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Book Review |
National Center for Health Statistics, Centers for Disease Control and Prevention, 6525 Belcrest Road, Room 900, Hyattsville, MD 20782, E-mail: kflegal{at}cdc.gov
This book emphasizes public health aspects of the nutritional and epidemiologic transitions occurring in Latin America and the Caribbean, particularly among the poor in these countries. The volume includes 12 brief chapters by authors from Latin America, the Caribbean, and North America, grouped into 4 sections. A Spanish-language version is also available from the publisher.
A strength of the book is that many of the chapters focus on demographic and social aspects of health, development, and obesity in Latin America and the Caribbean. The changes in health and disease that take place during a time of economic and social transition are complex and multifactorial. In developing countries, higher body weights tend to be associated with wealth and high social standing; in developed countries, higher body weights tend to be associated with poverty and low social standing. In transition from one pattern to the other, the poor may suffer disproportionately from malnutrition and noncommunicable chronic diseases, such as diabetes and hypertension, associated with overnutrition. Social inequities contribute to and exacerbate these inequalities in health.
In the first section—Obesity and its Economic, Sociocultural and Environmental Determinants—the editors Peña and Bacallao provide an overview of the developing situation in Latin America and the Caribbean, where malnutrition and overnutrition may coexist even within the same family. The editors suggest that there are different types of obesity. Two particularly interesting contributions are the chapter by Aguirre on the socioanthropologic aspects of obesity in poverty in Argentina and the chapter by Torun on physical activity patterns in Central America, which contrasts the lives of rural peasants with those of poor urban dwellers.
In the second section, case studies in Chile, Cuba, and Brazil provide additional insights about obesity in these countries. Bacallao presents a typologic analysis of countries in Latin America and the Caribbean, dividing them into 3 clusters. Amador discusses obesity in adolescence, drawing on data from Cuba.
Other chapters are less specific to the region and provide more general discussions. Schroeder and Martorell discuss the possible effects of fetal malnutrition on adult chronic disease and the relevance of the "Barker hypothesis" in Latin America. Stunkard presents a brief overview of factors leading to obesity; Williamson analyzes issues related to public health surveillance, and Himes discusses factors affecting the choice of anthropometric indicators used to determine obesity.
This book would be of interest to 3 main categories of readers: those with a primary interest in health in Latin America and the Caribbean, those with an interest in the epidemiologic transition in the developing world, and those with an interest in obesity as a sociodemographic phenomenon.
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