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C Panter-Brick

Publications and source records attributed to C Panter-Brick.

17 recordsLinked to original sources
PubMed2001

Elevated acute-phase protein in stunted Nepali children reporting low morbidity: different rural and urban profiles.

This study examined the associations between severity of stunting, plasma protein concentrations and morbidity of 104 Nepali boys, aged 10-14 years, living in contrasting environments. Boys from a remote village were compared with three similarly aged urban groups: poor squatters, homeless street children, and middle-class schoolchildren. All but the middle-class group were stunted, particularly village boys whose mean height-for-age z-score (-2.97, SD 0.82) indicates severe growth retardation. Stunting was significantly associated with increased plasma levels of the acute-phase protein alpha1-antichymotrypsin itself inversely related to plasma levels of albumin. Plasma ACT levels of village children (mean 1.52 g/l, SD 0.43) were three to four times higher than those of squatters and homeless street children, and five times higher than those of middle-class boys. Despite being the most severely stunted and having the most abnormal plasma protein values, village children reported the lowest burden of disease, a contradiction which may reflect exposure to sub-clinical infections or habituation to illness and low expectation of treatment. This study draws attention to the strikingly high levels of ACT and of stunting in the rural sample, and cautions on the use of uncorroborated morbidity reports across different epidemiological and socio-ecological environments. Possible mechanisms to explain the impact of illness and inflammation on growth faltering are discussed.

Acute-Phase Proteins↗
PubMed1996

Seasonal and sex variation in physical activity levels among agro-pastoralists in Nepal.

Considerable attention has been devoted to variation in levels of energy expenditure between and within populations; these are commonly evaluated following international guidelines for grading light, moderate, and heavy physical activity levels (PAL). This study presents activity profiles by season and sex for subsistence agro-pastoralists in Nepal, comparing data for a sample of 20 men observed four times across the year with previously published data on women. Total energy expenditure (TEE) was estimated from direct minute-by-minute observation (totaling 1,679 h for men, 3,601 h for women) and measures of the energy cost of single tasks (117 for men, 168 for women). PAL were calculated and graded as multiples of predicted basal metabolic rate (BMR). Despite an explicitly egalitarian organization of labor, men achieved higher PAL than women (P <.0001), although according to international gradings, both men and women assume moderately heavy PAL in the winter and very heavy PAL in the monsoon. PAL were 1.88 and 2.22 x BMR for men in respective seasons (P <.005; TEE, 11.8 MJ/d and 13.9 MJ/d) and 1.77 and 2.0 x BMR for women (TEE, 9.1 MJ/d and 10.5 MJ/ d). High TEE values result from time-consuming work in subsistence tasks, most of which are of moderate energy cost. Results show that the international guideline (FAO/WHO/UNU [1985]) for grading levels of energy expenditure, which adopts discrepant sex-specific values to define thresholds for moderate or heavy PAL, can mask significant gender variation. Male/female ratios of PAL values are suggested instead for population-level comparisons.

Adult↗
PubMed1996

Growth status of homeless Nepali boys: do they differ from rural and urban controls?

The rapid increase in numbers of homeless children in cities of the developed and developing world is a matter of grave concern. A multi-disciplinary study was undertaken to examine the health and lifestyles of the homeless in Nepal in comparison to other local children. Few studies have quantified the health of street-children in the developing world using anthropometric indicators, and to our knowledge this is the first to systematically compare the homeless with appropriate controls from both rural and urban areas. Heights and weights were measured for 307 six to fourteen year-old boys (III homeless 62 squatter, 82 privileged school and 52 village boys). Height for age (HAz), weight for age (WAz) and weight for height (WHz) I-scores relative to reference data from the National Center for Health Statistics (NCHS) were used as indicators of growth status. Stunting characterized all but the school-boys, but wasting was not observed. the homeless were less stunted than either poor squatter or village boys. On arrival on the streets, they were taller than village boys, and duration of homelessness had no effect on their growth status. Thus in terms of physical growth, and despite frequent health complaints, homeless boys in Nepal fare relatively better than control groups of poor urban and rural boys. Comparative studies which reveal some successful aspects of street-life show that urban homelessness may represent an appropriate response to circumstances of poverty.

Adolescent↗
PubMed1996

Prolactin response to suckling and maintenance of postpartum amenorrhea among intensively breastfeeding Nepali women.

The aim of the study was to determine the association between PRL responses to suckling and maintenance of postpartum amenorrhea among breastfeeding mothers. Three blood spot samples (5, 30, and 50 min following a timed nursing bout) were collected from 71 intensively breastfeeding Nepali women for PRL determination. Maternal age, BMI (weight/height2), menstrual status, caste, infant age, nursing bout length, and duration of supplementation were recorded at time of sample collection. Independent and paired t tests, linear regression analyses, and general linear models were used to evaluate differences between cycling (n = 36) and amenorrheic (n = 35) women and associations among variables. Logistic regression analyses were used to relate PRL measures to the odds of maintaining lactational amenorrhea. Amenorrheic breastfeeding mothers had higher (P < .001) PRL levels at all 3 collection times than cycling breastfeeding mothers, and PRL levels declined with time since birth (P < 0.05). The odds (OR) of having ceased lactational amenorrhea was significantly higher (OR = 5.0, 95% Cl = 1.3-19.9) among mothers with lower PRL levels (< or = 10 ng/mL) at 50 min post-sucking, and PRL at 50 min showed a significant dose response relationship with menstrual status. The association between 50 min PRL levels and lactational amenorrhea appears to be independent of time postpartum, maternal age, BMI, nursing bout length, and duration of supplementation. Among intensively nursing women, maintenance of elevated PRL levels across the interbout interval increases the odds of maintaining lactational amenorrhea.

Adult↗
PubMed1996

Salivary testosterone levels among Tamang and Kami males of central Nepal.

Salivary testosterone levels are reported for 65 Nepalese males between the ages of 15 and 48 years who were drawn from 2 different ethnic populations (Tamang and Kami) from the central highlands of Nepal. Subjects collected morning and evening saliva samples on five consecutive days in two contrasting seasons, the winter dry season and the summer monsoon season. Anthropometric indexes of acute and chronic nutritional status were also measured. Morning and evening salivary testosterone levels in the winter averaged 233 +/- 14 (SE) pmol/L and 166 +/- 8 pmol/L, respectively, for the Tamang and 249 +/- 14 pmol/L and 163 +/- 13 pmol/L, respectively, for the Kami. In the summer the corresponding values were 219 +/- 12 pmol/L and 156 +/- 8 pmol/L for the Tamang and 249 +/- 19 pmol/L and 147 +/- 12 pmol/L for the Kami. These levels are significantly lower than those reported for Western populations and close to those reported for other non-Western populations. The magnitude of diurnal variation in salivary testosterone levels and the absence of significant age variation are also comparable with observations made on other populations. Weak relationships were observed between testosterone levels and indexes of acute and chronic nutritional status in the winter only. The absence of pronounced variation in salivary testosterone levels between populations and the absence of strong associations between salivary testosterone levels and indexes of acute and chronic nutritional status contrast with the prominent ecological and interpopulation variation reported for salivary progesterone levels in women. Male gonadal function seems less sensitive to moderate energetic stress than female gonadal function, probably reflecting the fact that energy availability is less crucial to male reproductive success than to female reproductive success. Variation in testosterone level associated with chronic energetic stress may be an adaptive somatic response to avoid the maintenance costs of a large active metabolic mass with little direct impact on male fecundity.

Adolescent↗
PubMed1995

Inter-individual and seasonal weight variation in rural Nepali women.

Changes in body weight were examined for non-pregnant women in rural Nepal, using 183 anthropometric measures between the early winter and monsoon seasons in 1982, 1982-83, 1990-91 and 1993. The women gained weight when work loads decreased after the monsoon, but despite substantial changes in total energy expenditure, which were out of phase with changes in food intake, seasonal changes were small, averaging only up to 2.6% of initial body weight. There were notable differences between individual women, changes in body weight ranging from -5.6 kg to 4.8 kg. Weight change was examined with respect to lactation status, age, body mass index, mid upper arm circumference and skinfolds as well as total energy expenditure and intake. Nonlactating women, very thin women and women aged under 25 years gained more weight than their counterparts, both before and after the monsoon. Data for a sub-sample in 1982-83 indicated that women who maintained high physical activity levels throughout the year were less prone to weight loss than women whose activity fluctuated between seasons. Initial energy reserves, age-related maturation factors, levels of physical activity and energy intake combine to produce the notable inter-individual variation in body weight changes observed in this population.

Adolescent↗
PubMed1993

Seasonality of energy expenditure during pregnancy and lactation for rural Nepali women.

Total energy expenditure (TEE) was estimated for 19 nonpregnant, nonlactating (NPNL) and 24 pregnant (P) or lactating (L) women from 3601 h of minute-by-minute observation and 168 measurements of the energy cost of activities. NPNL women significantly increased subsistence activity and TEE from 9.9 MJ [1.89 x basal metabolic rate (BMR)] in the winter to 10.5 MJ (2.01 x BMR) in the monsoon season. There were differences between NPNL,P, and L women in the winter, but not in the spring or monsoon season when all individuals sustained very heavy physical activity. High TEE values resulted from spending very long hours in tasks that, although appearing physically demanding to the casual observer, were characterized by light or moderate energy cost. The study highlights the importance of seasonal constraints on women's work, which prevent P and L women from significantly curtailing physical activity during the monsoon season, and which effectively limit the scope of behavioral mechanisms for saving energy and reducing TEE.

Adolescent↗
PubMed1993

The ecological context of human ovarian function.

New methods for monitoring ovarian function have allowed an extension of research venue beyond typical clinical settings to studies of human populations in their natural settings. Such studies have confirmed that patterns of variation in ovarian function with age and energetic factors are general features of human reproductive biology. Age patterns of ovarian function are extremely robust across populations of distinct genetic, ecological and cultural backgrounds. Comparable ovarian responses to energetic stresses are likewise observable in different populations where they arise as correlates of local ecologies rather than as correlates of voluntary patterns of diet or exercise. Maternal age and energetic factors also appear to interact with lactation in the modulation of postpartum, ovarian function. Average levels of ovarian function, however, differ considerably between populations, perhaps correlated with chronic environmental conditions that affect growth, development, and the establishment of adult set-points. Western populations appear to represent an extreme of the spectrum of variation in ovarian function, a fact which may relate to the epidemiology of breast and ovarian cancer.

Aging↗
PubMed1993

Seasonality of reproductive function and weight loss in rural Nepali women.

Menstrual and hormonal disturbances have been reported in thin, dieting and exercising Western women, and also recently in rural African women. A study of salivary progesterone profiles was undertaken in a Nepali population to examine whether seasonal increases in workload and changes in energy balance influenced ovarian function. Women's energy expenditure levels were moderately heavy in the winter and very heavy in the monsoon, and body mass fluctuated by -2.8 to +4.8 kg. Samples were collected from 24 normally menstruating women in two seasons, each individual serving as her own control. Progesterone levels were significantly depressed in the monsoon relative to winter for women who lost weight, but not for women who gained weight, indicating that energy imbalance is associated with a loss of fecundity. No differences in body mass index were found between women who lost or gained weight. Progesterone levels were age-dependent, and the degree of hormonal disturbance between age-groups was related to weight loss. The study demonstrates seasonal changes in the fecundity of hard-working Nepali women and a direct link between ovarian function and weight loss (negative energy balance), which is independent of current nutritional status.

Adolescent↗
PubMed1992

The energy cost of common tasks in rural Nepal: levels of energy expenditure compatible with sustained physical activity.

Three hundred and six measurements of energy expenditure by indirect calorimetry of sitting at rest and self-paced activity were made on 41 men, 48 women and 6 adolescents in a mountain village of Nepal. Except for walking and carrying uphill, measured activities fell within the range of values for light to moderate effort, despite appearing physically demanding. Villagers tended to reduce travel speed when carrying heavy loads (54-102% of body mass on various inclines), averaging a moderate level of energy expenditure which could be sustained throughout the day. Such moderately demanding work was also assumed by pregnant, lactating women and young adolescents. Pregnant women worked more slowly at some tasks, but did not differentiate themselves from their non-pregnant, non-lactating counterparts for travel on the mountain side.

Adolescent↗
PubMed1992

Coping with an affected birth: genetic counseling in Saudi Arabia.

Saudi parents who have received genetic counseling following the birth of a child affected by a neurometabolic disorder were interviewed during their visits to a specialist hospital. As is common in the West, understanding of heredity was often incompletely assimilated, and this was related to parental education level. Coping behaviors, however, were substantially different from those in the West. The wide range of attitudes recorded toward consanguineous marriage and future births was a reflection of the position of Saudi families in a society undergoing rapid change.

Adaptation, Psychological↗
PubMed1991

Parental responses to consanguinity and genetic disease in Saudi Arabia.

In-depth interviews of 36 Saudi families whose children suffered from neuro-metabolic disorders were conducted at a specialist hospital in Riyadh in order to examine parental understanding of disease and attitudes towards future births and consanguineous marriages. Parents had difficulty accepting a genetic explanation for diseases that did not affect all children at the time of birth; they also expressed religious or folk beliefs to account for illness. Coping behaviours included denial and resignation to the situation, divorce and remarriage. Some families adopted a cautious approach to cousin marriages and future births; this was significantly related to their education level, but not to previous infant deaths. Awareness of medical facts brought little emotional comfort to parents but allowed for preventive measures through screening adult carriers and identifying affected infants. This study presents new material from Saudi Arabia to strengthen current awareness that the range of religious beliefs, social attitudes and reproductive behaviours adopted by families in a society undergoing rapid change is of direct relevance to health care.

Adaptation, Psychological↗
PubMed1991

Lactation, birth spacing and maternal work-loads among two castes in rural Nepal.

The nursing behaviour of rural Nepali women, from two castes inhabiting the same village, is quantified on the basis of 2202 hr of continuous and direct day-time observation over 1 year. Feed duration, interval, total time and daily frequency are examined in relation to women's work, particularly the type of subsistence activity and seasonality. 'Opportunity' feeds are governed both by infant demands and maternal activity. Caste differences in birth intervals are also discussed.

Adolescent↗
PubMedDate not supplied

Seasonal growth patterns in rural Nepali children.

This paper reports on the prevalence of growth retardation, the impact of seasonality on height and weight gains, and significant relationships between growth velocity, nutritional status and morbidity, for a population living at subsistence level in rural Nepal. Monthly variation in growth pattern was examined for 71 boys and girls 0-49 months of age. At the height of the monsoon season, 71% of children were moderately stunted, but none was wasted (mean -2.61 SD height-for-age and -0.91 SD weight-for-height by reference to NCHS z-score values). Measures of stunting deteriorated from moderate to severe after 1 year of age. No differences by sex or ethnicity were detected. Environmental changes from the winter to the monsoon seasons were reflected in significant losses of weight and lower weight-for-height z-scores, especially for 0-35 month-olds, although height for 12-35-month-olds continued to be gained over this period. Growth velocity was significantly related to previous growth status (thinner and shorter children did not show catch-up in height or weight) and to morbidity reported over the period of observation. The prevalence of illnesses rose six-fold from the winter to the monsoon, and children with a high frequency of illnesses experienced a significant shortfall in weight and height increments. A poor diet and recurrent illnesses explain the slow and uneven growth of these children. Despite an increase in women's agricultural workloads in the monsoon season, childcare patterns per se do not seem to adversely affect small children. Small stature through later childhood and in adults is one consequence of the growth pattern seen at these young ages.

Child Nutrition Disorders↗