title: Caregiving, gender, and nutritional status in Nyanza Province, Kenya: grandmothers gain, grandfathers lose.
abstract: Based on anecdotal and qualitative reports, a general assumption is that caregiving negatively impacts grandparents in Africa.
  
  
  OBJECTIVE
  The purpose of this article is to determine how caregiving and gender impact nutritional status over four waves of data from Luo elders.
  
  
  METHODS
  Luo elders, aged 60 and over (age 73.6 ± 7.9) were sampled. Participant recruitment was rolling and included 287 Luo grandparents in 2005, 396 in 2006, 389 in 2007, and 390 in 2009. A total of 689 elders participated in at least 1 year. Standard anthropometric measures were used to determine nutritional status. Impact of caregiving was examined using structural equation models.
  
  
  RESULTS
  Caregiving positively associated with nutritional status among women. This main effect was mediated by caregiving intensity, which also positively associated with nutritional status. Among men, caregiving negatively associated with nutritional status, although caregiving intensity did not significantly associate with most anthropometric measures. Socioeconomic status (SES) positively associated with five of nine anthropometric measures in women and all measures in men. Several measures indicated that both men and women became larger over time but few of the variables tested predicted growth.
  
  
  CONCLUSIONS
  The beneficial impact on grandmothers might indicate a coping strategy. These results indicated that researchers should shift away from comparing caregivers to noncaregivers and instead look at the multiple factors which may make some families resilient and others at risk. Human biologists can contribute to this literature by examining the ecological and cultural contexts under which caregiving represents a burden with physiological repercussions.
authors.affiliation: Department of Social Medicine Heh, Office of Research and Grants, University College of Osteopathic Medicine, Athens, Ohio, USA. iceg@ohio.edu
authors.forename: Gillian H
authors.initials: GH
authors.lastname: Ice
authors.forename: Victor
authors.initials: V
authors.lastname: Heh
authors.forename: Jaja
authors.initials: J
authors.lastname: Yogo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Juma
mesh_terms: D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology*; D016009:Chi-Square Distribution; D002648:Child; D002654:Child Care / Q000523:psychology*; D054540:Child, Orphaned / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016901:Intergenerational Relations; D007630:Kenya / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D036301:Qualitative Research; D012737:Sex Factors; D012923:Social Class