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Delgado Y, Gaytan C, Perez N, Miranda E, Morales BC, Santos M. Association of congenital heart defects (CHD) with factors related to maternal health and pregnancy in newborns in Puerto Rico. CONGENIT HEART DIS 2024; 19:19-31. [PMID: 38912385 PMCID: PMC11192526 DOI: 10.32604/chd.2024.046339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/09/2024] [Indexed: 06/25/2024]
Abstract
Background Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States, there is a compelling need to investigate the intricate interplay among BMI, pregestational, and gestational maternal diabetes, and their potential impact on the occurrence of congenital heart defects (CHD) during neonatal development. Methods Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico, we conducted a focused analysis on neonates diagnosed with CHD between 2016 and 2020. Our assessment encompassed a range of variables, including maternal age, gestational age, BMI, pregestational diabetes, gestational diabetes, hypertension, history of abortion, and presence of preeclampsia. Results A cohort of 673 patients was included in our study. The average maternal age was 26 years, within a range of 22 to 32 years. The mean gestational age measured 39 weeks, with a median span of 38 to 39 weeks. Of the 673 patients, 274 (41%) mothers gave birth to neonates diagnosed with CHD. Within this group, 22 cases were linked to pre-gestational diabetes, while 202 were not; 20 instances were associated with gestational diabetes, compared to 200 without; and 148 cases exhibited an overweight or obese BMI, whereas 126 displayed a normal BMI. Conclusion We identified a statistically significant correlation between pre-gestational diabetes mellitus and the occurrence of CHD. However, our analysis did not show a statistically significant association between maternal BMI and the likelihood of CHD. These results may aid in developing effective strategies to prevent and manage CHD in neonates.
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Affiliation(s)
- Yamixa Delgado
- Biochemistry & Pharmacology Department, San Juan Bautista School of Medicine, Caguas, 00726, Puerto Rico
| | - Caliani Gaytan
- Biochemistry & Pharmacology Department, San Juan Bautista School of Medicine, Caguas, 00726, Puerto Rico
| | - Naydi Perez
- Hispanic Alliance for Clinical and Translational Research, University of Puerto Rico Medical Sciences Campus, San Juan, 00936, Puerto Rico
| | - Eric Miranda
- Department of Internal Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, 00936, Puerto Rico
| | - Bryan Colón Morales
- Biochemistry & Pharmacology Department, San Juan Bautista School of Medicine, Caguas, 00726, Puerto Rico
| | - Mónica Santos
- Biochemistry & Pharmacology Department, San Juan Bautista School of Medicine, Caguas, 00726, Puerto Rico
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2
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Rosario-Santos A, Torres-Cintrón CR, López-Rexach AG, Gonzalez-Carcache P, Tortolero-Luna G, Umpierre S. A comparative analysis of endometrial cancer disparities in incidence, mortality, and survival between women living in Puerto Rico, Non-Hispanic Blacks, Non-Hispanic Whites, and US Hispanics between 2000-2018. Gynecol Oncol Rep 2023; 49:101275. [PMID: 37791112 PMCID: PMC10542592 DOI: 10.1016/j.gore.2023.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Endometrial cancer diagnosis in younger women is increasing in Puerto Rico and the United States. The study aims to evaluate the endometrial cancer trends in incidence, mortality, and survival by comparing US ethnic groups (NHW, NHB, and Hispanic) to women living in PR to assess whether disparities exist by age and stage at diagnosis on outcomes of interest. Methods We performed a secondary data analysis and comparison of the age-specific and age-adjusted incidence rates, mortality rates, and the survival of endometrial cancer in PR with that of NHB, NHW, and Hispanic using data from the PR Central Cancer Registry, the SEER Program, and PR Demographic Registry from 2000 to 2018. Results PR had the highest incidence rates (41.3 per 100,000 women) of endometrial cancer, followed by NHW, NHB, and Hispanic. Women in PR younger than 65 years old had higher incidence rates of endometrial cancer than compared groups. NHB have higher overall mortality rates (12.5 per 100,000 women). Between ages 20-34 and 35-49, women in PR have the highest mortality rates, and after age 50, mortality rates are higher for NHB. Conclusions Women in PR had higher endometrial cancer incidence rates in increasing trend from 2000 to 2018 compared to similar NHB, Hispanic, and NHW cohorts. Also, women in PR experienced higher incidence and mortality rates below 50 years old among all races and ethnicities. Future studies are needed to evaluate histology, obesity trends, and the impact on the quality of life for this cohort.
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Affiliation(s)
- Ana Rosario-Santos
- University of Puerto Rico School of Medicine, Gynecologic Oncology Division of Obstetrics and Gynecology Department, United States
| | - Carlos R. Torres-Cintrón
- University of Puerto Rico, Comprehensive Cancer Center. Puerto Rico Central Cancer Registry, United States
| | - Ana G. López-Rexach
- University of Puerto Rico School of Medicine, Gynecologic Oncology Division of Obstetrics and Gynecology Department, United States
| | - Paulina Gonzalez-Carcache
- University of Puerto Rico School of Medicine, Gynecologic Oncology Division of Obstetrics and Gynecology Department, United States
| | - Guillermo Tortolero-Luna
- University of Puerto Rico, Comprehensive Cancer Center. Puerto Rico Central Cancer Registry, United States
| | - Sharee Umpierre
- University of Puerto Rico School of Medicine, Obstetrics and Gynecology Department, Gynecologic Oncology Division, United States
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3
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Sharma N, Behl T, Singh S, Kaur P, Zahoor I, Mohan S, Rachamalla M, Dailah HG, Almoshari Y, Salawi A, Alshamrani M, Aleya L. Targeting Nanotechnology and Nutraceuticals in Obesity: An Updated Approach. Curr Pharm Des 2022; 28:3269-3288. [PMID: 36200206 DOI: 10.2174/1381612828666221003105619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/22/2022] [Indexed: 01/28/2023]
Abstract
HYPOTHESIS This review article represents a brief layout of the risk factors and pathophysiology responsible for obesity, customary treatment strategies, and nanotechnology-based nutraceutical for the therapeutics of obesity. EXPERIMENTS An exhaustive search of the literature was done for this purpose, using Google Scholar, PubMed, and ScienceDirect databases. A literature study was conducted using publications published in peer-reviewed journals between 2000 and 2022. FINDINGS This was revealed that risk factors responsible for obesity were genetic abnormalities and environmental and socio-economic factors. Several research articles published between 2000 and 2022 were based on phytoconstituents-based nanoformulation for obesity therapeutics and, therefore, have been systematically compiled in this review. Various nutraceuticals like Garcinia cambogia, quercetin, resveratrol, capsaicin, Capsicum, Curcuma longa, Camella Sinensis, Zingiber officinalis, Citrus aurantium, Aegle marmelos, Coffea canephora, Asparagus officinalis, Gardenia jasminoides, Catha edulis, Clusia nemroisa, Rosmarinus officinalis, Cirsium setidens, Betula platyphylla, Tripterygium wilfordi possessing anti-obesity actions are discussed in this review along with their patents, clinical trials as well as their nanoformulation available. CONCLUSION This review illustrates that nanotechnology has a great propensity to impart a promising role in delivering phytochemicals and nutraceuticals in managing obesity conditions and other related disorders.
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Affiliation(s)
- Neelam Sharma
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana- Ambala, Haryana 133207, India
| | - Tapan Behl
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
| | - Sukhbir Singh
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana- Ambala, Haryana 133207, India
| | - Parneet Kaur
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Ishrat Zahoor
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Syam Mohan
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India.,Substance Abuse and Toxicology Research Center, Jazan University, Jazan, Saudi Arabia
| | - Mahesh Rachamalla
- Department of Biology, University of Saskatchewan, 112 Science Place, Saskatoon, SK S7N 5E2, Canada
| | - Hamed Ghaleb Dailah
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Yosif Almoshari
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Salawi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Lotfi Aleya
- Chrono-environment Laboratory, Bourgogne Franche-Comté University, Besançon, France
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Lerman Ginzburg S. Sweetened syndemics: diabetes, obesity, and politics in Puerto Rico. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01345-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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5
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Amankwaa I, Nelson K, Rook H, Hales C. Association between body mass index, multi-morbidity and activities of daily living among New Zealand nursing home older adults: a retrospective analysis of nationwide InterRAI data. BMC Geriatr 2022; 22:62. [PMID: 35042475 PMCID: PMC8767739 DOI: 10.1186/s12877-021-02696-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background Obesity is a well-established risk factor for multi-morbidity and disability among older adults in the community and acute care settings. However, nursing home residents with body mass index (BMI) below 18.5 kg/m2 and above 25.0 kg/m2 have been understudied. We examined the prevalence of multi-morbidity and disability in activities of daily living (ADL) by BMI category and further investigated the association between BMI, multi-morbidity, and disability of ADL in a large cohort of older adults in nursing homes in New Zealand. Methods A retrospective review of nursing home residents’ data obtained from the New Zealand International Resident Assessment Instrument national dataset from 2015 to 2018. One hundred ninety-eight thousand seven hundred ninety older adults (≥60 years) living in nursing homes were included. BMI was calculated as weight in kilograms (kg) divided by height in meters squared (m2). Multimorbidity was defined as the presence of ≥2 health conditions. The risk of disability was measured by a 4-item ADL self-performance scale. The prevalence ratio (PR) of the association between BMI and multi-morbidity and between BMI and disability in ADL was assessed using Poisson regression with robust variance. Results Of the 198,790 residents, 10.6, 26.6, 11.3 and 5.4% were underweight, overweight, obese, and extremely obese, respectively. 26.4, 31.3 and 21.3% had one, two and three disease conditions, respectively, while 14.3% had four or more conditions. 24.1% could perform only one ADL, and 16.1% could perform none. The prevalence of multi-morbidity increased with increasing BMI, whereas mean disability in ADL decreased with increasing BMI. The risk of multi-morbidity was higher for the overweight (PR, 95%CI: 1.03, 1.02–1.03) and obese (PR, 95% CI: 1.07, 1.06–1.08) compared to normal weight after controlling for age, sex, ethnicity, and region. BMI was inversely associated with mean ADL; β, 95% CI for overweight (− 0.30, − 0.32, − 0.28) and obese − 0.43, − 0.45, − 0.40 compared to normal weight. Conclusion Being underweight was associated with a decline in the performance of ADL in nursing home residents. In contrast, being overweight and obese positively affected functional performance, demonstrating that the obesity paradox plays an important role in this population. The observed associations highlight areas where detection and management of underweight and healthy aging initiatives may be merited.
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Mackert M, Mandell D, Donovan E, Walker L, Henson-García M, Bouchacourt L. Mobile Apps as Audience-Centered Health Communication Platforms. JMIR Mhealth Uhealth 2021; 9:e25425. [PMID: 34402797 PMCID: PMC8408750 DOI: 10.2196/25425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/06/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022] Open
Abstract
Health communication campaigns often suffer from the shortcomings of a limited budget and limited reach, resulting in a limited impact. This paper suggests a shift of these campaigns to audience-centered communication platforms—particularly, apps on mobile phones. By using a common platform, multiple interventions and campaigns can combine resources and increase user engagement, resulting in a larger impact on health behavior. Given the widespread use of mobile phones, mobile apps can be an effective and efficient tool to provide health interventions. One such platform is Father’s Playbook, a mobile app designed to encourage men to be more involved during their partner’s pregnancy. Health campaigns and interventions looking to reach expectant fathers can use Father’s Playbook as a vehicle for their messages.
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Affiliation(s)
- Michael Mackert
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, United States.,Center for Health Communication, The University of Texas at Austin, Austin, TX, United States
| | - Dorothy Mandell
- School of Community and Rural Health, University of Texas Health Science Center at Tyler, Tyler, TX, United States.,Population Health, The University of Texas System, Austin, TX, United States
| | - Erin Donovan
- Department of Communication Studies, The University of Texas at Austin, Austin, TX, United States
| | - Lorraine Walker
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
| | - Mike Henson-García
- Center for Health Communication, The University of Texas at Austin, Austin, TX, United States.,School of Public Health, University of Texas Health Science Center - Dallas Regional Campus, Dallas, TX, United States
| | - Lindsay Bouchacourt
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, United States
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7
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Loprinzi PD, Crawford LK, Scott T, Tucker KL. Association of physical activity on memory interference: Boston Puerto Rican Health Study. Health Promot Perspect 2021; 11:256-260. [PMID: 34195050 PMCID: PMC8233684 DOI: 10.34172/hpp.2021.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background : The objective of this study was to evaluate the association between habitual physical activity engagement on memory interference. The present analysis used cross-sectional data from the Boston Puerto Rican Health Study (n=1,241; mean age= 57.2; 72.1% female). Methods : Physical activity was evaluated via self-report. Memory interference was evaluated using a word-list paradigm. The memory task included learning a list of 16 words (List A; 5 trials), followed by a distractor list (List B), and then an immediate recall of List A. Proactive interference occurs when preceding stimuli (e.g., Trial 1 and Trial 5 of List A) interferes with performance on a subsequent stimuli (List B). Retroactive interference occurs when subsequent stimuli (List B) interferes with the recall of previously encoded stimuli (Trial 5). Results : For proactive interference, there was no association between physical activity and the difference between performance on List B and Trial 1 of List A (β=0.00001; P =0.96). Similarly, for retroactive interference, there was no association between physical activity and the difference between the short delay recall and Trial 5 of List A (β=0.0002; P=0.50). Conclusion : The present study did not observe an association between habitual physical activity on attenuating memory interference.
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Affiliation(s)
- Paul D Loprinzi
- Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Mississippi, USA
| | - Lindsay K Crawford
- Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Mississippi, USA
| | - Tammy Scott
- Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA, USA
| | - Katherine L Tucker
- Center for Population Health, Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, Ma, USA
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8
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Tramontin NDS, Luciano TF, Marques SDO, de Souza CT, Muller AP. Ginger and avocado as nutraceuticals for obesity and its comorbidities. Phytother Res 2020; 34:1282-1290. [PMID: 31989713 DOI: 10.1002/ptr.6619] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/19/2019] [Accepted: 01/13/2020] [Indexed: 12/17/2023]
Abstract
Obesity is a worldwide epidemic and is one of the factors involved in the etiology of type 2 diabetes mellitus. Obesity induces low-grade inflammation and oxidative stress. The treatment for obesity involves changes in diet, physical activity, and even medication and surgery. Currently, the use of nutraceutical compounds is associated with health benefits. Ginger and avocado are used for many people all around the world; however, its effect as a nutraceutical compound is less known by the general population. For this reason, we searched information of the literature to point its effects on distinct mechanisms of defense against the obesity its comorbidities. The present review aimed showing that these nutraceuticals may be useful in obesity treatment. Reports have shown that ginger and avocado induce antioxidant and anti-inflammatory effects by improving enzymatic activity and modulating obesity-related impairments in the anti-inflammatory system in different tissues, without side effects. Furthermore, ginger and avocado were found to be effective in reversing the harmful effects of obesity on blood lipids. In conclusion, on the basis of the positive effects of ginger and avocado in in vitro, animal, and human studies, these nutraceuticals may be useful in obesity treatment.
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Affiliation(s)
| | - Thais F Luciano
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | | | - Claudio T de Souza
- Department of Internal Medicine, Medicine School, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Alexandre P Muller
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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9
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Association of Body Mass Index With Adherence to Cervical Cancer Screening Recommendations in Hispanic Women. J Low Genit Tract Dis 2020; 24:14-20. [DOI: 10.1097/lgt.0000000000000504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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10
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Weitlauf JC, Ortiz A, Kroll-Desrosiers AR, Quiñones Vázquez ME, Cannell B, Hernandez MNB, Brandt C, Mattocks K. Characterization and Comparison of Physical and Mental Health Profiles and Department of Veterans Affairs Health Care Utilization Patterns among Operation Iraqi Freedom/Operation Enduring Freedom Women Veterans in Puerto Rico versus the United States. Womens Health Issues 2019; 30:49-56. [PMID: 31796346 DOI: 10.1016/j.whi.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Research on the physical and mental health profiles and patterns of health care use among women veterans receiving health care from the Department of Veterans Affairs (VA) on the island of Puerto Rico is lacking. METHODS This cross-sectional study examines differences in physical and mental health conditions, and patterns of VA health care use, between women veterans of the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) era who were using VA facilities in Puerto Rico (n = 897) and those using U.S.-based VA facilities (n = 117,216) from 2002 to 2015. RESULTS Results of fully adjusted logistic regression models revealed that OIF/OEF women in Puerto Rico had heightened risk for global pain-related disorders (i.e., any pain) (adjusted odds ratio [AOR], 1.45; 95% confidence interval [CI], 1.22-1.71), back pain (AOR, 1.83; 95% CI, 1.56-2.14), diabetes (AOR, 1.42; 95% CI, 1.03-1.95), hyperlipidemia (AOR, 3.34; 95% CI, 2.80-3.98), major depression (AOR, 1.78; 95% CI, 1.53-2.06), and bipolar depression (AOR, 1.66; 95% CI, 1.34-2.04). They also evidenced greater risk for a host of reproductive health conditions and had higher average annual use of VA health care than their U.S. counterparts. CONCLUSIONS OIF/OEF women receiving VA health care in Puerto Rico evidenced a greater burden of physical illness, depression, and heightened use of VA health care services relative to their U.S. counterparts. Providers' increased awareness of the physical and mental health care needs of this population is warranted. Research efforts that help to identify efficient and effective strategies to provide culturally tailored and/or personalized health care for this population could also be useful.
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Affiliation(s)
- Julie C Weitlauf
- Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation (CI2I), Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
| | - Ana Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico & University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Aimee R Kroll-Desrosiers
- Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Brad Cannell
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, Dallas, Texas
| | | | - Cynthia Brandt
- Veterans Affairs Connecticut Health Care System, West Haven, Connecticut; Department of Emergency Medicine, Yale University, New Haven, Connecticut
| | - Kristin Mattocks
- Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Veterans Affairs Central Western Massachusetts Health Care System, Leeds, Massachusetts
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Factors Associated With Underestimation of Weight Among Adults Living in Puerto Rico. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:185-191. [DOI: 10.1177/0272684x19879809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this cross-sectional study was to examine the associations between underestimation of weight and sociodemographic, health, and dietary factors among adults living in a rural community in Puerto Rico. For data collection, a researcher-designed questionnaire was distributed to each household in the area. A multivariable logistic regression was conducted for data analysis. Results revealed that the prevalence of overweight and obesity was 34.4% and 38.7%, respectively. A total of 53.4% of the participants underestimated their weight, most of whom were either overweight or obese. Weight underestimation was associated with being male, age ≥35 years, living below the poverty level estimate, perceiving diet quality as excellent/very good, and consuming fast food ≥1 times/week. In conclusion, overweight/obesity rates were high in this sample, and underestimation of weight was common among people with higher body mass index levels. Future public health interventions targeting obesity in this population should consider self-perception of body weight.
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12
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Banitalebi E, Rahimi A, Faramarzi M, Mardaniyan Ghahfarrokhi M. The effects of elastic resistance band training and green coffee bean extract supplement on novel combined indices of cardiometabolic risk in obese women. Res Pharm Sci 2019; 14:414-423. [PMID: 31798658 PMCID: PMC6827197 DOI: 10.4103/1735-5362.268202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The main purpose of this study was to investigate the effects of elastic resistance band training (ERBT) and green coffee bean extract (GCBE) supplement on novel cardiometabolic indices in obese women. To this end, a total number of 60 obese women aged 30-50 years with a body mass index of > 30 kg/m2 were selected for inclusion in this study and then they were randomly assigned to one of the following four groups: placebo (n = 15), GCBE supplement (n = 15), GCBE supplement + ERBT (n = 15), and placebo + ERBT (n = 15). Each commercially prepared GCBE supplement capsule used in this study contained 500 mg of GCBE supplement and it was also claimed by the manufacturer to have 50% chlorogenic acid (CGA) (250 mg). The participants in the placebo + ERBT and GCBE supplement + ERBT groups attended an 8-week ERBT program, 3 sessions / week, and 60 min each session. In the GCBE supplement + ERBT group, Framingham risk score (P = 0.018), atherogenic index of plasma (P = 0.003), and metabolic syndrome severity score (P = 0.001) significantly decreased. Taken together, the results of the present study supported the importance of supplemental and resistance-type training in improving obesity and novel cardiometabolic risk scores, despite the fact that longer nutritional and exercise interventions could enhance some cardiometabolic risk scores in obese women.
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Affiliation(s)
- Ebrahim Banitalebi
- Department of Sports Sciences, Faculty of Letters and Humanities, Shahrekord University, Shahrekord, I.R. Iran
| | - Atefeh Rahimi
- Department of Sports Sciences, Faculty of Letters and Humanities, Shahrekord University, Shahrekord, I.R. Iran
| | - Mohammad Faramarzi
- Department of Sports Sciences, Faculty of Letters and Humanities, Shahrekord University, Shahrekord, I.R. Iran
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Loprinzi PD, Scott TM, Ikuta T, Addoh O, Tucker KL. Association of physical activity on changes in cognitive function: Boston Puerto Rican Health Study. PHYSICIAN SPORTSMED 2019; 47:227-231. [PMID: 30412458 PMCID: PMC7150609 DOI: 10.1080/00913847.2018.1547087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the association of habitual physical activity engagement on changes in cognitive function among Puerto Rican adults. METHODS Longitudinal data (2-year follow-up) from the Boston Puerto Rican Health Study were analyzed (n = 862; mean age = 56.5 year). A daily energy expenditure score was calculated using the number of hours over a 24-h period engaged in various activities, including sleeping, light activity, and moderate-to-vigorous exercise. Energy expenditure estimates were weighted based on the rate of oxygen consumption associated with each activity. Seven cognitive function outcomes were evaluated, including an assessment of general cognitive function, episodic memory, attention and working memory, cognitive flexibility, response inhibition, processing speed, and visuo-spatial organization. From these, overall executive function and memory capacity were derived using principal components analysis. RESULTS Physical activity was not associated with changes in overall executive function. However, compared to those with low baseline physical activity, those with moderate physical activity had 48% reduced odds of having ≥1 standard deviation decline in memory function (OR = 0.52; 95% CI: 0.32, 0.84; p = 0.008) in 2 years. CONCLUSION Among Puerto Rican adults, physical activity may help attenuate memory decline.
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Affiliation(s)
- Paul D. Loprinzi
- Exercise & Memory Laboratory, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Oxford, USA
| | - Tammy M. Scott
- Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, USA
| | - Toshikazu Ikuta
- Digital Neuroscience Laboratory, Department of Communication Sciences and Disorders, University of Mississippi, Oxford, USA
| | - Ovuokerie Addoh
- Physical Activity Translational Health Science (PATHs) Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Oxford, USA
| | - Katherine L. Tucker
- Center for Population Health, Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Boston, USA
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14
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Halperin DT, Laux J, LeFranc-García C, Araujo C, Palacios C. Findings From a Randomized Trial of Weight Gain Prevention Among Overweight Puerto Rican Young Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:205-216. [PMID: 30291016 DOI: 10.1016/j.jneb.2018.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 07/09/2018] [Accepted: 07/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Assess impact of multimodality weight gain prevention intervention. METHODS Randomized clinical trial among 39 overweight young Puerto Rico college students using 10 weekly peer-support sessions promoting dietary, physical activity, and other lifestyle changes enhanced by stress-reduction and mindfulness approaches. Body mass index (BMI) and self-reported behaviors were measured at baseline and at 10 weeks and 6 months after baseline. RESULTS At the completion of the intervention, BMIs in the experimental arm were 0.8 units lower than at baseline (z = -3.0; P = .008) and 1.2 lower at 6 months after baseline (z = -4.1; P < .001); BMIs in the control arm were 0.7 higher (z = 2.7; P = .02) at 10 weeks and 0.8 higher at 6 months (z = 3.1; P = .005). Group × time interaction confirmed that BMI differed significantly over time between arms (χ2 = 26.9; degrees of freedom = 2; P < .001). Analysis of behavioral changes was mostly inconclusive although the experimental arm reported a considerable increase in walking at 10 weeks. Qualitative data suggested that yoga and mindfulness components were particularly useful for motivating participants to maintain healthier lifestyle patterns. CONCLUSIONS Body mass index in the experimental arm decreased at the end of intervention and was maintained at 6 months' follow-up.
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Affiliation(s)
- Daniel T Halperin
- Department of Health Behavior, School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Robert Stempel College of Public Health and Social Work, Florida International University, FL.
| | - Jeffrey Laux
- North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carlos LeFranc-García
- Sciences and Technology Department, Inter-American University of Puerto Rico, Ponce Campus, Ponce, Puerto Rico
| | | | - Cristina Palacios
- Robert Stempel College of Public Health and Social Work, Florida International University, FL
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Guariguata L, Brown C, Sobers N, Hambleton I, Samuels TA, Unwin N. An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean. Rev Panam Salud Publica 2018; 42:e171. [PMID: 31093199 PMCID: PMC6385809 DOI: 10.26633/rpsp.2018.171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/15/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To conduct an analysis of the most recent data on diabetes and its risk factors by gender and other social determinants of health to understand why its prevalence is higher among women than men in the Caribbean; to inform policy agenda-setting for diabetes prevention and control in the Caribbean; and to identify gaps in the evidence that require further research. METHODS A previous systematic review of the literature describing studies conducted in the Caribbean that presented the distribution of diabetes, its outcomes, and risk factors, by one or more social determinants, was updated to include sources from 1 January 2007 - 31 December 2016. Surveys by the World Health Organization (WHO) were also included. Where data were sufficient, meta-analyses were undertaken. RESULTS A total of 8 326 manuscripts were identified. Of those, 282 were selected for full text review, and 114, for abstraction. In all, 36 papers, including WHO-related surveys, had sufficient information for meta-analysis. More women compared to men were obese (OR: 2.1; 95%CI = 1.65 - 2.69), physically inactive (OR: 2.18; 95%CI = 1.75 - 2.72), and had diabetes (OR: 1.48; 95%CI = 1.25 - 1.76). More men smoked (OR: 4.27; 95%CI = 3.18 - 5.74) and had inadequate fruit and vegetable intake (OR: 1.37; 95%CI = 1.21 - 1.57). CONCLUSION Thirty-six papers were added to the previously conducted systematic review; of those, 13 were added to the meta-analysis. Diabetes and its risk factors (primarily obesity and physical inactivity) continue to disproportionately affect women in the Caribbean. Smoking interventions should be targeted at men in this geographic area.
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Affiliation(s)
- Leonor Guariguata
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Catherine Brown
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Natasha Sobers
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados.
| | - Ian Hambleton
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - T. Alafia Samuels
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Nigel Unwin
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
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Mattei J, Tamez M, Ríos-Bedoya CF, Xiao RS, Tucker KL, Rodríguez-Orengo JF. Health conditions and lifestyle risk factors of adults living in Puerto Rico: a cross-sectional study. BMC Public Health 2018; 18:491. [PMID: 29650018 PMCID: PMC5898045 DOI: 10.1186/s12889-018-5359-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 03/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background Puerto Rico is experiencing an economic and healthcare crisis, yet there are scarce recent and comprehensive reports on the population’s health profile. We aimed to describe prevalent risk factors and health conditions of adults living in Puerto Rico and assess their interrelationship. Methods Participants (n = 380) aged 30-75y recruited from a 2015 convenience sample in primary care clinics in the San Juan, Puerto Rico metropolitan area answered cross-sectional interviewer-administered questionnaires on sociodemographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, health services, and psychosocial factors. Anthropometric measures were obtained. Logistic regression models assessed factors associated with having ≥2 cardiometabolic conditions or ≥ 2 chronic diseases. Results Most participants had completed ≥college education (57%), had household income <$10,000/y (60%), received government-assisted food benefits (51%), and had health insurance (93%). Nearly 20% reported smoking, 27% alcohol use, 74% light/sedentary physical activity, 51% sleeping difficulties, and 36% self-rated fair/poor diet. Social support was moderate, and 53% screened positive for depressive symptomatology. Abdominal obesity was observed in 33% of men and 76% of women (p < 0.0001). Self-reported medically-diagnosed conditions included hypertension (39%), anxiety (30%), obesity (28%), arthritis (26%), hypercholesterolemia (24%), depression (22%), respiratory problems (21%), and diabetes (21%). Higher odds of having ≥2 cardiometabolic conditions (37%) was observed among participants aged ≥50y, with sedentary physical activity, and self-rated fair/poor diet. Odds of having ≥2 chronic diseases (62%) were higher among ≥50y, sleeping difficulties, > 2 h/day television, and self-rated fair/poor diet. Participants obtained (79%) and trusted (92%) health information from physicians. While most participants with a cardiometabolic condition reported receiving medical recommendations on diet (> 73%) and physical activity (> 67%), fewer followed them (< 67% and < 53%, respectively), yet most adhered to medication treatments (> 73%). Participants following medical recommendations were more likely to report healthy vs. poor behaviors (90% vs. 75%, self-rated diet); (73% vs. 56%, physical activity). Conclusions Adults living in Puerto Rico have multiple lifestyles risk factors and high prevalence of chronic diseases, namely cardiometabolic and psychological conditions. Comprehensive epidemiological studies are needed to identify contributors to chronic disease, including lifestyle behaviors. Concerted multi-level public health and clinical programs should be prioritized to help this population improve their health.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg. 2, Boston, MA, 02115, USA.
| | - Martha Tamez
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg. 2, Boston, MA, 02115, USA
| | - Carlos F Ríos-Bedoya
- Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.,FDI Clinical Research, San Juan, PR, USA
| | - Rui S Xiao
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg. 2, Boston, MA, 02115, USA
| | - Katherine L Tucker
- Department of Biochemical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - José F Rodríguez-Orengo
- FDI Clinical Research, San Juan, PR, USA.,Department of Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
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Avilés-Santa ML, Colón-Ramos U, Lindberg NM, Mattei J, Pasquel FJ, Pérez CM. From Sea to Shining Sea and the Great Plains to Patagonia: A Review on Current Knowledge of Diabetes Mellitus in Hispanics/Latinos in the US and Latin America. Front Endocrinol (Lausanne) 2017; 8:298. [PMID: 29176960 PMCID: PMC5687125 DOI: 10.3389/fendo.2017.00298] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/16/2017] [Indexed: 12/13/2022] Open
Abstract
The past two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus (DM) and its complications. Increased screening has led to a greater recognition of type 2 diabetes mellitus (type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the US, have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the US, the prevalence of DM varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower among South Americans. The risk and prevalence of diabetes among Hispanics/Latinos are significantly higher than in non-Hispanic Whites, and nearly 40% of Hispanics/Latinos with diabetes have not been formally diagnosed. Despite these striking facts, the representation of Hispanics/Latinos in pharmacological and non-pharmacological clinical trials has been suboptimal, while the prevalence of diabetes in these populations continues to rise. This review will focus on the epidemiology, etiology and prevention of type 2 DM in populations of Latin American origin. We will set the stage by defining the terms Hispanic, Latino, and Latin American, explaining the challenges identifying Hispanics/Latinos in the scientific literature and databases, describing the epidemiology of diabetes-including type 2 DM and gestational diabetes mellitus (GDM)-and cardiovascular risk factors in Hispanics/Latinos in the US and Latin America, and discussing trends, and commonalities and differences across studies and populations, including methodology to ascertain diabetes. We will discuss studies on mechanisms of disease, and research on prevention of type 2 DM in Hispanics/Latinos, including women with GDM, youth and adults; and finalize with a discussion on lessons learned and opportunities to enhance research, and, consequently, clinical care oriented toward preventing type 2 DM in Hispanics/Latinos in the US and Latin America.
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Affiliation(s)
- M. Larissa Avilés-Santa
- National Heart, Lung, and Blood Institute at the National Institutes of Health, Bethesda, MD, United States
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Nangel M. Lindberg
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Francisco J. Pasquel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Cynthia M. Pérez
- University of Puerto Rico Graduate School of Public Health, San Juan, Puerto Rico
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Pérez C, Ailshire JA. Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults. J Aging Health 2017; 29:1056-1078. [PMID: 28599584 PMCID: PMC5746478 DOI: 10.1177/0898264317714144] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize the health status of older island Puerto Ricans, a segment of the U.S. population that has been largely overlooked in aging research. METHOD Data from the 2002 Puerto Rican Elderly Health Conditions Project and the 2002 Health and Retirement Study are used to examine differences in disease, disability, and self-rated health among island Puerto Ricans and the mainland U.S.-born older adult population. Differences are further examined by gender. RESULTS Island Puerto Ricans were less likely to have heart disease, stroke, lung disease, cancer, activities of daily living (ADL) limitations, and poor self-rated health, but more likely to have hypertension and diabetes. Island Puerto Rican women had worse health relative to island Puerto Rican men. DISCUSSION Recent challenges in the funding and provision of health care in Puerto Rico are worrisome given the large number of aging island adults, many of whom have hypertension and diabetes, two conditions that require long-term medical care.
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19
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Mattei J, Rodríguez-Orengo JF, Tamez M, Corujo F, Claudio A, Villanueva H, Campos H, Willett WC, Tucker KL, Ríos-Bedoya CF. Challenges and opportunities in establishing a collaborative multisite observational study of chronic diseases and lifestyle factors among adults in Puerto Rico. BMC Public Health 2017; 17:136. [PMID: 28143452 PMCID: PMC5282646 DOI: 10.1186/s12889-017-4035-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Prevalence of chronic diseases and unhealthy lifestyle behaviors among the adult population of Puerto Rico (PR) is high; however, few epidemiological studies have been conducted to address these. We aimed to document the methods and operation of establishing a multisite cross-sectional study of chronic diseases and risk factors in PR, in partnership with academic, community, clinical, and research institutions. Methods The Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) documented lifestyle and health characteristics of adults living in PR, with the goal of informing future epidemiological and intervention projects, as well as public health, policy, and clinical efforts to help improve the population’s health. The study was conducted in three primary care clinics in the San Juan, PR metropolitan area. Eligible volunteers were 30–75y, living in PR for at least 10 months of the previous year, and able to answer interviewer-administered questionnaires without assistance. Questions were recorded electronically by trained interviewers, and included socio-demographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, and psychosocial factors. Waist and hip circumferences were measured following standardized protocols. A subset of participants answered a validated food frequency questionnaire, a legumes questionnaire, and had medical record data abstracted. Process and outcome evaluation indicators were assessed. Results The study screened 403 participants in 5 months. Of these, 396 (98%) were eligible and 380 (94%) had reliable and complete information. A subset of 242 participants had valid dietary data, and 236 had medical record data. The mean time to complete an interview was 1.5 h. Participants were generally cooperative and research collaborators were fully engaged. Having multiple sites helped enhance recruitment and sociodemographic representation. Diagnosed conditions were prevalent across sites. Challenges in data monitoring, interviewer training, and scheduling were identified and corrected, and should be addressed in future studies. Conclusions Epidemiological studies in PR can be successfully implemented in partnership with multiple institutions. Effective recruitment and implementation requires concerted planning and continued involvement from partners, frequent quality control, brief interviews, reasonable incentives, and thorough training/re-training of culturally-sensitive interviewers. Further studies are feasible and needed to help address highly prevalent chronic conditions in PR.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.
| | - José F Rodríguez-Orengo
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA.,Department of Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Martha Tamez
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA
| | | | - Aida Claudio
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA
| | | | - Hannia Campos
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.,Centro de Investigación e Innovación en Nutrición Translacional y Salud, Universidad Hispanoamericana, San José, Costa Rica
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Carlos F Ríos-Bedoya
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA.,Hurley Medical Center, Department of Internal Medicine, Flint, MI, USA
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Tomashek KM, Rivera A, Torres-Velasquez B, Hunsperger EA, Munoz-Jordan JL, Sharp TM, Rivera I, Sanabria D, Blau DM, Galloway R, Torres J, Rodriguez R, Serrano J, Chávez C, Dávila F, Perez-Padilla J, Ellis EM, Caballero G, Wright L, Zaki SR, Deseda C, Rodriguez E, Margolis HS. Enhanced Surveillance for Fatal Dengue-Like Acute Febrile Illness in Puerto Rico, 2010-2012. PLoS Negl Trop Dis 2016; 10:e0005025. [PMID: 27727271 PMCID: PMC5058557 DOI: 10.1371/journal.pntd.0005025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/08/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Dengue is a leading cause of morbidity throughout the tropics; however, accurate population-based estimates of mortality rates are not available. METHODS/PRINCIPAL FINDINGS We established the Enhanced Fatal Acute Febrile Illness Surveillance System (EFASS) to estimate dengue mortality rates in Puerto Rico. Healthcare professionals submitted serum and tissue specimens from patients who died from a dengue-like acute febrile illness, and death certificates were reviewed to identify additional cases. Specimens were tested for markers of dengue virus (DENV) infection by molecular, immunologic, and immunohistochemical methods, and were also tested for West Nile virus, Leptospira spp., and other pathogens based on histopathologic findings. Medical records were reviewed and clinical data abstracted. A total of 311 deaths were identified, of which 58 (19%) were DENV laboratory-positive. Dengue mortality rates were 1.05 per 100,000 population in 2010, 0.16 in 2011 and 0.36 in 2012. Dengue mortality was highest among adults 19-64 years and seniors ≥65 years (1.17 and 1.66 deaths per 100,000, respectively). Other pathogens identified included 34 Leptospira spp. cases and one case of Burkholderia pseudomallei and Neisseria meningitidis. CONCLUSIONS/SIGNIFICANCE EFASS showed that dengue mortality rates among adults were higher than reported for influenza, and identified a leptospirosis outbreak and index cases of melioidosis and meningitis.
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Affiliation(s)
- Kay M. Tomashek
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
- * E-mail:
| | - Aidsa Rivera
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Brenda Torres-Velasquez
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Elizabeth A. Hunsperger
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Jorge L. Munoz-Jordan
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Tyler M. Sharp
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Irma Rivera
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Dario Sanabria
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Dianna M. Blau
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, CDC, Atlanta, Georgia, United States of America
| | - Renee Galloway
- Bacterial Special Pathogens Branch, Division of High Consequence Pathogens, CDC, Atlanta, Georgia, United States of America
| | - Jose Torres
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Rosa Rodriguez
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Javier Serrano
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Carlos Chávez
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Francisco Dávila
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Janice Perez-Padilla
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | - Esther M. Ellis
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
| | | | - Laura Wright
- Geospatial Research, Analysis, and Services Program, Division of Toxicology and Human Health Sciences, ATSDR, Atlanta, Georgia, United States of America
| | - Sherif R. Zaki
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, CDC, Atlanta, Georgia, United States of America
| | - Carmen Deseda
- Puerto Rico Department of Health, San Juan, Puerto Rico
| | - Edda Rodriguez
- Puerto Rico Institute of Forensic Sciences, San Juan, Puerto Rico
| | - Harold S. Margolis
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), San Juan, Puerto Rico
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Fred-Jiménez RM, Arroyo-Ávila M, Mayor ÁM, Ríos G, Vilá LM. Clinical Manifestations Associated with Overweight/Obesity in Puerto Ricans with Fibromyalgia Syndrome. J Obes 2016; 2016:1379289. [PMID: 26885384 PMCID: PMC4739457 DOI: 10.1155/2016/1379289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 12/20/2022] Open
Abstract
Objective. To determine the clinical manifestations associated with overweight/obesity in Hispanics from Puerto Rico with fibromyalgia syndrome (FMS). Methods. A cross-sectional study was performed in 144 patients with FMS (per American College of Rheumatology (ACR) classification criteria). Sociodemographic features, FMS-related symptoms, tender points (per ACR criteria), comorbidities, and FMS treatment were examined. BMI was calculated and patients were grouped into two categories: BMI ≤ 24.9 kg/m(2) (nonoverweight/obese) and BMI ≥ 25 kg/m(2) (overweight/obese). Bivariate and multivariate analyses were used to evaluate differences between the study groups. Results. The mean (standard deviation (SD)) age of patients was 50.2 (9.9) years; 95.1% were females and 75.7% were overweight/obese. In the bivariate analysis, overweight/obese patients were more likely to have self-reported memory impairment, anxiety, shortness of breath, and urinary frequency than nonoverweight/obese patients. In addition, the tender point count was higher in the overweight/obese group. In the logistic regression analyses, self-reported memory impairment and urinary frequency differences remained significant after adjusting for confounding variables. Conclusion. In this population of Puerto Ricans with FMS, overweight/obese patients experienced more FMS-related manifestations than nonoverweight/obese individuals. However, prospective studies are needed to confirm these associations and to elucidate if weight reduction interventions could favorably impact the severity of FMS.
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Affiliation(s)
- Ruth M. Fred-Jiménez
- Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
| | - Mariangelí Arroyo-Ávila
- Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
| | - Ángel M. Mayor
- Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
- Retrovirus Research Center, Department of Internal Medicine, Universidad Central del Caribe School of Medicine, Bayamón, PR 00960, USA
| | - Grissel Ríos
- Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
| | - Luis M. Vilá
- Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
- *Luis M. Vilá:
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Salgado-Montilla J, Soto Salgado M, Surillo Trautmann B, Sánchez-Ortiz R, Irizarry-Ramírez M. Association of serum lipid levels and prostate cancer severity among Hispanic Puerto Rican men. Lipids Health Dis 2015; 14:111. [PMID: 26377420 PMCID: PMC4574177 DOI: 10.1186/s12944-015-0096-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/16/2015] [Indexed: 02/07/2023] Open
Abstract
Background While obesity and fat intake have been associated with an increased risk of prostate cancer (PCa) aggressiveness and mortality, the association between lipid levels and PCa phenotype remains unclear. Previous reports evaluating this association are inconsistent and highly variable when considering different racial/ethnic groups. There are scarce data regarding this association among Hispanics, and specifically Puerto Rico’s Hispanic men, a population with a higher burden of PCa, metabolic syndrome and overweight. This population has a different ancestry profile than other Hispanics from Central and South America. Due to the above the researchers inquired if there is a relationship between serum lipid levels and PCa phenotype in this understudied population using a cohort of patients treated with radical prostatectomy as their first treatment. Methods We performed an exploratory retrospective medical record review study of 199 PCa patients who underwent radical prostatectomy between 2005 and 2012. Variables analyzed included age at PCa diagnosis, Body Mass Index (BMI), preoperative serum prostate-specific antigen (PSA), lipid levels, and clinical parameters such as prostatectomy pathologic stage and Gleason Score (GS). PCa severity was defined using pathologic stage and GS. Unadjusted and adjusted logistic regression models were fitted to estimate the odds ratios (ORs) with 95 % confidence intervals (CI) to define the relationship among clinical characteristics and PCa severity. Results Mean age for the cohort was 58.8 years (range: 40–75), 78.9 % were overweight or obese, 36.7 % had hypertriglyceridemia, and 35.2 % had low HDL levels. In the unadjusted logistic regression model, hypertriglyceridemia (OR: 2.11, 95 % CI = 1.13–3.93), low HDL (OR: 1.90, 95 % CI = 1.02–3.56-), and age (OR: 2.34, 95 % CI 1.25–4.40) were significantly associated with a diagnosis of high severity of PCa. Conclusions In Puerto Rican men with PCa, elevated hypertriglyceridemia, low HDL levels, and age were statistically associated with high grade PCa on bivariate analysis. Total cholesterol level was not associated with severity of disease. Associations lost significance upon multivariate adjustment. These data generate important hypotheses regarding the potential relationship between lipid pathways and PCa development and underscore the need to perform larger scale and longitudinal studies to sort out whether, hypertriglyceridemia is associated with PCa phenotype and development.
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Affiliation(s)
- Jeannette Salgado-Montilla
- UPR/MDACC Partnership in Excellence in Cancer Research Program, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Marievelisse Soto Salgado
- UPR/MDACC Partnership in Excellence in Cancer Research Program, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Barbara Surillo Trautmann
- Graduate Department, Clinical Laboratory Sciences, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Ricardo Sánchez-Ortiz
- Urology Section, School of Medicine, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Margarita Irizarry-Ramírez
- Graduate Department, Clinical Laboratory Sciences, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
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Mattei J, Malik V, Wedick NM, Hu FB, Spiegelman D, Willett WC, Campos H. Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative. Global Health 2015; 11:23. [PMID: 26040275 PMCID: PMC4489001 DOI: 10.1186/s12992-015-0109-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 05/26/2015] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources. DISCUSSION We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Vasanti Malik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Nicole M Wedick
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Donna Spiegelman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Hannia Campos
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
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Hill SE, Bell C, Bowie JV, Kelley E, Furr-Holden D, LaVeist TA, Thorpe RJ. Differences in Obesity Among Men of Diverse Racial and Ethnic Background. Am J Mens Health 2015; 11:984-989. [PMID: 25862694 DOI: 10.1177/1557988315580348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Racial/ethnic disparities exist in obesity prevalence among men, with Hispanic men exhibiting the highest prevalence compared with non-Hispanic White and non-Hispanic Black men. Most studies do not parse out Hispanic groups; therefore, it is unclear whether the increases in obesity rates among Hispanic men applies to all groups or if there are particular groups of Hispanic men that are driving the increase. The goal of this study is to examine the variations in obesity among men of diverse racial/ethnic backgrounds and determine if obesity is affected by nativity. The data used in this study were from 11 years (2002-2012) of the National Health Interview Survey. Logistic regression was used to examine the relationship between race/ethnicity, obesity, and nativity. After adjusting for covariates, there are differences in obesity prevalence, with the largest prevalence among Puerto Rican men and Mexican American men. Consistent with previous literature, it has been suggested that men born in the United States are more likely to be obese than men born outside the United States. This study underscores the importance of distinguishing Hispanic groups when examining obesity, and provides information for future, targeted intervention strategies related to obesity among high-risk groups.
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Affiliation(s)
- Sarah E Hill
- 1 Undergraduate Program in Public Health Studies, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD, USA.,2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caryn Bell
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janice V Bowie
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Kelley
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Debra Furr-Holden
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas A LaVeist
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Vitamin D status is inversely associated with obesity in a clinic-based sample in Puerto Rico. Nutr Res 2015; 35:287-93. [PMID: 25708459 DOI: 10.1016/j.nutres.2015.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/28/2015] [Accepted: 02/06/2015] [Indexed: 12/31/2022]
Abstract
Studies show that vitamin D status is associated to obesity but data in Hispanic individuals is scarce. The aim of this study was to assess the association between vitamin D status and obesity in a clinic-based sample in Puerto Rico. We hypothesized that subjects with a higher adiposity would have a lower vitamin D status. We extracted the following data from medical records of a private clinic: age, gender, serum 25(OH)D levels, weight, height, and waist circumference. Body mass index (BMI) (kg/m(2)) and waist-to-height ratio were calculated and categorized according to standard guidelines. Statistical analyses included analysis of covariance, Pearson correlations and χ(2) test. From 797 individuals (mean age 53.7 ± 15.4 years; 63.5% females), 35.6% were overweight and 43.7% obese. Mean 25(OH)D levels were 24.7 ± 8.7 ng/mL; 5.3% had levels <12 ng/mL, 30.6% had levels 12 to 20 ng/mL, and 43.5% had levels 21 to 30 ng/mL. Mean 25(OH)D levels were significantly higher in normal weight and overweight males compared to obese males (P < .05) and in overweight females compared to obese females (P < .05). Levels were also higher in those with low risk compared to high risk of waist circumference and waist-to-height ratio (P < .001). BMI, waist circumference, and waist-to-height ratio were inversely correlated to 25(OH)D levels (P < .001). A greater proportion of obese individuals (41.4%) were vitamin D deficient or insufficient compared to the normal weight (33.9%) and overweight individuals (30.3%) (P < .05). In conclusion, in this clinic-based sample of Puerto Rican adults, those with higher BMI, waist circumference, and waist-to-height ratio had a significantly lower vitamin D status.
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Suárez-Martínez EB, Pérez CM, Cruz SK, Khorsandi S, Chardón C, Ferder L. Importance of vitamin D and vitamin D levels status in Puerto Ricans. J Health Care Poor Underserved 2014; 24:38-47. [PMID: 24241259 DOI: 10.1353/hpu.2014.0000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is growing and compelling evidence demonstrating the extra-skeletal role of vitamin D and the importance of maintaining adequate levels of this nutrient. Currently, there is very limited information available on the vitamin D status in children and adults in underserved groups, including Puerto Ricans. We assessed the vitamin D status of 4,090 Puerto Ricans living in six geographical regions in the island. Only 31.5% of the studied population had sufficient vitamin D levels (>30 ng/ml). The 18-39 year age group and the females showed inadequate (<30 ng/ml) levels of vitamin D (76.9% and 69.8%, respectively). Participants aged 60 or older showed the highest mean values of serum 25(OH)D (28.8 ng/ml) and the highest percentage (37.1%) of sufficient levels (>30 ng/ml). Future studies are certainly warranted to understand the prevalence of vitamin D deficiency and influencing factors (including obesity) in Puerto Ricans.
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