Behavioral and dietary risk factors for noncommunicable diseases

Comparative assessment of respiratory, hematological and inflammatory profiles of long-term users of cigarettes, shisha, and e-cigarettes in Saudi Arabia

INTRODUCTION

Globally, over 1 billion people smoke, resulting in approximately 8 million deaths each year. Although the health risks associated with traditional cigarettes are extensively documented, there is an increasing need to evaluate the long-term effects of alternative tobacco products, particularly shisha, and e-cigarettes. This study seeks to compare the respiratory, hematological, and inflammatory profiles of long-term users of cigarettes, shisha, and e-cigarettes in Saudi Arabia.

METHODS

A cross-sectional, observational study was conducted at the Respiratory Therapy laboratories of Batterjee Medical College (BMC), Jeddah, Saudi Arabia, between February 2022 and August 2023. It involved four groups: cigarette smokers, shisha smokers, e-cigarette users, and non-smokers. Pulmonary function tests (PFTs) measured FEV1, FVC, and other lung function parameters. Hematological profiles, including WBC, neutrophils, lymphocytes, monocytes, and C-reactive protein (CRP) levels, were assessed.

RESULTS

Cigarette and shisha users demonstrated significantly reduced FEV1 (cigarettes: 3.11 ± 0.54 L/s, shisha: 3.26 ± 0.71 L/s; p≤0.0001), FEV1 (% predicted: 81.63 ± 12.11 for cigarettes, 88.09 ± 12.92 for shisha; p≤0.0001), and FVC (3.87 ± 0.68 L for cigarettes, 3.95 ± 0.880 L for shisha; p=0.004), compared to non-smokers and e-cigarette users. Cigarette smokers exhibited significantly elevated WBC (7.92 ± 2.84 ×109/L; p≤0.001), neutrophil (4.03 ± 2.29 ×109/L), lymphocyte (2.95 ± 0.95 ×109/L), and monocyte counts (0.67 ± 0.21 ×109/L) compared to non-smokers, shisha, and e-cigarette users (p≤0.0001). Cigarette smokers and shisha smokers presented different lung function results but similar inflammatory profiles. However, e-cigarette users demonstrated comparatively higher lung function and lower inflammatory markers compared to both cigarette and shisha users.

CONCLUSIONS

Compared to non-smokers, long-term cigarette and shisha smoking is associated with airway obstructive changes and increased inflammatory responses. Although e-cigarette users demonstrated lower inflammatory markers and less deviation from normal PFT, some exhibited borderline values with airway obstruction. Further research is needed to clarify the long-term health consequences of e-cigarette use.

Dietary risk factors for non-communicable diseases among Omani adults by latent class analysis and structural equation modelling

BACKGROUND

Risk factor surveillance is vital for public health interventions in non-communicable diseases (NCD) control due to a noticeable nutrition transition among the population affecting dietary patterns. The objective was to investigate the dietary risk factors and its associations based on a first-of-its-kind analysis employing both Latent Class Analysis (LCA) and Structural equation modelling (SEM) to explore the hidden heterogeneity and subgroups with shared dietary pattern and to demonstrate the complex interaction of dietary factors with other risk factors in the development of NCDs.

METHODS

A cross-sectional survey was used. Secondary analysis of the 2017 Oman NCD Risk Factors Survey data was performed to investigate three major dietary risk factors (fruits and vegetables intake, eating out, and the type of oil used in cooking) of Omanis using LCA and SEM.

RESULTS

Dietary risk factors are prevalent in Omanis with 55.8% reporting intake of less than five fruit and vegetable servings per day, 45.3% ate outside the home 1-3 times per week, and 87.3% used vegetable oil for cooking. LCA showed two distinct classes of Omani population with majority belonging to the class mainly eating out 1-3 times per week, eating less than the recommended servings of fruits and vegetables, vegetable oil users, educated, and married young adults. SEM showed the intricate interplay of dietary factors with 8 direct paths and several indirect paths with NCD indicators.

CONCLUSIONS

These findings may have important implications for targeting health promotion strategies among the high-risk group of Omanis identified in this analysis and inform decision makers for the reduction of NCDs.

Potential impact of the time trend of fried food consumption on the cardiovascular disease burden in China

Background: Cardiovascular disease (CVD) is a leading cause of death in China. Fried foods are a risk factor for increasing CVD and their consumption in China is rapidly rising. Evaluation of the impact of fried foods on the CVD burden has important implications for future public health and policy making. This study aimed to evaluate the impact of fried foods on the CVD burden. Methods: We estimated the temporal trends of fried food consumption from 1997 to 2011 using data from the China Health and Nutrition Survey. We estimated CVD events attributed to fried food consumption using comparative risk assessment methods. We also projected fried food consumption and the related CVD burden from 2011 to 2031. Results: Fried food consumption continued to increase from 1997 to 2011, reaching 110.2 g per week in 2011. It is estimated that high consumption of fried foods is responsible for 3.4%, 2.3%, and 14.3% of the CVD, CHD, and stroke burden, accounting for 0.112 million CVD cases, 0.036 million CHD cases, and 0.243 million stroke cases, respectively. Notably, fried food consumption is projected to increase to 127.6 g per week by 2031. High consumption levels are projected to cause 0.239 million CVD cases, 0.078 million CHD cases, and 0.529 million stroke cases by 2031. Conclusions: The consumption of fried foods has continued to increase over time, which has an important impact on the burden of CVD in China. Dietary guidelines should continue to emphasize on decreasing the consumption of fried foods to reduce the CVD burden in China.

The prevalence and behavioral risk factors contributing to non-communicable diseases in Bushbuckridge, Mpumalanga province, South Africa

Background

Intervention strategies such as health campaigns, pre-screening, health education, and health talks exist. Still, they are only active if there are outbreaks of the specific infectious disease not mainly NCDs. Therefore, there is a need to develop intervention strategies to improve the prevention and control of behavioral risk factors for NCDs by determining social, economic, and health system factors. Hence, the study aimed to determine the prevalence and determinants of behavioral risk factors contributing to NCDs in Bushbuckridge, South Africa.

Methods

This cross-sectional descriptive study involved 2,400 respondents selected from healthcare facilities. The participants were selected using simple random sampling. Data was analyzed using SPSS version 29. A comparison of proportions was performed using the chi-square test. The association between sociodemographic and lifestyle factors with predictors of behavioral risk factors for NCD was analyzed using binary regression analysis, and the statistical significance was set at a p-value of <0.05.

Results

The mean age of the study was 46.27 ± 13.38. The prevalence of Smoking was 51.3% (1,211). The prevalence of alcohol consumption within the past year was 19.3% (463), while inadequate fruit and vegetable intake was 76.2%. Physical inactivity was 97.2%. Additionally, hypertension and diabetes were 51% and 50.1% respectively. Participants (≥35 years) were likely to have low fruit and vegetable intake (aOR = 1.3; 95% CI: 0.99-1.62). Widows were 30% less likely to smoke (aOR = 0.72; 95% CI: 0.57-0.92), yet they were 1.4 times more likely to consume alcohol (aOR = 1.4; 95% CI: 0.99-1.84). Unemployed participants were found to have a higher likelihood of consuming alcohol (aOR = 1.3; 95% CI: 1.02-1.54).

Conclusion

The prevalence of behavioral risk factors for NCDs was found to be high among rural populations residing in Bushbuckridge, underscoring the need for sustained and comprehensive interventions. In rural areas like Bushbuckridge, the combination of poverty, unemployment, limited healthcare access, and evolving social dynamics creates a challenging environment that fosters unhealthy behaviors and increases the risk of NCDs. To effectively reduce the burden of these diseases in such communities, public health strategies must focus on socio-economic and cultural determinants, rather than just demographic factors.

Off-label use of anlotinib in malignancies' treatment: efficacy and management of adverse reactions

Anlotinib is a novel small-molecule multi-target tyrosine kinase inhibitor (TKIs) independently developed in China, it possesses the functions of inhibiting tumor angiogenesis and suppressing tumor growth. Anlotinib has achieved notable therapeutic effects in approved indications for advanced non-small cell lung cancer, soft tissue sarcoma, small cell lung cancer, and medullary thyroid carcinoma. Additionally, with unanimous expert consensus, it has been used off-label in various other tumors, yielding favorable outcomes. This article reviews the efficacy and common adverse reactions, as well as their management, of off-label use of anlotinib in various malignant tumors.

Protective Effect of Dietary Fiber on Blood Pressure and Vascular Dysfunction Through Regulation of Sympathetic Tone and Immune Response in Genetic Hypertension

The mechanisms underlying the antihypertensive effect of dietary fibers remain poorly understood. This study investigates whether dietary fiber supplementation can prevent cardiovascular damage and high blood pressure in a genetic model of neurogenic hypertension. Six-week-old male spontaneously hypertensive rats (SHR) and their respective normotensive control, Wistar Kyoto rats (WKY), were divided into four groups: Untreated WKY, untreated SHR, SHR treated with resistant starch (SHR + RS), and SHR treated with inulin-type fructans (SHR + ITF) for 12 weeks. Additionally, a faecal microbiota transplantation (FMT) experiment was conducted, transferring faecal content from treated SHR donors to recipient SHRs. A diet rich in RS fiber reduced vascular oxidative stress, inflammation, and high blood pressure. These protective effects were associated with a reshaped gut microbiota, leading to increased short-chain fatty acid production, reduced endotoxemia, decreased sympathetic activity, and a restored balance between Th17 and Treg lymphocytes in mesenteric lymph nodes and aorta. Elevated plasma levels of acetate and butyrate in the SHR + RS group correlated with increased expression of aortic GPR41, GRP43 and PPARδ. Conversely, ITF treatment failed to prevent hypertension or endothelial dysfunction in SHR. FMT from the SHR + RS group to recipient SHR partially replicated these beneficial effects. This study highlights the antihypertensive benefits of dietary insoluble RS fiber, which are attributed to enhanced short-chain fatty acids production in the gut. This leads to improved gut permeability, reduced sympathetic tone, and diminished vascular T-cell accumulation. Therefore, dietary interventions with RS fiber may offer promising therapeutic strategies for preventing hypertension.

Efficacy and safety of ayurvedic intervention (Sarpgandha Mishran) vs amlodipine for Stage-I primary hypertension- study protocol for a prospective Double-Dummy, Double-Blind, placebo-controlled Randomized Clinical Trial

BACKGROUND

Hypertension presents as a modifiable risk factor for cardiovascular diseases, with approximately two-thirds of the global hypertensive population concentrated in low- and middle-income nations. Sarpagandha Mishran is an Ayurveda intervention utilized for the management of hypertension. The objective of the study is to assess the clinical efficacy and safety of Sarpgandha Mishran in the Management of Stage-I Hypertension.

METHODS

This clinical trial employs a prospective design characterized by a double-dummy, double-blind, placebo-controlled methodology being conducted at Cardiology Outpatient Department of the AIIMS, New Delhi. A total of 150 participants (75 per group), diagnosed with Stage-I essential hypertension will be randomized and allocated in a 1:1 allocation ratio, to either Ayurveda group or Conventional Care group. Participants in Group I will receive Ayurvedic intervention, Sarpagandha Mishran 500 mg capsules orally twice daily, in addition to a matching placebo of Amlodipine 5 mg capsules orally once daily. Group II will receive a matching placebo of Sarpagandha Mishran 500 mg capsules along with Amlodipine 5 mg capsules orally once daily. All participants will also be administered Hydrochlorothiazide 12.5 mg tablets orally once daily for a duration of 12 weeks. The primary endpoint of this study involves evaluating changes in SBP and DBP from baseline to week 12. Secondary outcome includes assessing changes in IL-6, Serum Pro-BNP, oxidative stress markers, lipid profile, and the SF-36 Health Survey Score. Safety assessments will be done through recording of AE/ADR and assessments of liver function tests and renal function tests parameters.

DISCUSSION

The present study is poised to furnish comprehensive insights into the clinical efficacy and safety profile of Sarpagandha Mishran in the management of Grade 1 hypertension. By adopting a rigorous scientific methodology, this investigation aims to contribute robust evidence that may significantly impact the formulation of future guidelines for integrative treatment protocols in hypertension management.

TRIAL REGISTRATION

The trial is prospectively registered with the Clinical Trial Registry of India [CTRI/2021/12/038589], dated 13.12.2021.

Systematic Review on the Impact of Salt-Reduction Initiatives by Socioeconomic Position to Address Health Inequalities in Adult Populations

CONTEXT

International evidence shows that individuals from low socioeconomic positions (SEPs) consume a greater amount of salt than those from higher SEPs. This health inequality reflects a disproportionate effect of salt-reduction initiatives, and explains a higher prevalence of cardiovascular disease among the most vulnerable populations. Assessing this impact can help tailor implementation strategies in the future for the benefit of the whole population.

OBJECTIVE

The aim was to systematically review the literature and assess the impact of salt-reduction initiatives on health and behavioral outcomes of adults by SEP.

DATA SOURCES

The search strategy was conducted in 6 databases (CINAHL, Scopus, Embase, MEDLINE, PubMed, and Web of Science) using the terms sodium or salt, social class, policy, intervention or campaign. Peer-reviewed articles assessing salt-reduction interventions in adults reporting dietary or behavioral changes on salt consumption measurements by SEP were considered for inclusion. Articles in which salt intake data were not reported by SEP were excluded.

DATA EXTRACTION

Two reviewers collected data independently using a predesigned electronic form. The AXIS and RoB 2 tools were used for critical appraisal.

DATA ANALYSIS

Eight studies containing data from 111 548 adults were interpreted according to study design following a narrative synthesis approach.

RESULTS

Salt-reduction initiatives are effective at reducing the intake of salt and sodium in adults. When reporting the impact of these initiatives, research outcomes are generally not evaluated by SEP, representing a question yet to be explored.

CONCLUSION

A small number of articles that focused on the impact of salt-reduction interventions reported salt consumption measurements by SEP, indicating a critical gap in research. The limited evidence suggests potentially greater health benefits to be gained from the implementation of population-wide initiatives in adults of low SEP.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021238055.

A Body Shape Index as a Simple Anthropometric Marker for the Risk of Cardiovascular Events

PURPOSE OF REVIEW

To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events.

RECENT FINDINGS

ABSI has been reported to have an association with development of cardiovascular diseases, and its usefulness for predicting major cardiovascular events including cardiovascular mortality, nonfatal coronary syndrome and nonfatal stroke has been investigated. The formula for ABSI includes waist circumference, which is not included in the conventional calculation of body mass index (BMI), along with BMI and height. High ABSI is independently associated with a high incidence of cardiovascular events. ABSI with specific cutoff values can be a useful tool for cardiovascular risk stratification by detecting the presence of abdominal obesity and it can be used for evaluation of the risk of cardiovascular events. Nonetheless, other factors such as race, gender, age, and physical, environmental and socioeconomic purviews also need be taken into consideration.

Moderators of a Diet and Physical Activity Intervention: who Responds Best to Sequential vs. Simultaneous Approaches

BACKGROUND

Given that low physical activity levels and poor dietary intake are co-occurring risk factors for chronic disease, there is a need for interventions that target both health behaviors, either sequentially or simultaneously. Little is known about participant characteristics that are associated with better or worse response to sequential and simultaneous interventions.

METHOD

The 12-month Counseling Advice for Lifestyle Management (CALM) randomized trial (N = 150; Mage = 55.3 years) targeted these two behaviors either via a sequential approach - dietary advice first then exercise advice added ("Diet-First") or exercise advice first then dietary advice added ("Exercise-First") - or via a simultaneous approach. The objective was to examine demographic, clinical, and psychosocial moderators of intervention effects on 12-month change in (1) moderate-to-vigorous physical activity (MVPA), (2) fruit/vegetable intake, (3) caloric intake from saturated fat, and (4) weight. Hierarchical regressions first compared Diet-First to Exercise-First, followed by comparisons of these arms combined ("sequential") to the simultaneous arm.

RESULTS

Older age, higher baseline BMI, and lower social support were associated with higher MVPA in Exercise-First vs. Diet-First, while lower tangible support was associated with higher fruit/vegetable intake in Exercise-First but not in Diet-First. Poor sleep was associated with higher levels of MVPA in the sequential arm than in the simultaneous arm. Lower vitality was associated with greater weight loss in the sequential arm than in the simultaneous arm, while the opposite was true for those who were not married.

CONCLUSION

Identifying moderators of treatment response can allow the behavioral medicine field to enhance intervention efficacy by matching participant subgroups to their best-fitting interventions.

TRIAL REGISTRATION

NCT00131105.

Resveratrol: A Narrative Review Regarding Its Mechanisms in Mitigating Obesity-Associated Metabolic Disorders

Resveratrol (RSV) is a naturally occurring astragalus-like polyphenolic compound with remarkable weight loss properties. However, the mechanism of RSV in treating obesity is unclear. In this narrative review, we explored electronic databases (PubMed) for research articles from 2021 to the present using the keywords "resveratrol" and "obesity". This article explores the mechanisms involved in the alleviation of obesity-related metabolic disorders by RSV. RSV affects obesity by modulating mitochondrial function, insulin signaling, and gut microbiota, regulating lipid metabolism, inhibiting oxidative stress, and regulating epigenetic regulation. Administering RSV to pregnant animals exhibits maternal and first-generation offspring benefits, and RSV administration to lactating animals has long-term benefits, which involve the epigenetic modulations by RSV. A comprehensive understanding of the epigenetic mechanisms of RSV regulation could help in developing drugs suitable for pregnancy preparation groups, pregnant women, and nursing infants.

The Mediating Effect of Concurrent Changes in Dietary Behaviors on the Associations Between Intervention and Changes in Adiposity Outcomes: Evidence from a Cluster-Randomized Controlled Trial

Behavioral interventions have been shown to be effective in improving dietary behavior and reducing childhood obesity. There is limited evidence on how concurrent changes in dietary behavior from intervention studies affect childhood obesity. The present study aimed to evaluate the mediating effect of concurrent changes in dietary behaviors between the intervention and changes in adiposity indicators. This study included 1180 children from the DECIDE-Children study, which was conducted across three areas in China, aiming to promote children's healthy diet and physical activity, while also engaging schools and families to support children's behavioral changes. Dietary behaviors were collected by a revised version of the Food Frequency Questionnaire and a self-designed questionnaire. Adiposity outcomes were objectively measured by trained personnel. Generalized linear mixed models were used to estimate the association between scores of dietary behavioral changes and adiposity indicator changes. Mediation analyses were used to evaluate how scores of dietary behavioral changes mediated the effect of intervention on adiposity indicator changes. Six hundred children in the intervention group and five hundred and eight in the control group with both baseline and follow-up data were included. Each increase in dietary behavioral change score was associated with a 0.06 (p = 0.016) decrease in changes in BMI and other adiposity indicators. Scores of dietary behavioral changes mediated 13.87% (p < 0.001), 11.81% (p < 0.001), 17.60% (p = 0.024), and 16.78% (p = 0.032) of the association between intervention and changes in body mass index (BMI), BMI z-score, body fat percentage, and waist circumference, respectively. Scores of dietary behavioral changes mediated the intervention effect on adiposity indicator changes. Future interventions targeting childhood obesity should incorporate promoting multiple dietary behaviors simultaneously.

Multimorbidity and risk of adverse outcomes in the Hertfordshire Cohort Study: does sex matter?

AIMS

We examined whether admission risk increases at a certain threshold of number of systems medicated or whether any increase confers greater admission risk in either sex in a community-dwelling cohort of older persons in Hertfordshire. This study uses a longitudinal retrospective study design.

METHODS

Data from 2997 men and women (aged 59-73 at baseline) were analyzed. Participants were followed up from baseline (1998-2004) until December 2018 using Hospital Episode Statistics and mortality data, reporting clinical outcomes using ICD-10 coding. Number of systems medicated in relation to mortality (all-cause, cancer-related, cardiovascular-related) and admission (any, neurological, cardiovascular, and respiratory) were examined using Cox regression.

RESULTS

Apart from cancer-related mortality among women, more systems medicated predicted increased risk of all events among both sexes (p ≤ 0.001). For 'any', cardiovascular and respiratory admissions, there were increases in risk for each category of number of systems medicated. For example, compared to men with no systems medicated, those with 1, 2 and > 2 systems medicated had hazard ratios (95% CI) for cardiovascular admissions of 1.82 (1.57,2.12), 2.39 (2.00,2.84) and 3.45 (2.84,4.20) respectively; estimates among women were 1.74 (1.44,2.11), 2.35 (1.92,2.88) and 3.40 (2.79,4.13).

CONCLUSIONS

Increases in numbers of systems medicated conferred greater risk of admission in both sexes. Interventions aimed at reducing the burden of chronic disease in mid-late adulthood are required.

Trends in breast density and other risk factors for breast cancer and associations with trends in the incidence of breast cancer in Korean women

INTRODUCTION

This study investigated the trends in breast density in Korean women and their association with the incidence of breast cancer, incorporating the trends in the known risk factors for breast cancer from an ecological perspective.

METHODS

The prevalence of risk factors for breast cancer from the National Health and Nutrition Survey, breast density from Korea's national breast cancer screening program, and breast cancer incidence from the Korea Central Cancer Registry during 2010-2018 were applied after age-standardization to the population at the middle of the year 2000. The association between the prevalence of risk factors for breast cancer, the prevalence of dense breast, and the incidence rate of breast cancer was estimated using linear regression.

RESULTS

The proportion of age-standardized dense breasts steadily increased from 45.8 % in 2010 to 51.5 % in 2018. The increased prevalence of dense breasts in women was positively related to the prevalence of smoking, drinking, lack of exercise, early menarche age (<15 years old), premenopausal status, nulliparity, and no history of breastfeeding, and negatively related to the prevalence of obesity. The increased prevalence of the dense breast was associated with an increase in the incidence of breast cancer, and 96 % of the variation in breast cancer incidence could be explained by the variation in the prevalence of dense breast. The factors associated with dense breast and breast cancer incidence overlapped.

CONCLUSIONS

Trends in breast cancer risk factors were associated with an increased prevalence of dense breast, which, in turn, was associated with an increased incidence of breast cancer in Korea.

Associations between cooking method of food and type 2 diabetes risk: A prospective analysis focusing on cooking method transitioning

Cooking process for food significantly impacts household air and increases exposure to endocrine disruptors such as acrylamide, consequently affecting human health. In the past 30 years, the transformation of cooking methods to high-temperature thermal processing has occurred widely in China. Yet the transition of cooking methods on the onset of type 2 diabetes (T2D) remains unclear, which may hinder health-based Sustainable Development Goals. We aimed to estimate the associations between dietary intake with different cooking methods and T2D risk. We included 14,745 participants (>20 y) from the China Health and Nutrition Survey (1991-2015). Food consumption was calculated using three consecutive 24-h dietary recalls combined with both individual participant level and household food inventory. Cooking methods, including boiling, steaming, baking, griddling, stir-frying, deep-frying, and raw eating, were also recorded. The consumption of baked/griddled and deep-fried foods was positively associated with 39% and 35% higher of T2D risk by comparing the highest with the lowest category of food consumption, respectively. The use of unhealthy cooking methods for processing foods including baked/griddled and deep-fried foods was attributable for 15 million T2D cases of the total T2D burden in 2011, resulting in a medical cost of $2.7 billion and was expected to be attributable for 39 million T2D cases in 2030, producing a medical cost of $223.8 billion. Replacing one serving of deep-fried foods and baked/griddle foods with boiled/steamed foods was related to 50% and 20% lower risk of T2D, respectively. Our findings recommend healthy driven cooking methods for daily diet for nourishing sustainable T2D prevention in China.

Comparative effects of behaviour change techniques using eHealth and mHealth in promoting dietary behaviour: protocol for a systematic review and component network meta-analysis

INTRODUCTION

Globally, it is estimated that dietary habits contribute to 22% of adult deaths and 15% of disability-adjusted life years, highlighting the critical role of dietary behaviour in public health. Despite the known benefits of healthy eating, many individuals find it challenging to change their diet for disease prevention. eHealth and mHealth interventions using behaviour change techniques (BCTs) have emerged as promising strategies to address this issue. However, the specific BCTs that are most effective in promoting dietary behaviour are not well established. This systematic review and component network meta-analysis (CNMA) aims to estimate the effect size of each BCT on fostering healthy eating.

METHODS AND ANALYSIS

We will include randomised controlled trials that assess the effects of eHealth and mHealth interventions on promoting changes in dietary behaviours among healthy adults. Studies with a minimum follow-up period of 3 weeks will be considered. Searches will be conducted in MEDLINE [PubMed], Embase [Dialogue], Cochrane Central Register of Controlled Trials, PsycInfo [Dialogue], ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and the University Hospital Medical Information Network Clinical Trials Registry on 27 January 2024. Two independent reviewers will conduct title and abstract screening followed by a full-text review. Disagreements will be resolved through discussion or consultation with a third reviewer. The primary outcome is dietary behaviour, as measured by changes in the diet quality score and the intake of a specific food. Our data synthesis will apply a frequentist random-effects model for pairwise meta-analysis, network meta-analysis and an additive CNMA model to compute the effect size of each BCT. This methodological approach will reveal the positive and negative effects of each BCT and provide a ranking of these techniques, considering both direct and indirect evidence.

ETHICS AND DISSEMINATION

Ethical approval is not required for this systematic review because it uses existing published data. These results will be submitted for publication in a peer-reviewed journal. The current protocol was submitted to PROSPERO on 16 January 2024 (CRD 42024502217).

Tobacco- and alcohol-attributable burden of early-onset lip, oral cavity, and pharyngeal cancer in 204 countries and territories from 1990 to 2019, with projections to 2040

Background

Rising trends in early-onset Lip and oral cavity cancer (LOC) and Other pharyngeal cancer (OPC) burden had been observed. This study aimed to evaluate the burdens of LOC and OPC attributable to tobacco and alcohol in young adults aged 15-49 years from 1990 to 2040.

Methods

Tobacco- and alcohol-attributable death and disability-adjusted life years (DALYs) for LOC and OPC and the corresponding population-attributable fraction were obtained from Global Burden of Disease Study 2019 for individuals aged 15-49 years. Estimated annual percent change was calculated to quantify the temporal trend of disease burden between 1990 and 2019. The Bayesian age-period-cohort model was used to predict the age-standardized mortality rate from 2020 to 2040.

Results

In 2019, an estimated 16,887 deaths and 799,495 DALYs for tobacco- and alcohol-attributable early-onset LOC, and 8,402 deaths and 386,418 DALYs for early-onset OPC attributable to tobacco and alcohol were reported globally. Despite the global decrease in age-standardized mortality and DALYs rates of tobacco- and alcohol-attributable LOC and OPC in young adults aged 15-49 years between 1990 and 2019, certain regions experienced increases, such as regions of Asia, Eastern Europe, and Western Sub-Saharan Africa. Moreover, a growing age-standardized mortality in individuals aged <34 years was found. The socio-demographic index level was positively associated with a faster reduction of early-onset LOC and OPC DALYs attributable to alcohol use and smoking, except for that due to chewing tobacco. Furthermore, projections have also indicated an expected increase in the age-standardized mortality for tobacco- and alcohol-attributable early-onset LOC and OPC.

Conclusions

Significant regional and demographic disparities in tobacco and alcohol-related early-onset LOC and OPC burden and their attributable proportion highlight a need for tailored age- and region-appropriate interventions to reduce the future LOC and OPC burden among young adults.

Evidence of gene-nutrient interaction association with waist circumference, cross-sectional analysis

BACKGROUND AND AIMS

Waist circumference (WC) is a significant indicator of body adiposity and is associated with increased mortality and morbidity of cardiovascular diseases. Although, single nutrient intake and candidate genes were previously associated with WC. Little is known about WC association with overall diet quality, genetic risk score and gene-nutrient interaction. This study aims to investigate the influence of overall diet quality and multiple WC-associated single nucleotide polymorphisms on WC. In addition to investigating gene-nutrient interaction association with WC.

METHODS

This study explored cross-sectional data from two large sample-size studies, to provide reproducible results. As a representation of the UK population, the Airwave Health Monitoring Study (n = 6,502) and the UK-Biobank Cohort Study (n = 171,129) were explored for factors associated with WC. Diet quality was evaluated based on the Mellen Index for Dietary Approaches to Stop Hypertension (Mellen-DASH). The genetic risk score for WC (GRS-Waist) was calculated by screening the population genotype for WC-associated single nucleotide polymorphisms. Multivariate linear regression models were built to explore WC association with diet quality and genetic risk score. Gene-nutrient interaction was explored by introducing the interaction term (GRS-Waist X Mellen-DASH score) to multivariate linear regression analysis.

RESULTS

The prevalence of high WC (Female > 80 cm, Male > 94 cm) was 46.5% and 51.7% in both populations. Diet quality and genetic risk score of WC were significantly associated with WC. There was no evidence of interaction between GRS-Waist, DASH diet scores and nutrient intake on WC.

CONCLUSION

This study's findings provided reproducible results on waist circumference association with diet and genetics and tested the possibility of gene-nutrient interaction. These reproducible results are successful in building the foundation for using diet and genetics for early identification of those at risk of having high WC and WC-associated diseases. In addition, evidence on gene-diet interactions on WC is limited and lacks replication, therefore our findings may guide future research in investigating this interaction and investigating its application in precision nutrition.

Taste Preference for Salt Predicts Salt Intake in a Chinese Population

OBJECTIVE

This study describes the association between taste preference for salt and actual salt intake, thus guiding and refining personal and public health campaigns designed to lower salt intake in China.

METHODS

A cross-sectional survey of 1489 residents aged 18 to 69 years was conducted in 2017 in China. A multistage random sampling strategy was used, and a combination of questionnaires and physical and laboratory measurements were conducted to collect baseline characteristics and knowledge, attitudes, and behavior (KAB) related to salt. A 24 h urine collection was obtained for sodium and potassium excretion analysis. Participants were divided into two groups, light taste preference and salty taste preference, according to their answer to the question "Compared to others, how do you think your taste preference is for salt?".

RESULTS

The mean age of the 1489 participants was 46.26 years, 48.9% were males, over 1/3 (35.7%) were identified as hypertensive, and 317 (21.3%) self-reported a salty taste preference. The mean of 24 h urinary sodium excretion was 167.32 mmol/24 h, corresponding to 9.79 g salt/d intake, and the sodium-to-potassium ratio (Na/K) was 4.90. The 24 h urinary sodium excretion of salty taste preference (177.06 mmol/24 h) was significantly higher than that of light taste preference (164.69 mmol/24 h). The multiple logistic regression analysis showed that the salty taste preference group had significantly higher 24 h urinary sodium (ORa(95%CI) = 1.004(1.002-1.006)), diastolic blood pressure (DBP), proportion of greasy food preference, and drinking levels, but lower potassium excretion, response levels to most KAB questions, and regular physical activity compared to the light taste preference group.

CONCLUSION

Self-reported taste preference for salt predicted actual salt intake, which was verified by 24 h urinary sodium monitoring. Taste preference for salt could be used as a proxy for intake in terms of targeted salt intake, nutrition, and health education.

Fructooligosaccharides benefits on glucose homeostasis upon high-fat diet feeding require type 2 conventional dendritic cells

Diet composition impacts metabolic health and is now recognized to shape the immune system, especially in the intestinal tract. Nutritional imbalance and increased caloric intake are induced by high-fat diet (HFD) in which lipids are enriched at the expense of dietary fibers. Such nutritional challenge alters glucose homeostasis as well as intestinal immunity. Here, we observed that short-term HFD induced dysbiosis, glucose intolerance and decreased intestinal RORγt+ CD4 T cells, including peripherally-induced Tregs and IL17-producing (Th17) T cells. However, supplementation of HFD-fed male mice with the fermentable dietary fiber fructooligosaccharides (FOS) was sufficient to maintain RORγt+ CD4 T cell subsets and microbial species known to induce them, alongside having a beneficial impact on glucose tolerance. FOS-mediated normalization of Th17 cells and amelioration of glucose handling required the cDC2 dendritic cell subset in HFD-fed animals, while IL-17 neutralization limited FOS impact on glucose tolerance. Overall, we uncover a pivotal role of cDC2 in the control of the immune and metabolic effects of FOS in the context of HFD feeding.

Food for thought: Making the case for food produced via regenerative agriculture in the battle against non-communicable chronic diseases (NCDs)

Non-communicable diseases (NCDs) pose a global health challenge, leading to substantial morbidity, mortality, and economic strain. Our review underscores the escalating incidence of NCDs worldwide and highlights the potential of regenerative agriculture (RA) products in mitigating these diseases. We also explore the efficacy of dietary interventions in NCD management and prevention, emphasizing the superiority of plant-based diets over those high in processed foods and red meat. Examining the role of the gut microbiome in various diseases, including liver disorders, allergies, metabolic syndrome, inflammatory bowel disease, and colon cancer, we find compelling evidence implicating its influence on disease development. Notably, dietary modifications can positively affect the gut microbiome, fostering a symbiotic relationship with the host and making this a critical strategy in disease prevention and treatment. Investigating agricultural practices, we identify parallels between soil/plant and human microbiome studies, suggesting a crucial link between soil health, plant- and animal-derived food quality, and human well-being. Conventional/Industrial agriculture (IA) practices, characterized in part by use of chemical inputs, have adverse effects on soil microbiome diversity, food quality, and ecosystems. In contrast, RA prioritizes soil health through natural processes, and includes avoiding synthetic inputs, crop rotation, and integrating livestock. Emerging evidence suggests that food from RA systems surpasses IA-produced food in quality and nutritional value. Recognizing the interconnection between human, plant, and soil microbiomes, promoting RA-produced foods emerges as a strategy to improve human health and environmental sustainability. By mitigating climate change impacts through carbon sequestration and water cycling, RA offers dual benefits for human and planetary health and well-being. Emphasizing the pivotal role of diet and agricultural practices in combating NCDs and addressing environmental concerns, the adoption of regional RA systems becomes imperative. Increasing RA integration into local food systems can enhance food quality, availability, and affordability while safeguarding human health and the planet's future.

The direct and spillover effects of diabetes diagnosis on lifestyle behaviours

Using blood sample data we exploit an arbitrary cut-off of diabetes risk and through a fuzzy regression kink design we estimate the effect of a diabetes diagnosis on own and partner health-related behaviours. Diabetes diagnosis increases the probability of exercising, both for those diagnosed with diabetes and their partner. We also conduct mediation analysis which suggests that joint household participation is the channel behind this effect. Our results have significant implications for the understanding of the channels that induce behavioural change, and household decision making, as well as, for the evaluation of diabetes related policies.

Social inequality in prevalence of NCD risk factors: a cross-sectional analysis from the population-based Tromsø Study 2015-2016

OBJECTIVE

We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men.

DESIGN

Population-based cross-sectional study.

SETTING

All inhabitants of the municipality of Tromsø, Norway, aged ≥40 years, were invited to the seventh survey (2015-2016) of the Tromsø Study; an ongoing population-based cohort study.

PARTICIPANTS

Of the 32 591 invited; 65% attended, and a total of 21 069 women (53%) and men aged 40-99 years were included in our study.

OUTCOME MEASURES

We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit/vegetable intake (<5 units/day), harmful alcohol use (>10 g/day in women, >20 g/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men.

RESULTS

In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95% CI 1.60 to 1.78), physical inactivity (OR 1.38; 95% CI 1.31 to 1.46), insufficient fruit/vegetable intake (OR 1.54, 95% CI 1.43 to 1.66), hypertension (OR 1.25; 95% CI 1.20 to 1.30), obesity (OR 1.23; 95% CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95% CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95% CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95% CI 0.72 to 0.78).

CONCLUSION

We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol use, which increased at higher educational levels.

Hemodynamic Mechanisms Initiating Salt-Sensitive Hypertension in Rat Model of Primary Aldosteronism

Few studies have investigated the hemodynamic mechanism whereby primary hyperaldosteronism causes hypertension. The traditional view holds that hyperaldosteronism initiates hypertension by amplifying salt-dependent increases in cardiac output (CO) by promoting increases in sodium retention and blood volume. Systemic vascular resistance (SVR) is said to increase only as a secondary consequence of the increased CO and blood pressure. Recently, we investigated the primary hemodynamic mechanism whereby hyperaldosteronism promotes salt sensitivity and initiation of salt-dependent hypertension. In unilaterally nephrectomized male Sprague-Dawley rats given infusions of aldosterone or vehicle, we found that aldosterone promoted salt sensitivity and initiation of salt-dependent hypertension by amplifying salt-induced increases in SVR while decreasing CO. In addition, we validated mathematical models of human integrative physiology, derived from Guyton's classic 1972 model - Quantitative Cardiovascular Physiology-2005 and HumMod-3.0.4. Neither model accurately predicted the usual changes in sodium balance, CO, and SVR that normally occur in response to clinically realistic increases in salt intake. These results demonstrate significant limitations with the hypotheses inherent in the Guyton models. Together these findings challenge the traditional view of the hemodynamic mechanisms that cause salt-sensitive hypertension in primary aldosteronism. Key words: Aldosterone, Blood pressure, Salt, Sodium, Rat.

The association between physical activities combined with dietary habits and cardiovascular risk factors

Objectives

The aim of this study was to investigate the association between physical activities combined with dietary habits and cardiovascular risk factors in adults from Nanjing, China.

Methods

The cross-sectional survey conducted in 2017 involved a sample of 60 283 individuals aged ≥18 years in Nanjing municipality, China. The sampling method used was multistage stratified cluster sampling. The primary outcomes from multivariate logistic regression analysis with adjusted potential confounders were the relationships between physical activities combined with dietary habits and cardiovascular risk variables. Relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S) were used to assess an additive interaction between dietary habits and physical activities.

Results

After adjusting potential confounders, cardiovascular risk factors were significantly associated with the association of physical inactivity and unhealthy diet, with the highest odds ratios (ORs) for low density lipoprotein-cholesterol (HLDL-c) (1.64, 95% CI [1.47, 1.84]) and hypertension (1.55, 95% CI [1.46, 1.64]). Additive interactions between physical inactivity and unhealthy diet were found in on cardiovascular risk factors of higher low-density lipoprotein-cholesterol (HLDL-c) (S, 2.57; 95% CI [1.27, 5.21]), type 2 diabetes (T2D) (S, 1.96; 95% CI [1.23, 3.13]), dyslipidemia (S, 1.69; 95% CI [1.08, 2.66]) and hypertension (S, 1.46; 95% CI [1.12, 1.89]). Their RERI was 0.39 (95% CI [0.18, 0.60]), 0.22 (95% CI [0.09, 0.35]), 0.11 (95% CI [0.03, 0.19]) and 0.17 (95% CI [0.06, 0.28]), respectively. OR of being HLDL-c, T2D, hypertension and dyslipidemia in participants of physical inactivity and unhealthy diet was 24%, 15%, 11% and 8.3%, respectively. Multiplicative interaction was detected in obesity, hypertension, T2D and HLDL-c.

Conclusion

An unhealthy diet and physical inactivity were strongly linked to cardiovascular risk factors. This study also showed that an unhealthy diet and physical inactivity combined to produce an additive effect on T2D, hypertension, HLDL-c, and dyslipidemia, suggesting a higher risk than the total of these factors, especially HLDL-c. Preventive strategies aimed at reducing cardiometabolic risks such as hypertension, T2D, HLDL-c, and dyslipidemia are necessary for targeting physical inactivity and unhealthy diet.

Diabetes-related instrument to assess preventive behaviors among adolescents (DIAPBA): a tool development and psychometric research

BACKGROUND

Type 2 diabetes is a chronic but preventable disease that is on the rise among adolescents. Evaluating adolescents' behavior and planning to prevent it require a valid and reliable instrument. This study aims at designing a psychometric instrument to measure adolescents' behavior with respect to type-2 diabetes.

RESEARCH DESIGN AND METHODS

In this methodological research, 770 students (adolescent boys and girls aged 13-15 years) participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by examining the relevant literature and the existing questionnaires as well as considering the research team's comments. The validity of the study was determined through face validity and content validity both quantitatively and qualitatively. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via intraclass consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and Eq. 6.1 were used for data analysis.

RESULTS

At first, a list of 47 initial items was designed and compiled, and after by removing similar (10 questions) or inappropriate sentences (12 questions), a draft questionnaire with 25 questions was designed. No items were removed in the face validity phase. Based on exploratory factor analysis, the number of items in the questionnaire was reduced to 20 items and was categorized in five dimensions of stress management, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.70 with ICC = 0.80.

CONCLUSION

The questionnaire designed has standard psychometric properties to assess adolescents' behavior with respect to type-2 diabetes prevention. The reliability and the validity of the questionnaire as well as its general structure were confirmed.

Lactobacillus induced by irbesartan on spontaneously hypertensive rat contribute to its antihypertensive effect

OBJECTIVE

Hypertension is linked to gut dysbiosis. Here, the impact of the angiotensin receptor antagonist irbesartan on the gut microbiota of spontaneously hypertensive rats (SHR) were investigated. In addition, we assessed their contribution to its antihypertensive effect.

METHODS

Eight-week-old Wistar-Kyoto (WKY) rats and SHR were administered irbesartan for 8 weeks. Fecal microbiota transplantation (FMT) was performed from SHR treated with irbesartan or untreated SHR to recipient untreated SHR. The preventive effect of Lactobacillus on hypertension in SHR was evaluated. Blood pressure (BP) was calculated using a tail-sleeve sphygmomanometer. To better assess the composition of the gut microbiota, the V3-V4 region of the 16S rRNA gene was amplified while short-chain fatty acids (SCFAs) in feces were tested by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS).

RESULTS

Irbesartan restored gut dysbiosis, increased the abundance of Lactobacillus , and improved anti-inflammatory ability, antioxidative ability, intestinal integrity, and intestinal inflammation in SHR. The microbiota in SHR-treated irbesartan could reduce BP and improve antioxidative ability and gut integrity in SHR. Lactobacillus johnsonii ( L. johnsonii ) and Lactobacillus reuteri ( L. reuteri ) reduced BP, restored gut dysbiosis and improved anti-inflammatory ability, antioxidative ability, intestinal integrity in SHR. Most notably, irbesartan, L. johnsonii , and L. reuteri can significantly increase SCFA content in SHR feces.

CONCLUSION

The current study demonstrated that irbesartan treatment ameliorated gut dysbiosis in SHR. Irbesartan induced alterations in gut microbiota, with increased prevalence of Lactobacillus .

Frequency of regular walking among Croatian adults

The aim of this study was to determine the share of Croatian adults who walk 210 min or more a week and to explore the relationship between regular walking and demographic factors, health-related behaviours, and chronic non-communicable diseases/conditions. To this end, we used the EHIS-PAQ questionnaire and collected self-reported data on minutes spent walking during a typical week from a total of 3,496 respondents. The data were additionally analysed by gender, age, education, residence (urban/rural), counties and regions, smoking, other types of physical activity, and diseases/chronic conditions. The results show that, overall, 40.9 % of the adult Croatian population walks 210 or more minutes a week, with the largest share found among those from the Lika-Senj County (76.8 %), those who spend 300 min or more weekly on health-enhancing (non-work-related) aerobic physical activity (57.6 %), those who reported having diabetes (49.3 %), and those aged 65-74 years (44.7 %). Despite its limitations, our study gives a valuable insight into the frequency and factors determining healthy walking habits in a representative sample of Croatian adults and provides grounds for further research.

Exercising healthy behaviors: A latent class analysis of positive coping during the COVID-19 pandemic and associations with alcohol-related and mental health outcomes

OBJECTIVE

To identify latent classes of positive coping behaviors during the COVID-19 pandemic and examine associations with alcohol-related and mental health outcomes across participants with and without a history of alcohol use disorder (AUD).

METHODS

Baseline data from 463 participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol (C19-PIA) Study were analyzed. Latent class analysis (LCA) was applied to five positive coping behaviors during COVID-19: taking media breaks, taking care of their body, engaging in healthy behaviors, making time to relax, and connecting with others. Latent class differences and the moderating role of history of AUD on six alcohol-related and mental health outcomes were examined using multiple regression models.

RESULTS

LCA revealed two latent classes: 83.4% High Positive Coping and 16.6% Low Positive Coping. Low Positive Coping was associated with higher levels of perceived stress, anxiety symptoms, and loneliness. A history of AUD was consistently associated with higher levels of alcohol-related and mental health outcomes. Significant interactions between Coping Latent Classes and history of AUD indicated that the associations of Low Positive Coping with problematic alcohol use, depressive symptoms, and drinking to cope motives were either stronger or only significant among individuals with a history of AUD.

CONCLUSIONS

Individuals with a history of AUD may be particularly vulnerable to depressive symptoms and alcohol-related outcomes, especially when they do not utilize positive coping strategies. The promotion of positive coping strategies is a promising avenue to address alcohol-related and mental health problems during a public health crisis and warrants future research.

Prospective association between fruit and vegetable intake and the risk of type 2 diabetes amongst Chinese adults: the China Health and Nutrition Survey

This study aimed to prospectively explore the relationship between fruit and vegetable intake (FVI) and type 2 diabetes (T2D) risk amongst 13,175 Chinese adults. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of T2D events in relation to FVI. Results showed that the highest quintile of FVI was inversely associated with T2D risk in men (HR = 0.72, 95% CI: 0.50, 0.98) and women (HR = 0.74, 95% CI: 0.55, 0.97), whereas no such associations were observed between total vegetable intake and T2D in either men (HR = 0.92, 95% CI: 0.65, 1.26) or women (HR = 1.02, 95% CI: 0.77, 1.38). In addition, greater fruit intake was inversely associated with T2D risk in men (HR = 0.42, 95% CI: 0.28, 0.63) and women (HR = 0.64, 95% CI: 0.45, 0.90). Overall, FVI and total fruit intake were inversely associated with T2D risk amongst Chinese adults.

Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste

OBJECTIVES

Knowledge of smoking is a protective factor for adolescent smoking. This study is the first to examine sociodemographic and lifestyle factors associated with adolescents' knowledge of smoking in Timor-Leste. It is also a pioneering investigation into the ways in which exposure to anti-tobacco messages and health warnings on cigarette packages, and involvement in smoking-related education at schools and home mediate the relationship between school grade levels and smoking knowledge.

METHODS

Data were obtained from the Global Youth Tobacco Survey Timor-Leste. Ordered logistic regressions were used to examine the associations between knowledge of smoking and sociodemographic, and lifestyle factors. Structural equation modelling was utilized to explore the mediating effects.

RESULTS

Adolescents were less likely to have high knowledge of smoking if they were lower-secondary students, were males, had unemployed parents and had no closest friends who smoked. The relationship between grade levels and smoking knowledge was partly mediated by awareness of anti-tobacco messages on mass media, school education about the dangers of smoking and family discussion about smoking.

CONCLUSIONS

Sociodemographic and lifestyle factors play an important role in determining knowledge of smoking among adolescents. To some extent, awareness-, education- and family-related variables explain how grade levels affect smoking knowledge.

Ultra-Processed Food Consumption and Mortality: Three Cohort Studies in the United States and United Kingdom

INTRODUCTION

Given the increase in ultra-processed food (UPF) consumption, their potential health effects have aroused concern. Whether UPF consumption is associated with cancer and cardiovascular disease mortality is debatable. This study evaluates the association of UPF consumption with mortality.

METHODS

A total of 108,714 U.S. adults from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (1993-2001), 208,051 UK adults from UK Biobank (2006-2010), and 41,070 U.S. adults from National Health and Nutrition Examination Survey (1999-2018) were included. Dietary data were collected by dietary questionnaire and classified using the NOVA classification. UPF consumption was expressed as the weight proportion of UPFs in total foods consumed. Cox proportional hazard models were used to calculate hazard ratios and 95% CIs. Mediation analysis was used to evaluate whether multiple metabolic pathways mediated the associations in UK Biobank. Analyses were performed in 2022-2023.

RESULTS

Combined analyses of the three cohorts showed that those with the highest quartile of UPF consumption had higher risks of all-cause mortality (hazard ratio, 1.16; 95% CI, 1.11-1.20) and cardiovascular disease mortality (hazard ratio, 1.17; 95% CI, 1.06-1.28) compared to the lowest quartile of UPF consumption. UPF consumption was not associated with cancer mortality risk. Biomarkers of liver function have the greatest mediating effects on all-cause mortality (20.3%), and biomarkers of inflammation have the greatest mediating effects on cardiovascular disease mortality (29.2%).

CONCLUSIONS

Higher UPF consumption was associated with increased all-cause and cardiovascular disease mortality risk, with multiple metabolic pathways playing mediating roles.

The role of social support and the built environment on diabetes management among structurally exposed populations in three regions in Ghana

Sub-Saharan Africa is undergoing an epidemiological transition driven by rapid, unprecedented demographic, socio-cultural, and economic transitions. These transitions are driving increases in the risk and prevalence of diabetes and other non-communicable diseases (NCDs). As NCDs rise, several attempts have been made to understand the individual level factors that increase NCDs risks, knowledge, and attitudes around specific NCDs as well as how people live and manage NCDs. While these studies are important, and enhance knowledge on chronic diseases, little attention has been given to the role of social and cultural environment in managing chronic NCDs in underserved settings. Using purposive sampling among persons living with Diabetes Mellitus (PLWD) and participating in diabetes programs from regional and municipal hospitals in the three underserved regions in Ghana (n = 522), we assessed diabetes management and supportive care needs of PLWDs using linear latent and mixed models (gllamm) with binomial and a logit(log) link function. The result indicates that PLWDs with strong perceived social support (OR = 2.27, p ≤ 0.05) were more likely to report good diabetes management compared to PLWDs with weak perceived social support. The built environment, living with other health conditions, household wealth, ethnicity and age were associated with diabetes management. Overall, the study contributes to wider discussions on the role changing built and socio-cultural environments in the rise of diet-related diseases and their management as many Low- and Middle-Income Countries (LMICs) experience rapid epidemiological and nutrition transitions.

Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors

BACKGROUND

Vietnam conducted the national Noncommunicable Disease Risk-Factor Surveillance (STEPs) surveys in the years 2010, 2015, and 2021. This study aims to use STEPs data to assess the burden of comorbidity between diabetes and hypertension, analyze trends over time, and identify factors associated with this comorbidity.

METHODS

The study extracted data for the population aged 25-64 years old from three STEPs surveys. Survey weight was used for all estimations of prevalence and 95% CI. Correlated factors with comorbidity were examined by a multivariate logistics model.

RESULTS

The prevalence of comorbidity in 2021 was about 3.92% among Vietnamese people aged 25-64. In the last 10 years, this prevalence has increased more than 8 times (from 0.44% to 3.92%). Sub-populations demonstrating the most significant changes included the male population, people living in urban areas, and older people. Significant factors correlated with comorbidity included demographic factors, body mass index (BMI), and clustering of 4 noncommunicable diseases (NCDs) behavioral risk factors (OR = 3.48, p < 0.05).

CONCLUSION

The high comorbidity between hypertension and diabetes underscores the imperative for integrated treatment and management approaches in Vietnam. Coordinated care is essential for addressing the complex interplay between these two prevalent conditions.

Development of a Virtual Human for Supporting Tobacco Cessation During the COVID-19 Pandemic

People who consume tobacco are at greater risk of developing severe COVID-19. Unfortunately, the COVID-19 pandemic reduced the accessibility of tobacco cessation services as a result of necessary social restrictions. Innovations were urgently needed to support tobacco cessation during the pandemic. Virtual humans are artificially intelligent computer agents with a realistic, humanlike appearance. Virtual humans could be a scalable and engaging way to deliver tobacco cessation information and support. Florence, a virtual human health worker, was developed in collaboration with the World Health Organization to remotely support people toward tobacco cessation during the COVID-19 pandemic. Florence delivers evidence-based information, assists with making quit plans, and directs people to World Health Organization-recommended cessation services in their country. In this viewpoint, we describe the process of developing Florence. The development was influenced by a formative evaluation of data from 115 early users of Florence from 49 countries. In general, Florence was positively perceived; however, changes were requested to aspects of her design and content. In addition, areas for new content were identified (eg, for nonsmoker support persons). Virtual health workers could expand the reach of evidence-based tobacco cessation information and personalized support. However, as they are a new innovation in tobacco cessation, their efficacy, feasibility, and acceptability in this application needs to be evaluated, including in diverse populations.

Risk profiles of adults with heavy alcohol use: Drinking patterns, behavioral and metabolic factors, health problems, and racial and ethnic disparities

BACKGROUND

Heavy alcohol use is a growing risk factor for chronic disease, yet little is known about its co-occurrence with other risk factors and health problems. This study aimed to identify risk profiles of adults with heavy alcohol use and examined potential disparities by race and ethnicity.

METHODS

This cross-sectional study included 211,333 adults with heavy alcohol use (in excess of daily or weekly limits recommended by National Institute on Alcohol Abuse and Alcoholism) between June 1, 2013 and December 31, 2014 in Kaiser Permanente Northern California. Latent class analysis was used to examine how heavy drinking patterns clustered with other behavioral and metabolic risk factors and health problems to form risk profiles. Multinomial logistic regression models were fit to examine associations between race, ethnicity, and risk profiles.

RESULTS

A 5-class model was selected as best fitting the data and representing clinically meaningful risk profiles: (1) "heavy daily drinking and lower health risks" (DAILY, 44.3%); (2) "substance use disorder and mental health disorder" (SUD/MH, 2.3%); (3) "heavy weekly drinking and lower health risks" (WEEKLY, 19.6%); (4) "heavy daily drinking and more health risks" (DAILY-R, 18.5%); (5) "heavy weekly drinking and more health risks" (WEEKLY-R, 15.3%). American Indian or Alaska Native (AIAN) and Black patients had higher odds than White patients of being in the SUD/MH, DAILY-R, and WEEKLY-R profiles than the DAILY profile. AIAN, Black, and Latino/Hispanic patients had higher odds than White patients of being in the SUD/MH, DAILY-R, and WEEKLY-R profiles rather than the WEEKLY profile.

CONCLUSIONS

AIAN, Black, and Latino/Hispanic patients with self-reported heavy drinking were more likely to be in risk profiles with greater alcohol consumption, more health risks, and higher morbidity. Targeted, culturally appropriate interventions for heavy alcohol use that may address other modifiable risk factors are needed to work towards health equity.

Precision Nutrition to Improve Risk Factors of Obesity and Type 2 Diabetes

PURPOSE OF REVIEW

Existing dietary and lifestyle interventions and recommendations, to improve the risk factors of obesity and type 2 diabetes with the target to mitigate this double global epidemic, have produced inconsistent results due to interpersonal variabilities in response to these conventional approaches, and inaccuracies in dietary assessment methods. Precision nutrition, an emerging strategy, tailors an individual's key characteristics such as diet, phenotype, genotype, metabolic biomarkers, and gut microbiome for personalized dietary recommendations to optimize dietary response and health. Precision nutrition is suggested to be an alternative and potentially more effective strategy to improve dietary intake and prevention of obesity and chronic diseases. The purpose of this narrative review is to synthesize the current research and examine the state of the science regarding the effect of precision nutrition in improving the risk factors of obesity and type 2 diabetes.

RECENT FINDINGS

The results of the research review indicate to a large extent significant evidence supporting the effectiveness of precision nutrition in improving the risk factors of obesity and type 2 diabetes. Deeper insights and further rigorous research into the diet-phenotype-genotype and interactions of other components of precision nutrition may enable this innovative approach to be adapted in health care and public health to the special needs of individuals. Precision nutrition provides the strategy to make individualized dietary recommendations by integrating genetic, phenotypic, nutritional, lifestyle, medical, social, and other pertinent characteristics about individuals, as a means to address the challenges of generalized dietary recommendations. The evidence presented in this review shows that precision nutrition markedly improves risk factors of obesity and type 2 diabetes, particularly behavior change.

The association between dietary intake of macro- and micronutrients and multimorbidity: a cross-sectional study in Cyprus

Research on the link between diet and multimorbidity is scarce, despite significant studies investigating the relationship between diet and individual chronic conditions. This study examines the association of dietary intake of macro- and micronutrients with multimorbidity in Cyprus's adult population. It was conducted as a cross-sectional study, with data collected using a standardised questionnaire between May 2018 and June 2019. The questionnaire included sociodemographic information, anthropometrics, medical history, dietary habits, sleep quality, smoking habits, and physical activity. The participants were selected using a stratified sampling method from adults residing in the five government-controlled municipalities of the Republic of Cyprus. The study included 1137 adults with a mean age of 40⋅8 years, of whom 26 % had multimorbidity. Individuals with multimorbidity consumed higher levels of sodium (P = 0⋅009) and vitamin A (P = 0⋅010) compared to those without multimorbidity. Additionally, higher fibre and sodium intake were also observed in individuals with at least one chronic disease of the circulatory system or endocrine system, compared to those with no chronic diseases in these systems (P < 0⋅05). Logistic regression models revealed that individuals with ≥2 chronic diseases compared to 0 or 1 chronic disease had higher fat intake (OR = 1⋅06, 95 % CI: 1⋅02, 1⋅10), higher iron intake (OR = 1⋅05, 95 % CI: 1⋅01, 1⋅09), lower mono-unsaturated fat intake (OR = 0⋅91, 95 % CI: 0⋅86, 0⋅96), and lower zinc intake (OR = 0⋅98, 95 % CI: 0⋅96, 0⋅99). Future research should replicate these results to further explore the intricate relationships between nutrient intake and multimorbidity. Our study's findings suggest that specific dietary components may contribute to preventing and managing multimorbidity.

Individual- and supply-level macronutrient intakes are well correlated over a 50-year period (1961-2011) in 18 countries in Asia, North America, and Europe

Reliable information on dietary trends is essential. We compared individual-level dietary estimates for total energy, carbohydrate, fat, and protein intake over time with national supply data from the Global Expanded Nutrient Supply Model (186 paired estimates from 1961 to 2011, 18 countries). We hypothesized that supply data would overestimate individual measures and that the two measures would be weakly correlated. Individual- and supply-level estimates were compared using Spearman correlation coefficients and linear mixed-effect models were used to estimate the differences between measures. Overall, the correlations between individual- and supply-level measures were moderate for energy (rs = 0.34) and carbohydrate (rs = 0.39), strong for fat (rs = 0.85), and protein (rs = 0.69). Trends in total energy measured by individual-level surveys and total energy supply were positively correlated in 38.9% of countries, whereas trends in macronutrients aligned between estimates in most countries. Supply-level dietary data overestimated individual-level intakes, especially in higher income countries in Europe and in the United States. In the United States, supply-level data exceeded individual-level estimates by 26.3% to 29.9% for energy, carbohydrate, and fat, whereas protein estimates were similar between measures. In Europe, supply-level estimates overestimated individual-level intake by 19.9% for energy, 17.0% for carbohydrate, 13.7% for fat, and 7.7% for protein, whereas estimates for energy and macronutrients were similar in Asia. In Asia and lower income countries, our findings generally support the use of supply-level data in the absence of individual-level data, though this finding may be related to smaller sample size and differences in underlying national statistics that inform supply data.

Chromatographic Analyses of Spirulina (Arthrospira platensis) and Mechanism of Its Protective Effects against Experimental Obesity and Hepatic Steatosis in Rats

Background and Objectives: Obesity is currently a major health problem due to fatty acid accumulation and excess intake of energy, which leads to an increase in oxidative stress, particularly in the liver. The main goal of this study is to evaluate the protective effects of spirulina (SP) against cafeteria diet (CD)-induced obesity, oxidative stress, and lipotoxicity in rats. Materials and Methods: The rats were divided into four groups and received daily treatments for eight weeks as follows: control group fed a standard diet (SD 360 g/d); cafeteria diet group (CD 360 g/d); spirulina group (SP 500 mg/kg); and CD + SP group (500 mg/kg, b.w., p.o.) according to body weight (b.w.) per oral (p.o.). Results: Our results show that treatment with a CD increased the weights of the body, liver, and abdominal fat. Additionally, severe hepatic alteration, disturbances in the metabolic parameters of serum, and lipotoxicity associated with oxidative stress in response to the CD-induced obesity were observed. However, SP treatment significantly reduced the liver alteration of CD feed and lipid profile disorder associated with obesity. Conclusions: Our findings suggest that spirulina has a marked potential therapeutic effect against obesity and mitigates disturbances in liver function parameters, histological alterations, and oxidative stress status.

Low-quality protein modulates inflammatory markers and the response to lipopolysaccharide insult: the case of lysine

The relationship between non-communicable diseases and eating behaviour has long been attributed to a surplus of food and energy. However, the increase in the prevalence of non-communicable disease and their underlying low-grade inflammatory milieu among people of low socio-economic status has highlighted the existence of a confounding factor. In this work, we aim to study the effect of lysine deficiency on some inflammatory markers in the absence or presence of an inflammatory insult (lipopolysaccharide (LPS)). For this purpose, thirty-two 5-week-old male Sprague Dawley rats were randomly distributed into four groups: (1) control diet, (2) control diet+LPS, (3) lysine-deficient diet and (4) lysine-deficient diet + LPS. Groups were only allowed their experimental diets for 4 weeks, during which LPS (50 µg/kg) or saline injections were administered intraperitoneally three times per week. The study showed that lysine deficiency blunted growth and body compartments development, decreased albumin production and elevated liver C-reactive protein (CRP) expression, independently of IL-6 and IL-1β, the main precursors of CRP. Also, the insufficient levels of lysine in the diet increased hyperactivity and triggered an anxiety-like behaviour, exacerbated with LPS. This work presents evidence that various physiological changes are associated with the absence of a sufficient amount of lysine in the diet and can potentially increase the risk factor for diseases. Thus, the increment in non-communicable disease among the low socio-economic status populations, who heavily rely on cereals as a main source of protein, can be, at least partially, blamed on low lysine availability in diets.

Revisiting carotenoids as dietary antioxidants for human health and disease prevention

Humans are unique indiscriminate carotenoid accumulators, so the human body accumulates a wide range of dietary carotenoids of different types and to varying concentrations. Carotenoids were once recognized as physiological antioxidants because of their ability to quench singlet molecular oxygen (1O2). In the 1990s, large-scale intervention studies failed to demonstrate that supplementary β-carotene intake reduces the incidence of lung cancer, although its antioxidant activity was supposed to contribute to the prevention of oxidative stress-induced carcinogenesis. Nevertheless, the antioxidant activity of carotenoids has attracted renewed attention as the pathophysiological role of 1O2 has emerged, and as the ability of dietary carotenoids to induce antioxidant enzymes has been revealed. This review focuses on six major carotenoids from fruit and vegetables and revisits their physiological functions as biological antioxidants from the standpoint of health promotion and disease prevention. β-Carotene 9',10'-oxygenase-derived oxidative metabolites trigger increases in the activities of antioxidant enzymes. Lutein and zeaxanthin selectively accumulate in human macular cells to protect against light-induced macular impairment by acting as antioxidants. Lycopene accumulates exclusively and to high concentrations in the testis, where its antioxidant activity may help to eliminate oxidative damage. Dietary carotenoids appear to exert their antioxidant activity in photo-irradiated skin after their persistent deposition in the skin. An acceptable level of dietary carotenoids for disease prevention should be established because they can have deleterious effects as prooxidants if they accumulate to excess levels. Finally, it is expected that the reason why humans are indiscriminate carotenoid accumulators will be understood soon.

Health beliefs on type 2 diabetes: a methodological research for development and psychometric evaluation of "DIABA" (Diabetes-related Instrument to Assess Beliefs of Adolescents) health beliefs on type 2 diabetes

BACKGROUND

Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents' attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents' health beliefs regarding type-2 diabetes.

RESEARCH DESIGN AND METHODS

In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by extensive literature review and the related existing questionnaires, as well as considering the research team's comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis.

RESULTS

The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73.

CONCLUSION

The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.

Blackberries and Mulberries: Berries with Significant Health-Promoting Properties

Blackberries and mulberries are small and perishable fruits that provide significant health benefits when consumed. In reality, both are rich in phytochemicals, such as phenolics and volatile compounds, and micronutrients, such as vitamins. All the compounds are well-known thanks to their medicinal and pharmacological properties, namely antioxidant, anti-inflammatory, anti-cancer, antiviral, and cardiovascular properties. Nevertheless, variables such as genotype, production conditions, fruit ripening stage, harvesting time, post-harvest storage, and climate conditions influence their nutritional composition and economic value. Given these facts, the current review focuses on the nutritional and chemical composition, as well as the health benefits, of two blackberry species (Rubus fruticosus L., and Rubus ulmifolius Schott) and one mulberry species (Morus nigra L.).

Co-occurrence of hypertension and type 2 diabetes: prevalence and associated factors among Haramaya University employees in Eastern Ethiopia

Background

Both hypertension (HTN) and diabetes are public health concerns in low- and middle-income countries, particularly in sub-Saharan African countries. The co-occurrence of HTN and diabetes is associated with an increased risk of mortality, morbidity, and reduced productivity in the working force. In Ethiopia, there is limited evidence on the co-occurrence of HTN and type 2 diabetes (T2DM). Therefore, this study was conducted to assess the co-occurrence of HTN and T2DM and their associated factors among Haramaya University employees in Eastern Ethiopia.

Methods

A cross-sectional survey was conducted among 1,200 employees at Haramaya University using a simple random sampling technique from December 2018 to February 2019. Demographic and behavioral factors were collected on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Blood glucose and lipid profile measurements were performed by collecting 6 ml of venous blood samples after 8 h of overnight fasting. Data were entered into EpiData 3.1 version and analyzed using Stata 16 software. Bivariable and multivariable logistic regressions were applied to observe the association between independent variables with co-occurrence of HPN and T2DM using odds ratio, 95% confidence interval (CI), and p-values of ≤ 0.05 were considered statistically significant.

Results

The prevalence of HTN and T2DM was 27.3 and 7.4%, respectively. The co-occurrence of HTN and T2DM was 3.8%. The study found that being older (AOR = 3.97; 95 % CI: 1.80-8.74), khat chewing (AOR = 2.76; 95 % CI: 1.23-6.18), body mass index ≥ 25 kg/m² (AOR = 5.11; 95 % CI: 2.06-12.66), and sedentary behavior ≥8 h per day (AOR = 6.44; 95 % CI: 2.89-14.34) were statistically associated with co-occurrence of HTN and T2DM. On the other hand, consuming fruits and vegetables (AOR = 0.10; 95 % CI: 0.04-0.22) and a higher level of education (AOR = 0.39; 95% CI: 0.17-0.89) were negatively statistically associated with the co-occurrence of HTN and T2DM.

Conclusion

The co-occurrence of HTN and T2DM was prevalent among the study participants. This may create a substantial load on the healthcare system as an end result of increased demand for healthcare services. Therefore, rigorous efforts are needed to develop strategies for screening employees to tackle the alarming increase in HTN and T2DM in university employees.

Adolescents diabetes awareness test (ADAT): Tool development and psychometrics evaluation research

BACKGROUND

During the last two decades, several reports have indicated an increase in the number of type-2 diabetes among adolescents. Therefore, an assessment of adolescents' awareness of this disease deserves serious consideration. This study aims at designing a psychometric tool for assessing adolescents' awareness of type-2 diabetes.

METHODS AND MATERIAL

In this methodological research, 770 students attending 10 middle schools (five girls "schools and five boys" schools) from Tehran participated in the study. The questionnaire was designed by examining the relevant literature and the existing questionnaires, as well as considering the research team's comments, and the initial pool of items with 57 questions was designed. Face validity, content validity, and construct validity were calculated to determine the validity of the instrument. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured with Cronbach Alpha. SPSS 16 was used for data analysis.

RESULTS

The questionnaire was initially designed with 57 items. Based on the results of CVR and CVI, five questions were removed. The average CVR and CVI were 0.75 and 0.82, respectively. Following exploratory factor analysis, the 30 questions in the questionnaire were categorized into five dimensions: public awareness, symptoms, behavioral risk factors, long-term effects, and medium-term effects. The internal reliability was calculated for the whole questionnaire-ICC = 0.87 with a Cronbach alpha coefficient of 0.80.

CONCLUSIONS

The resulting questionnaire on adolescents' awareness of type-2 diabetes, with 30 questions in five dimensions, can be employed by researchers for its high factor loading in factor analysis and its standard psychometric properties.

Cancer Metabolism: The Role of ROS in DNA Damage and Induction of Apoptosis in Cancer Cells

Cancer is a huge challenge for people worldwide. High reactive oxygen species (ROS) levels are a recognized hallmark of cancer and an important aspect of cancer treatment research. Abnormally elevated ROS levels are often attributable to alterations in cellular metabolic activities and increased oxidative stress, which affects both the development and maintenance of cancer. Moderately high levels of ROS are beneficial to maintain tumor cell genesis and development, while toxic levels of ROS have been shown to be an important force in destroying cancer cells. ROS has become an important anticancer target based on the proapoptotic effect of toxic levels of ROS. Therefore, this review summarizes the role of increased ROS in DNA damage and the apoptosis of cancer cells caused by changes in cancer cell metabolism, as well as various anticancer therapies targeting ROS generation, in order to provide references for cancer therapies based on ROS generation.

School-based peer-led diabetes intervention among female adolescents: a cluster randomized trial

BACKGROUND

The prevalence of type 2 diabetes is increasing among adolescents and clear strategies are needed to prevent it. The aim of this study was to determine the effect of peer education on knowledge, health beliefs and preventive behaviors of type 2 diabetes in female adolescents.

METHODS

In this cluster randomized trial study, 168 students (84 people in each group) were enrolled. The data collection instrument was a questionnaire of knowledge (30 questions), health beliefs (16 questions) and behavior (20 questions) whose validity and reliability were confirmed. Then eight capable students were chosen as peer educators after being trained. The intervention group received 8 sessions of 90-min education through training, lectures, question and answer, and group discussion and with teaching aids such as pamphlets, educational clips and text messages. The post-test was administered two months after the treatment. Data collected using software SPSS16 and Chi-Square and ANCOVA test were used.

RESULTS

The result showed that the mean and standard deviation of general knowledge, disease symptoms, behavioral risk factors, mid-term outcomes and long-term outcomes, perceived self-efficacy, behavioral beliefs, perceived susceptibility, perceived severity, prevention of stress, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care in the intervention group has increased significantly 2 months after intervention compared of control group (P < 0.001).

CONCLUSIONS

Peer education increased knowledge and improved adolescents' health beliefs and behaviors. Therefore, training in adolescence in order to prevention of diabetes can be considered as an effective step, and the use of peer-led education in this field is recommended.

TRIAL REGISTRATION

Trial registration number IRCT20200811048361N1 from School of Public Health & Neuroscience Research Center-Shahid Beheshti University of Medical Sciences. Date applied: 30/12/2020. Date assigned: 01/12/2020.

Associations Between Personality Traits and Energy Balance Behaviors in Emerging Adulthood: Cross-Sectional Study

BACKGROUND

Internalizing and externalizing personality traits are robust risk factors for substance use and mental health, and personality-targeted interventions are effective in preventing substance use and mental health problems in youth. However, there is limited evidence for how personality relates to other lifestyle risk factors, such as energy balance-related behaviors, and how this might inform prevention efforts.

OBJECTIVE

This study aimed to examine concurrent cross-sectional associations between personality traits (ie, hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) and sleep, diet, physical activity (PA), and sedentary behaviors (SB), 4 of the leading risk factors for chronic disease, among emerging adults.

METHODS

Data were drawn from a cohort of young Australians who completed a web-based, self-report survey in 2019 during early adulthood. A series of Poisson and logistic regressions were conducted to examine the concurrent associations between the risk behaviors (sleep, diet, PA, and sitting and screen time) and personality traits (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) among emerging adults in Australia.

RESULTS

A total of 978 participants (mean age 20.4, SD 0.5 years) completed the web-based survey. The results indicated that higher scores on hopelessness were associated with a greater daily screen (risk ratio [RR] 1.12, 95% CI 1.10-1.15) and sitting time (RR 1.05, 95% CI 1.0-1.08). Similarly, higher scores on anxiety sensitivity were associated with a greater screen (RR 1.04, 95% CI 1.02-1.07) and sitting time (RR 1.04, 95% CI 1.02-1.07). Higher impulsivity was associated with greater PA (RR 1.14, 95% CI 1.08-1.21) and screen time (RR 1.06, 95% CI 1.03-1.08). Finally, higher scores on sensation seeking were associated with greater PA (RR 1.08, 95% CI 1.02-1.14) and lower screen time (RR 0.96, 95% CI 0.94-0.99).

CONCLUSIONS

The results suggest that personality should be considered when designing preventive interventions for lifestyle risk behaviors, particularly in relation to SB, such as sitting and screen time.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12612000026820; https://tinyurl.com/ykwcxspr.

Impact of surgical resection on the survival in Mexican patients with gastric cancer: A meta-analysis and systematic review

BACKGROUND

Gastric cancer (GC) is one of the most frequent cancer types in Mexico. The primary method used as a treatment is surgical resection. The role of surgery in increasing survival is controversial. This study aimed to determine whether surgical resection increases the survival of patients with GC in a Mexican population.

METHODS

A systematic review of literature searches (Evidence-based MEDLINE/PubMed, Web of Science, Cochrane Library, and SciELO) and meta-analysis were performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria. The published articles from 2000 to the current time were divided into cross-sectional and randomized studies. The inclusion criteria were survival, surgical resections, patients treated in Mexico, and primary GC. The effect estimation was calculated using the risk ratio (RR). The random-effects model and a confidence interval (CI) of 95% were used.

RESULTS

The RR of the pooled studies was 1.09 (95% CI, 0.71-1.67). RR of 0.82 (95% CI, 0.63-1.07) was obtained in cross-sectional studies, and randomized studies showed a RR of 2.08 (95% CI, 0.25-17.07).

CONCLUSION

This work is the first systematic study that assesses the role of surgery on the survival of patients with GC in the Mexican population, the results showed that surgical resection did not improve survival in patients with GC.