Topics: Working with the Maya Biocultural facts The Maya of Merida Research, training and intervention Impact What’s next?

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)

6. Biocultural facts

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

15. 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

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

22. Social Media
Twitter: @inesvarelasilva
LinkedIn
ResearchGate.net
http://bemicelu.blogspot.co.uk/

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???

27. Thank you