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The Nuances in “Normal”

One word. Malinalco. We had the unique experience of going to Malinalco, a small but breathtaking rural town close to Mexico City, to conduct anthropometric and psychosociocultural research regarding nutrition and obesity on the population of children there. In awe of being surrounded by towering green mountains and the wonder of nature, it was hard to imagine that this was the everyday “normal” for the people of Malinalco. Coming to Malinalco, I had no idea what to expect. Even though we had workshops to prepare us, I knew that actually being out there in the field was going to be something completely different. I braced myself for the nuances to come.

As part of the anthropometric team, I was very excited and nervous to be working with the participants up close. I was quite flustered at first, but slowly fell into the groove of taking heights, and measuring the waist and hip sizes of the children and their parents. The most bittersweet part of the job for me was language difference. As I was unable to communicate fluently with the participants, there were so many questions and interactions that I was unable to ask and experience. On the other hand, I slowly learned many valuable key words in Spanish related to health, measurements, and dealing with patients in general. This was through a process of observation and collaboration with my fellow researchers, and teamwork in this case was very important in ensuring a smooth process. But I really enjoyed getting to interact with the participants. There are some emotions and sentiments that can be conveyed even without language, and it was wonderful to be able to have even the smallest moments of joy and recognition with the kids and their mothers, who were also extremely affable.At the end of the day we are all humans, and feelings are universal!

Another challenging aspect for me was measuring the mothers. They were often surprised that they had to be measured too, and when it came to hip and waist measurements, I sensed shyness and embarrassment from them. Most of the mothers were observably overweight or obese, and having to confront their physical status probably contributed to their lack of full cooperation. I encountered some resistance and it was hard to get accurate measurements if they were reluctant or wearing clothing that changed their natural form. But a few smiles, some laughter, and showing support and understanding can go a long way.

I was surprised that most of the kids did not look overweight. Although many seemed to look “normal” and have “healthy” measurements, looks can often be deceiving. The numbers tell us a different story. As I analyzed some of the data, only about 25% of them were overweight, and almost none were obese. However, I noticed a trend, in that most of the kids who fell in the “normal” BMI category were dangerously close to entering the overweight category. We had previously learned that as kids get older, there is a higher prevalence of overweight and obesity. It is worrisome to think that these kids may be making the jump between normal and overweight soon, or even from overweight to obese. And it is more grim knowing that most of the mothers and even teachers are likely overweight or obese, especially as most of them are housewives. But what I truly appreciated out of this initiative was its function as a preventative and early diagnosis program. Often, especially in Mexico, people will only go the doctor when they are sick due to socioeconomic limitations, but not much is being done to prevent unhealthy outcomes or inform the population about their risk profiles, which would be much more effective in the long run. There needs to be a more holistic and multi-layered approach to combating obesity in a place like Malinalco. By understanding their “normal”, in comparison to my own, I found that I left with even more questions regarding societal factors, unhealthy habits, the complexity of public health, incentives, nutrition, prevention, and physical status. Malinalco has opened a lot of doors, but we still need to dig deeper to find out what’s behind them to give Mexico a healthier “normal”.

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