Poor pregnancy outcomes in developing countries have often been blamed on maternal depletion or on the cumulative nutritional drain of many closely spaced pregnancies. Despite its widespread acceptance, the maternal depletion hypothesis remains unproven. This study examines nutritional status and fertility history for 873 women in highland Lesotho. Parity, age, pregnancy status, length of last closed birth interval, open interval, and median birth interval were used to predict nutritional status (BMI, triceps skinfold, arm muscle area). While there is evidence that both short-term and long-term nutritional depletion are related to lactation and pregnancy spacing, both BMI and triceps fat increase with parity. For this population, then, the assumption of cumulative depletion due simply to high fertility is not supported.
Anthropologists interested in human nutrition have become intrigued by the possibility of a link between nutritional status, fat stores, and fertility. Frisch (1978) and Frisch and McArthur (1974) have hypothesized such a link, based on studies of body composition at menarche and menstrual dysfunction in anorectics. This review indicates that both over-and undernutrition may interfere with reproductive function, but probably do so only when extreme. Evidence for fat as a regulator of fecundity is conflicting, and is best documented for age at puberty. Effects of fat on birth interval (a demographically more significant parameter) are confounded by the influence of lactation. A review of hormonal and metabolic patterns in obesity and inanation indicate similarities between these conditions and general or psychological stress. It is suggested that fat is better seen as an indicator of systemic function than as a single independent factor. The adaptive value of fat for human populations may lie in its ability to enhance work performance as much as in its influence on fecundity.65
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