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Early Environments on Health Trajectories

Understanding and Improving Nutrition for Pregnancy 

Growing evidence shows that the nutrition a baby receives while still in the womb affects its health as an adult in many ways. This has vital implications for public policy to improve pregnant women’s health and diet. Nutrition includes both micronutrients—vitamins and minerals—and macronutrients, or fat, carbohydrates, and protein. Adding vitamin supplements during pregnancy can increase birth weight, a measure of newborn health. But what about macronutrients? IPR anthropologist Christopher Kuzawa, Zaneta Thayer (PhD 2013) of Dartmouth College, and former IPR postdoctoral fellow Julienne Rutherford of the University of Illinois at Chicago propose a new model to understand how nutrition is delivered to the fetus during pregnancy. In Evolution, Medicine, & Public Health, they argue that their Maternal Nutritional Buffering Model explains why other changes to pregnant women’s diets have limited effects on fetal development and birth weight. Using an evolutionary perspective, the authors point out that the mother’s body protects the growing fetus from both nutritional ups and downs, tempering the benefits of short-term diet interventions. The researchers propose that the most effective way to improve babies’ health both at birth and as future adults is to improve their mothers’ nutrition far earlier before they become pregnant.

Early Origins of Socioeconomic Inequalities in Chronic Inflammation

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IPR biological anthropologists Thomas McDade (left) and Christopher Kuzawa have discovered that environmental conditions early in development can cause inflammation in adulthood.

The United States is characterized by persistent and widening social inequities in many adult health outcomes, and researchers have begun to ask how these outcomes trace back to childhood. In Social Science & Medicine, IPR anthropologist Thomas McDade and IPR postdoctoral fellow Stephanie Koning consider the extent to which socioeconomic inequalities in adult health may be influenced by experiences earlier in life. Utilizing data from the National Longitudinal Study of Adolescent to Adult Health of 7,610 young adults aged 24­–32 years, the researchers documented a strong relationship between  lower socioeconomic status (SES) and higher levels of chronic inflammation in adulthood, as measured by C-reactive protein. They also examined the participants’ birth weight and duration of breastfeeding in infancy, and investigated whether they could account for the SES gradient in chronic inflammation.  They find that increasing the time a mother breastfeeds to three or more months reduces the SES gradient in inflammation  by more than 80%. The results indicate that environments early in infancy are important determinants of chronic inflammation in adulthood, and that breastfeeding three months or longer could reduce SES-based inequalities in cardiometabolic disease, which result in part from higher levels of chronic inflammation. The researchers suggest that social policies addressing structural barriers to extended breastfeeding, such as paid family leave, could have the greatest impact in reducing inequalities in breastfeeding. McDade is Carlos Montezuma Professor of Anthropology.

How Therapists Can Help Patients With Unexplained Illness

Functional Neurological Disorders (FNDs) are surprisingly common, yet poorly understood neurological conditions which are determined to be “incompatible” with known diseases. In a 2020 article for Social Science & Medicine, IPR anthropologist Rebecca Seligman and her postdoctoral fellow, Northwestern anthropologist Maddalena Canna, who is the paper’s lead author, argue that a cultural analysis is required to better understand and help people with FNDs. Seligman and Canna analyze three case studies, focusing on one particular kind of FND, a disorder known as PNES (Psychogenic-Non-Epileptic Seizure). They describe three key ways in which FNDs are mediated by culture: how patients use existing cultural meanings and representations to mediate and describe their own experience; the forms of expression available and strategies for dealing with trauma in a given context; and the judgment and social stigma patients may face due to their symptoms. Seligman and Canna conclude that given this complex system of cultural factors, effective therapies should be based on constructing a shared set of meanings between patient and therapist. They recommend therapists and patients de-emphasize the need to come to an objective “truth” about the disease, in favor of a willingness to view it through the other’s perspective. The researchers note that making space for patients’ definition of their disorder leaves open the possibility of future medical diagnoses that may explain the roots and causes of FNDs.