The effects of lifestyle change on indicators of cardiometabolic health in semi-nomadic pastoralists

Zane S. Swanson*, Hilary Bethancourt, Rosemary Nzunza, Emmanuel Ndiema, David R. Braun, Asher Y. Rosinger, Herman Pontzer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and objectives: Non-communicable disease risk and the epidemic of cardiometabolic diseases continue to grow across the expanding industrialized world. Probing the relationships between evolved human physiology and modern socioecological conditions is central to understanding this health crisis. Therefore, we investigated the relationships between increased market access, shifting subsistence patterns and cardiometabolic health indicators within Daasanach semi-nomadic pastoralists who vary in their engagement in traditional lifestyle and emerging market behaviors. Methodology: We conducted cross-sectional socioecological, demographic and lifestyle stressor surveys along with health, biomarker and nutrition examinations among 225 (51.6% female) Daasanach adults in 2019-2020. We used linear mixed-effects models to test how differing levels of engagement in market integration and traditional subsistence activities related to blood pressure (BP), body composition and blood chemistry. Results: We found that systolic and diastolic BP, as well as the probability of having high BP (hypertension), were negatively associated with distance to market, a proxy for market integration. Additionally, body composition varied significantly by socioeconomic status (SES), with significant positive associations between BMI and body fat and higher SES among adults. Conclusions and implications: While evidence for evolutionary mismatch and health variation have been found across a number of populations affected by an urban/rural divide, these results demonstrate the effects of market integration and sedentarization on cardiometabolic health associated with the early stages of lifestyle changes. Our findings provide evidence for the changes in health when small-scale populations begin the processes of sedentarization and market integration that result from myriad market pressures.

Original languageEnglish (US)
Pages (from-to)318-331
Number of pages14
JournalEvolution, Medicine and Public Health
Issue number1
StatePublished - 2023


  • evolutionary mismatch
  • market integration
  • noncommunicable disease
  • pastoralism
  • sedentarization

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Health, Toxicology and Mutagenesis
  • Medicine (miscellaneous)


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