Frameworks of population obesity and the use of cultural consensus modeling in the study of environments contributing to obesity
Introduction
Across the past 60 years or so, social, economic and technological changes have altered patterns of life almost everywhere on earth. In tandem, changes in diet and physical activity patterns have been central to the emergence of obesity among many of the world's populations (Ulijaszek and Lofink, 2006). Two trends are locked together in the production of population obesity. The first is the demographic transition, towards low fertility, low mortality and high life expectancy, while the second is the epidemiologic transition towards high prevalence of chronic and degenerative diseases associated with urban-industrial life styles. The timing of these trends in Eastern Europe was in most cases late relative to most Western European populations, but well in advance of most developing countries.
In Eastern Europe, obesity rates (as determined by body mass index (BMI) above 30 kg/m2) among adult females are much higher than males in Romania, Russia, Bulgaria and Latvia, rates being similar for both sexes in the Czech Republic, Hungary, Poland, Slovakia, Lithuania and Estonia (Fig. 1). When compared with Western Europe, obesity rates among adult females in Eastern European nations are in the top half of obesity rates for Western European women, while rates for adult males are within the range of all values for Western European nations. Where it has been related to ecological factors, obesity has been linked to privilege and status prior to the collapse of communism, and to exposure to free-market economics after it. Neither formulation is adequate, since neither of them explain the large gender differences in obesity rates in a number of Eastern European nations, nor the social status-related inversions in obesity rates known to have taken place prior to the collapse of communism in Poland (Bielicki et al., 2001), for example. It is therefore useful to examine the potential value of more dominant models of population obesity for the understanding of this phenomenon in Eastern Europe. These include those of (1) thrifty genotypes; (2) obesogenic behaviour; (3) obesogenic environments; (4) nutrition transition; and (5) obesogenic culture. In this article, these models of population obesity are described briefly, and the value of each for the understanding of obesity in Eastern European nations discussed. Any explanation of population obesity is likely to involve at least two of these frameworks, and a sixth framework, of biocultural interactions of genetics, environment, behaviour and culture, is also described.
At the broadest level, obesity emerges from the interaction of thrifty genotype (Neel, 1962) with obesogenic environment (Swinburn et al., 1999). However, defining obesogenic environments remains problematic (van der Horst et al., 2006). Since different identity groups may share different values concerning the obesogenicity of the environment, a priori assumptions about group homogeneity may lead to flawed interpretations of the importance of sociocultural factors in obesogenic environments. A way to identify cultural coherence in relation to obesogenic environments is put forward here, that of cultural consensus modeling, and ways in which it might be applied in Eastern European nations are discussed.
Section snippets
Models of population obesity
Increasing rates of obesity across the world have been broadly attributed to environments which are obesogenic (French et al., 2001, Brownell, 2002, Hill et al., 2003), against an evolutionary heritage which is maladaptive in these new contexts (Neel, 1962, Eaton et al., 1998, Neel et al., 1998, Lev-Ran, 2001). Physiologically, obesity can only develop if food consumption is high and/or energy expenditure is low, resulting in positive energy balance across months or years. However, there are
Cultural consensus modeling and environments contributing to obesity
Cultural consensus modeling was elaborated in the 1980s following the emergence of cognitive anthropology (Romney et al., 1986), and has been effective in anthropological analyses of beliefs about disease contagiousness (Romney, 1999, Romney et al., 1986), cultural drivers of ecosystemic degradation (Atran et al., 2005), ethnobotanical knowledge (Reyes-Garcia et al., 2003), and healthcare in clinical settings (Smith et al., 2004). In this framework, cultures are not regarded as material
Discussion
This article summarises six models of population obesity, which show a range of structures available for the study of obesity in Eastern European nations. Some attention has been paid to the use of nutrition transition models in Eastern Europe, but the use of obesogenic environment, behaviour and culture frameworks for the understanding of environmental predispositions to obesity remains limited there. Genotyping for obesity also remains at an early stage. Key features of the sociocultural
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