The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index; none of the 13 sources its claims cite is checked for support yet.
Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S.
Open accessAbstract
OBJECTIVE—Type 2 diabetes and obesity have genetic and environmental determinants. We studied the effects of different environments on these diseases in Pima Indians in Mexico and the U.S. RESEARCH DESIGN AND METHODS—Adult Pima-Indian and non-Pima populations in the Sierra Madre mountains of Mexico were examined using oral glucose tolerance tests and assessments for obesity, physical activity, and other risk factors. Results were compared with those from Pima Indians in Arizona. Both Pima populations were typed for DNA polymorphisms to establish their genetic similarity. RESULTS—The age- and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%). The prevalence of obesity was similar in the Mexican Pima Indians (7% in men and 20% in women) and non-Pima Mexicans (9% in men and 27% in women) but was much lower than in the U.S. Pima Indians. Levels of physical activity were much higher in both Mexican groups than in the U.S. Pima Indians. The two Pima groups share considerable genetic similarity relative to other Native Americans. CONCLUSIONS—The much lower prevalence of type 2 diabetes and obesity in the Pima Indians in Mexico than in the U.S. indicates that even in populations genetically prone to these conditions, their development is determined mostly by environmental circumstances, thereby suggesting that type 2 diabetes is largely preventable. This study provides compelling evidence that changes in lifestyle associated with Westernization play a major role in the global epidemic of type 2 diabetes.
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Written from the paper’s full text.
TL;DR
Pima Indians in a traditional Mexican environment had much lower type 2 diabetes and obesity prevalence than genetically similar Pima Indians in the U.S., despite sharing a similar gene pool. The findings suggest that environmental/lifestyle factors associated with Westernization largely determine whether genetically susceptible populations develop type 2 diabetes.
Key findings
- Age- and sex-adjusted type 2 diabetes prevalence was 6.9% in Mexican Pima Indians, 38% in U.S. Pima Indians, and 2.6% in non-Pima Mexicans; the U.S. Pima prevalence was 5.5 times higher than Mexican Pima and 16 times higher than non-Pima Mexicans (P < 0.01).
- Obesity was similar in Mexican Pima Indians (7% men, 20% women) and non-Pima Mexicans (9% men, 27% women) but much higher in U.S. Pima Indians (63.8% men, 74.8% women).
- Physical activity was much higher in both Mexican groups than in U.S. Pima Indians: moderate-to-heavy activity was ~2.5-fold higher in Mexican men and 7-fold higher in Mexican women than in their U.S. Pima counterparts.
- The two Pima groups clustered together genetically relative to other Native Americans, with a bootstrap support value of 95% (947 of 1,000), indicating a very similar gene pool.
Methods
- Cross-sectional study of adult Pima and non-Pima Mexicans in the Sierra Madre mountains of Mexico, examined with oral glucose tolerance tests, anthropometry, physical activity questionnaires, and 24-h dietary recalls; results were compared with U.S. Pima Indians from the Gila River Indian Community in Arizona examined during June 1995–June 1996.
- Diabetes and impaired glucose tolerance were defined by 1999 WHO criteria; obesity was defined as BMI ≥30 kg/m², with body fat estimated by bioelectrical impedance.
- Genetic similarity was assessed by typing 309 independent DNA markers in 52 unrelated full Pima Indians from Mexico and 52 full Pima Indians from the U.S.; prevalence rates were directly standardized for age and sex.
Limitations
- The paper states that cause and effect cannot be proven from this cross-sectional study, although it proposes that low diabetes prevalence in the Mexican populations is largely due to lesser obesity.
- The paper states that a difference between the Pima populations in frequencies of unidentified diabetes susceptibility genes due to genetic drift or founder effects cannot be excluded.
- The paper notes that dietary intake was not evaluated in the U.S. Pima sample used for comparison; an earlier U.S. Pima dietary study was cited instead. Evident from the text: participation was 77% of eligible Mexican Pima Indians and 71% of non-Pima Mexicans, and the diabetes difference between Mexican Pima and non-Pima Mexicans was not statistically significant.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The age-and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The age-and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The age-and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The two Pima groups share considerable genetic similarity relative to other Native Americans.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Levels of physical activity were much higher in both Mexican groups than in the U.S. Pima Indians.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The age-and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The age-and sex-adjusted prevalence of type 2 diabetes in the Mexican Pima Indians (6.9%) was less than one-fifth that in the U.S. Pima Indians (38%) and similar to that of non-Pima Mexicans (2.6%).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Total energy expenditure is higher in Mexican Pima Indians than in U.S. Pima Indians.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
What the sources say
- Not checked yetcites [10] Esparza J, Fox C, Harper IT, Bennett PH, Schulz LO, Valencia ME, Ravussin E: Daily energy expenditure in Mexican and USA Pima Indians: low physical activity as a possible cause of obesity. Int J Obes Relat Metab Disord 24:55–59, 2000 source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This study provides compelling evidence that changes in lifestyle associated with Westernization play a major role in the global epidemic of type 2 diabetes.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The much lower prevalence of type 2 diabetes and obesity in the Pima Indians in Mexico than in the U.S. indicates that even in populations genetically prone to these conditions, their development is determined mostly by environmental circumstances, thereby suggesting that type 2 diabetes is largely preventable.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
- Rests on an assumption: The cross-sectional prevalence differences reflect lifetime risk of diabetes.
- It may state two separate claims as one. 9
- Probably not a substantial claim. 6
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The two Pima groups are not identical but cluster together and share common ancestry distinct from other Native Americans with a supporting bootstrap value of 95% (947 of 1,000).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“BMI, waist and hip circumference, and percent body fat were similar in the Pima and non-Pima Mexican men and women, respectively, but markedly greater in the U.S. Pima group.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Obesity
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The prevalence of obesity was similar in the Mexican Pima Indians (7% in men and 20% in women) and non-Pima Mexicans (9% in men and 27% in women) but was much lower than in the U.S. Pima Indians.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The levels of moderate to heavy physical activity were ϳ2.5-fold higher in the Mexican men and 7-fold higher in the Mexican women than in their U.S. Pima-Indian counterparts.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Physical activity
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
None of the sources cited for this claim have been checked yet.
In the paper
“Obesity and physical inactivity are major behavioral risk factors for the disease (22,23), although other factors such as low birth weight, breast-feeding, and the intrauterine environment also play a role (24 -26).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
What the sources say
- Not checked yetcites [22] Knowler WC, Pettitt DJ, Savage PJ, Bennett PH: Diabetes incidence in Pima Indians: contributions of obesity and parental diabetes. Am J Epidemiol 113:144–156, 1981 source
- Not checked yetcites [23] Kriska AM, Saremi A, Hanson RL, Bennett PH, Kobes S, Williams DE, Knowler WC: Physical activity, obesity, and the incidence of type 2 diabetes in a high-risk population. Am J Epidemiol 158:669–675, 2003 source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“All subjects were administered an activity questionnaire (13).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > T
What the sources say
- Not checked yetcites [13] Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH: Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 13:401–411, 1990 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nonetheless, a difference between these Pima populations in frequencies of as yet unidentified diabetes susceptibility genes resulting from genetic drift or founder effects cannot be excluded.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Percent body fat was estimated from bioelectrical impedance (BIA-103; RJL Systems) using an equation developed for the U.S. Pima Indians (12).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > T
What the sources say
- Not checked yetcites [12] Rising R, Swinburn B, Larson K, Ravussin E: Body composition in Pima Indians: validation of bioelectrical resistance. Am J Clin Nutr 53:594–598, 1991 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Complete glucose tolerance data were obtained for 77.2% of the eligible Mexican Pima Indians and for 71.5% of the non-Pima Mexicans.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Prevalence of diabetes
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Pima Indians in the U.S. reside mainly in the desert regions of Arizona and have the world's highest recorded prevalence and incidence of type 2 diabetes (5,6).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > T
What the sources say
- Not checked yetcites [5] Bennett PH, Burch TA, Miller M: Diabetes mellitus in American (Pima) Indians. Lancet 2:125–128, 1971 source
- Not checked yetcites [6] Knowler WC, Pettitt DJ, Saad MF, Bennett PH: Diabetes mellitus in the Pima Indians: incidence, risk factors and pathogenesis. Diabetes Metab Rev 6:1–27, 1990 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings indicate that, even in a genetically highly susceptible population, type 2 diabetes is not inevitable and is preventable in environments that promote low levels of obesity and high levels of physical activity.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
- Rests on an assumption: The cross-sectional prevalence differences reflect lifetime risk of diabetes.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on these data, the U.S. Pima and the Mexican Pima Indians are closely related to each other and share a very similar gene pool.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Relationship between Mexican Pima and U.S. Pima Indians
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Directly standardized age-and age-and sex-adjusted prevalence rates of diabetes were compared among the populations, using the combined Mexican Pima and non-Pima samples (within the age and sex groups shown in Table 1) as the reference population.”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > Statistical analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Diabetes and impaired glucose tolerance were defined using 1999 World Health Organization criteria (11).”
§ Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S > T
What the sources say
- Not checked yetcites [11] World Health Organization Consultation-Group: Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications. Part 1. Diagnosis and Classification of Diabetes Mellitus. Geneva, World Health Org., 1999, p. 59
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
The paper relies on this without support.
The U.S. Pima-Indian sample used for comparison is typical of the larger Pima population examined in the ongoing longitudinal study.
“The data in the U.S. Pima-Indian sample used for comparison are typical of those seen in the larger Pima population examined in the ongoing longitudinal study.”
The paper relies on this without support.
The 24-h dietary recall accurately represents the usual diet of the Mexican populations.
“A 24-h dietary recall was conducted in the Mexican populations.”
The paper relies on this without support.
The non-Pima Mexicans have no parental Amerindian heritage.
“The non-Pima Mexicans reported no parental Amerindian heritage.”
The paper relies on this without support.
The Pima heritage classification accurately identifies full and part Pima individuals.
“Subjects were considered full Pima if they reported that both their parents were full Pima and part Pima if one parent was Pima.”
The paper relies on this without support.
The cross-sectional prevalence differences reflect lifetime risk of diabetes.
“The much lower prevalence of diabetes in the Mexican Pima Indians aged Ն55 years (9%) compared with that in the U.S. Pima Indians (77%) suggests that the lifestyle of the Mexican Pima Indians may result in life-long protection from type 2 diabetes, even among the majority of those who are genetically susceptible.”
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“large disparities in both the prevalence of established risk factors and the rates of cardiovascular events in genetically similar populations both over time and across regions confirm that genetic effects are subordinate to lifestyle and environmental influences.50 -52,57-59”
From Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease (2008) · cites this paper as [52]
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Metadata
- Authors
- Schulz, L. O., Bennett, P. H., Ravussin, E., Kidd, J. R., Kidd, K. K., Esparza, J., & Valencia, M. E.
- Affiliations
- University of Wisconsin–Milwaukee (US)
- National Institutes of Health (US)
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Yale University (US)
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
- Centro de Investigacion en Alimentación y Desarrollo A.C., Hermosillo, Mexico
- Centro de Investigación en Alimentación y Desarrollo (MX)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-08-01
- Volume
- 29
- Issue
- 8
- Pages
- 1866-1871
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2098164111
- Semantic Scholar
- f27562df093bb1339566f61b0f3a457411b4880f
- Cited by
- 420
- References
- 28
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 22 · 2023: 21 · 2022: 20 · 2021: 15 · 2020: 29 · 2019: 17 · 2018: 11 · 2017: 19 · 2016: 16 · 2015: 16 · 2014: 24 · 2013: 31 · 2012: 21
- FWCI
- 41.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of General Medical Sciences (GM 57672, P01GM057672)
- National Institute of Diabetes and Digestive and Kidney Diseases (76-DK-0256, DK-49957)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Indigenous Health and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- type 2 diabetes, Pima Indians, diabetes prevalence, obesity, physical activity, Westernization, lifestyle modification, genetic susceptibility, Sierra Madre, diabetes prevention, Native Americans, DNA polymorphism
- MeSH terms
- Adult, Culture, Diabetes Mellitus, Type 2, Diet, Female, Humans, Indians, North American, Male, Mexico, Middle Aged, Motor Activity, Obesity, Sex Characteristics, United States, Age Distribution
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