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Sobngwi-Tambekou JL, Guewo-Fokeng M, Katte JC, Ekwoge DD, Kamdem L, Fezeu L, Sobngwi E. Development and implementation of a nutrition education programme for school-going adolescents in the context of double burden of malnutrition: a narrative essay. Pan Afr Med J 2024; 47:40. [PMID: 38586065 PMCID: PMC10998257 DOI: 10.11604/pamj.2024.47.40.42456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 04/09/2024] Open
Abstract
The early prevention of non-communicable diseases in Cameroon schools program was initiated in 2018 to address the alarming trend of obesity among adolescents through a nutrition education intervention aimed at increasing knowledge on nutrition and the benefits of healthy eating and physical activity. The program included: school surveys to document eating habits and health-risky behaviors in students, the development of a training curriculum, training and sensitization sessions for school staff, school vendors and students, and advocacy meetings with parliamentarians and mayors. We carried out a quasi-experimental study to assess the effect of the intervention on the student's knowledge and eating behavior three months after the training sessions. We compared the knowledge of a sample of students from five schools that were part of the program (IG) to that of students that were not (CG). The mean (±SD) score was 14.4/20 (±2.1) and 9.7/20 (±2.7) for IG and CG, respectively (p<0.001). Those who scored above 12/20 accounted for 89.8% of IG vs 23.8% of CG (p<0.001). Other significant achievements of this program are the amendment of the National School Hygiene Policy to include compulsory training in food hygiene and nutrition education for school canteen vendors and the integration of nutrition education sensitization sessions into the routine activities of school healthcare. The study showed that a well-structured multi-sectoral nutritional education program could be the bedrock to improve healthy nutrition among adolescents, thereby serving as a vehicle for non-communicable disease prevention.
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Affiliation(s)
| | - Magellan Guewo-Fokeng
- RSD Institute, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Jean Claude Katte
- RSD Institute, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | | | | | | | - Eugene Sobngwi
- RSD Institute, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
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Sobngwi E, Sobngwi-Tambekou J, Katte JC, Echouffo-Tcheugui JB, Balti EV, Kengne AP, Fezeu L, Ditah CM, Tchatchoua AP, Dehayem M, Unwin NC, Rankin J, Mbanya JC, Bell R. Gestational diabetes mellitus in Cameroon: prevalence, risk factors and screening strategies. Front Clin Diabetes Healthc 2024; 4:1272333. [PMID: 38374923 PMCID: PMC10876121 DOI: 10.3389/fcdhc.2023.1272333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/07/2023] [Indexed: 02/21/2024]
Abstract
Background The burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population. Methods We carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies. Findings GDM prevalence was 5·9%, 17·7%, and 11·0% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3·14, 95%CI: 1·27-7·76)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5·9 mmol/L for RPG (c-statistic 0·62) and 7·1 mmol/L for 1-hour 50g GCT (c-statistic 0·76). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6·5 mmol/L (c-statistic 0·61) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66·9 and 41·0% of the cases. Interpretation GDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield.
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Affiliation(s)
- Eugene Sobngwi
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
- Department of Non-Communicable Diseases, Recherche Santé et Développement (RSD) Institute, Yaoundé, Cameroon
| | - Joelle Sobngwi-Tambekou
- Department of Non-Communicable Diseases, Recherche Santé et Développement (RSD) Institute, Yaoundé, Cameroon
| | - Jean Claude Katte
- Department of Non-Communicable Diseases, Recherche Santé et Développement (RSD) Institute, Yaoundé, Cameroon
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, United Kingdom
| | - Justin B. Echouffo-Tcheugui
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Eric V. Balti
- Diabetes Research Center, Faculty of Medicine and Pharmacy, Brussels Free University-Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Andre-Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Leopold Fezeu
- Nutritional Epidemiology Research Unit-UMR U557 Institut National de la Santé et de la Recherche Médicale (INSERM), U1125 INRA, CNAM, University of Paris 13, Bobigny, France
| | - Chobufo Muchi Ditah
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Alain-Patrick Tchatchoua
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Mesmin Dehayem
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Nigel C. Unwin
- Faculty of Medical Sciences, Public Health and Epidemiology, University of the West Indies at Cave Hill, Bridgetown, Barbados
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Ruth Bell
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Wendeu-Foyet G, Bellicha A, Chajes V, Huybrechts I, Debras C, Srour B, Sellem L, Fezeu L, Deschasaux-Tanguy M, Touvier M. Trans fatty acid intake and risk of type 2 diabetes in the NutriNet-Santé prospective cohort. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Type 2 diabetes (T2D) is one of the most common noncommunicable diseases worldwide, with an increasing prevalence and a considerable global health burden. Substantial evidence has linked consumption of trans fatty acids (TFAs) to an increased risk of cardiovascular disease. However, the effects of T2D remain unclear. We aimed to investigate the associations between different types of TFAs (total, ruminant, industrial and corresponding specific isomers) and risk of T2D in the NutriNet-Santé prospective cohort. Overall, 105,551 participants aged 18 years or older from the French NutriNet-Santé cohort (2009-2021) were included (mean age at baseline=42.7y (SD = 14.6y), 79.2% women). Dietary intake data, including usual TFA intake, were collected using repeated 24-hour dietary records (n = 5.7 [SD = 3.1]). Associations between sex-specific quartiles of dietary intake of TFAs and type 2 diabetes risk were assessed using multivariable Cox proportional hazard models adjusted for known risk factors. A total of 969 incident type 2 diabetes cases occured during follow-up. Total TFAs was associated with higher T2D risk (HRfor quartile 4 versus 1=1.38; 95% CI = 1.11-1.73; Ptrend<0.001). This association, specifically observed for industrial TFAs (HR = 1.45; 95% CI = 1.15-1.83; Ptrend<0.001), was mainly driven by elaidic acid (HR = 1.37; 95% CI = 1.09-1.72; Ptrend<0.001) and linolelaidic acid (HR = 1.29; 95% CI = 1.04-1.58; Ptrend=0.07). In contrast, ruminant trans fatty acids were not significantly associated with the risk of T2D. In this large prospective cohort, higher dietary intakes of total and industrial TFAs were associated with increased T2D risk. These findings support WHO's recommendation to eliminate industrially-produced TFAs from the food supply worldwide. As such, consumers should be advised to limit the consumption of food products containing partially hydrogenated oils (main vector of iTFAs) as this, specifically, may contribute to lower the substantial global burden of T2D.
Key messages
• Higher dietary intakes of total and industrial trans fatty acids were associated with increased type 2 diabetes risk.
• Our findings support WHO’s recommendation to eliminate industrially-produced TFAs from the food supply worldwide.
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Affiliation(s)
- G Wendeu-Foyet
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - A Bellicha
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - V Chajes
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
- Director’s Office, International Agency for Research on Cancer , Lyon, France
| | - I Huybrechts
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
- Director’s Office, International Agency for Research on Cancer , Lyon, France
| | - C Debras
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - B Srour
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - L Sellem
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - L Fezeu
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
| | - M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Inserm U1153 , Inrae U1125, Bobigny, France
- Nutrition and Cancer Research Network , Jouy-en-Josas, France
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Chazelas E, Debras C, Srour B, Fezeu L, Julia C, Hercberg S, Deschasaux M, Touvier M. Les deux font la paire : boissons sucrées, boissons édulcorées et risque de maladies cardiovasculaires dans la cohorte NutriNet-Santé. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chazelas E, Debras C, Fezeu L, Julia C, Hercberg S, Deschasaux M, Touvier M. Sugary drinks, artificially sweetened beverages and cardiovascular disease in NutriNet-Santé cohort. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sugary drinks consumption has increased worldwide in recent years and evidence demonstrating their detrimental impact on cardio-metabolic health is accumulating. Artificially sweetened beverages (ASB) are marketed as a healthier alternative, but their cardio-metabolic impact is being debated in the scientific community. This study aimed to investigate the relationships between the consumption of ASB, sugary drinks and the risk of first incident cardiovascular disease (CVD) in a large prospective cohort.
Methods
The French NutriNet-Santé cohort was launched in 2009. Every 6 months participants are asked to fill 3 validated web-based 24-hour dietary records. All major health events reported by participants were validated based on their medical records by a committee of physicians. Data were also linked to national health insurance system and to the French national cause of specific mortality registry. For each type of beverage, 3 categories were defined as follows: non-consumers, low consumers and high consumers (separated by sex-specific median among consumers). Multi-adjusted Cox proportional hazard models with age as the primary time scale were performed.
Results
A total of 104,761 participants were included. During follow-up (2009-2019), 1,379 first incident cases of CVD occurred. Compared to non-consumers, higher consumers of sugary drinks had a higher risk of overall CVD (HR = 1.21, 95% CI 1.04 to 1.40, Ptrend=0.009). Higher consumers of ASB had also a significantly higher risk of CVD (HR = 1.30, 95% CI 1.00 to 1.71, Ptrend =0.04).
Conclusions
Both sugary drinks and ASB were similarly associated with CVD risk. The health effects of non-nutritive sweeteners is currently being debated based on contrasted epidemiological results. Mechanistic data suggests metabolic effects through gut microbiota perturbation and body weight gain. To imply a causal link, they need replication in other large-scale prospective cohort as well as further mechanistic investigations.
Key messages
Higher consumption of sugary drinks and ASB was associated with higher risk of CVD, suggesting that ASB might not be a healthy substitute for sugary drinks when considering cardiovascular health. These data provide additional arguments to feed the current debate on taxes, labeling and regulation of sugary and artificially sweetened beverages.
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Affiliation(s)
- E Chazelas
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
| | - C Debras
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
| | - L Fezeu
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
| | - C Julia
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny Cedex, France
| | - S Hercberg
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny Cedex, France
| | - M Deschasaux
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
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Chaltiel D, Julia C, Chaltiel R, Baudry J, Touvier M, Fezeu L, Druesne-Pecollo N, Galan P, Hercberg S, Kesse-Guyot E. Association entre la qualité de l’alimentation selon les recommandations alimentaires françaises de 2017 et le risque de décès, de maladies cardiovasculaires et de cancer. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Combination of Healthy Lifestyle Factors on the Risk of Hypertension in a Large Cohort of French Adults. Nutrients 2019; 11:nu11071687. [PMID: 31340445 PMCID: PMC6683281 DOI: 10.3390/nu11071687] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended to improve hypertension prevention: normal weight, regular physical activity, limited alcohol consumption, adoption of a healthy diet; to evaluate their combined impact on hypertension incidence. Methods: We prospectively followed the incidence of hypertension among 80,426 French adults participating in the NutriNet-Santé cohort study. Self-reported dietary, socio-demographic, lifestyle and health data were assessed at baseline and yearly using a dedicated website; the association between HLI and hypertension risk was assessed by multivariable Cox proportional hazards models adjusted for age, sex, family history of hypertension, socio-demographic and lifestyle factors. Hypothetical Population Attributable Risks associated to each factor were estimated. Results: During a median follow-up of 3.5 years (IQR: 1.5–5.3), 2413 incident cases of hypertension were identified. Compared with no or one healthy lifestyle factor, the hazard ratios (HR) for hypertension were 0.76 (95% CI, 0.67–0.85) for two factors, 0.47 (95% CI, 0.42–0.53) for three factors and 0.35 (95% CI, 0.30–0.41) for all healthy lifestyle factors (p-trend <0.0001). Compared with adhering to 0, 1, 2 or 3 healthy lifestyles, adhering to all of them was found associated with a reduction of the hypertension risk of half (HR = 0.55 (95% CI, 0.46–0.65)). Conclusion: Active promotion of healthy lifestyle factors at population level is a key leverage to fight the hypertension epidemic.
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Affiliation(s)
- Helene Lelong
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France.
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France.
| | - Jacques Blacher
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Julia Baudry
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Solia Adriouch
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Pilar Galan
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Leopold Fezeu
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Serge Hercberg
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
- Department of Public Health, Avicenne Hospital, 93000 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
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Buscail C, Bourcier V, Fezeu L, Roulot D, Brûlé S, Ben Abdesselam Z, Cagnot C, Hercberg S, Nahon P, Ganne N, Julia C. Comportements alimentaires des patients atteints de cirrhose compensée et non compliquée : étude cas-témoins en Île-de-France. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Laville V, Le Clerc S, Ezzedine K, Jdid R, Taing L, Labib T, Coulonges C, Ulveling D, Galan P, Guinot C, Fezeu L, Morizot F, Latreille J, Malvy D, Tschachler E, Zagury J. A genome wide association study identifies new genes potentially associated with eyelid sagging. Exp Dermatol 2018; 28:892-898. [DOI: 10.1111/exd.13559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Vincent Laville
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Sigrid Le Clerc
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Khaled Ezzedine
- Department of DermatologyHenri Mondor Hospital and EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques)UPEC‐Université Paris‐Est Créteil France
| | - Randa Jdid
- Department of Skin Knowledge & Women BeautyChanel R & T Pantin France
| | - Lieng Taing
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Toufik Labib
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Cédric Coulonges
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Damien Ulveling
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
| | - Pilar Galan
- Université Paris 13Equipe de Recherche en Epidémiologie Nutritionnelle (EREN)Centre d’Epidemiologie et Biostatistiques Sorbonne Paris Cité (CRESS)Inserm U1153, Inra U1125Cnam, COMUE Sorbonne‐Paris‐Cité Bobigny France
| | - Christiane Guinot
- Computer Science LaboratoryUniversity François Rabelais of Tours Tours France
| | - Leopold Fezeu
- Université Paris 13Equipe de Recherche en Epidémiologie Nutritionnelle (EREN)Centre d’Epidemiologie et Biostatistiques Sorbonne Paris Cité (CRESS)Inserm U1153, Inra U1125Cnam, COMUE Sorbonne‐Paris‐Cité Bobigny France
| | | | - Julie Latreille
- Department of Skin Knowledge & Women BeautyChanel R & T Pantin France
| | - Denis Malvy
- Université Paris 13Equipe de Recherche en Epidémiologie Nutritionnelle (EREN)Centre d’Epidemiologie et Biostatistiques Sorbonne Paris Cité (CRESS)Inserm U1153, Inra U1125Cnam, COMUE Sorbonne‐Paris‐Cité Bobigny France
- Department of Internal Medicine and Tropical DiseasesHôpital Saint‐André Bordeaux France
| | - Erwin Tschachler
- Department of DermatologyUniversity of Vienna Medical School Vienna Austria
| | - Jean‐François Zagury
- Équipe GénomiqueBioinformatique et ApplicationsChaire de BioinformatiqueConservatoire National des Arts et Métiers Paris France
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Andreeva VA, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. A systematic literature review of observational studies of the bidirectional association between metabolic syndrome and migraine. Diabetes Metab 2017; 45:11-18. [PMID: 29336986 DOI: 10.1016/j.diabet.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/24/2017] [Accepted: 12/07/2017] [Indexed: 01/03/2023]
Abstract
AIMS To evaluate all epidemiological evidence in the literature linking the metabolic syndrome (MetS) and migraine in adults. METHODS Database (Medline, Embase; published reports up to November 2017) and manual searches were performed. Information on data collection, sample characteristics, study design, MetS and migraine assessment, and results was extracted from each relevant publication. The methodological quality of each study was also assessed. RESULTS A total of 15 observational epidemiological studies in adults, published between 2009 and 2017, were retrieved. Of these, one employed a prospective design, while the rest had a cross-sectional (13 studies) or case-control (one study) design. Five studies assessed the presence of migraine in individuals with MetS, whereas 10 studies assessed the presence or risk of MetS in migraineurs. Most participants were female hospital outpatients. The sole prospective cohort study reported 11-year MetS incidence of 21.8% in migraineurs with aura, 16.8% in migraineurs without aura and 14.5% in subjects without headaches. Most studies (60%) provided no statistical estimates of association. Methodological flaws included selection biases, lack of power analysis, unsuitable research plans and no multivariable analyses. Meta-analysis was not feasible with the available data. CONCLUSION Our systematic review has identified major gaps in knowledge and weaknesses in research that should provide an impetus for future epidemiological investigations using more rigorous methodology, large general-population prospective cohorts, and substantial data on dietary behaviours and lifestyle.
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Affiliation(s)
- V A Andreeva
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France.
| | - P Galan
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - C Julia
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France; Département de santé publique, Hôpital Avicenne, 93017 Bobigny, France
| | - L Fezeu
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - S Hercberg
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France; Département de santé publique, Hôpital Avicenne, 93017 Bobigny, France
| | - E Kesse-Guyot
- Équipe de recherche en épidémiologie nutritionnelle (EREN), Centre de recherche en épidémiologie et statistiques, SMBH Université Paris 13, Inserm U1153/Inra U1125/Cnam, COMUE-Sorbonne-Paris-Cité, 74, rue Marcel-Cachin, 93017 Bobigny, France
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Andreeva V, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. A systematic literature review of the association between metabolic syndrome and migraine. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- V Andreeva
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
| | - P Galan
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
| | - C Julia
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
| | - L Fezeu
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
| | - S Hercberg
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
| | - E Kesse-Guyot
- Nutritional Epidemiology Group, University of Paris XIII/INSERM U1153/INRA U1125/CNAM, Bobigny, France
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Julia C, Blanchet O, Méjean C, Péneau S, Ducrot P, Allès B, Fezeu L, Touvier M, Kesse-Guyot E, Singler E, Hercberg S. Impact d’un système d’information nutritionnel simplifié sur les achats des consommateurs. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2017.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lécuyer L, Bala AV, Deschasaux M, Bouchemal N, Triba M, Hercberg S, Galan P, Kesse-Guyot E, Latino-Martel P, Fezeu L, Savarin P, Touvier M. Découverte de métabolites prédictifs du risque de cancer du sein : approche métabolomique RMN appliquée à l’épidémiologie nutritionnelle. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2017.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Balde N, Camara A, Sobngwi-Tambekou J, Balti EV, Tchatchoua A, Fezeu L, Limen S, Ngamani S, Ngapout S, Kengne AP, Sobngwi E. Improving access to HbA1c in sub-Saharan Africa (IA3) cohort: cohort profile. Pan Afr Med J 2017; 27:275. [PMID: 29187944 PMCID: PMC5660907 DOI: 10.11604/pamj.2017.27.275.10270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/18/2016] [Indexed: 12/27/2022] Open
Abstract
Introduction Glycated haemoglobin (HbA1c) is the best surrogate of average blood glucose control in diabetic patients, and lowering HbA1c significantly reduces diabetes complications. Moreover, immediate feedback of HbA1c measurement to patients may improve control. However, HbA1c is unavailable in most parts of Africa, a continent with one of the highest burden of diabetes. To translate these evidences, we are conducting a multicentric project in 10 health care facilities in Guinea and Cameroon to evaluate the feasibility and one-year benefit of affordable HbA1c measurement with immediate feedback to patients on diabetes control and related outcomes. Participants We consecutively enrolled patients with diabetes mellitus independently of the type of disease. We hypothesised an average 1%-decrease in HbA1c in a 1000-patient study population, with a 20% increase in the number of patients reaching treatment goals within 12 months of intervention and follow-up. Findings to date A total of 1, 349 diabetic patients aged 56.2±12.6 years are enrolled (813 in Cameroon and 536 in Guinea) of whom 59.8% are women. The mean duration of diabetes is 7.4±6.3 years and baseline HbA1c is 9.7±2.6% in Guinea and 8.6±2.5% in Cameroon. Future plans To investigate whether the introduction of routine HbA1c measurement with immediate feedback to patients and provision of relevant education would improve diabetes control after one year. The impact of the intervention on diabetes associated-complications and mortality warrant further assessment in the long term.
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Affiliation(s)
- Naby Balde
- University Hospital Donka, Conakry, Guinea
| | | | - Joelle Sobngwi-Tambekou
- Catholic University of Central Africa, Yaoundé, Cameroon.,Recherche Santé Développement, Yaoundé, Cameroon
| | - Eric Vounsia Balti
- Recherche Santé Développement, Yaoundé, Cameroon.,Diabetes Research Center, Faculty of Medicine and Pharmacy, Free University of Brussels-VUB, Brussels, Belgium.,Universitair Ziekenhuis Brussel- UZ Brussel, Brussels, Belgium
| | | | | | - Serge Limen
- Recherche Santé Développement, Yaoundé, Cameroon
| | | | | | - Andre Pascal Kengne
- South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Eugene Sobngwi
- Recherche Santé Développement, Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension: Prospective Analysis From the NutriNet-Santé Cohort. Hypertension 2017; 70:712-720. [PMID: 28760943 DOI: 10.1161/hypertensionaha.117.09622] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 05/11/2017] [Accepted: 07/11/2017] [Indexed: 11/16/2022]
Abstract
Dietary intake is pointed as one of the major determinants in hypertension development. Data in the area are mostly obtained from cross-sectional studies. We aimed to investigate the prospective association between (1) individual nutritional factors and (2) adherence to the Dietary Approach to Stop Hypertension and the risk of incident hypertension in a large cohort study. We prospectively examined the incidence of hypertension among 80 426 French adults participating in the NutriNet-Santé cohort study. Self-reported sociodemographic, lifestyle health questionnaires and dietary consumption assessed by three 24-hour records were completed at baseline and yearly thereafter. Associations between quartiles (Q) of nutrients and food groups and adherence to Dietary Approach to Stop Hypertension diet and hypertension risk were assessed by multivariable Cox proportional hazards models. During a mean follow-up of 3.4±2.1 years, 2413 cases of incident hypertension were documented. Dietary intakes of sodium (Q4 versus Q1): hazard ratio (HR)=1.17 (95% confidence interval [CI], 1.02-1.35), potassium: HR=0.82 (95% CI, 0.72-0.94), animal protein: HR=1.26 (95% CI, 1.11-1.43), vegetable protein: HR=0.85 (95% CI, 0.75-0.95), fiber: HR =0.81 (95% CI, 0.71-0.93), magnesium: HR=0.77 (95% CI, 0.67-0.89), fruit and vegetables: HR=0.85 (95% CI, 0.74-0.97), whole grain: HR=0.84(95% CI, 0.76-0.93), nuts: HR=0.72 (95% CI, 0.63-0.83), and red and processed meat: HR=1.25 (95% CI, 1.11-0.42) were associated with risk of hypertension. Besides, adherence to the Dietary Approach to Stop Hypertension was strongly inversely associated with incident hypertension: (Q4 versus Q1) HR=0.66 (95% CI, 0.58-0.75). Our results confirmed the association of several nutritional factors intake and incident hypertension and highlighted that adopting a global healthy diet could strongly contribute to the prevention of hypertension.
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Affiliation(s)
- Helene Lelong
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Jacques Blacher
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.).
| | - Julia Baudry
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Solia Adriouch
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Pilar Galan
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Leopold Fezeu
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Serge Hercberg
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
| | - Emmanuelle Kesse-Guyot
- From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.)
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Fosse-Edorh S, Rigou A, Morin S, Fezeu L, Mandereau-Bruno L, Fagot-Campagna A. [Algorithms based on medico-administrative data in the field of endocrine, nutritional and metabolic diseases, especially diabetes]. Rev Epidemiol Sante Publique 2017. [PMID: 28625707 DOI: 10.1016/j.respe.2017.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Medico-administrative databases represent a very interesting source of information in the field of endocrine, nutritional and metabolic diseases. The objective of this article is to describe the early works of the Redsiam working group in this field. METHODS Algorithms developed in France in the field of diabetes, the treatment of dyslipidemia, precocious puberty, and bariatric surgery based on the National Inter-schema Information System on Health Insurance (SNIIRAM) data were identified and described. RESULTS Three algorithms for identifying people with diabetes are available in France. These algorithms are based either on full insurance coverage for diabetes or on claims of diabetes treatments, or on the combination of these two methods associated with hospitalizations related to diabetes. Each of these algorithms has a different purpose, and the choice should depend on the goal of the study. Algorithms for identifying people treated for dyslipidemia or precocious puberty or who underwent bariatric surgery are also available. CONCLUSION Early work from the Redsiam working group in the field of endocrine, nutritional and metabolic diseases produced an inventory of existing algorithms in France, linked with their goals, together with a presentation of their limitations and advantages, providing useful information for the scientific community. This work will continue with discussions about algorithms on the incidence of diabetes in children, thyroidectomy for thyroid nodules, hypothyroidism, hypoparathyroidism, and amyloidosis.
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Affiliation(s)
- S Fosse-Edorh
- Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
| | - A Rigou
- Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
| | - S Morin
- Haute Autorité de santé, 93210 Saint-Denis, France
| | - L Fezeu
- Inserm (U1153), Inra (U1125), université Paris 13, équipe de recherche en épidémiologie nutritionnelle (EREN), centre de recherche en épidémiologie et statistiques, Cnam, COMUE, Sorbonne Paris Cité, 93000 Bobigny, France
| | - L Mandereau-Bruno
- Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
| | - A Fagot-Campagna
- Caisse nationale d'assurance maladie des travailleurs salariés, 75020 Paris, France
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Adriouch S, Aziz R, Fezeu L. [Nutrition and cardiometabolic diseases]. Rev Prat 2017; 67:329-334. [PMID: 30666861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Numerous published scientific studies in the field of human nutrition suggest, with mixed levels of evidence, that nutrients, foods, and dietary patterns are major determinants of cardiometabolic diseases. In some cases, the convergence of scientific arguments is such that the scientific community have issued in international consensus nutritional recommendations. In other cases, on the contrary, the arguments available do not yet make it possible to affirm the reality of the link between the suspected nutritional factors and cardiometabolic diseases. This article is based on the state-ofthe- art scientific evidence available to enlighten the reader on the components of a beneficial, deleterious or neutral diet on cardiometabolic health.
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Affiliation(s)
- Solia Adriouch
- CRESS Sorbonne - Paris-Cité, équipe de recherche en épidémiologie nutritionnelle, Paris, France
| | - Rabiah Aziz
- CRESS Sorbonne - Paris-Cité, équipe de recherche en épidémiologie nutritionnelle, Paris, France
- Laboratoire d’informatique médicale et d’ingénierie des connaissances en e-santé, Bobigny, France
| | - Leopold Fezeu
- CRESS Sorbonne - Paris-Cité, équipe de recherche en épidémiologie nutritionnelle, Paris, France
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Adriouch S, Julia C, Kesse-Guyot E, Méjean C, Ducrot P, Péneau S, Donnenfeld M, Deschasaux M, Menai M, Hercberg S, Touvier M, Fezeu L. Association prospective entre la qualité nutritionnelle des aliments consommés et le risque de maladies cardiovasculaires. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Donnenfeld M, Julia C, Kesse-Guyot E, Méjean C, Ducrot P, Péneau S, Deschasaux M, Latino-Martel P, Fezeu L, Hercberg S, Touvier M. Association entre le risque de cancer et un score individuel de qualité de l’alimentation basé sur un système de profilage nutritionnel des aliments dans la cohorte SU.VI.MAX. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lassalle M, Fezeu L, Couchoud C, Hannedouche T, Massy Z, Czernichow S. Obésité et accès à la greffe rénale parmi des patients démarrant une dialyse : une étude de cohorte prospective. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lelong H, Blacher J, Menai M, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Association Between Blood Pressure and Adherence to French Dietary Guidelines. Am J Hypertens 2016; 29:948-58. [PMID: 26908464 DOI: 10.1093/ajh/hpw017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/29/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adopting a healthy diet like the Dietary Approach to Stop Hypertension (DASH) or Mediterranean diet (MD) represents a major lifestyle for blood pressure (BP) control in general population. Nutritional policies, such as the French Nutrition and Health Program (Programme National Nutrition Santé or PNNS), have been implemented in several countries with the aims of preventing chronic diseases. The objective of our study was to investigate association between BP and adherence to PNNS guidelines compared with adherence to DASH or MD. METHODS We conducted a cross-sectional study in 11,302 untreated participants from the NutriNet-Santé study, a French web-based cohort study. Three validated scores reflecting adherence to PNNS guidelines, DASH diet, and MD were calculated from repeated 24-hour records. Three BP measurements using a standardized protocol were collected. Multivariate linear models were used to assess the associations between the dietary scores and BP. RESULTS In women, independent of age, socioeconomic status, body mass index, tobacco use, alcohol consumption, and physical activity, adherence to PNNS guidelines was inversely significantly associated with systolic BP (β = -0.63, P < 0.0001). This association was of similar amplitude that between BP and adherence to DASH-style diet (β = -0.66, P < 0.0001) or MD (β = -0.63, P = 0.0002). No significant association was found in men. CONCLUSION Adherence to French nutritional recommendations was found negatively associated with BP at the same magnitude as adherence to well-known dietary pattern in the prevention and treatment of hypertension.
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Affiliation(s)
- Helene Lelong
- Paris-Descartes University, Faculty of Medicine, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France;
| | - Jacques Blacher
- Paris-Descartes University, Faculty of Medicine, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Mehdi Menai
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Pilar Galan
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Leopold Fezeu
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Serge Hercberg
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France; Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
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Balti EV, Akwo EA, Fezeu L, Kengne AP, Sobngwi E, Mbanya JC. Somatostatin analogues, dopamine agonists or growth hormone antagonists for pituitary adenoma-induced acromegaly. Hippokratia 2015. [DOI: 10.1002/14651858.cd008292.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Eric V Balti
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
| | - Elvis A Akwo
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
| | - Leopold Fezeu
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
| | - Andre Pascal Kengne
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
| | - Eugene Sobngwi
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
| | - Jean Claude Mbanya
- University of Yaounde I; National Obesity Centre and HoPiT Research Group, FMSB; PO Box 7535 Yaounde Cameroon
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Kesse-Guyot E, Julia C, Andreeva V, Fezeu L, Hercberg S, Galan P. Evidence of a cumulative effect of cardiometabolic disorders at midlife and subsequent cognitive function. Age Ageing 2015; 44:648-54. [PMID: 25918184 DOI: 10.1093/ageing/afv053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 01/14/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND longitudinal data as regards the link between the cumulative effect of cardiometabolic disorders and cognition are relatively scant and heterogeneous. OBJECTIVE we examined the cross-time associations of MetS status with cognitive performance in ageing adults. DESIGN AND METHODS using data from the French SU.VI.MAX cohort, we studied 2,788 adults. The presence of abdominal obesity, hyperglycaemia, dyslipidaemia and elevated blood pressure was clinically evaluated in 1994-96. Cognitive performance was assessed after a mean of 13 years via a battery of six validated instruments. The standardised individual test scores were summed up to provide a composite cognitive performance measure; principal component analysis was performed to define performance scores on verbal memory and executive functioning. Associations between MetS and subsequent cognitive performance were examined via ANCOVA, providing estimates of mean difference and corresponding 95% confidence intervals (CI). RESULTS MetS status at midlife was not associated with subsequent cognitive function. However, a 1-unit increase in the number of cardiometabolic disorders present was associated with a decrease in the composite cognitive score (mean difference = -0.36; 95% CI: -0.68, -0.05). Significant associations were also found with several cardiometabolic disorders (hyperglycaemia, central obesity and dyslipidaemia) and specific cognitive domains. CONCLUSION this study supports the existence of a cross-time, cumulative effect of cardiometabolic disorders present at midlife and subsequent cognitive performance. Given the worldwide population ageing and the increase in MetS prevalence, there is an urgent need for recommendations as regards cognitive ageing.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
| | - Chantal Julia
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
| | - Valentina Andreeva
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
| | - Leopold Fezeu
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
| | - Serge Hercberg
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
| | - Pilar Galan
- Université Paris 13, Sorbonne Paris Cité, Research Unit on Nutritional Epidemiology, U1153 Inserm/Inra/Cnam/Universite Paris 13, Centre de Recherche en Epidemiologies et Biostatistiques Sorbonne Paris Cite, UFR SMBH, 74, rue Marcel Cachin, Bobigny Cedex 93017, France
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Lelong H, Galan P, Kesse-Guyot E, Fezeu L, Hercberg S, Blacher J. Relationship between nutrition and blood pressure: a cross-sectional analysis from the NutriNet-Santé Study, a French web-based cohort study. Am J Hypertens 2015; 28:362-71. [PMID: 25189870 DOI: 10.1093/ajh/hpu164] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hypertension is the most prevalent chronic disease worldwide. Lifestyle behaviors for its prevention and control are recommended within worldwide guidelines. Nevertheless, their combined relationship with blood pressure (BP) level, particularly in the general population, would need more investigations. Our aim in this study was to evaluate the relative impact of lifestyle and nutritional factors on BP level. METHODS Cross-sectional analyses were performed using data from 8,670 volunteers from the NutriNet-Santé Study, an ongoing French web-based cohort study. Dietary intakes were assessed using three 24-hour records. Information on lifestyle factors was collected using questionnaires and 3 BP measurements following a standardized protocol. Age-adjusted associations and then multivariate associations between systolic BP (SBP) and lifestyle behaviors were estimated using multiple linear regressions. RESULTS SBP was higher in participants with elevated body mass indices (BMIs). Salt intake was positively associated with SBP in men but not in women. The negative relationship between consumption of fruits and vegetables and SBP was significant in both sexes. Alcohol intake was positively associated with SBP in both sexes; physical activity was not. The 5 parameters representing the well-accepted modifiable factors for hypertension reduction plus age and education level, accounted for 19.7% of the SBP variance in women and 12.8% in men. Considering their squared partial correlation coefficient, age and BMI were the most important parameters relating to SBP level. Salt intake was not associated with SBP in either sex after multiple adjustments. CONCLUSIONS BMI was the main contributory modifiable factor of BP level after multiple adjustments.
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Affiliation(s)
- Helene Lelong
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; Assistance Publique-Hopitaux de Paris; Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Pilar Galan
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Leopold Fezeu
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Serge Hercberg
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France; Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Jacques Blacher
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; Assistance Publique-Hopitaux de Paris; Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France;
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Ducrot P, Méjean C, Julia C, Touvier M, Kesse-Guyot E, Fezeu L, Hercberg S, Péneau S. P224: Compréhension objective vis-à-vis de différents systèmes d’information nutritionnelle simplifiés sur la face avant des emballages des aliments : étude NutriNet-Santé. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70866-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Montlahuc C, Julia C, Touvier M, Fezeu L, Hercberg S, Kesse-Guyot E, Chevret S. Impact de la consommation alimentaire de polyphénols sur un marqueur biologique du stress oxydatif : l’étude SU.VI.MAX. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Julia C, Czernichow S, Charnaux N, Ahluwalia N, Andreeva V, Touvier M, Galan P, Fezeu L. Relationships between adipokines, biomarkers of endothelial function and inflammation and risk of type 2 diabetes. Diabetes Res Clin Pract 2014; 105:231-8. [PMID: 24931702 DOI: 10.1016/j.diabres.2014.05.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/14/2014] [Accepted: 05/12/2014] [Indexed: 12/17/2022]
Abstract
AIMS Identification of novel biomarkers of diabetes risk help to understand mechanisms of pathogenesis and improve risk prediction. Our objectives were to examine the relationships between adipokines, biomarkers of inflammation and endothelial function and development of type 2 diabetes; and to assess the relevance of including these biomarkers in type 2 diabetes prediction risk models. METHODS 1345 subjects from the SU.VI.MAX study, who were free of diabetes at baseline and who completed 13 years of follow-up were included in the present analyses. Odds ratios (OR) with 95% confidence intervals (95% CI) of incident type 2 diabetes associated with a 1-SD increase in adiponectin, leptin, C-reactive protein (CRP), soluble intracellular adhesion modecule-1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), E-selectin and monocyte chemoattractant protein-1 (MCP-1) were estimated. Predicitive performances of models including biomarkers were assessed with area under the receiver operating curves (AUC) and integrated discrimination improvement (IDI) statistics. RESULTS 82 subjects developed type 2 diabetes during follow-up. The risk of developing type 2 diabetes increased with increasing concentrations of leptin (2.04 (1.28;3.26)), sICAM-1 (1.39 (1.08;1.78)) and sVCAM-1 (1.29 (1.01;1.64)). Type 2 diabetes associations with leptin remained significant after adjusting for a combination of biomarkers. Models adjusted for novel biomarkers had improved performance compared to models adjusted for classical risk factors as assessed by IDI, but not by AUC. CONCLUSIONS Adipokines, biomarkers of inflammation and endothelial function were significantly associated to onset of type 2 diabetes. However their inclusion in predictive scores is not supported by the present study.
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Affiliation(s)
- C Julia
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France; Département de Santé Publique, Hôpital Avicenne (AP-HP); Université Paris 13, Bobigny, France.
| | - S Czernichow
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France; Université Versailles St-Quentin, Boulogne-Billancourt, France; APHP, Hôpital Ambroise Paré, Service de Nutrition, Boulogne-Billancourt, France
| | - N Charnaux
- Department of Biochemistry, Jean-Verdier Hospital (AP-HP), Bondy, France
| | - N Ahluwalia
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France
| | - V Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France
| | - M Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France
| | - P Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France
| | - L Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité (CRESS) U1153 Inserm; U1125, Inra; Cnam; Université Paris 13, Université Paris 7, Uniersité Paris 5, Bobigny, France
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Fezeu L, Bankir L, Hansel B, Guerrot D. Differential circadian pattern of water and Na excretion rates in the metabolic syndrome. Chronobiol Int 2014; 31:861-7. [DOI: 10.3109/07420528.2014.917090] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rothwell JA, Fillâtre Y, Martin JF, Lyan B, Pujos-Guillot E, Fezeu L, Hercberg S, Comte B, Galan P, Touvier M, Manach C. New biomarkers of coffee consumption identified by the non-targeted metabolomic profiling of cohort study subjects. PLoS One 2014; 9:e93474. [PMID: 24713823 PMCID: PMC3979684 DOI: 10.1371/journal.pone.0093474] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 03/04/2014] [Indexed: 11/23/2022] Open
Abstract
Coffee contains various bioactives implicated with human health and disease risk. To accurately assess the effects of overall consumption upon health and disease, individual intake must be measured in large epidemiological studies. Metabolomics has emerged as a powerful approach to discover biomarkers of intake for a large range of foods. Here we report the profiling of the urinary metabolome of cohort study subjects to search for new biomarkers of coffee intake. Using repeated 24-hour dietary records and a food frequency questionnaire, 20 high coffee consumers (183–540 mL/d) and 19 low consumers were selected from the French SU.VI.MAX2 cohort. Morning spot urine samples from each subject were profiled by high-resolution mass spectrometry. Partial least-square discriminant analysis of multidimensional liquid chromatography-mass spectrometry data clearly distinguished high consumers from low via 132 significant (p-value<0.05) discriminating features. Ion clusters whose intensities were most elevated in the high consumers were annotated using online and in-house databases and their identities checked using commercial standards and MS-MS fragmentation. The best discriminants, and thus potential markers of coffee consumption, were the glucuronide of the diterpenoid atractyligenin, the diketopiperazine cyclo(isoleucyl-prolyl), and the alkaloid trigonelline. Some caffeine metabolites, such as 1-methylxanthine, were also among the discriminants, however caffeine may be consumed from other sources and its metabolism is subject to inter-individual variation. Receiver operating characteristics curve analysis showed that the biomarkers identified could be used effectively in combination for increased sensitivity and specificity. Once validated in other cohorts or intervention studies, these specific single or combined biomarkers will become a valuable alternative to assessment of coffee intake by dietary survey and finally lead to a better understanding of the health implications of coffee consumption.
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Affiliation(s)
- Joseph A. Rothwell
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Clermont University, Human Nutrition Unit, Clermont-Ferrand, France
| | - Yoann Fillâtre
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Clermont University, Human Nutrition Unit, Clermont-Ferrand, France
| | - Jean-François Martin
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- INRA, Plateforme d'Exploration du Métabolisme, Clermont-Ferrand, France
| | - Bernard Lyan
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- INRA, Plateforme d'Exploration du Métabolisme, Clermont-Ferrand, France
| | - Estelle Pujos-Guillot
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- INRA, Plateforme d'Exploration du Métabolisme, Clermont-Ferrand, France
| | - Leopold Fezeu
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Research Center, INSERM U1153, INRA U1125, CNAM, Paris 5 University, Paris 7 University, Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Research Center, INSERM U1153, INRA U1125, CNAM, Paris 5 University, Paris 7 University, Bobigny, France
| | - Blandine Comte
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Clermont University, Human Nutrition Unit, Clermont-Ferrand, France
| | - Pilar Galan
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Research Center, INSERM U1153, INRA U1125, CNAM, Paris 5 University, Paris 7 University, Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Research Center, INSERM U1153, INRA U1125, CNAM, Paris 5 University, Paris 7 University, Bobigny, France
| | - Claudine Manach
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Clermont University, Human Nutrition Unit, Clermont-Ferrand, France
- * E-mail:
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Touvier M, Deschasaux M, Montourcy M, Sutton A, Charnaux N, Kesse-Guyot E, Fezeu L, Latino-Martel P, Druesne-Pecollo N, Guinot C, Malvy D, Latreille J, Galan P, Hercberg S, Souberbielle J, Ezzedine K. Déterminants du taux de vitamine D plasmatique : données épidémiologiques et enjeux en 2013 en France. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lassale C, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. P019 Adéquation aux recommandations nutritionnelles, adiposité et santé cardiométabolique : étude NutriNet-Santé, France. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70352-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lekoubou A, Kengne AP, Fezeu L, Mbanya JC. Determinants of active convulsive epilepsy in rural Cameroon: a population based case–control study. Neurol Res 2013; 34:159-62. [DOI: 10.1179/1743132811y.0000000075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Alain Lekoubou
- Neurological and Neurosurgical Hospital and Claude Bernard UniversityLyon, France
| | - André Pascal Kengne
- South African Medical Research Council and University of Cape Town, South Africa
| | - Leopold Fezeu
- Department of Nutritional EpidemiologyFrench Institute of Health and Medical Research, Bobigny, France
| | - Jean Claude Mbanya
- Department of Internal Medicine and SpecialitiesFaculty of Medicine and Biomedical, Sciences, University of Yaounde, Cameroon
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Lassale C, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. Association between adherence to nutritional guidelines, the metabolic syndrome and adiposity markers in a French adult general population. PLoS One 2013; 8:e76349. [PMID: 24124548 PMCID: PMC3790685 DOI: 10.1371/journal.pone.0076349] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/22/2013] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Few studies have focused on the association between diet quality scores and the Metabolic Syndrome (MetS), a multi-component condition predictive of cardiovascular diseases (CVD) and death. The present study aims at investigating, in a cross-sectional design, the association between adherence to the French dietary guidelines through an a priori score - the French Nutrition and Health Program-Guideline Score (PNNS-GS) - and cardiovascular risk factors (CVRF) including the MetS and adiposity markers. METHODS 7902 French adults participating in the NutriNet-Santé study (an on-going web-based cohort study) attended a clinical and biological examination between January 2011 and November 2012: a fasting blood sample was drawn, blood pressure and body composition (bio-impedance) were measured. Multivariate linear and logistic regression models were used to assess the association between PNNS-GS and CVRF or the MetS. RESULTS An increase of PNNS-GS was significantly negatively associated with waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP) and serum triglycerides concentrations. From bottom to top quartile of PNNS-GS, SBP decreased from 129.9 to 128.8 mm Hg, DBP from 76.7 to 75.9 mm Hg, serum triglycerides concentrations from 110.8 to 104.6 mg/dL and WC from 94.8 to 90.1 cm for men and 81.3 to 78.9 cm for women. All adiposity markers (waist and hip circumference, % body fat, % trunk fat, % leg fat) were markedly reduced across quartiles of PNNS-GS and linearly. Individuals with a better PNNS-GS (quartile 4 vs quartile 1) were less likely to have the MetS (OR=0.71, 95% CI: 0.56-0.89). CONCLUSION The negative association between a higher adherence to the French dietary guidelines and a number of CVRF, the MetS prevalence and regional adiposity supports the importance of promoting the PNNS dietary guidelines in the population for the prevention of cardiometabolic abnormalities and hence, cardiovascular diseases.
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Affiliation(s)
- Camille Lassale
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
| | - Pilar Galan
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
| | - Chantal Julia
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
- Public Health Department, Hôpital Avicenne, Université Paris 13, Bobigny, France
| | - Leopold Fezeu
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
| | - Serge Hercberg
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
- Public Health Department, Hôpital Avicenne, Université Paris 13, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Paris 13, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U557), INRA (U1125), CNAM, Bobigny, France
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Kesse-Guyot E, Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovasc Dis 2013; 23:677-683. [PMID: 22633793 DOI: 10.1016/j.numecd.2012.02.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 02/14/2012] [Accepted: 02/14/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Benefits of Mediterranean diet on MetS risk have been suggested, but overall prospective evidence in the general population is limited. For the first time, the prospective association of adherence to Mediterranean diet with the 6-y risk of MetS and its components was evaluated in a large cohort in Europe. METHODS AND RESULTS Subjects included were participants from the Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) study. Adherence to Mediterranean diet was assessed using traditional Mediterranean diet score (MDS), an updated Mediterranean score (MED) and Mediterranean style-dietary pattern score (MSDPS) calculated from at least three 24-h records. In 3232 subjects, the association between Mediterranean diet scores and 6-y risk of MetS was evaluated. The association between Mediterranean scores and MetS components was also estimated. A lower risk of MetS was observed with increasing MED score (P-trend = 0.001) and MDS (P-trend = 0.03) in multivariate models. The adjusted odds ratios (95% Confidence Interval) for MetS risk were 0.47 (0.32-0.69) and 0.50 (0.32-0.77) in subjects in the highest versus lowest tertile of MED score and MDS, respectively. The MED score was inversely associated with waist circumference, systolic blood pressure and triglycerides, and directly associated with HDL-cholesterol. The MDS was negatively associated with waist circumference and triglycerides, and MSDPS was positively associated with HDL-cholesterol. CONCLUSIONS All Mediterranean diet scores were associated in a potentially beneficial direction with components of MetS or MetS incidence. Our findings support that individuals should be encouraged to follow a Mediterranean dietary pattern for reduction of MetS risk.
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Affiliation(s)
- E Kesse-Guyot
- UREN (Nutritional Epidemiology Research Unit), UMR U557 Inserm, U1125 INRA, CNAM, Paris 13, SMBH, 74 rue Marcel Cachin, F-93017 Bobigny, France.
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Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, Van Wely M, Cao J, Martini AC, Eskandar M, Chavarro JE, Koloszar S, Twigt JM, Ramlau-Hansen CH, Borges E, Lotti F, Steegers-Theunissen RPM, Zorn B, Polotsky AJ, La Vignera S, Eskenazi B, Tremellen K, Magnusdottir EV, Fejes I, Hercberg S, Lévy R, Czernichow S. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Update 2012; 19:221-31. [PMID: 23242914 DOI: 10.1093/humupd/dms050] [Citation(s) in RCA: 371] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The global obesity epidemic has paralleled a decrease in semen quality. Yet, the association between obesity and sperm parameters remains controversial. The purpose of this report was to update the evidence on the association between BMI and sperm count through a systematic review with meta-analysis. METHODS A systematic review of available literature (with no language restriction) was performed to investigate the impact of BMI on sperm count. Relevant studies published until June 2012 were identified from a Pubmed and EMBASE search. We also included unpublished data (n = 717 men) obtained from the Infertility Center of Bondy, France. Abstracts of relevant articles were examined and studies that could be included in this review were retrieved. Authors of relevant studies for the meta-analysis were contacted by email and asked to provide standardized data. RESULTS A total of 21 studies were included in the meta-analysis, resulting in a sample of 13 077 men from the general population and attending fertility clinics. Data were stratified according to the total sperm count as normozoospermia, oligozoospermia and azoospermia. Standardized weighted mean differences in sperm concentration did not differ significantly across BMI categories. There was a J-shaped relationship between BMI categories and risk of oligozoospermia or azoospermia. Compared with men of normal weight, the odds ratio (95% confidence interval) for oligozoospermia or azoospermia was 1.15 (0.93-1.43) for underweight, 1.11 (1.01-1.21) for overweight, 1.28 (1.06-1.55) for obese and 2.04 (1.59-2.62) for morbidly obese men. CONCLUSIONS Overweight and obesity were associated with an increased prevalence of azoospermia or oligozoospermia. The main limitation of this report is that studied populations varied, with men recruited from both the general population and infertile couples. Whether weight normalization could improve sperm parameters should be evaluated further.
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Affiliation(s)
- N Sermondade
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Hôpital Jean Verdier (AP-HP), Bondy, France
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Ekali LG, Johnstone LK, Echouffo-Tcheugui JB, Kouanfack C, Dehayem MY, Fezeu L, Nouthe B, Hayes L, Unwin NC, Sobngwi E. Fasting blood glucose and insulin sensitivity are unaffected by HAART duration in Cameroonians receiving first-line antiretroviral treatment. Diabetes Metab 2012; 39:71-7. [PMID: 23153435 DOI: 10.1016/j.diabet.2012.08.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 08/20/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
Abstract
AIMS This study assessed the relationship between highly active antiretroviral therapy (HAART) duration and cardiometabolic disorders in HIV-infected Cameroonians. METHODS HIV-infected Cameroonians aged 21 years or above were cross-sectionally recruited at the Yaoundé Central Hospital, a certified HIV care centre, and their anthropometry, body composition (impedancemetry), fasting blood glucose (FBG) and lipid levels, and insulin sensitivity (IS; short insulin tolerance test) were measured. RESULTS A total of 143 participants with various durations of HAART [treatment-naïve (n=28), 1-13 months (n=44), 14-33 months (n=35) and 34-86 months (n=36)] were recruited. They were mostly women (72%), and had a mean age of 39.5 (SD: 9.8) years. Half (52%) were using a stavudine-containing regimen. There was a significant trend towards a positive change in body mass index and waist-to-hip ratio with increasing duration of HAART (all P=0.02). Systolic (P=0.04) and diastolic (P=0.03) blood pressure, total cholesterol (P=0.01), prevalence of hypertension (P=0.04) and hypercholesterolaemia (P=0.007) were also significantly increased with HAART duration, whereas triglycerides, FBG and IS were unaffected. Clustering of metabolic disorders increased (P=0.02 for ≥1 component of the metabolic syndrome and P=0.09 for ≥2 components) with HAART duration. CONCLUSION HAART duration is associated with obesity, fat distribution, blood pressure and cholesterol levels in HIV-infected Cameroonians, but does not appear to significantly affect glucose metabolism.
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Affiliation(s)
- L G Ekali
- Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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An JN, Lee JP, Oh YK, Lim CS, Shoaf S, Bricmont P, Mallikaarjun S, Volpini RA, De Braganca AC, Canale D, Goncalves JG, Brandao TPB, Andrade L, Seguro AC, Shimizu MHM, Lee J, Joo KW, Oh YK, Jung YC, Earm JH, Han JS, Poch E, Burst V, Greenberg A, Makin A, Chase S, Walther B, Blom RE, Van Dijken GD, Hene RJ, Yu-Bao W, Valerie L, Thomas E, Arvid M, Alain D, Pierre-Yves M, Feraille E, Tovbin D, Avnon L, Bloch D, Zlotnik M, Abdelkadir A, Storch S, Fezeu L, Bankir L, Hansel B, Guerrot D, Anzai N, Jutabha P, Tolle M, Jankowski V, Kretschmer A, Santos RAS, Zidek W, Jankowski J, Bader M, Bourderioux M, Ida Chiara G, Thao NK, Ludovic J, Cerina C, Gabrielle P, Bertrand K, Estelle E, Bernard E, Aleksander E, Picard N, Loffing J. Acid-base / Electrolytes. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D, Kesse-Guyot E. Adherence to Mediterranean diet assessed using various a priori scores is associated with reduced 6‐y risk of metabolic syndrome (MetS) in French adults. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.1006.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Camille Lassale
- Faculty of MedicineUniversity of Paris13INSERM U557BobignyFrance
| | - Serge Hercberg
- Faculty of MedicineUniversity of Paris13INSERM U557BobignyFrance
| | - Leopold Fezeu
- Faculty of MedicineUniversity of Paris13INSERM U557BobignyFrance
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Kesse-Guyot E, Fezeu L, Andreeva V, Touvier M, Scalbert A, Hercberg S, Galan P. P020 Association à long terme entre les apports en polyphénols totaux et spécifiques et les performances cognitives : résultats de l’étude SU.VI.MAX 2. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70088-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Fezeu L, Julia C, Henegar A, Bitu J, Hu FB, Grobbee DE, Kengne AP, Hercberg S, Czernichow S. Obesity is associated with higher risk of intensive care unit admission and death in influenza A (H1N1) patients: a systematic review and meta-analysis. Obes Rev 2011; 12:653-9. [PMID: 21457180 DOI: 10.1111/j.1467-789x.2011.00864.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this study was to assess the association between obesity and the risk of intensive care unit (ICU) admission and death among patients hospitalized for influenza A (H1N1) viral infection. A systematic review of the Medline and Cochrane databases using 'obesity', 'hospitalization', 'influenza A viral infection', various synonyms, and reference lists of retrieved articles from January 2009 to January 2010. Studies comparing the prevalence of obesity among patients with confirmed infection for influenza A virus and who were either hospitalized or admitted to ICU/died were included. A total of 3059 subjects from six cross-sectional studies, who were hospitalized for influenza A (H1N1) viral infection, were included in this meta-analysis. Severely obese H1N1 patients (body mass index ≥ 40 kg m(-2), n = 804) were as twice as likely to be admitted to ICU or die (odds ration: 2.01, 95% confidence interval: 1.29-3.14, P < 0.002) compared with H1N1 patients who were not severely obese. Having a body mass index ≥ 30 kg m(-2) was similarly associated with a more than twofold increased risk of ICU admission or death although this did not reach statistical significance (2.14, 0.92-4.99, P < 0.07). This meta-analysis supports the view that obesity is associated with higher risks of ICU admission or death in patients with influenza A (H1N1) infection. Therefore, morbid obese patients should be monitored more intensively when hospitalized.
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Affiliation(s)
- L Fezeu
- Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
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Abstract
BACKGROUND A good knowledge about diabetes could lead to early diagnosis and improved management. OBJECTIVE To evaluate the level of diabetes awareness in Cameroonians, and to identify factors that influence this awareness. METHODS In subjects aged ≥ 25 years (n=1000, 93.4% of response), details regarding risk factors, symptoms, treatment and complications of type 2 diabetes were collected. One mark was attributed to each true answer and a global diabetes awareness score was computed. Influence of age, gender, educational level, occupational level, notion of a relative having a chronic condition and presence of chronic disease were analyzed. RESULTS Eighty percent of subjects scored more than the total mean score. The highest score obtained by participants (0.10%) was 28/30. The mean total score was higher in men (p < 0.02) and in subjects with a relative having a chronic condition (p < 0.001). In multivariate analyses, age classes (p < 0.01), educational level (p < 0.001) and relatives with a chronic condition (p < 0.001) were associated to the global diabetes awareness score. CONCLUSIONS Diabetes awareness was generally good. This may be due to the fact that the study was conducted in an area where health promotion and health education on diabetes have been intensively delivered for the past 4 years.
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Affiliation(s)
- Leopold Fezeu
- Health of Populations in Transition Research Group, Cameroon, France.
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Fezeu L, Henegar A, Kesse-Guyot E, Julia C, Galan P, Hercberg S, Ristow M, Czernichow S. Physical activity does not influence the effect of antioxidant supplementation at nutritional doses on the incidence of impaired fasting glucose: a 7.5 year post-hoc analysis from the SU.VI.MAX study. Horm Metab Res 2010; 42:826-7. [PMID: 20665424 DOI: 10.1055/s-0030-1261953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Supplementation with high doses of antioxidant vitamins prevents the insulin-sensitizing effects of physical exercise. However, little is known whether antioxidant supplementation affects the incidence of impaired fasting glucose (IFG). Data from 8938 subjects included in a randomized controlled trial on supplementation with antioxidants vitamins and trace elements at nutritional doses (SU.VI.MAX) were used to examine the effects of antioxidants on incident IFG after 7.5 years of follow-up, with and without stratification for daily physical exercise. The odds-ratio (95% CI) for developing an IFG among study participants receiving antioxidant supplementation was 1.34 (0.90-1.97) (p=0.33), in comparison to placebo. This risk did not vary significantly according to physical activity level (p for homogeneity=0.10). Supplementation with trace elements and antioxidants at nutritional doses apparently does not affect the incidence of IFG irrespective of self-reported physical exercise habits.
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Affiliation(s)
- L Fezeu
- Unité de Recherche en Epidémiologie Nutritionnelle-UMR U557 INSERM, U1125 INRA, CNAM, Université Paris 13, CRNH-IdF, Bobigny, France
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Mbeh GN, Edwards R, Ngufor G, Assah F, Fezeu L, Mbanya JC. Traditional healers and diabetes: results from a pilot project to train traditional healers to provide health education and appropriate health care practices for diabetes patients in Cameroon. Glob Health Promot 2010; 17:17-26. [PMID: 20595335 DOI: 10.1177/1757975910363925] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In resource-limited countries where the challenge of diabetes management is especially severe, there has been a recent call for the inclusion of traditional healers in the fight against diabetes. In response, some researchers have highlighted the dangers of incorporating traditional healers while others, have presented them as a potential asset to the health care system if well trained and guided. We report here on a pilot intervention to include traditional healers in the health promotion and prevention efforts for diabetes in Cameroon, as part of the Cameroon Burden of Diabetes (CAMBoD) project. We trained 106 healers in a range of topics and practices relating to diabetes prevention and care. Eight months later we carried out a field evaluation of 36 of them using in-depth semi-structured interviews and direct observation methods to find out if they remembered and applied the learning from the training. Most healers recalled and were applying some of the lessons learnt, including referral of patients for blood glucose tests at biomedical health facilities, desisting from scarifying patients with diabetes, and educating their patients, peers and other people in their communities about diabetes. Healers were enthusiastic about collaboration with the diabetes control program, though some wanted additional responsibilities. We conclude that healers could learn prevention strategies of diabetes relatively rapidly and collaborate in health promotion.
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Affiliation(s)
- George N Mbeh
- Health of Populations in Transition Yaounde, Cameroon.
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Kengne AP, Djouogo CFT, Dehayem MY, Fezeu L, Sobngwi E, Lekoubou A, Mbanya JC. Admission trends over 8 years for diabetic foot ulceration in a specialized diabetes unit in cameroon. INT J LOW EXTR WOUND 2010; 8:180-6. [PMID: 19934180 DOI: 10.1177/1534734609349704] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High rates of foot complications have been reported in people with diabetes in sub-Saharan Africa (SSA). However, there is a paucity of data in support of the changing pattern with time. We report here data on trends in hospitalization for foot ulceration over an 8-year consecutive period in a specialized diabetes unit in SSA. Admission and discharge registers of the diabetes and endocrine unit of the Yaounde Central hospital, Cameroon, were reviewed for the period 2000 through 2007. Data were collected on the status for diabetes, presence of foot ulcer, age, sex, duration of hospitalization, amputation, and deaths.We found that 1841 patients with diabetes were admitted during the study period. The prevalence of foot ulceration was 13% (95% confidence interval [CI] = 11%-15%) and varied significantly by year of study (P = .001). The mean duration of hospitalization significantly decreased with time. Foot ulcer was associated with 115% (95% CI = 87%-148%) more bed use than other conditions in diabetes. Foot ulcer was associated with a nonsignificantly lower risk of death or dropout, with evidence of some attenuation with time. With one exception, the amputation rate of 16% (95% CI = 11%-20%) was similar across years. Foot ulcer is a major cause of hospital admission and bed use for diabetes in Cameroon.
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Affiliation(s)
- Andre Pascal Kengne
- The George Institute for International Health, The University of Sydney, Australia.
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Kengne AP, Sobngwi E, Fezeu L, Awah P, Dongmo S, Mbanya JC. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa. Pan Afr Med J 2010. [DOI: 10.4314/pamj.v3i1.52449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fezeu L, Balkau B, Sobngwi E, Kengne AP, Vol S, Ducimetiere P, Mbanya JC. Waist circumference and obesity-related abnormalities in French and Cameroonian adults: the role of urbanization and ethnicity. Int J Obes (Lond) 2010; 34:446-53. [PMID: 20065972 PMCID: PMC2941697 DOI: 10.1038/ijo.2009.256] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the effect of urbanization and ethnicity on correlations between waist circumference (WC) and obesity-related cardiovascular risk factors. METHODS 1471 rural and urban Cameroonians, and 4185 French, from community-based studies, aged > or =25 years, not treated for hypertension, diabetes and dyslipidemia participated in this study. Slopes of obesity-related abnormalities with WC were compared using an interaction term between place of residence and WC. RESULTS Women in urban Cameroon and men in France had significantly higher WC and BMI relative to their gender counterparts. Urban Cameroonians had higher abdominal adiposity, but lower BP and better metabolic profile than the French. WC was positively associated to all the obesity-related abnormalities in the three sites except to FPG (both genders) and blood lipids (women) in rural Cameroon. A 5 cm larger WC was associated with a higher increment among urban than rural Cameroonians for diastolic blood pressure (DBP) (women, 1.95/0.63 mm Hg; men, 2.56/1.44 mm Hg), HOMA-IR (women, 0.11/0.05), fasting plasma glucose (FPG) (men, 0.09/-0.01 mmol/l) and triglycerides (women, 0.06/0.01 mmol/l; men, 0.09/0.03 mmol/l), all P<0.05. A 5 cm larger WC was associated with a higher increment among urban Cameroon than French people for DBP (women, 1.95/1.28 mm Hg, P<0.01; men, 2.56/1.49 mm Hg, P<0.01), but with a lower increment for HOMA-IR (women, 0.11/0.14, P<0.05), FPG (women, 0.05/0.09 mmol/l), total cholesterol (women, 0.07/0.11 mmol/l; men, 0.10/0.13 mmol/l) and triglycerides (women, 0.06/0.11 mmol/l; men, 0.09/0.13 mmol/l) all P<0.05. CONCLUSION Ethnicity and urbanization modify the association of WC with obesity-related metabolic abnormalities. WC cutoff points derived from Caucasians may not be appropriate for black Sub-Saharan Africans.
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Affiliation(s)
- L Fezeu
- INSERM U780-IFR69, Epidemiological and Biostatistical Research, Villejuif, France.
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Lekoubou A, Awah P, Fezeu L, Sobngwi E, Kengne AP. Hypertension, diabetes mellitus and task shifting in their management in sub-Saharan Africa. Int J Environ Res Public Health 2010; 7:353-63. [PMID: 20616978 DOI: 10.3390/ijerph7020353] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 01/23/2010] [Indexed: 12/18/2022]
Abstract
Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA). The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension and diabetes mellitus.
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Affiliation(s)
- Alain Lekoubou
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon.
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49
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Kengne AP, Sobngwi E, Fezeu L, Awah PK, Dongmo S, Mbanya JC. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa. Pan Afr Med J 2009; 3:10. [PMID: 21532719 PMCID: PMC2984281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 10/11/2009] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon. METHODS The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country's circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available. RESULTS Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics. CONCLUSION In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care.
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Affiliation(s)
- Andre Pascal Kengne
- Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon,
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The George Institute for International Health, The University of Sydney, Australia,
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Corresponding author: Cardiovascular division, The George Institute for International Health, PO Box M201, Sydney, Australia, Phone/Fax +612 99934597/99934502.
| | - Eugene Sobngwi
- Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon,
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Institute of Health and Society, Medical School, Newcastle University,
| | - Leopold Fezeu
- Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon,
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Epidemiologic and Biostatistics Research Unit, Inserm Unit 780, Villejuif, France,
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University of Paris XI, Kremlin Bicêtre, France,
| | - Paschal Kum Awah
- Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon,
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Department of Anthropology, Faculty of Arts, Letters and Social Sciences, University of Yaoundé I, Cameroon,
| | | | - Jean-Claude Mbanya
- Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon,
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Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon.
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Fezeu L, Kengne AP, Balkau B, Awah PK, Mbanya JC. Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon. J Epidemiol Community Health 2009; 64:360-5. [PMID: 19692732 DOI: 10.1136/jech.2008.086355] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hypertension is becoming increasingly important in sub-Saharan Africa. However, evidences in support of this trend with time are still not available. The aim of this study was to evaluate the 10-year change in blood pressure levels and prevalence of hypertension in rural and urban Cameroon. METHODS Two cross-sectional population-based surveys in Yaounde (urban area) and Evodoula (rural area) in 1994 (1762 subjects) and 2003 (1398 subjects) used similar methodologies in women and men aged >or=24 years. Data on systolic and diastolic blood pressures (SBP and DBP), body mass index, educational level, alcohol consumption and tobacco smoking were collected during the two periods. RESULTS Between 1994 and 2003, blood pressure levels significantly increased in rural women (SBP, +18.2 mm Hg; DBP, +11.9 mm Hg) and men (SBP, +18.8 mm Hg; DBP, +11.6 mm Hg), all p<0.001. In the urban area, SBP increased in women (+8.1 mm Hg, p<0.001) and men (+6.5 mm Hg, p<0.001), and DBP increased only in women (+3.3 mm Hg, p<0.001). The OR (95% CI) adjusted on confounders comparing the prevalence of hypertension (blood pressure >or= 140/90 mm Hg and/or treatment) between 2003 and 1994 ranged from 1.5 (1.1 to 2.2) in urban men to 5.3 (3.2 to 8.9) in rural men. CONCLUSION Blood pressure levels of this population have deteriorated over time, and the prevalence of hypertension has increased by twofold to fivefold. Adverse effects of risk factors could account for some of these changes. Prevention and control programmes are needed to reverse these trends and to avoid the looming complications.
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Affiliation(s)
- L Fezeu
- George Institute for International Health, Level 10, KGV Building, Missenden Road, Camperdown, 2050 NSW, Australia
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