Wednesday, September 15, 2010

AAPA abstracts: foods that impact system inflammation, and why we shouldn't give hormonal contraceptives to twelve year olds

Today is the deadline for submission of abstracts to the American Association of Physical Anthropology meetings that take place in mid-April (don't get me started on the difficulty of anticipating where your research will be in seven months!). I was lucky enough to be involved in two special symposia: one organized by myself and the always-amazing Julienne Rutherford, the other by also-fantastic Grazyna Jasienska and Diana Sherry. I thought I would share them so you can see what I'm up to. I also want to notice the significant efforts of four different undergraduates in this research, all of whom have author credit in the abstracts. My research would not be possible without the many undergraduates in my laboratory.

Here's the first abstract:
Pro- and anti-inflammatory food proteins and their impact on maternal ecology

1Department of Anthropology, University of Illinois, Urbana-Champaign, 2School of Molecular and Cellular Biology, University of Illinois, Urbana-Champaign, 3School of Integrative Biology, University of Illinois, Urbana-Champaign

Undiagnosed gluten intolerance can lead to a number of serious fertility issues, including recurrent pregnancy loss and infertility. Independent of an immune response to gluten, diets high in refined carbohydrates, trans and saturated fatty acids, and sugar promote inflammation through the overproduction of pro-inflammatory cytokines. The overconsumption of refined carbohydrates (processed cereal grains as well as sugar) leads to high selectin-carbohydrate interactions that promote adhesion mechanisms that then help direct leukocytes to regions of inflammation. This suggests that a high carbohydrate diet may produce inflammation even in individuals who do not have food intolerances. In contrast, prebiotics and probiotics (soluble fiber and bacterial cultures found in foods like yogurt) promote an anti-inflammatory response. Prebiotics, or soluble fiber, stimulate growth and activity of bacteria in the digestive system and has a local anti-inflammatory effect. Fermentation of soluble fiber by GI bacteria generates short-chain fatty acids (SCFAs), some of which are histone inhibitors and thus have the greatest potential role in immunity and inflammation.

This work reviews the potentially contrasting effects of many cereal grains and fiber content on local inflammation, which likely impacts pregnancy success. However, the relationship between systemic inflammation and cereal grains has not been tested. Thus, we also report the initial results from a pilot study to examine the relationship between C-reactive protein, a biomarker for inflammation used in clinical work and shown to correlate with pregnancy loss, and autoantibodies to gluten, as the first examination of this relationship.

This study was funded by the University of Illinois Hewlett International Travel Grant.

This abstract is part of the symposium titled “Eating for two: maternal ecology and nutrition in human and non-human primates,” organized by Kathryn Clancy and Julienne Rutherford

This abstract comes out of literature review I have been doing for the last year or so, and a pilot project largely executed by Laura Klein this past summer. The field notes for my time at the Mogielica Human Ecology Study Site are up, and I hope at some point Laura will also share her experiences and perspective.

Here is the second abstract:
Variation in adolescent menstrual cycles, doctor-patient relationships, and why we shouldn't prescribe hormonal contraceptives to twelve year olds

1Illinois Natural History Survey, University of Illinois, Urbana-Champaign, 2Department of Anthropology, University of Illinois, Urbana-Champaign

Despite evidence that demonstrates the fundamental characteristics of adolescent menstrual cycles are variability and frequent anovulation, young girls, particularly in the United States, are regularly prescribed hormonal contraceptives to control irregularity. Though it takes five years or more to achieve regular ovulatory cycles, girls as young as twelve are visiting their doctors with complaints of infrequent cycles and being diagnosed with amenorrhea. Some medical doctors suggest a more stringent determination of amenorrhea in adolescents than in adults, from six months down to only three months without menses. We suggest that the use of hormonal contraceptives in young girls can have negative health consequences related to lifetime estrogen exposure, including breast cancer.

We propose several reasons for this phenomenon of very early hormonal contraceptive use. First, doctors and patients are largely unaware of the body of evidence showing that variation in cycle length and anovulation are normal and healthy in adolescents. Second, doctors often assume that young girls who report menstrual irregularity do so in order to secure hormonal contraceptives to have safe sex, but feel prohibited or embarrassed from asking outright. Finally, doctors are mired in a health system that mimics a customer support model, where they are expected to end symptoms. We suggest that a large number of young girls may visit their doctors for these issues under duress of their parents, or to seek reassurance from an expert that they are normal, but not necessarily to secure contraception.

This abstract is part of the symposium titled “Evolution and Health over the Life Course,” organized by Grazyna Jasienska and Diana Sherry.

The work for this abstract arose out of personal rants of my own over the last decade regarding the ubiquity of hormonal contraceptives for off-label use to treat "irregularity," and then a special blend of brilliant colleagues at the Early Development and Reproductive Health Workshop at the Evolution of Diseases of the Modern Environment Symposium, which was part of the World Health Summit last year. These colleagues helped me focus my thinking, and Ben Campbell, Grazyna Jasienska and I produced this document out of that workshop. I then had two students who needed senior projects and had an interest in the topic, Theresa and Ashley, who did a bang-up job finding some great articles to provide evidence-based heft to our concerns. We are following up on this project this fall.


  1. Hi Professor Clancy,
    I'm really interested in the subject of your second abstract, and I have a few comments/questions. I was one of those children who was given hormonal contraceptives for irregular cycles. My cycles varied anywhere from between 20 to 60 days. I waited four and a half years before I went to the doctor, though. That means I was 15 and a half at the time. You mention five years or more, however the doctor told me that since it had not balanced within 2 or 3 years, it probably never would. Do you know if the age at which a girl begins menstruation affects how long it will take for her body to become regular, assuming it isn't at the beginning? You mention some kind of "intervention in lifestyle" - can you elaborate on that?


  2. Hello again,
    I forgot to mention this!! Does "Some medical doctors suggest a more stringent determination of amenorrhea in adolescents than in adults, from six months down to only three months without menses." mean that because my cycle was at most 60 days, I should not have been prescribed any medication at all because my cycle variation falls within the realm of normal?


  3. Thanks for writing, Monica. I should have linked to this post over at my Laboratory for Evolutionary Endocrinology blog, written by Ashley and Theresa. Check out figure 2. It shows variation in time to ovulatory cycles based on age at first period.

    And while I'm not a medical doctor, I can say that a 60 day cycle does not fall into the category of amenorrhea.