Association between physical activity and insulin resistance in Iranian adults: National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007)

V, Shastry BA. Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus-A randomized controlled trial

OBJECTIVE

Impaired glucose control & Insulin resistance are reported to be risk factors for the development of cardiovascular diseases. To find the effects of a structured exercise program on insulin resistance, glycaemic control, functional capacity, and quality of life in patients with Type 2 diabetes mellitus.

DESIGN

Randomized, controlled trial.

SETTING

Diabetic Foot Clinic, Department of Physiotherapy & Department of General Medicine, Kasturba Hospital in Manipal, Karnataka, India.

PARTICIPANTS

160 participants aged between 30-65 years with Type 2 diabetes mellitus.

INTERVENTION

A set of structured exercise programs (aerobic, resistance, and combined) along with the standard hospital care was performed 3-5 times weekly for 12 weeks.

MEASUREMENTS: PRIMARY OUTCOME MEASURES

Fasting Insulin Level, Homa-IR, Six-minute walk test (6MWT), and WHOQOL-BREF questionnaire at baseline and 12th week.

SECONDARY OUTCOME MEASURES

Body composition analysis, Fasting Blood Sugar, Postprandial Blood Sugar, Glycated Haemoglobin (HbA1c), and GPAQ questionnaire at baseline and 12th week.

RESULTS

Significant differences have been observed in Homeostasis model assessment for insulin resistance (Homa-IR) (F (1, 144) = 89.29, p < 0.001); Fasting insulin (FI) (F (1, 144) = 129.10, p < 0.001); Fasting blood sugar (FBS) (F (1, 144) = 12.193, p< 0.001); Post prandial blood sugar (PPBS) (F (1, 144) = 53.015, p< 0.001); glycated haemoglobin (HbA1c) (F (1, 144) = 80.050, p < 0.001); WHOQOL-Physical health (F (1, 144) = 20.008, p< 0.001), Psychological (F (1, 144) = 77.984, p< 0.001), Social relationship (F (1, 144) = 44.866, p< 0.001); Environmental (F (1, 144) = 69.974, p< 0.001); Six minute walk test (6MWT) (F (1, 144) = 84.135, p< 0.001) in the study group when compared with the control group from baseline to 12th week.

CONCLUSIONS

The study reveals that a 12-week structured exercise training program effectively reduces insulin resistance, improves quality of life, enhances functional capacity, and improves glycaemic control in type 2 diabetes mellitus.

Associations of Sedentary Time and Physical Activity with Metabolic Syndrome among Chinese Adults: Results from the China Health and Nutrition Survey

OBJECTIVE

This study aimed to determine the independent and joint associations of sedentary time (ST) and physical activity (PA) with metabolic syndrome (MetS) and its components among Chinese adults.

METHODS

The study analyzed data from 4,865 adults aged ≥ 18 years who participated in the 2009 and 2015 China Health and Nutrition Surveys (CHNS). Four types of leisure ST and three types of PA self-reported at baseline were collected. Multivariable logistic regressions were used to determine the independent and joint associations of ST and PA with the odds of MetS or its components.

RESULTS

For independent effects, higher levels of television time and total leisure ST was associated with higher MetS risk [odds ratio ( OR) 1.3, 95% confidence interval ( CI) 1.1-1.6, P < 0.001; OR 1.4, 95% CI 1.2-1.8, P < 0.001, respectively]. The MetS risk in the computer time > 7 hours/week (h/w) group was higher than that in the < 7 h/w group in ( OR 1.5, 95% CI 1.2-1.9). Higher levels of moderate-to-vigorous-intensity physical activity (MVPA) and total PA were associated with a lower MetS risk ( OR 0.7, 95% CI 0.6-0.9, P < 0.001; OR 0.8, 95% CI 0.7-0.9, P < 0.001, respectively). For the joint effects, compared with those reporting the lowest level of total leisure ST (< 14 h/w) and the most active tertile of MVPA (≥ 61.0 MET-h/w), participants reporting the most total leisure ST (≥ 35 h/w) and the lowest level of MVPA (0 MET-h/w) had the highest odds of MetS ( OR 2.0; 95% CI 1.4-2.7). Except for people reporting ST (14-21 h/w) within the most active tertile of MVPA, the associations in all other groups were significant. With the increase of TV time and decreased MVPA, the odds of MetS almost showed a curve acceleration.

CONCLUSIONS

MVPA and total PA have independent preventive effects, and sedentary behavior (mainly watching TV) has an unsafe effect on MetS and its components. Strengthening the participation of MVPA and combining the LPA to replace the TV-based ST to increase the total PA may be necessary to reduce the prevalence of MetS in Chinese adults.

Dietary Inflammatory Index and Breast Cancer: report from a Large-Scale Case-Control Study

OBJECTIVE

The relationship between diet, including its inflammatory potential, and breast cancer has led to inconsistent results. We investigated the association between a dietary inflammatory index (DII) and the odds of breast cancer in a large case-control study among women.

METHODS

This case-control study was carried out on 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls. DII scores were calculated from dietary intake data. Multi-variable adjusted logistic regression was used to obtain odds ratios for breast cancer across quartiles of DII.

RESULTS

A total participants aged 45 ± 10.8 years were included in the present study. After adjustment for potential confounders, individuals in the highest quartile of DII scores had 1.5 times higher odds of breast cancer than those with the lowest (OR= 1.56; 95%CI: 1.04-2.35, Ptrend=0.02). Premenopausal women with the greatest DII had higher odds for breast cancer, compared with those with the lowest DII (OR= 1.92; 95% CI: 1.14-3.25, Ptrend=0.01). No significant association was seen between DII and odds of breast cancer in postmenopausal women.

CONCLUSION

Dietary inflammatory index might be directly associated with odds of breast cancer particularly in premenopausal women. Prospective cohort studies are needed to confirm these findings.

Trends of low physical activity among Iranian adolescents across urban and rural areas during 2006-2011

It is well documented that physical inactivity is related to weight gain and a whole host of chronic diseases. This study investigated trends of low physical activity among Iranian adolescents in urban and rural areas between 2006-2011. A total of 12,178 adolescents, aged between 15 and 19 years, participated in National Surveys of Risk Factors for Non-Communicable Diseases. Data on physical activity was obtained using the global physical activity questionnaire. A complex sample survey and multinomial logistic regression were used to model physical activity levels. The percentage of adolescents who had low levels of physical activity increased from 2006 to 2011 in both urban and rural areas. Low and moderate levels of physical activity were lower in rural girls as compared with urban girls, with a prevalence ratio of 0.59 (95% CI 0.47-0.74) and 0.59 (95% CI 0.47-0.74), respectively. The corresponding values for boys residing in rural areas compared with boys in urban areas were 0.56 (95% CI 0.43-0.75) and 0.60 (95% CI 0.48-0.74), respectively. The adolescents' lifestyles showed an increasing trend for physical inactivity in both genders; however, in rural areas, only girls had a rising affinity for a sedentary lifestyle throughout the 2006-2011 years.

Physical activity and self-rated health: role of contexts

The purpose of this study is to examine how much variance in self-rated health is attributable to household and administrative-area levels. Additionally, the study investigates the association between physical activity and self-rated health while adjusting for various covariates at the individual, household, and district levels in Seoul, South Korea. A cross-sectional study of the 2009 Seoul Welfare Panel Study conducted by Seoul Welfare Foundation was utilized. The final sample included 7,761 individuals within 3,617 households in 25 administrative areas. Three-level random intercept logistic models were fitted. The results showed that a small proportion (3.52%) of variance in self-rated health was attributed to the administrative-area level, while a relatively large proportion (33.78%) was attributed to the household level. This study also found a positive association between physical activity and self-rated health, even after controlling for covariates at multiple levels. The results indicated that public health interventions promoting physical activity may have a beneficial effect on individual health. Additionally, public health interventions for improving individual health may not be efficient if directed only at the administrative-area level, as only a small portion of variance in self-rated health was attributable to this level.

Geographical Patterning of Physical Activity Prevalence in Iran: Spatial Analysis of 4 Pooled National Health Surveys Among 119,560 Adults

BACKGROUND

To investigate the geographical distribution of physical activity (PA) prevalence among adults aged 15-64 years old across Iran provinces using geographic maps.

METHODS

Data from 4 consecutive national surveys conducted between 2007 and 2010 were pooled to determine the geographical distribution. Prevalence of low PA with 95% confidence interval was estimated by sociodemographic subpopulations over provinces using complex survey design.

RESULTS

In total, 119,560 participants (49.9% females) were included in the analyses. The mean (SD) age of participants was 39.5 (14.3) years. The prevalence of the low PA in the pooled 2007-2010 was 35.8% (95% confidence interval, 34.1-37.6). The 3 provinces with the highest prevalence of low PA were Sistan and Baluchestan, Yazd, and Hormozgan. The results of hot spot analysis showed that the Kerman province was a hot spot, and Ilam, Kermanshah, Hamedan, and Markazi were cold spots for low PA. Ilam, Kohgiluyeh and Boyer-Ahmad, and Mazandaran had the highest total PA volume (metabolic equivalent minutes per week). Hot spot analysis showed that Ilam and Khuzestan provinces were hot spots for the total PA volume.

CONCLUSIONS

The regions with low and high PA are predominately situated in the near center/southeast and west, respectively.

Simultaneous Improvement of Habitual Physical Activity and Life Quality in Kidney Transplant Recipients Involved in Structured Physical Activity Program

OBJECTIVES

The aim of the study was to compare the effects of a physical activity program on daily physical activity and quality of life in kidney transplant (KTx) recipients and in patients with chronic kidney disease (CKD).

MATERIALS AND METHODS

The study group consisted of 24 KTx recipients and 15 patients with stage 3 to 4 CKD. Habitual physical activity was monitored for 72 hours. Individualized structured programs of increased physical activity were prepared based on baseline physical performance. The measurements were repeated after 1 and 3 months. Participants completed the 36-item Short Form Health Survey questionnaire and an International Physical Activity Questionnaire at baseline and after 1, 2, and 3 months.

RESULTS

Physical activity duration and total energy expenditure significantly increased after 3 months in both KTx recipients (from 126 ± 87 to 200 ± 132 min/d, P = .001, and from 1.73 ± 0.37 to 2.24 ± 0.59 cal/min, P < .001, respectively) and CKD patients (from 79 ± 78 to 129 ± 114 min/d, P < .001, and from 1.5 ± 0.5 to 1.92 ± 0.47 cal/min, P < .001, respectively). Short Form Health Survey total score and physical component scale score improved significantly in both groups. Mental component scale score increased significantly only in KTx patients.

CONCLUSION

Increased physical activity induces similar beneficial effects on total and physical activity component of quality of life and habitual daily activity in CKD and KTx patients.

Contribution of lower physical activity levels to higher risk of insulin resistance and associated metabolic disturbances in South Asians compared to Europeans

BACKGROUND

Insulin resistance and related metabolic disturbances are major risk factors for the higher T2D risk and associated morbidity and mortality amongst South Asians. The contribution of physical activity to the increased prevalence of insulin resistance and related disturbances amongst South Asians is unknown.

METHODS

We recruited 902 South Asian and European men and women, aged 35-85 years from the ongoing LOLIPOP study. Clinical characterisation comprised standardised questionnaire and measurement of height, weight, waist and hip circumference and blood pressure. Fasting bloods were taken for assessment of glucose, insulin, lipids and HbA1c. Physical activity was quantified using a validated accelerometer, Actigraph GT3X+, worn for 7 days. Univariate and multivariate approaches were used to investigate the relationship between ethnicity, physical activity, insulin resistance and related metabolic disturbances.

RESULTS

Total physical activity was ~31% (P = 0.01) lower amongst South Asians compared to Europeans (Mean MET.minutes [SD]: 1505.2 [52] vs. 2050.9 [86.6], P<0.001). After adjusting for age and sex, total physical activity had a negative association with HOMA-IR (B [SE]: -0.18 [0.08], P = 0.04) and fasting glucose levels (B[SE]: -0.11 [0.04], P = 0.02). There was no association between physical activity and other glycemic and lipid parameters. Total physical activity per week contributed towards the differences in insulin resistance and associated metabolic disturbances between South Asians and Europeans.

CONCLUSION

Lower levels of physical activity may contribute to the increased insulin resistance in South Asians compared to Europeans. Our results suggest that lifestyle modification through increased physical activity may help to improve glucose metabolism and reduce the burden of excess T2D and related complications amongst South Asians.

Prevalence and correlates of low physical activity in the Iranian population: National survey on non-communicable diseases in 2011

To assess the prevalence and correlates of low physical activity among Iranian population aged 15-64 years. We used the data collected in National Surveillance of Risk Factors of Non-Communicable Diseases in Iran, 2011. Physical activity was categorized in 3 levels of low, moderate, and high based on a Persian version of Global Physical Activity Questionnaire. The multistage cluster sampling design was accounted for using complex survey analysis method. The sample included 10016 individuals; 41.7% (n = 4178) were men and 58.3% (n = 5837) were women. The mean (SD) age of participants was 38.8 (14.9) years also, and 69.8% (n = 6991) of the participants were from urban areas. The prevalence of low physical activity in the whole population was estimated to be 44.8% (95% CI: 41.7, 48.1). The odds of lower physical activity in the women were 3 times greater than men (OR = 3.14; 95% CI: 2.64, 3.57); in the wealthiest people was 25% lower than the poorest people (OR = 0.75; 95% CI: 0.60, 0.94). The odds of lower physical activity in the age groups 55-64 years were 44% greater than the youngest age groups 15-24 years (OR = 1.44; 95% CI: 1.23, 1.68). The odds of lower physical activity in the obese participants were 18% greater than normal-weight people (OR = 1.18; 95% CI: 1.01, 1.38).). The odds of lower physical activity in diabetic patients were 30% greater than healthy people (OR: 1.30; 95% CI: 1.07, 1.57). The prevalence of low physical activity in Iran, 2011 was high. The correlates of low physical activity in Iran are different to those of Western populations. The main associated factors with low physical activity were female gender, urban area, low socioeconomic status, obesity, diabetes, and older age. Public health policies should target the groups at highest risk of low physical activity.

The association of MC4R rs17782313 polymorphism with dietary intake in Iranian adults

BACKGROUND

Malfunction in the energy homeostasis system is a major cause of developing obesity. Melanocortin-4 receptor (MC4R) plays a crucial role in this system as a key receptor. Although MC4R gene as an obesity candidate gene is associated with higher BMI, only few attempts have been carried out to understand the mechanism underlying body-weight regulation.

OBJECTIVE

The aim of this study is to investigate the association between variant rs17782313 near MC4R gene and both dietary energy and macronutrient intakes.

METHODS

An Iranian population, 400 adults aged over 22years were selected from the Iranian Multicenter Osteoporosis Study (IMOS). Genotyping for the near MC4R rs17782313 was performed by PCR-RFLP. Weight and height were measured. Dietary intake and physical activity were assessed by using validated questionnaires. Analysis was carried out in two groups with regard to BMI. Multiple linear regression models adjusted for covariates were used to examine the association between rs17782313 and dietary intake.

RESULTS

MC4R rs17782313 was associated with high energy intake (P<0.001), and low carbohydrate and protein intakes (P<0.001 and P<0.01 respectively). In addition, the significant association between variant rs17782313 and fat intake disappeared after adjusting for energy.

CONCLUSIONS

The rs17782313 variant contributes to the variety of dietary energy and energy-dense macronutrient intakes. Moreover, a novel association was suggested between this polymorphism and dietary fat intake.

Evidence Gap on the Prevalence of Non-conventional Risk Factors for Type 2 Diabetes in Iran

OBJECTIVES

Robust scientific evidence exists about the role of non-conventional risk factors in type 2 diabetes worldwide. The current epidemiological pattern of the disease in Iran suggests a precipitating role for these non-conventional risk factors. This review was performed to examine the research evidence suggesting a higher prevalence of non-conventional type 2 diabetes risk factors in Iran.

METHODS

MeSH keywords were applied to search several databases, including PUBMED, MEDLINE, AMED, EMBASE, Iran DOC, and the Scientific Information Database without a time limit from inception to September 2011. The quality of the non-interventional and population-based studies on Iranians included in these databases was assessed by the authors and any disagreement was resolved with consensus.

RESULTS

The literature search yielded 1847 publications, of which 62 were included in this study after eliminating non-relevant and overlapping papers. No study was found that verified a higher prevalence of the non-conventional type 2 diabetes risk factors in the Iranian population.

CONCLUSION

The identified evidence gap about the role of prominent non-conventional risk factors of type 2 diabetes in the Iranian population could be a major caveat in the application of an evidence-based approach to endorse or reject existing hypothesis about these risk factors. Studies on the prevalence of non-conventional biomarkers of type 2 diabetes among Iranians could be a promising area of research.

Linking lifestyle factors and insulin resistance, based on fasting plasma insulin and HOMA-IR in middle-aged Japanese men: a cross-sectional study

OBJECTIVE

Insulin resistance (IR) is regarded as one of the earliest features of many metabolic diseases, and major efforts are aimed at improving insulin function to confront this issue. The aim of this study was to investigate the relationship of body mass index (BMI), cigarette smoking, alcohol intake, physical activity, green tea and coffee consumption to IR.

METHODS

We performed a cross-sectional study of 1542 male self defense officials. IR was defined as the highest quartile of the fasting plasma insulin (≥ 50 pmol/L) or the homeostasis model assessment-estimated IR (HOMA-IR ≥ 1.81). An unconditional logistic model was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between IR and influential factors. Stratified analysis by obesity status (BMI < 25 kg/m(2), non-obese; ≥ 25 kg/m(2), obese) was performed.

RESULTS

IR was significantly positively related to BMI and glucose tolerance, negatively related to alcohol use. Independent of obesity status, significant trends were observed between IR and alcohol use. Drinking 30 mL or more of ethanol per day reduced IR by less than 40%. Strong physical activity was associated with decreased risk of IR based on fasting plasma insulin only in the obese. Coffee consumption was inversely associated with the risk of IR based on HOMA-IR in the non-obese group.

CONCLUSION

Higher coffee consumption may be protective against IR among only the non-obese. Further studies are warranted to examine the effect modification of the obesity status on the coffee-IR association.

Association between physical activity and metabolic syndrome among Malay adults in a developing country, Malaysia

OBJECTIVES

Metabolic syndrome is a highly prevalent health problem within the adult population in developing countries. We aimed to study the association of physical activity levels and metabolic risk factors among Malay adults in Malaysia.

DESIGN

Cross-sectional.

METHODS

Body mass index, waist circumference, and systolic/diastolic blood pressure, fasting blood glucose, fasting triglyceride and high-density lipoprotein cholesterol levels were measured in 686 Malay participants (aged 35-74 years). Self-reported physical activity was obtained with the validated International Physical Activity Questionnaire (Malay version) and categorized into low, moderate or high activity levels.

RESULTS

Individuals who were classified as overweight and obese predominated (65.6%). On the basis of the modified NCEP ATP III criteria, metabolic syndrome was diagnosed in 31.9% of all participants, of whom 46.1% were men and 53.9% were women. The prevalence of metabolic syndrome among participants with low, moderate or high activity levels was 13.3%, 11.7% and 7.0%, respectively (p<0.001). Statistically significant negative associations were found between a number of metabolic risk factors and activity categories (p<0.05). The odds ratios for metabolic syndrome in the moderate and high activity categories were 0.42 (95% CI: 0.27-0.65) and 0.52 (95% CI: 0.35-0.76), respectively, adjusted for gender.

CONCLUSIONS

Moderate and high activity levels were each associated with reduced odds for metabolic syndrome independent of gender. Although a slightly lower prevalence of metabolic syndrome was associated with high activity than with moderate activity, potential health benefits were observed when moderate activity was performed.

Lifestyle and the risk of diabetes mellitus in a Japanese population

The objective was to examine the association between lifestyle and risk for diabetes. For an average of 9.9 years, this study prospectively followed a cohort of 7,211 (2,524 men and 4,687 women) community residents aged 30-69 years without diabetes at a health check-up conducted between April 1990 and March 1992 until diabetes was confirmed or until the end of 2006. The subjects were divided into 6 groups according to their total scores of Breslow's lifestyle index (1-2, 3, 4, 5, 6 and 7 points). The association between lifestyle and diabetes incidence was investigated using Cox proportional hazards regression models. The results showed that the multivariate-adjusted hazard ratios were 0.45 in subjects who scored 5 points, 0.39 in subjects who scored 6 points, and 0.31 in subjects who scored 7 points, compared with subjects who scored 1-2 points. These data indicate that the healthy behaviors prevent the incidence of diabetes.

Interaction between physical activity and sleep duration in relation to insulin resistance among non-diabetic Chinese adults

BACKGROUND

It is of a public health interest to explore the relationship between different types of physical activity, sleep duration and diabetes/insulin resistance. However, little is known about such relationship. This study examines the single and joint associations of different types of physical activity, and sleep duration on insulin resistance among non-diabetic Chinese adults.

METHODS

Data was collected from 1124 non-diabetic adults in Jiangsu Province from the China Health and Nutrition Survey (CHNS). Domestic, occupational, transportation and leisure physical activity were assessed in terms of metabolic equivalent (MET)-hours-per-week to account for both intensity and time spent. Sleep duration was categorized into three groups: ≤ 7 hours, 7-9 hours, and ≥ 9 hours. Insulin resistance was evaluated by the homeostasis model of assessment (HOMA) and defined as the highest quartile of HOMA.

RESULTS

Total physical activity was mainly composed of occupational activity (75.1%), followed orderly by domestic, transportation and leisure time activity in both men and women. Total physical activity level was strongly negatively associated with fasting insulin and HOMA (p < 0.001). Among four types of physical activity, occupational activity was significantly negatively associated with HOMA after full adjustment (p < 0.05). Transportation activity was also negatively associated with HOMA when adjusted for age and gender (p = 0.028). Moreover, the combination of low physical activity and short sleep duration was associated with the highest odds of insulin resistance (adjusted OR = 3.26, 95% CI: 1.57-6.78), compared to those with high physical activity and adequate sleep duration.

CONCLUSIONS

Physical activity, mainly occupational physical activity, was negatively associated with insulin resistance in non-diabetic Chinese population, independently of potential confounders. There was a synergic effect of low physical activity and short sleep duration on insulin resistance.

Coronary artery disease and its risk factors status in iran: a review

Background

Coronary artery disease (CAD) is a leading cause of mortality, morbidity, and disability in the world. The high prevalence and morbidity associated with CAD in Iran is one of the most pressing health problems.

Methods

We have reviewed the status of CAD and prevalence of its traditional and novel risk factors based on the published papers in recent years that may have an impact on the rate of CAD in Iran. Evaluation of current impact of metabolic syndrome in Iran was the other aim of this review, as it contributes to pathogenesis of coronary artery disease. We reviewed all PubMed indexed related studies. Some evidences from national articles which were published by the Ministry Of Health and Medical Education Research Council Certified Medical Journals of Islamic Republic of Iran were also included.

Results

The prevalence of CAD, coronary risk factors and metabolic syndrome in Iran is higher than Western countries and similar to some Middle East countries. There are limited data with regard to novel coronary risk factors in Iran.

Conclusion

Primary and secondary prevention of CAD including life style modifications and dietary interventions strongly recommended in Iranian population.

Physical activity is correlated with serum leptin independent of obesity: results of the national surveillance of risk factors of noncommunicable diseases in Iran (SuRFNCD-2007)

Reports on the relationship between leptin and physical activity (PA) at the population level are scarce. The present study examined the relationship between serum leptin concentrations and PA in a nationally representative sample of 3001 Iranian adults aged 25 to 64 years. Data of our third national surveillance of risk factors of noncommunicable diseases were analyzed. Using the Global Physical Activity Questionnaire, the duration and intensity of PA were evaluated in 3 domains: work, commuting, and recreation. Total PA was calculated using metabolic equivalents for PA intensity. Serum leptin was measured with an enzyme-linked immunosorbent assay. After adjustment for age, area of residence, smoking, body mass index, and waist circumference, total PA (r = -0.129, P = .038 in men and r = -0.226, P = .006 in women), the duration of vigorous-intensity activity (r = -0.120, P = .044 in men and r = -0.154, P = .019 in women), the duration of moderate-intensity activity (r = -0.114, P = .047 in men and r = -0.160, P = .018 in women), and time spent on sedentary behaviors (r = 0.194, P = .014 in men and r = -0.204, P = .007 in women) were significantly correlated with serum leptin. In both sexes, participants in higher categories of PA had significantly lower serum leptin levels. In conclusion, our results demonstrated an inverse association between leptin concentrations and PA independent of age, sex, smoking, and body adiposity. Our results point to the regulatory effects of PA on serum leptin.

Trends of diabetes according to body mass index levels in Iran: results of the national Surveys of Risk Factors of Non-Communicable Diseases (1999-2007)

AIMS

The prevalence of diabetes is increasing dramatically worldwide. Less is known about whether this trend is similar among obese and lean individuals.

METHODS

We analysed the data sets of three cross-sectional national surveys in adults aged 25-64 years: the National Health Survey-1999 (n=21,576), and the national Surveys of Risk Factors of Non-Communicable Diseases (SuRFNCD)-2005 (n=70,981) and SuRFNCD-2007 (n=4233). Diagnosed diabetes was ascertained, and height and weight were measured in all surveys. In SuRFNCD-2005 and SuRFNCD-2007, fasting plasma glucose was used to identify subjects with newly diagnosed diabetes (≥ 7 mmol/l) and impaired fasting glucose (5.6 - 6.9 mmol/l) among individuals not reporting diabetes.

RESULTS

The prevalence of diagnosed diabetes (after adjustment for age, sex and residential area) was 2.5, 4.0 and 4.6% in 1999, 2005 and 2007, respectively. The total prevalence of diabetes increased from 7.7% in 2005 to 8.7% in 2007, about half of which was attributed to newly diagnosed disease (in both surveys). The prevalence of diabetes increased in all categories of obesity, with the most evident trend being among subjects with body mass index <25 kg/m(2) .

CONCLUSIONS

The prevalence of diabetes among Iranian adults has increased more than 1.8-fold in a period of only 8 years since 1999. This is the first report from Iran, and urgent measures need to be taken in order to prevent the progression and worsening of the problem and emergence of its undesired consequences.

Associations between physical activity and health parameters in adolescent pupils in Egypt

Physical activity (PA) could be protective against hypertension, atherosclerosis, coronary heart disease and cardiovascular disease. This quantitative study assessed the association between a PA intervention and three anthropometric parameters (weight, body mass index, body fat) and four physiological parameters (cholesterol level, systolic blood pressure, diastolic blood pressure, heart rate) among secondary school pupils (N = 160) in Egypt through the school term. The pupils were randomised to an intervention group (80 pupils) and controls (80 pupils). Measurements were obtained for all pupils twice: at baseline; and then again after three months. The PA intervention programme comprised an ‘afterschool’ one hour of moderate exercise three times a week for three months. Both the controls and the intervention pupils attended the ‘normal’ exercise schedule provided by the school; in addition, the intervention group attended afterschool PA programme from about 2–3 o’clock in the afternoon. At baseline, employing pupil’s BMI, 27.5% and 28.8% of the intervention and control pupils respectively were classified as overweight. After three months, the percentage of overweight decreased to 12.5% in the intervention pupils, while it increased to 37.3% in the controls. At the end of the three months period, there were significant improvements across most anthropometric and physiological parameters of the intervention pupils when compared with the control children. The correlation coefficient of the improvements for the boys and the girls was 0.97, indicating clearly that the intervention was having nearly the same beneficial effect for boys and girls. A moderate PA programme for a modest period of 3 months could be effective in maintaining or enhancing pupil’s anthropometric and physiological parameters in comparison to the controls where there was deterioration in both parameters. Policy makers and secondary schools in Egypt might need to pay more attention to PA programmes conducted on school days, in order to motivate pupils to attend such programmes. There is also an urgent need to look at current PA systems within schools in Egypt in order to assess PA outside school times.