Generational health and welfare – from The Fragile Wisdom

31 Dec

I’m really enjoying this book right now. Jasienska studies anthropological hormone levels and women’s health. She carefully builds up her cases through studies and develops her ideas in a detailed, nuanced manner that gives comfort and confidence. This passage

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We know that fetuses who are nutritionally deprived during development, or who have mothers who are nutritionally deprived, but who are later raised in nutritionally sufficient environments, are more at risk for developing cardiovascular diseases. obesity and diabetes. Jasienska proposes that the mismatch between expected conditions (as from the signals the fetus receives during gestation, or from the mother’s primed signals) and actual life conditions is the reason why these children present with a metabolic mismatch with their environment. As these children, if living in nutritionally deprived environments while growing up, would be better physically adapted (than their better fed foetal peers) to conserve resources for survival.

Here Jasienska builds the case for the hypothesis that generations of good nutritional maternal conditions (including in childhood) prime the body of infants to ‘expect’ a nutritionally deficit environment after birth. Despite the fact that the French and British diet have similar animal fat content and blood cholesterol (25.7% of all consumed calories & 6.1nmol/L vs 27% & 6.2nmol/L in males over age fifty), a British man is four times as likely to have heart disease than a French man. This has been called the “French Paradox”.

To explain this, Jasienska looks to historical evidence of better maternal conditions among the French, particularly concerning consistent nutritional welfare for women.

1. 1820s established Public Nurseries (entirely free of charge regardless of parental income); 1881 law passed that guaranteed free public primary education to all children (including the ecole maternelle)

2. 1882: Legislation require all towns and villages to have a school fund to support educational expenses for poor children, including meals at school for all children. This was free for families that were not able to afford it.

3.1892 Pierre Budin in Paris/1894 Dr. Leon Dufour in Normandy: established baby welfare clinics that promoted breastfeeding and gave mothers who could not breastfeed a daily supply of sterilized milk. Also provided continuous medical care for babies during first year of life.

4. 1904 In Paris, L’Oeuvre du Lait Maternel provided free meals for nursing mothers. A year later, the government & charitable organizations contracted with 5 restaurants in Paris to provide free meals for nursing mothers.”Any mother is welcome to come in. She will have to give neither name nor address nor reference of any kind. She has but to show that she feeds her baby”.

5.  1945 established Protection Maternelle et Infantile, a program that kept records of all pregnancies and babies, provided assistance for women and children, and identified pregnancies at risk.

6. 1991: Beginning at the 3rd month of pregnancy, regardless of income or number of children they already have, all women receive a fixed payment until the child is 3 months old. Must follow schedule of free, compulsory medical examinations.

Similar programs in England did appear following the French model, but were less consistent, implemented on a smaller scale, and had more strings attached.

Below is an excerpt from page 100 :

Many countries attempted to follow the French model of maternal and childhood welfare but with mixed success. Medical practitioners and social workers active in London between 1870 and 1930 observed that malnutrition and poor health were common among women, and East London mothers living in poor neighborhoods were portrayed as “haggard and worn” (Marks 1992, 48). Susan Pedersen, describing the differences between the French and British family welfare systems, wrote:

French policies reflect what I have termed a “parental” logic of welfare while British choices exhibit a “male breadwinner” logic since, in the former, some portion of the earnings of all adults was forcibly expended in the support of all children, while in the latter both wage and benefit income was directed disproportionately to men in the expectation that some would use it to support dependent wives and children. (Pedersen 1993, 413 – 414)

It is likely then that some British children did not benefit much from family welfare.

In following the logic of “fetal programming,” we may conclude that due to many generations of improved nutritional conditions French babies came into the world “physiologically programmed” that their future life conditions will be good. This prediction of future conditions is base don the intergenerational experience of past conditions. In France, thanks to a long history of many programs aimed at improving maternal and child nutrition and health, this experience indicates that life conditions, mostly in terms of availability of metabolic energy, are of good quality. In these circumstances, the fetus develops its physiology “ready” for a nutritionally adequate environment – that is, no physiological and metabolic adjustments prepare the physiology of the fetus for poor conditions.

Most modern French citizens do indeed encounter such good conditions during their entire postnatal lives. Therefore, following the logic of the hypothesis of Gluckman and Hanson (2005, chapter 4), we can say that the French people do not experience any mismatch between the predated and the encountered environments. This “mismatch hypothesis” suggests that poor in utero conditions lead to an increased risk of metabolic diseases in adults only when developmental conditions and adult conditions are different. A lack of such a mismatch in the French population may lead to the low risk of cardiovascular disease despite their high fat diet and the resulting high blood cholesterol levels.

In this case, I find the correlation between consistent supportive welfare policy and improved generational health fascinating.

I happened across this book in our local library. It is a book that I would not have happened across otherwise, and I feel so grateful for an awesome community library!

Vive la bibliothèque!

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