The thrifty genotype hypothesis: concepts and evidence after 30 years
Author:Boyd Swinburn
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Abstract:see pdf file.
Asia Pac J Clin Nutr. 1995;4(4):337-338.doi:
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Overview of the thrifty genotype hypothesis
Author:O'Dea K
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Abstract:The thrifty genotype hypothesis was proposed by Neel in 1962 to explain the increasing incidence of diabetes in the western world. Since then it has been invoked frequently to explain the epidemics of obesity and non-insulin dependent diabetes (NIDDM) in populations all over the world as they have made the rapid transition to a westernised lifestyle in the twentieth century. An examination of the archaeological record indicates that human populations were exposed to nutritional stresses throughout history (both as hunter-gatherers and agriculturalists) which could have selected strongly for a "thrifty" metabolism. The metabolic basis of the "thrifty" genotype has been attributed to selective insulin resistance, in which the gluco-regulatory pathways of insulin action are affected primarily, thereby promoting compensatory hyperinsulinaemia and overstimulation of those pathways less affected by insulin resistance such as those involved in fat deposition. Both physical inactivity and an energy-dense diet high in saturated fat and fibre-depleted carbohydrate have been shown to increase insulin resistance. Thus, key components of the western lifestyle act to exacerbate insulin resistance and facilitate weight gain, which itself also worsens insulin resistance. Finally, Hales and Barker have argued provocatively for a "thrifty" phenotype as the major predisposing factor in NIDDM: that poor nutrition in the perinatal period is associated with increased risk of NIDDM in adulthood, mediated either through sustained effects on b -cell function or insulin sensitivity. The difficulties in differentiating between "nature" and "nurture" in the aetiology of this complex condition cannot be overstated.
Asia Pac J Clin Nutr. 1995;4(4):339-340.doi:
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"Civilisation" and the thrifty genotype
Author:John S Allen, Susan Cheer
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Asia Pac J Clin Nutr. 1995;4(4):341-342.doi:
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Insulin resistance and low metabolic rate: do they cause obesity?
Author:Swinburn B
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Abstract:Insulin resistance and obesity have genetic determinants which are separate and probably polygenic. Under certain environmental conditions, both probably offer selective advantages for survival. Under modern environmental conditions, a genetic predisposition to both would result in marked insulin resistance and be a major risk for the development of NIDDM. A low relative metabolic rate and a high insulin sensitivity have been shown to predict weight gain. However, upon the weight gain these "metabolic risks" appear to normalise thus raising doubts about whether these factors are truly aetiological. The thrifty genotype hypothesis remains a valid construct to explain the presence of common, genetically-determined factors which are currently detrimental to health, however, the original mechanisms proposed by Neel of an "efficient" metabolism or hyperinsulinaemia need considerable rethinking in light of 30 years of evidence.
Asia Pac J Clin Nutr. 1995;4(4):343-344.doi:
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Role of amylin in the regulation of energy metabolism in health and disease
Author:Garth JS Cooper
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Abstract:abstract only
Asia Pac J Clin Nutr. 1995;4(4):345.doi:
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Insulin resistance and obesity have genetic determinants which are separate and probably polygenic. Under certain environmental conditions, both probably offer selective advantages for survival. Under modern environmental conditions, a genetic predispositi
Author:Simmons D
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Abstract:The prevalence of non insulin dependent diabetes mellitus (NIDDM) is increasing exponentially. While the genetic causes of NIDDM remain unclear, the differences in prevalence of NIDDM over time, between and within different ethnic groups highlight the importance of environmental factors in the development of NIDDM in any given individual. Besides the classical risk factors for NIDDM such as obesity and indolence, the role of intra-uterine over-exposure or deficit of nutrients is increasingly felt to be of importance in the aetiology of NIDDM. Indeed, ethnic differences in hyperinsulinaemia, can be detected at birth in some populations. In utero exposure to increased fuel supply may be of particular importance in Polynesian and American Indian populations. If this is so, efforts to control NIDDM will take several generations to be successful.
Asia Pac J Clin Nutr. 1995;4(4):346-348.doi:
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Intrauterine nutrition and adult disease
Author:Jane Harding
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Abstract:abstract only
Asia Pac J Clin Nutr. 1995;4(4):349.doi:
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Strong and weak linkages in the thrifty genotype hypothesis
Author:Paul T Baker
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Abstract:abstract only
Asia Pac J Clin Nutr. 1995;4(4):350.doi:
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Thrifty genotype concepts and health in modernising Samoans
Author:McGarvey ST
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Abstract:Thrifty genotype concepts are described and applied to the case of increasing overweight with modernisation. The prevalence of overweight (BMI >= 30 kg/m2) among American Samoans and Western Samoans is increasing substantially as described in surveys conducted in 1976-82 and in 1990-91. There is a possible role of insulin and the sympathetic nervous system in weight gain and energy balance. The thrifty genotype concept provides important hypotheses which can be applied to concrete studies among modernising Samoans.
Asia Pac J Clin Nutr. 1995;4(4):351-353.doi:
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Polynesian body size: an adaptation to environmental temperature?
Author:Houghton P
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Abstract:A computer simulation of exposure at sea in the tropical Pacific supports the hypothesis that humans colonising this region have been subject to strong directional selection for a large muscular body. This is advanced as an explanation for the typical Polynesian phenotype, and suggestions are made linking this phenotype with the metabolic disorders of gout and non-insulin dependent diabetes mellitus.
Asia Pac J Clin Nutr. 1995;4(4):354-356.doi:
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Cultural elaborations of obesity - fattening practices in Pacific societies
Author:Pollock NJ
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Abstract:Fattening rituals in Pacific societies are examined within a discussion of the cultural aspects of obesity as a disease of modernisation. Those rituals contributed to a strong aesthetic value of large body size and light skin, while also incorporating the symbolic value of food. They may have enhanced survival value of a genetic potential in the face of irregular diet. Today with a more regular diet available only the negative aspects of large body size prevail.
Asia Pac J Clin Nutr. 1995;4(4):357-360.doi:
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Patterns of colonisation and the "thrifty" genotype in Pacific prehistory
Author:Brewis AA, Irwin G, Allen JS
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Abstract:The seemingly distinctive markers of Polynesian biology - serologic, molecular, anatomical, and developmental - have been argued to have emerged from the special circumstances of colonisation and early settlement of the region. Models point to the microevolutionary impact of mortality selection while voyaging, small founding group size forcing bottlenecking, and subsequent relative isolation of groups introducing heterogeneity through genetic drift within Polynesia. These ideas have drawn on a melange of ideas about the colonising experience to construct evolutionary narratives, including that of the "thrifty" genotype in Polynesia. The substantial problem is that there previously has been no independent theory of colonisation and inter-island contact for the region. We critically examine which microevolutionary forces would have impacted prehistoric Polynesians in terms of an independent navigational theory of colonisation, and map out the expected biological/ evolutionary sequelae. This theory suggests that Remote Oceania was settled by directed return voyages, that the tempo of population expansion was probably rapid, that voyaging continued after settlement, that whereas episodes of colonisation were directed to safety, subsequent inter-group voyages followed the pattern of mutual inter-island accessibility. The implication is that mortality selection would not have been the predominant force shaping the Polynesian genotype; the development of survival sailing strategies were designed to remove these very risks. This makes it unlikely that the specific experience of Polynesian colonisation would promote an efficient insulin mechanism, and so explain, for example, the high incidence of Type II diabetes mellitus in contemporary Polynesian groups.
Asia Pac J Clin Nutr. 1995;4(4):361-365.doi:
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Body mass index and cardiovascular risk factors in Pacific Island Polynesians and Europeans in New Zealand
Author:Judy McAnulty, Robert Scragg
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Abstract:abstract only
Asia Pac J Clin Nutr. 1995;4(4):366.doi:
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Body mass index: is it an appropriate measure of obesity in Polynesians?
Author:Boyd Swinburn, P Craig, B Strauss, R Daniel
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Asia Pac J Clin Nutr. 1995;4(4):367.doi:
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Metabolic markers of hyperinsulinaemia in normotensive Maori and Caucasian New Zealanders
Author:Maling T, van Wissen K, Toomath R, Siebers R
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Abstract:New Zealand Maori are hyperinsulinaemic and insulin resistant, compared with age- and blood pressure-matched Caucasians and are therefore an important group in which to study previously described metabolic correlates of insulin resistance, including plasma urate, triglycerides and erythrocytic sodium. Only fasting triglycerides were associated with hyperinsulinaemia. Erythrocyte sodium and plasma urate were not correlated with fasting or stimulated insulin in either race. The reduced fractional urate clearance in Maori, compared with Caucasians, was positively correlated with fractional lithium clearance (proximal tubular sodium reabsorption), suggesting an ethnically expressed dependence of urate clearance on proximal tubular sodium reabsorption. Our findings indicate the need for caution in the generalisability of the variously described "markers" of hyperinsulinaemia.
Asia Pac J Clin Nutr. 1995;4(4):369-370.doi:
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Antigen absorption: food, fire or fuel?
Author:Kamath KR
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Abstract:The epithelium of the gastrointestinal tract is constantly exposed to varieties of antigens. In healthy individuals, only small amounts of ingested dietary antigens are absorbed. The normal immune response to absorbed food antigens is one of tolerance, which enables food to play its nutritive ("food") role without causing disease. Breakdown in tolerance may result in a spectrum of clinical problems, including food allergy, food sensitive enteropathy and food intolerance ("fire"). When food-sensitive enteropathy is subclinical, continued ingestion of the offending food antigen sometimes results in development of tolerance and resolution of the enteropathy. The development of tolerance to a specific food antigen under these circumstances may be prevented by briefly excluding the antigen from the diet, substituting it with a different antigen and then reintroducing the first antigen. In this situation, the second food antigen not only prevents the mucosal recovery expected if the infant had been continuously fed food containing the first antigen alone, but frequently seems to worsen the damage when the first antigen is reintroduced ("fuel"). While genetic constitution seems to be the major player in the heightened IgE responsiveness in atopic subjects, the pathophysiology of food-sensitive enteropathy in non-atopic children is less well understood. Complex interplay between environmental factors such as breast feeding, and host factors such as the integrity of the absorptive gut epithelium and its immunological responsiveness at the time of introduction of various food antigens seems to be important in its genesis as well as in its tendency to be a transient disorder of infancy.
Asia Pac J Clin Nutr. 1995;4(4):371-375.doi:
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Cigarette smoking and socio-economic indicators as determinants of body fatness in three Southern Chinese communities of China
Author:Grievink L, Hsu-Hage BH, Rao X, Wahlqvist ML, Li Y
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Abstract:Obesity is one of the major risk factors for cardiovascular disease and non-insulin dependent diabetes mellitus. This study describes cigarette smoking and the socio-demographic differences of body fatness in three sub-ethnic distinctive communities in Guangdong Province, China. In this study, 935 adult Chinese (Chauzhou - 203 men and 111 women; Meixian - 169 men and 140 women; Xinhui - 194 men and 118 women) were randomly sampled from three communities. A standard protocol was used to measure stature, body weight, waist and hip circumferences. Body mass index (BMI) and waist-to-hip circumference ratio (WHR) were calculated as measures of total body fatness and abdominal body fatness, respectively. The questionnaire was self-administered and demographic and lifestyle factors were assessed. WHR was positively related to age in men (p=0.0001) and in women (p=0.0001) while BMI was associated with age only in women (p=0.0001). In women, WHR was significantly related to education levels after adjusting for age and BMI (p=0.0300). In men, BMI differed by educational level, after adjusting for age and WHR (p=0.0329). BMI was significantly associated with occupational status in men, after adjusting for age and WHR (p=0.0004). Gross household income was significantly associated with WHR in men, after adjusting for age and BMI (p=0.0469). Male smokers had a significantly lower mean BMI than the non-smokers, after adjusting for age and WHR (p=0.0037). Marital status was not related to body fatness measurements after adjusting for age and WHR. The differences in body fatness in Chinese living in Southern China can not be totally explained by educational level, occupational status, marital status, gross household income and cigarette smoking, particularly in women. Age was the only consistent predictor of abdominal body fatness in both men and women and also of total body fatness in women.
Asia Pac J Clin Nutr. 1995;4(4):376-383.doi:
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Family studies in nutrition at Monash Medical School
Author:Amanda L Smith, Jessica Luzhansky
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Asia Pac J Clin Nutr. 1995;4(4):384.doi:
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The place of food and nutrient supplementation in a family's health belief system
Author:Luzhansky J
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Abstract:The use of food and nutrient supplements was considered as part of a long-term, in-depth study of a family by medical students of Monash University. Questions posed were: Who makes the decisions regarding such supplementation? What are the intended outcomes/ gains for the family? What does supplementation signify regarding food/ health beliefs in the family? How needed is it?
Asia Pac J Clin Nutr. 1995;4(4):385-388.doi:
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Food shopping practices and family health
Author:Smith AL
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Abstract:"The way in which a family selects, obtains and stores food has a major impact on diet. This includes who in the family makes decisions about food and how, who does the shopping and where, whether they stick to a pre-determined plan or buy whatever looks good at the time, and how much influence the shopper's knowledge of the health effects of diet has on shopping practices. Ways in which shopping practices could be changed - with a high likelihood of compliance over the long term - to improve the family's diet were considered as an exercise in medical education."
Asia Pac J Clin Nutr. 1995;4(4):389-393.doi:
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Biographical Sketches of nutritionists in the Asia Pacific Region
Author:Poorwo Soedarmo
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Abstract:see pdf file.
Asia Pac J Clin Nutr. 1995;4(4):394.doi:
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