Thomas L. Leatherman

Contributions of nutrition versus hypoxia to growth in rural Andean populations

Previous research on diet and nutrition among peasant agriculturalists in the Andes has produced inconsistent results. As a consequence it has been difficult to determine the extent to which nutritional factors contribute to the slowed, prolonged growth and resultant small adult body size that is characteristic of these highland populations. The study examines patterns of diet and growth in the rural highland community of Nuñoa, Peru (elevation 4,000 m), and compares them to similar data collected on this community during the 1960s. Additional data from other locations in the Andes are then evaluated to discern critical determinants of growth variation.

Biocultural synthesis in medical anthropology

Medical anthropology has developed distinct and separate biological and cultural approaches to the study of health and disease in human populations. Within cultural anthropology a major focus has been the ethnomedical perspective that analyzes the process of defining disease and describing the social response to disease. In biological anthropology, an ecological perspective considers the interaction of the population, the insult and the environment at the core of the disease process. There has been limited success in integrating the cultural and biological perspective. Some cultural anthropologists claim that the ecological perspective relies on a biomedical model and therefore is not useful in studying non-Western societies. Others are critical of the adaptivist perspective that they believe fails to consider political economic factors that affect the disease process. The lack of a biocultural integration has hindered the systematic analysis of health and disease in contemporary traditional and non-Western groups. An ecological model that addresses these problems will provide a biocultural integration of the disease process.

Changes in stature, weight, and nutritional status with tourism-based economic development in the Yucatan

Over the past 40 years, tourism-based economic development has transformed social and economic conditions in the Yucatan Peninsula, Mexico. We address how these changes have influenced anthropometric indicators of growth and nutritional status in Yalcoba, a Mayan farming community involved in the circular migration of labor in the tourist economy. Data are presented on stature and weight for children measured in 1938 in the Yucatan Peninsula and from 1987 to 1998 in the Mayan community of Yalcoba. In addition, stature, weight and BMI are presented for adults in Yalcoba based on clinic records. Childhood stature varied little between 1938 and 1987. Between 1987 and 1998 average male child statures increased by 2.6cm and female child statures increased by 2.7cm. Yet, 65% of children were short for their ages. Between 1987 and 1998, average child weight increased by 1.8kg. Child BMIs were similar to US reference values and 13% were considered to be above average for weight. Forty percent of adult males and 64% of females were overweight or obese. The anthropometric data from Yalcoba suggest a pattern of stunted children growing into overweight adults. This pattern is found elsewhere in the Yucatan and in much of the developing world where populations have experienced a nutrition transition toward western diets and reduced physical activity levels.

Work performance of high-altitude Aymara males.

The sample for this study consisted of 28 Aymara males between the ages of 15 and 43 years. The subjects were rural high-altitude natives who were temporarily working as porters in La Paz, Bolivia (3700 m). Mean VO2max was 46 X 5 ml/kg/min. There was a significant negative relationship between VO2max and age in adult porters . However, there was also a significant positive relationship between maximal work output and age and a significant negative relationship between VO2 during submaximal exercise and age. Relative work intensity (VO2/VO2max) during submaximal exercise did not change significantly with age. Thus, even though VO2max decreased significantly with age, these data suggest that there may not be a substantial decrease with age in the adaptive status of these men. Minimal support was found for the hypothesis that chest size in Andean highlanders influences the effectiveness of the oxygen transport system.

Evolution of infectious Disease: A Biocultural Analysis of AIDS

The evolution of infectious disease can be understood from an ecological model that incorporates information from anthropology, epidemiology, and biomedicine. This model considers variables such as the pathogen, the host population, and the environment. In this model, the role that culture as well as other environmental variables plays in the transmission of infectious disease in human populations is considered. In addition, the sociocultural response and its impact on the disease process can be analyzed. The present AIDS epidemic is placed in an ecological and evolutionary context of the disease in hominid evolution. The interaction between Human Immunodeficiency Virus (HIV) and human populations is considered in this perspective. The ability of the virus to survive in semen and blood both increases as well as limits the possibility of transmission. Cultural practices that increase the transmission of blood and semen or increase sexual activity will obviously increase the potential risk of viral transmission. In societies that practice exchange of blood, blood transfusion, and where vaccinations with unclean needles exist or where there is intravenous (IV) drug use, the transmission of HIV by blood is enhanced. HIV which can cause a breakdown of the immunological system is paradoxically a very fragile pathogen. Replication occurs within T‐cells, an important part of the immunological system. Outside of the blood or semen the virus dies quickly. From the perspective of the pathogens adaptation, the virus has effectively solved the problem of survival. The fragile viruss long incubation period and its ability to survive in the presence of antibodies help to assure its transmission. HIVs ability to suppress the immunological system may assure its immediate survival, but this adaptation may cause the death of its host from other opportunistic pathogens that are usually not lethal.

Changing biocultural perspectives on health in the Andes

New directions toward biocultural approaches to health and illness in Andean peoples have emerged since the original Health in the Andes volume was published in 1981. The reformulation of these perspectives was stimulated in part by the growth of political-economic perspectives in Andean ethnography and by critiques of medical ecology by critical medical anthropologists. This paper provides a brief history of changing biocultural perspectives on Andean health, and contrasts two projects dealing with Andean biology and health carried out in the 1960s and 1980s in the District of Nuñoa in Southern Peru. The recent Nuñoa research provides one example of a more critical biocultural approach that attempts to integrate perspectives from ecology and anthropological political economy. The utility of the approach is explored through the Nuñoa case study, which focused on the reproduction of illness and poverty in Andean households in contexts of social and economic change. Findings of this research are compared with recent work in the Andes to illustrate how a more critical biocultural perspective can better articulate with the diversity of approaches in medical anthropology and Andean health studies.

Maximal aerobic power in trained youths at high altitude

The sample for this study consisted of 25 males and 19 females between the ages of 8.8 and 19.5 years. The subjects were healthy, well nourished and trained swimmers residing in La Paz, Bolivia (mean altitude 3700 m). The purpose of this study was to provide normative values for the work capacity of high-altitude youths. Mean VO2 max was 46.9 ml/kg/min in males and 39.3 ml/kg/min in females. VO2max increased significantly with age in males but not in females. Mean VO2max tended to be 10-20% lower in the swimmers than in sea-level athletes.