"If these improvements in income translated into increased net nutrition and weight gain, then blacks, and especially Southern blacks, should, under the hypothesis, have been particularly susceptible to Type 2 diabetes," Steckel said.
Under the hypothesis, pregnant women living in poverty influence fetal development by sending biological signals that adequate nutrition will be hard to come by in life. When children instead grow up under relatively prosperous conditions, their bodies can't adjust.
"The fetus builds inadequate organs because of the forecast on the part of the mother received from earlier generations that there is going to be a lean world. When the child then becomes obese and stresses these organs, this leads to metabolic syndrome among adults, and then diabetes," he said.
"You have uncoordinated growth. Growth in utero is uncoordinated with your needs as an adult. It has been a disaster for the South."
There is more to the prosperity than just income, which serves as a proxy for all kinds of ways household behavior changed with added wealth. More food was available, and mothers entering the labor market were less likely to monitor children's diet and physical activity. With industrialization came mechanization, which lowered physical effort at work, while at the same time higher incomes reduced the need for such manual labor as chopping wood and farm chores around a home. Health club memberships also are lower in the South than in other parts of the country.
"This article does not contradict studies that show proximate causes of diabetes. I'm just trying to back up behind those proximate causes and say this is the underlying mechanism: a socioeconomic revolution, a nutrition revolution and a 'derevolution' of exercise and work," Steckel said.
This is why socioeconomic data could be useful during a physical exam, he said, in a way that could mak
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Ohio State University