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Bansal M, Misra A. Cardiovascular Disease and Diabetes in South Asians: The Twin Epidemic. Curr Diabetes Rev 2021; 17:e122820189512. [PMID: 33371854 DOI: 10.2174/1573399817666201228121145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Manish Bansal
- Clinical and Preventive Cardiology Medanta- The Medicity Gurgaon, India
| | - Anoop Misra
- Fortis-CDOC Hospital for Diabetes and Allied Sciences President, Diabetes Foundation (India), and President National Diabetes Obesity and Cholesterol Foundation (NDOC), India
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Khamar MB, Sthapak AP, Vijayevarshcini D, Patel PM. Association between hypertriglyceridemia and open angle glaucoma: A case report. Indian J Ophthalmol 2019; 67:1202-1204. [PMID: 31238465 PMCID: PMC6611287 DOI: 10.4103/ijo.ijo_1618_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Hypertriglyseridemia is a metabolic disorder that can cause vascular dysfucntion and be causally associated with glaucoma. Herein we present the case of a 16-year-old boy with hypertriglyseridemia with open-angle glaucoma.
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Affiliation(s)
- Mayuri Bakulesh Khamar
- Department of Glaucoma, Raghudeep Eye Hospital, Gurukul Road, Memnagar, Ahmedabad, India
| | - Arpita P Sthapak
- Department of Glaucoma, Raghudeep Eye Hospital, Gurukul Road, Memnagar, Ahmedabad, India
| | - D Vijayevarshcini
- Department of Glaucoma, Raghudeep Eye Hospital, Gurukul Road, Memnagar, Ahmedabad, India
| | - Priyanka M Patel
- Department of Glaucoma, Raghudeep Eye Hospital, Gurukul Road, Memnagar, Ahmedabad, India
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Basit A, Fawwad A, Siddiqui SA, Baqa K. Current management strategies to target the increasing incidence of diabetes within Pakistan. Diabetes Metab Syndr Obes 2019; 12:85-96. [PMID: 30643443 PMCID: PMC6314051 DOI: 10.2147/dmso.s141356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
According to the recently published National Diabetes Survey of Pakistan (NDSP 2016-2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994-1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes.
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Affiliation(s)
- Abdul Basit
- Department of Medicine, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan,
| | - Asher Fawwad
- Department of Biochemistry, Baqai Medical University, Research Departments, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan
| | - Shaista Ali Siddiqui
- Kaizen Management Consultancy, Sharjah, United Arab Emirates
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University Karachi, Karachi, Pakistan
| | - Kulsoom Baqa
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University Karachi, Karachi, Pakistan
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Abstract
OBJECTIVES Obesity in children can lead to morbidity and mortality due to metabolic and inflammatory comorbidities. AIMS The objective of the study was to investigate the alterations in acute inflammatory markers, serum amyloid P (SAP) and cortisol, and endocrine markers, leptin and insulin, in obese children. MATERIALS AND METHODS Serum leptin, insulin, cortisol, and amyloid P concentrations were measured in obese (BMI percentile >85, n = 17) and nonobese (BMI percentile < 75, n = 20) children using ELISA and Bio-Plex Bead-based assay. STATISTICAL ANALYSIS USED Serum concentrations of analytes were compared between normal and obese groups using 2-tailed student's t-test. RESULTS Mean leptin, insulin, and SAP serum concentrations were significantly higher in obese children as compared to the controls (97.19 vs. 4.06, P < 0.05; 21.31 vs 3.56, P < 0.05; 46.77 vs. 17.89, P < 0.05; respectively). No difference was found in mean serum cortisol levels of the two groups. However, cortisol values were higher in obese subjects compared to the control group (7.89 vs 6.30, P = 0.15). Leptin corelated with insulin (r = 0.42, P = 0.043) and cortisol (r = 0.48, P = 0.025) levels in the obese group. Furthermore, leptin, insulin, and SAP levels were corelated with BMI (r = 0.80, P < 0.000; r = 0.67, P = 0.015, respectively) and body weight (r = 0.52, P = 0.01; r = 0.52, P = 0.002; r = 0.54, P = 0.01, respectively) in the obese group but did not demonstrate a significant relationship in the nonobese group. CONCLUSION Elevated SAP levels and increase in leptin and insulin indicated a preeminent disposition of morbidly obese children to the development of low-grade inflammation and metabolic syndrome.
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Affiliation(s)
- Mehwish Anwer
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
| | - Muhammad J. Iqbal
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
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Basit A, Fawwad A, Qureshi H, Shera AS. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016-2017. BMJ Open 2018; 8:e020961. [PMID: 30082350 PMCID: PMC6078264 DOI: 10.1136/bmjopen-2017-020961] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The second National Diabetes Survey of Pakistan (second NDSP) was planned to ascertain the updated prevalence of diabetes, pre-diabetes and associated risk factors at the national and provincial levels. RESEARCH DESIGN AND METHODS The survey was conducted by using multistage clustering technique in all four provinces of Pakistan from February 2016 to August 2017. An estimated sample size of 10 800 was calculated using probability sampling and multistage stratified sampling technique. Twenty-seven clusters were selected out of total 213 clusters from all four provinces (strata) of Pakistan. A total of 46 subclusters were selected by using the 'Rule of thumb'. Out of 12 486 targeted individuals, 10 834 study subjects finally participated in the study (87% response rate). Seventeen trained teams collected data using the structured questionnaire. The clinical and anthropometric measurements included height, weight, blood pressure, waist circumference and waist-to-hip ratio while the blood tests included Oral Glucose Tolerance Test (OGTT), haemoglobin A1c and fasting lipid profiles. WHO criteria were used for the diagnosis of diabetes and pre-diabetes. RESULTS Overall weighted prevalence of diabetes was 26.3%, of which 19.2% had known diabetes, and 7.1% were newly diagnosed people with diabetes. Prevalence of diabetes in urban and rural areas was 28.3% and 25.3%, respectively. Prevalence of pre-diabetes was 14.4% (15.5% in urban areas and 13.9% in rural areas). Age greater than or equal to 43 years, family history of diabetes, hypertension, obesity and dyslipidaemia were significant associated risk factors for diabetes. CONCLUSION The findings of the 2nd NDSP imply that diabetes has reached epidemic proportion and urgently need national strategies for early diagnosis and effective management as well as cost-effective diabetes primary prevention programme in Pakistan.
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Affiliation(s)
- Abdul Basit
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Sindh, Pakistan
| | - Asher Fawwad
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Sindh, Pakistan
- Department of Biochemistry, Baqai Medical University, Karachi, Sindh, Pakistan
| | - Huma Qureshi
- Director, Pakistan Health Research Council, Islamabad, Pakistan
| | - A S Shera
- Secretary General, Diabetic Association of Pakistan and WHO Collaborating Centre, Karachi, Sindh, Pakistan
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Ethical issues in obesity prevention for school children: a systematic qualitative review. Int J Public Health 2017; 62:981-988. [PMID: 28801690 DOI: 10.1007/s00038-017-1027-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/22/2017] [Accepted: 07/29/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Planning and conducting preventive measures against obesity for school children is beset with ethical issues which should be known to make well-informed decisions. The goal of this study was to provide a comprehensive spectrum of these ethical issues by means of a systematic review. In this context, the study also assesses the value of different search strategies for ethical literature in public health. METHODS Literature was searched in Medline, EBSCO and others. Three different search strategies with varied scopes were applied and their output was compared. Qualitative content analysis was used for extracting and categorizing ethical issues. RESULTS 109 publications (published from 1995 to 2015) were finally included. The qualitative analysis resulted in 60 potentially relevant ethical issues. The three search strategies showed substantial differences regarding their search results. CONCLUSIONS The presented spectrum provides an initial evidence base for dealing with ethical issues adequately. The findings of the study further suggest that a broader scope is more fruitful for systematic reviews on ethical issues in the field of public health.
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Abstract
Diabetes mellitus is becoming a global health issue with more than 80% diabetics living in developing countries. India accounts for 62.4 million diabetics (2011). Indian Council of Medical Research India Diabetes Study (ICMR-INDIAB) study showed highest weighted prevalence rate in the north India among all studied regions. Diabetes in north India has many peculiarities in all aspects from risk factors to control programmers. North Indians are becoming more prone for diabetes and dyslipidemia because rapid westernization of living style and diet due rapid migration to metropolitan cities for employment. North Indian diabetes is plagued with gender bias against females, poor quality of health services, myths, and lack of disease awareness compounded with small number of prevention and awareness programmers that too are immature to counteract the growing pandemic.
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Affiliation(s)
- Manish Gutch
- Department of Endocrinology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
| | - Syed Mohd Razi
- Department of Endocrinology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
| | - Sukriti Kumar
- Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India
| | - Keshav Kumar Gupta
- Department of Endocrinology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
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Mahmood S, Perveen T, Dino A, Ibrahim F, Mehraj J. Effectiveness of school-based intervention programs in reducing prevalence of overweight. Indian J Community Med 2014; 39:87-93. [PMID: 24963224 PMCID: PMC4067935 DOI: 10.4103/0970-0218.132724] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 11/20/2013] [Indexed: 12/13/2022] Open
Abstract
Objectives: To assess the effectiveness of school-based interventions program in reducing the prevalence of overweight or obesity among schoolchildren. Data source: Ovid Medline (1950-December 2012), Embase (1980-2012), CINAHL (1982-2012), secondary references, review articles, and expert in the field. Study selection: All published clinical trials were eligible for study if were randomized, methodologically strong-based on a validity assessment, aimed to evaluate a school-based intervention for childhood overweight or obesity, and measured outcome in term of prevalence/incidence difference in overweight and obesity among both groups. Studies involved in cost-effective analysis of school-based intervention have been excluded. Data from eligible studies abstracted and pooled for relative risk. Results: Five trials with 3,904 schoolchildren were included. Mean age of the students (boys and girls) ranges 8.6-12.6 years. Meta-analysis showed a statistical significance beneficial effect of school-based intervention programs on obesity status of schoolchildren (risk ratio (RR) 0.58, 95% confidence interval (CI) 0.43-0.78) and suggested 42% reduction in prevalence of obesity among schoolchildren through school-based intervention programs. Individual studies also showed effectiveness of these school-based interventions. Conclusion: School-based intervention programs are effective in prevention of childhood overweight and obesity problem and our results quantitatively supported this argument.
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Affiliation(s)
- Sajid Mahmood
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Tahira Perveen
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Allah Dino
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Faisa Ibrahim
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Jaishri Mehraj
- Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan
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Prasad D, Kabir Z, Dash A, Das B. Effect of obesity on cardiometabolic risk factors in Asian Indians. J Cardiovasc Dis Res 2013; 4:116-22. [PMID: 24027368 PMCID: PMC3770112 DOI: 10.1016/j.jcdr.2012.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 09/14/2012] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To determine the prevalence of overweight and obesity and their effects on cardiometabolic risk factors in a representative sample of urban population in Eastern India. MATERIALS AND METHODS A population-based survey was conducted among a randomly selected study population aged 20-80 years in an urban population of Berhampur city of Eastern India. Both anthropometric and biochemical information were collected, in addition to detailed information on classical cardiometabolic risk factors. Both descriptive and inferential statistical analyses were performed. Obesity and overweight were defined based on the revised Asian-Pacific population criteria (Body mass index [BMI] ≥25 kg/m(2) and ≥23 kg/m(2), respectively). RESULTS The age-standardized rates of obesity and overweight are 36.8% (Males: 33.2%; Females: 40.8%) and 17.6%, (Males: 20.4%; Females: 15.1%) respectively, i.e., over half are either obese or overweight in this study population. Compared to the World Health Organization (WHO) standard cutoff criteria of overweight [BMI ≥25 kg/m(2)] and obesity [BMI >30 kg/m(2)], the cardiometabolic risk factors studied showed a significant incremental rise even with the lower cutoffs of the revised Asia-Pacific criteria. Older age, female gender, family history of diabetes, being hypertensive, hypertriglyceridemia, hypercholesterolemia, physical inactivity and middle to higher socioeconomic status significantly contributed to increased obesity risk among this urban population. CONCLUSION One-third of the urban populations are obese in Eastern India - an underestimate compared to the standard BMI cutoff criteria. Nevertheless, significant associations of the classical cardiometabolic risk factors with obesity were observed using the revised Asia-Pacific criteria clearly indicating a more aggressive cardiovascular prevention strategy for Asian Indians.
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Affiliation(s)
- D.S. Prasad
- Consultant Cardiologist, Sudhir Heart Centre, Berhampur 760 002, Orissa, India
| | - Zubair Kabir
- Department of Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - A.K. Dash
- Department of Pathology, M. K. C. G. Medical College, Berhampur 760004, Orissa, India
| | - B.C. Das
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar 751024, Orissa, India
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Mushtaq MU, Gull S, Abdullah HM, Shahid U, Shad MA, Akram J. Prevalence and socioeconomic correlates of overweight and obesity among Pakistani primary school children. BMC Public Health 2011; 11:724. [PMID: 21943029 PMCID: PMC3195095 DOI: 10.1186/1471-2458-11-724] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 09/25/2011] [Indexed: 12/11/2022] Open
Abstract
Background Childhood obesity is becoming an equally challenging, yet under-recognized, problem in developing countries including Pakistan. Children and adolescents are worst affected with an estimated 10% of the world's school-going children being overweight and one quarter of these being obese. The study aimed to assess prevalence and socioeconomic correlates of overweight and obesity, and trend in prevalence statistics, among Pakistani primary school children. Methods A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged 5-12 years in Lahore, Pakistan. Overweight (> + 1SD) and obesity (> + 2SD) were defined using the World Health Organization child growth reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors for overweight and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P < 0.05. Results Seventeen percent (95% CI 15.4-18.8) children were overweight and 7.5% (95% CI 6.5-8.7) were obese. Higher prevalence of obesity was observed among boys than girls (P = 0.028), however, there was no gender disparity in overweight prevalence. Prevalence of overweight showed a significantly increasing trend with grade (P < 0.001). Children living in the urban area with high socioeconomic status (SES) were significantly at risk for being overweight and obese (both P < 0.001) as compared to children living in the urban area with lower SES and rural children. Being in higher grade (aOR 2.39, 95% CI 1.17-4.90) and living in the urban area with higher SES (aOR 18.10, 95% CI 10.24-32.00) independently predicted the risk of being overweight. Conclusion Alarmingly rapid rise in overweight and obesity among Pakistani primary school children was observed, especially among the affluent urban population. The findings support the urgent need for National preventive strategy for childhood obesity and targeted interventions tailored to local circumstances with meaningful involvement of communities.
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Affiliation(s)
- Muhammad Umair Mushtaq
- Ubeera Memorial Research Society, Allama Iqbal Medical College, Lahore, 54000 Punjab, Pakistan.
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Abstract
A pathogenic relationship exists between type 2 diabetes and obesity. Over the last decade, the escalation in diabetes cases has paralleled the rapid increase in obesity rates, constituting a global health crisis. Environmental risk factors attributed to the global increase in obesity include the consumption of high-calorie, high-fat foods and inadequate physical activity. Obese individuals may also have a genetic predisposition for obesity. Both diabetes and obesity confer an elevated risk of developing a range of complications and comorbidities, including cardiovascular disease, hypertension and stroke, which can complicate disease management. This review examines the aetiology of the linkages between diabetes and obesity and the range of available therapies. Recent clinical evidence substantiating the efficacy and safety of incretin-based antidiabetic therapies is analysed, in addition to data on antiobesity therapeutic strategies, such as antiobesity agents, behaviour modification and bariatric surgery. Glucose control is often accompanied by weight-neutral or modest weight reduction effects with DPP-4 inhibitor treatment (sitagliptin, vildagliptin, saxagliptin) and weight loss with GLP-1 receptor agonist therapy (exenatide, liraglutide). Studies of antiobesity agents including orlistat, sibutramine and rimonabant have shown attrition rates of 30-40%, and the long-term effects of these agents remain unknown. Bariatric surgical procedures commonly performed are laparoscopic adjustable banding of the stomach and the Roux-en-Y gastric bypass, and have produced type 2 diabetes remission rates of up to 73%. Therapeutic strategies that integrate glycaemic control and weight loss will assume greater importance as the prevalence of diabetes and obesity increase.
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Affiliation(s)
- S Colagiuri
- Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, Sydney, NSW, Australia.
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Abstract
Prevalence of type 2 diabetes has rapidly increased in native and migrant Asian populations. Diabetes develops at a younger age in Asian populations than in white populations, hence the morbidity and mortality associated with the disease and its complications are also common in young Asian people. The young age of these populations and the high rates of cardiovascular risk factors seen in Asian people substantially increase lifetime risk of cardiovascular disease. Several distinctive features are apparent in pathogenetic factors for diabetes and their thresholds in Asian populations. The economic burden due to diabetes at personal, societal, and national levels is huge. National strategies to raise public awareness about the disease and to improve standard of care and implementation of programmes for primary prevention are urgently needed.
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Affiliation(s)
- Ambady Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes Hospitals, Chennai, India.
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Misra A, Khurana L. The Metabolic Syndrome in South Asians: Epidemiology, Determinants, and Prevention. Metab Syndr Relat Disord 2009; 7:497-514. [DOI: 10.1089/met.2009.0024] [Citation(s) in RCA: 228] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Anoop Misra
- Department of Diabetes and Metabolic Diseases, Fortis Hospital, Vasant Kunj, Delhi, India
- Center for Diabetes, Obesity, and Cholesterol Disorders (C-DOC), Diabetes Foundation (India), SDA, New Delhi, India
| | - Lokesh Khurana
- Center for Diabetes, Obesity, and Cholesterol Disorders (C-DOC), Diabetes Foundation (India), SDA, New Delhi, India
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Warraich HJ, Javed F, Faraz-Ul-Haq M, Khawaja FB, Saleem S. Prevalence of obesity in school-going children of Karachi. PLoS One 2009; 4:e4816. [PMID: 19308262 PMCID: PMC2655713 DOI: 10.1371/journal.pone.0004816] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 01/23/2009] [Indexed: 01/06/2023] Open
Abstract
Background Obesity is an emerging problem in Pakistan. The authors sought to determine prevalence of obesity and malnutrition in school-going children, from grades 6th to 8th of different schools of Karachi and assess associations that affect the weight of the children. Methodology/Principal Findings A cross sectional study design with children studying in grades 6th to 8th grade, in different schools of Karachi. We visited 10 schools of which 4 consented; two subsidized government schools and two private schools. A questionnaire was developed in consultation with a qualified nutritionist. Height and weight were measured on calibrated scales. A modified BMI criterion for Asian populations was used. Data was collected from 284 students. Of our sample, 52% were found to be underweight whereas 34% of all the children were normal. Of the population, 6% was obese and 8% overweight. Of all obese children, 70% belonged to the higher socio-economic status (SES) group, while of the underweight children, 63.3% were in the lower SES. Amongst obese children in our study, 65% ate meat every day, compared to 33% of normal kids. Conclusion Obesity and undernutrition co-exist in Pakistani school-children. Our study shows that socio-economic factors are important since obesity and overweight increase with SES. Higher SES groups should be targeted for overweight while underweight is a problem of lower SES. Meat intake and lack of physical activity are some of the other factors that have been highlighted in our study.
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Kaur M, M Hegde A. Are we Aware of what we are, we are what we Eat- An Epidemiological Survey. Int J Clin Pediatr Dent 2008; 1:13-6. [PMID: 25206083 PMCID: PMC4086540 DOI: 10.5005/jp-journals-10005-1003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 10/15/2008] [Indexed: 11/23/2022] Open
Abstract
The lure of convenience in addition to good taste gets people to junk food addiction. With the advent of television even in the remotest areas people have become more aware of the fast food items available. Children watch television where fast food continues to dominate the food advertisements viewed by children. The easily available fast food in and around school campus and with little knowledge of the far reaching effects of these food items consumed, children fall an easy prey to junk food. Children are unaware of the food they eat and the effects it has on their growth and development. This survey reflects the large percentageof children who surrender to the temptation junk food consumption with little knowledge of its far sighted effects on their health.
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Affiliation(s)
- Manpreet Kaur
- Postgraduate Student, Department of Pedodontics and Preventive Children Dentistry, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Amitha M Hegde
- Professor and Head, Department of Pedodontics and Preventive Children Dentistry, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
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Misra A. Coronary risk in autoimmune rheumatological diseases: an unfolding saga and perspective for Asian Indians. INDIAN JOURNAL OF RHEUMATOLOGY 2008. [DOI: 10.1016/s0973-3698(10)60138-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Basit A, Shera AS. Prevalence of Metabolic Syndrome in Pakistan. Metab Syndr Relat Disord 2008; 6:171-5. [DOI: 10.1089/met.2008.0005] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Abdul Basit
- Baqai Medical University, Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan
| | - A. Samad Shera
- WHO Collaborating Centre, Diabetic Association of Pakistan, Karachi, Pakistan
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Kim ES, Im JA, Kim KC, Park JH, Suh SH, Kang ES, Kim SH, Jekal Y, Lee CW, Yoon YJ, Lee HC, Jeon JY. Improved insulin sensitivity and adiponectin level after exercise training in obese Korean youth. Obesity (Silver Spring) 2007; 15:3023-30. [PMID: 18198311 DOI: 10.1038/oby.2007.360] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the association among adiposity, insulin resistance, and inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha] and adiponectin and to study the effects of exercise training on adiposity, insulin resistance, and inflammatory markers among obese male Korean adolescents. RESEARCH METHODS AND PROCEDURES Twenty-six obese and 14 lean age-matched male adolescents were studied. We divided the obese subjects into two groups: obese exercise group (N = 14) and obese control group (N = 12). The obese exercise group underwent 6 weeks of jump rope exercise training (40 min/d, 5 d/wk). Adiposity, insulin resistance, lipid profile, hs-CRP, IL-6, TNF-alpha, and adiponectin were measured before and after the completion of exercise training. RESULTS The current study demonstrated higher insulin resistance, total cholesterol, LDL-C levels, triglyceride, and inflammatory markers and lower adiponectin and HDL-C in obese Korean male adolescents. Six weeks of increased physical activity improved body composition, insulin sensitivity, and adiponectin levels in obese Korean male adolescents without changes in TNF-alpha, IL-6, and hs-CRP. DISCUSSION Obese Korean male adolescents showed reduced adiponectin levels and increased inflammatory cytokines. Six weeks of jump rope exercise improved triglyceride and insulin sensitivity and increased adiponectin levels.
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Affiliation(s)
- Eun Sung Kim
- Department of Sport and Leisure Studies, Yonsei University, Seodaemun-Gu Shinchon-Dong 134, Seoul, Korea
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Misra A, Khurana L, Vikram NK, Goel A, Wasir JS. Metabolic syndrome in children: current issues and South Asian perspective. Nutrition 2007; 23:895-910. [DOI: 10.1016/j.nut.2007.08.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Revised: 08/14/2007] [Accepted: 08/29/2007] [Indexed: 01/19/2023]
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Misra A, Ganda OP. Migration and its impact on adiposity and type 2 diabetes. Nutrition 2007; 23:696-708. [PMID: 17679049 DOI: 10.1016/j.nut.2007.06.008] [Citation(s) in RCA: 149] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 06/08/2007] [Accepted: 06/08/2007] [Indexed: 12/30/2022]
Abstract
In this review, we discuss the impact of migration on the incidence and prevalence of obesity and type 2 diabetes mellitus (T2DM) in different ethnic groups and populations. We also analyze the determinants of such phenomena in view of the global increase in the migration and escalating prevalence of obesity and T2DM. The risk escalation of the obesity and T2DM followed a gradient, as migrants (Blacks, Hispanics, Chinese, South Asians, etc.) became more affluent and urbanized, indicating an important role of environmental factors. A stepwise increase in the prevalence of obesity in Blacks along the path of migration (5% in Nigeria, 23% in Jamaica, and 39% in the United States) is a classic example. Furthermore, South Asian migrants, who are particularly predisposed to develop insulin resistance and T2DM, showed nearly four times prevalence rates of T2DM than rural sedentee populations. Similar observations were also reported in intracountry migrants and resettled indigenous populations. The determinants were found to include nutrition transition, physical inactivity, gene-environment interaction, stress, and other factors such as ethnic susceptibility. However, certain contradictory trends were also seen in some migrant communities and have been explained by various phenomena such as healthy migrant effect, "salmon bias", and adherence to traditional diets. A review of the evidence suggests a critical role of environmental factors in conferring an increased risk of obesity and T2DM. The important contributory factors to this phenomenon were urbanization, mechanization, and changes in nutrition and lifestyle behaviors, but the role of stress and as yet unknown factors remain to be determined.
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Affiliation(s)
- Anoop Misra
- Department of Diabetes and Metabolic Diseases, Fortis Hospital, New Delhi, India.
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Metabolic syndrome in children and adolescents: Problems in definition, and ethnicity-related determinants. Diabetes Metab Syndr 2007. [DOI: 10.1016/j.dsx.2007.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Nagelkerke NJD, Bernsen RMD, Sgaier S, Jha P. Body mass index, sexual behaviour, and sexually transmitted infections: an analysis using the NHANES 1999-2000 data. BMC Public Health 2006; 6:199. [PMID: 16884541 PMCID: PMC1559603 DOI: 10.1186/1471-2458-6-199] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2006] [Accepted: 08/02/2006] [Indexed: 12/16/2022] Open
Abstract
Background Factors determining human sexual behaviour are not completely understood, but are important in the context of sexually transmitted disease epidemiology and prevention. Being obese is commonly associated with a reduced physical attractiveness but the associations between body mass index, sexual behaviour and the risk of acquiring sexually transmitted infections has never been studied. Methods The National Health and Nutrition Examination Survey (NHANES) files of 1999–2000 were used. Linear regression was used to relate the reported number of sex partners in the last year and lifetime to Body Mass Index (BMI). Logistic regression was used to relate Herpes Simplex Virus type II (HSV-2) antibodies to BMI and other variables. Results Data on 979 men and 1250 women were available for analysis. Obese (mean number of partners for men:1.12, women: 0.93) and overweight (mean for men: 1.38, women: 1.03) individuals reported fewer partners than individuals of normal BMI (mean for men:2.00, women: 1.15) in the last year (p < .0.01 & p < 0.05 for men, p < 0.05 & n.s. for women). The same relationship held for lifetime partners in men (mean 11.94, 18.80, and 22.08 for obese, overweight and normal BMI respectively (p < 0.05 & n.s. for obese and overweight vs normal respectively), but not in women (mean 7.96, 4.77, and 5.24 respectively). HSV-2 antibodies were significantly correlated with the number of lifetime partners in both men and women, with the odds of being HSV-2 positive increasing by 0.6% (p < 0.01) and 2.7% (p < 0.01) for men and women respectively. HSV-2 antibodies increased with age, even after adjustment for lifetime partners (p < 0.01). Being obese (HSV-2 prevalence 15.9 and 34.9% for men and women respectively) or overweight (HSV-2 prevalence 16.7 and 29.3 for men and women respectively) was not associated with HSV-2 antibodies (HSV-2 prevalence for normal BMI: 15.6 and 23.2% respectively), independent of whether the association was adjusted for life time sexual partners or not. There was evidence of substantial misreporting of sexual behaviour. Conclusion Obese and overweight individuals, especially men, self report fewer sex partners than individuals of normal weight, but surprisingly this is not reflected in their risk of HSV-2 infection. HSV-2 antibodies provide information not contained in self-reported number of partners and may better estimate sexual risk than self-reported behaviour.
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Affiliation(s)
- Nico JD Nagelkerke
- Department of Community Medicine, United Arab Emirates University, Al Ain, UAE
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Roos MD Bernsen
- Department of Community Medicine, United Arab Emirates University, Al Ain, UAE
| | - Sema Sgaier
- Centre for Global Health Research, St Michael's Hospital, Toronto, Canada
| | - Prabhat Jha
- Centre for Global Health Research, St Michael's Hospital, Toronto, Canada
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