Effects of a Traditional Lifestyle on Obesity in Pima Indians
Abstract
OBJECTIVE: The Pima Indians of Arizona have the highest reported prevalences of obesity and non-insulin-dependent diabetes mellitus (NIDDM). In parallel with abrupt changes in lifestyle, these prevalences in Arizona Pimas have increased to epidemic proportions during the past decades. To assess the possible impact of the environment on the prevalences of obesity and NIDDM, data were collected on members of a population of Pima ancestry (separation 700–1,000 years ago) living in a remote mountainous location in northwestern Mexico, with a lifestyle contrasting markedly with that in Arizona. RESEARCH DESIGN AND METHODS: Pima heritage was established by history and by use of Pima language. Measurements of weight, height, body fat (bio-impedance), blood pressure, plasma levels of glucose, cholesterol, and HbA1c were obtained in 19 women (36 ±13 years of age) and 16 men (48 ±14 years of age) and compared with sex-, age- and diabetes status-matched Pimas living in Arizona (10 Arizona Pimas for each Mexican Pima). RESULTS: Mexican Pimas were lighter (64.2 ± 13.9 vs. 90.2 ± 21.1 kg, P < 0.0001; means ± SD) and shorter (160 ± 8 vs. 164 ± 8 cm, P < 0.01) with lower body mass indexes (24.9 ± 4.0 vs. 33.4 ± 7.5 kg/m2, P < 0.0001) and lower plasma total cholesterol levels (146 ± 30 vs. 174 ± 31 mg/dl, P < 0.0001) than Arizona Pimas. Only two women (11%) and one man (6%) had NIDDM, contrasting with the expected prevalences of 37 and 54% in female and male Arizona Pimas, respectively. CONCLUSIONS: This preliminary investigation shows that obesity, and perhaps NIDDM, is less prevalent among people of Pima heritage living a “traditional” lifestyle than among Pimas living in an “affluent” environment. These findings suggest that, despite a similar potential genetic predisposition to these conditions, a traditional lifestyle, characterized by a diet including less animal fat and more complex carbohydrates and by greater energy expenditure in physical labor, may protect against the development of cardiovascular disease risk factors, obesity, and NIDDM.
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Mexican Pima Indians have experienced relatively little recent change in environmental conditions.
“In contrast with the U.S. Pima Indians, they have experienced relatively little recent change in environmental conditions (9,10).”
From Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S. (2006) · cites this paper as [9]
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Shmulewitz, D., Auerbach, S. B., Lehner, T., Blundell, M. L., Winick, J. D., Youngman, L. D., Skilling, V. A., Heath, S. C., Ott, J., Stoffel, M., et al. (2000) · Human Heredity · doi:10.1159/000022953 · Cited by 80 · see citing works
“These changes resulted in a dramatically increased prevalence of obesity, an outcome similar to that of many other indigenous populations, such as the Pima Indians of Arizona and the Nauruans [”
ResultObesity among Latinx people in the United States: A review
Alemán, J. O., Almandoz, J. P., Frías, J. P., & Galindo, R. J. (2023) · Obesity · doi:10.1002/oby.23638 · Cited by 78 · see citing works
“remote location in Mexico (living a more traditional lifestyle) [22].”
BackgroundGene-Diet Interactions on Body Weight Changes
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Obesity: lessons from evolution and the environment
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“However, only 13% of the Pima Indians who live in the restrictive environment of the remote Mexican Sierra Madre Mountains are obese (3).”
BackgroundShmulewitz, D., Heath, S. C., Blundell, M. L., et al. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0510156103 · Cited by 77 · see citing works
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High-Risk Populations: The Pimas of Arizona and Mexico
Schulz, L. O., & Chaudhari, L. S. (2015) · Current Obesity Reports · doi:10.1007/s13679-014-0132-9 · Cited by 71 · see citing works
“Only two women (11 %) and one man (6 %) had type 2 diabetes, contrasting with the expected prevalence of 37 % and 54 % in female and male Arizona Pimas, respectively [19].”
InfluentialSelf-citationProcter, K. L., Clarke, G., Ransley, J. K., & Cade, J. E. (2008) · Area · doi:10.1111/j.1475-4762.2008.00822.x · Cited by 68 · see citing works
Type 2 Diabetes in Children and Adolescents
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Introductory comments for the consensus on physical activity and obesity
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“Given the potential impact of genetic [18-20] and lifestyle [21, 22] factors on telomeric aging and obesity pathologies, confirmation of previous findings in other ethnic groups with a wide range of age distribution in community-based populations is clearly required.”
BackgroundDiabetes in North America and The Caribbean: An update
Yisahak, S. F., Beagley, J., Hambleton, I. R., & Narayan, K. M. V. (2013) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2013.11.009 · Cited by 65 · see citing works
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“These differences have been related to unfavorable trends in factors such as overweight and sedentary habits, as demonstrated in longitudinal, ecological and migration studies [4-6] and to interactions between environmental and genetic factors when individuals become exposed to an obesogenic environment [4,7].”
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“Several studies clearly showed a positive association between these variables (Ravussin et al. 1994; Astrup et al. 2000), whereas a number of population-based surveys did not (Dreon et al. 1988; Gutiérrez-Fisac et al. 2000).”
BackgroundFagot‐Campagna, A., Burrows, N. R., & Williamson, D. F. (1999) · Clinica Chimica Acta · doi:10.1016/s0009-8981(99)00095-9 · Cited by 62 · see citing works
- Authors
- Ravussin, E., Valencia, M. E., Esparza, J., Bennett, P. H., & Schulz, L. O.
- Affiliations
- Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Phoenix, Arizona
- Centro de Investigación en Alimentación y Desarrollo (MX)
- Nutrition Division Centro de Investigacion en Alimentacion y Desarrollo Sonora, Mexico
- National Institutes of Health (US)
- University of Wisconsin–Milwaukee (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1994-09-01
- Volume
- 17
- Issue
- 9
- Pages
- 1067-1074
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2069685883
- Cited by
- 376
- References
- 0
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 15 · 2015: 11 · 2014: 10 · 2013: 19 · 2012: 18
- FWCI
- 20.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Indigenous Health and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- Pima Indians, obesity, type 2 diabetes, traditional way of life, lifestyle modification, body mass index, serum cholesterol, HbA1c, physical activity, energy expenditure, cardiovascular risk factors, genetic susceptibility, diet and obesity, blood pressure, glucose concentration
- MeSH terms
- Adolescent, Adult, Aged, Arizona, Blood Glucose, Body Composition, Cholesterol, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diet, Female, Glycated Hemoglobin, Humans, Indians, North American, Life Style, Male, Mexico, Middle Aged, Obesity, Exercise, Causality, Prevalence, Diabetes Complications
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