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Alizadeh G, Gholipour K, Kazemi Shishavan M, Dehnavieh R, Goharinejad S, Arab-Zozani M, Khosravi MF, Khodayari-Zarnaq R. Future of myocardial infarction mortality in Iran: a scenario-based study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:19. [PMID: 36927700 PMCID: PMC10018627 DOI: 10.1186/s41043-023-00356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
This study defines futures myocardial infarction landscapes and proposes a few policy options to reduce the burden of cardiovascular diseases using the scenario development method. We identified the effective drivers of myocardial infarction by reviewing the literature and completed the returned list with "experts" opinions. The results were classified using the STEEP (Social, Technological, Environmental, Economic, and Political) framework. We plotted the critical uncertainties in a two-dimensional ranking of "effect" and "uncertainty" levels. Eleven drivers with uncertainty and high potential impact were selected and categorized into three groups: Political Development, Access to health services, and Self-Care. Scenarios were developed, and 3 scenarios (optimistic, pessimistic, and possible) were selected based on scoring. For each scenario, policy options were formulated. Utilizing the capacity of Non-Governmental Organizations and charities and strengthening restrictive and punitive legislation was chosen as policy options for addressing possible scenarios. Building infrastructure and improving prevention services, designing and regenerating curative infrastructure were selected as optimal strategies for addressing issues related to the optimistic scenario. Strengthening restrictive and punitive legislation related to community health and population empowerment were proposed as critical policy options for health improvement regarding the pessimistic scenario. Increasing people's participation, strengthening infrastructure and punitive policies can be effective in Myocardial infarction mortality prevention policies in Iran.
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Affiliation(s)
- Gisoo Alizadeh
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Daneshgah Street, 5165665811, Tabriz, Iran
| | - Kamal Gholipour
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Daneshgah Street, 5165665811, Tabriz, Iran
| | - Maryam Kazemi Shishavan
- Department of Family and Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Dehnavieh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Salime Goharinejad
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Farough Khosravi
- Department of Health Economics and Management, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Khodayari-Zarnaq
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Daneshgah Street, 5165665811, Tabriz, Iran.
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Cabrera-Rode E, Cubas-Dueñas I, Acosta JR, Hernández JC, González AIC, Calero TMG, Domínguez YA, Rodríguez JH, Rodríguez ADR, Álvarez Álvarez A, Valdés RE, Espinosa LJ, Belent OT, Benavides ZB, Estévez ES, Rodríguez YA, del Valle Rodríguez J, Juliá SM. Efficacy and safety of Obex® in overweight and obese subjects: a randomised, double-blind, placebo-controlled clinical trial. BMC Complement Med Ther 2023; 23:58. [PMID: 36804035 PMCID: PMC9940432 DOI: 10.1186/s12906-023-03847-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Obex® may be helpful in reducing body weight and fat. The current study was carried out to evaluate the efficacy and safety of Obex® in the treatment of overweight and obese subjects. METHODS A double-blind, randomised, controlled phase III clinical trial was conducted involving 160 overweight and obese subjects (BMI ≥ 25.0 and < 40 kg/m2) aged 20 to 60 years, who received Obex® (n = 80) and placebo (n = 80) plus non-pharmacological treatment (physical activity and nutritional counseling). One sachet of Obex® or placebo were administered before the two main meals each day for 6 months. In addition to anthropometric measurements and blood pressure, fasting plasma and 2 h glucose levels during the oral glucose tolerance test, lipid profile, insulin, liver enzymes, creatinine, and uric acid (UA) were determined, insulin resistance (HOMA-IR) beta-cell function (HOMA-β) were assessed and insulin sensitivity (IS) was calculated with three indirect indexes. RESULTS After 3 months of Obex®, 48.3% of the participants (28/58) achieved complete success in reducing both weight and waist circumference by greater than or equal to 5% from baseline, as opposed to 26.0% (13/50) of individuals receiving placebo (p = 0.022). Compared to baseline, at 6 months no differences were found between the groups concerning anthropometric and biochemical measurements, except for high-density lipoprotein cholesterol (HDL-c) levels, which were higher in subjects receiving Obex® compared to those receiving placebo (p = 0.030). After 6 months of treatment, both groups showed reduced cholesterol and triglyceride levels (p < 0.012) compared to baseline value. However, only those intake Obex® showed reduced insulin concentrations and HOMA-IR, improved IS (p < 0.05), and decreased creatinine and UA levels (p < 0.005). CONCLUSIONS The consumption of Obex® together with lifestyle changes increased HDL-c, contributed to a rapid reduction of weight and waist circumference, as well as improved insulin homeostasis, which did not occur in the placebo group, and appears to be safe as an adjunct at conventional obesity treatment. TRIAL REGISTRATION Clinical trial protocol was registered in the Cuban public registry of clinical trials under code RPCEC00000267 on 17/04/2018 and also registered in the international registry of clinical trials, ClinicalTrials.gov, under code: NCT03541005 on 30/05/2018.
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Affiliation(s)
- Eduardo Cabrera-Rode
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba.
| | - Ileana Cubas-Dueñas
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Janet Rodríguez Acosta
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Jeddú Cruz Hernández
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Ana Ibis Conesa González
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Teresa M. González Calero
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Yuri Arnold Domínguez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - José Hernández Rodríguez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Antonio D. Reyes Rodríguez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Aimee Álvarez Álvarez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Ragmila Echevarría Valdés
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Liudmila Jorge Espinosa
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Onelia Torres Belent
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Zoila Bell Benavides
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Elizabeth Senra Estévez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Yanet Abreu Rodríguez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Juana del Valle Rodríguez
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
| | - Silvia Marín Juliá
- Institute of Endocrinology, University of Medical Sciences of Havana, Zapata and D, Vedado 10400, Havana, Cuba
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Delclòs-Alió X, Rodríguez DA, Olmedo NL, Ferrer CP, Moore K, Stern D, de Menezes MC, de Oliveira Cardoso L, Wang X, Guimaraes JM, Miranda JJ, Sarmiento OL. Is city-level travel time by car associated with individual obesity or diabetes in Latin American cities? Evidence from 178 cities in the SALURBAL project. CITIES (LONDON, ENGLAND) 2022; 131:103899. [PMID: 36277810 PMCID: PMC7613723 DOI: 10.1016/j.cities.2022.103899] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
There is growing evidence that longer travel time by private car poses physical and mental risks. Individual-level obesity and diabetes, two of the main public health challenges in low- and middle-income contexts, could be associated to city-level travel times by car. We used individual obesity and diabetes data from national health surveys from individuals in 178 Latin American cities, compiled and harmonized by the SALURBAL project. We calculated city-level travel times by car using the Google Maps Distance Matrix API. We estimated associations between peak hour city-level travel time by car and obesity and diabetes using multilevel logistic regression models, while adjusting for individual characteristics and other city-level covariates. In our study we did not observe a relationship between city-level peak-hour travel time by car and individual obesity and diabetes, as reported in previous research for individual time spent in vehicles in high-income settings. Our results suggest that this relationship may be more complex in Latin America compared to other settings, especially considering that cities in the region are characterized by high degrees of population density and compactness and by a higher prevalence of walking and public transportation use.
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Affiliation(s)
- Xavier Delclòs-Alió
- Institute of Urban and Regional Development, University of California, Berkeley, CA, USA
- Research Group on Territorial Analysis and Tourism Studies (GRATET), Department of Geography, Universitat Rovira i Virgili, Spain
| | - Daniel A. Rodríguez
- Department of City and Regional Planning & Institute for Transportation Studies, University of California, Berkeley, 228 Wurster Hall, Berkeley, CA 94720, USA
| | - Nancy López Olmedo
- Instituto Nacional de Salud Pública, Mexico, Avenida Universidad 655, 62100 Cuernavaca, Morelos, Mexico
| | - Carolina Pérez Ferrer
- CONACyT-Instituto Nacional de Salud Pública, Cerrada de Fray Pedro de Gante 50, 14080 Mexico City, Mexico
| | - Kari Moore
- Dornsife School of Public Health, Drexel University, 3600 Market Street, Philadelphia, PA 19104, USA
| | - Dalia Stern
- CONACyT-Instituto Nacional de Salud Pública, Cerrada de Fray Pedro de Gante 50, 14080 Mexico City, Mexico
| | - Mariana Carvalho de Menezes
- Department of Clinical and Social Nutrition, Federal University of Ouro Preto, Av. Pres. Antônio Carlos, 6627, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Letícia de Oliveira Cardoso
- Oswaldo Cruz Foundation, National School of Public Health, Av. Brasil 4365, Rio de Janeiro, 21040-900, Rio de Janeiro, Brazil
| | - Xize Wang
- Department of Real Estate, National University of Singapore, 4 Architecture Dr, 117566, Singapore
| | - Joanna M.N. Guimaraes
- Oswaldo Cruz Foundation, National School of Public Health, Av. Brasil 4365, Rio de Janeiro, 21040-900, Rio de Janeiro, Brazil
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, 15074 Lima, Peru
| | - Olga L. Sarmiento
- School of Medicine, Universidad de Los Andes, Carrera 1, 111711 Bogotá, Colombia
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Ahammed B, Sarder MA, Kundu S, Keramat SA, Alam K. Multilevel exploration of individual- and community-level factors contributing to overweight and obesity among reproductive-aged women: a pooled analysis of Bangladesh Demographic and Health Survey, 2004-2018. Public Health Nutr 2022; 25:1-10. [PMID: 35570669 PMCID: PMC9991804 DOI: 10.1017/s1368980022001124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/25/2022] [Accepted: 04/21/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity. DESIGN A total of 70 651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual- and community-level factors of overweight and obesity. SETTING Five most recent nationally representative household surveys across all regions. PARTICIPANTS Reproductive-aged (15-49 years) non-pregnant women. RESULTS Approximately 35·2 % (95 % CI: 34·9-35·6 %) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (adjusted odds ratio (aOR) = 5·79, 95 % CI: 5·28-6·34), secondary or higher education (aOR = 1·69 [1·60-1·78]), relatively wealthiest households (aOR = 4·41 [4·10-4·74]), electronic media access (aOR = 1·32 [1·26-1·37]) and community high literacy (aOR = 1·10 [1·04-1·15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR = 0·79 [0·76-0·82]) from larger-sized households (aOR = 0·80 [0·73-0·87]) and have high community employment (aOR = 0·92 [0·88-0·97]) were negatively associated with the probability of being overweight or obese. CONCLUSION Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus.
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Affiliation(s)
- Benojir Ahammed
- Statistics Discipline, Science, Engineering and Technology (SET) School, Khulna University, Khulna9208, Bangladesh
| | - Md. Alamgir Sarder
- Statistics Discipline, Science, Engineering and Technology (SET) School, Khulna University, Khulna9208, Bangladesh
| | - Subarna Kundu
- Statistics Discipline, Science, Engineering and Technology (SET) School, Khulna University, Khulna9208, Bangladesh
| | - Syed Afroz Keramat
- Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Khorshed Alam
- School of Business, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
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5
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Okunogbe A, Nugent R, Spencer G, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for eight countries. BMJ Glob Health 2021; 6:e006351. [PMID: 34737167 PMCID: PMC8487190 DOI: 10.1136/bmjgh-2021-006351] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/29/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is a growing public health challenge worldwide with significant health and economic impacts. However, much of what is known about the economic impacts of obesity comes from high-income countries and studies are not readily comparable due to methodological differences. Our objective is to demonstrate a method for estimating current and future national economic impacts of obesity and apply it across a sample of heterogeneous contexts globally. METHODS We estimated economic impacts of overweight and obesity for eight countries using a cost-of-illness approach. Direct and indirect costs of obesity from 2019 to 2060 were estimated from a societal perspective as well as the effect of two hypothetical scenarios of obesity prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS In per capita terms, costs of obesity in 2019 ranged from US$17 in India to US$940 in Australia. These economic costs are comparable to 1.8% of gross domestic product (GDP) on average across the eight countries, ranging from 0.8% of GDP in India to 2.4% in Saudi Arabia. By 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 3.6% of GDP on average ranging from 2.4% of GDP in Spain to 4.9% of GDP in Thailand. Reducing obesity prevalence by 5% from projected levels or keeping it at 2019 levels will translate into an average annual reduction of 5.2% and 13.2% in economic costs, respectively, between 2020 and 2060 across the eight countries. CONCLUSION Our findings demonstrate that the economic impacts of obesity are substantial across countries, irrespective of economic or geographical context and will increase over time if current trends continue. These findings strongly point to the need for advocacy to increase awareness of the societal impacts of obesity, and for policy actions to address the systemic roots of obesity.
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Affiliation(s)
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Seattle, Washington, USA
| | - Garrison Spencer
- Center for Global Noncommunicable Diseases, RTI International, Seattle, Washington, USA
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Hadi H, Triastanti RK, Anggraeni D, Nurwanti E, Lewis EC, Colon-Ramos U, Kang Y, Yamaguchi M, Gittelsohn J. The role of the school food environment in improving the healthiness of school canteens and the readiness to reopen post COVID-19 pandemic: A study conducted in Indonesia. J Public Health Res 2021; 11:2287. [PMID: 34498452 PMCID: PMC8883554 DOI: 10.4081/jphr.2021.2287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Indonesian school children spend one-third of their time in school, where they are exposed to a variety of foods at school canteens. However, the healthiness of school canteens is not yet well understood. This study was conducted to characterize the healthiness and quality of management of school canteens, and measure readiness of school canteens to reopen following COVID-19 closures. DESIGN AND METHODS Mixed-methods were used to conduct a cross-sectional study. Data were collected from schools located in the Bantul District of Indonesia. Primary schools (n=152) were randomly selected, with a final sample size of 147. Data were collected using Google Forms, delivered via WhatsApp or email. School canteens were classified as healthy if they had a Healthy Canteen Score (HCS) >= 10, or unhealthy if they had a HCS < 10. RESULTS Less than half (43.5%) of school canteens were deemed to be healthy. School canteens were more likely to be healthy if the canteen manager had a formal decision letter (OR=15.2; 95% CI=3.7-62.5); used print material messaging (OR= 3.2 to 4.6 times); or received inspection by external officers periodically (OR=2.8; 95% CI= 1.04-7.5). Readiness to reopen was 4.5 (OR=4.5; 95%CI: 1.1-17.9) times higher among schools that had their own canteen, and 4 (OR=3.9; 95% CI =1.1-13.8) times higher among schools located in rural areas, adjusting for the remaining variables. CONCLUSIONS School canteen healthiness can be improved by implementing national food policy and healthy school canteen standards accompanied by the existence of good management practices within schools, particularly following the COVID-19 pandemic.
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Affiliation(s)
- Hamam Hadi
- Alma Ata Graduate School of Public Health; Alma Ata Center for Healthy Life and Foods (ACHEAF), University of Alma Ata, Yogyakarta.
| | - Resti K Triastanti
- Department of Nutrition, Faculty of Health Sciences, University of Alma Ata, Yogyakarta.
| | - Devita Anggraeni
- Department of Nutrition, Faculty of Health Sciences, University of Alma Ata, Yogyakarta.
| | - Esti Nurwanti
- Alma Ata Graduate School of Public Health; Alma Ata Center for Healthy Life and Foods (ACHEAF), University of Alma Ata, Yogyakarta.
| | - Emma C Lewis
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore.
| | - Uriyoan Colon-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington DC.
| | - Yunhee Kang
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore.
| | - Miwa Yamaguchi
- International Center for Nutrition and Information, National Institute of Health and Nutrition National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo.
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore.
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Safaei M, Sundararajan EA, Driss M, Boulila W, Shapi'i A. A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity. Comput Biol Med 2021; 136:104754. [PMID: 34426171 DOI: 10.1016/j.compbiomed.2021.104754] [Citation(s) in RCA: 167] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 01/02/2023]
Abstract
Obesity is considered a principal public health concern and ranked as the fifth foremost reason for death globally. Overweight and obesity are one of the main lifestyle illnesses that leads to further health concerns and contributes to numerous chronic diseases, including cancers, diabetes, metabolic syndrome, and cardiovascular diseases. The World Health Organization also predicted that 30% of death in the world will be initiated with lifestyle diseases in 2030 and can be stopped through the suitable identification and addressing of associated risk factors and behavioral involvement policies. Thus, detecting and diagnosing obesity as early as possible is crucial. Therefore, the machine learning approach is a promising solution to early predictions of obesity and the risk of overweight because it can offer quick, immediate, and accurate identification of risk factors and condition likelihoods. The present study conducted a systematic literature review to examine obesity research and machine learning techniques for the prevention and treatment of obesity from 2010 to 2020. Accordingly, 93 papers are identified from the review articles as primary studies from an initial pool of over 700 papers addressing obesity. Consequently, this study initially recognized the significant potential factors that influence and cause adult obesity. Next, the main diseases and health consequences of obesity and overweight are investigated. Ultimately, this study recognized the machine learning methods that can be used for the prediction of obesity. Finally, this study seeks to support decision-makers looking to understand the impact of obesity on health in the general population and identify outcomes that can be used to guide health authorities and public health to further mitigate threats and effectively guide obese people globally.
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Affiliation(s)
- Mahmood Safaei
- Centre for Software Technology and Management, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia (UKM), Bangi, 43600, Selangor, Malaysia
| | - Elankovan A Sundararajan
- Centre for Software Technology and Management, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia (UKM), Bangi, 43600, Selangor, Malaysia.
| | - Maha Driss
- RIADI Laboratory, University of Manouba, Manouba, Tunisia; College of Computer Science and Engineering, Taibah University, Medina, Saudi Arabia
| | - Wadii Boulila
- RIADI Laboratory, University of Manouba, Manouba, Tunisia; College of Computer Science and Engineering, Taibah University, Medina, Saudi Arabia
| | - Azrulhizam Shapi'i
- Center for Artificial Intelligence Technology, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia (UKM), Bangi, 43600, Selangor, Malaysia
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8
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Mellon G, Hammas K, Burdet C, Duval X, Carette C, El-Helali N, Massias L, Mentré F, Czernichow S, Crémieux AC. Population pharmacokinetics and dosing simulations of amoxicillin in obese adults receiving co-amoxiclav. J Antimicrob Chemother 2021; 75:3611-3618. [PMID: 32888018 DOI: 10.1093/jac/dkaa368] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pneumonia, skin and soft tissue infections are more frequent in obese patients and are most often treated by co-amoxiclav, using similar dosing regimens to those used for non-obese subjects. No data are available on amoxicillin pharmacokinetics among obese subjects receiving co-amoxiclav. MATERIALS AND METHODS Prospective, single-centre, open-label, non-randomized, crossover pharmacokinetic trial having enrolled obese otherwise healthy adult subjects. A first dose of co-amoxiclav (amoxicillin/clavulanate 1000/200 mg) was infused IV over 30 min, followed by a second dose (1000/125 mg) administered orally, separated by a washout period of ≥24 h. We assayed concentrations of amoxicillin by a validated ultra HPLC-tandem MS technique. We estimated population pharmacokinetic parameters of amoxicillin by non-linear mixed-effect modelling using the SAEM algorithm developed by Monolix. RESULTS Twenty-seven subjects were included in the IV study, with 24 included in the oral part of the study. Median body weight and BMI were 109.3 kg and 40.6 kg/m2, respectively. Amoxicillin pharmacokinetics were best described by a two-compartment model with first-order elimination. Mean values for clearance, central volume, intercompartmental clearance and peripheral volume were, respectively, 14.6 L/h, 9.0 L, 4.2 L/h and 6.4 L for amoxicillin. Oral bioavailability of amoxicillin was 79.7%. Amoxicillin Cmax after oral administration significantly reduced with weight (P = 0.013). Dosing simulations for amoxicillin predicted that most of the population will achieve the pharmacodynamic target of fT>MIC ≥40% with the regimen of co-amoxiclav 1000/200 mg (IV) or 1000/125 mg (oral) q8h for MICs titrated up to 0.5 mg/L (IV) and 1 mg/L (oral). CONCLUSIONS Pharmacokinetic/pharmacodynamic goals for amoxicillin can be obtained in obese subjects.
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Affiliation(s)
- G Mellon
- AP-HP, Tropical and Infectious Diseases department, Hôpital Saint-Louis, Paris, France
| | - K Hammas
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - C Burdet
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - X Duval
- CIC-EC 1425, INSERM, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - C Carette
- AP-HP, Nutrition department, Hôpital Georges-Pompidou, Paris, France
| | - N El-Helali
- Microbiology Laboratory, Hôpital Paris Saint Joseph, Paris, France
| | - L Massias
- Université de Paris, IAME, INSERM, F-75018 Paris, France.,AP-HP, Toxicology Laboratory, Hôpital Bichat, Paris, France
| | - F Mentré
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - S Czernichow
- AP-HP, Nutrition department, Hôpital Georges-Pompidou, Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
| | - A-C Crémieux
- AP-HP, Tropical and Infectious Diseases department, Hôpital Saint-Louis, Paris, France
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Nie P, Ding L, Sousa-Poza A, Leon AA, Xue H, Jia P, Wang L, Wang Y. Inequality of weight status in urban Cuba: 2001-2010. Popul Health Metr 2021; 19:24. [PMID: 33947417 PMCID: PMC8097838 DOI: 10.1186/s12963-021-00251-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
Background Although understanding changes in the body weight distribution and trends in obesity inequality plays a key role in assessing the causes and persistence of obesity, limited research on this topic is available for Cuba. This study thus analyzed changes in body mass index (BMI) and waist circumference (WC) distributions and obesity inequality over a 9-year period among urban Cuban adults. Methods Kolmogorov-Smirnov tests were first applied to the data from the 2001 and 2010 National Survey on Risk Factors and Chronic Diseases to identify a rightward shift in both the BMI and WC distributions over the 2001–2010 period. A Shapley technique decomposed the increase in obesity prevalence into a mean-growth effect and a (re)distributional component. A univariate assessment of obesity inequality was then derived by calculating both the Gini and generalized entropy (GE) measures. Lastly, a GE-based decomposition partitioned overall obesity inequality into within-group and between-group values. Results Despite some relatively pronounced left-skewing, both the BMI and WC distributions exhibited a clear rightward shift to which the increases in general and central obesity can be mostly attributed. According to the Gini coefficients, both general and central obesity inequality increased over the 2001–2010 period, from 0.105 [95% confidence interval (CI) = 0.103–0.106] to 0.110 [95% CI = 0.107–0.112] and from 0.083 [95% CI = 0.082–0.084] to 0.085 [95% CI = 0.084–0.087], respectively. The GE-based decomposition further revealed that both types of inequality were accounted for primarily by within-group inequality (93.3%/89.6% and 87.5%/84.8% in 2001/2010 for general/central obesity, respectively). Conclusions Obesity inequality in urban Cuba worsened over the 2001–2010 time period, with within-group inequality in overall obesity dominant over between-group inequality. In general, the results also imply that the rise in obesity inequality is immune to health care system characteristics. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00251-6.
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Affiliation(s)
- Peng Nie
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China. .,Institute for Health Care & Public Management, University of Hohenheim, Stuttgart, Germany. .,Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China. .,Institute of Labor Economics (IZA), Bonn, Germany.
| | - Lanlin Ding
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Alfonso Sousa-Poza
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.,Institute for Health Care & Public Management, University of Hohenheim, Stuttgart, Germany.,Institute of Labor Economics (IZA), Bonn, Germany
| | - Alina Alfonso Leon
- Centre for Demographic Studies (CEDRM), University of Havana, Havana, Cuba
| | - Hong Xue
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, 22030, USA
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
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Yamada G, Castillo-Salgado C, Jones-Smith JC, Moulton LH. Obesity prediction by modelling BMI distributions: application to national survey data from Mexico, Colombia and Peru, 1988-2014. Int J Epidemiol 2021; 49:824-833. [PMID: 31665300 DOI: 10.1093/ije/dyz195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The prediction of future obesity patterns is crucial for effective strategic planning. However, disproportionally changing body mass index (BMI) distributions pose particular challenges. Flexible modelling of the shape of BMI distributions may improve prediction performance. METHODS We used data from repeated national health surveys conducted in Mexico, Colombia and Peru at four or five time points between 1988 and 2014. Data from all surveys except the last survey were used to construct prediction models for three obesity indicators (median BMI, overweight/obesity prevalence and obesity prevalence) for the time of the last survey. We assessed their performance using predicted curves, absolute prediction errors and comparison of actual and predicted distributions. With one method, we modelled the shape of BMI distributions assuming BMI follows a Box-Cox Power Exponential (BCPE) distribution, whose parameters were modelled as a function of interval or nominal 5-year age groups, time and their interaction terms. In a second method, we modelled each of the obesity indicators directly as a function of the same covariates using quantile and logistic regression. RESULTS The BCPE model with interval age groups yielded the best prediction performance in predicting obesity prevalence. Average absolute prediction errors across all age groups were 4.3 percentage points (95% percentile interval: 1.9, 7.5), 2.5 (1.2, 6.1) and 1.7 (1.0, 9.3), with data from Mexico, Colombia and Peru, respectively. This superiority was weak or none for overweight/obesity prevalence and median BMI. CONCLUSION The BCPE model performed better for prediction of the extremes of BMI distribution, possibly by incorporating its shape more precisely.
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Affiliation(s)
- Goro Yamada
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, Room 717D, Philadelphia, PA 19104, USA. E-mail:
| | - Carlos Castillo-Salgado
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jessica C Jones-Smith
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Health Services/Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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11
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Nonalcoholic Steatohepatitis Is the Most Rapidly Increasing Indication for Liver Transplantation in the United States. Clin Gastroenterol Hepatol 2021; 19:580-589.e5. [PMID: 32531342 DOI: 10.1016/j.cgh.2020.05.064] [Citation(s) in RCA: 284] [Impact Index Per Article: 94.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/12/2020] [Accepted: 05/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The profile of chronic liver disease (CLD) in the United States has changed due to obesity trends and advances in treatment of viral hepatitis. We assessed liver transplant listing trends by CLD etiology. METHODS Adult candidates for liver transplantation were selected from the Scientific Registry of Transplant Recipients (2002 through 2019). We calculated proportion trends for common CLD etiologies at time of placement on the wait list, including chronic infection with hepatitis B virus, chronic infection with hepatitis C virus (HCV), nonalcoholic steatohepatitis (NASH, including cryptogenic cirrhosis), alcohol-related liver disease (ALD) without or with chronic HCV infection, autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, in patients with and without hepatocellular carcinoma (HCC). RESULTS From the 168,441 patients with known etiology and non-acute liver failure on the liver transplant waitlist, 27,799 patients (16.5%) had HCC. In 2002, the most common etiologies in patients without HCC were chronic HCV infection (37%) and ALD (16%), whereas only 5% had NASH. Among patients with HCC, 58% had chronic HCV infection and 10% had ALD and only 1% had NASH. In 2019, among patients without HCC, NASH was the second leading indication for liver transplantation (28% of patients), after ALD (38% of patients). Among patients with HCC, chronic HCV infection remained the leading indication (40% of patients) but NASH (24% of patients) surpassed ALD (16% of patients) to become the second leading indication. NASH was the leading indication in women without HCC (34%), in patients older than 54 years (36%), and in patients on Medicare (41%). In trend analysis, NASH was the most rapidly increasing indication for liver transplantation in patients without HCC (Kendall tau=0.97; P < .001) and in patients with HCC (tau=0.94; P < .0001). CONCLUSIONS In an analysis of data from the Scientific Registry of Transplant Recipients (2002 through 2019), we found NASH to be the second most common indication for liver transplant in 2019, and the fastest increasing indication. In 2019, NASH was the leading indication for liver transplantation among women without HCC.
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12
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Multiple Health Risk Factors in Vocational Education Students: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020637. [PMID: 33451108 PMCID: PMC7828627 DOI: 10.3390/ijerph18020637] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 12/13/2022]
Abstract
Health risk factors such as tobacco smoking, inadequate fruit intake, inadequate vegetable intake, risky alcohol consumption, physical inactivity, obesity, anxiety and depression often commence during adolescence and young adulthood. Vocational education institutions enrol many students in these age groups making them an important setting for addressing multiple health risk factors. This systematic review examined (i) co-occurrence of health risk factors, (ii) clustering of health risk factors, and (iii) socio-demographic characteristics associated with co-occurrence and/or clusters of health risks among vocational education students. MEDLINE, PsycINFO, EMBASE, CINAHL and Scopus were searched to identify eligible studies published by 30 June 2020. Two reviewers independently extracted data and assessed methodological quality using the National Heart, Lung and Blood Institute Quality Assessment Tool. Five studies assessed co-occurrence and three studies clustering of health risks. Co-occurrence of health risk factors ranged from 29–98% and clustering of alcohol use and tobacco smoking was commonly reported. The findings were mixed about whether gender and age were associated with co-occurrence or clustering of health risks. There is limited evidence examining co-occurrence and clustering of health risk factors in vocational education students. Comprehensive assessment of how all these health risks co-occur or cluster in vocational education students is required.
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13
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Chumponsuk T, Gruneck L, Gentekaki E, Jitprasertwong P, Kullawong N, Nakayama J, Popluechai S. The salivary microbiota of Thai adults with metabolic disorders and association with diet. Arch Oral Biol 2021; 122:105036. [PMID: 33421657 DOI: 10.1016/j.archoralbio.2020.105036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to investigate abundance of specific bacterial taxa in the saliva of 105 Thai adults with different BMI (lean, overweight, and obese) and T2DM subjects using qPCR targeting the 16S rRNA gene of various bacteria taxa. DESIGN We employed qPCR targeting 16S rRNA genes to explore the bacterial profiles and abundances in the saliva of Thai adult subjects with different BMI and T2DM. Multivariate statistical analyses (multiple factor analysis (MFA) and sparse Partial Least Squares Discriminant Analysis (sPLS-DA) were performed to assess the associations of salivary bacteria with diet, blood profile, gender, age, and use of antibiotics. RESULTS We found that abundance profiles of the examined salivary bacteria were similar across the four groups. When diet, blood profile, and gender, age, and use of antibiotics were considered, significant differences were noted between subgroups. A positive correlation was also found between consumption of carbonate soft drinks and Bacteroidetes, Gamma-proteobacteria, Veillonella, Fusobacterium and Fusobacterium nucleatum. CONCLUSIONS This is the first study demonstrating the relative abundance of salivary bacteria in adult Thai subjects with different levels of BMI and T2DM. Regardless of the similar pattern of bacterial profiles across groups, sPLS-DA analysis highlighted the influence of host variables (gender, age, and use of antibiotics) on the abundance of salivary microbiota. Our findings pave the way for further hypothesis testing to gain insight into the association between host factors and salivary microbiome.
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Affiliation(s)
| | - Lucsame Gruneck
- Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand
| | - Eleni Gentekaki
- School of Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand; Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand
| | - Paiboon Jitprasertwong
- School of Geriatric Oral Health, Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Niwed Kullawong
- School of Health Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand
| | - Jiro Nakayama
- Department of Bioscience and Biotechnology, Faculty of Agriculture, Kyushu University, Fukuoka, Japan
| | - Siam Popluechai
- School of Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand; Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand.
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14
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Gruneck L, Kullawong N, Kespechara K, Popluechai S. Gut microbiota of obese and diabetic Thai subjects and interplay with dietary habits and blood profiles. PeerJ 2020; 8:e9622. [PMID: 32832269 PMCID: PMC7409811 DOI: 10.7717/peerj.9622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/07/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity and type 2 diabetes mellitus (T2DM) have become major public health issues globally. Recent research indicates that intestinal microbiota play roles in metabolic disorders. Though there are numerous studies focusing on gut microbiota of health and obesity states, those are primarily focused on Western countries. Comparatively, only a few investigations exist on gut microbiota of people from Asian countries. In this study, the fecal microbiota of 30 adult volunteers living in Chiang Rai Province, Thailand were examined using next-generation sequencing (NGS) in association with blood profiles and dietary habits. Subjects were categorized by body mass index (BMI) and health status as follows; lean (L) = 8, overweight (OV) = 8, obese (OB) = 7 and diagnosed T2DM = 7. Members of T2DM group showed differences in dietary consumption and fasting glucose level compared to BMI groups. A low level of high-density cholesterol (HDL) was observed in the OB group. Principal coordinate analysis (PCoA) revealed that microbial communities of T2DM subjects were clearly distinct from those of OB. An analogous pattern was additionally illustrated by multiple factor analysis (MFA) based on dietary habits, blood profiles, and fecal gut microbiota in BMI and T2DM groups. In all four groups, Bacteroidetes and Firmicutes were the predominant phyla. Abundance of Faecalibacterium prausnitzii, a butyrate-producing bacterium, was significantly higher in OB than that in other groups. This study is the first to examine the gut microbiota of adult Thais in association with dietary intake and blood profiles and will provide the platform for future investigations.
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Affiliation(s)
- Lucsame Gruneck
- School of Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand.,Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand
| | - Niwed Kullawong
- Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand.,School of Health Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand
| | | | - Siam Popluechai
- School of Science, Mae Fah Luang University, Muang, Chiang Rai, Thailand.,Gut Microbiome Research Group, Mae Fah Luang University, Muang, Chiang Rai, Thailand
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15
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Hessel P, Rodríguez-Lesmes P, Torres D. Socio-economic inequalities in high blood pressure and additional risk factors for cardiovascular disease among older individuals in Colombia: Results from a nationally representative study. PLoS One 2020; 15:e0234326. [PMID: 32516351 PMCID: PMC7282633 DOI: 10.1371/journal.pone.0234326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Studies in high-income countries have documented a consistent gradient between socio-economic status (SES) and high blood pressure (HBP), a key risk factor for cardiovascular disease (CVD). However, evidence from Latin American countries (LA) remains comparatively scarce and inconclusive. Data Data for 3,984 individuals came from a nationally representative survey of individuals aged 60 years or above in Colombia (Encuesta de Salud, Bienestar y Envejecimiento) (SABE) conducted in 2015. SES was measured by educational achievement and household assets. CVD risk factors included objectively measured HBP and body mass index (BMI), as well as behaviors (smoking, alcohol consumption, fruit and vegetables intake, and physical activity). Methods Bivariate methods and multivariate regression models were used to assess associations between SES with HBP as well as additional risk factors for CVD. Results Individuals with lower SES have significantly higher risk of suffering from HBP. Compared to those with no formal education, individuals with secondary or post-secondary education have a 37% lower risk of HBP (odds ratio [OR] = 0.63, P-value<0.001). Being in the highest asset quartile (most affluent) is associated with a 44% lower risk (OR = 56, P-value = 0.001) of HBP compared to those in the lowest asset quartile (most deprived). Individuals with lower SES are more likely to smoke, not engage in regular physical activity and not regularly consume fruits or vegetables. In contrast, individuals with higher SES are more likely to consume alcohol and, those with more assets, more likely to be obese. Conclusions Among older Colombians there exists a marked SES gradient in HBP as well as several additional risk factors for CVD. The results highlight the importance of a public health approach towards HBP and additional CVD risk factors that takes into account the specific conditions of older individuals, especially among disadvantaged groups.
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Affiliation(s)
- Philipp Hessel
- University of the Andes, Alberto Lleras Camargo School of Government, Bogotá, Colombia
- * E-mail:
| | | | - David Torres
- University of the Andes, Alberto Lleras Camargo School of Government, Bogotá, Colombia
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16
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Association between the frequency of television watching and overweight and obesity among women of reproductive age in Nepal: Analysis of data from the Nepal Demographic and Health Survey 2016. PLoS One 2020; 15:e0228862. [PMID: 32040537 PMCID: PMC7010261 DOI: 10.1371/journal.pone.0228862] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 01/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of overweight and obesity, particularly among women, is increasing in Nepal. Previous studies in the South Asia have found television watching to be a risk factor for overweight and obesity among women of reproductive age. However, this association had not been studied in the context of Nepal. This study aims to identify the association between frequency of television watching and overweight and obesity among Nepalese women of reproductive age. Methods This cross-sectional study utilized the Nepal Demographic and Health Survey 2016 (NDHS 2016) data. A total weighted sample of 6,031 women were included in the final analyses. The women were 15–49 years of age and were either not pregnant or had not delivered a child within the two months prior to the survey. Body mass index (BMI) was the primary outcome of this study, which was categorized using an Asia-specific cutoff value. Normal and/or underweight was defined as a BMI <23.0 kg/m2, overweight was defined as a BMI between 23.0 kg/m2 and <27.5 kg/m2, and obesity was defined as a BMI ≥27.5 kg/m2. Frequency of watching television was the main independent variable of this study, which was divided into the following three categories: not watching television at all, watching television less than once a week, and watching television at least once a week. Multilevel ordered logistic regression was conducted to find the factors associated with overweight and obesity. A p-value <0.05 was considered significant in the final model. Results Around 35% of the participants were overweight or obese (overweight: 23.7% and obese: 11.6%). A majority of the study participants was aged between 15 and 24 years (36.5%), and resided in an urban area (63.2%), Province No. 3 (22.3%), and the Terai ecological region (49.5%). Around one-third (34.0%) of the participants received no formal education while an almost similar proportion (35.5%) completed secondary education. Approximately half of the study participants (50.6%) reported watching television at least once a week, whereas more than a quarter (28.7%) of them did not watch television at all. Women who watched television at least once a day had a higher prevalence of overweight and obesity than the other groups (p-value <0.0001). Women who watched television at least once a week were 1.3 times more likely to be overweight or obese in comparison to women who never watched television (Adjusted Odds Ratio (AOR): 1.3, 95% CI: 1.0–1.7; p-value <0.05). In the urban areas, women who watched television at least once a week were 40% more likely to be overweight or obese than those who did not watch television at all (AOR: 1.4, 95% CI: 1.1–1.7; p-value <0.01). No significant association between overweight and obesity and the frequency of viewing television was observed in the rural area. Conclusions Watching television at least once a week is associated with overweight and obesity in women of reproductive age living in the urban areas of Nepal. Public health promotion programs should raise awareness among women regarding harmful health consequences of sedentary lifestyle due to television watching.
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Abstract
PURPOSE The purpose of this study was to review the evidence on global dietary intake and trends in dietary patterns over time and to examine associations between diets and health, environment, and equity. RECENT FINDINGS Diets now serve as a significant risk factor for the global burden of disease and death. Diet-related non-communicable disease and rising obesity are increasingly prevalent, affecting much of the global population. At the same time, the food system is producing food in ways that are not aligned with planetary health. Inequity restricts access to healthy diets and is associated with broad social determinants. Current dietary patterns are increasingly unhealthy, unsustainable, and inequitable for many populations. Multi-pronged interventions are needed to address the impacts of diets in order to improve human and planetary well-being.
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Affiliation(s)
- Jessica Fanzo
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.
- School of Advanced International Studies, Johns Hopkins University, Washington, DC, USA.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Claire Davis
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
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18
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Fay AP, McKay RR, Lin X, Simantov R, Choueiri TK. Impact of Geographic Regions on Overall Survival in Patients With Metastatic Renal Cell Carcinoma: Results From an International Clinical Trials Database. J Glob Oncol 2019; 4:1-14. [PMID: 30241151 PMCID: PMC6223429 DOI: 10.1200/jgo.17.00119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose Health determinants vary according to geographic region and may affect the outcomes of patients with metastatic renal cell carcinoma (mRCC) treated during clinical trials of targeted therapy. Here, we investigate the overall survival (OS) of patients with mRCC treated in the era of targeted therapy by geographic region. Methods We conducted a pooled analysis of patients with mRCC who were treated during phase II or III clinical trials. Clinical characteristics and survival data were collected. Statistical analyses were performed with the Kaplan-Meier method and log-rank test in univariable analysis. Results Overall, 4,736 patients were included in the analysis. Patient characteristics differed according to geographic region. No statistically significant differences in OS were observed when the United States/Canada (USC) was compared with the following other regions: Latin America, Asia/Oceania/Africa, and Eastern Europe. In a univariable analysis, OS differed among patients enrolled in trials in USC compared with Western Europe (20.3 v 17.4 months; hazard ratio, 1.15; 95% CI, 1.03 to 1.3; P = .015), but it did not differ in a multivariable analysis. All-grade treatment-related adverse events (AEs) were observed more frequently in USC. There were no significant differences in grade 3 to 5 AEs among groups. Conclusion Despite different baseline characteristics, OS was similar among patients enrolled in clinical trials across different geographic regions. Access to clinical trials as well as disease biology, AE reporting, and quality of care may contribute to potential differences in outcomes.
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Affiliation(s)
- Andre P Fay
- Andre P. Fay, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Rana R. McKay, University of California San Diego, San Diego, CA; Xun Lin and Ronit Simantov, Pfizer Oncology, New York, NY; and Toni K. Choueiri, Dana-Farber Cancer Institute, Boston, MA
| | - Rana R McKay
- Andre P. Fay, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Rana R. McKay, University of California San Diego, San Diego, CA; Xun Lin and Ronit Simantov, Pfizer Oncology, New York, NY; and Toni K. Choueiri, Dana-Farber Cancer Institute, Boston, MA
| | - Xun Lin
- Andre P. Fay, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Rana R. McKay, University of California San Diego, San Diego, CA; Xun Lin and Ronit Simantov, Pfizer Oncology, New York, NY; and Toni K. Choueiri, Dana-Farber Cancer Institute, Boston, MA
| | - Ronit Simantov
- Andre P. Fay, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Rana R. McKay, University of California San Diego, San Diego, CA; Xun Lin and Ronit Simantov, Pfizer Oncology, New York, NY; and Toni K. Choueiri, Dana-Farber Cancer Institute, Boston, MA
| | - Toni K Choueiri
- Andre P. Fay, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Rana R. McKay, University of California San Diego, San Diego, CA; Xun Lin and Ronit Simantov, Pfizer Oncology, New York, NY; and Toni K. Choueiri, Dana-Farber Cancer Institute, Boston, MA
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19
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On the limitations of barriers: Social visibility and weight management in Cuba and Samoa. Soc Sci Med 2019; 239:112501. [DOI: 10.1016/j.socscimed.2019.112501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/11/2022]
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20
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A feasibility of simulation-based exercise programme for overweight adult in higher learning institutions. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Das Gupta R, Haider SS, Sutradhar I, Hashan MR, Sajal IH, Hasan M, Haider MR, Sarker M. Association of frequency of television watching with overweight and obesity among women of reproductive age in India: Evidence from a nationally representative study. PLoS One 2019; 14:e0221758. [PMID: 31465465 PMCID: PMC6715273 DOI: 10.1371/journal.pone.0221758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/14/2019] [Indexed: 01/22/2023] Open
Abstract
Background For women of reproductive age, overweight and obesity are an established risk factor for several medical complications. To address the increasing rate of obesity in India through public health awareness programs, the association between common behaviors and overweight and obesity needs to be investigated. This study aims to determine whether there is any association between the frequency of television watching and overweight and obesity among women of reproductive age (15–49 years) in India. Methods This is a cross-sectional study that utilized data from the National Family Health Survey (NFHS-4), which utilized a nationally representative sample from all 29 states and 7 union territories of India. The survey itself followed a two-staged stratified random sampling technique. The primary outcome of interest was overweight (23.0 kg/m2 to <27.5 kg/m2) and obesity (≥27.5 kg/m2), measured by using the Asian body mass index cut-off. The major explanatory variable was the frequency of television watching, measured in days per week. Sample weight of NFHS-4 was adjusted during the analysis. Multilevel ordered logistic regression was conducted to identify the factors associated with overweight and obesity. To show the strength of association, both the unadjusted Crude Odds Ratio (COR) and the Adjusted Odds Ratio (AOR) were reported with a 95% confidence interval (CI). A p-value<0.05 was considered statistically significant. Results The analysis included weighted data from 644,006 Indian women of reproductive age (15–49 years). Among the respondents, 33.5% were overweight or obese (BMI ≥23.0 kg/m2). The prevalence of overweight and obesity increased with age (p-value <0.0001) and almost half of the women aged 35–49 years were either overweight or obese (48.6%). The prevalence was significantly higher among those living in an urban area compared to a rural area (urban 46.5% vs. rural 26.5%; p-value <0.001). The prevalence of overweight and obesity increased with the frequency of watching television and was the highest among the individuals who reported watching television almost every day (p-value <0.0001). Women watching television almost every day had 24% (AOR: 1.24, 95% CI: 1.21–1.26; p-value <0.001) increased odds of being overweight and obese compared to their counterparts who never watched television. Conclusions This study found that the likelihood of being overweight and obese significantly increased with the frequency of watching television; likely due to physical inactivity during leisure time. Further studies should examine the physical activity and food habits of this target group. Public health promotion programs in India should raise awareness regarding the harmful effects of the sedentary lifestyle associated with watching television.
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Affiliation(s)
- Rajat Das Gupta
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
- * E-mail:
| | - Shams Shabab Haider
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Ipsita Sutradhar
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | | | - Ibrahim Hossain Sajal
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Department of Mathematical Sciences, School of Natural Sciences & Mathematics, The University of Texas at Dallas, Dallas, Texas, United States of America
| | - Mehedi Hasan
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Mohammad Rifat Haider
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, Ohio, United States of America
| | - Malabika Sarker
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Centre for Science of Implementation & Scale-Up, BRAC James P Grant School of Public Health, BRAC University, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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Brown M, Roman NV. Nutritional Knowledge, Parenting Styles and Feeding Practices of a South African Sample of Parents. Ecol Food Nutr 2019; 58:529-547. [PMID: 31317784 DOI: 10.1080/03670244.2019.1641800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Parenting can be considered as being an all-encompassing network of development for children. Children learn about eating not only through their own experiences but also by watching others. Mothers and children show similar patterns of food acceptance and food preferences. Children's intake of fruit and vegetables was positively related to parents' intake of fruit and vegetables. The current study used self-reported data from parents/primary caregivers' children aged 3-18 covering sociodemographic characteristics, feeding style dimensions ('control overeating', 'emotional feeding', 'encouragement to eat' and 'instrumental feeding') and parenting style dimensions ('involvement' and 'strictness'). The results suggest, that in general, parents were inclined to encourage balance and variety in the food intake of their children, modeling healthy eating behavior, as well as monitoring the food intake of children while restricting unhealthy foods. Further research is needed into whether parents' diets affect children's food choices feeding.
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Affiliation(s)
- Melissa Brown
- Child and Family Studies, Social Work Department, University of the Western Cape, Bellville, South Africa
| | - Nicolette V Roman
- Child and Family Studies, Social Work Department, University of the Western Cape, Bellville, South Africa
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23
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Araghi M, Soerjomataram I, Jenkins M, Brierley J, Morris E, Bray F, Arnold M. Global trends in colorectal cancer mortality: projections to the year 2035. Int J Cancer 2019; 144:2992-3000. [PMID: 30536395 DOI: 10.1002/ijc.32055] [Citation(s) in RCA: 310] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of cancer death. Predictions of the future burden of the disease inform health planners and raise awareness of the need for cancer control action. Data from the World Health Organization (WHO) mortality database for 1989-2016 were used to project colon and rectal cancer mortality rates and number of deaths in 42 countries up to the year 2035, using age-period-cohort (APC) modelling. Mortality rates for colon cancer are predicted to continue decreasing in the majority of included countries from Asia, Europe, North America and Oceania, except Latin America and Caribbean countries. Mortality rates from rectal cancer in general followed those of colon cancer, however rates are predicted to increase substantially in Costa Rica (+73.6%), Australia (+59.2%), United States (+27.8%), Ireland (+24.2%) and Canada (+24.1%). Despite heterogeneous trends in rates, the number of deaths is expected to rise in all countries for both colon and rectal cancer by 60.0% and 71.5% until 2035, respectively, due to population growth and ageing. Reductions in colon and rectal cancer mortality rates are probably due to better accessibility to early detection services and improved specialized care. The expected increase in rectal cancer mortality rates in some countries is worrisome and warrants further investigations.
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Affiliation(s)
- Marzieh Araghi
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mark Jenkins
- University of Melbourne, Centre for MEGA Epidemiology, Carlton, Victoria, Australia
| | - James Brierley
- University of Toronto, Department of Radiation Oncology, Toronto, Ontario, Canada
| | - Eva Morris
- University of Leeds, Leeds Institute of Cancer Studies & Pathology, Division of Epidemiology & Biostatistics, St James's University Hospital, Leeds, United Kingdom
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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24
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Chen-Ku CH, Gonzalez-Galvez G, Vásquez M, Fuente G, Nakazone MA, Silva Giordano AI, de Sa Pereira MH. VASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES: PREVALENCE AND COMORBIDITIES IN 6 COUNTRIES OF LATIN AMERICA (A COHORT OF THE DISCOVER STUDY PROGRAM). Endocr Pract 2019; 25:994-1002. [PMID: 31170372 DOI: 10.4158/ep-2018-0473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To provide real world observational data about glucose control, the burden of diabetes, comorbidities, and cardiovascular risk factors among patients initiating second-line therapy in Latin America (LA). Methods: This report is a cross-sectional analysis of the LA cohort of the DISCOVER study, describing the regional prevalence of microvascular and macrovascular complications in Mexico, Costa Rica, Panama, Colombia, Argentina, and Brazil. Results: One thousand six hundred and sixteen patients were included in 69 investigational sites. Hemoglobin A1c was >7% (42 mmol/mol) in 81.3% of subjects. Macrovascular complications were reported by 13.8% of the subjects. Microvascular conditions were reported in 15.2% of the subjects. The prevalence of hypertension and of hyperlipidemia was 55.5% and 45.9%, respectively. Blood pressure, total cholesterol, and low-density lipoprotein were out of target levels in 38.5%, 51.2%, and 81.7% of the patients, respectively. Overweight or obesity was reported in 83.8% of the cases. Conclusion: Our study shows that patients with type 2 diabetes in LA are not reaching their glucose, lipids, blood pressure, and weight targets. The prevalence of microvascular (15.2%), macrovascular (13.8%), and uncontrolled comorbidities in patients at an early stage of the disease (initiating a second-line therapy) highlights the need for more aggressive risk factor screening as well as treatment in LA. Abbreviations: CV = cardiovascular; CVD = cardiovascular disease; DM = diabetes mellitus; HbA1c = hemoglobin A1c; LA = Latin America/Latin American; LDL = low density cholesterol; T2DM = type 2 diabetes mellitus.
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Graf S, Cecchini M. Identifying patterns of unhealthy diet and physical activity in four countries of the Americas: a latent class analysis. Rev Panam Salud Publica 2019; 42:e56. [PMID: 31093084 PMCID: PMC6385803 DOI: 10.26633/rpsp.2018.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 01/11/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine clusters of individuals who present similar health behaviors in terms of diet, physical activity, and sedentarism, in four countries of the Americas: Brazil (2013), Chile (2009), Mexico (2012), and the United States of America (2013). This makes it possible to determine which of these behaviors occur simultaneously, as well as the demographic and sociodemographic characteristics associated with each cluster. Methods The individual-level data analyzed were drawn from national health interviews and health examination surveys in Brazil, Chile, Mexico, and the United States, for different time periods. Using international physical activity guidelines and national dietary guidelines, the health behaviors of each individual were assessed. A latent class analysis was conducted to classify individuals into clusters based on these behaviors, and was followed by multinomial regressions to determine the characteristics of those in each class. Results Overall, most individuals belonged to the classes characterized by average or unhealthy diets but sufficient amounts of physical activity. However, large differences exist across countries and population groups. Men with higher socioeconomic characteristics were globally more likely to belong to the least healthy class in each country. Conclusions Findings from this analysis support the implementation of more refined policy actions to target specific unhealthy behaviors in different population groups, defined by gender, age group, socioeconomic status, and, to some extent, place of residence. The at-risk populations identified through this paper are those that should be targeted by upcoming interventions.
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Affiliation(s)
| | - Michele Cecchini
- Organisation for Economic Co-operation and Development, Health Division, Paris, France
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26
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Li J, Xiao C, Yang H, Zhou Y, Wang R, Cao Y. Anemia and Iron Status Among Different Body Size Phenotypes in Chinese Adult Population: a Nation-Wide, Health and Nutrition Survey. Biol Trace Elem Res 2018; 185:1-10. [PMID: 29224080 DOI: 10.1007/s12011-017-1213-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/28/2017] [Indexed: 12/18/2022]
Abstract
Previous studies have shown that there is a controversial relationship between iron homeostasis and obesity. This study aims to explore the relationship of anemia and iron status with different body size phenotypes in adult Chinese population. Using information on iron status-related parameters and lifestyle data from 8462 participants of the 2009 wave of China Health and Nutrition Survey (2009 CHNS), we performed multivariable logistic regression analyses to estimate the odds ratios (ORs) for the risk of anemia and iron parameters according to different body size phenotypes. Participants with higher body mass index (BMI) had a lower anemia prevalence with significant trends in both metabolic status groups (P < 0.001). Serum ferritin, transferrin, and soluble transferrin receptor (sTfR)/log ferritin index were significant in different metabolic status groups and in different body size phenotypes, respectively. The ORs for higher ferritin and transferrin increased across different body size phenotypes in both genders, and for sTfR/log ferritin index decreased (P < 0.01 for trend). This association was still statistically significant after adjustment for multiple confounders. We found an inverse association of BMI levels with the prevalence of anemia and strong association of serum ferritin and transferrin with higher risk of obesity or overweight in both metabolic status groups.
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Affiliation(s)
- Jiang Li
- Department of Laboratory Medicine, China-Japan Friendship Hospital, No. 2 Yinghua East Rd, Beijing, 100029, China.
| | - Cheng Xiao
- China-Japan Friendship Hospital, Institute of Clinical Medicine, Beijing, 100029, China
| | - Hui Yang
- Department of Laboratory Medicine, China-Japan Friendship Hospital, No. 2 Yinghua East Rd, Beijing, 100029, China
| | - Yun Zhou
- Department of Laboratory Medicine, China-Japan Friendship Hospital, No. 2 Yinghua East Rd, Beijing, 100029, China
| | - Rui Wang
- Blood Screening Laboratory, Beijing Red Cross Blood Center, Beijing, 100088, China
| | - Yongtong Cao
- Department of Laboratory Medicine, China-Japan Friendship Hospital, No. 2 Yinghua East Rd, Beijing, 100029, China.
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27
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Foley JT, Lloyd M, Turner L, Temple VA. Body mass index and waist circumference of Latin American adult athletes with intellectual disability. SALUD PUBLICA DE MEXICO 2018; 59:416-422. [PMID: 29211262 DOI: 10.21149/8204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/15/2017] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To examine both body mass index (BMI) status and waist circunference (WC) in a large international sample of adult Special Olympics participants from Latin America. It also explored the association of age and sex with obesity in this population. MATERIALS AND METHODS BMI and WC records from a total of 4174 (2683 male and 1491 female) participant records from the Special Olympics International Health Promotion database were examined. RESULTS The prevalence of overweight and obesity was quite high (i.e. > 40%), but generally lower than studies involving adults with intellectual disabilities from Europe and the USA. Chi-square analyses revealed that both increasing age and being female significantly predicted levels of overweight, obesity, and WC. CONCLUSIONS These results suggest that efforts need to be made to prevent and reduce rates of overweight and obesity among Latin American Special Olympics participants, particularly women.
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Affiliation(s)
- John T Foley
- Physical Education Department, State University of New York College at Cortland. USA
| | - Meghann Lloyd
- Faculty of Health Sciences, University of Ontario Institute of Technology. Canada
| | - Lesley Turner
- Physical Education Department, State University of New York College at Cortland. USA
| | - Viviene A Temple
- School of Exercise Science, Physical and Health Education, University of Victoria. Canada
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28
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Carriquiry G, Giganti MJ, Castilho JL, Jayathilake K, Cahn P, Grinsztejn B, Cortes C, Pape JW, Padgett D, Sierra‐Madero J, McGowan CC, Shepherd BE, Gotuzzo E. Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort. J Int AIDS Soc 2018; 21:e25088. [PMID: 29569354 PMCID: PMC5864576 DOI: 10.1002/jia2.25088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/29/2018] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The "greying" of the HIV epidemic necessitates a better understanding of the healthcare needs of older HIV-positive adults. As these individuals age, it is unclear whether comorbidities and their associated therapies or the ageing process itself alter the response to antiretroviral therapy (ART). In this study, HIV treatment outcomes and corresponding risk factors were compared between older ART initiators and those who were younger using data from the Caribbean, Central and South America Network for HIV Epidemiology (CCASAnet). METHODS HIV-positive adults (≥18 years) initiating ART at nine sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Patients were classified as older (≥50 years) or younger (<50 years) based on age at ART initiation. ART effectiveness was measured using three outcomes: death, virologic failure and ART treatment modification. Cox regression models for each outcome compared risk between older and younger patients, adjusting for other covariates. RESULTS Among 26,311 patients initiating ART between 1996 and 2016, 3389 (13%) were ≥50 years. The majority of patients in both ≥50 and <50 age groups received a non-nucleoside reverse transcriptase inhibitor-based regimen (89% vs. 87%), did not have AIDS at baseline (63% vs. 62%), and were male (59% vs. 58%). Older patients had a higher risk of death (adjusted hazard ratio (aHR) 1.64; 95% confidence intervals (CI): 1.48 to 1.83) and a lower risk of virologic failure (aHR: 0.73; 95% CI: 0.63 to 0.84). There was no difference in risk of ART modification (aHR: 1.00; 95% CI: 0.94 to 1.06). Risk factors for death, virologic failure and treatment modification were similar for each group. CONCLUSIONS Older age at ART initiation was associated with increased mortality and decreased risk of virologic failure in our cohort of more than 26,000 ART initiators in Latin America and the Caribbean. To the best of our knowledge this is the first study from the region to evaluate ART outcomes in this growing and important population. Given the complexity of issues related to ageing with HIV, a greater understanding is needed in order to properly respond to this shifting epidemic.
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Affiliation(s)
| | | | | | | | | | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas‐Fundação Oswaldo CruzRio de JaneiroBrazil
| | | | - Jean W Pape
- Le Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Port‐au‐PrinceHaiti and Weill Cornell Medical CollegeNew YorkNYUSA
| | - Denis Padgett
- Instituto Hondureño de Seguridad Social and Hospital Escuela UniversitarioTegucigalpaHonduras
| | - Juan Sierra‐Madero
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
| | | | | | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von HumboldtLimaPeru
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Carrillo-Larco RM, Miranda JJ, Gilman RH, Checkley W, Smeeth L, Bernabé-Ortiz A. Trajectories of body mass index and waist circumference in four Peruvian settings at different level of urbanisation: the CRONICAS Cohort Study. J Epidemiol Community Health 2018; 72:397-403. [PMID: 29472520 PMCID: PMC5909748 DOI: 10.1136/jech-2017-209795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 12/31/2017] [Accepted: 01/26/2018] [Indexed: 11/29/2022]
Abstract
Background Studies have reported the incidence/risk of becoming obese, but few have described the trajectories of body mass index (BMI) and waist circumference (WC) over time, especially in low/middle-income countries. We assessed the trajectories of BMI and WC according to sex in four sites in Peru. Methods Data from the population-based CRONICAS Cohort Study were analysed. We fitted a population-averaged model by using generalised estimating equations. The outcomes of interest, with three data points over time, were BMI and WC. The exposure variable was the factorial interaction between time and study site. Results At baseline mean age was 55.7 years (SD: 12.7) and 51.6% were women. Mean follow-up time was 2.5 years (SD: 0.4). Over time and across sites, BMI and WC increased linearly. The less urbanised sites showed a faster increase than more urbanised sites, and this was also observed after sex stratification. Overall, the fastest increase was found for WC compared with BMI. Compared with Lima, the fastest increase in WC was in rural Puno (coefficient=0.73, P<0.001), followed by urban Puno (coefficient=0.59, P=0.001) and Tumbes (coefficient=0.22, P=0.088). Conclusions There was a linear increase in BMI and WC across study sites, with the greatest increase in less urbanised areas. The ongoing urbanisation process, common to Peru and other low/middle-income countries, is accompanied by different trajectories of increasing obesity-related markers.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,Área de Investigación y Desarrollo, AB PRISMA, Lima, Peru
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Liam Smeeth
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Nie P, Alfonso Leon A, Díaz Sánchez ME, Sousa-Poza A. The rise in obesity in Cuba from 2001 to 2010: An analysis of National Survey on Risk Factors and Chronic Diseases data. ECONOMICS AND HUMAN BIOLOGY 2018; 28:1-13. [PMID: 29197237 DOI: 10.1016/j.ehb.2017.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 11/08/2017] [Accepted: 11/11/2017] [Indexed: 06/07/2023]
Abstract
Using two waves of the National Survey on Risk Factors and Chronic Diseases in Cuba, we identify demographic and socioeconomic characteristics associated with obesity among urban adults aged 18+ and decompose the change in obesity within this 9-year period using both the mean-based Blinder-Oaxaca decomposition and a nonlinear approach. Our results reveal significant increases in overweight and obesity (2.3, 3.1, and 7.6 percentage points for BMI-based overweight, BMI-based obesity, and abdominal obesity, respectively). Depending on the decompositional approach and obesity measure, our analysis explains between 13% and 51% of the rise in overweight and obesity, with most part attributable to changes in risky behavior, age, and education. Of particular importance are the large decline in smoking and the population's changing age structure.
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Affiliation(s)
- Peng Nie
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China; Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany.
| | | | | | - Alfonso Sousa-Poza
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany.
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Knuchel-Takano A, Hunt D, Jaccard A, Bhimjiyani A, Brown M, Retat L, Brown K, Hinde S, Selvarajah C, Bauld L, Webber L. Modelling the implications of reducing smoking prevalence: the benefits of increasing the UK tobacco duty escalator to public health and economic outcomes. Tob Control 2017; 27:e124-e129. [PMID: 29212863 DOI: 10.1136/tobaccocontrol-2017-053860] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 11/01/2017] [Accepted: 11/12/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Taxing tobacco is one of the most effective ways to reduce smoking prevalence, mitigate its devastating consequential health harms and progress towards a tobacco-free society. This study modelled the health and economic impacts of increasing the existing cigarette tobacco duty escalator (TDE) in the UK from the current 2% above consumer price inflation to 5%. METHODS A two-stage modelling process was used. First, a non-linear multivariate regression model was fitted to cross-sectional smoking data, creating longitudinal projections from 2015 to 2035. Second, these projections were used to predict the future incidence, prevalence and cost of 17 smoking-related diseases using a Monte Carlo microsimulation approach. A sustained increase in the duty escalator was evaluated against a baseline of continuing historical smoking trends and the existing duty escalator. RESULTS A sustained increase in the TDE is projected to reduce adult smoking prevalence to 6% in 2035, from 10% in a baseline scenario. After increasing the TDE, only 65% of female and 60% of male would-be smokers would actually be smoking in 2035. The intervention is projected to avoid around 75 200 new cases of smoking-related diseases between 2015 and 2035. In 2035 alone, £49 m in National Health Service and social care costs and £192 m in societal premature mortality and morbidity costs are projected to be avoided. CONCLUSION Increasing the UK TDE to 5% above inflation could effectively reduce smoking prevalence, prevent diseases and avoid healthcare costs. It would deliver substantial progress towards a tobacco-free society and should be implemented by the UK Government with urgency.
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Affiliation(s)
- Andre Knuchel-Takano
- Department of Public Health Modelling, UK Health Forum (formerly the National Heart Forum), London, UK
| | - Daniel Hunt
- Department of Prevention, Cancer Research UK, London, UK
| | - Abbygail Jaccard
- Department of Public Health Modelling, UK Health Forum (formerly the National Heart Forum), London, UK
| | - Arti Bhimjiyani
- Department of Translational Health Sciences, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Martin Brown
- Department of Public Health Modelling, UK Health Forum (formerly the National Heart Forum), London, UK
| | - Lise Retat
- Department of Public Health Modelling, UK Health Forum (formerly the National Heart Forum), London, UK
| | - Katrina Brown
- Department of Analysis and Evaluation, Cancer Research UK, London, UK
| | - Sebastian Hinde
- Team for Economic Evaluation and Health Technology Assessment (TEEHTA), Centre for Health Economics, University of York, York, UK
| | | | - Linda Bauld
- Department of Prevention, Cancer Research UK, London, UK.,Institute for Social Marketing and UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Laura Webber
- Department of Public Health Modelling, UK Health Forum (formerly the National Heart Forum), London, UK
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Hunt D, Knuchel-Takano A, Jaccard A, Bhimjiyani A, Retat L, Selvarajah C, Brown K, Webber LL, Brown M. Modelling the implications of reducing smoking prevalence: the public health and economic benefits of achieving a 'tobacco-free' UK. Tob Control 2017; 27:129-135. [PMID: 28495977 DOI: 10.1136/tobaccocontrol-2016-053507] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Smoking is still the most preventable cause of cancer, and a leading cause of premature mortality and health inequalities in the UK. This study modelled the health and economic impacts of achieving a 'tobacco-free' ambition (TFA) where, by 2035, less than 5% of the population smoke tobacco across all socioeconomic groups. METHODS A non-linear multivariate regression model was fitted to cross-sectional smoking data to create projections to 2035. These projections were used to predict the future incidence and costs of 17 smoking-related diseases using a microsimulation approach. The health and economic impacts of achieving a TFA were evaluated against a predicted baseline scenario, where current smoking trends continue. RESULTS If trends continue, the prevalence of smoking in the UK was projected to be 10% by 2035-well above a TFA. If this ambition were achieved by 2035, it could mean 97 300 +/- 5 300 new cases of smoking-related diseases are avoided by 2035 (tobacco-related cancers: 35 900+/- 4 100; chronic obstructive pulmonary disease: 29 000 +/- 2 700; stroke: 24 900 +/- 2 700; coronary heart disease: 7600 +/- 2 700), including around 12 350 diseases avoided in 2035 alone. The consequence of this health improvement is predicted to avoid £67 +/- 8 million in direct National Health Service and social care costs, and £548 million in non-health costs, in 2035 alone. CONCLUSION These findings strengthen the case to set bold targets on long-term declines in smoking prevalence to achieve a tobacco 'endgame'. Results demonstrate the health and economic benefits that meeting a TFA can achieve over just 20 years. Effective ambitions and policy interventions are needed to reduce the disease and economic burden of smoking.
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Affiliation(s)
- Daniel Hunt
- Department of Prevention, Cancer Research UK, London, UK
| | | | - Abbygail Jaccard
- Department of Public Health Modelling, UK Health Forum, London, UK
| | - Arti Bhimjiyani
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Lise Retat
- Department of Public Health Modelling, UK Health Forum, London, UK
| | | | - Katrina Brown
- Department of Analysis and Evaluation, Cancer Research UK, London, UK
| | - Laura L Webber
- Department of Public Health Modelling, UK Health Forum, London, UK
| | - Martin Brown
- Department of Public Health Modelling, UK Health Forum, London, UK
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Caro-Gomez MA, Naranjo-González A, Parra-Marín MV, Gallego-Lopera N, Valencia DM, Rúa-Molina DC, Rosique-Gracia J, García-Pineda AF, Gómez-Isaza LF, Pizano-Ramírez ND, Arcos EG, Villegas-Perrasse A, Duque-Botero J, Bedoya-Berrío G. Insulin resistance and β-cell function in Colombian mestizo and Embera-Chamí populations and their relation with adiposity degree. ACTA ACUST UNITED AC 2017; 64:211-220. [PMID: 28417876 DOI: 10.1016/j.endinu.2017.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Insulin resistance (IR) is a condition favored by metabolic and endocrine changes experienced by adipose tissue in the context of obesity. The prevalence and the presentation of both IR and obesity vary among the populations, and may be affected by ancestral genetic composition among other factors. The aim of this study was to compare the presence of IR and obesity in Amerindians of the Embera-Chamí ethnicity and Colombian mestizo population. PATIENTS AND METHODS A sample of 630 individuals, 471 mestizos and 159 Amerindians of the Embera-Chamí ethnicity, from the general population of Colombia were studied. For each participant, anthropometric and biochemical measurements, as well as blood pressure and the Homeostatic Model Assessment (HOMA) of IR and β-cell function (%B) were recorded. These values were compared between the two populations. RESULTS While prevalence of central obesity was similar in both populations (48.7% and 42.6% in the mestizo and Embera groups respectively; p=0.148), body mass index (BMI) values suggested a higher prevalence of overweight in the Embera than in mestizo population (43.4% Embera, 31.8% mestizo; p=0.027). Despite the similarities in the prevalence of HOMA-IR and HOMA-%B status between both populations, the Embera population had a significantly greater pancreatic β-cell function, higher insulin levels, and better glucose control, across BMI and central obesity categories, than the mestizo population. CONCLUSION There are differences in aspects related to energy metabolism between the samples of the mestizo and Amerindian populations analyzed.
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Affiliation(s)
- María Antonieta Caro-Gomez
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia.
| | - Andrés Naranjo-González
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; Thrombosis Group, Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | - María Victoria Parra-Marín
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; CBATA Group, Tecnológico de Antioquia-Institución Universitaria (Tech University Institution) - TdeA, Calle 78B No 72A-220, Medellin, Colombia
| | - Natalia Gallego-Lopera
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; Biology Systems Group, School of Medicine, Universidad Pontificia Bolivariana, Calle 78B No. 72A-109, Medellin, Colombia
| | - Diana María Valencia
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; Biology Systems Group, School of Medicine, Universidad Pontificia Bolivariana, Calle 78B No. 72A-109, Medellin, Colombia
| | - Diana Carolina Rúa-Molina
- Thrombosis Group, Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | - Javier Rosique-Gracia
- Environment and Society Group - MASO, Department of Anthropology, School of Social and Human Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | - Andres Felipe García-Pineda
- Environment and Society Group - MASO, Department of Anthropology, School of Social and Human Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | - Luis Felipe Gómez-Isaza
- Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | | | - Edgar Gerardo Arcos
- Obesity and Metabolism Center Foundation (Fundación Centro de Obesidad y Metabolismo, COMETA), Research Division, Cra 33 No 12A-44, Pasto, Colombia
| | | | - Julieta Duque-Botero
- Thrombosis Group, Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia; Department of Internal Medicine, School of Medicine, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
| | - Gabriel Bedoya-Berrío
- Research Group on Molecular Genetics (GENMOL), Institute of Biology, School of Exact and Natural Sciences, Universidad de Antioquia - UdeA, Calle 70 No. 52-21, Medellin, Colombia
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Di Sibio A, Abriata G, Forman D, Sierra MS. Female breast cancer in Central and South America. Cancer Epidemiol 2016; 44 Suppl 1:S110-S120. [PMID: 27678313 DOI: 10.1016/j.canep.2016.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/31/2016] [Accepted: 08/05/2016] [Indexed: 12/21/2022]
Abstract
RATIONALE AND OBJECTIVE The burden of breast cancer has increased worldwide. Breast cancer mortality has been increasing in Central and South America (CSA) in the last few decades. We describe the current burden of breast cancer in CSA and review the current status of disease control. METHODS We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence and mortality rates per 100,000 person-years for 2003-2007 and the estimated annual percentage change to describe time trends. RESULTS In the most recent 5-year period, Argentina, Brazil, and Uruguay had the highest incidence rates (67.7-71.9) and Bolivia and El Salvador had the lowest (7.9-12.7). For most countries, mortality rates were ≤12.3, except in Uruguay, Argentina and Cuba (14.9-20.5). Age-specific rates increased after the age of 40-50 years and reached a maximum after age 65 years (mean age at diagnosis 56-62 years). Most countries have developed national screening guidelines; however, there is limited capacity for screening. CONCLUSION The geographic variation of breast cancer rates may be explained by differences in the prevalence of reproductive patterns, lifestyle factors, early detection, and healthcare access. Extending early-detection programs is challenging because of inequalities in healthcare access and coverage, limited funding, and inadequate infrastructure, and thus it may not be feasible. Given the current status of breast cancer in CSA, data generated by population-based cancer registries is urgently needed for effective planning for cancer control.
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Affiliation(s)
| | | | - David Forman
- The International Agency for Research on Cancer, Section of Cancer Surveillance, France
| | - Mónica S Sierra
- The International Agency for Research on Cancer, Section of Cancer Surveillance, France.
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Sierra MS, Forman D. Burden of colorectal cancer in Central and South America. Cancer Epidemiol 2016; 44 Suppl 1:S74-S81. [PMID: 27678325 DOI: 10.1016/j.canep.2016.03.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/17/2016] [Accepted: 03/18/2016] [Indexed: 02/07/2023]
Abstract
RATIONALE AND OBJECTIVE The colorectal cancer (CRC) burden is increasing in Central and South American due to an ongoing transition towards higher levels of human development. We describe the burden of CRC in the region and review the current status of disease control. METHODS We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries, as well as cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years for 2003-2007 and the estimated annual percentage change for 1997-2008. RESULTS The CRC rate in males was 1-2 times higher than that in females. In 2003-2007, the highest ASRs were seen in Uruguayan, Brazilian and Argentinean males (25.2-34.2) and Uruguayan and Brazilian females (21.5-24.7), while El Salvador had the lowest ASR in both sexes (males: 1.5, females: 1.3). ASMRs were<10 for both sexes, except in Uruguay, Cuba and Argentina (10.0-17.7 and 11.3-12.0). CRC incidence is increasing in Chilean males. Most countries have national screening guidelines. Uruguay and Argentina have implemented national screening programs. CONCLUSION Geographic variation in CRC and sex gaps may be explained by differences in the prevalence of obesity, physical inactivity, diet, smoking and alcohol consumption, early detection, and cancer registration practices. Establishing optimal CRC screening programs is challenging due to lack of healthcare access and coverage, funding, regional differences and inadequate infrastructure, and may not be feasible. Given the current status of CRC in the region, data generated by population-based cancer registries is crucial for cancer control planning.
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Affiliation(s)
- Monica S Sierra
- International Agency for Research on Cancer, Lyon, Rhone, France.
| | - David Forman
- International Agency for Research on Cancer, Lyon, Rhone, France
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Castillo H, Santos IS, Matijasevich A. Maternal pre-pregnancy BMI, gestational weight gain and breastfeeding. Eur J Clin Nutr 2016; 70:431-6. [PMID: 26813940 PMCID: PMC4827014 DOI: 10.1038/ejcn.2015.232] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES The aims were to investigate the association of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with breastfeeding (BF) duration and BF pattern at 3 months of age. SUBJECTS/METHODS This was a prospective cohort study of 4231 children who were enrolled at birth and were followed-up at 3, 12, 24 and 48 months of age to gather information on maternal and offspring characteristics including BF patterns and BF duration. Maternal pre-pregnancy BMI was categorized according to the WHO classification and GWG according to the 2009 Institute of Medicine recommendations. Cox's proportional hazards model was used to assess whether pre-pregnancy BMI and GWG were associated with BF and exclusive breastfeeding (EBF) duration. Predicted probabilities of BF patterns at 3 months were estimated by multinomial logistic regression. RESULTS Information on BF was available to 4011 infants. The total BF and EBF median durations were 7.0 months and 1.5 months, respectively. There were no differences in duration of any BF or EBF according to pre-pregnancy BMI or GWG categories. There was an increased predicted probability for weaning before the age of 3 months among infants from obese women, compared with those from mothers with normal pre-pregnancy BMI, with margins adjusted predictions of 0.36 (95% confidence interval (CI) 0.31-0.41) and 0.23 (95% CI 0.21-0.25), respectively. CONCLUSIONS Infants from pre-pregnancy overweight/obese mothers presented higher probability of early weaning compared with infants from normal-weight mothers. Obese/overweight pregnant women need supplementary guidance about BF benefits to infant health during prenatal and postnatal care.
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Affiliation(s)
- H Castillo
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - I S Santos
- Department of Social Medicine, Postgraduate Program in Epidemiology, School of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - A Matijasevich
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Kroes M, Osei-Assibey G, Baker-Searle R, Huang J. Impact of weight change on quality of life in adults with overweight/obesity in the United States: a systematic review. Curr Med Res Opin 2016; 32:485-508. [PMID: 26652030 DOI: 10.1185/03007995.2015.1128403] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To review published evidence on the impact of weight/BMI change on health-related quality of life (HRQoL) in adults from the US with overweight/obesity. METHODS The systematic review was conducted in accordance with PRISMA guidelines. MEDLINE, Embase, EconLit, and Cochrane Library databases were reviewed using pre-defined eligibility criteria to identify relevant US studies in adults with overweight/obesity, with ≥1 year follow-up, quantified weight change, and measured HRQoL. This manuscript focuses on HRQoL derived using the Short-Form 36 (SF-36) and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) instruments. RESULTS In total, 32 of 6793 identified publications reported HRQoL according to SF-36 or IWQOL-Lite; 20 provided adequate data for inclusion in this review. Although study design and outcomes were heterogeneous, improvements in HRQoL were generally observed with weight loss. Bariatric surgery studies provided the most evidence (12 publications) and demonstrated dramatic (≥20%) weight loss and associated HRQoL improvements. Sustained weight loss was associated with maintenance of HRQoL improvements out to 6 years in some studies. In lifestyle and pharmaceutical intervention studies showing weight loss of 5%-10%, some aspects of HRQoL improved, although the association with weight was not typically explored. Across the 20 publications, physical versus mental HRQoL improvements were more commonly statistically significant. CONCLUSION Overweight/obesity is typically associated with poorer HRQoL than normal weight (BMI 18.5-24.9 kg/m(2)). This systematic review of US literature demonstrated that significant weight loss after bariatric surgery may be associated with improvements in HRQoL. In non-bariatric studies with weight loss of ≥5%, improvements in some aspects of HRQoL were noted, although the causal nature of the relationship is uncertain. Although many SF-36 and IWQOL-Lite domain scores increased, improvements were typically only significant for physical, rather than mental, HRQoL. This systematic review provides evidence supporting that weight loss may improve HRQoL in people with overweight/obesity.
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Benziger CP, Bernabé-Ortiz A, Gilman RH, Checkley W, Smeeth L, Málaga G, Miranda JJ. Metabolic Abnormalities Are Common among South American Hispanics Subjects with Normal Weight or Excess Body Weight: The CRONICAS Cohort Study. PLoS One 2015; 10:e0138968. [PMID: 26599322 PMCID: PMC4658165 DOI: 10.1371/journal.pone.0138968] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/08/2015] [Indexed: 02/06/2023] Open
Abstract
Objective We aimed to characterize metabolic status by body mass index (BMI) status. Methods The CRONICAS longitudinal study was performed in an age-and-sex stratified random sample of participants aged 35 years or older in four Peruvian settings: Lima (Peru’s capital, costal urban, highly urbanized), urban and rural Puno (both high-altitude), and Tumbes (costal semirural). Data from the baseline study, conducted in 2010, was used. Individuals were classified by BMI as normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30 kg/m2), and as metabolically healthy (0–1 metabolic abnormality) or metabolically unhealthy (≥2 abnormalities). Abnormalities included individual components of the metabolic syndrome, high-sensitivity C-reactive protein, and insulin resistance. Results A total of 3088 (age 55.6±12.6 years, 51.3% females) had all measurements. Of these, 890 (28.8%), 1361 (44.1%) and 837 (27.1%) were normal weight, overweight and obese, respectively. Overall, 19.0% of normal weight in contrast to 54.9% of overweight and 77.7% of obese individuals had ≥3 risk factors (p<0.001). Among normal weight individuals, 43.1% were metabolically unhealthy, and age ≥65 years, female, and highest socioeconomic groups were more likely to have this pattern. In contrast, only 16.4% of overweight and 3.9% of obese individuals were metabolically healthy and, compared to Lima, the rural and urban sites in Puno were more likely to have a metabolically healthier profile. Conclusions Most Peruvians with overweight and obesity have additional risk factors for cardiovascular disease, as well as a majority of those with a healthy weight. Prevention programs aimed at individuals with a normal BMI, and those who are overweight and obese, are urgently needed, such as screening for elevated fasting cholesterol and glucose.
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Affiliation(s)
- Catherine P. Benziger
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H. Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
- Asociación Benéfica PRISMA, Lima, Peru
| | - William Checkley
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
- Division of Pulmonary and Critical Care, School of Medicine Johns Hopkins University, Baltimore, MD, United States of America
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Germán Málaga
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru
- * E-mail:
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Mc Donald A, Bradshaw RA, Fontes F, Mendoza EA, Motta JA, Cumbrera A, Cruz C. Prevalence of obesity in panama: some risk factors and associated diseases. BMC Public Health 2015; 15:1075. [PMID: 26489845 PMCID: PMC4618152 DOI: 10.1186/s12889-015-2397-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 10/07/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To estimate the prevalence of obesity in Panama and determine some risk factors and associated diseases in adults aged 18 years and older. METHODS A cross-sectional descriptive study was conducted in the provinces of Panama and Colon where 60.4 % of all Panamanians 18 years or older reside, by administering a survey regarding the consumption of protective and predisposing foods and assessing the development of obesity by measuring the weight, height, and waist circumference of 3590 people. A single-stage, probabilistic, and randomized sampling strategy employing multivariate stratification was used. Individuals with a body mass index ≥ 30 kg/m(2) (men and women) were considered obese. Prevalence and descriptive analysis were conducted according to sex using Odds Ratio, with statistical significance set at a p value ≤ 0.05. RESULTS The general prevalence of obesity was 27.1 % (30.9 % women and 18.3 % men). In women, obesity was associated with living in urban areas, being 40-59 years of age, being Afro-Panamanian, consuming beverages / foods rich in sugar, being physically inactive and having a family history of obesity. In men, obesity was associated with living in urban areas, consuming beverages/foods rich in sugar, and having a family history of obesity. Almost the totality of obese women (97.9 %), and 80.0 % of men with obesity had abdominal obesity according to the WHO classification. In both sexes, obesity was a risk factor associated to type 2 Diabetes Mellitus, hypertension, LDL values ≥ 100 mg/dL, and low HDL values (<50 mg/dL for women and < 40 mg/dL for men), Odds Ratio > 1.0; P < 0.05. CONCLUSIONS Obesity represents a very serious threat to Panamanian public health. Our study confirms a direct association in Panama between excess weight, hypertension, type 2 Diabetes Mellitus, LDL values ≥ 100 mg/dL and low HDL values for women and men (<50 mg/dL and < 40 mg/dL, respectively). Intervention / treatment programs should be targeted, specially, to Afro-Panamanian women, whom are 40-59 years old, living in urban areas, and those having a family history of obesity.
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Affiliation(s)
- Anselmo Mc Donald
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Ryan A Bradshaw
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Flavia Fontes
- Department of Nutrition, Ministry of Health of Panama, Gorgas Avenue, Ancon, Panama.
| | - Enrique A Mendoza
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Jorge A Motta
- Gorgas Memorial Institute for Health Studies, Panama, Panama.
| | - Alberto Cumbrera
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Clara Cruz
- School of Statistics, Faculty of Sciences, University of Panama, Avenida Transístmica, Panama, Panama.
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Roman S, Panduro A. Genomic medicine in gastroenterology: A new approach or a new specialty? World J Gastroenterol 2015; 21:8227-37. [PMID: 26217074 PMCID: PMC4507092 DOI: 10.3748/wjg.v21.i27.8227] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/24/2015] [Accepted: 05/04/2015] [Indexed: 02/06/2023] Open
Abstract
Throughout history, many medical milestones have been achieved to prevent and treat human diseases. Man's early conception of illness was naturally holistic or integrative. However, scientific knowledge was atomized into quantitative and qualitative research. In the field of medicine, the main trade-off was the creation of many medical specialties that commonly treat patients in advanced stages of disease. However, now that we are immersed in the post-genomic era, how should we reevaluate medicine? Genomic medicine has evoked a medical paradigm shift based on the plausibility to predict the genetic susceptibility to disease. Additionally, the development of chronic diseases should be viewed as a continuum of interactions between the individual's genetic make-up and environmental factors such as diet, physical activity, and emotions. Thus, personalized medicine is aimed at preventing or reversing clinical symptoms, and providing a better quality of life by integrating the genetic, environmental and cultural factors of diseases. Whether using genomic medicine in the field of gastroenterology is a new approach or a new medical specialty remains an open question. To address this issue, it will require the mutual work of educational and governmental authorities with public health professionals, with the goal of translating genomic medicine into better health policies.
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Politis M, Higuera G, Chang LR, Gomez B, Bares J, Motta J. Trend Analysis of Cancer Mortality and Incidence in Panama, Using Joinpoint Regression Analysis. Medicine (Baltimore) 2015; 94:e970. [PMID: 26091467 PMCID: PMC4616533 DOI: 10.1097/md.0000000000000970] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cancer is one of the leading causes of death worldwide and its incidence is expected to increase in the future. In Panama, cancer is also one of the leading causes of death. In 1964, a nationwide cancer registry was started and it was restructured and improved in 2012. The aim of this study is to utilize Joinpoint regression analysis to study the trends of the incidence and mortality of cancer in Panama in the last decade. Cancer mortality was estimated from the Panamanian National Institute of Census and Statistics Registry for the period 2001 to 2011. Cancer incidence was estimated from the Panamanian National Cancer Registry for the period 2000 to 2009. The Joinpoint Regression Analysis program, version 4.0.4, was used to calculate trends by age-adjusted incidence and mortality rates for selected cancers. Overall, the trend of age-adjusted cancer mortality in Panama has declined over the last 10 years (-1.12% per year). The cancers for which there was a significant increase in the trend of mortality were female breast cancer and ovarian cancer; while the highest increases in incidence were shown for breast cancer, liver cancer, and prostate cancer. Significant decrease in the trend of mortality was evidenced for the following: prostate cancer, lung and bronchus cancer, and cervical cancer; with respect to incidence, only oral and pharynx cancer in both sexes had a significant decrease. Some cancers showed no significant trends in incidence or mortality. This study reveals contrasting trends in cancer incidence and mortality in Panama in the last decade. Although Panama is considered an upper middle income nation, this study demonstrates that some cancer mortality trends, like the ones seen in cervical and lung cancer, behave similarly to the ones seen in high income countries. In contrast, other types, like breast cancer, follow a pattern seen in countries undergoing a transition to a developed economy with its associated lifestyle, nutrition, and body weight changes.
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Affiliation(s)
- Michael Politis
- From the The Gorgas Memorial Institute for Health Studies (MP, BG, JM); Santo Tomas Hospital (GH); MINSA (Ministry of Health, Panama) (LRC); and FUNDACANCER, Panama City, Panama (JB)
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del Carmen MG, Rice LW, Schmeler KM. Global health perspective on gynecologic oncology. Gynecol Oncol 2015; 137:329-34. [DOI: 10.1016/j.ygyno.2015.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 03/09/2015] [Indexed: 12/30/2022]
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Velázquez MA. [Impact of maternal overnutrition on the periconceptional period]. ACTA ACUST UNITED AC 2015; 62:246-53. [PMID: 25733194 DOI: 10.1016/j.endonu.2015.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 10/23/2022]
Abstract
Overnutrition may lead to obesity. Maternal obesity may affect fertility not only via anovulation, but also through direct effects on oocytes and preimplantation embryos, indicating that the periconceptional period is sensitive to conditions of overnutrition. The periconceptional period includes from folliculogenesis to implantation. Animal model studies suggest that oocytes derived from obese females usually have a small size and mitochondrial abnormalities. These disruptions are probably induced by changes in the components of the ovarian follicular fluid. Experimental evidence also suggests that obesity may affect the microenvironment in oviducts and uterus, resulting in development of preimplantation embryos with reduced cell numbers and up-regulation of proinflammatory genes. However, further research is needed for in-depth characterization of the effects of maternal obesity during the periconceptional period.
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Affiliation(s)
- Miguel Abraham Velázquez
- Centre for Biological Sciences, University of Southampton, Southampton General Hospital , Southampton, Reino Unido.
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Mc Donald Posso AJ, Motta Borrel JA, Fontes F, Cruz Gonzalez CE, Pachón Burgos AA, Cumbrera Ortega A. High blood pressure in Panama: prevalence, sociodemographic and biologic profile, treatment, and control (STROBE). Medicine (Baltimore) 2014; 93:e101. [PMID: 25396327 PMCID: PMC4616318 DOI: 10.1097/md.0000000000000101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/05/2014] [Accepted: 08/09/2014] [Indexed: 01/13/2023] Open
Abstract
The objective of this study is to estimate the prevalence, treatment, and control of high blood pressure, hypertension (HBP) in Panama and assess its associations with sociodemographic and biologic factors.A cross-sectional, descriptive study was conducted in Panama by administering a survey on cardiovascular risk factors to 3590 adults and measuring their blood pressure 3 times. A single-stage, probabilistic, and randomized sampling strategy with a multivariate stratification was used. The average blood pressure, confidence intervals (CIs), odds ratio (OR), and a value of P ≤ 0.05 were used for the analysis.The estimated prevalence of HBP was 29.6% (95% CI, 28.0-31.1); it was more prevalent in men than in women, OR = 1.37 (95% CI, 1.17-1.61); it increased with age and was more frequent among Afro-Panamanians (33.8%). HBP was associated with a family history of HBP with being physically inactive and a body mass index ≥25.0 kg/m or a waist circumference >90 cm in men and >88 cm in women (P < 0.001). Of those found to have HBP, 65.6% were aware of having HBP and taking medications, and of these, 47.2% had achieved control (<140/90 mm Hg).HBP is the most common cardiovascular risk factor among Panamanians and consequently an important public health problem in Panama. The health care system needs to give a high priority to HBP prevention programs and integrated care programs aimed at treating HBP, taking into consideration the changes in behavior that have been brought about by alterations in nutrition and sedentary lifestyles.
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Affiliation(s)
- Anselmo J Mc Donald Posso
- Department of Endocrinology and Metabolism (AAPB), Hospital Rafael Hernández, David, Chiriquí; Gorgas Memorial Institute of Health Studies (AJMDP, JAMB, ACO); Ministry of Health of Panama (FF); and School of Statistics (CECG), Faculty of Sciences, University of Panama, Panama
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Rivera-Andrade A, Luna MA. Trends and heterogeneity of cardiovascular disease and risk factors across Latin American and Caribbean countries. Prog Cardiovasc Dis 2014; 57:276-85. [PMID: 25218566 DOI: 10.1016/j.pcad.2014.09.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Aging, globalization and urbanization in Latina America and the Caribbean (LAC) have made cardiovascular disease (CVD) the number one cause of death and disability, while communicable diseases have decreased. This epidemiological transition has been more heterogeneous than in other areas of the world. While countries like Argentina, Chile, Brazil and Colombia have seen a significant decrease in CVD mortality, the rest of the countries have seen an increase, particularly Central American and Caribbean countries. These latter countries have now coexisting high prevalence of communicable and non-communicable diseases, threatening the socioeconomic development. Recent multinational cross sectional studies have provided a better perspective of the prevalence and distribution of cardiovascular risk factors in the region. While there has been a decrease in prevalence of smoking in the region, obesity, diabetes and physical inactivity continue to increase the CVD disease burden in LAC.
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Affiliation(s)
- Alvaro Rivera-Andrade
- INCAP Comprehensive Center for the Prevention of Chronic Diseases/Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Max A Luna
- Department of Medicine, University of Virginia, Charlottesville, VA.
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Dufour DL, Bender RL, Reina JC. Local trends in diet in urban Colombia, 1990-1995 to 2008: Little evidence of a nutrition transition among low-income women. Am J Hum Biol 2014; 27:106-15. [DOI: 10.1002/ajhb.22621] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 07/18/2014] [Accepted: 08/20/2014] [Indexed: 12/11/2022] Open
Affiliation(s)
- Darna L. Dufour
- Department of Anthropology; University of Colorado; Boulder Colorado 80309-0233
| | - Richard L. Bender
- Department of Anthropology; University of Colorado; Boulder Colorado 80309-0233
| | - Julio C. Reina
- Departamento de Pediatría; Universidad del Valle and Centro Médico Imbanaco de Cali; Colombia
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Shook RP, Blair SN, Duperly J, Hand GA, Matsudo SM, Slavin JL. What is Causing the Worldwide Rise in Body Weight? EUROPEAN ENDOCRINOLOGY 2014; 10:136-144. [PMID: 29872478 PMCID: PMC5983083 DOI: 10.17925/ee.2014.10.02.136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 12/15/2022]
Abstract
The worldwide rise in body weight has reached epidemic proportions and this has serious public health consequences. Despite the universal recognition of this problem, its causes are still debated: some attribute it to excess caloric intake; others blame a lack of physical activity (PA); some implicate specific changes to micro- and macro-nutrients. During the past century, government health agencies have developed guidance on healthy eating. These, along with advances in agriculture and food manufacturing, have largely eliminated nutrient deficiencies and helped reduce the consumption of fat. Over the past 60 years, however, technological advances and shifts in the types of occupations prominent in industrialised as well as developing countries have resulted in well-documented decreases in energy expenditure. Energy intake must be balanced with energy expenditure in order to prevent weight gain, and there is increasing evidence that this balance must be at a relatively high level of energy flux. A programme that was started in São Paulo in 1996 known as 'Agita' has sought to motivate populations to engage in small amounts of physical exercise daily to tackle growing obesity levels. This multi-agency initiative is one example of how to successfully increase exercise within a community and scale both within (e.g. all states in Brazil) and across many nations. Reducing caloric intake in whole populations is challenging especially at relatively low levels of energy expenditure, and evidence suggests that there is a critical energy flux threshold for regulating intake to achieve energy balance. Increasing PA, however, may be more achievable than reducing intake. Activity raises caloric expenditure and can offset excess intake. The implementation of programmes to achieve greater PA is therefore vital if the worldwide rise in body weight is to be halted, while we also need to implement programmes to help people eat smarter.
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Affiliation(s)
- Robin P Shook
- Postdoctoral Researcher, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, US
| | - Steven N Blair
- Professor, Departments of Exercise Science, Epidemiology, and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia South Carolina, US
| | - John Duperly
- Associate Professor, Department of Internal Medicine, Universidad de los Andes Medical School, Bogotá, Colombia
| | - Gregory A Hand
- Professor, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, US
| | - Sandra M Matsudo
- Professor and Director General, Agita São Paulo Program-Studies Center, Physical Fitness Research Center for São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
| | - Joanne L Slavin
- Professor, Department of Food Science and Nutrition, University of Minnesota, St Paul, Minnesota, US
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Kain J, Hernández Cordero S, Pineda D, de Moraes AF, Antiporta D, Collese T, Costa de Oliveira Forkert E, González L, Miranda JJ, Rivera J. Obesity Prevention in Latin America. Curr Obes Rep 2014; 3:150-5. [PMID: 26626601 DOI: 10.1007/s13679-014-0097-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those <5 years), respectively. In adults, Mexico and Chile present similar high rates of obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.
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Affiliation(s)
| | | | | | | | - Daniel Antiporta
- Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Tatiana Collese
- Growth, Exercise, Nutrition and Development, University of Zaragoza, Zaragoza, Spain.
| | | | | | - Juan Jaime Miranda
- Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Juan Rivera
- National Institute of Public Health, Cuernavaca, Mexico.
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Kilpi F, Webber L, Musaigner A, Aitsi-Selmi A, Marsh T, Rtveladze K, McPherson K, Brown M. Alarming predictions for obesity and non-communicable diseases in the Middle East. Public Health Nutr 2014; 17:1078-86. [PMID: 23642403 PMCID: PMC10282274 DOI: 10.1017/s1368980013000840] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 01/28/2013] [Accepted: 02/05/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study aimed to model obesity trends and future obesity-related disease for nine countries in the Middle East; in addition, to explore how hypothetical reductions in population obesity levels could ameliorate anticipated disease burdens. DESIGN A regression analysis of cross-sectional data v. BMI showed age- and sex-specific BMI trends, which fed into a micro simulation with a million Monte Carlo trials for each country. We also examined two alternative scenarios where population BMI was reduced by 1 % and 5 %. SETTING Statistical modelling of obesity trends was carried out in nine Middle East countries (Bahrain, Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Saudi Arabia and Turkey). SUBJECTS BMI data along with disease incidence, mortality and survival data from national and sub-national data sets were used for the modelling process. RESULTS High rates of overweight and obesity increased in both men and women in most countries. The burden of incident type 2 diabetes, CHD and stroke would be moderated with even small reductions in obesity levels. CONCLUSIONS Obesity is a growing problem in the Middle East which requires government action on the primary prevention of obesity. The present results are important for policy makers to know the effectiveness of obesity interventions on future disease burden.
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Affiliation(s)
- Fanny Kilpi
- National Heart Forum, 7th Floor Victoria House, London WC1B 4AD, UK
| | - Laura Webber
- National Heart Forum, 7th Floor Victoria House, London WC1B 4AD, UK
| | - Abdulrahman Musaigner
- Nutrition and Health Studies Unit, Deanship of Scientific Research, University of Bahrain, Manama, Bahrain
| | - Amina Aitsi-Selmi
- Epidemiology & Public Health, Division of Population Health, University College London, London, UK
| | - Tim Marsh
- National Heart Forum, 7th Floor Victoria House, London WC1B 4AD, UK
| | | | | | - Martin Brown
- National Heart Forum, 7th Floor Victoria House, London WC1B 4AD, UK
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Prevalence and associated factors of obesity among Panamanian adults. 1982-2010. PLoS One 2014; 9:e91689. [PMID: 24621825 PMCID: PMC3951445 DOI: 10.1371/journal.pone.0091689] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 02/13/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In Central America, there has been a marked increase in obesity in the last 30 years. Over this time frame, in Panama, there have been lifestyle changes associated with economic development and urbanization that may have facilitated increases in body weight. The aim of the study is to describe the change in the prevalence of obesity in the country since 1982 and to analyze the association of obesity with gender, place of residence and socioeconomic factors. METHODS We analyzed three nationally representative cross-sectional studies and one sub-national study of Panamanian adults that evaluated anthropometric and socioeconomic variables; ENPA-1982 (n = 11 611), ENV-II 2003 (n = 14 737), ENV-III 2008 (n = 15 484), PREFREC-2010 (n = 3 590). We also evaluated one nationally representative study that evaluated people's perception of their body weight, ENSCAVI-2007 (n = 25 748). RESULTS In 1982, the prevalence in males of a body mass index (BMI) ≥ 30 kg/m2 was 3.8% (3.3-4.2) and in females 7.6% (6.9-8.2). In 2003, the prevalence in males increased to 14.4% (13.6-15.2) and in females to 21.8% (20.8-22.7). In 2008, the prevalence in males was 16.9% (16.0-17.7) and in females it was 23.8% (22.8-24.7). Nevertheless, in 2007, the national perception of being obese was only 4% among males and 6.7% among females. The highest prevalence of obesity was noted in urban areas. Female gender and higher income were found to be positively associated with obesity. Income level was positively associated with abdominal obesity in men but not in women. CONCLUSIONS There has been a marked increase of obesity in Panama in the last 3 decades. Initiatives to control this problem will have to take into consideration the observed gender difference and the lifestyle changes that have contributed to the rise of this problem.
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