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Azim G, Hamidi H, Azim MS, Rasoly B, Azim MH, Halimi SA, Tahoun MM, Tanoli J. Factors associated with total cholesterol and blood glucose levels among Afghan people aged 18-69 years old: Evidence from a national survey. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0004079. [PMID: 40138652 PMCID: PMC11942368 DOI: 10.1371/journal.pgph.0004079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 01/27/2025] [Indexed: 03/29/2025]
Abstract
The objective of this study was to determine the associated factors of total cholesterol (TC) and blood glucose (BG) levels in people aged 18-69 years old in Afghanistan. This was an analytical cross-sectional study using data from the National Survey of Non-Communicable Disease STEPs 2018 (NCD STEPS) in Afghanistan. The total sample size in the original study was 3,972 and a multi-stage cluster sampling method was used. Total cholesterol and blood glucose were the outcome variables for this study; simple and multiple linear regression was performed to find the associated factors for the outcome variables using a designed-based modeling incorporating sampling techniques and weights. The result of univariate linear regression analysis indicates that age, marital status, hypertension, and BMI are positively associated with TC and BG levels while education, salt intake, and any type of physical activity are negatively associated with TC and BG levels (p-values<0.05). Each year of age increases TC by 0.42 mg/dl and BG by 0.48 mg/dl; ever-married individuals have higher TC (21.8 mg/dl) and BG (8.8 mg/dl) levels; hypertension increases TC by 16.8 mg/dl and BG by 14.5 mg/dl; and higher BMI is associated with increased TC (1.3 mg/dl) and BG (0.9 mg/dl). Moreover, multivariate analysis using multiple linear regression indicates the same result; however, the results of marital status and gender are not significant with BG level and results of education levels, salt intake and any type of physical activity are not significant with TC levels. The finding of this study shows that total cholesterol and blood glucose increase in people of older age categories, married people, people with hypertension, overweight, and obesity; while decreases in people with higher education categories, people who always take salt, and people who do physical exercise.
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Affiliation(s)
- Giti Azim
- World Health Organization Country Office, Kabul, Afghanistan
| | - Hosna Hamidi
- World Health Organization Country Office, Kabul, Afghanistan
| | | | | | | | | | - Mohamed Mostafa Tahoun
- World Health Organization Country Office, Kabul, Afghanistan
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Jamshed Tanoli
- World Health Organization Country Office, Kabul, Afghanistan
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Raman P, Sagadevan Y, Dhanapalan S, Fernandez BJ, Tan SY, Appalasamy JR, Ramadas A. Lifestyle-Related Risk Factors and Primary Prevention Strategies for Cardiovascular Diseases in a Middle-Income Country: A Scoping Review and Implication for Future Research. JOURNAL OF PREVENTION (2022) 2024; 45:579-609. [PMID: 38839738 PMCID: PMC11271377 DOI: 10.1007/s10935-024-00782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/07/2024]
Abstract
Cardiovascular diseases are the leading cause of death in middle-income countries such as Malaysia. There is a significant gap in knowledge between cardiovascular disease-related risk assessments and interventions in the Malaysian population. In this scoping review, we have determined the status of cardiovascular research in Malaysia by prioritising lifestyle-related risk assessments and interventions. We searched five electronic databases (Ovid MEDLINE, Cochrane Central Register of Controlled Trials, APA PsychINFO, Embase and Scopus) to identify relevant research articles that had been published. The Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews served as a guide for the scoping review. Study selection was made using the Covidence platform, screened, and extracted. Thirty-one studies were included in this review. Studies reviewed reported a significant positive association between physical inactivity, smoking, poor dietary patterns, working hours, clustering of lifestyle risk, and cardiovascular disease risk. Most interventions focused on physical activity and a multimodal lifestyle approach, significantly improving primary and secondary cardiovascular disease-related outcomes. The findings suggest improving lifestyle-related risk assessments and interventions to prevent cardiovascular diseases in this population. It is unclear if these outcomes can translate to higher effectiveness in preventing cardiovascular disease. Nevertheless, intervention using the multifaceted lifestyle approach can improve cardiovascular disease-related outcomes.
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Affiliation(s)
- Pragashini Raman
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Yoganishalini Sagadevan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Sornavalli Dhanapalan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Brandon J Fernandez
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Sheng Yew Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Jamuna Rani Appalasamy
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia.
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Kasović M, Štefan L, Kalčik Z. The associations between health-related physical fitness and fasting blood glucose in war veterans: a population-based study. Sci Rep 2022; 12:6997. [PMID: 35487937 PMCID: PMC9055040 DOI: 10.1038/s41598-022-11059-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/19/2022] [Indexed: 12/20/2022] Open
Abstract
The main purpose of the study was to analyze the associations between health-related physical fitness and fasting blood glucose in war veterans. In this cross-sectional study, we recruited 764 men and women aged 45-75 years, who were part of the Homeland War between 1990 and 1995 (33.5% women). Health-related physical fitness included: (1) fat mass and fat-free mass (body composition), (2) push-ups in 30 s (muscular dynamic endurance of upper extremities), (3) sit-ups in 30 s (repetitive upper body strength), (4) chair-stands in 30 s (lower body strength), (5) sit-and-reach test (flexibility) and (6) the 2-min step test (cardiorespiratory function). Laboratory measurement of fasting blood glucose was performed according to standardized procedures in resting seated position after a 12-h overnight fast. Generalized estimating equations with multiple regression models were used to calculate the associations between health-related physical fitness and fasting blood glucose. In men, fasting blood glucose was significantly correlated with fat-free mass (β = - 0.25, p < 0.001), push-ups in 30 s (β = - 0.55, p < 0.001), chair-stands in 30 s (β = - 0.50, p < 0.001), sit-ups in 30 s (r = - 0.45, p < 0.001), the sit-and reach test (r = - 0.46, p < 0.001) and the 2-min step test (r = - 0.19, p < 0.001), while fat mass was positively correlated with fasting blood glucose (β = 0.14, p = 0.004). In women, fasting blood glucose was significantly correlated with fat mass (β = 0.20, p = 0.002), fat-free mass (β = - 0.15, p = 0.014), push-ups in 30 s (β = - 0.49, p < 0.001), chair-stands in 30 s (β = - 0.43, p < 0.001), sit-ups in 30 s (β = - 0.52, p < 0.001), the sit-and reach test (β = - 0.40, p < 0.001) and the 2-min step test (β = - 0.35, p < 0.001). This study shows that fasting blood glucose may be predicted by health-related physical fitness test in war veterans.
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Affiliation(s)
- Mario Kasović
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000, Zagreb, Croatia.,Division of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000, Zagreb, Croatia. .,Division of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic. .,Recrutiment and Examination (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.
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Lee YS, Chia M, Komar J. A Systematic Review of Physical Activity Intervention Programs in ASEAN Countries: Efficacy and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095357. [PMID: 35564751 PMCID: PMC9103551 DOI: 10.3390/ijerph19095357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022]
Abstract
A systematic review was conducted on the efficacy of interventions to improve physical activity. PubMed, Scopus and Web of Science were scanned for eligible studies published from 1978 to August 2021, resulting in a total of 52 relevant studies for review. The Downs and Black checklist was used as a quality assessment ool for a risk of bias assessment. The 52 studies were then broadly categorised into three major approach types: informational, behavioural and/or social, as well as direct. Within each major approach, studies were further sub-categorised into more specific intervention types before being assessed for their efficacy and applicability. Overall, the intervention types that seemed to be the most efficacious in increasing physical activity levels were those that involved home-based information provision, community-wide campaigns, incentivised change, individually adapted health behaviour programs, family-based social support interventions and the provision of self-monitoring tools. However, the results must be interpreted holistically, as many of the successful interventions included more than one approach type and success is likely contingent on effectively addressing several concurrent facets. The systematic review is registered on PROSPERO. Registration number: 282752.
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Mohd Saat NZ, Hanawi SA, M. F. Farah N, Mohd Amin H, Hanafiah H, Shamsulkamar NS. Relationship between Physical Activity and Cardiovascular Risk Factors: A Cross-Sectional Study among Low-Income Housewives in Kuala Lumpur. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116090. [PMID: 34200066 PMCID: PMC8200207 DOI: 10.3390/ijerph18116090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 01/17/2023]
Abstract
Cardiovascular disease is a significant public health concern worldwide, including in Malaysia. Various attempts have been made to resolve this issue. One of the most important methods of controlling cardiovascular risk factors is physical exercise. However, today’s women, especially housewives, are often identified by a lack of physical activity. This is alarming to society, as cardiovascular disease can affect the quality of their life. The aim of this study is to determine the relationship between physical activity and cardiovascular risk factors among low-income housewives in Kuala Lumpur. A total of 63 housewives participated in this cross-sectional study. All participating housewives were asked to fill out a sociodemographic questionnaire and the short version of the International Physical Activity Questionnaire (IPAQ). To evaluate cardiovascular risk factors, anthropometric measurements and blood samples were taken. Findings showed that an average of 70.5 ± 232.4 min/week was spent on moderate-to-vigorous physical activity (MVPA), which indicated a low level of physical activity. Data showed that 90.5% of the subjects had low physical activity, 6.3% were moderate, and 3.2% were considered as having a high level of physical activity. For body mass index (BMI), 58.7% of the respondents were obese, 28.6% were overweight (29.10 ± 5.67 kg m–2), and 81.0% of subjects had a waist circumference (WC) value above the normal range (92.74 ± 16.40 cm). A two-way ANOVA test revealed significant mean differences between systolic blood pressure (mm/Hg) and age groups (p > 0.05). Nevertheless, there was a significant association between MVPA and cardiovascular risk factors using negative binomial regression (p < 0.01). The findings of this study highlight the need for health promotional programs to raise awareness, educate, and engage low-income housewives in lifestyle-enhancing behaviors.
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Affiliation(s)
- Nur Zakiah Mohd Saat
- Biomedical Science Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
- Correspondence: ; Tel.: +60-39-289-7606
| | - Siti Aishah Hanawi
- SOFTAM, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia; (S.A.H.); (H.M.A.)
| | - Nor M. F. Farah
- Occupational Therapy Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Hazilah Mohd Amin
- SOFTAM, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia; (S.A.H.); (H.M.A.)
| | - Hazlenah Hanafiah
- Faculty of Computer and Mathematical Science, Universiti Teknologi MARA Sabah Branch, Kota Kinabalu Campus, Sabah 88997, Malaysia;
| | - Nur Shazana Shamsulkamar
- Biomedical Science Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
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Zhuang Z, Gao M, Yang R, Li N, Liu Z, Cao W, Huang T. Association of physical activity, sedentary behaviours and sleep duration with cardiovascular diseases and lipid profiles: a Mendelian randomization analysis. Lipids Health Dis 2020; 19:86. [PMID: 32384904 PMCID: PMC7206776 DOI: 10.1186/s12944-020-01257-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background Observational studies have shown that moderate-to-vigorous physical activity (MVPA), vigorous physical activity (VPA), sedentary behaviours, and sleep duration were associated with cardiovascular diseases (CVDs) and lipid levels. However, whether such observations reflect causality remain largely unknown. We aimed to investigate the causal associations of physical activity, sedentary behaviours, and sleep duration with coronary artery disease (CAD), myocardial infarction (MI), stroke and lipid levels. Methods We conducted a Mendelian randomization (MR) study using genetic variants as instruments which are associated with physical activity, sedentary behaviours, and sleep duration to examine the causal effects on CVDs and lipid levels. This study included analyses of 4 potentially modifiable factors and 7 outcomes. Thus, the threshold of statistical significance is P = 1.8 × 10− 3 (0.05/4 × 7) after Bonferroni correction. Results In the present study, there was suggestive evidence for associations of genetically predicted VPA with CAD (odds ratio, 0.65; 95% confidence intervals, 0.47–0.90; P = 0.009) and MI (0.74; 0.59–0.93; P = 0.010). However, genetically predicted VPA, MVPA, sleep duration and sedentary behaviours did not show significant associations with stroke and any lipid levels. Conclusions Our findings from the MR approach provided suggestive evidence that vigorous exercise decreased risk of CAD and MI, but not stroke. However, there was no evidence to support causal associations of MVPA,sleep duration or sedentary behaviours with cardiovascular risk and lipid levels. Translational perspective The findings of this study did not point out specific recommendations on increasing physical activity required to deliver significant health benefits. Nevertheless, the findings allowed clinicians and public health practitioners to provide advice about increasing the total amount of excising time by demonstrating that such advice can be effective. Reliable assessment of the association of physical activity levels with different subtypes of CVDs is needed to provide the basis for a comprehensive clinical approach on CVDs prevention, which can be achieved through lifestyle interventions in addition to drug therapy.
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Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China
| | - Meng Gao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China
| | - Ruotong Yang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China
| | - Nan Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China.,Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Bejing, 100191, China
| | - Zhonghua Liu
- Department of Statistics and Actuarial Science, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Weihua Cao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China.
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Bejing, 100191, China. .,Department of Global Health, School of Public Health, Peking University, Bejing, 100191, China. .,Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Bejing, 100191, China.
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