Diabesity among the Yucatecan Maya. Metabolism, genotype, phenotype and considerations of the sociocultural environment and early development.

Abstract

Diabetes and obesity are diseases of relevance in the epidemiological context of Yucatan. The high coexistence and complex interaction between these pathologies have generated an initial characterization of the phenomenon called diabesity, however, it is necessary to resort to comprehensive theoretical frameworks that contribute to the understanding of this phenomenon. Diabesity is particularly relevant in the native population of Mexico. Taking the Maya from Yucatan as a case study, we propose that an ecological perspective of diabesity allows for the identification of the presence of factors at different scales of analysis that help to understand the phenomenon. In this article, we aim to analyze the phenomenon of diabesity in the context of the Yucatecan Maya population, given the demographic importance of this ethnic group in the country and due to the high prevalence of diabetes and obesity. In this descriptive review, we first describe the phenotypic and genotypic traits associated with diabesity; we then discuss the role of the sociocultural factors that have impacted the dietary pattern of the Maya and the available evidence regarding the phenotypic characteristics acquired during the early stages of development and their possible repercussions on metabolism and the presence of obesity and diabetes. Finally, we propose that the failure of insulin secretion and glucolipotoxicity are common factors and a possible unifying factor of diabesity among the Maya. For this purpose, we resort to primary sources of information, including original research articles and chapters from edited books about diabesity and socio-historical essays on the Maya population.