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Choi CK, Yang JH, Kweon SS, Shin MH. Exploring Disparities for Obesity in Korea Using Hierarchical Age-Period-Cohort Analysis With Cross-Classified Random Effect Models. J Korean Med Sci 2024; 39:e169. [PMID: 38804013 PMCID: PMC11136680 DOI: 10.3346/jkms.2024.39.e169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND This research article investigates the age, period, and birth cohort effects on prevalence of obesity in the Korean population, with the goal of identifying key factors to inform effective public health strategies. METHODS We analyzed data from the Korea National Health and Nutrition Examination Survey, spanning 2007-2021, including 35,736 men and 46,756 women. Using the hierarchical age-period-cohort (APC) analysis with cross-classified random effects modeling, we applied multivariable mixed logistic regression to estimate the marginal prevalence of obesity across age, period, and birth cohort, while assessing the interaction between APC and lifestyle and socioeconomic factors. RESULTS Our findings reveal an inverted U-shaped age effect on obesity, influenced by smoking history (P for interaction = 0.020) and physical activity (I for interaction < 0.001). The period effect was positive in 2020 and 2021, while negative in 2014 (P for period effect < 0.001). A declining trend in obesity prevalence was observed in birth cohorts from 1980s onward. Notably, disparities in obesity rates among recent birth cohorts have increased in relation to smoking history (P for interaction = 0.020), physical activity (P for interaction < 0.001), and residence (P for interaction = 0.005). Particularly, those born after 1960 were more likely to be obese if they were ex-smokers, physical inactive, or lived in rural areas. CONCLUSION These findings highlight growing disparities in obesity within birth cohorts, underscoring the need for targeted health policies that promote smoking cessation and physical activity, especially in rural areas.
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Affiliation(s)
- Chang Kyun Choi
- Division of Cancer Early Detection, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jung-Ho Yang
- Cardio-Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea.
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Oktaviani S, Mizutani M, Nishide R, Tanimura S. Spatial Clusters of High Prevalences of Overweight and Obesity Among Children in Indonesia. Cureus 2024; 16:e57370. [PMID: 38694630 PMCID: PMC11061772 DOI: 10.7759/cureus.57370] [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] [Accepted: 04/01/2024] [Indexed: 05/04/2024] Open
Abstract
Objective Childhood obesity has emerged as a pressing health concern in both high-income and lower-middle-income countries, including Indonesia. The prevalence of overweight and obesity among school children aged 5-12 years has been increasing in Indonesia, with 20% of Indonesian children identified as obese or overweight in 2018. Therefore, addressing this problem will be challenging. This study aims to identify district- and city-level clusters with high prevalences of overweight and obese children aged 5-12 years in Indonesia. Methodology This is an ecological study that utilizes secondary data from the 2018 Basic Health Research report conducted by the Indonesian Ministry of Health. We included 514 districts and cities to detect district- and city-level clusters. Spatial cluster analysis was performed using restricted flexible scan statistics to identify clusters with high prevalences of childhood overweight and obesity in Indonesian districts and cities. Results The findings reveal that childhood overweight and obesity are not randomly distributed. The study detected 20 clusters with high prevalences of childhood overweight and 36 clusters of obesity, with a particular concentration in Western Indonesia. A primary cluster of childhood overweight occurred in Sijunjung, Tanah Datar, Agam, Pasaman, South Solok, Dharmasraya, West Pasaman, Sawah Lunto City, Padang Panjang City, and Kampar. A primary cluster of obesity occurred in Mandailing Natal, South Tapanuli, Central Tapanuli, North Tapanuli, Labuhan Batu, North Padang Lawas, Padang Lawas, North Labuhan Batu, West Pasaman, and Rokan Hilir. Conclusions This study found 20 clusters with high prevalences of childhood overweight and 36 clusters of obesity in Indonesia. Implementing health promotion programs in the identified cluster regions will be crucial to effectively addressing the growing problem of childhood obesity in Indonesia.
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Affiliation(s)
- Sofi Oktaviani
- Department of Public Health Nursing, Graduate School of Medicine, Mie University, Tsu, JPN
- Department of Nursing, Indramayu College of Health Sciences, Indramayu, IDN
| | - Mayumi Mizutani
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, JPN
| | - Ritsuko Nishide
- Department of Nursing, Nagoya University of Arts and Sciences, Nagoya, JPN
| | - Susumu Tanimura
- Department of Public Health Nursing, Graduate School of Medicine, Mie University, Tsu, JPN
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Nsabimana P, Sombié OO, Pauwels NS, Boynito WG, Tariku EZ, Vasanthakaalam H, De Henauw S, Abbeddou S. Association between urbanization and metabolic syndrome in low- and middle-income countries: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:235-250. [PMID: 38182494 DOI: 10.1016/j.numecd.2023.07.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 01/07/2024]
Abstract
AIMS The prevalence of metabolic syndrome (MetS) is on the rise in an increasingly urbanized world. The study aimed to review the association between urbanization and MetS in low- and middle-income countries (LMICs). DATA SYNTHESIS A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns. CONCLUSIONS There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.
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Affiliation(s)
- Phenias Nsabimana
- School of Agriculture and Food Sciences, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O Box 210 Musanze, Rwanda; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium.
| | - Olivier O Sombié
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/ Direction Régionale de l'Ouest (IRSS-DRO), 01 P.O Box 545, Bobo Dioulasso, Burkina Faso
| | - Nele S Pauwels
- Knowledge Centre for Health, Ghent University Hospital, B-9000 Ghent, Belgium
| | - Wanzahun Godana Boynito
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Zerihun Tariku
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hilda Vasanthakaalam
- School of Agriculture and Food Sciences, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O Box 210 Musanze, Rwanda
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium
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Rawal T, Muris JWM, Mishra VK, Arora M, Tandon N, van Schayck OCP. Effect of an educational intervention on diet and physical activity among school-aged adolescents in Delhi -The i-PROMISe (PROMoting health literacy in Schools) Plus Study. DIALOGUES IN HEALTH 2023; 2:100123. [PMID: 36919028 PMCID: PMC9991929 DOI: 10.1016/j.dialog.2023.100123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/21/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
Purpose Emerging lifestyle changes due to rapid urbanization have led to an epidemiological transition and the rising prevalence of obesity is responsible for major non-communicable diseases (NCDs) which have further aggravated due to the COVID-19 pandemic. This study aims to assess the effectiveness of a comprehensive school-based intervention on diet and physical activity-related behavior of adolescents. Methods In 2019, a cluster-randomized controlled trial was conducted in randomly selected (n = 8) private schools. A 2-year intervention program was implemented over consecutive academic years (2019-2020 and 2020-2021) with students who were in the 6th and 7th grades when the study began. Four schools were randomly assigned to the intervention (n = 794) and four schools to the control group (n = 774). Results The difference in changes in diet and physical-activity-related behaviors of the students between the intervention and control schools were not significant in the intention to treat analysis probably due to the large drop-out due to COVID-19 measures: 304 students were available for follow-up in the intervention group and 122 in the control group (391 cases were excluded to make data comparable with baseline survey). The intake of vegetables (once a day) [β = 0.35, OR = 1.42, 95% CI (1.03, 1.95)] in the per-protocol analysis has increased among adolescents in the intervention group as compared to the control group. Conclusion The findings of this study indicated a positive effect of the intervention on diet and physical-activity-related changes in the expected direction and highlights the importance of addressing such behavior to prevent obesity among adolescents and thus NCDs in the later stage of life.
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Affiliation(s)
- Tina Rawal
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Jean W M Muris
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Vijay Kumar Mishra
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Onno C P van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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de Vries Mecheva M, Rieger M, Sparrow R, Prafiantini E, Agustina R. Behavioural and environmental risk factors associated with primary schoolchildren's overweight and obesity in urban Indonesia. Public Health Nutr 2023; 26:1562-1575. [PMID: 37138496 PMCID: PMC10410387 DOI: 10.1017/s1368980023000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. DESIGN Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. SETTING Public primary schools in Central Jakarta, sampled at random. PARTICIPANTS Children (n 1674) aged 6-13 years from 18 public primary schools. RESULTS Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively). CONCLUSIONS This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.
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Affiliation(s)
- Margarita de Vries Mecheva
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Matthias Rieger
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Robert Sparrow
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
- Development Economics Group, Wageningen University, Wageningen, the Netherlands
| | - Erfi Prafiantini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Elshaer N, Mohamed A. Relationship Between Rotating Night Shift Work and Anthropometric Markers of Overall and Central Adiposity. Risk Manag Healthc Policy 2023; 16:537-549. [PMID: 37035269 PMCID: PMC10075386 DOI: 10.2147/rmhp.s402411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose This study aimed to investigate possible association between rotating night shift (RNS) work and anthropometric markers of overall and central adiposity among male workers. Methods Medical records of workers who underwent medical examination at the Occupational Medicine Unit affiliated with Alexandria Faculty of Medicine were reviewed in December 2021 to extract data about RNS, overall adiposity [body mass index (BMI) from 25 to 29.9 kg/m2 indicated overweight, while BMI ≥30 kg/m2 indicated obesity], central adiposity (waist circumference ≥94 cm). Univariate and multivariate logistic regression were done to model adiposity as a function of potential demographic, lifestyle, and occupational factors. Results Data of 647 male workers, including daytime workers (26.9%) and RNS workers (73.1%) who spent 1-5 years, 6-9 years, or ≥10 years working RNS, were analyzed. No association was found between RNS work and overall adiposity (BMI ≥30 kg/m2). In multivariate regression, age, residence, and smoking status were predictors of an increased BMI. Compared with young workers (<30 years old), the odds of an increased BMI (BMI ≥25 kg/m2) were 2.6 and 3.01 times higher among workers who were 30-<40, and 40-<50 years old, respectively [95% CI=(1.35, 5.05) and (1.19, 7.56), respectively]. Workers who lived in urban areas were less likely to have had an increased BMI (OR=0.34, 95% CI=0.16, 0.74). The odds of an increased BMI were 2.14 times higher in workers who never smoked compared with current smokers (95% CI=1.12, 4.11). No association was found between RNS and central adiposity. In multivariate regression, age was the sole predictor of central adiposity. Conclusion The study supports the idea that RNS work might not be associated with overall or central adiposity and highlights a possible association between central adiposity and age and association between BMI and age, residence, and smoking behavior. Longitudinal, larger studies are required to explore the relationship between RNS and adiposity.
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Affiliation(s)
- Noha Elshaer
- Industrial Medicine and Occupational Health, Community Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Correspondence: Noha Elshaer, Industrial Medicine and Occupational Health, Community Medicine Department, Faculty of Medicine, Alexandria University, El-Khartoum Square, El Azareeta Medical Campus, Alexandria, 21131, Egypt, Email
| | - Abdelrahman Mohamed
- Preventive Medicine Sector, Ministry of Health and Population, Alexandria, Egypt
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Mohanraj J, D’Souza UJA, Fong SY, Karkada IR, Jaiprakash H. Association between Leptin (G2548A) and Leptin Receptor (Q223R) Polymorphisms with Plasma Leptin, BMI, Stress, Sleep and Eating Patterns among the Multiethnic Young Malaysian Adult Population from a Healthcare University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148862. [PMID: 35886710 PMCID: PMC9316401 DOI: 10.3390/ijerph19148862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/25/2022] [Accepted: 06/30/2022] [Indexed: 02/04/2023]
Abstract
Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction−Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age.
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Affiliation(s)
- Jaiprakash Mohanraj
- Department of Biochemistry, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia; or
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Urban J. A. D’Souza
- Department of Physiology, Father Muller College of Allied Health Sciences, Father Muller Medical College, Mangalore 575002, India;
| | - Siat Yee Fong
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Correspondence:
| | - Ivan Rolland Karkada
- Department of Physiology, Faculty of Medicine, MAHSA Universiti, Jenjarom 42610, Malaysia;
| | - Heethal Jaiprakash
- Department of Pharmacology, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia;
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Fritz M, Fromell H. How to Dampen the Surge of Non-Communicable Diseases in Southeast Asia: Insights from a Systematic Review and Meta-Analysis. Health Policy Plan 2021; 37:152-167. [PMID: 34791261 PMCID: PMC8757494 DOI: 10.1093/heapol/czab138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 11/12/2021] [Indexed: 01/04/2023] Open
Abstract
Non-communicable diseases (NCDs), such as diabetes, cancer, cardiovascular diseases and chronic respiratory diseases, have overtaken infectious diseases as the number one cause of death worldwide. The rise of these diseases is especially grave in Southeast Asia, where existing research however falls short on offering guidance on how policy can best prevent and control NCDs in the region. Additionally, low- and middle-income countries in Southeast Asia cannot directly incorporate lessons drawn from interventions in richer countries, since health system capacities and human and financial resources are thoroughly different. Preventive interventions, thus, need to correspond to local capacities and require contextual solutions. In this article, we provide a systematic review of a wide scope of NCD interventions conducted in Southeast Asia to inform about existing intervention designs and to derive sound evidence of their effectiveness. Our literature search results in 51 studies from five Southeast Asian countries from which we can extract 204 estimates. We sort the studies into six intervention categories and analyse them with respect to 23 different health and behavioural outcomes. While we find positive and significant average effects across all six types of interventions, we also document evidence of substantial publication bias. Using a meta-regression approach in which we correct for the publication bias, we instead fail to confirm positive average effects for some interventions. Especially dietary and physical activity interventions fail to achieve improvements in analysed health outcomes, while programs focusing on smoking cessation, on the take-up of preventive screening activities or educating patients on how to cope with NCDs achieve sizeable effects. We also present evidence that the size of the effect differs with the participants’ characteristics as well as with design features of the intervention. For local policymakers, the results provide important knowledge on how to address the increasing NCD burden in the coming years.
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Affiliation(s)
- Manuela Fritz
- University of Passau, Faculty of Economics, Business and Information Systems, Chair of Development Economics, Innstraße 29, 94032 Passau, Germany.,University of Groningen, Department of Economics, Econometrics and Finance, Nettelbosje 2, 9747 AE Groningen, The Netherlands
| | - Hanna Fromell
- University of Groningen, Department of Economics, Econometrics and Finance, Nettelbosje 2, 9747 AE Groningen, The Netherlands.,Aarhus University, Department of Economics and Business Economics, Fuglesangs Allé 4, 8210 Aarhus V, Denmark
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He Y, Fang Y, Bromage S, Fung TT, Bhupathiraju SN, Batis C, Deitchler M, Fawzi W, Stampfer MJ, Hu FB, Willett WC, Li Y. Application of the Global Diet Quality Score in Chinese Adults to Evaluate the Double Burden of Nutrient Inadequacy and Metabolic Syndrome. J Nutr 2021; 151:93S-100S. [PMID: 34689199 PMCID: PMC8542094 DOI: 10.1093/jn/nxab162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/01/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The double burdens of under- and overnutrition are changing the health of individuals and the economic and disease burdens in China. Poor diet plays an important role; however, a valid and easily operationalized metric that could capture the full range of characteristics of the diet that are relevant to both under- and overnutrition is lacking in China. OBJECTIVES We aimed to examine the application of the Global Diet Quality Score (GDQS) to evaluate nutrient inadequacy and metabolic syndrome in different demographic groups of Chinese adults. METHODS A total of 35,146 individuals (men 14,978, women 20,168) aged >18 y from the 2010-2012 China National Nutrition and Health Survey were included. We scored the GDQS using average intakes of 25 food groups from 3 d of 24-h dietary recalls. Double burden was defined as coexisting metabolic syndrome and nutrient inadequacy. RESULTS Diet quality assessed by GDQS was significantly higher in urban than in rural residents (20.8 compared with 18.7), and increased with both educational level and household income (P-trends < 0.0001). A higher GDQS score was inversely associated with metabolic syndrome and nutrient inadequacy, or both (P-trends < 0.0001): multivariate adjusted ORs comparing extreme quintiles of GDQS were 0.79 (95% CI: 0.69, 0.91) for metabolic syndrome, 0.17 (95% CI: 0.14, 0.20) for nutrient inadequacy, and 0.59 (95% CI: 0.50, 0.69) for the double burden. These associations were consistent across different household income levels (P-interaction = 0.26), suggestively stronger in younger (<50 y), females, urban residents, and the more highly educated (P-interaction < 0.05) compared with their counterparts. CONCLUSIONS A higher GDQS was inversely associated with a double burden of nutrient inadequacy and metabolic syndrome across various subgroups of Chinese adults. The finding supports the use of the GDQS in different demographic groups of Chinese adults to assess diet quality and nutritional status.
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Affiliation(s)
- Yuna He
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuehui Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carolina Batis
- CONACYT—Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Megan Deitchler
- Intake – Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | - Wafaie Fawzi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Meir J Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Westbury S, Ghosh I, Jones HM, Mensah D, Samuel F, Irache A, Azhar N, Al-Khudairy L, Iqbal R, Oyebode O. The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-006358. [PMID: 34635553 PMCID: PMC8506857 DOI: 10.1136/bmjgh-2021-006358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions. Methods We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively. Results 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap. Conclusion ‘Zoning’ or ‘healthy food cart’ interventions to alter food availability may be appropriate in urban LMIC. PROSPERO registration number CRD42020207475.
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Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Daniel Mensah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Folake Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nida Azhar
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Romaina Iqbal
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
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Talukder A, Das Gupta R, Hashan MR, Haider SS, Sajal IH, Sarker M. Association between television viewing and overweight and obesity among women of reproductive age in Timor-Leste: evidence from the demographic health survey 2016. BMJ Open 2021; 11:e045547. [PMID: 34380718 PMCID: PMC8359523 DOI: 10.1136/bmjopen-2020-045547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aimed to assess the possible relationship between television viewing and overweight and obesity among Timorese women of reproductive age. METHODS This cross-sectional study analysed the Timor-Leste Demographic and Health Survey 2016 dataset. A weighted sample of 11 398 Timorese women aged 15-49 years was chosen using a two-stage stratified random sampling technique. Asian criteria-based body mass index (BMI) cut-offs were used to define overweight (BMI 23.0 to <27.5 kg/m2) and obesity (BMI ≥27.5 kg/m2). Frequency of TV viewing was categorised into three groups: (1) not at all, (2) less than once a week and (3) at least once a week. Multilevel ordered logistic regression was performed to identify the correlates of overweight and obesity. Both crude and adjusted odds ratios (AOR) along with a 95% CI were calculated to show the strength of association. RESULTS Among 11 398 respondents, 19.4% were overweight or obese (overweight: 15.7% and obese: 3.8%). Although about half of the respondents reportedly did not watch TV at all, just over two-thirds watched TV at least once a week. Women who watched TV at least once a week were found to have 1.3 times the odds of being overweight or obese compared with those who never watched TV (AOR: 1.3, 95% CI: 1.1 to 1.5; p<0.001). However, when stratified by settlement type, the statistical significance stood for the rural women only (AOR: 1.5, 95% CI: 1.2 to 1.8; p<0.001), after adjusting for the covariates. CONCLUSION Watching TV at least once a week was found to be a significant correlate of overweight and obesity in rural Timorese women of reproductive age. Further studies need to be undertaken to assess physical activity, sedentary and dietary patterns to clarify the possible mechanism through which TV viewing may influence BMI in those groups.
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Affiliation(s)
- Animesh Talukder
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Rajat Das Gupta
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | | | - Shams Shabab Haider
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Ibrahim Hossain Sajal
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Mathematical Sciences, School of Natural Sciences & Mathematics, University of Texas at Dallas, Dallas, Texas, USA
| | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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12
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Lee ZV, Llanes EJ, Sukmawan R, Thongtang N, Ho HQT, Barter P. Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region. Lipids Health Dis 2021; 20:33. [PMID: 33858442 PMCID: PMC8051043 DOI: 10.1186/s12944-021-01450-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
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Affiliation(s)
- Zhen-Vin Lee
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Elmer Jasper Llanes
- Division of Cardiovascular Medicine, University of the Philippines, Manila, Philippines
| | - Renan Sukmawan
- Department of Cardiology & Vascular Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Nuntakorn Thongtang
- Division of Endocrinology and Metabolism, Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand
| | | | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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Cunningham-Myrie C, Theall KP, Younger-Coleman N, Greene LG, Lyew-Ayee P, Wilks R. Associations of neighborhood physical and crime environments with obesity-related outcomes in Jamaica. PLoS One 2021; 16:e0249619. [PMID: 33819299 PMCID: PMC8021199 DOI: 10.1371/journal.pone.0249619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/22/2021] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To examine whether proximity and density of public open spaces, public parks, street connectivity, and serious and violent crimes were associated with Body Mass Index (BMI) and Waist Circumference (WC) within and across levels of urbanicity, sex and socioeconomic status (SES) in Jamaica, a small island developing state (SIDS). METHODS Secondary analysis was conducted using data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II). All respondents were geocoded to area of residence in Enumeration Districts (EDs). Intraclass correlation coefficients (ICCs) were derived and multilevel mixed effects regression models applied to 2529 participants nested within 101 EDs from all 14 parishes in Jamaica. RESULTS There was significant clustering across neighborhoods for mean BMI (ICC = 4.16%) and mean WC (ICC = 4.42%). In fully adjusted models statistically significant associations included: increased mean BMI among men, with increased intersection density/ km2 (β = 0.02; 95% CI = 1.96 x10-3, 0.04, p = 0.032); increased mean WC among urban residents with increased crimes/km2/yr (β = 0.09; 95% CI = 0.03, 0.16, p<0.01) and among persons in the middle class, with further distance away from public parks (β = 0.30; 95% CI = 0.08, 0.53, p<0.01). CONCLUSIONS Neighborhood physical and crime environments were associated with obesity-related outcomes in Jamaica. Policymakers in SIDS such as Jamaica should also note the important differences by urbanicity, sex and SES in prevention efforts designed to stem the growing obesity epidemic.
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Affiliation(s)
| | - Katherine P. Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
| | - Novie Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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Thapa R, Dahl C, Aung WP, Bjertness E. Urban-rural differences in overweight and obesity among 25-64 years old Myanmar residents: a cross-sectional, nationwide survey. BMJ Open 2021; 11:e042561. [PMID: 33653748 PMCID: PMC7929804 DOI: 10.1136/bmjopen-2020-042561] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To investigate whether urban-rural location and socioeconomic factors (income, education and employment) are associated with body mass index (BMI) and waist-hip ratio (W/H-ratio), and to further explore if the associations between urban-rural location and BMI or W/H-ratio could be mediated through variations in socioeconomic factors. DESIGN Cross-sectional, WHO STEPS survey of non-communicable disease risk factors. SETTING Urban and rural areas of Myanmar. PARTICIPANTS A total of 8390 men and women aged 25 to 64 years included during the study period from September to December 2014. Institutionalised people (Buddhist monks and nuns, hospitalised patients) and temporary residents were excluded. RESULTS The prevalence of overweight and obesity was higher in the urban areas and increased with increasing socioeconomic status (SES) score. Mean BMI was higher among urban residents (ß=2.49 kg/m2; 95% CI 2.28 to 2.70; p<0.001), individuals living above poverty line, that is, ≥US$1.9/day (ß=0.74 kg/m2; 95% CI 0.43 to 1.05; p<0.001), and those with high education attainment (ß=1.48 kg/m2; 95% CI 1.13 to 1.82; p<0.001) when adjusting for potential confounders. Similarly, greater W/H-ratio was observed in participants living in an urban area, among those with earnings above poverty line, and among unemployed individuals. The association between urban-rural location and BMI was found to be partially mediated by a composite SES score (9%), income (17%), education (16%) and employment (16%), while the association between urban-rural location and W/H-ratio was found to be partially mediated by income (12%), education (6%) and employment (6%). CONCLUSION Residents living in urban locations had higher BMI and greater W/H-ratio, partially explained by differences in socioeconomic indicators, indicating that socioeconomic factors should be emphasised in the management of overweight and obesity in the Myanmar population. Furthermore, new national or subnational STEPS surveys should be conducted in Myanmar to observe the disparity in trends of the urban-rural differential.
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Affiliation(s)
- Rupa Thapa
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Dahl
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Wai Phyo Aung
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Occupational and Environmental Health Division, Department of Public Health, Ministry of Health and Sports, Naypyitaw, Myanmar
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Lam TM, Vaartjes I, Grobbee DE, Karssenberg D, Lakerveld J. Associations between the built environment and obesity: an umbrella review. Int J Health Geogr 2021; 20:7. [PMID: 33526041 PMCID: PMC7852132 DOI: 10.1186/s12942-021-00260-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background In the past two decades, the built environment emerged as a conceptually important determinant of obesity. As a result, an abundance of studies aiming to link environmental characteristics to weight-related outcomes have been published, and multiple reviews have attempted to summarise these studies under different scopes and domains. We set out to summarise the accumulated evidence across domains by conducting a review of systematic reviews on associations between any aspect of the built environment and overweight or obesity. Methods Seven databases were searched for eligible publications from the year 2000 onwards. We included systematic literature reviews, meta-analyses and pooled analyses of observational studies in the form of cross-sectional, case–control, longitudinal cohort, ecological, descriptive, intervention studies and natural experiments. We assessed risk of bias and summarised results structured by built environmental themes such as food environment, physical activity environment, urban–rural disparity, socioeconomic status and air pollution. Results From 1850 initial hits, 32 systematic reviews were included, most of which reported equivocal evidence for associations. For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land use mix and urban sprawl. Risks of bias were predominantly high. Conclusions Thus far, while most studies have not been able to confirm the assumed influence of built environments on weight, there is evidence for some obesogenic environmental characteristics. Registration: This umbrella review was registered on PROSPERO under ID CRD42019135857.
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Affiliation(s)
- Thao Minh Lam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands.
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Dutch Health Foundation, The Hague, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Julius Global Health, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Derek Karssenberg
- Department of Physical Geography, Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
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Alathari BE, Aji AS, Ariyasra U, Sari SR, Tasrif N, Yani FF, Sudji IR, Lovegrove JA, Lipoeto NI, Vimaleswaran KS. Interaction between Vitamin D-Related Genetic Risk Score and Carbohydrate Intake on Body Fat Composition: A Study in Southeast Asian Minangkabau Women. Nutrients 2021; 13:nu13020326. [PMID: 33498618 PMCID: PMC7911469 DOI: 10.3390/nu13020326] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
Metabolic diseases have been shown to be associated with low vitamin D status; however, the findings have been inconsistent. Hence, the objective of our study was to investigate the relationship between vitamin D status and metabolic disease-related traits in healthy Southeast Asian women and examine whether this relationship was modified by dietary factors using a nutrigenetic study. The study included 110 Minangkabau women (age: 25–60 years) from Padang, Indonesia. Genetic risk scores (GRS) were constructed based on five vitamin D-related single nucleotide polymorphisms (SNPs) (vitamin D-GRS) and ten metabolic disease-associated SNPs (metabolic-GRS). The metabolic-GRS was significantly associated with lower 25-hydroxyvitamin D (25(OH)D) concentrations (p = 0.009) and higher body mass index (BMI) (p = 0.016). Even though the vitamin D-GRS had no effect on metabolic traits (p > 0.12), an interaction was observed between the vitamin D-GRS and carbohydrate intake (g) on body fat percentage (BFP) (pinteraction = 0.049), where those individuals who consumed a high carbohydrate diet (mean ± SD: 319 g/d ± 46) and carried >2 vitamin D-lowering risk alleles had significantly higher BFP (p = 0.016). In summary, we have replicated the association of metabolic-GRS with higher BMI and lower 25(OH)D concentrations and identified a novel interaction between vitamin D-GRS and carbohydrate intake on body fat composition.
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Affiliation(s)
- Buthaina E. Alathari
- Department of Food Science and Nutrition, Faculty of Health Sciences, The Public Authority for Applied Education and Training, Al Faiha 72853, Kuwait;
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK;
| | - Arif Sabta Aji
- Department of Public Health, Alma Ata Graduate School of Public Health, University of Alma Ata, Yogyakarta 55183, Indonesia;
- Department of Nutrition, Faculty of Health Sciences, University of Alma Ata, Yogyakarta 55183, Indonesia
| | - Utami Ariyasra
- Biomedical Science Department, Faculty of Medicine, Andalas University, West Sumatra 25172, Indonesia; (U.A.); (S.R.S.)
| | - Sri R. Sari
- Biomedical Science Department, Faculty of Medicine, Andalas University, West Sumatra 25172, Indonesia; (U.A.); (S.R.S.)
| | - Nabila Tasrif
- Public Health Department, Faculty of Medicine, Andalas University, West Sumatra 25172, Indonesia;
| | - Finny F. Yani
- Department of Child Health, Faculty of Medicine, Andalas University, West Sumatra 25172, Indonesia;
| | - Ikhwan R. Sudji
- Department of Medical Laboratory Technology, Faculty of Health Science, University Perintis, Padang 25586, Indonesia;
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK;
| | - Nur I. Lipoeto
- Department of Nutrition, Faculty of Medicine, Andalas University, West Sumatra 25172, Indonesia;
| | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK;
- Correspondence:
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Gupta RD, Haider MR, Das S. Factors and Inequality of Underweight and Overweight among Women of Reproductive Age in Myanmar: Evidence from the Demographic Health Survey 2015-2016. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2020; 1:31-43. [PMID: 36417210 PMCID: PMC9620888 DOI: 10.3390/epidemiologia1010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
(1) Background: This study aims to identify the factors of underweight and overweight/obesity among reproductive age (15-49 years) women in Myanmar, and assess the level of inequity in the double burden of malnutrition. (2) Methods: The study used Myanmar Demographic and Health Survey 2015-2016 data. Multinomial logistic regression models were fitted to identify the factors affecting underweight and overweight/obesity; and concentration indices (CI) were estimated to assess socioeconomic inequalities. (3) Results: A total of 12,643 reproductive age women were included in the analysis. Higher risk of underweight was found in women aged 20-29 years, aged 30-39 years, and 40-49 years compared to women aged 15-19 years; women who were unemployed or had manual occupation relative to those in non-manual employment. Women aged 40-49 years (compared to those who were 15-29 years); had primary education, and secondary education (compared to those who had no education); being married, and widowed/divorced/separated (compared to being never married); belonging to the poor quintile, middle quintile, richer, richest quintile (compared to the poorest quintile); having residence in urban areas (compared to rural areas) and in Kachin, Taninthayi, Yangon province (than those who lived in Naypytiaw province) had a higher risk of being overweight/obese. Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (CI: 0.19) amongst the higher quintiles and underweight concentrated (CI: -0.060) amongst the poorest. (4) Conclusions: Equity oriented nutrition interventions with a focus on improving the socioeconomic status of poor households may benefit undernourished women, while richer households should be focused to curb the overweight/obesity problem.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Mohammad Rifat Haider
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH 45701, USA
- Correspondence: ; Tel.: +1-740-566-8015
| | - Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajudddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh;
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Interaction between the genetic risk score and dietary protein intake on cardiometabolic traits in Southeast Asian. GENES AND NUTRITION 2020; 15:19. [PMID: 33045981 PMCID: PMC7552350 DOI: 10.1186/s12263-020-00678-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
Background Cardiometabolic diseases are complex traits which are influenced by several single nucleotide polymorphisms (SNPs). Thus, analysing the combined effects of multiple gene variants might provide a better understanding of disease risk than using a single gene variant approach. Furthermore, studies have found that the effect of SNPs on cardiometabolic traits can be influenced by lifestyle factors, highlighting the importance of analysing gene-lifestyle interactions. Aims In the present study, we investigated the association of 15 gene variants with cardiometabolic traits and examined whether these associations were modified by lifestyle factors such as dietary intake and physical activity. Methods The study included 110 Minangkabau women [aged 25–60 years and body mass index (BMI) 25.13 ± 4.2 kg/m2] from Padang, Indonesia. All participants underwent a physical examination followed by anthropometric, biochemical and dietary assessments and genetic tests. A genetic risk score (GRS) was developed based on 15 cardiometabolic disease-related SNPs. The effect of GRS on cardiometabolic traits was analysed using general linear models. GRS-lifestyle interactions on continuous outcomes were tested by including the interaction term (e.g. lifestyle factor*GRS) in the regression model. Models were adjusted for age, BMI and location (rural or urban), wherever appropriate. Results There was a significant association between GRS and BMI, where individuals carrying 6 or more risk alleles had higher BMI compared to those carrying 5 or less risk alleles (P = 0.018). Furthermore, there were significant interactions of GRS with protein intake on waist circumference (WC) and triglyceride concentrations (Pinteraction = 0.002 and 0.003, respectively). Among women who had a lower protein intake (13.51 ± 1.18% of the total daily energy intake), carriers of six or more risk alleles had significantly lower WC and triglyceride concentrations compared with carriers of five or less risk alleles (P = 0.0118 and 0.002, respectively). Conclusions Our study confirmed the association of GRS with higher BMI and further showed a significant effect of the GRS on WC and triglyceride levels through the influence of a low-protein diet. These findings suggest that following a lower protein diet, particularly in genetically predisposed individuals, might be an effective approach for addressing cardiometabolic diseases among Southeast Asian women.
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The COVID-19 Pandemic Lockdowns and Changes in Body Weight among Polish Women. A Cross-Sectional Online Survey PLifeCOVID-19 Study. SUSTAINABILITY 2020. [DOI: 10.3390/su12187768] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There is limited information on the relationships between restrictions linked to COVID-19 and changes in body weight. The aim of the study was to identify the body weight changes and their determinants in the nutritional and socio-demographic context during the COVID-19 pandemic in Polish women. During lockdown in Poland, 34% of women gained weight, while 18% of women reduced weight. As many as 44% of women with obesity before the pandemic increased their body weight, and 74% of women that were underweight reduced their body weight. In a group with weight gain, women increased their body weight by 2.8 kg on average and around 65% of them increased their total food intake. Unhealthy dietary changes and the negative lifestyle changes that comprised of an increase in screen time and a decrease in physical activity were found as key factors associated with weight gain. A higher risk of weight gain was associated with being obese before the pandemic or living in a macroeconomic region >50% of EU-28 GDP, while those younger in age and carrying out remote work had a higher chance of weight loss. Concluding, the specific conditions during lockdown worsened the nutritional status, which may increase the risk of complicatedness and mortality from COVID-19. It seems advisable to create dietary and lifestyle recommendations tailored to the individual needs of women who are underweight or have excessive body weight. More attention should be paid also to environmental impacts. Both, the reduction of excessive body weight and the maintenance of a normal weight should be based on the principle to eat and live sustainably and healthily.
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Tay W, Kaur B, Quek R, Lim J, Henry CJ. Current Developments in Digital Quantitative Volume Estimation for the Optimisation of Dietary Assessment. Nutrients 2020; 12:E1167. [PMID: 32331262 PMCID: PMC7231293 DOI: 10.3390/nu12041167] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/23/2022] Open
Abstract
Obesity is a global health problem with wide-reaching economic and social implications. Nutrition surveillance systems are essential to understanding and addressing poor dietary practices. However, diets are incredibly diverse across populations and an accurate diagnosis of individualized nutritional issues is challenging. Current tools used in dietary assessment are cumbersome for users, and are only able to provide approximations of dietary information. Given the need for technological innovation, this paper reviews various novel digital methods for food volume estimation and explores the potential for adopting such technology in the Southeast Asian context. We discuss the current approaches to dietary assessment, as well as the potential opportunities that digital health can offer to the field. Recent advances in optics, computer vision and deep learning show promise in advancing the field of quantitative dietary assessment. The ease of access to the internet and the availability of smartphones with integrated cameras have expanded the toolsets available, and there is potential for automated food volume estimation to be developed and integrated as part of a digital dietary assessment tool. Such a tool may enable public health institutions to be able to gather an effective nutritional insight and combat the rising rates of obesity in the region.
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Affiliation(s)
- Wesley Tay
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Rina Quek
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Joseph Lim
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
- Department of Biochemistry, Yong Loo Lin School of Medicine, Singapore 117596, Singapore
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The prevalence of underweight and overweight/obesity and its correlates among adults in Laos: a cross-sectional national population-based survey, 2013. Eat Weight Disord 2020; 25:265-273. [PMID: 30225825 DOI: 10.1007/s40519-018-0571-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/22/2018] [Indexed: 01/26/2023] Open
Abstract
PURPOSE The study aimed to assess the prevalence of underweight and overweight or obesity and their sociodemographic, lifestyle, and health factors in a national adult population in Lao People's Democratic Republic (PDR) (Laos). METHODS A national cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The total sample included 2531 individuals 18-64 years, (females = 59.3%; mean age 38.7 years, SD = 12.8) from Laos. Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted. Multinomial logistic regression was utilized to determine the association between sociodemographic, lifestyle and health status factors, and underweight and overweight or obesity relative to normal weight. RESULTS Using Asian criteria for body mass index (BMI) classification, 9.7% of the population was underweight (BMI < 18.5, kg/m2), 47.5% had normal weight (BMI 18.5-22.9 kg/m2), 17.5% overweight (23.0-24.9 kg/m2), 19.6% class I obesity (BMI 25.0-29.9 kg/m2), and 5.6% class II obesity (BMI ≥ 30.0 kg/m2) (or 42.8% overweight, class I or class II obesity). In adjusted multinomial logistic regression, female sex (adjusted relative risk ratio-ARRR 0.67, confidence interval-CI 0.45, 0.99), current tobacco use (ARRR 1.57, CI 1.02, 2.41), and having no hypertension (ARRR 0.50, CI 0.26, 0.97) were associated with underweight, and middle and older age (ARRR 1.79, CI 1.41, 2.25), being Lao-Tai (ARRR 1.37, CI 1.06, 1.76), urban residence (ARRR 1.62, CI 1.20, 2.17), having meals outside home (ARRR 1.36, CI 1.04, 1.77), no current tobacco use (ARRR 0.57, CI 0.34, 0.59), low physical activity (ARRR 1.39, CI 1.01, 1.92), having hypertension (ARRR 2.52, CI 1.94, 3.26), and dyslipidaemia (ARRR 1.56, CI 1.21, 2.00) were associated with overweight or obesity. CONCLUSION A dual burden of both adult underweight and overweight or obesity was found in Laos. Sociodemographic, lifestyle, and health status risk factors were identified for underweight and overweight or obesity, which can help in guiding public health programmes to address both these conditions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional survey.
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Thike TZ, Saw YM, Lin H, Chit K, Tun AB, Htet H, Cho SM, Khine AT, Saw TN, Kariya T, Yamamoto E, Hamajima N. Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw union territory, Myanmar. BMC Public Health 2020; 20:206. [PMID: 32041555 PMCID: PMC7011543 DOI: 10.1186/s12889-020-8308-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Ready-to-eat (RTE) food consumption has become popular in the working community with the increase in full-time jobs and the limited time to prepare food. Although RTE food is essential for this community, its consumption causes obesity. In Myanmar, obesity is a modifiable risk factor for non-communicable diseases, causing increases in morbidity and mortality. This study aimed to identify the association between body mass index (BMI) and RTE food consumption among sedentary staff in Nay Pyi Taw Union Territory, Myanmar. METHODS A cross-sectional study was conducted in 2018, in which 400 respondents participated in face-to-face interviews. The study area was selected using simple random sampling and drawing method. Measuring tape and digital weighing scale were used to measure the height and weight of the respondents. BMI was calculated by dividing the weight by height squared (kg/m2). Overweight and obesity were categorized by World Health Organization cut-off points. The collected data were analyzed using multiple logistic regression to estimate the adjusted odds ratio (AOR), and the 95% confidence interval (CI). RESULTS This study revealed that sedentary staff who consumed RTE food once or more per month were nearly five times more likely to be overweight and obese (AOR = 4.78, 95% CI 1.44-15.85) than those who consumed RTE food less frequently. In addition, five factors namely being older than 32 years (AOR = 3.97, 95% CI 1.82-8.69), preference for RTE food (AOR = 8.93, 95% CI 2.54-31.37), light-intensity of physical exercise (AOR = 3.55, 95% CI 1.63-7.73), sedentary leisure activities (AOR = 3.32, 95% CI 1.22-9.03), and smoking (AOR = 5.62, 95% CI 1.06-29.90) were positively associated with overweight and obesity. CONCLUSION Frequent consumers of RTE food and less physically active sedentary staff were more likely to be overweight and obese. This study highlights the urgent need to raise awareness regarding healthy lifestyle behaviors among the working community to reduce the burden of obesity-related chronic diseases. Moreover, sedentary workers should be aware of the food-based dietary guidelines of the country. Policy makers should strictly enforce nutritional labeling of RTE food, and strictly prohibit over-branding of RTE food.
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Affiliation(s)
- Thin Zar Thike
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Htin Lin
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Khin Chit
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aung Ba Tun
- Directorate of Medical Service, Nay Pyi Taw, Myanmar
| | - Hein Htet
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Preventative and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Aye Thazin Khine
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
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Ware LJ, Prioreschi A, Bosire E, Cohen E, Draper CE, Lye SJ, Norris SA. Environmental, Social, and Structural Constraints for Health Behavior: Perceptions of Young Urban Black Women During the Preconception Period-A Healthy Life Trajectories Initiative. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:946-957. [PMID: 31101479 DOI: 10.1016/j.jneb.2019.04.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/31/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Obesity and noncommunicable disease are rapidly increasing in sub-Saharan Africa. Prevention efforts are critical, particularly for women before conception to maximize intergenerational effects. The authors sought to examine perceptions of health and everyday factors that influenced nutrition, exercise, and other health behaviors to inform a novel community preconception intervention. DESIGN Four focus groups, each with 6-10 participants, were conducted using semistructured interview guides. SETTING Urban Soweto, South Africa. PARTICIPANTS Young nulliparous women aged 18-24 years were recruited using snowball sampling. PHENOMENON OF INTEREST Health behaviors of young women and barriers and facilitators to these behaviors. ANALYSIS After inductive thematic analysis, data were further interpreted within the theoretical framework of the Behavior Change Wheel. RESULTS The data suggested an obesogenic environment in which structural and social factors strongly influenced young women's health choices and limited their capacity for behavior change. CONCLUSIONS AND IMPLICATIONS Community interventions to improve young women's diet, physical activity, and health should recognize (1) the home and social contexts as a source of both role models and barriers to change, (2) the current normalization of obesity, and (3) contextual issues of safety and violence within the community. Understanding young women who overcome these barriers could be beneficial.
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Affiliation(s)
- Lisa J Ware
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Alessandra Prioreschi
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Edna Bosire
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel Cohen
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Catherine E Draper
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen J Lye
- Department of Physiology, Department of Obstetrics and Gynaecology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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He S, Allen JC, Razali NS, Win NM, Zhang JJ, Ng MJ, Yeo GSH, Chern BSM, Tan KH. Are women in Singapore gaining weight appropriately during pregnancy: a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:290. [PMID: 31409285 PMCID: PMC6693141 DOI: 10.1186/s12884-019-2443-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 07/31/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We aimed to study gestational weight gain (GWG) in a Singaporean population and compare it with Institute of Medicine (IOM) 2009 GWG guidelines. METHODS Nine hundred twenty-six women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital. Seven hundred twenty-four patients had maternal weight information till term pregnancy and were included in analysis. Participants were categorized according to their first antenatal visit body mass index (BMI) as underweight, normal weight, overweight and obese. Total GWG for each BMI group was calculated. Multivariate logistic regression was performed to determine the predictors of total GWG above and below IOM guidelines. RESULTS Obese women had a mean total GWG (9.1 kg) that exceeded the upper limit IOM guidelines (9 kg). In multivariate analysis of predictors of total GWG above IOM guidelines, being overweight (adjusted OR: 3.91 [95% CI, 2.60-5.88]; p < .0001) and obese (adjusted OR: 4.78 [95% CI, 2.80, 8.15]; p < .0001) significantly increased the risks of gaining weight above IOM guidelines during pregnancy, compared to being normal weight. CONCLUSIONS Overweight and obesity are independent significant risk factors for gaining excessive gestational weight. Appropriate weight management for overweight and obese Singaporean women prior to and during pregnancy is important.
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Affiliation(s)
- Song He
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - John Carson Allen
- Office of Clinical Sciences, Duke-NUS Medical School, Singapore, Singapore
| | - Nurul Syaza Razali
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Nyo Mie Win
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jun Jim Zhang
- Division of Obstetrics and Gynaecology, OBGYN Academic Clinical Program (ACP), KK Women's and Children's Hospital, Singapore, Singapore
| | - Mor Jack Ng
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - George Seow Heong Yeo
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899,, Singapore
| | - Bernard Su Min Chern
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899,, Singapore.
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Country Characteristics and Variation in Diabetes Prevalence among Asian Countries - an Ecological Study. J ASEAN Fed Endocr Soc 2019; 34:80-86. [PMID: 33442140 PMCID: PMC7784088 DOI: 10.15605/jafes.034.01.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 04/08/2019] [Indexed: 12/12/2022] Open
Abstract
Objectives To determine the variation in diabetes prevalence across Asian countries and its relationship with the quality of health system and socioeconomic characteristics of the country. Methodology An ecological analysis was conducted using publicly available data from the World Bank, the World Health Organization and the International Diabetes Federation. Geographical variation in diabetes prevalence across countries was examined using control charts while the relationships between country-level determinants and diabetes prevalence were investigated using linear regression analysis. Results The control chart shows special-cause variation in diabetes prevalence in 21 (58%) of the Asian countries; nine countries were below the 99.8% control limits while twelve were above it.Fifteen (42%) countries suggest common-cause variation. Three country characteristics independently associated with diabetes prevalence were hypertension prevalence (OR 0.39, 95% CI 0.22 to 0.55; p-value<0.001), obesity prevalence (OR 0.15, 95% CI 0.13 to 0.18; p-value<0.001), and quality of health care governance (OR 0.18, 95% CI 0.04 to 0.34; p-value=0.02). Conclusions There is a considerable geographical variation in diabetes prevalence across Asian countries. A substantial part of this variation could be explained by differences in the quality of health care governance, hypertension prevalence and obesity prevalence.
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Hashmi AH, Paw MK, Nosten S, Darakamon MC, Gilder ME, Charunwatthana P, Carrara VI, Wickramasinghe K, Angkurawaranon C, Plugge E, McGready R. 'Because the baby asks for it': a mixed-methods study on local perceptions toward nutrition during pregnancy among marginalised migrant women along the Myanmar-Thailand border. Glob Health Action 2018; 11:1473104. [PMID: 29785874 PMCID: PMC5965027 DOI: 10.1080/16549716.2018.1473104] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Under- and over-nutrition during pregnancy are known risk factors for pregnancy complications and adverse pregnancy and infant outcomes. Understanding perceptions around nutrition in pregnancy can create culturally appropriate interventions for improved health outcomes. Objective: A mixed-methods study was performed to explore local perceptions and practices of diet and physical activity in pregnancy in a marginalised population along the Myanmar–Thailand border. Methods: From April to July 2017, a cross-sectional survey and focus group discussions were conducted with pregnant women reporting to antenatal care; in-depth interviews were conducted with senior midwives at participating organisations along the Myanmar–Thailand border. Results: A total of 388 pregnant women were interviewed at two clinic sites along the Myanmar–Thailand border. A high proportion of women had limited knowledge of and poor dietary practices. Consuming a sweetened drink in the last 24 hours as well as being a non-teenage, multigravida woman was significantly associated with high body mass index (BMI) compared to normal BMI. Qualitative analysis combined focus group discussions (n = 66) and in-depth interviews (n = 4) summarising emergent themes: common foods eaten or avoided and rationale; benefits of nutrition; perceptions of overweight and weight gain during pregnancy; barriers to a healthy diet; and sources of diet information. Conclusions: There is limited awareness about healthy diets and lifestyle in these marginalised, migrant communities along the Myanmar–Thailand border. This study suggests that simple, culturally appropriate messaging should be provided to women and communities with low health literacy to generate awareness about healthy lifestyles and their effects on pregnancy outcomes as an important element of a broader strategy to address maternal nutrition in this population. However, more studies to determine the effectiveness of a broad range of interventions in low- and middle-income countries (LMIC) are needed, especially in marginalised migrant populations.
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Affiliation(s)
- Ahmar H Hashmi
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand.,b Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
| | - Moo Kho Paw
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand
| | - Suphak Nosten
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand
| | - Mu Chae Darakamon
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand
| | - Mary Ellen Gilder
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand
| | | | - Verena I Carrara
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand
| | - Kremlin Wickramasinghe
- d WHO European Office for the Prevention and Control of Non-Communicable Disease , Moscow, Russia
| | - Chaisiri Angkurawaranon
- b Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
| | - Emma Plugge
- e Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford , UK
| | - Rose McGready
- a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit , Mahidol University , Mae Sot , Thailand.,e Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford , UK
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Poh KK, Ambegaonkar B, Baxter CA, Brudi P, Buddhari W, Chiang FT, Horack M, Jang Y, Johnson B, Lautsch D, Sawhney J, Vyas A, Yan BP, Gitt AK. Low-density lipoprotein cholesterol target attainment in patients with stable or acute coronary heart disease in the Asia-Pacific region: results from the Dyslipidemia International Study II. Eur J Prev Cardiol 2018; 25:1950-1963. [PMID: 30198749 DOI: 10.1177/2047487318798927] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND As mortality due to cardiovascular disease increases throughout the world, accurate data on risk factors such as hyperlipidemia are required. This is lacking in the Asia-Pacific region. DESIGN The observational Dyslipidemia International Study (DYSIS) II was established to quantify the extent of hyperlipidemia in adults with acute and stable coronary heart disease globally. METHODS Patients with stable coronary heart disease or hospitalised with an acute coronary syndrome were enrolled across nine Asia-Pacific countries from July 2013 to October 2014. Lipid-lowering therapy and low-density lipoprotein cholesterol target attainment (<70 mg/dL) were assessed. The acute coronary syndrome cohort was followed up 4 months post-discharge. RESULTS Of the 4592 patients enrolled, 2794 had stable coronary heart disease and 1798 were admitted with an acute coronary syndrome. In the coronary heart disease cohort, the mean low-density lipoprotein cholesterol level was 86.9 mg/dL, with 91.7% using lipid-lowering therapy and 31% achieving low-density lipoprotein cholesterol of less than 70 mg/dL. In the acute coronary syndrome cohort at admission, the corresponding values were 103.2 mg/dL, 63.4% and 23.0%, respectively. Target attainment was significantly higher in lipid-lowering therapy-treated than non-treated patients in each cohort (32.6% vs. 12.9% and 31.1% vs. 9.0%, respectively). Mean atorvastatin-equivalent dosages were low (20 ± 15 and 22 ± 18 mg/day, respectively), with little use of non-statin adjuvants (13.0% and 6.8%, respectively). Low-density lipoprotein cholesterol target attainment had improved by follow-up for the acute coronary syndrome patients, but remained low (41.7%). CONCLUSIONS Many patients in Asia at very high risk of recurrent cardiovascular events had a low-density lipoprotein cholesterol level above the recommended target. Although lipid-lowering therapy was common, it was not used to its full potential.
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Affiliation(s)
- Kian-Keong Poh
- 1 Department of Cardiology, National University Heart Centre, Singapore.,2 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | | | - Wacin Buddhari
- 5 Division of Cardiovascular Medicine, Chulalongkorn University, Thailand
| | - Fu-Tien Chiang
- 6 Department of Internal Medicine, National Taiwan University Hospital, Taiwan
| | - Martin Horack
- 7 Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - Yangsoo Jang
- 8 Division of Cardiology, Yonsei University College of Medicine, Korea
| | - Brett Johnson
- 9 Merck Sharp & Dohme (Australia) Pty Ltd., Australia
| | | | - Jps Sawhney
- 10 Department of Cardiology, Sri Ganga Ram Hospital, Rajinder Nagar, India
| | - Ami Vyas
- 11 Department of Epidemiology, Rutgers University, USA.,12 Department of Pharmacy Practice, University of Rhode Island, USA
| | - Bryan P Yan
- 13 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Anselm K Gitt
- 7 Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany.,14 Medizinische Klinik B, Klinikum der Stadt Ludwigshafen, Germany
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Chen C, Xu X, Yan Y. Estimated global overweight and obesity burden in pregnant women based on panel data model. PLoS One 2018; 13:e0202183. [PMID: 30092099 PMCID: PMC6084991 DOI: 10.1371/journal.pone.0202183] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/29/2018] [Indexed: 12/14/2022] Open
Abstract
Objective To estimate the global and country-level burden of overweight and obesity among pregnant women from 2005 to 2014. Methods Publicly accessible country-level data were collected from the World Health Organization, the World Bank and the Food and Agricultural Organization. We estimated the number of overweight and obese pregnant women among 184 countries and determined the time-related trend from 2005 to 2014. Based on panel data model, we determined the effects of food energy supply, urbanization, gross national income and female employment on the number of overweight and obese pregnant women. Results We estimated that 38.9 million overweight and obese pregnant women and 14.6 million obese pregnant women existed globally in 2014. In upper middle income countries and lower middle income countries, there were sharp increases in the number of overweight and obese pregnant women. In 2014, the percentage of female with overweight and obesity in India was 21.7%, and India had the largest number of overweight and obese pregnant women (4.3 million), which accounted for 11.1% in the world. In the United States of America, a third of women were obese, and the number of obese pregnant women was 1.1 million. In high income countries, caloric supply and urbanization were positively associated with the number of overweight and obese pregnant women. The percentage of employment in agriculture was inversely associated with the number of overweight and obese pregnant women, but only in upper middle income countries and lower middle income countries. Conclusion The number of overweight and obese pregnant women has increased in high income and middle income countries. Environmental changes could lead to increased caloric supply and decreased energy expenditure among women. National and local governments should work together to create a healthy food environment.
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Affiliation(s)
- Cheng Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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Verma RK, Paraidathathu T, Taha NA, Chong WW. Perceptions of the Malaysian general public on community pharmacy-based weight management services. J Pharm Policy Pract 2018; 11:17. [PMID: 30094032 PMCID: PMC6081823 DOI: 10.1186/s40545-018-0146-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is now widely regarded as a main contributor to poor health. Involvement of community pharmacists can be a valuable tool in obesity management. However, there is still a lack of data in Malaysia on the potential involvement of and opportunities for community pharmacists in providing weight management services. Thus, it is essential to investigate the perceptions of the general public on weight management services in the community pharmacy setting. To evaluate the general public's perceptions on weight management services by community pharmacists in terms of perceived availability, utilization and factors influencing acceptability of services. METHODS A descriptive, cross sectional-survey was conducted using a self-administered questionnaire comprising of sections that focused on public preferences and options on weight management approaches, perceived availability of extended services and resources provided by community pharmacists in relation to weight management, utilization of these services and resources, and factors influencing acceptability of weight management services provided by community pharmacists. The questionnaires were distributed to the general public aged 18 years and above in Klang Valley, Malaysia. RESULTS A total of 730 respondents with a median age of 31 years participated in this study. Majority of respondents ranked dieticians as their preferred first line of consultation, with only about a quarter of respondents ranking community pharmacists as their preferred first or second line of consultation. Although more than half show of the study respondents perceived that community pharmacies they had visited offered services for measuring weight, height, blood pressure, blood glucose and blood cholesterol, fewer perceived that community pharmacies provided advice on physical activity and healthy eating to achieve weight loss. Additionally, majority of the respondents indicated that they had not utilized these services. However, most respondents perceived that community pharmacists should provide weight management services. The main factors influencing acceptability show of services included training of pharmacists, payment, waiting time and the issue of privacy. CONCLUSION The findings of this study demonstrated that the majority of respondents were in support of weight management services in community pharmacy; however only a low percentage reported utilizing these services. Factors influencing acceptability of services included payment, waiting time and the issue of privacy. With adequate training among pharmacists and increased awareness of services among the public, community pharmacists could play a larger and important role in addressing the issue of obesity in Malaysia.
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Affiliation(s)
- Rohit Kumar Verma
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Thomas Paraidathathu
- Faculty of Health and Medical Sciences, Taylor’s University, 47500 Subang Jaya, Malaysia
| | - Nur Akmar Taha
- Faculty of Pharmacy, Cyberjaya University College of Medical Sciences, Edusphere, Persiaran Bestari, 63200 Cyberjaya, Selangor Malaysia
| | - Wei Wen Chong
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
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Troy AR, Bonnell LN, Littenberg B. Relationship Between the Built Environment and Body Mass Index in a Rural Context: A Cross-Sectional Study from Vermont. Cureus 2018; 10:e3040. [PMID: 30258739 PMCID: PMC6153091 DOI: 10.7759/cureus.3040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate the association between a marker of urban development (commercial building density) and body mass index (BMI) in a predominantly rural context. Methods A cross-sectional analysis of two geocoded datasets from Vermont. The first includes subjects from the Vermont Diabetes Information System (VDIS), an extensively attributed dataset of adult diabetics (n = 610); the second was the complete driver's license records for Vermont (n = 401,367). The dependent variable was BMI, measured objectively for the VDIS data and self-reported for the driver's license data. The explanatory variable was commercial buildings per hectare within 250 m of the home address used as a proxy for walkability. We regressed BMI against density in both datasets, controlling for age and gender; a separate regression was run for the VDIS data, controlling for a number of additional confounders related to health, activity, diet, and income. Results All models demonstrated a significant positive relationship between BMI and commercial building density. For the three VDIS data models, coefficients of density were +0.75, +0.79, and +0.90, all of which indicate an approximate ¾ kg/m2 increase in BMI for each additional commercial facility per hectare (p < 0.01). For the driver’s license data, the coefficient was +0.16, which also indicates an increase in BMI with increasing density (p < 0.01). Discussion We found that BMI displays a positive association with commercial building density in Vermont, which is inconsistent with previous findings. The difference may be due to the unique rural focus of this study. Other characteristics of rural life may be associated with lower incidence of obesity and should be studied further.
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Affiliation(s)
- Austin R Troy
- Department of Planning and Design, University of Colorado, Denver, USA
| | - Levi N Bonnell
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, USA
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What factors may contribute to sex differences in childhood obesity prevalence in China? Public Health Nutr 2018; 21:2056-2064. [PMID: 29478427 DOI: 10.1017/s1368980018000290] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Previous studies in China showed large sex differences in childhood overweight and obesity (OW/OB) rates. However, limited research has examined the cause of these sex differences. The present study aimed to examine individual and parental/familial factors associated with sex differences in childhood OW/OB rates in China. DESIGN Variables associated with child weight status, beliefs and behaviours, and obesity-related parenting practices were selected to examine their sex differences and association with a sex difference in child OW/OB outcomes using logistic regression analysis. SETTING Cross-sectional data analysis using the 2011 China Health and Nutrition Survey. SUBJECTS Children aged 6-17 years (n 1544) and their parents. RESULTS Overall child OW/OB prevalence was 16·8 %. Adolescent boys (AB; 12-17 years) were about twice as likely to be overweight/obese as adolescent girls (AG; 15·5 v. 8·4 %, P<0·05). AB more likely had energy intake exceeding recommendations, self-perceived underweight, underestimated their body weight and were satisfied with their physical activity level than AG. AG more likely practised weight-loss management through diet and self-perceived overweight than AB. Mothers more likely identified AG's weight accurately but underestimated AB's weight. Stronger associations with risk of childhood OW/OB were found in boys than girls in dieting to lose weight (OR=6·7 in boys v. 2·6 in girls) and combined maternal and child perception of the child's overweight (OR=35·4 in boys v. 14·2 in girls). CONCLUSIONS Large sex differences in childhood obesity may be related to the sex disparities in weight-related beliefs and behaviours among children and their parents in China.
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Guzmán-de la Garza FJ, González Ayala AE, Gómez Nava M, Martínez Monsiváis LI, Salinas Martínez AM, Ramírez López E, Mathiew Quirós A, Garcia Quintanilla F. Body frame size in school children is related to the amount of adipose tissue in different depots but not to adipose distribution. Am J Hum Biol 2017; 29. [PMID: 28455842 DOI: 10.1002/ajhb.23014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 02/20/2017] [Accepted: 04/08/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES The main aim of this study was to test the hypothesis that body frame size is related to the amount of fat in different adipose tissue depots and to fat distribution in schoolchildren. METHODS Children aged between 5 and 10 years were included in this cross-sectional study (n = 565). Body frame size, adiposity markers (anthropometric, skinfolds thickness, and ultrasound measures), and fat distribution indices were analyzed. Correlation coefficients adjusted by reliability were estimated and analyzed by sex; the significance of the difference between two correlation coefficients was assessed using the Fisher z-transformation. RESULTS The sample included primarily urban children; 58.6% were normal weight, 16.1% overweight, 19.6% obese, and the rest were underweight. Markers of subcutaneous adiposity, fat mass and fat-free mass, and preperitoneal adiposity showed higher and significant correlations with the sum of the biacromial + bitrochanteric diameter than with the elbow diameter, regardless of sex. The fat distribution conicity index presented significant but weak correlations; and visceral adipose tissue, hepatic steatosis, and the waist-for-hip ratio were not significantly correlated with body frame size measures. CONCLUSIONS Body frame size in school children was related to the amount of adipose tissue in different depots, but not adipose distribution. More studies are needed to confirm this relationship and its importance to predict changes in visceral fat deposition during growth.
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Affiliation(s)
- Francisco J Guzmán-de la Garza
- Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 66455, Mexico.,Unidad de Investigación Epidemiológica y en Servicios de Salud de Monterrey, Centro de Investigaciones Biomédicas del Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, 64720, Mexico
| | - Alejandra E González Ayala
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 66455, Mexico
| | - Marisol Gómez Nava
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 66455, Mexico
| | | | - Ana M Salinas Martínez
- Unidad de Investigación Epidemiológica y en Servicios de Salud de Monterrey, Centro de Investigaciones Biomédicas del Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, 64720, Mexico.,Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 66455, Mexico
| | - Erik Ramírez López
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 66455, Mexico
| | - Alvaro Mathiew Quirós
- Unidad de Investigación Epidemiológica y en Servicios de Salud de Monterrey, Centro de Investigaciones Biomédicas del Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, 64720, Mexico
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Increasing prevalence of overweight and obesity in Bangladeshi women of reproductive age: Findings from 2004 to 2014. PLoS One 2017; 12:e0181080. [PMID: 28753680 PMCID: PMC5533452 DOI: 10.1371/journal.pone.0181080] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/26/2017] [Indexed: 11/19/2022] Open
Abstract
Background Overweight and obesity are a particular concern for women of reproductive age. They not only increase the risk of chronic diseases but they are also associated with adverse perinatal, neonatal, infant and child outcomes. The objective of this study was to examine the trend of overweight and obesity among Bangladeshi women of reproductive age between 2004 and 2014. Method This is a secondary data analysis of the 2004, 2007, 2011 and 2014 Bangladesh Demographic and Health Surveys (BDHS). We determined the age standardized prevalence of overweight and obesity of women aged 15–49 years, who had their weight and height measured. Overweight and obesity were determined using the Asian specific BMI cut-offs criteria. Result The prevalence of overweight increased from 11.4% [95% CI: 10.4to 12.5] in 2004 to 25.2% [95% CI: 24.0 to 26.4] in 2014. The prevalence of obesity increased from 3.5% [95% CI: 3.0to4.2] to 11.2% [95% CI: 10.1to12.5%] over the same period of time. This was seen in all age groups. However, the greatest increase was observed in women aged 35 to 49 years. The highest prevalence of overweight and obesity were observed in those women with the highest education level and wealth, larger family size, living in urban areas and not being in paid employment. Conclusion The prevalence of overweight and obesity among women of reproductive age in Bangladesh is high and increasing. We speculate that this has the potential to jeopardize the improvements that have been made in maternal and infant health over the last two decades. Evidence based prevention strategies are required to address this serious public health issue.
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Akhter J, Ahmed A, Mawani M, Lakhani L, Kalsekar A, Tabassum S, Islam N. Patterns, control and complications of diabetes from a hospital based registry established in a low income country. BMC Endocr Disord 2017; 17:30. [PMID: 28583113 PMCID: PMC5460467 DOI: 10.1186/s12902-017-0179-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 05/24/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetes registry enables practitioners to measure the characteristics and patterns of diabetes across their patient population. They also provide insight into practice patterns which can be very effective in improving care and preventing complications. The aim of this study was to assess the patterns, control levels and complications at the baseline of the patients attending clinic at the large tertiary care hospital in Karachi, Pakistan with the help of the registry. This can be used as a reference to monitor the control and also for a comparison between peer groups. METHODS This was a cross sectional study with the data obtained from diabetes registry collected with the help of pre-designed questionnaire. HbA1c was used as a central diabetes measure and other related factors and complications were assessed with it. RESULTS Only 16.6% of the participants had optimal HbA1c ≤ 7.0%. 52.9% of the patients were classified as having poor control defined by HbA1c of >8%. Three fourth of the study population were obese according to Asian specific BMI cutoffs and majority had type 2 diabetes with duration of diabetes ranging from less than one to about 35 years, mean(SD) duration being 7.6 years (7.1). Overall only 4% of the patients were on combine target of HbA1c, LDL and BP. Results of multivariable logistic regression showed that the odds of having optimal glycemic control increased by 3% with every one year increase in age. In addition, having longer duration of diabetes was associated with 56% lower odds of having good glycemic control. Moreover, having higher triglyceride levels was associated with 1% lower odds of having good glycemic control. CONCLUSION This highlights the large burden of sub optimally controlled people with diabetes in Pakistani population, a low income country with huge diabetes prevalence and ineffective primary health care system creating enormous health and economic burden.
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Affiliation(s)
- Jaweed Akhter
- SETMA Diabetes Center, Beaumont, TX USA
- Aga Khan University, Karachi, Pakistan
| | - Asma Ahmed
- Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan
- Endocrine & Diabetes Section, Department of Medicine, The Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, 74800 Pakistan
| | - Minaz Mawani
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Ayaz Kalsekar
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Shehla Tabassum
- Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Najmul Islam
- Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan
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Lindsay AC, Sitthisongkram S, Greaney ML, Wallington SF, Ruengdej P. Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040436. [PMID: 28422081 PMCID: PMC5409637 DOI: 10.3390/ijerph14040436] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 03/28/2017] [Accepted: 04/12/2017] [Indexed: 12/13/2022]
Abstract
Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies (n = 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts-Boston, Boston, MA 02125, USA.
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02125, USA.
| | | | - Mary L Greaney
- Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA.
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Wang W, Wu Y, Zhang D. Association of dairy products consumption with risk of obesity in children and adults: a meta-analysis of mainly cross-sectional studies. Ann Epidemiol 2016; 26:870-882.e2. [PMID: 27756684 DOI: 10.1016/j.annepidem.2016.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/01/2016] [Accepted: 09/16/2016] [Indexed: 01/03/2023]
Abstract
PURPOSE The association of dairy products consumption with risk of obesity remains controversial. Therefore, we reviewed and quantitatively synthesized the evidence from observational studies with a meta-analysis. METHODS A literature search was performed in relevant databases. Random-effects model was used to pool odds ratios with 95% confidence intervals. Dose-response relationship was assessed by restricted cubic spline model. RESULTS Seventeen studies for total dairy products and 16 studies for milk with risk of obesity were eligible. The pooled odds ratios (95% confidence intervals) of obesity for the highest versus lowest category of total dairy products consumption were 0.54 (0.38-0.77) in children, 0.75 (0.69-0.81) in adults, and 0.74 (0.68-0.80) for both. Evidence of a nonlinear relationship was found (Pfor nonlinearity = .009). Milk consumption was also associated with risk of obesity [0.81 (0.75-0.88)] both in children [0.87 (0.80-0.95)] and in adults [0.77 (0.68-0.87)], and a linear relationship (Pfor nonlinearity = .598) suggested that risk of obesity decreased by 16% [0.84 (0.77-0.92)] for every 200 g/d increment of milk consumption. CONCLUSIONS This meta-analysis indicates that dairy products consumption may be associated with a decreased risk of obesity. This association may be of public health significance.
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Affiliation(s)
- Weijing Wang
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong, People's Republic of China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong, People's Republic of China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong, People's Republic of China.
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Prasad A, Gray CB, Ross A, Kano M. Metrics in Urban Health: Current Developments and Future Prospects. Annu Rev Public Health 2016; 37:113-33. [PMID: 26789382 DOI: 10.1146/annurev-publhealth-032315-021749] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The research community has shown increasing interest in developing and using metrics to determine the relationships between urban living and health. In particular, we have seen a recent exponential increase in efforts aiming to investigate and apply metrics for urban health, especially the health impacts of the social and built environments as well as air pollution. A greater recognition of the need to investigate the impacts and trends of health inequities is also evident through more recent literature. Data availability and accuracy have improved through new affordable technologies for mapping, geographic information systems (GIS), and remote sensing. However, less research has been conducted in low- and middle-income countries where quality data are not always available, and capacity for analyzing available data may be limited. For this increased interest in research and development of metrics to be meaningful, the best available evidence must be accessible to decision makers to improve health impacts through urban policies.
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Affiliation(s)
- Amit Prasad
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Chelsea Bettina Gray
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Alex Ross
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Megumi Kano
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
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Spiller RC. Changing views on diverticular disease: impact of aging, obesity, diet, and microbiota. Neurogastroenterol Motil 2015; 27:305-12. [PMID: 25703217 DOI: 10.1111/nmo.12526] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 01/15/2015] [Indexed: 12/13/2022]
Abstract
The development of colonic diverticulosis is a common aging change in industrialized nations. While most patients have asymptomatic diverticulosis, around one in five develops symptomatic diverticular disease. This is characterized by recurrent abdominal pain and disturbed bowel habit. Some of the pain episodes are prolonged and are due to acute diverticulitis, which itself may be complicated by abscess, perforation, fistulation, or stricture formation. Risk factors favouring the development of symptomatic diverticular disease include obesity, smoking and diets low in fiber but high in red meat and animal fat. What determines the transition from asymptomatic diverticulosis to symptomatic diverticular disease is unclear but neuromuscular changes following acute diverticulitis may be responsible in some cases. The severity of symptoms generated depends on cerebral pain processing which is influenced by psychosocial factors. These are important considerations in deciding optimal patient management. Prior theories of the cause of diverticulosis suggested that constipation was an important cause, but new data challenge this and has provoked new ideas. Underlying mechanisms causing diverticulosis include weakening of the colonic wall and/or degenerative changes in the enteric nerves. Dietary induced changes in microbiota and the host inflammatory response may underlie the subsequent development of acute/chronic diverticulitis and its sequela.
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Affiliation(s)
- R C Spiller
- Nottingham Digestive Diseases Centre, University of Nottingham, Queens Medical Centre, Nottingham, UK
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Lack of association between leptin G-2548A polymorphisms and obesity risk: Evidence based on a meta-analysis. Obes Res Clin Pract 2015; 9:389-97. [PMID: 25733497 DOI: 10.1016/j.orcp.2015.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 01/07/2015] [Accepted: 01/13/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND The prevalence of obesity is increasing in most industrialized and developing countries. We aimed to investigate the association between leptin (LEP) G-2548A polymorphisms and the risk of obesity. METHODS We searched the PubMed, Web of Science, and China National Knowledge Infrastructure databases for studies that evaluated the association between LEP G-2548A polymorphisms and obesity risk prior to March 2014. The odds ratio (OR) and its 95% confidence interval (95% CI) were calculated to estimate the risk of obesity. Meta-analysis of subgroup populations and different control sources was conducted using homozygote (AA vs. GG), allelic (A vs. G), dominant (AA+GA vs. GG), recessive (AA vs. GG+GA), and heterozygote (AG vs. GG) models. The heterogeneity of the studies was assessed using χ(2)-tests based on Q-statistics. The pooled ORs were calculated using a random-effects model if there was no heterogeneity; otherwise, a random-effects model was used. Two authors extracted the data independently. The funnel plots, Begg's and Egger's test were used to assess publication bias. All statistical analyses were performed using STATA 12.0 software. RESULTS Nine case-controlled publications that evaluated the association between LEP G-2548A polymorphisms and obesity risk, which included 2594 subjects (1235 obesity cases and 1359 controls), were included in our meta-analysis. No significant association between this polymorphism and obesity risk was observed (P>0.05). Significant heterogeneity was detected among the studies. The results of subgroup analysis according to ethnicity and different control groups suggested that LEP G-2548A polymorphisms might increase the obesity risk in African populations in the homozygote (AA vs. GG: OR=2.38, 95% CI=1.15-4.93, P=0.020) and recessive (AA vs. GG+GA: OR=2.03, 95% CI=1.34-3.06, P=0.001) models. CONCLUSIONS Overall, this meta-analysis indicated that LEP G-2548A polymorphisms are not associated with obesity risk, although significant associations were observed in the homozygote model (AA vs. GG) and the recessive model (AA vs. GG+GA) in Africa populations. Further studies are still needed to validate and confirm this association.
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