AnthroNotes Volume 30 No. 1 Spring 2009
THE ANTHROPOLOGY OF OVERWEIGHT, OBESITYAND THE BODY
by PeterJ. Brown andJennifer Sweeney
Throughout most ofhuman history, obesity was nota common health problem. It was not even arealistic possibility for most people. Today,particularly in affluent societies, obesity is common andhas increased dramatically in recent years.For example, among American adults obesityincreased 6 1% from 1 99 1 to 2000. Most recent estimatesclassify 63% of the adult US population as overweightand 29% as obese. Internationally, over 300 million adultsare obese and 700 million are considered overweight(Nishida and Mucavele 2005).Because obesity and overweight involve the inter-action ofgenetic traits with culturally patterned behaviorsand beliefs, the causes of obesity can best be understoodin the context of human cultural and genetic evolution.Behaviors that were adaptive in the context of past foodscarcities may be maladaptive today in the context of af-fluence and food surpluses.Genetic and cultural traits related to obesity, re-markably common in human societies, are evolutionaryproducts ofsimilar selection processes related to past food
scarcities. In a modern context of food abundance, suchcultural and genetic traits cause some people to add dan-gerous levels of fat tissue to their bodies. The increasingprevalence ofoverweight and obesity in the United States,especially in children, has risen to national attention andconcern; in fact, it has been called an "epidemic."Unfortunately, existing biomedical treatments for theseconditions are not effective and the risks for obesity-causedchronic diseases are high. Furthermore, obesity preventionposes a special challenge for Public Health officials since meetingthis challenge necessitates a more thorough understanding ofmultiple and complex factors of causation.An Anthropological ModelThis article uses an anthropological model of culture toexplore why and how societies have encouraged behav-iors and beliefs that predispose individuals to overweight.
This approach has advantages over the commonly usedundifferentiated concept of"environment" for generatinghypotheses about behavioral causes of obesity. It is par-ticularly useful for understanding the social epidemiologi-
cal distribution ofobesity and minimizing the widespreadnotion that obesity represents psychological failure.We begin with two questions: Why do people findit so hard to reduce their intake of fat and sugar even whenthe medical risks and benefits of a dietary change are wellknown? Why do people find it so hard to exercise?Anthropology suggests that the answer to thesequestions is a complex combination of near-universal, in-born preferences for sugar and fat. These calorically densesubstances were rare in the pre-agricultural world whereprey animals often carried little extra fat and natural sugars(honey, ripe fruit) were very limited. Such food prefer-ences are coupled with cultural practices that are salient inshaping food preferences and activity patterns from a youngage (Turner et al. 2008). Like many aspects ofhuman biol-ogy and behavior, the ultimate answers are linked to ourevolutionary heritage.
Contexts of Food Scarcity and AbundanceMany global health problems are related to food: somepeople are underfed and some people are over-stuffed.This striking inequality did not always exist. In most ofprehistory and history, food shortages were common; infact, seasonal hunger was a virtually inevitable fact ofhu-man life. Because food shortages affect health, survival andreproduction, they were a powerful evolutionary force.Seasonal food availability results in a seasonal cycle ofweightloss and weight gain in both hunting and gathering andagricultural societies. Approximately 12,000 years ago, somehuman groups shifted from a food foraging economy toone of food production. This economic transformationallowed the evolution ofcomplex civilization. The archeo-logical record clearly shows that agriculture was often as-sociated with nutritional stress, poor health, and diminished
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stature, whether due to tooth decay from increased con-sumption of sugars and carbohydrates, or an increase ininfectious disease from more crowded living conditions,or actual food scarcity.Anthropological research has demonstrated thatfood foragers are generally healthier than many less indus-trialized populations relying on agriculture - at least beforetheywere displaced from their original territories. Althoughour food foraging ancestors suffered risks ofperiodic foodshortages, they commonly enjoyed high quality diets, lowexposure to infectious diseases, and high levels ofphysicalfitness. In addition, studies oftraditional hunting and gath-ering populations report no obesity.Since food shortages were ubiquitous for humansunder natural conditions, selection favored individuals whocould effectively store calories in times ofsurplus. For mostsocieties, such fat stores would be called on at least everytwo to three years. The evolutionary scenario indicates thatfemales with greater energy reserves in fat would have aselective advantage over their lean counterparts in with-standing the stress of food shortage, not only for them-
selves, but for their fetuses or nursing children.In this evolutionary context the usual range ofhuman metabolic variation must have produced many in-dividuals with a predisposition to become obese; yet suchindividuals would never have the opportunity to do so.Furthermore, in this context there could be little or no naturalselection against such a tendency towards fatness. Selectioncould not provide for the eventuality of continuous sur-plus because it had simply never existed.In contrast to a history of scarcity, developed so-
cieties like the contemporary United States have created anobesogenic environment, wherein the physical, economic,social and cultural environments encourage a positive en-ergy balance in their population. The idea of a nutritiontransition" is one way to explain the emergence of theobesogenic environment (Popkin 1994). According to thistheory, as societies undergo globalization, westernizationand urbanization, their diets change dramatically. Post-tran-sition diets are marked by energy dense foods with highlevels of quickly digestible carbohydrates as well as highlevels of dietary fat.Three basic cultural changes accompany such nu-trition transition:
1
)
Diets decrease in fiber intake and increase in fatand carbohydrate consumption, particularly in sugar andits substitutes such as high-fructose corn syrup. The indus-trialized food system adds calories and encourages increasedfood portion size due to consumer demand and higherprofit opportunities.2) The nutrition transition is associated with de-creased energy expenditures related to work, modes oftransportation, recreation, and daily activities. Because tech-nological changes have reduced requirements for humanlabor, people in developed societies must burn energy toprevent overweight and obesity through daily workoutsrather than daily work.3) From the cultural perspective of the popula-tions undergoing the nutrition transition and economicmodernization, increasing body size may initially be seen asa good thing (rather than a health problem) but subse-quently fat becomes a symbol of lower class status.The Problems of Obesity and OverweightThroughout most of human history, obesity was never acommon health problem. Today it is common and hasincreased dramatically in recent years. Not only are over-weight and obesity relatively common conditions in oursociety, but they are also extremely complex and intrac-table. Obesity is a serious public health problem notbecause it is a disease itselfbut because it is associated withmajor causes of morbidity and mortality from chronicdiseases. These include cardiovascular disease, type-twodiabetes mellitus, hypertension, and some cancers. Cardio-vascular disease is the most common cause of death indeveloped countries.The direct relationship between overweight andhealth is under debate, as physical activity may actually bemore important to health than body weight. On the indi-vidual level, obesity and overweight bring with them anenormous amount ofpersonal psychological pain. The factthat the obese are subjected to significant social and eco-nomic discrimination is well documented.Fat is extraordinarily difficult to shed because the bodyguards its fat stores. The remarkable failure of diet therapieshas made some researchers rethink the commonsensical theoryofobesity as being simply caused by overeating. Clinical evi-
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dence ofthe past forty years simply does not support such asimplistic notion. Increasingly, obesity and overweight arebeing linked to physical inactivity and metabolic pathwaysthat lead to excess fat storage related to modern diets.Even in the absence of good scientific data aboutthe effectiveness of diet therapy, the diet and weight loss in-dustry in the United States is remarkably successful in captur-ing the hope and money of people who perceive themselvesto be overweight. This industry thrives because ofa complexof cultural beliefs about the ideal body and sexual attractive-ness rather than medical advice and the prevention ofchronicdiseases per se. The American cultural concern about weightloss and the positive value placed on slenderness amongAmerican middle and upper class women is difficult to over-emphasize. Chernin ( 1 985) has referred to this cultural diemeas an "obsession" and the "tyranny of slenderness." Withinthis context, it is impossible to claim that overweight and obe-
sity are purely medical issues.Changing Definitions of ObesityMany basic scientific issues regarding obesity are, in fact,controversial. Obesity is simply "excess adipose tissue," butmost measures in medicine and public health cannot mea-sure this directly. Definitions of obesity and overweightare partly debated because they are based upon inferreddefinitions of normality or "ideal" body proportions.Current medical literature utilizes Body Mass Index (BMI)defined as body weight divided by height squared. BMI(W/H2) is correlated with total body fat, and a BMI greaterthan 30 is generally considered obese.However, muscular athletes have high BMIs be-cause muscle mass weighs more than fat. BMI is currentlyused in clinical settings for individual patients even thoughit was developed as a population-level measure; some schol-
ars believe this is an inappropriate use. Also, BMI measuresmay not be appropriately valid in all populations. Increasedrisk of chronic disease affects some Chinese and SouthAsian populations at lower BMIs than among Europeanpopulations.An important and often neglected dimension todefining obesity involves the distribution of fat around thebody trunk or on the limbs. Central or truncal body fatdistribution is closely correlated with serious chronic dis-eases like cardiovascular disease, while peripheral body fatin the hips and limbs does not carry similar medical risks.In other words, peripheral body fat typical of women
appears to be epidemiologically benign. Because of thisclinically important distinction, measures of fat distribu-tion like waist to hip ratio (WHR), wherein lowerWHRindicates lower risk ofchronic disease consequences, are avaluable addition to the measurement of obesity.Increased morbidity due to disease is seen at bothextremes of the BMI spectrum. Very low BMI —such as isseen in parts ofthe developing world like India—increasesrisk of deaths due to infectious diseases because of a lackof energy reserves. At the higher end, BMI is linked tochronic diseases including coronary heart disease, high bloodpressure, stroke, type-two diabetes mellitus, and a rangeof cancers. Both high and low BMIs are associated withpoor health, whereas "normal" levels of adiposity (fat)should include a range ofbody types. It is particularly im-portant to note that levels ofphysical inactivity are linkedto poor health outcomes more strongly than are body sizeor weight; in other words, it is possible to be fit and fat.
Biological and Cultural Perspectives on the BodyThe nonrandom social distribution ofadiposity within andbetween human populations may provide a key to under-standing obesity. In addition to the circumstances of thenutrition transition discussed above, three features of thesocial distribution ofobesity are particularly cogent for ananthropological analysis: one, a gender difference in thetotal percent and site distribution of body fat, as well asthe prevalence of obesity; two, the concentration of obe-
sity in certain ethnic groups; and three, a powerful and com-plex relationship between social class and obesity. Any use-ful theory concerning the etiology (origins) ofobesity musthelp account for these social epidemiological patterns.
Sexual Dimorphism Humans show only mild sexual dimor-phism in stature: males are only 5 to 9 percent taller than fe-males. Men are larger than women in height and total bodymass, butwomen have more subcutaneous fat. However, thegreatest degree of sexual dimorphism is found in the distri-bution offat tissue, with women having much more periph-
eral fat in the legs and hips. This difference is epidemiologicallyimportant. With the same BMI, the greater proportion ofperipheral fatness in females may be associated with reducedmorbidity and enhanced fertility, whereas more central bodyfat may pardy explain higher cardiovascular disease rates andlower life expectancies in males.
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10 20 30 40 50PERCENT FEMALES OBESEo DEVELOPED
• UNDERDEVELOPEDGender differences in prevalences of obesity in 14 populationsby general industrial development. The unbroken linedemarcates equal male-female obesity prevalences. Thebroken line indicates an apparent distinction in genderproportions of obesity in developed and underdevelopedcountries. From Brown, P.J., and M. Konner, An AnthropologicalPerspective on Obesity. In R. J. Wurtman, and J. J. Wurtman,eds., Human Obesity, Annals of New York Academy of Sciences499:29-46. Copyright 1987. Reprinted with permission.
Sex differences are also seen in the prevalence ofobesity. Data from the 14 population surveys shown inFigure 2 indicate that in all of the studies females have ahigher prevalence of obesity than males. Despite contro-versies concerning measurement, a greater risk for obesityfor females appears to be a basic fact of human biology.Evolution has favored female ancestors who areable to retain surplus body fat, thus improving their abilityto bear and feed children even in times ofnutritional scar-
city. Peripheral body fat is mobilized after being primedwith estrogen during the late stages ofpregnancy and lac-tation. In addition, a minimal level of female fatness in-creases reproductive success because of its association withregular cycling as well as earlier menarche. Fat metabolismis influenced by hormones including reproductive hormonesand insulin.Pregnancy and lactation represent serious and con-tinuing energy demands on women in societies that have notundergone the demographic transition - the historical shiftfrom high to low fertility rates associated with the reductionofmortality due to infectious disease. In underdeveloped so-
cieties with high fertility, higher numbers ofpregnancies andlonger periods of breast feeding place high energy demands
upon women, especially ifthey cannot supplement their diet.As a result, such women suffer greater risk of protein-energymalnutrition. Conversely, with fewer pregnancies and the re-duction ofbreast-feeding, women in developed societies haveless opportunity to mobilize peripheral fat stores and suffergreater risk ofobesity (Worthman et al. 1989).
Ethnicity The idea that particular populations have highrates of a genotype that predisposes individuals to obesityand related diseases is not new, and is supported by a con-vincing body of adoption and twin data, as well as workfocusing on obesity-prone populations like the Pima Indi-ans. This is evidence of genetic predisposition to obesity.In the United States, ethnic groups with elevated rates ofobesity include: African Americans (particularly in the ruralsouth), Mexican Americans, Puerto Ricans, and NativeAmericans. Given that these groups are often over-repre-sented in lower socioeconomic strata, it may be difficult todistinguish the causal effects of class versus ethnicity. Thefact that certain ethnic groups have high rates ofobesity isnot easy to interpret because of the entanglement of theeffects of class with genetic heredity, cultural beliefs, andopportunities for exercise.
Social class Socioeconomic status is a powerful predictorof the prevalence of obesity in both modernizing andaffluent societies, although the direction ofthe association
varies with the type ofsociety. In developing countries thereis a strong and consistent positive association ofsocial classand obesity for men, women, and children. Correspond-ingly, there is an inverse correlation between social classand protein-calorie malnutrition. On the other hand, it haslong been recognized that in heterogeneous and affluentsocieties like the U.S., there is a strong inverse correlationof social class and obesity for females. The association ofobesity and social class among women in affluent societiesis not constant through the life cycle. Garn and Clark ( 1 976)have demonstrated a pattern of reversal in which economi-
cally advantaged girls are initially fatter than their poor coun-terparts. For females, social class remains the strongest so-
cial epidemiological predictor of obesity.
Cultural Perceptions of Body SizeFrom an anthropological perspective, the most important as-pects ofculture relating to body weight may be cultural sym-bols, beliefs and values. Aspects of ideology relevant to the
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etiology ofobesity include the symbolic meaning of fatness,ideal body types, and perceived risks of future food short-ages. Fatness is symbolically linked to psychological dimen-sions such as "self worth" and sexuality in many of theworld's societies, but the nature of that symbolic associa-tion is not constant. In mainstream U.S. culture, obesity issocially stigmatized, but for many cultures of the world,fatness is viewed as a welcome sign of health and prosper-ity. Given the rarity ofobesity in preindustrial societies, it isnot surprising that ethnomedical terms for obesity are usu-
ally non-existent.Perhaps it is large body size rather than obesityper se that is an admired symbol of health, prestige, pros-perity or maternity. The agricultural Tiv of Nigeria, forexample, distinguish between a very positive category "toobig" (kehe) and an unpleasant condition "to grow fat" {ahon).The first is a compliment because it is a sign of prosperity;the second term is a rare and undesirable condition. Forwomen, fatness may also be a symbol of maternity,nurturance, and adult success. Symbolically, a fat woman iswell taken care of, and, in turn, takes good care of herchildren. The ethnographic record indicates that FellahinArabs in Egypt describe the proper woman as fat becauseshe has more room to bear a child, lactates abundantly,and gives warmth to her children. In contrast, the culturalideal of thinness in developed societies is found wheremotherhood is neither the sole nor primary means of sta-tus attainment for women. The ideas that fat babies arebeautiful and that fat children are healthy children are verywidespread throughout the world. Foods, particularly sweetfoods, can be treated as symbols of love and nurturanceon the part of parents and grandparents; the growingproblem of child obesity in China is related to increasedeconomic resources, the one-child policy, and doting grand-parents. In some cultures it may be impolite for a guest torefuse some offered food, but it is taboo to refuse foodfrom ones mother.
Fatness and CrossCultural Standards of BeautyCulturally defined standards of beauty for women varybetween societies and may have been a factor in the sexualselection for phenotypes predisposed to obesity. A classicexample is the custom of "fattening huts" for elite Efikpubescent girls in traditional Nigeria. Here fatness was aprimary criterion of beauty as defined by the elites, who
alone had the economic resources to participate in this cus-tom. An important recent ethnography of Azawagh Ar-abs ofNiger entitled Feeding Desire (Popenoe, 2004) illus-trates these cultural notions to an extreme degree. Here,fatness to the point of voluptuous immobility is encour-aged by systematic over-eating in order to hasten puberty,enhance sexuality, and ripen girls for marriage. The peoplebelieve that women's bodies should be fleshy and lacedwith stretch-marks in order to contrast with thin, malebodies. Similarly, fatter brides (as well as early maturingbrides) demand significantly higher bridewealth paymentsamong the Kipsigis of Kenya. The Tarahumara of north-ern Mexico consider fat legs a fundamental aspect of theideal feminine body; a good-looking woman is called a
"beautiful thigh." Ramotswe, the large and beautiful pro-tagonist ofa popular mystery series by Smith (2009) set inBotswana, is referred to as "traditionally built."Among the Amhara of the Horn of Africa, thinfemale hips are called "dog hips" in a typical insult, andthin women in Jamaica are thought to be meager and pow-
erless, like a mummy or a dried empty husk. Yet in Belizebody shape is more important than body size, with mostpeople preferring women to have a curved, hourglass fig-ure like a Coca-Cola or Fanta soda bottle.Among the world's cultures, it is difficult to knowhow widespread is the association ofplumpness and beauty.
Zeinabou,considered verybeautiful in theAzawagh Arabculture.Tassara, Niger,1991. PhotocourtesyRebeccaPopenoe.
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A preliminary indication can be found through acrosscultural survey based upon the Human Relation AreaFiles (a cross-indexed compilation of ethnographic infor-mation on over 300 of the most thoroughly studied soci-
eties). This data offers the basis for some preliminary gen-eralizations, notably that cultural standards ofbeauty tendnot to refer to physical extremes. On the other hand, thedesirability of "plumpness" or being "filled out" is foundin 81 percent of the societies. This standard, which prob-ably includes the clinical categories ofoverweight and mildobesity, apparently refers to the desirability of fat deposits,particularly on the hips and legs.Although crosscultural variation in standards ofbeauty is evident, this variation falls within a certain range.American ideals of thinness occur in a setting where it iseasy to become fat, and preference for plumpness occursin settings where it is easy to remain lean. In context, bothstandards require the investment of individual effort andeconomic resources; furthermore, each in its own contextinvolves a display ofwealth. Cultural beliefs about attrac-tive body shape in mainstream American culture place pres-sure on females to lose weight; such cultural beliefs arecentral to the etiology of anorexia nervosa and bulimia.
Ideal Male Body Type, Size, and Symbolic PowerThe ethnographic record concerning body preferences inmales is weak, yet preliminary research suggests a universalpreference for a muscular physique and for tall or moder-ately tall stature. Men tend to aspire to a muscular shapecharacterized by well-developed upper body muscles andslim waist and hips. Efforts to achieve this ideal body gen-erally center around exercise rather than diet.Large body size may serve as an attribute of at-tractiveness in men because it symbolizes health, economicsuccess, political power, and social status. "Big Men," thepolitical leaders in tribal New Guinea, are described bytheir constituents in terms of their size and physical well-being: he is a man "whose skin swells with 'grease' [or fat]underneath" (Strathern 1971). The spiritual power (jnana)and noble breeding of a Polynesian chief are expected tobe reflected in his large physical size. In American societythere are historical vestiges ofa similar idea, for example, a
"fat cat" is a wealthy and powerful man who can "throwhis weight around."Contemporary rap and hip-hop is filled with posi-tive references to large bodies indicating largesse in life,
Female Silhouettesf f ft f
Male Silhouettesf # # t
Figure 1 The silhouettes used In the perception of body size (1 —thin,2= normal, 3 = overweight, 4= obese).Illustration courtesy D. T. Simeon. Published in Simeon, D.T., et
al. 2003.
especially in names such as the Notorious B.I.G., Heavy D,and the Fat Boys. Most male college students in the U.S., incontrast to women, want to gain weight because it is equiva-lent to gaining muscle mass and physical power in a pro-cess called "bulking up."ConclnciusionsThree conclusions can be drawn from this discussion ofculture and its relationship to obesity.
• First, recognition of cultural variation in beliefs and be-haviors related to obesity needs to be incorporated intohealth programs aimed at reducing the prevalence ofobe-
sity.
• Second, more education is needed about the importanceofthe location ofbody fat (rather than solely BMI) as wellas the medical benefits of increased physical activity re-gardless of body size.
• Third, more research is necessary on the role of culture
as it interacts with genes, on the etiology ofobesity, and onassociated chronic diseases.Existing cultural beliefs must be taken into accountin the design and implementation of health promotionprojects. A classic example is an obesity prevention cam-paign in a Zulu community outside of Durban (Gampel1962). It featured one health education poster that depictedan obese woman and an overloaded truck with a flat tire,with a caption "Both carry too much weight." Anotherposter showed a slender woman easily sweeping under atable next to an obese woman who is using the table forsupport; it has the caption, "Who do you prefer to look
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like?" The intended message of these posters was misin-terpreted by the community because ofa cultural connec-tion between obesity and social status. The woman in thefirst poster was perceived to be rich and happy, since shewas not only fat but had a truck overflowing with herpossessions. The second poster was perceived as a sceneofan affluent mistress directing her underfed servant.Health interventions must be culturally acceptable,and in this regard we cannot assume that people place thehighest priority on their health or on their physical appear-ance. Many people at risk of obesity live in poverty, orhave a history of poverty, and therefore feel insecure re-garding possible future food shortages. Similarly, eating highcalorie comfort foods can be a psychological adaptationto stressful living conditions. Finally, disadvantaged peoplemay discount their futures — that is, ignore somewhat vague
risks offuture chronic disease associated with obesity whenthey do not feel empowered and live in a fundamentallyrisky world. The social distribution of overweight andobesity may reflect social inequalities as well as a changing
"obesogenic" environment.The frequency of past food shortages, the socialdistribution of obesity, and the cultural meanings of fat-
ness, when taken altogether, suggest a biocultural hypoth-
esis of the evolution of obesity. Both genetic and culturalpredispositions to obesity may be products of the sameevolutionary pressures, involving two related processes. First,genetic traits that cause fatness were selected because theyimproved chances of survival in the face of food scarci-ties, particularly for pregnant and nursing women. Second,in the context of unequal access to food, fatness may havebeen socially selected because it is a cultural symbol ofsocial prestige and an index ofgeneral health. Under West-ern conditions of abundance, our biological tendency toregulate body weight at levels above our ideal weight can-not be easily controlled even with a reversal of the wide-spread cultural ideal of plumpness.Recent advances in understanding the genetic basesof obesity are echoed by new understandings about therole of "environment." Recent research into the role ofurban sprawl, the built environment, and resulting seden-tary modern lives demonstrates that decreasing physicalactivity has contributed to current levels ofoverweight andobesity. Despite increased understanding of the etiologyof overweight and obesity, as well as the combined
biocultural contributions to the conditions, many questionsand avenues for future anthropological research remain.These include: social discrimination against fat people, evenwhen the majority of a population is fat; relative influencesof dietary change and decreased physical activity in obe-
sity; changing cultural standards ofbody ideals and physi-cal activity related to acculturation and class mobility; thecultural perception ofthe medical community, particularlyobesity researchers; cultural patterns of accommodationsfor an increasingly fat and less mobile population; and un-derstanding of the cultural beliefs and behaviors of indi-viduals or groups who are successful in reducing risks forchronic disease through sustained weight loss.
References CitedChernin, K. 1985. The Hungry Self: Women, EatingandIdentity.Harper and Row.Gampel, B. 1962. The 'Hilltops' Community. In S.L. KarkandG. E. Steuart eds., Practice ofSocialMedicine. E & SLivingston.Garn, S.M., and D.C. Clark. 1 976. Trends in fatness and the ori-gins of obesity. Pediatrics 57: 443-56.Nishida, G, and P. Mucavele. 2005. Monitoring the rapidly emerg-ing public health problem of overweight and obesity:theWHO global database on body mass index. UnitedNations System Standing Committee on Nutrition. 29:5-12.Popenoe, R. 2004. Feeding Desire: Fatness, BeautyandSexualityamonga Saharan People. Routledge.Popkin, B. 1994. The Nutrition Transition in Low-IncomeCountries: An Emerging Crisis. Nutrition Review 52(9): 285-298.Simeon, D.T., et al. 2003. Body image of adolescents in a multi-ethnic Caribbean population. EuropeanJournal of ClinicalNutri-tion 51:157-62.Smith, A. 2009. Tea Timefortbe Traditionally Built: TheNew No. 1Ladies'DetectiveAgency Novel. Pantheon Books.Strathern, A. 1971 . The Rope ofMoka. Cambridge University Press.Turner, B., K. Maes, J. Sweeney and G. Armelagos. 2008. HumanEvolution, Diet and Nutrition: Where the Body Meets theBuffet. InW Trevanthan, E. Smith and J. McKenna, eds., NewPerspectives in Evolutionary Medicine. Oxford University Press.Worthman, CM., J.E Stallings, andM.E. Sweeney. 1989. Relativeeffects of weight loss, decreased total body fat, and exercise onreproductive function in calorie-restricted American women.AmericanJournalofPhysicalAnthropology 78: 326-327.
Peter J. Brown is professor ofanthropology andJenniferSweeney a doctoral candidate atEmory University, Atlanta,Georgia.
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