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28 de Outubro, 2009

O paradoxo das ilhas Trobriand: a boa forma física dá saude ou a saúde é que proporciona boa forma física? Independentemente disto, a chave para ambas está certamente num estilo de vida natural, longe da civilização

Autor: O Primitivo. Categoria: Primitivos| Saúde

Foto: Ancião centenário de Kitava, na Papua-Nova Guiné. Este homem nunca ouviu falar de morte repentina ou de sintomas de AVC.
Dr. Satffan Lindeberg. 



At 12:36 -0700 98-05-11, Art De Vany wrote:
>Staffan Lindeberg made this very interesting point:
>"However, contemporary Trobriand Islanders in Kitava are very lean and
>obesity is absent despite a carbohydrate intake which is higher than in
>Western populations (approximately 70 per cent of calories). There
>is food
>in abundance and no starvation. Low serum insulin levels (extremely well
>predicted from their body mass index) which decrease with age suggest
>rarity or absence of insulin resistance (Lindeberg et al, submitted).
>Possibly, the quality rather than the quantity of carbohydrates is
>important; carbohydrate-rich foods with a low glycemic index and a high
>nutrient density (per energy unit), such as Kitavan tubers and fruit, may
>be preferable to cereals and sugar (and potatoes?)."
>I wonder if Staffan could indicate something of the nature of the
>physical activties, and their patterns over the season and by age,
>of these islanders. Surely, their fitness would be a factor so
>that, even with a very high CHO intake, they might retain their
>insulin sensitivity. Is it not also true that insulin resistance
>increases as body fat accumulates, particularly in the abdominal
>area? Might not the leanness of these peoples be a factor? If they
>are active, have adequate lean body mass, and (therefore) retain
>insulin sensitivity, then perhaps the Trobriand Islanders Paradox
>can be explained. The quality of the food may also be a
>contributing factor, as this assures a good lean body mass among all


Subject: Re: The Trobriand Islanders Paradox
From: Staffan Lindeberg
Reply-To: Paleolithic Diet Symposium List
Date: Tue, 19 May 1998 22:52:52 +0100


The level of physical activity of Kitavans was roughly estimated at 1.7 multiples of the basal metabolic rate (BMR) [1]. BMR multiples for westerners with low occupational activity level who are non-active at leisure time is 1.4 for both sexes, while moderately active persons at work as well as during leisure time is 1.7 for males and 1.6 for females [2]. For 18-30 year old Kitavan males the estimated energy expenditure was 9.4 MJ, while their estimated total daily calorie intake from diet history was 9.2 MJ. Energy expenditure decreased with aged in both populations. In the Swedish population self reported physical activity during work and leisure time were each coded to a three-point scale (low, medium and high level of physical activity) using a questionnaire [3].

Men spend their time gardening, relaxing, fishing, building houses, carving and playing football (soccer), while women most of the time are weaving, cooking, gardening, relaxing or washing clothes. The two single most common activies are gardening and sitting still. The annual variation of physical activity is considerable, particularly for men. It seems to decrease slightly with age in both sexes. Individual levels of physical activity were not assessed.

Although the precision in the calculated energy expenditure is low, it is obvious that Malinowski’s statement that "half of the natives’ working life is spent in the garden" [5] will falsely suggest that Kitavan life is filled with hardship. On the other hand, if "working life" means time for production of food, clothing and houses, Malinowski’s figure seems accurate.

The given figure of estimated energy expenditure is too uncertain to admit any strict comparison with other traditional populations or with westerners [6]. Nevertheless, by modern western standards, the annual mean level of physical activity appears high, although a considerable proportion of western labourers evidently work more strenuously and have less time for leisure activities. Furthermore, the leisure activities of many westerners are quite heavy and time-consuming.

In conclusion, the mean level of physical activity was higher in Kitava than in Sweden, although overlapping between the two populations appears considerable (which it was not for leanness). Although the higher level of physical activity may explain some of the beneficial health status of Kitavans, diet appears even more important. Unfortunately this is not much more than a guess because our survey methods preclude any detailed judgement.

A fairly low level of physical activity has been the rule among many traditional populations, particularly hunter-gatherers and tribal horticulturalists, who have spent an average of three hours or less each day on food production [7-10]. On the one extreme, a female Machiguenga of the Amazon dug up enough tubers in one hour to feed 25 adults for one day [11]. On the other extreme we find populations living in deserts, the Arctic or similar marginal habitats and who have spent more than seven hours a day hunting or gathering [7]. The very high level of physical exercise exerted by the Tarahumara Mayans of Mexico [12] can hardly be considered representative for traditional human populations. Loren may however not agree on this last one [13].

Physical activity undoubtedly exerts a number of potentially beneficial effects on cardiovascular risk factors, including reduction of blood pressure, body weight and waist to hip ratio, and elevation of HDL-C [14]. Higher levels of physical activity are furthermore prospectively associated with lower mortality [15, 16]. Besides its possible genuine effects, exercise may facilitate an adequate intake of essential nutrients by way of increased energy expenditure [17]. Nevertheless, available evidence do not suggest that exercise is as efficient as dietary changes to lower body weight [14] or blood pressure [18] and exercise alone is apparently insufficient to fully prevent insulin resistance [4]. My personal impression from cross-cultural surveys is not that a high level of physical activity is a necessary condition for very low rates of IHD.

As for fitness, this is very difficult to evaluate. Does fitness give health or does health give fitness?

Best wishes, Staffan



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