those more closely based on inequality (elite, established middle class, technical middle class, new affluent workers, traditional working class).Adult obesity rates vary negatively across local authorities according to the proportion of people in the elite (F=39.06, p<0.001) and technical middle class (F=8.10, p<0.001) and positively with respect to the proportion of people of the established middle class (F=26.36, p<0.001), new affluent workers (F=73.03, p<0.001), traditional working class (F=23.00, p<0.001) and precariat (F=13.13, p<0.001). Social classes more closely based on inequality show greater association with adult obesity rates across local authorities than social classes more closely based on insecurity.Both insecurity and inequality are associated with the geographical patterning of adult obesity rates across England.

male, humans, socioeconomic factors, food supply, SBTMR, obesity, England, cross-sectional studies, female

Anorexia Nervosa

August 2013

Journal article

With its multidimensional etiology, rich history, and increasingly complex epidemiology, anorexia nervosa (from here on, referred to as “anorexia”) has emerged as a biocultural disorder of significance for medical anthropology. Anthropological work on anorexia was first published in the 1980s, with these initial engagements examining the Western cultural context wherein anorexia was known to be expressed. Over the decades, paradigm shifts in medical anthropology—from culture-bound syndromes and explanatory models of disease to analyses of globalization and ethnographies of the body and self—transitioned the anthropological discussion of anorexia away from “culture” and toward the critical analysis of practice, experience, and subjectivity. But the anthropological narrative of anorexia is even richer, having been informed by more than a century of multidisciplinary work: a vast corpus that constitutes an unlikely gathering of disciplines, all searching for the key to anorexia’s causation and course. Since its clinical definition in the 1870s, anorexia—a disorder of ambiguous and complex causation, with striking psychological, social, physiological, and behavioral manifestations—has been subject to myriad interpretations. In fields ranging from biomedical (including genetic and neuro-) science to the many schools of psychology, history, and feminist social theory, scholars have offered interpretations of anorexia, each addressing a facet of this condition. With historical analyses tracing anorexia through the 1800s and to pre-Enlightenment times, feminist analyses positioning anorexia as the embodiment of sociopolitical thought, and evolutionary and genetic analyses suggesting anorexia is the possible expression of adaptive traits, multidisciplinary work on anorexia has captured a complexity that is yet to be fully understood. It is this complexity, blurring the boundaries of body, society, history, and self, that makes anorexia so relevant for medical anthropology, its enduring ambiguities evoking the wholeness of the human experience that anthropological research seeks to explain. Given the nature of the anorexia literature on which anthropological research draws, this article does not highlight genres of publication: journals and textbooks dedicated to eating disorders tend to be exclusively clinical, emphasizing biomedical research and quantitative data analyses (rather than clinical case reports), such that they would not provide the most-salient references for anthropologists. The works featured in this article are divided, therefore, according to the analytic perspectives they express. Emphasis is placed on the history of thought on anorexia, while drawing out the salience of specific works for contemporary anthropological research.

Late childhood and adolescence growth sensitivity to political transition: the case of South African Cape coloured schoolchildren during and post-apartheid

January 2012

Journal article

Anthropological Review

South Africa underwent major social and economic change between 1987 and 1995. The release of Nelson Mandela in February 1990 proclaimed an end to the political system of apartheid, and the first freely elected non-White government in 1994 instigated social and economic reforms aimed at alleviating the consequences of apartheid. This paper aims to examine the impact of these socio-economic and political changes on height, weight and body mass index (BMI) in childhood and late adolescence. An analysis was carried out of longitudinal data of 258 urban and rural South African Cape Coloured schoolchildren (6-18 years old) across the transitional periods from apartheid between 1987 and 1990, to this transition between 1991 and 1993, and finally to post-apartheid between 1994 and 1995. The anthropometric measures were standardized into age independent Z-scores. Analyses of variance with repeated measures were conducted to examine the growth in height, weight and BMI across these periods. The results show a significant main effect of measurement periods on height, weight and BMI Z-scores. Across time, the subjects increased in overall size, height, weight and BMI. For all the anthropometric measures there was a significant interaction effect between measurement period and sex, but none between measurement period and SES. The average increase in height, weight and BMI across time differed significantly for girls and boys, the average z-scores being greater in girls than in boys. For boys, there was little difference in height, weight and BMI Z-scores according to SES, and little increase across periods. Girls were generally taller, heavier with greater BMI than boys, and their scores increased across the time periods. High SES girls were taller, heavier and had higher BMI than low SES girls. Across the measurement periods, BMI and weight somewhat converged between the high and low SES girls. In the discussion these differences reflecting social sex distinctions are addressed.

SBTMR

The international growth standard for children and adolescents project: environmental influences on preadolescent and adolescent growth in weight and height.

December 2006

Journal article

Food Nutr Bull

This review has two aims. The first is to identify important environmental influences on the growth of children aged 1 to 9 years and of adolescents, defined as those aged 10 to 19 years. The second is to identify possible environmentally based criteria for the selection of individuals and populations for data collection in the development of an international growth reference for these age ranges. There are many common environmental influences on the growth of children between the ages of 1 and 19 years; the examination and description of these forms the main body of this review. Subsequently, environmental factors influencing adolescent growth only are considered. In both cases, possible selection criteria are put forward. The most important inclusion criteria for both preadolescence and adolescence are good nutrition, lack of infection, and socioeconomic status that does not constrain growth. Additionally, low birthweight, catchup growth, breastfeeding, and early adiposity rebound have impacts on growth and/or body composition into puberty. Exclusion of children born at low birth and/or experiencing catch-up growth could be most realistically operationalized if populations in which secular trends in growth were either completed or minimal were selected. Although an effect of hypoxia on child and adolescent growth, independent of nutrition, is small at most, many high-altitude populations have high prevalances of low birthweight and should be excluded on this basis. Since all populations are exposed to pollutants, contaminants, and toxicants in varying degrees, they cannot be realistically excluded from the sample frame. However, it may be desirable to exclude populations that are habitually exposed to extremely high levels of environmental pollution, including air pollution, and those living in close proximity to toxic waste. It is impossible to exclude populations and individuals on the basis of their exposure to aflatoxin contamination of food. However, exclusion on the basis of low socioeconomic status or poverty may well act as a proxy for this. There are a small number of populations that show extreme patterns of growth in body size and proportion in preadolescence and adolescence, and these should be excluded from the sample frame.

Adolescent, Adolescent Development, Body Height, Body Weight, Child, Child Development, Child, Preschool, Environment, Female, Growth, Humans, Infant, Male, Reference Standards, Reference Values, Social Class, Socioeconomic Factors

The International Growth Standard for Children and Adolescents Project: Environmental influences on preadolescent and adolescent growth in weight and height

January 2006

Journal article

Food and Nutrition Bulletin

Changing patterns of social variation in stature in Poland: effects of transition from a command economy to the free-market system?

July 2005

Journal article

J Biosoc Sci

The aim of this analysis was to examine the effects on stature in two nationally representative samples of Polish 19-year-old conscripts of maternal and paternal education level, and of degree of urbanization, before and after the economic transition of 1990. Data were from two national surveys of 19-year-old Polish conscripts: 27,236 in 1986 and 28,151 in 2001. In addition to taking height measurements, each subject was asked about the socioeconomic background of their families, including paternal and maternal education, and the name of the locality of residence. The net effect of each of these social factors on stature was determined using four-factor analysis of variance. The secular trend towards increased stature of Polish conscripts has slowed down from a rate 2.1 cm per decade across the period 1965-1986 to 1.5 cm per decade between 1986 and 2001. In both cohorts, mean statures increase with increasing size of locality of residence, paternal education and maternal education. The effect of each of these three social factors on conscript height is highly significant in both cohorts. However, the effect of maternal education has increased substantially while that of size of locality of residence and paternal education diminished between 1986 and 2001. These results imply that the influence of parental education on child growth cannot be due solely to a relationship between education and income, but is also perhaps a reflection of household financial management which benefits child health and growth by better educated parents, regardless of level of income. In addition they suggest that, irrespective of whether there are one or two breadwinners in the family, it is the mother, more so than the father, who is principally responsible for the extent to which such management best favours child health and growth. The asymmetry between the importance of maternal as against paternal education for child growth, clearly seen in the 1986 cohort, became more accentuated in 2001, after the abrupt transition from a command to a free-market economy in the early 1990s.

Adult, Body Height, Educational Status, Female, Humans, Male, Parents, Poland, Social Change, Urbanization

Village distance from urban centre as the prime modernization variable in differences in blood pressure and body mass index of adults of the Purari delta of the Gulf Province, Papua New Guinea.

January 2005

Journal article

Ann Hum Biol

OBJECTIVE: The study examined the extent to which the geographical proximity of villages to an urban centre and other modernization variables are associated with variation in blood pressure and body mass index (BMI) of adults of the Purari delta of the Gulf Province, Papua New Guinea (PNG). METHODS: Mean BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 292 adults surveyed in 1995-1997 in the Purari delta, PNG, are reported by village of residence, and related to modernization variables, including village of residence, urban life, urban connectedness, economic status and education. RESULTS: Mean BMI, SBP and DBP differ according to village of residence, there being a gradient in mean blood pressure from highest in the village closest to the urban centre, Baimuru, and lowest in the village most distant from it. The gradients in these variables across the three villages are not due to differences in age structures between the villages. Place of residence, which represents the distance from town, has the greatest impact on the BMI of males, while among the females, the number of relatives living in urban centres had a significant effect on BMI. For both males and females, place of residence has the strongest effect on SBP. While for the males, place of residence is the only significant factor associated with SBP, for the females, SBP is also associated with BMI, level of income and to a lesser extent with age. Very similar results were obtained for DBP. CONCLUSIONS: Distance to urban centre appears to have a strong effect, relative to other modernization variables, on BMI and blood pressure, this effect being far stronger for males than for females. In large part, this effect operates by way of differences in number of sources of income as well as number of close relatives of women who are resident in an urban centre. Reasons for the male-female differences observed may include gender differences in degree of mobility, and possibly greater physical sensitivity of males to the environment than females. Traditionally, there have been clear divisions of labour between males and females, the latter spending longer in subsistence activities than the former. It is speculated that males have more free time to travel to town should they wish, while women may travel to town to take produce to market, and be limited by how much time they spend in town when they are there, by the need to return to carry out household and subsistence tasks. It may also be that young adult males are more susceptible to modernization, in that they exhibit a greater degree of non-conformity than young women, and may be more favourably disposed to adopt aspects of western lifestyle.

Adult, Blood Pressure, Body Mass Index, Female, Humans, Life Style, Male, Middle Aged, Papua New Guinea, Residence Characteristics, Rural Population, Sex Factors, Socioeconomic Factors

Maternal work and childhood nutritional status among the Purari, Papua New Guinea.

January 2003

Journal article

Am J Hum Biol

In traditional economies, body size, physical work capacity, subsistence productivity, and nutrition of adults may be interrelated, and one cross-generational effect of these relationships may operate through the household, influencing nutritional status of children. In this analysis, the relationships among adult body size, work productivity in terms of time spent making sago starch, dietary diversity, nutrient availability, and childhood nutritional status are examined in the Purari population of Papua New Guinea, a group largely dependent on the starchy staple palm sago, which is devoid of all nutrients apart from energy. Observations of work scheduling, household food and nutrient availability, and nutritional status were carried out for 16 women, their households, and their children. A multiple regression model of hours spent in sago making on a particular day with days spent in other subsistence activities showed a negative relationship with the number of days spent in sago-making and a positive relationship with the number of days spent fishing. The number of hours spent in sago-making on a particular day was also positively related to daily per capita availability of protein at the household level. This is not a function of maternal nutritional status, however, since there is no association between body size of adult females and the number of hours spent making sago on a particular day. Nor does the greater per capita protein availability at the household level in households where women spend longer on a particular day in sago-making result in improved childhood nutritional status. Since relationships among adult body size, work productivity, dietary diversity, nutrient availability, and childhood nutritional status are only partially demonstrated in this population, it may be that these linkages may only be important if physically arduous work is needed more consistently than is the case in the Purari delta.

Agriculture, Anthropometry, Child, Child Nutritional Physiological Phenomena, Child, Preschool, Efficiency, Energy Intake, Family Characteristics, Female, Food Supply, Humans, Infant, Infant, Newborn, Mothers, Nutritional Status, Papua New Guinea, Plants, Work

Serum insulin-like growth factor-I, insulin-like growth factor binding protein-3, and the pubertal growth spurt in the female rhesus monkey.

May 2002

Journal article

Am J Phys Anthropol

While there is good evidence suggesting IGF-I links to pubertal development and crown-rump length growth among rhesus monkeys, linkages between IGF-I and other measures of morphological growth have not been established. In this study, the pubertal growth spurt in a number of morphological characteristics of female rhesus monkeys is related to serum endocrine status of insulin-like growth factor-I (IGF-I) and its binding protein, insulin-like growth factor binding protein-3 (IGFBP-3), to test the hypothesis that elevations in IGF-I and IGFBP-3 coincide with the time of greatest growth rate of different morphological characteristics. A longitudinal study of pubertal growth among four female rhesus monkeys was carried out across a 3-year period. Morphometric measurements included weight, crown-rump length, foot-length, and skinfolds at five sites (biceps, triceps, abdominal, subscapular, and suprailiac). These measures were taken as being representative of total mass, skeletal growth of the trunk and head, limb length, and body fatness, respectively. Measurements were carried out as closely as possible to 3-monthly, with interpolations being performed to standardise the data to exactly 3-monthly intervals for all individuals. Blood samples were taken at time of morphometry. Elevations in serum IGF-I and IGFBP-3 took place in a manner similar to that of humans, and across the period associated with onset of puberty. Mean 3-monthly gain in crown-rump length and foot length showed significant peaks across the measurement period, while mean 3-monthly gains in weight and sum of five skinfolds did not. Greatest foot length gain occurred on average between 3-3.5 years of age, while crown-rump length gain was greatest between 3.75-4 years of age. Periods of greatest gain in crown-rump length and foot length took place across the period of elevated serum IGF-I levels, which was between 3-4.5 years of age. Significant elevations in IGF-I and IGFBP-3 were not coincident with greatest gains in foot length or crown-rump length. Thus the hypothesis does not hold true for the two measures showing significant peaks in 3-monthly gain across the measurement period. The nature of the endocrine impact on macaque morphology remains unclear, although this may be fundamental to the understanding of the variation in the pubertal growth spurt and its influence on morphology at maturity both within and across primate species.

Animals, Biometry, Body Constitution, Female, Insulin-Like Growth Factor Binding Protein 3, Insulin-Like Growth Factor I, Macaca mulatta

Increasing body size among adult cook islanders between 1966 and 1996.

January 2001

Journal article

Ann Hum Biol

There is limited evidence of a secular trend toward increased body size among populations in the Pacific Region, although some populations have shown a clear rise in overweight and obesity across the past 30 years or so. Mean height, weight and body mass index (BMI) of adults surveyed in 1996 on Rarotonga, the Cook Islands, are reported by age group and compared with data collected in 1966 by Evans and Prior, to determine the extent to which a secular trend in increasing body size has taken place across this 30-year period. In addition, a comparison of these anthropometric variables between subjects born on the most modernized island of Rarotonga with those born on other less-modernized islands is made, to determine the extent to which adult body size differs according to place of origin. Comparing the sample of those born on Rarotonga, the most modernized island, with those born on other, less modernized islands shows those born on Rarotonga to be taller, but not relatively heavier than those born elsewhere in the Cook Islands. Both males and females of the 1996 sample of adults are significantly taller, heavier, with higher BMI compared with the 1966 sample, indicating a secular trend toward increased body size across this 30-year period. The mean BMIs of the younger age groups in 1996 are greater than those of the same age groups in 1966, indicating a secular trend toward greater body fatness. There has been a significant increase in obesity among both males and females. In 1966, 14% of males had a BMI greater than 30, while in 1996, the proportion was 52%. Among females, 44% of those measured in 1966 had a BMI greater than 30, while in 1996 the proportion was 57%. The higher mean stature of younger adult males relative to older ones suggests that the secular trend toward increasing height may have been underway prior to 1966. The mean statures and weights of adults aged 60 years and older in the 1996 sample are more similar to values given for most age groups in the 1966 sample, indicating that the secular trend toward increased weight and height may have begun 50-60 years ago.

Adult, Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Body Constitution, Body Mass Index, Female, Humans, Male, Middle Aged, Obesity, Polynesia, Sex Factors, Skinfold Thickness, Time Factors

Secular trend in birthweight among the Purari delta population, Papua New Guinea.

January 2001

Journal article

Ann Hum Biol

The aim of this analysis was to examine the extent and possible seasonal nature of the secular trend in mean birthweight in the Purari delta, Papua New Guinea. This is a country undergoing rapid modernization, and with this has come a secular trend toward increased adult body size in some parts of the country but not others. Birthweight data, collected by month of delivery at Kapuna Hospital in the Purari delta between the years 1969 and 1996, was analysed by year of birth and by season, using one-way analysis of variance and post hoc Scheffé tests with the statistical software SPSS-PC+. A total of 927 birthweights for the years 1969, 1972, 1977, 1994 and 1996 were included in the analysis. Twin births were excluded from analysis, as were births below 1.5 kg. There is clear evidence of a secular trend in increasing mean birthweight between the period 1969 and 1996, with the largest significant difference being between 1977 and 1994, from 2.70 to 2.92 kg. There were no significant differences in mean birthweight between the sexes. The rate of birthweight increase between 1977 and 1994 was 130 g per decade, lower than the gain of 200 g per decade in the period 1994-1996. The decline in birthweight of 90 g per decade during the period 1969-1977 is not statistically significant. The proportion of infants born with low birth weight (< 2.5 kg) shows an increase between 1969 and 1972, and a decline thereafter. While seasonal differences in birthweight during any of the years examined is non-significant, significantly greater mean birthweight across the period 1969-1996 was found for births during the wet season (April to July), and the drier season (August to November), respectively. The secular increase in mean birthweight is likely to be a consequence of the improvements in maternal diet and increased maternal body size that have come with economic modernization. The secular trend of seasonality in mean birthweight among the Purari delta population may be a function of seasonally varied displacement of traditional diet by non-local bought foods, as well as reduced seasonality of maternal workload associated with the processing of the traditional staple food.

Agriculture, Analysis of Variance, Birth Weight, Body Constitution, Delivery, Obstetric, Diet, Ethnicity, Female, Food Handling, Food Supply, Humans, Industry, Infant, Newborn, Male, Mothers, Nutritional Physiological Phenomena, Papua New Guinea, Pregnancy, Seasons, Sex Characteristics, Social Change, Socioeconomic Factors, Workload

Secular trends in growth: The narrowing of ethnic differences in stature

January 2001

Journal article

Nutrition Bulletin

Ethnic differences in growth patterns between countries have been observed even after controlling for nutrition, environment, and a range of other factors. The literature on markers of human growth patterns in different affluent populations was compared, with the aim of identifying similarities or differences that might be ascribed to nonenvironmental factors. To this end, the stature characteristics of different affluent child populations at various ages and stages (stature attained at 7 and 8 years of age; age at peak height velocity; peak height velocity) have been compared. The obvious flaw to this approach is that not all of them show maximal growth trajectories, because mean body size is still increasing for many, as the secular trend toward increasing body size has not ceased for many populations. Therefore, a review of the extent to which the same stature characteristics of populations of differing ethnicities have changed across time has been carried out, to determine the extent to which they might be approaching or attaining similar secular trend end-points associated with the achievement of genetic potential for growth. The comparison of mean heights of 7-year-old boys from populations of industrialised countries and from the highest socio-economic groups in developing countries, shows that the range of means for European and European-origin populations is similar to those of African and African-origin, and Latin-American and Indo-Mediterranean populations, but slightly higher than those of Asiatic populations. This supports the view that genetic potential for prepubertal growth may be similar for all groups examined in this way, apart from Asiatic populations. However, the secular trend toward increased body size has continued to take place among many populations, including affluent ones. The Asiatic populations observed since 1990 are much more similar in stature to their counterparts elsewhere in the world than they were prior to this date. A similar comparison among affluent adolescents shows Asiatic populations to have earlier onset of the pubertal growth spurt in stature than other major population typologies, but to have similar peak height velocities. The similarities in attained stature by mid-childhood of children of most major population typologies, apart from the Asiatic one, suggests that an international growth reference could be used currently for all major population typologies apart from the Asiatic one. It is possible that they may also be applicable to preadolescent Asiatic populations, given the dramatic secular increase in childhood stature in recent decades, if they were to achieve the same statures for age as affluent populations elsewhere in the world. With respect to pubertal growth, international references may be applied to all major population typologies apart from the Asiatic one, as the earlier age of peak height velocity in these populations is unlikely to be due to differences in environmental quality.

Socioeconomic status, body size and physical activity of adults on Rarotonga, the Cook Islands.

January 2001

Journal article

Ann Hum Biol

Much of the secular trend toward increased body size among populations in the Pacific Region has been attributed to the processes of economic modernization and socioeconomic change. The primary objective of the present analysis was to examine the relationships between socioeconomic factors and stature, weight, body mass index and physical activity level of adult Cook Islanders living a largely modernized lifestyle in the Pacific Region. In a cross-sectional study of physical activity, body size and socioeconomic status, a volunteer sample of 345 Cook Islanders aged 20-65 years was obtained from the total adult population of Rarotonga, and measured at six out-patient clinics. Stature, weight, body mass index (BMI), physical activity level and age were calculated by sex and occupational category, years of education, island of birth and number of years lived on Rarotonga, respectively, using SPSSPC for Windows. Stepwise multiple regression was used to examine the relationships between stature, weight, BMI, PALweekday (a measure of physical activity level), age and non-linear functions of age, and the socioeconomic variables. These analyses indicate that the secular trend in stature is a function of the relative level of modernization on Rarotonga relative to other Cook Islands, and with level of education. These factors associate differently among males and females, the secular trend among males appearing to be a general phenomenon in response to lifestyle change associated with life on Rarotonga, while among females the trend is a function of lifestyle change associated with education and independent of island of origin. The trend toward increasing body fatness is also different for males and females. Weight declines with age for both men and women, in a linear way for the males, but in a non-linear fashion for the females. Body weight is also greater among those males in more skilled and professional occupations than among those with less-skilled professions. For the women, weight is independent of occupation category. Physical activity patterns of modernizing adult Cook Islanders show no relationships with socioeconomic variables for the males, but while older women are less active, those born on Rarotonga are less active than those born elsewhere in the Cook Islands. The number of years spent on Rarotonga shows no significant relationships with any of the physical measures, or with physical activity level. This is likely to be as much a function of small sample size as a lack of effect. Although declines in energy expenditure with increasing age have been demonstrated for both males and females in various populations around the world, on Rarotonga this holds true for females and not males, indicating that physical activity declines with increasing age in modernizing societies do not occur in uniform fashion.

Adult, Aged, Analysis of Variance, Body Constitution, Body Height, Body Mass Index, Cross-Sectional Studies, Educational Status, Ethnicity, Exercise, Female, Humans, Male, Middle Aged, Polynesia, Prevalence, Regression Analysis, Sex Factors, Socioeconomic Factors

Nutrition, infection and child growth in Papua New Guinea.

December 2000

Journal article

Coll Antropol

Growth patterns of populations in Papua New Guinea (PNG) have traditionally shown considerable variation, with the greatest difference lying between coastal and highland populations. While genetic differences in explaining these patterns cannot be excluded, the generally poor growth relative to western growth references is largely due to the complex interactive effects of undernutrition and infection. The effects of diet, nutrition and infection on the nutritional status of a child vary with age, the general disease ecology and the type and extent of exposure to it, patterns of infant and young child feeding, and types of food consumed. There are two possible ways in which the relationship between undernutrition and infection can begin; one in which poor nutritional status leads to impaired immunocompetence and reduced resistance to infection, and the other in which exposure to infectious disease can lead to a range of factors that reduce food intake, absorption of nutrients, or increase nutrient requirements. In PNG prior to, and at early stages of modernisation, primary malnutrition is likely to have been the usual initiating factor in the onset of growth faltering due to undernutrition-infection interactions. However, the possibility that infection may have been the initiating event in some societies cannot be excluded. This would have happened by way of early dietary supplementation of infants with foods of minor nutritional significance, which could have acted as a vehicle for the introduction of infectious disease to the child. With modernisation and adoption of primary health care principles, earlier supplementation of infant diet than was previously the case became common in PNG. This has lead to general improvements in growth and nutritional status. However, in populations where undernutrition is still common, infection has become more important than primary malnutrition as the initiator of growth faltering due to undernutrition-infection interactions.

Adolescent, Anthropology, Child, Child Development, Child, Preschool, Communicable Diseases, Female, Growth, Humans, Infant, Infant, Newborn, Male, Nutrition Disorders, Nutritional Status, Papua New Guinea, Public Health

Parental education, body mass index and prevalence of obesity among 14-year-old boys between 1987 and 1997 in Wrocław, Poland.

January 2000

Journal article

Eur J Epidemiol

The main aim of this study was to examine changes in relative weight and prevalence of obesity across a ten-year period among 14-year-old boys according to parental education level. Data from two surveys, carried out in 1987 and 1997, of boys attending the 7th grade of primary schools in Wrocław were used in the analysis. The heights and weights of 3165 boys aged 14 years selected from cohort of 6969 7th and 8th grade boys from all primary schools of the city Wrocław were used. The data of the second sample of 14-year-old boys (n = 1014) were obtained from a health examination study carried out in the Silesian Centre for Preventive Medicine, 'DOLMED', in Wrocław in 1997. All boys attended the 7th grade of 34 randomly selected primary schools from a total of 129 schools in the city of Wrocław. Social status was assessed on the basis of parental education level scored to four categories: university, secondary school, trade school, and elementary school. The prevalence of overweight and obesity was defined as the percentage of children above the 85th and 95th percentiles of the body mass index (BMI), the means of which were 21.27 and 23.75 kg/m2 respectively. Prevalence of overweight among boys is slightly lower in the 1997 sample, whereas the prevalence of obesity shows the opposite trend and is higher by more than one percent in comparison with the 1987 sample. Similar trends of declining medians and increasing variance are observed in all educational groups. The differences in medians between the two samples within educational groups did not achieve statistical significance for the groups with parents with education at elementary level and fathers with university education. There is a trend toward increasing prevalence of obesity across the decade considered, according to father's education level. With respect to mother's education levels, the most dramatic changes in BMI and obesity occurred in the elementary education group, where the percentage of obese subjects increased more than twofold. A significant increase is also observed in the group with parents attaining university education.

Adolescent, Body Mass Index, Educational Status, Health Knowledge, Attitudes, Practice, Health Surveys, Humans, Male, Obesity, Parents, Poland, Prevalence, Probability, Risk Assessment, Risk Factors, Statistics, Nonparametric

Anthropometric measurement error and the assessment of nutritional status.

September 1999

Journal article

The British journal of nutrition

Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.

Humans, Body Weight, Observer Variation, Anthropometry, Body Constitution, Body Height, Skinfold Thickness, Nutrition Assessment, Sensitivity and Specificity, Nutritional Status

Professor Stanley Ulijaszek: List of publications

Translating models of obesity to tackle common obesity.

Obesity and environments external to the body.

Introduction: Population Change, Social Reproduction and Local Understandings of Fertility in Melanesia

Using a new socioepidemiological questionnaire to analyse associations between intergenerational upward social mobility and body fat distribution: A pilot study with the Oxford BioBank cohort

Ecological Sensing Through Taste and Chemosensation Mediates Inflammation: A Biological Anthropological Approach

Productive simplification in the use of anthropometric nutritional status

Last Word on Viewpoint: Rejuvenation of the term sarcopenia

Identifying notions of environment in obesity research using a mixed‐methods approach

Physical activity and the human body in the (increasingly smart) built environment

Rejuvenation of the term Sarcopenia.

The problem with relying on dietary surveys: sociocultural correctives to theories of dietary change in the Pacific islands

Beware the medicalisation of loneliness

Models of Obesity

Governance by campaign: the co-constitution of food issues, publics and expertise through new information and communication technologies

Diabetes on twitter: Influence, activism and what we can learn from all the food jokes

Digital food activism

Digital food activism: Values, expertise and modes of action

Introduction: Digital food activism - food transparency one byte/bite at a time?

The 'who' and 'what' of #diabetes on Twitter

Epigenetics and Obesity

Mobile activism, material imaginings, and the ethics of the edible: Framing political engagement through the Buycott app

Conceptualizing ecobiosocial interactions: lessons from obesity

Framing obesity in United Kingdom policy from the Blair years, 1997-2015. The persistence of individualistic approaches despite overwhelming evidence of societal and economic factors, and the need for collective responsibility

Inequality and childhood overweight and obesity: a commentary

Low grandparental social support combined with low parental socioeconomic status is closely associated with obesity in preschool‐aged children: a pilot study

With the benefit of foresight: obesity, complexity and joined-up government

Preface

An anthropological insight into the Pacific island diabetes crisis and its clinical implications

Population Genetics: the study of the genetic structure of human populations

An Introduction

Population in the Human Sciences

Social Aspects of Dietary Sugars

Obesity emergence in the Pacific islands: why understanding colonial history and social change is important

From abject eating to abject being: Representations of obesity on 'Supersize vs. Superskinny'

Research Protocol: The practice of medical humanitarian emergency: ethnography of practitioners’ response to nutritional crisis

Do adult obesity rates in England vary by insecurity as well as by inequality? An ecological cross-sectional study

Introduction: Obesity, eating disorders and the media

Obesity, eating disorders and the media

Preface

VARIATION IN HEIGHT AND BMI OF ADULT INDIANS

Predicting adult obesity from measures in earlier life.

The emergence of obesity among Australian Aboriginal children

Predicting adult obesity from measures in earlier life

Anorexia Nervosa

Intercontinental differences in overweight of adopted Koreans in the United States and Europe

One reason why waist-to-height ratio is usually better related to chronic disease risk and outcome than body mass index.

Concluding remarks: what's in a name? "Negritos" in the context of the human prehistory of Southeast Asia

Concluding remarks: what's in a name? "Negritos" in the context of the human prehistory of Southeast Asia.

High fructose corn syrup and diabetes prevalence: A global perspective

High fructose corn syrup and diabetes prevalence: a global perspective.

The Unpredictable Species. What Makes Humans Unique.

When Culture Impacts Health: Global Lessons for Effective Health Research

Detrimental effects of early rural life on blood pressure among urban male migrants in Wroclaw, Poland

Evolving Human Nutrition Implications for Public Health

Results of epidemiological studies of blood pressure are biased by continuous variation in arm size related to body mass.

Insecurity, Inequality, and Obesity in Affluent Societies

Socio-economic status, forms of capital and obesity.

Hungry City. How Food Shapes Our Lives

In Defence of Food. The Myth of Nutrition and the Pleasures of Eating

Late childhood and adolescence growth sensitivity to political transition: the case of South African Cape coloured schoolchildren during and post-apartheid

Socio-economic Status, Forms of Capital and Obesity

Stuffed & Starved. From Farm to Fork, the Hidden Battle for the World Food System

Childhood Obesity as an Amplifier of Societal Inequality in the United States

Waist-to-hip ratio and woman's education level as predictors of breastfeeding duration

Waist-to-hip ratio and woman's education level as predictors of breastfeeding duration.

Variation in Human Growth Patterns due to Environmental Factors

Obesity under affluence varies by welfare regimes: The effect of fast food, insecurity and inequality

Human Variation From the Laboratory to the Field

Body frame dimensions are related to obesity and fatness: Lean trunk size, skinfolds, and body mass index.

Medical Anthropology. A Biocultural Approach.

Income level and food intake patterns among male bengalee slum dwellers in Kolkata, India

Seasonality and Human Ecology

Body frame dimensions can predict obesity: Body mass index, body frame and fatness

Food and Globalization. Consumption, Markets and Politics in the Modern World

Human Protein Requirements and Infection Stress among Young Children at the Origins of Agriculture

Seven models of population obesity.

The economics of climate change. The Stern review

Changes in BMI and the prevalence of overweight and obesity in children and adolescents in Cracow, Poland, 1971-2000.

Frameworks of population obesity and the use of cultural consensus modeling in the study of environments contributing to obesity.