Am J Hum Biol
· 2025 Sep · PMID 40878738
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OBJECTIVE: This study aimed to describe inter-individual variation in growth velocity during puberty among Brazilian children, considering maturity status to better understand differences in the timing and intensity of g...OBJECTIVE: This study aimed to describe inter-individual variation in growth velocity during puberty among Brazilian children, considering maturity status to better understand differences in the timing and intensity of growth spurts. METHODS: Longitudinal stature data from 398 Brazilian children (197 girls, 201 boys) aged 6-19 years, collected annually from 1997 to 2010, were analyzed. Growth and velocity curves were estimated using the SITAR model within a Bayesian framework. Maturity groups were classified based on the standard deviation of the estimated age at peak growth velocity, categorizing participants as early, average, or late maturers. RESULTS: The mean age at peak growth velocity was 11.30 years for girls and 13.55 years for boys. Mean peak velocities were 8.38 and 9.52 cm/year, respectively. Pubertal takeoff occurred at 8.41 years for girls and 11.19 years for boys, with mean velocities of 5.85 and 5.43 cm/year. Early maturers exhibited earlier onset and higher growth velocities, while late maturers showed delayed growth for both sexes. CONCLUSIONS: Considerable variability in growth velocity patterns during puberty was observed. Compared to Northern Hemisphere populations, Brazilian children experienced earlier and more intense pubertal growth spurts. These findings highlight the importance of accounting for maturational timing in physical education planning, training load management, and pediatric growth assessment.
Am J Hum Biol
· 2025 Aug · PMID 40853648
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OBJECTIVES: This study was conducted to determine whether possible allometries in hand digit lengths have an effect on the observed sexual dimorphism in digit ratios. METHODS: The lengths of four digits from the second t...OBJECTIVES: This study was conducted to determine whether possible allometries in hand digit lengths have an effect on the observed sexual dimorphism in digit ratios. METHODS: The lengths of four digits from the second to the fifth digits on the right and left hands of 500 adult participants (250 males, 250 females) were measured and six different ratios were calculated. ANCOVA and regression analyses were used to examine the allometry effect. RESULTS: The findings revealed that the sexual dimorphism that emerged in the right and left 2D:4D ratios was independent of the allometry effect. On the other hand, it was observed that the allometry effect emerged in the three digit ratios (right and left 2D:5D, left 3D:5D). CONCLUSIONS: These results reveal that the allometry effect is not observed on the ratios calculated from the digits (2D and 4D) that are claimed to have formed under the influence of prenatal steroids, but it can be observed on the other digits.
Am J Hum Biol
· 2025 Aug · PMID 40853225
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INTRODUCTION: Son preference remains a deeply rooted sociocultural phenomenon in Pakistan and plays a critical role in shaping fertility behavior. The study investigates the influence of son preference on fertility behav...INTRODUCTION: Son preference remains a deeply rooted sociocultural phenomenon in Pakistan and plays a critical role in shaping fertility behavior. The study investigates the influence of son preference on fertility behavior, with a specific focus on birth intervals and the sex composition of existing children, within the context of marital structure (monogamous vs. polygynous unions) in Pakistan. METHOD: Using nationally representative data from the Pakistan Demographic and Health Survey (2012-2013 and 2017-2018), data are analyzed using Cox proportional hazards regression to assess the timing of subsequent births at parity three and linear regression to measure son preference. The sample size included 100 733 women of reproductive age (15-49 years), of whom 96 975 were in monogamous unions and 3758 were in polygynous unions. RESULTS: The results demonstrate a persistent and significant son preference in fertility decisions. Women with fewer or no sons are more likely to proceed to another birth, as evidenced by shorter birth intervals. A key finding is that polygynous marriages are associated with both higher son preference and shorter birth intervals compared to monogamous unions. While rural polygynous women exhibit stronger son preference, urban polygynous women tend to have quicker transitions to the next birth. In contrast, monogamous women generally report longer birth intervals and lower levels of son preference, regardless of residence. CONCLUSION: The study finds that polygynous marriages are associated with stronger son preference compared to their monogamous counterparts. While rural polygynous women exhibit a stronger son preference than urban polygynous women, the latter have shorter birth intervals.
Am J Hum Biol
· 2025 Aug · PMID 40852876
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In 2009 we published an article in the American Journal of Human Biology arguing for a developmental contribution to US racial inequities in cardiovascular disease (CVD), inspired by emerging evidence that stress during...In 2009 we published an article in the American Journal of Human Biology arguing for a developmental contribution to US racial inequities in cardiovascular disease (CVD), inspired by emerging evidence that stress during pregnancy reduces birth weight (BW) while also elevating offspring CVD risk. The 15 years since our piece was published provide an opportunity to update the status of the hypothesis. Although relevant studies are sparse, work to date has revealed an apparent paradox: although Black Americans have lower BWs and higher CVD rates, and even though lower BW elevates future CVD risk, studies generally report stronger inverse BW-CVD relationships in white compared to Black samples. Drawing on current understandings of intergenerational pathways, we propose an updated model that could help explain the weakening of BW-CVD relationships in Black Americans: Structural racism not only elevates CVD risk through pathways that reduce BW, as we originally emphasized, but also increases the likelihood of maternal weight gain and elevated glucose, which elevate offspring CVD risk but increase BW. We review newer evidence that these offsetting, "push-pull" effects on BW operate across the full BW spectrum. As a result, when BW is used as a marker, a dimension of CVD risk is rendered invisible, with the degree of invisibility proportionate to the strength of these opposing pathways. BW will thus be particularly uncoupled from CVD risk in minoritized US populations, who often face psychosocial stress but are also more likely to be exposed to environments that lead to weight gain and metabolic dysregulation.
Flores LA, Enríquez-Del Castillo LA, Datta Banik S
… +5 more, Laborde-Daisson D, Cervantes-Hernández N, Quintana-Mendias E, Villegas-Balderrama CV, Rodríguez-Villalobos JM
Am J Hum Biol
· 2025 Aug · PMID 40836479
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OBJECTIVE: To analyze the influence of sociodemographic factors and BMI-based nutritional status on the somatic maturity of Mexican children. METHODS: BMI-based nutritional status and maturity offset by the Moore-II meth...OBJECTIVE: To analyze the influence of sociodemographic factors and BMI-based nutritional status on the somatic maturity of Mexican children. METHODS: BMI-based nutritional status and maturity offset by the Moore-II method were estimated. Information on age, sex, weight, height of 2- to 18-year-old children and adolescents, household socioeconomic status, and geographic region were obtained from the 2012 and 2018 databases of the National Health and Nutrition Survey (ENSANUT), National Institute of Public Health (INSP), and the National Institute of Statistics and Geography (INEGI) in Mexico. Saturated log-linear and logistic regression models were used to evaluate the associations among the variables. The association between the prevalence of excess weight (BMI-based overweight and obesity) and age, transforming the logistic model to a linear model using the logit function, was estimated. RESULTS: The prevalence of overweight and obesity showed a cubic correlation with age and maturity offset in both sexes. In boys, the highest prevalence was observed at ages 12-14 years, which coincides with the peak height velocity. In girls, the highest prevalence occurred at ages 14-15 years, with this trend being stronger than in boys; additionally, overweight and obesity prevalence peaks at -2 and -1 years from APHV in boys, and between 0 and 2 years from APHV in girls. Children from rural areas, lower socioeconomic levels, and those from the southern region had a higher probability of late somatic maturity. CONCLUSION: Socioeconomic and geographic factors play important roles in shaping nutritional status and somatic maturation patterns in Mexican children. Health and nutrition intervention programs and strategies for children and adolescents, based on these factors, are recommended.
Am J Hum Biol
· 2025 Aug · PMID 40832723
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More than any other scholar in our field, Professor Roy J. Shephard's research has shaped and transformed our understanding of the biology and health of circumpolar populations. His long-term research among the Inuit of...More than any other scholar in our field, Professor Roy J. Shephard's research has shaped and transformed our understanding of the biology and health of circumpolar populations. His long-term research among the Inuit of Igloolik, Canada has provided the field of human biology with foundational insights into how human populations adapt to arctic climates, and how the transition to a market-oriented lifestyle erodes fitness and metabolic health. Shephard was the prime architect of early research done in the Canadian Arctic as part of the Human Adaptability Program (HAP) of the International Biological Programme (IBP) in the 1960s and early 1970s. After the original IBP studies, Shephard and collaborator Andris Rode continued their research in Igloolik through the early 1990s. This long-term research provided some of the first clear evidence on how the process of acculturation and lifestyle change erodes physical development and metabolic health among Indigenous populations of the north. This paper provides an overview of the major findings and insights from Roy Shephard and colleagues' research in Igloolik and highlights how these contributions are shaping ongoing research on the biology and health of circumpolar populations.
Am J Hum Biol
· 2025 Aug · PMID 40801239
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OBJECTIVES: In growing humans, densitometric scans of whole-body bone mass "less head" are recommended to circumvent the excessive contribution of youths' proportionally larger heads but potentially inflate inter-scan va...OBJECTIVES: In growing humans, densitometric scans of whole-body bone mass "less head" are recommended to circumvent the excessive contribution of youths' proportionally larger heads but potentially inflate inter-scan variation and least significant change due to measurement error. We aimed to determine biological benchmarks for achievement of adult head-body proportions in a sample of US females. METHODS: Annual whole-body dual energy x-ray absorptiometry (DXA) scans tracked growth, maturation, and bone mass accrual in a prospective longitudinal cohort of girls for up to 19 years (baseline age 7-15 years). We used cubic smoothing spline mixed effects models to generate chronological and gynecological age-based curves for head versus whole-body bone mass proportions (ratios). Females with ≥ 3 annual scans were included (n = 148, age 7-30 years). RESULTS: Models yielded trajectories extending beyond observed age at peak bone mass for our sample. From age 18 years, "adult" mean of means for head vs. whole-body bone mass proportions was 0.204 (n = 66: 95% confidence interval = 0.198-0.210). Individual proportions stabilized to "adult" mean levels circum-menarche (n = 124: mean = 0.198; 95% confidence interval = 0.194-0.202). The minimum age for 95% confidence intervals overlapping with adult values was 12 years, circum-peak height velocity (n = 120: mean = 0.211; 95% confidence interval = 0.207-0.216). CONCLUSION: In US girls with diverse activity exposures, head vs. whole-body bone mass proportions are "adult" from menarche onward; an "adult" age threshold of 12 years, or age at peak height velocity, may be used in the absence of extreme maturational delay to evaluate whole-body bone mass including the head.
da Silva MAC, de Lucena Martins CM, Alencar MA
… +2 more, Firmino PRA, Bandeira PFR
Am J Hum Biol
· 2025 Aug · PMID 40792395
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BACKGROUND: There are several associated factors that have an impact on a child's development, including the cognitive and motor domains. Motor competence is intrinsically linked to executive functioning, even though the...BACKGROUND: There are several associated factors that have an impact on a child's development, including the cognitive and motor domains. Motor competence is intrinsically linked to executive functioning, even though the causal links between the development of motor skills and the development of cognitive skills are not always obvious. Even in early childhood, with advances in cognitive processes in the child's development, processes emerge that make the child capable of regulating their own behavior. OBJECTIVES: These variables are important for child development; however, there are no previous studies that examine the associations of motor competence, executive functions, and self-regulation together. There is also no study that takes a holistic view to better understand the interrelationships of these variables. This study aimed to investigate the association between motor competence, executive functions, and self-regulation in childhood and identify the variables with the highest network influence values. METHODS: The research adopted a cross-sectional design; it is a descriptive and associative study. Two hundred and eighty-three children aged 3-6 years of both sexes, from two of the most populous cities in the interior of northeastern Brazil participated. The instruments used were the TGMD-3 for motor competence, the Early Years Toolbox battery for executive functions, and HTKS-R for self-regulation. The data was analyzed using network analysis. RESULTS: It was observed that motor competence and executive functions were positively related, and self-regulation had an indirect association with motor competence. These findings corroborate previous studies on the relationship between motor competence and executive functions and highlight the importance of self-regulation in this association. The network showed clusters between motor competence skills, executive functions, and self-regulation, which are part of the same construct. The skills of running, receiving, kicking, and inhibitory control had the highest centrality rates, highlighting their importance for the interconnection of variables. The highest values of expected influence were from running, inhibitory control, and kicking, modifications of which can result in significant changes in the overall behavior of the network. CONCLUSIONS: These findings reinforce the integrated nature of motor, cognitive, and self-regulatory processes in childhood, suggesting that specific skills (e.g., running, inhibitory control) play a central role in the development network.
MacLean CA, Dimanlig M, Godfrey D
… +1 more, Madrigal L
Am J Hum Biol
· 2025 Aug · PMID 40785353
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INTRODUCTION: In this research, we seek to understand the evolutionary forces which have resulted in the distribution of the MTHFR C677T single nucleotide polymorphism, which is associated with fertility-related, cardiov...INTRODUCTION: In this research, we seek to understand the evolutionary forces which have resulted in the distribution of the MTHFR C677T single nucleotide polymorphism, which is associated with fertility-related, cardiovascular, cancerous, and neurological morbidities. Due to the negative effects of the gene, it is likely frequent due to genetic drift or natural selection. METHODS: Using secondary data gathered by systematic review, we test proposals stating that under conditions of ample folate, individuals who are heterozygous (CT) and homozygous (TT) for the MTHFR C677T polymorphism would suffer from fewer or no deleterious pregnancy or birth outcomes. Using descriptive and bivariate statistics, we determined if significant differences exist between pregnancy or birth outcomes based on genotype. We then modeled the effects of genotype, folate, cobalamin, and homocysteine (and their interactions) on the frequency of the pregnancy outcomes. RESULTS: Even with ample and high serum folate, CT and TT women sampled had worse pregnancy outcomes. Folate (sometimes interacting with insolation) mediates pregnancy outcomes in a genotype-dependent fashion. For this reason, we caution against the use of a "one size fits all" approach to clinical treatment for CT and TT individuals. CONCLUSIONS: We conclude that natural selection is the primary force of evolution acting on this mutation despite its numerous negative effects. We reject the hypothesis that in conditions of ample folate supply, CT or TT pregnant people might have a fitness advantage. Genotype was a strong predictor of birth outcomes, indicating that for this polymorphism, there is a strong folate-genotypic and genotype-insolation interaction.
Am J Hum Biol
· 2025 Aug · PMID 40772405
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OBJECTIVE: The aim of this study is to evaluate the influences exerted by temperature on the circadian rhythm of births. METHODS: In the past births occurred mainly between midnight and dawn, while today births tend to b...OBJECTIVE: The aim of this study is to evaluate the influences exerted by temperature on the circadian rhythm of births. METHODS: In the past births occurred mainly between midnight and dawn, while today births tend to be less frequent during the night hours. Today, almost all births are hospitalized and, therefore, they may adapt to the organizational requirements of the health care structures and staff. This piece of research regards births in Udine, a city in north-eastern Italy, recorded at the beginning of the 19th century. The data on births come from the French civil register. Weather data come from very detailed daily collection with three measurements per day. From the statistical point of view, we apply methods developed for circular data. In order to highlight relationships between time of birth and explanatory variables, we estimate MANOVA (multivariate analysis of variance) models and perform a statistical test for comparison between groups. RESULTS: The test against the homogeneity of the hour-of-birth distributions across the 4 seasons is significant (p < 0.01). One-to-one comparison of the distributions is performed via Watson's two-sample test on data for each couple of seasons: the Summer-Autumn comparison is the only non-significant test of homogeneity. Moreover, we consider daily temperatures in the bivariate model in several different ways and transformations. The daily temperature effect is more significant if considered as the difference between the evening temperature of the day before the birth and the mean daily temperature of the same day, over the nine-year period 1807-1815. Finally, based on this division of the births, Watson's two-sample homogeneity test for the distribution of the hour of birth is significant (p < 0.05). CONCLUSIONS: We found that the circadian rhythm of births is influenced by temperature, with an anticipation of the time of birth on warmer days. To our knowledge, our results are the first evidence of the effects of daily temperature on the time of birth.
Am J Hum Biol
· 2025 Aug · PMID 40762372
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OBJECTIVES: The ratio of the index finger to the ring finger length (2D:4D) differs between sexes; it is typically higher in females than in males. This difference is thought to be related to intrauterine androgen exposu...OBJECTIVES: The ratio of the index finger to the ring finger length (2D:4D) differs between sexes; it is typically higher in females than in males. This difference is thought to be related to intrauterine androgen exposure. Antenatal hydronephrosis is the most frequently detected anomaly during prenatal ultrasonographic evaluation of fetal development. This study aims to investigate the relationship between the 2D:4D ratio in newborns and the presence of congenital hydronephrosis. METHODS: Between July 2023 and April 2024, the lengths of the second and fourth digits and medical birth records of newborns were documented. Infants who were followed antenatally for hydronephrosis and exhibited persistent findings on postnatal renal ultrasonography were included in the study group. The control group consisted of newborns without any antenatal or postnatal renal abnormalities. RESULTS: A total of 82 newborns were included in the analysis. Among them, 50 had no antenatal or postnatal renal anomalies and comprised the control group. In 32 newborns, both antenatal and postnatal hydronephrosis were diagnosed. The 2D:4D was significantly higher in the hydronephrosis group compared to the control group (p < 0.001). No significant differences were found between right and left hand 2D:4D measurements within either group (p > 0.05). CONCLUSION: The observation of significantly higher 2D:4D ratios in newborns with antenatal hydronephrosis may suggest a possible association with decreased prenatal androgen exposure. While the 2D:4D ratio is generally expected to be higher in females and lower in males, the finding of higher ratios in newborns with hydronephrosis may indicate a reduced androgen effect during fetal development in these cases. Although this finding is consistent with the fact that hydronephrosis is more frequently observed in male fetuses, it should be interpreted with caution and supported by further studies.
Am J Hum Biol
· 2025 Aug · PMID 40755362
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Human biologists have long studied the ecology, health, and adaptive patterns of pastoralist populations around the world. Over the last 20 years, research among pastoralists has increasingly focused on how ongoing clima...Human biologists have long studied the ecology, health, and adaptive patterns of pastoralist populations around the world. Over the last 20 years, research among pastoralists has increasingly focused on how ongoing climatic and socioeconomic changes are influencing these populations and threatening this lifeway. Additionally, with the development and broader use of "field friendly" methods for measuring energy expenditure, metabolism, and diverse biomarkers of physiological health, we are now able to gain a much more detailed and dynamic picture of the adaptive strategies of pastoralists. This Virtual Special Issue of the American Journal of Human Biology, "Human Biology of Pastoralists Populations" (Edited by Benjamin Campbell), showcases important advancements in this research domain and highlights the foundational contributions of Michael A. Little to our understanding of the biology and health of pastoralist societies.
Barboza LLS, de Oliveira Araujo RH, Pessoa MLF
… +3 more, da Silva DRP, de Lucena Martins CM, South American Physical Activity and Sedentary Behavior Network (SAPASEN) Collaborators
Am J Hum Biol
· 2025 Aug · PMID 40748181
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OBJECTIVES: This study aimed to systematically review and apply meta-analytic procedures to investigate the prevalence and time spent in different physical activity (PA) intensities among South American children across t...OBJECTIVES: This study aimed to systematically review and apply meta-analytic procedures to investigate the prevalence and time spent in different physical activity (PA) intensities among South American children across the childhood spectrum, according to sex and protocol used. METHODS: We searched PubMed, Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SCiELO); only studies with children between 0 and 11 years were included. Random-effects meta-analysis models were used to calculate the pooled estimates with their respective 95% confidence intervals (CI). All analyses were conducted using Stata 18.0. RESULTS: The literature search yielded 12 217 articles, with 28 studies remaining relevant for this review. The main exclusion criteria for the manuscripts were lack of prevalence data and doubled data. Pooled estimates revealed that children spent 61.4 (95% CI, 54.4-68.5) min/day of moderate-vigorous PA (MVPA), with differences in the time spent between girls (mean: 49.8 [95% CI, 38.8-60.8]) and boys (mean: 63.4 [95% CI, 55.7-71.1]). We noticed a great variability in PA prevalence, which ranged from 1.7% to approximately 80%, and was consistently lower among girls. Studies using device-based measures tend to report lower levels of PA than those relying on self-reported data. CONCLUSIONS: On average, South American children spend 61.4 min/day on MVPA, with high variability of both device-measured and self-reported PA. Regardless of the method used to measure PA, sex inequalities favorable to boys were noted.
Miller EM, Fujita M, Hinde K
… +3 more, Martin MA, Wander K, Quinn EA
Am J Hum Biol
· 2025 Aug · PMID 40734373
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Since we published "Field and Laboratory Methods in Human Milk Research" in 2013, human milk research has increased dramatically in both number and diversity of studies. Anthropological human biologists and biological an...Since we published "Field and Laboratory Methods in Human Milk Research" in 2013, human milk research has increased dramatically in both number and diversity of studies. Anthropological human biologists and biological anthropologists have played key roles in the realization of this research, arguing that evolutionary, developmental, and biocultural perspectives as essential for understanding variation in human milk. The purpose of this review is to highlight human biologists' and biological anthropologists' contributions to our understanding of human milk, often made in broadly collaborative research, as part of the 50th anniversary of the Human Biology Association. In this review, we identify three areas where human biologists have made major contributions: (1) understanding milk as a phenotype, (2) sex-differentiated milk synthesis, and (3) the cultural ecology of milk. We end this review by discussing future research directions and the applied and translational potentials of milk research, calling on human biologists to continue our leadership in the field in the decades to come.
Am J Hum Biol
· 2025 Jul · PMID 40682458
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This article considers how to approach sporting injury from the perspective of gender/sex entanglement. Taking the case of anterior cruciate ligament (ACL) injuries, I explore how the gender differences and inequalities...This article considers how to approach sporting injury from the perspective of gender/sex entanglement. Taking the case of anterior cruciate ligament (ACL) injuries, I explore how the gender differences and inequalities that fundamentally shape many sporting environments may contribute to injury in women athletes. I look to Australian Rules football (Aussie Rules)-a male-dominated, high-contact, highly skilled running game and Australia's largest commercial sport-where, following the launch of a women's professional league in 2017, a marked gender disparity in ACL injury has been reported. Rather than attribute this reported disparity to essential biological differences between women and men, I consider how gendered practices and disparities may accumulate across the life course of athletes with consequences for the embodied experiences of women and girls. Building on the concept of structural sexism as a key determinant of health, I document gender-related differences and inequalities at the early childhood, youth, and elite levels of Aussie Rules football. Via this case, I contribute to calls for a dynamic, developmental, and fundamentally gendered approach to studies of injury both in and beyond sport.
Am J Hum Biol
· 2025 Jul · PMID 40678930
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OBJECTIVES: Handgrip strength is a widely used indicator of muscle strength and general health, but its association with facial morphology remains unclear. This study examined whether handgrip strength or its asymmetry i...OBJECTIVES: Handgrip strength is a widely used indicator of muscle strength and general health, but its association with facial morphology remains unclear. This study examined whether handgrip strength or its asymmetry is related to facial sexual shape dimorphism, perceived masculinity/femininity, and facial asymmetry in two culturally and genetically distinct populations: Cameroonian and Czech adults. METHODS: Geometric morphometric methods were applied to full-face portraits of 226 individuals (balanced by sex, aged 19-59), using 72 facial landmarks and semi-landmarks. Pearson correlations and a series of ANOVA analyses were then used to assess possible associations between facial traits and both absolute and asymmetric grip strength. RESULTS: Across all models and subgroups, associations between handgrip strength and facial morphology were weak and nonsignificant. None of the facial characteristics reliably predicted either handgrip strength or its asymmetry in either men or women. CONCLUSIONS: These findings suggest that facial morphology on its own does not reliably reflect muscular strength. Further research should incorporate longitudinal and cross-cultural designs.
INTRODUCTION: This study analyzes the spatial clustering and socioeconomic and demographic determinants of child undernutrition in Tucumán, Argentina. METHODS: We conducted an observational, cross-sectional study using d...INTRODUCTION: This study analyzes the spatial clustering and socioeconomic and demographic determinants of child undernutrition in Tucumán, Argentina. METHODS: We conducted an observational, cross-sectional study using data from over 11 000 school-aged children in Greater San Miguel de Tucumán, the largest metropolitan area in the Northwestern Greater Argentina (NGA) region. We examined undernutrition at the population level-focusing on stunting, wasting, and general undernutrition-by analyzing both individual-level factors (age, sex, birth weight, and preterm birth) and neighborhood-level factors (percentage of households with unmet basic needs and the presence of informal settlements). Spatial cluster analysis was performed using SaTScan to detect geographic patterns of stunting and wasting. We then described and compared area-level social determinants within the identified clusters. Statistical analyses were carried out using SPSS version 25, and mapping was conducted with QGIS version 3.10. RESULTS: In our study, about 6% of schoolchildren presented undernutrition of some kind, with similar percentages for stunting (2.77%) and wasting (2.98%). Multivariate analysis reveals these associations with stunting: age, low birth weight, preterm birth, and residence in high-poverty neighborhood; wasting was associated with preterm birth and residence in high-poverty neighborhood. Cluster analysis shows that undernutrition is concentrated spatially, in areas around informal settlements that lack clean water and modern sewers and have lower educational levels. CONCLUSION: Our findings underscore the value of a multi-scalar and ecological approach to child undernutrition in rapidly growing urban areas. This study contributes to the growing body of evidence on nutritional inequalities and highlights the relevance of spatial justice in the development of targeted public health interventions.