Canibais e Reis

Vídeo: Papua New Guinea.

Whole Health Source:

The Kitavans: Wisdom from the Pacific Islands
Cardiovascular Risk Factors on Kitava, Part I: Weight and Blood Pressure
Cardiovascular Risk Factors on Kitava, Part II: Blood Lipids
Cardiovascular Risk Factors on Kitava, Part III: Insulin
Cardiovascular Risk Factors on Kitava, Part IV: Leptin
Kitava: Wrapping it Up
 

Ligações relacionadas:

Staffan Lindeberg - Paleolithic Diet in Medical Nutrition
Staffan Lindeberg - The Kitava Study
On the benefits of ancient diets (Staffan Lindeberg)
Pubmed - Kitava Study - all articles (Staffan Lindeberg)
Trobriand Islands (Wikipedia)
Living on the isolated island of Kitava (Petro Dobromylskyj)

Publicações:

Serum uric acid in traditional Pacific Islanders and in Swedes (pdf)
Lindeberg S, Cordain L, Råstam L, Ahrén B.
Department of Medicine, Lund University, Lund, Sweden. staffan.lindberg@med.lu.se

BACKGROUND: In some western populations, increased serum uric acid has been positively associated with cardiovascular disease, possibly because hyperuricaemia could be an untoward part of the insulin-resistant metabolic syndrome. However, there is evidence that uric acid is a free radical scavenger capable of inhibiting LDL oxidation. Amongst the traditional horticulturalists of Kitava, Trobriand Islands, Papua New Guinea, cardiovascular disease, hypertension, hyperinsulinaemia and abdominal obesity are absent or rare. In contrast, serum triglycerides are similar to Swedish levels. OBJECTIVE: To compare serum uric acid between nonwesternized and westernized populations. METHODS: Fasting levels of serum uric acid were measured cross-sectionally in 171 Kitavans aged 20-86 years and in 244 randomly selected Swedish subjects aged 20-80 years. RESULTS: There were small differences in serum uric acid between the two populations, although a slight increase with age was found only in Swedish males (r = 0.20; P = 0.03) and females (r = 0.36; P < 0.0001). Above 40 years of age, uric acid was approximately 10% lower in Kitavans, a difference which was statistically significant only in males, possibly because of the limited number of females. Regarding hyperuricaemia, two Kitavan males had uric acid above 450 micromol L-1 whilst none of the females was above 340 micromol L-1. Amongst the Swedish subjects, five of 117 males and 19 of 127 females had hyperuricaemia according to these definitions. CONCLUSION: The rather similar uric acid levels between Kitava and Sweden imply that uric acid is of minor importance to explain the apparent absence of cardiovascular disease in Kitava.

 

Determinants of serum triglycerides and high-density lipoprotein cholesterol in traditional Trobriand Islanders: the Kitava Study (pdf)
Lindeberg S, Ahrén B, Nilsson A, Cordain L, Nilsson-Ehle P, Vessby B.
Department of Medicine, Lund University, Sweden. staffan.lindeberg@med.lu.se

OBJECTIVES: To analyse variables explaining the variation between serum triglycerides (TGs) and high density lipoprotein cholesterol (HDL-C) in a non-western population characterized by unfavourable TG and HDL-C levels despite marked leanness, low blood pressure and low fasting serum insulin. The study subjects included yraditional Pacific Islanders from Kitava, Trobriand Islands, Papua New Guinea and a population in Sweden. METHODS: The study was designed as a cross-sectional survey. Fasting serum lipoproteins and apolipoproteins, insulin, blood pressure and anthropometric measurements were analysed in 122 male and 47 female Kitavans aged 20-86 years and in a control population of 729 healthy men and women aged 20-66 from Uppsala. Main outcome measures were determinants of TG and HDL-C using a simple and multiple linear regression analysis. RESULTS: A negative association was found between TGs and HDL-C in Kitava (r = -0.38. p < 0.0001) and Sweden (r = -0.46, p < 0.0001), while TGs were positively associated with non-HDL-C and ApoB in both groups. In contrast to what was found in the Swedish subjects, TG and HDL-C levels were not associated with body mass index, waist circumference, glucose, insulin or systolic blood pressure in the Kitavans. CONCLUSION: Despite an apparent absence of cardiovascular disease and the metabolic syndrome in the Kitavans, the relationship between TGs and HDL-C was similar to that observed in Caucasians, while neither of the variables was associated with markers of insulin sensitivity in the Kitavans. Whether the findings can be explained by normal physiology or partially reflect the high intake of carbohydrates and saturated fat in Kitava is uncertain.

 

Large differences in serum leptin levels between nonwesternized and westernized populations: the Kitava study (pdf)
Lindeberg S, Söderberg S, Ahrén B, Olsson T.
Department of Community Medicine, Lund University, Malmö, Sweden. staffan.lindeberg@smi.mas.lu.se

OBJECTIVES: To compare serum leptin between nonwesternized and westernized populations. SETTING: (i) The tropical island of Kitava, Trobriand Islands, Papua New Guinea and (ii) the Northern Sweden MONICA study population. Design. Cross-sectional survey. METHODS: Fasting levels of serum leptin were analysed in 163 randomly selected Kitavans aged 20-86 years and in 224 Swedes aged 25-74. MAIN OUTCOME MEASURE: Mean and determinants of serum leptin. RESULTS: Geometric mean of serum leptin in Kitavan males and females were 1.5 and 4.0 vs. 4.9 and 13.8 ng mL-1 in Swedish male and females (P < 0.0001 for both sexes). In Kitavans, observed geometric mean were close to predicted levels (1.8 ng mL(-1) for males and 4.5 ng mL-1 for females) based on multiple linear regression equations including body mass index (BMI), triceps skinfolds (TSF) and age from the Swedish population-based sample. In Kitavans serum leptin was positively related to TSF amongst both sexes and, amongst females, to BMI. In Kitavans leptin was not related to fasting serum insulin. TSF explained 55% of the variation of leptin amongst females. There was a slight age-related increase of leptin amongst males. In Kitava leptin was not related to fasting serum insulin which was substantially lower than in Sweden. CONCLUSION: The low concentrations of serum leptin amongst Kitavans probably relates to the absence of overweight and hyperinsulinaemia. At a population level serum leptin can apparently be predicted from simple measures of adiposity.

 

Low serum insulin in traditional Pacific Islanders--the Kitava Study (pdf)
Lindeberg S, Eliasson M, Lindahl B, Ahrén B.
Department of Community Medicine, Lund University, Malmö, Sweden.

Increased serum insulin is related to abdominal obesity and high blood pressure in affluent societies where insulin, weight, and blood pressure typically increase with age. The increased insulin level has been thought to reflect insulin resistance, a well-known associated factor in the metabolic syndrome. In most nonwesternized populations, body weight and blood pressure do not increase with age and abdominal obesity is absent. However, it is not known whether serum insulin likewise does not increase with age in nonwesternized societies. Fasting levels of serum insulin were measured cross-sectionally in 164 subsistence horticulturalists aged 20 to 86 years in the tropical island of Kitava, Trobriand Islands, Papua New Guinea, and in 472 randomly selected Swedish controls aged 25 to 74 years from the Northern Sweden WHO Monitoring Trends and Determinants in Cardiovascular Diseases (MONICA) Study. In Kitava, the intake of Western food is negligible and stroke and ischemic heart disease are absent or rare. The body mass index (BMI) and diastolic blood pressure are low in Kitavans. The main outcome measures in this study were the means, distributions, and age relations of serum insulin in males and females of the two populations. Serum fasting insulin levels were lower in Kitava than in Sweden for all ages (P < .001). For example, the mean insulin concentration in 50- to 74-year-old Kitavans was only 50% of that in Swedish subjects. Furthermore, serum insulin decreased with age in Kitava, while it increased in Sweden in subjects over 50 years of age. Moreover, the age, BMI, and, in females, waist circumference predicted Kitavan insulin levels at age 50 to 74 years remarkably well when applied to multiple linear regression equations defined to predict the levels in Sweden. The low serum insulin that decreases with age in Kitavans adds to the evidence that a Western lifestyle is a primary cause of insulin resistance. Low serum insulin may partly explain the low prevalence of cardiovascular disease in Kitavans and probably relates to their marked leanness.

 

Age relations of cardiovascular risk factors in a traditional Melanesian society: the Kitava Study (pdf)
Lindeberg S, Berntorp E, Nilsson-Ehle P, Terént A, Vessby B.
Department of Community Health Sciences, Lund University, Sweden. staffan.lindeberg@dalby.lu.se

This study examined cross-sectional age relations of blood pressure, anthropometric indexes, serum lipids, and hemostatic variables in 203 subsistence horticulturists aged 20-86 y in Kitava, Trobriand Islands, Papua New Guinea. The population is characterized by extreme leanness (despite food abundance), low blood pressure, low plasma plasminogen activator inhibitor 1 activity, and rarity of cardiovascular disease. Tubers, fruit, fish, and coconut are dietary staples whereas dairy products, refined fat and sugar, cereals, and alcohol are absent and salt intake is low. Although diastolic blood pressure was not associated with age in Kitavans, systolic blood pressure increased linearly after 50 y of age in both sexes. Body mass index decreased with age in both sexes. Serum total cholesterol, triacylglycerol, low-density-lipoprotein cholesterol, and apolipoprotein B increased in males between 20 and 50 y of age, whereas high-density-lipoprotein cholesterol and apolipoprotein A-I decreased. There were no significant differences in these indexes with age in the few females studied. A slight linear age-related increase of lipoprotein(a) was present in males. Plasma fibrinogen, factor VII clotting activity, factor VIII clotting activity, and von Willebrand factor antigen increased with age in both sexes but plasminogen activator inhibitor 1 activity did not. The modest or absent relations between the indexes measured and age are apparently important explanations of the virtual nonexistence of stroke and ischemic heart disease in Kitava.

 

Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease: the Kitava study (pdf)
Lindeberg S, Nilsson-Ehle P, Terént A, Vessby B, Scherstén B.
Department of Community Health Sciences, Lund University, Sweden.

OBJECTIVES. To compare cardiovascular risk factor levels between non-westernized Melanesians, apparently free from stroke and ischaemic heart disease, nd healthy Swedish populations, and to analyse, among adult Melanesians, relations with age, sex and smoking status. DESIGN. Cross-sectional survey. SUBJECTS. (i) Traditional horticulturalists in Kitava, Trobriand Islands, Papua New Guinea, uninfluenced by western diet. this study tested 151 males and 69 females aged 14-87 years with 76% and 80% smokers over 20 years. (ii) Healthy Swedish reference populations. MAIN OUTCOME MEASURES. Sitting systolic and diastolic blood pressure, weight, height, body mass index, circumferences of waist, pelvis and mid upper arm, triceps skinfold thickness, fasting serum total cholesterol, triglycerides, high-density lipoprotein cholesterol, estimated low-density lipoprotein cholesterol, apolipoprotein B, apolipoprotein A1 and apolipoprotein (a). RESULTS. Compared to Sweden, diastolic blood pressure, body mass index and triceps skinfold thickness were substantially lower in Kitava, where all subjects > or = 40 years were below Swedish medians. Among males > or = 20 and females > or = 60 years systolic blood pressure was lower in Kitavans. Fasting serum total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B were 10-30% lower in Kitavan males > or = 40 and females > or = 60 years. Triglycerides were higher in Kitavans aged 20-39. High-density lipoprotein cholesterol did not differ while apolipoprotein A1 was lower in Kitavans. Apolipoprotein (a) tended to be lower in Kitavans, but the differences were small. CONCLUSIONS. Of the analysed variables, leanness and low diastolic blood pressure seem to offer the best explanations for the apparent absence of stroke and ischaemic heart disease in Kitava. The lower serum cholesterol may provide some additional benefit. Differences in dietary habits may explain the findings.