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Zhang H, Zhou XD, Shapiro MD, Lip GYH, Tilg H, Valenti L, Somers VK, Byrne CD, Targher G, Yang W, Viveiros O, Opio CK, Mantzoros CS, Ryan JD, Kok KYY, Jumaev NA, Perera N, Robertson AG, Abu-Abeid A, Misra A, Wong YJ, Ruiz-Úcar E, Ospanov O, Kızılkaya MC, Luo F, Méndez-Sánchez N, Zuluaga M, Lonardo A, Al Momani H, Toro-Huamanchumo CJ, Adams L, Al-Busafi SA, Sharara AI, Chan WK, Abbas SI, Sookoian S, Treeprasertsuk S, Ocama P, Alswat K, Kong APS, Ataya K, Lim-Loo MC, Oviedo RJ, Szepietowski O, Fouad Y, Zhang H, Abdelbaki TN, Katsouras CS, Prasad A, Thaher O, Ali A, Molina GA, Sung KC, Chen QF, Lesmana CRA, Zheng MH. Global burden of metabolic diseases, 1990-2021. Metabolism 2024; 160:155999. [PMID: 39151887 DOI: 10.1016/j.metabol.2024.155999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex. METHODS Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Age-standardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI). RESULTS In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190-259] DALYs), whilst T2DM (75 million [95 % UI: 63-90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90-4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34-0.51]) and obesity (0.26 % [95 % UI: 0.17-0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (-0.30 % [95 % UI: -0.34 to -0.25]) and hypercholesterolemia (-0.33 % [95 % UI: -0.37 to -0.30]) is slowing. There is no significant change in MASLD over time (0.05 % [95 % UI: -0.06 to 0.17]). CONCLUSION In the 21st century, common metabolic diseases are presenting a significant global health challenge. There is a concerning surge in DALYs and mortality associated with these conditions, underscoring the necessity for a coordinated global health initiative to stem the tide of these debilitating diseases and improve population health outcomes worldwide.
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Affiliation(s)
- Huai Zhang
- Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Dong Zhou
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA
| | - Christopher D Byrne
- Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Octavio Viveiros
- Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
| | | | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
| | - John D Ryan
- Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
| | - Kenneth Yuh Yen Kok
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei
| | | | - Nilanka Perera
- Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Andrew Gerard Robertson
- Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
| | - Adam Abu-Abeid
- Division of Surgery, Tel Aviv Sourasky Medical Center affiliated to Tel Aviv University, Tel Aviv, Israel
| | - Anoop Misra
- Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Elena Ruiz-Úcar
- Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
| | - Oral Ospanov
- Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan
| | - Mehmet Celal Kızılkaya
- Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Türkiye
| | - Fei Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | | | - Mauricio Zuluaga
- Department of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia
| | - Amedeo Lonardo
- Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Hazem Al Momani
- Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
| | - Carlos Jesus Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Lima, Peru; OBEMET Center for Obesity and Metabolic Health, Lima, Peru; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
| | - Leon Adams
- Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
| | - Said A Al-Busafi
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ala I Sharara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical center, Beirut, Lebanon
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Syed Imran Abbas
- Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
| | - Silvia Sookoian
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Faculty of Health Science, Maimónides University, Buenos Aires, Argentina; Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina
| | | | - Ponsiano Ocama
- Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
| | - Khalid Alswat
- Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alice Pik-Shan Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | - Karim Ataya
- Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada
| | | | - Rodolfo J Oviedo
- Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, USA
| | - Olivia Szepietowski
- Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, United Kingdom
| | - Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Huijie Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tamer N Abdelbaki
- Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Christos S Katsouras
- First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
| | - Arun Prasad
- Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
| | - Omar Thaher
- Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, Herne, NRW, Germany
| | - Arshad Ali
- Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
| | | | - Ki-Chul Sung
- Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Qin-Fen Chen
- Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cosmas Rinaldi Adithya Lesmana
- Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia; Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia; Gastrointestinal Cancer Center, Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital, Jakarta, Indonesia
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China.
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Zheng L, Zhang M, Zhao W. Enhanced mycelium biomass and polysaccharide production in genetically modified Pleurotus ostreatus using agricultural wastes. Int J Biol Macromol 2024; 278:134318. [PMID: 39111500 DOI: 10.1016/j.ijbiomac.2024.134318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/11/2024] [Accepted: 07/28/2024] [Indexed: 08/18/2024]
Abstract
Edible fungi, healthier for humans and sustainable for the planet, attract unprecedented attention. In the study, the genetically modified Pleurotus ostreatus overexpression phosphoglucomutase (PGM) was constructed. P. ostreatus overexpression PGM (Po::PGM) had 4.96-folds higher expression level of PGM. Po::PGM grew thicker mycelium and more mycelium branches. Additional Ca2+ can inhibit mycelium growth, and cyclic adenosine monophosphate completely inhibited their growth of Po::PGM. Secondly, Overexpression of PGM made P. ostreatus become more sensitive to cell wall disruptors, and caused 12.75 % reduction of β-1, 3-glucan and 40.53 % increase of chitin in cell wall. In submerged fermentation, the mycelia biomass yield and endopolysaccharide (IPS) production of Po::PGM in basic PDB can reach 11.18 g/l and 2.55 g/l, increasing by 20.86 % and 28.79 %, respectively. Whereas exopolysaccharide (EPS) reduced by 3.28 %. After replacing potato and glucose in PDB by wheat bran, mycelia biomass and EPS production of Po::PGM were all improved. The additional lactose in wheat bran did not only furtherly enhance mycelia biomass yield of Po::PGM to 27.78 g/l by 199.03 %, but IPS production also increased by 277.99 % to 6.07 g/l. The results provided us key ideas and important research directions that at least manipulating the PGM gene could obtain high-efficient use of agricultural wastes producing more fungus-based foods.
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Affiliation(s)
- Libing Zheng
- School of Food and Technology, Jiangnan University, Wuxi 214122, China; Institute of Future Food Technology, JITRI, Yixing 214200, China
| | - Mengqing Zhang
- School of Food and Technology, Jiangnan University, Wuxi 214122, China; Institute of Future Food Technology, JITRI, Yixing 214200, China
| | - Wei Zhao
- School of Food and Technology, Jiangnan University, Wuxi 214122, China; Institute of Future Food Technology, JITRI, Yixing 214200, China.
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Zelber-Sagi S, Carrieri P, Pericàs JM, Ivancovsky-Wajcman D, Younossi ZM, Lazarus JV. Food inequity and insecurity and MASLD: burden, challenges, and interventions. Nat Rev Gastroenterol Hepatol 2024; 21:668-686. [PMID: 39075288 DOI: 10.1038/s41575-024-00959-4] [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] [Accepted: 06/20/2024] [Indexed: 07/31/2024]
Abstract
Liver disease prevalence, severity, outcomes and hepatic risk factors (for example, unhealthy diet) are heavily affected by socioeconomic status and food insecurity. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disease globally and is likely to co-occur with other liver diseases associated with food insecurity. Though weight reduction and adopting a healthy diet can reverse the course of MASLD, gaps between recommendations and practice transcend individual responsibility and preference. Broader sociocultural determinants of food choices (social nutrition) include food insecurity, community and social norms and the local environment, including commercial pressures that target people experiencing poverty, ethnic minorities and children. Food insecurity is a barrier to a healthy diet, as a low-quality diet is often less expensive than a healthy one. Consequently, food insecurity is an 'upstream' risk factor for MASLD, advanced fibrosis and greater all-cause mortality among patients with liver disease. Intervening on food insecurity at four major levels (environment, policy, community and health care) can reduce the burden of liver disease, thereby reducing social and health inequities. In this Review, we report on the current research in the field, the need for implementing proven interventions, and the role liver specialists can have.
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Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
- The Global NASH Council, Washington, DC, USA.
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain
| | - Dana Ivancovsky-Wajcman
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Zobair M Younossi
- The Global NASH Council, Washington, DC, USA
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
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Hagenaars LL, Fazzino TL, Mackenbach JD. Authors' response to the letter entitled 'zero value-added tax on fruit and vegetables: beyond health and fiscal standards'. Public Health Nutr 2024; 27:e172. [PMID: 39313489 DOI: 10.1017/s1368980024001629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Affiliation(s)
- Luc L Hagenaars
- Department of Public and Occupatonal Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Joreintje D Mackenbach
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Upstream Team, Amsterdam, The Netherlands
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Hesketh KD, Zheng M, Campbell KJ. Early life factors that affect obesity and the need for complex solutions. Nat Rev Endocrinol 2024:10.1038/s41574-024-01035-2. [PMID: 39313572 DOI: 10.1038/s41574-024-01035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 09/25/2024]
Abstract
The prevalence of obesity increases with age but is apparent even in early life. Early childhood is a critical period for development that is known to influence future health. Even so, the focus on obesity in this phase, and the factors that affect the development of obesity, has only emerged over the past two decades. Furthermore, there is a paucity of iterative work in this area that would move the field forward. Obesity is a complex condition involving the interplay of multiple influences at different levels: the individual and biological level, the sociocultural level, and the environmental and system levels. This Review provides a brief overview of the evidence for these factors with a focus on aspects specific to early life. By spotlighting the complex web of interactions between the broad range of influences, both causal and risk markers, we highlight the complex nature of the condition. Much work in the early life field remains observational and many of the intervention studies are limited by a focus on single influences and a disjointed approach to solutions. Yet the complexity of obesity necessitates coordinated multi-focused solutions and joined-up action across the first 2,000 days from conception, and beyond.
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Affiliation(s)
- Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Wang Y, Huang Y, Al Jawish MM, Bakheet NG, Acosta A, Ordog T, Clift K, Chase K, Kumbhari V, Badurdeen DS. Rising Obesity-Associated Mortality in Men: Exploration of Gender Disparity from the Global Burden of Disease Study, 1990-2019. J Gen Intern Med 2024:10.1007/s11606-024-09033-w. [PMID: 39302563 DOI: 10.1007/s11606-024-09033-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVES The global rise in overweight, obesity, and related diseases is undeniable; however, the pathogenesis of obesity and obesity-associated diseases is heterogeneous, with varied complications and a discordant response to treatment. Intriguingly, men have a shorter lifespan than women, despite being half as likely to be obese. This paradox suggests a potential gender disparity in the impact of obesity on mortality, with men potentially being more vulnerable to obesity-associated health risks. METHODS This retrospective study utilized Global Burden of Diseases data from 204 countries/territories to bridge the knowledge gap in understanding gender disparities in obesity-related mortality. Outcomes were obesity-associated mortality, years of life lost, years lived with disability, and disability-adjusted life years (DALYs). RESULTS In 2019, the global overweight/obesity-related disease burden reached 160.2 million DALYs, with 5.02 million associated deaths. From 1990 to 2019, the age-standardized death rates increased in males (from 58.19 to 66.55 per 100,000 person-years, APC = 0.36%, 95% CI: 0.30 to 0.42%, P < 0.001), while females experienced a decrease in age-standardized death rates (from 59.31 to 58.14 per 100,000 person-years, APC = -0.22%, 95% CI: -0.29% to -0.14%, P < 0.001). Age-standardized DALYs increased more in males (1632.5 to 2070.34 per 100,000 years, APC = 0.74%, 95% CI: 0.70% to 0.78%, P < .001) compared to females (1618.26 to 1789.67 per 100,000 years, APC = 0.24%, 95% CI: 0.19% to 0.29%, P < 0.001). Disparities were more pronounced in countries with a higher socioeconomic status and predominantly affected younger populations. CONCLUSIONS Overweight/obesity-related morbidity and mortality are higher among male sex. Identifying differences in pathogenesis, complications and treatment response is crucial to develop targeted interventions and equitable public health policies to combat this global burden.
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Affiliation(s)
- Yichen Wang
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuting Huang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Mhd Manar Al Jawish
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Nader G Bakheet
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Andres Acosta
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Tamas Ordog
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Kristin Clift
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Katherine Chase
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Vivek Kumbhari
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Dilhana S Badurdeen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
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Dos Santos TAR, Pedrosa AKP, Melo JMM, Silveira JAC. Are vegetarians' diets inherently healthy? Ultra-processed food consumption is associated with overweight among vegetarians: the brazilian survey on the health, food, and nutrition of vegetarians. Int J Food Sci Nutr 2024:1-13. [PMID: 39229727 DOI: 10.1080/09637486.2024.2397714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 07/14/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024]
Abstract
This cross-sectional study investigated ultra-processed food (UPF) consumption and its association with overweight among Brazilian vegetarian adults (n = 925). Data were collected using a self-administered structured online questionnaire. The prevalence of overweight was 26.2% (95% confidence interval [CI] 23.3-29.1). The median UPF consumption was 1.8 times/day (1.0-3.1 interquartile range [IQR]). The multivariable generalised linear model identified an increase in overweight probability as the UPF intake - categorised into quintiles - increases (prevalence ratio [PR] 1.08 [95%CI 1.01-1.17]). Additionally, age (PR 1.03 [95%CI 1.02-1.04]), eating more than three meals/day away from home (PR 1.56 [95%CI 1.08-2.23]), duration of vegetarianism (PR 0.98 [95%CI 0.97-0.99]) and living in the wealthiest regions in the country (PR 1.35 [95%CI 1.06-1.71]) were associated with overweight. Although vegetarians have a lower average UPF intake and overweight prevalence than the general population, UPF exposure can still lead to excessive weight gain or maintenance. This study endorses generalising the Brazilian Dietary Guidelines for the vegetarian population.
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Affiliation(s)
- T A R Dos Santos
- Faculty of Nutrition, Graduate Program in Nutrition, Federal University of Alagoas, Maceió, Alagaos, Brazil
| | - A K P Pedrosa
- Faculty of Nutrition, Graduate Program in Nutrition, Federal University of Alagoas, Maceió, Alagaos, Brazil
| | - J M M Melo
- Faculty of Nutrition, Graduate Program in Nutrition, Federal University of Alagoas, Maceió, Alagaos, Brazil
| | - J A C Silveira
- Faculty of Nutrition, Graduate Program in Nutrition, Federal University of Alagoas, Maceió, Alagaos, Brazil
- Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
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Huiberts I, Collard D, Singh A, Hendriks M, Chinapaw MJM. Uncovering the key working mechanisms of a complex community-based obesity prevention programme in the Netherlands using ripple effects mapping. Health Res Policy Syst 2024; 22:122. [PMID: 39232736 PMCID: PMC11373344 DOI: 10.1186/s12961-024-01182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/13/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Much remains unknown about how complex community-based programmes can successfully achieve long-term impact. More insight is needed to understand the key mechanisms through which these programmes work. Therefore, we conducted an in-depth study in five communities that implemented the Healthy Youth, Healthy Future (JOGG) approach, a Dutch community-based obesity prevention programme. We aimed to identify perceived outcomes and long-term impacts among local stakeholders and explore potential causal pathways and working mechanisms. METHODS We used ripple effects mapping (REM), a qualitative participatory method to map outcomes and identify causal pathways, in five communities. We involved 26 stakeholders, professionals and policy-makers affiliated with the local JOGG approach, spread over eight REM sessions and conducted individual interviews with 24 additional stakeholders. To uncover working mechanisms, we compared outcomes and causal pathways across communities. RESULTS Over 5-9 years of implementation, participants perceived that JOGG had improved ownership of local stakeholders, health policies, intersectoral collaboration and social norms towards promoting healthy lifestyles. Causal pathways comprised small initial outcomes that created the preconditions to enable the achievement of long-term impact. Although exact JOGG actions varied widely between communities, we identified five common working mechanisms through which the JOGG approach contributed to causal pathways: (1) creating a positive connotation with JOGG, (2) mobilizing stakeholders to participate in the JOGG approach, (3) facilitating projects to promote knowledge and awareness among stakeholders while creating successful experiences with promoting healthy lifestyles, (4) connecting stakeholders, thereby stimulating intersectoral collaboration and (5) sharing stakeholder successes that promote healthy lifestyles, which gradually created a social norm of participation. CONCLUSIONS The JOGG approach seems to work through activating initial stakeholder participation and bolstering the process towards ownership, policy change, and intersectoral collaboration to promote healthy lifestyles. Key working mechanisms can inform further development of JOGG as well as other complex community-based prevention programmes.
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Affiliation(s)
- Irma Huiberts
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Mulier Instituut, Herculesplein 269, 3584AA, Utrecht, The Netherlands.
| | - Dorine Collard
- Mulier Instituut, Herculesplein 269, 3584AA, Utrecht, The Netherlands
| | - Amika Singh
- Mulier Instituut, Herculesplein 269, 3584AA, Utrecht, The Netherlands
- Human Movement, School and Sport, Applied University of Windesheim, Campus 2, 8017CA, Zwolle, The Netherlands
| | - Mara Hendriks
- Mulier Instituut, Herculesplein 269, 3584AA, Utrecht, The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases and Methodology, Amsterdam, The Netherlands
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9
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de Sousa TM, Caldeira TCM, Ramos IEC, Canella DS, Claro RM. Association between depression and ultra-processed food consumption: a population-based study (Vigitel, 2023). Public Health 2024; 234:187-190. [PMID: 39029268 DOI: 10.1016/j.puhe.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/20/2024] [Accepted: 06/12/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVES To evaluate the association of ultra-processed food (UPF) consumption with depression among Brazilian adults (≥18 years). STUDY DESIGN Cross-sectional study. METHODS Data were obtained from a population-based survey conducted in 2023 (n = 21,690). UPF consumption was investigated using a questionnaire regarding the consumption on the previous day of 13 subgroups of UPF selected from those most consumed in Brazil according to a previous national survey (cutoff score ≥5 subgroups). The medical diagnosis of depression was self-reported. Logistic regression models were used to estimate the adjusted (by sex, age, education, presence of partner/spouse, and overweight) Odds Ratio (aOR) of UPF consumption according to the presence of depression. Analyses were conducted for the total population and stratified by sex. RESULTS Medical diagnosis of depression was reported by 12.3%. The prevalence of high UPF consumption (≥5 subgroups) was 17.7%, being higher in men (22.0%) and those with depression (19.3%). Depression increased the chance of presenting a high UPF consumption among the total population (aOR 1.35; CI 95% 1.08-1.68) and women (aOR 1.35; CI 95% 1.03-1.77), with no association among men. CONCLUSION The presence of depression was associated with greater consumption of UPF among Brazilian adults, especially among the female population. Public health actions to reduce UPF consumption could benefit from targeting this population group.
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Affiliation(s)
- T M de Sousa
- Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - T C M Caldeira
- Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - I E C Ramos
- Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - D S Canella
- Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - R M Claro
- Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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10
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Cobben RE, Collins CE, Charlton KE, Bucher T, Stanford J. Sustainability and cost of typical and heart-healthy dietary patterns in Australia. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 45:100448. [PMID: 39282012 PMCID: PMC11399559 DOI: 10.1016/j.ahjo.2024.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/18/2024]
Abstract
Study objective The aim was to quantify and compare the environmental and financial impact of two diets: a heart-healthy Australian diet (HAD) and the typical Australian diet (TAD). Design The study involved a secondary analysis of two modelled dietary patterns used in a cross-over feeding trial. Setting The evaluation focused on two-week (7-day cyclic) meal plans designed to meet the nutritional requirements for a reference 71-year-old male (9000 kJ) for each dietary pattern. Main outcome measures The environmental footprint of each dietary pattern was calculated using the Global Warming Potential (GWP*) metric, taking into account single foods, multi-ingredient foods, and mixed dishes. Prices were obtained from a large Australian supermarket. Results The HAD produced 23.8 % less CO2 equivalents (CO2e) per day (2.16 kg CO2e) compared to the TAD (2.83 kg CO2e per day). Meat and discretionary foods were the primary contributors to the environmental footprint of the TAD, whereas dairy and vegetables constituted the largest contributors to the HAD footprint. However, the HAD was 51 % more expensive than the TAD. Conclusion Transitioning from a TAD to a HAD could significantly reduce CO2 emissions and with benefits for human health and the environment. Affordability will be a major barrier. Strategies to reduce costs of convenient healthy food are needed. Future studies should expand the GWP* database and consider additional environmental dimensions to comprehensively assess the impact of dietary patterns. Current findings have implications for menu planning within feeding trials and for individuals seeking to reduce their carbon footprint while adhering to heart-healthy eating guidelines.
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Affiliation(s)
- Rachel E Cobben
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Division of Human Nutrition and Health, Wageningen University & Research (WUR), Stippeneng 4, 6708, WE, Wageningen, the Netherlands
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Karen E Charlton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Tamara Bucher
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Bern University of Applied Sciences, Division of Nutrition and Dietetics, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Jordan Stanford
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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11
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Sparling TM, Offner C, Deeney M, Denton P, Bash K, Juel R, Moore S, Kadiyala S. Intersections of Climate Change with Food Systems, Nutrition, and Health: An Overview and Evidence Map. Adv Nutr 2024; 15:100274. [PMID: 39019218 PMCID: PMC11382032 DOI: 10.1016/j.advnut.2024.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/04/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024] Open
Abstract
Scientific research linking climate change to food systems, nutrition, and nutrition-related health (FSNH) has proliferated, showing bidirectional and compounding dependencies that create cascading risks for human and planetary health. Within this proliferation, it is unclear which evidence to prioritize for action and which research gaps, if filled, would catalyze the most impact. We systematically searched for synthesis literature (i.e., reviews) related to FSNH published after 1 January, 2018. We screened and extracted characteristics of these reviews and mapped them in an interactive Evidence and Gap Map (EGM) supplemented by expert consultation. Eight hundred forty-four synthesis reports met inclusion criteria (from 2739 records) and were included in the EGM. The largest clusters of reports were those describing climate impacts on crop and animal-source food production and emissions from such (86%). Comparatively few reports assessed climate change impacts on nutrition-related health or food manufacture, processing, storage, and transportation. Reports focused on strategies of climate adaptation (40%), mitigation (29%), both (19%), or none (12%). Only 1 quarter of reports critically evaluated equity (25%), and fewer reports suggested that changes to equity and equitable practices would alter climate-FSNH dynamics (6%). The expert consultation mirrored the results of the EGM and contextualized findings further. This novel map describes a wide research landscape linking climate change to FSNH. We identified 4 key research gaps: 1) research on whole food systems or postharvest elements; 2) research evaluating relationships between climate change and nutrition-related health outcomes, especially among vulnerable populations; 3) promising methods (and additional data required) that can i) identify inflection points or levers for intervention, ii) incorporate complex dynamics and characterize trade-offs, iii) be understood and applied in context-specific, localized ways for decision making; and 4) research undertaken through interdisciplinary collaborations that enables producing and translating evidence to action, especially those that inherently consider coproduction and fairness.
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Affiliation(s)
- Thalia Morrow Sparling
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Claudia Offner
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Megan Deeney
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Kristin Bash
- Population Health, School of Medicine and Population Health, The University of Sheffield, Sheffield, United Kingdom
| | - Rachel Juel
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Susan Moore
- Health Sciences, School of Business, The University of York, York, United Kingdom
| | - Suneetha Kadiyala
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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12
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Gan T, Bambrick H, Li Y, Ebi KL, Hu W. Long-Term Effect of Temperature Increase on Liver Cancer in Australia: A Bayesian Spatial Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:97007. [PMID: 39269729 PMCID: PMC11398296 DOI: 10.1289/ehp14574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. https://doi.org/10.1289/EHP14574.
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Affiliation(s)
- Ting Gan
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hilary Bambrick
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yumin Li
- Key Laboratory of Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - Wenbiao Hu
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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13
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Kujawowicz K, Mirończuk-Chodakowska I, Witkowska AM. Sirtuin 1 as a potential biomarker of undernutrition in the elderly: a narrative review. Crit Rev Food Sci Nutr 2024; 64:9532-9553. [PMID: 37229564 DOI: 10.1080/10408398.2023.2214208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Undernutrition and inflammatory processes are predictors of early mortality in the elderly and require a rapid and accurate diagnosis. Currently, there are laboratory markers for assessing nutritional status, but new markers are still being sought. Recent studies suggest that sirtuin 1 (SIRT1) has the potential to be a marker for undernutrition. This article summarizes available studies on the association of SIRT1 and undernutrition in older people. Possible associations between SIRT1 and the aging process, inflammation, and undernutrition in the elderly have been described. The literature suggests that low SIRT1 levels in the blood of older people may not be associated with physiological aging processes, but with an increased risk of severe undernutrition associated with inflammation and systemic metabolic changes.
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Affiliation(s)
- Karolina Kujawowicz
- Department of Food Biotechnology, Medical University of Bialystok, Bialystok, Poland
| | | | - Anna Maria Witkowska
- Department of Food Biotechnology, Medical University of Bialystok, Bialystok, Poland
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14
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Alcaire F, Giménez A, Ares G. Food additives associated with gut dysbiosis in processed and ultra-processed products commercialized in the Uruguayan market. Food Res Int 2024; 191:114721. [PMID: 39059917 DOI: 10.1016/j.foodres.2024.114721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
Recent empirical evidence suggests that gut dysbiosis is one of the negative health outcomes potentially associated with chronic consumption of some food additives. In this context, the present study aimed at analyzing the disclosure of food additives associated with gut dysbiosis in the labels of products commercialized in the Uruguayan market. A cross-sectional survey of packaged products commercialized in nine supermarkets was conducted between August and September 2021. All packaged processed and ultra-processed products available in each data collection site were surveyed using a cellphone app. The information available on the labels was manually extracted and the disclosure of food additives was analyzed using a computer assisted approach. Results showed that 38.1% of the products disclosed at least one food additive associated with gut dysbiosis. Disclosure was most frequent in ice-cream and popsicles, beverages, meat products and analogues, desserts, and fats, oils and fat and oil emulsions. Potassium sorbate was the individual additive associated with gut dysbiosis most frequently disclosed on the labels, followed by mono- and di-glycerides of fatty acid, sucralose, carboxymethylcellulose, acesulphame potassium, carrageenan, and sodium benzoate. These food additives frequently co-occurred and network analysis enabled the identification of patterns of co-occurrence. Taken together, results from the present work suggest the need to conduct additional research to assess the intake of food additives associated with gut dysbiosis at the population level, as well as to evaluate potential synergistic effects of food additives.
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Affiliation(s)
- Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República. By Pass de Rutas 8 y 101 s/n, CP 91000. Pando, Canelones, Uruguay.
| | - Ana Giménez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República. By Pass de Rutas 8 y 101 s/n, CP 91000. Pando, Canelones, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República. By Pass de Rutas 8 y 101 s/n, CP 91000. Pando, Canelones, Uruguay
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15
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Ares G, Turra S, Bonilla L, Costa M, Verdier S, Brunet G, Alcaire F, Curutchet MR, Vidal L. WEIRD and non-consensual food deserts and swamps: A scoping review of operational definitions. Health Place 2024; 89:103315. [PMID: 39013213 DOI: 10.1016/j.healthplace.2024.103315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
The aim of the present study was to critically analyze operational definitions of food deserts and food swamps included in empirical studies published in peer-reviewed journals. A scoping review was conducted following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. A search of the scientific literature was performed on August 2023 to identify empirical studies including operational definitions of food deserts and/or food swamps in three databases: Scopus, PubMed, and Scielo. A total of 932 scientific articles were identified in the three databases, from which 157 articles, published between 2002 and 2023, were included in the review. The included studies were mainly conducted in WEIRD (Western, Educated, Industrilaized, Rich and Democractic) countries. They presented a total of 107 operational definitions of food deserts and 30 operational definitions of food swamps. Large heterogeneity in the operational definitions of food deserts and food swamps was found. Published studies differed in all the elements of the operational definitions analyzed in the present work. Results stress the need for standardization and the development of more objective and multivariate continuous measures of physical food accessibility that reflect the complexity of modern food environments globally. A series of recommendations to advance food environment research are derived.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay.
| | - Sergio Turra
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600, Montevideo, Uruguay
| | - Luciana Bonilla
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - María Costa
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Sofía Verdier
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
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16
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Muñoz-Labrador A, Hernandez-Hernandez O, Moreno FJ. A review of the state of sweeteners science: the natural versus artificial non-caloric sweeteners debate. Stevia rebaudiana and Siraitia grosvenorii into the spotlight. Crit Rev Biotechnol 2024; 44:1080-1102. [PMID: 39103281 DOI: 10.1080/07388551.2023.2254929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/08/2023] [Accepted: 07/13/2023] [Indexed: 08/07/2024]
Abstract
The rapid increase in the worldwide prevalence of obesity and certain non-communicable diseases (NCDs), such as: cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, has been mainly attributed to an excess of sugar consumption. Although the potential benefits of the synergetic use of sweeteners have been known for many years, recent development based on synthesis strategies to produce sucrose-like taste profiles is emerging where biocatalyst approaches may be preferred to produce and supply specific sweetener compounds. From a nutritional standpoint, high-intensity sweeteners have fewer calories than sugars while providing a major sweet potency, placing them in the spotlight as valuable alternatives to sugar. Due to the modern world awareness and incidence of metabolic diseases, both food research and growing markets have focused on two generally regarded as safe (GRAS) groups of compounds: the sweet diterpenoid glycosides present on the leaves of Stevia rebaudiana and, more recently, on the cucurbitane triterpene glycosides present on the fruits of Siraitia grosvenorii. In spite of their flavor advantages, biological benefits, including: antidiabetic, anticancer, and cardiovascular properties, have been elucidated. The present bibliographical review dips into the state-of-the-art of sweeteners and their role in human health as sugar replacements, as well as the biotransformation methods for steviol gylcosides and mogrosides apropos of enzymatic technology to update and locate the discoveries to date in the scientific literature to help boost the continuity of research efforts of the ongoing sweeteners.
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Affiliation(s)
| | | | - F Javier Moreno
- Institute of Food Science Research, CIAL (CSIC-UAM), Madrid, Spain
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17
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Tumas N, Vega CDL, Navarro MGZ, Cash-Gibson L, Carreño P, Pericàs JM, Benach J. [Public policies and interventions to prevent excess weight in Mexico: analysis from an intersectional perspective]. CIENCIA & SAUDE COLETIVA 2024; 29:e04142023. [PMID: 39194103 DOI: 10.1590/1413-81232024299.04142023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/18/2023] [Indexed: 08/29/2024] Open
Abstract
The scope of this article is to analyze public policies and interventions (PPI) prevailing in 2022 at the national level for the prevention of excess weight (overweight and obesity) in the adult population of Mexico, from an intersectional perspective. We performed documental analysis of PPI to prevent excess weight in Mexico in adulthood by applying a methodology for policy analysis based on intersectionality (Intersectionality-Based Policy Analysis Framework). A total of nine PPI were analyzed. The extent to which the PPI design considers an intersectional perspective is heterogeneous in the documents analyzed. In the definition of the problem, we identified two main tendencies, namely reductionist and holistic. Both are combined in a variable way in the PPI, revealing internal contradictions in their design. Most PPI consider relatively few cases of social inequality, and as an additive rather than an intersectional consideration. Overall, the PPI consider social inequalities predominantly in the definition of the problem and, to a far lesser extent, in the proposed solutions and in the consultation and negotiation processes. The consideration of the intersectional nature of the problem of excess weight in PPI is important to address the unequal epidemic of excess weight.
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Affiliation(s)
- Natalia Tumas
- Research Group on Health Inequalities, Environment - Employment Conditions Network (GREDS-EMCONET), JHU-UPF Public Policy Center, Departament de Ciències Polítiques i Socials, Universitat Pompeu Fabra (UPF). Ramon Trias Fargas 25-27. 08005 Barcelona España.
| | - Candela de la Vega
- Universidad Católica de Córdoba, Unidad Asociada a Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Córdoba Argentina
| | - Mariana Gutiérrez-Zamora Navarro
- Research Group on Health Inequalities, Environment - Employment Conditions Network (GREDS-EMCONET), JHU-UPF Public Policy Center, Departament de Ciències Polítiques i Socials, Universitat Pompeu Fabra (UPF). Ramon Trias Fargas 25-27. 08005 Barcelona España.
| | - Lucinda Cash-Gibson
- Research Group on Health Inequalities, Environment - Employment Conditions Network (GREDS-EMCONET), JHU-UPF Public Policy Center, Departament de Ciències Polítiques i Socials, Universitat Pompeu Fabra (UPF). Ramon Trias Fargas 25-27. 08005 Barcelona España.
| | - Paula Carreño
- Escuela de Nutrición, Facultad de Medicina, Universidad Nacional de Córdoba. Córdoba Argentina
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron University Hospital, VHIR, Universitat Autònoma de Barcelona, CIBERehd. Barcelona España
| | - Joan Benach
- Research Group on Health Inequalities, Environment - Employment Conditions Network (GREDS-EMCONET), JHU-UPF Public Policy Center, Departament de Ciències Polítiques i Socials, Universitat Pompeu Fabra (UPF). Ramon Trias Fargas 25-27. 08005 Barcelona España.
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18
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Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur J Prev Cardiol 2024:zwae279. [PMID: 39210708 DOI: 10.1093/eurjpc/zwae279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024]
Abstract
The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.
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Affiliation(s)
- Konstantinos C Koskinas
- Department of Cardiology, Bern University Hospital-INSELSPITAL, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland
| | - Emeline M Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Drie Eikenstraat 655, Antwerp 2650, Belgium
- Research group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Charalambos Antoniades
- Acute Multidisciplinary Imaging and Interventional Centre Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthias Blüher
- Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Thomas M Gorter
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nikolaus Marx
- Department of Internal Medicine I-Cardiology, RWTH Aachen University, Aachen, Germany
| | - Theresa A McDonagh
- Cardiology Department, King's College Hospital, London, UK
- King's College, London, UK
| | - Geltrude Mingrone
- Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli & Catholic University, Rome, Italy
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Ostra, Västra Götaland Region, Gothenburg, Sweden
| | - Eva B Prescott
- Bispebjerg Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
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Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J 2024:ehae508. [PMID: 39210706 DOI: 10.1093/eurheartj/ehae508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.
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Affiliation(s)
- Konstantinos C Koskinas
- Department of Cardiology, Bern University Hospital-INSELSPITAL, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland
| | - Emeline M Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Drie Eikenstraat 655, Antwerp 2650, Belgium
- Research group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Charalambos Antoniades
- Acute Multidisciplinary Imaging and Interventional Centre Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthias Blüher
- Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Thomas M Gorter
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nikolaus Marx
- Department of Internal Medicine I-Cardiology, RWTH Aachen University, Aachen, Germany
| | - Theresa A McDonagh
- Cardiology Department, King's College Hospital, London, UK
- King's College, London, UK
| | - Geltrude Mingrone
- Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli & Catholic University, Rome, Italy
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Ostra, Västra Götaland Region, Gothenburg, Sweden
| | - Eva B Prescott
- Bispebjerg Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
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20
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Pires LDJA, Ribeiro JM, Cruz MMD. [A brief overview of the 2030 Agenda, noncommunicable diseases and the challenges of leaving no one behind]. CAD SAUDE PUBLICA 2024; 40:e00139323. [PMID: 39194138 PMCID: PMC11346611 DOI: 10.1590/0102-311xpt139323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/26/2024] [Accepted: 03/08/2024] [Indexed: 08/29/2024] Open
Abstract
This essay provides a theoretical reflection on the challenges of meeting the Sustainable Development Goals of the 2030 Agenda, considering its motto of "leave no one behind". To exemplify these challenges, we discuss noncommunicable diseases (NCDs), one of the main issues on the global health agenda before the COVID-19 pandemic, and the political and economic dimensions that determine their presence and global spread. After a brief overview of NCDs, the text seeks to answer three questions: In "Leaving no one behind?" we list some themes to reflect on how and who has historically been left behind, delving a little deeper into the examples in "Who has been left behind in the world?" and "Who has been left behind in Brazil?". Using data from the most relevant and recent literature on the subject, we discuss the challenges and some ways to leave no one behind in a world where the mean of production has historically made some social groups vulnerable, especially black and Indigenous populations. In our final remarks, we draw inspiration from the Sankofa ideogram to remember that the answers to the sustainable development we seek may lie somewhere in our most primordial and traditional past. And that it is necessary to invest on building new paths from different worldviews and approaches to epistemology on the other side of the abyssal line.
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Affiliation(s)
| | - José Mendes Ribeiro
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Marly Marques da Cruz
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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21
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Nossar LF, Lopes JA, Pereira-Acácio A, Costa-Sarmento G, Rachid R, Wendt CHC, Miranda K, Galina A, Rodrigues-Ferreira C, Muzi-Filho H, Vieyra A. Chronic undernutrition impairs renal mitochondrial respiration accompanied by intense ultrastructural damage in juvenile rats. Biochem Biophys Res Commun 2024; 739:150583. [PMID: 39182354 DOI: 10.1016/j.bbrc.2024.150583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/08/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024]
Abstract
This study investigated whether chronic undernutrition alters the mitochondrial structure and function in renal proximal tubule cells, thus impairing fluid transport and homeostasis. We previously showed that chronic undernutrition downregulates the renal proximal tubules (Na++K+)ATPase, the main molecular machine responsible for fluid transport and ATP consumption. Male rats received a multifactorial deficient diet, the so-called Regional Basic Diet (RBD), mimicking those used in impoverished regions worldwide, from weaning to a juvenile age (3 months). The diet has a low content (8 %) of poor-quality proteins, low lipids, and no vitamins compared to control (CTR). We investigated citrate synthase activity, mitochondrial respiration (oxygraphy) in phosphorylating and non-phosphorylating conditions with different substrates/inhibitors, potential across the internal membrane (Δψ), and anion superoxide/H2O2 formation. The data were correlated with ultrastructural alterations evaluated using transmission electron microscopy (TEM) and focused ion beam scanning electron microscopy (FIB-SEM). Citrate synthase activity decreased (∼50 %) in RBD rats, accompanied by a similar reduction in respiration in non-phosphorylating conditions, maximum respiratory capacity, and ATP synthesis. The Δψ generation and its dissipation after carbonyl cyanide-4-(trifluoromethoxy) phenylhydrazone remained unmodified in the survival mitochondria. H2O2 production increased (∼100 %) after Complex II energization. TEM demonstrated intense matrix vacuolization and disruption of cristae junctions in a subpopulation of RBD mitochondria, which was also demonstrated in the 3D analysis of FIB-SEM tomography. In conclusion, chronic undernutrition impairs mitochondrial functions in renal proximal tubules, with profound alterations in the matrix and internal membrane ultrastructure that culminate with the compromise of ATP supply for transport processes.
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Affiliation(s)
- Luiz F Nossar
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Jarlene A Lopes
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Amaury Pereira-Acácio
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; Graduate Program of Translational Biomedicine, University of Grande Rio, Duque de Caxias, 25071-202, Brazil
| | - Glória Costa-Sarmento
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Rachel Rachid
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Camila H C Wendt
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Institute of Science and Technology for Structural Biology and Bioimaging/INBEB, Rio de Janeiro, 21941-902, Brazil
| | - Kildare Miranda
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Institute of Science and Technology for Structural Biology and Bioimaging/INBEB, Rio de Janeiro, 21941-902, Brazil
| | - Antonio Galina
- Leopoldo de Meis Institute of Medical Biochemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Clara Rodrigues-Ferreira
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Humberto Muzi-Filho
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil
| | - Adalberto Vieyra
- Center for Research in Precision Medicine, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil; Graduate Program of Translational Biomedicine, University of Grande Rio, Duque de Caxias, 25071-202, Brazil; National Institute of Science and Technology for Regenerative Medicine/REGENERA, Rio de Janeiro, 21941-902, Brazil.
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Guariguata L, Burlar A, Greaves N, Harewood H, Khan R, Rosario-Rosado RV, Jones W, Roy B, Hassan S. A systems thinking framework for understanding rising childhood obesity in the Caribbean. Health Res Policy Syst 2024; 22:115. [PMID: 39169406 PMCID: PMC11337753 DOI: 10.1186/s12961-024-01201-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE The aim of this study is to develop a systems thinking framework to describe the common complexities of childhood obesity in the Caribbean region and identify potential areas of intervention. METHODS Group model building (GMB) is a form of systems science. Trained GMB facilitators in Puerto Rico, the US Virgin Islands, Barbados, and Trinidad and Tobago convened a group of multi-disciplinary stakeholders in a series of virtual meetings in 2021 to elaborate a hypothesis of the system driving childhood obesity represented by causal loop diagrams (CLD). Commonalities and differences between the CLDs from each island were identified and reconciled to create a synthesized CLD. RESULTS A single explanatory CLD across the islands was developed and includes nine reinforcing loops. These loops addressed the interconnected role of schools, policy, commercial determinants, community and the personal experience of the child in rising childhood obesity rates. CONCLUSIONS Despite differences across settings, there is a core system driving childhood obesity in the Caribbean, as described by stakeholders in GMB workshops. Policy solutions to the problem must be multi-faceted and multi-level to address the interlinked reinforcing loops of the complex system and reduce rates of childhood obesity.
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Affiliation(s)
- Leonor Guariguata
- Faculty of Economics and Business, Access to Medicine Research Center, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Amy Burlar
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Natalie Greaves
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Heather Harewood
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Raveed Khan
- Department of Para Clinical Sciences, The University of the West Indies, St. Augustine, Trinidad
| | - Rosa V Rosario-Rosado
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico at Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Waneisha Jones
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Brita Roy
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Saria Hassan
- Department of Medicine, Emory School of Medicine, Atlanta, GA, USA.
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23
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Gerritsen S, Rosin M, Te Morenga L, Jiang Y, Kidd B, Shen S, Umali E, Mackay S, Ni Mhurchu C. Awareness, support, and opinions of healthy food and drink policies: a survey of staff and visitors in New Zealand healthcare organisations. BMC Public Health 2024; 24:2179. [PMID: 39135033 PMCID: PMC11318292 DOI: 10.1186/s12889-024-19693-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/05/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, "the Policy") was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors' awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. METHODS Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. RESULTS Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that "Hospitals should be good role models." Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. CONCLUSIONS The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.
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Affiliation(s)
- Sarah Gerritsen
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand.
| | - Magda Rosin
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Bruce Kidd
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Stephanie Shen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Te Whatu Ora - Te Toka Tumai Auckland, Auckland, New Zealand
| | - Elaine Umali
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- George Institute for Global Health, Sydney, Australia
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24
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Lara-Castor L, Micha R, Cudhea F, Miller V, Shi P, Zhang J, Sharib JR, Erndt-Marino J, Cash SB, Barquera S, Mozaffarian D. Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study. BMJ 2024; 386:e079234. [PMID: 39111807 PMCID: PMC11305379 DOI: 10.1136/bmj-2024-079234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents. DESIGN Population based study. SETTING Global Dietary Database. POPULATION Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence. RESULTS In 2018, mean global SSB intake was 3.6 (standardized serving=248 g (8 oz)) servings/week (1.3 (95% uncertainly interval 1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean). SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education. Between 1990 and 2018, mean global SSB intakes increased by 0.68 servings/week (22.9%), with the largest increases in sub-Saharan Africa (2.17 servings/week; 106%). Of 185 countries included in the analysis, 56 (30.3%) had a mean SSB intake of ≥7 servings/week, representing 238 million children and adolescents, or 10.4% of the global population of young people. CONCLUSION This study found that intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. SSB intakes showed large heterogeneity among children and adolescents worldwide and by age, parental level of education, and urbanicity. This research should help to inform policies to reduce SSB intake among young people, particularly those with larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa.
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Affiliation(s)
- Laura Lara-Castor
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Renata Micha
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- University of Thessaly, Volos, Greece
| | - Frederick Cudhea
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Victoria Miller
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Peilin Shi
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Center for Surgery and Public Health, Brigham and Women's Hospital Boston, MA, USA
| | - Julia R Sharib
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Simon Barquera
- Research Center on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
- Division of Cardiology, Tufts Medical Center, Boston, MA, USA
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25
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Maida M, Vitello A, Shahini E, Vassallo R, Sinagra E, Pallio S, Melita G, Ramai D, Spadaccini M, Hassan C, Facciorusso A. Green endoscopy, one step toward a sustainable future: Literature review. Endosc Int Open 2024; 12:E968-E980. [PMID: 39184060 PMCID: PMC11343619 DOI: 10.1055/a-2303-8621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/30/2024] [Indexed: 08/27/2024] Open
Abstract
Rapid climate change or climate crisis is one of the most serious emergencies of the 21st century, accounting for highly impactful and irreversible changes worldwide. Climate crisis can also affect the epidemiology and disease burden of gastrointestinal diseases because they have a connection with environmental factors and nutrition. Gastrointestinal endoscopy is a highly intensive procedure with a significant contribution to greenhouse gas (GHG) emissions. Moreover, endoscopy is the third highest generator of waste in healthcare facilities with significant contributions to carbon footprint. The main sources of direct carbon emission in endoscopy are use of high-powered consumption devices (e.g. computers, anesthesia machines, wash machines for reprocessing, scope processors, and lighting) and waste production derived mainly from use of disposable devices. Indirect sources of emissions are those derived from heating and cooling of facilities, processing of histological samples, and transportation of patients and materials. Consequently, sustainable endoscopy and climate change have been the focus of discussions between endoscopy providers and professional societies with the aim of taking action to reduce environmental impact. The term "green endoscopy" refers to the practice of gastroenterology that aims to raise awareness, assess, and reduce endoscopy´s environmental impact. Nevertheless, while awareness has been growing, guidance about practical interventions to reduce the carbon footprint of gastrointestinal endoscopy are lacking. This review aims to summarize current data regarding the impact of endoscopy on GHG emissions and possible strategies to mitigate this phenomenon. Further, we aim to promote the evolution of a more sustainable "green endoscopy".
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Affiliation(s)
- Marcello Maida
- Department of Medicine and Surgery, University of Enna 'Kore', Enna, Italy
- Gastroenterology Unit, Umberto I Hospital, Enna, Italy
| | - Alessandro Vitello
- Gastroenterology and Endoscopy Unit, S. Elia Hospital, ASP di Caltanissetta, Caltanissetta, Italy
| | - Endrit Shahini
- Gastroenterology Unit, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico Saverio de Bellis, Castellana Grotte, Italy
| | - Roberto Vassallo
- Gastroenterology Unit, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy
| | - Emanuele Sinagra
- Gastroenterology and Endoscopy Unit, Fondazione Istituto San Raffaele G Giglio di Cefalù, Cefalu, Italy
| | - Socrate Pallio
- Digestive Diseases Endoscopy Unit, Policlinico G. Martino Hospital, University of Messina, Messina, Italy
| | - Giuseppinella Melita
- Digestive Diseases Endoscopy Unit, Policlinico G. Martino Hospital, University of Messina, Messina, Italy
| | - Daryl Ramai
- Gastroenterology and Hepatology, The University of Utah School of Medicine, Salt Lake City, United States
| | - Marco Spadaccini
- Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Cesare Hassan
- Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
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26
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Schmidt K, Spann A, Khan MQ, Izzy M, Watt KD. Minimizing Metabolic and Cardiac Risk Factors to Maximize Outcomes After Liver Transplantation. Transplantation 2024; 108:1689-1699. [PMID: 38060378 DOI: 10.1097/tp.0000000000004875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Cardiovascular disease (CVD) is a leading complication after liver transplantation and has a significant impact on patients' outcomes posttransplant. The major risk factors for post-liver transplant CVD are age, preexisting CVD, nonalcoholic fatty liver disease, chronic kidney disease, and metabolic syndrome. This review explores the contemporary strategies and approaches to minimizing cardiometabolic disease burden in liver transplant recipients. We highlight areas for potential intervention to reduce the mortality of patients with metabolic syndrome and CVD after liver transplantation.
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Affiliation(s)
- Kathryn Schmidt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Ashley Spann
- Division of Gastroenterology and Hepatology, Vanderbilit University, Nashville, TN
| | - Mohammad Qasim Khan
- Division of Gastroenterology and Hepatology, University of Western Ontario, London, ON, Canada
| | - Manhal Izzy
- Division of Gastroenterology and Hepatology, Vanderbilit University, Nashville, TN
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
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27
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Kumanyika SK. A Black American Nutrition Scholar and Advocate: My Journey. Annu Rev Nutr 2024; 44:1-24. [PMID: 38603557 DOI: 10.1146/annurev-nutr-062322-030901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
I started my journey as a nutrition scholar in 1974 when I began PhD studies at Cornell University. My journey has been rich with opportunity. I engaged in research on diet-related risks for cardiovascular diseases, diabetes, and cancer, partly motivated by my strong commitment to addressing health disparities affecting Black Americans. Obesity became my major focus and would eventually involve both US and global lenses. This focus was also linked to other dietary intake issues and health disparities and drew on knowledge I had gained in my prior study and practice of social work. I positioned myself as a bridge builder across nutrition, epidemiology, and public health, advocating for certain new ways of thinking and acting in these spheres and in the academy itself. Life skills honed during my formative years living within racially segregated contexts have been critical to any successes I have achieved.
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Affiliation(s)
- Shiriki K Kumanyika
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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28
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Browne S, Corish C, Nordin S, Carlsson L. Sustainability-informed dietetics education: key messages for educators and national dietetics associations. J Hum Nutr Diet 2024; 37:909-918. [PMID: 38853418 DOI: 10.1111/jhn.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Dietetics curricula currently fail to meet the educational needs of the future dietetic workforce to contribute expertise in sustainable, healthy food systems in the settings in which dietitians work. A 'Global Networking Event on Sustainable Food Systems in Nutrition and Dietetics Education' was held in June 2023 with the goals of building relationships among international stakeholders and informing the development of shared curricula. METHODS Plenary lectures, panels and roundtable discussions were held over 2 days, designed to provide the background required to generate informed actions. Topics included recent research from practice and education, competency standards and relevant policy documents, examples from the field, 'big questions' about scope and student perspectives. Key messages were summarised thematically to inform educators and national dietetics associations. RESULTS Fifty-five delegates attended from 11 nations representing education, research, dietetic associations, industry and diverse practice backgrounds. Key priorities identified for educators included co-development of curricular frameworks and pedagogical theory, practical training supports and solutions to limited time and expertise. Key recommendations for national dietetics associations included strategic promotion of sustainable food systems in dietetic roles and practical supports. CONCLUSIONS Outcomes are anticipated to stimulate ongoing discussion, collaboration and actions on sustainable food systems education within the dietetics profession leading to shared curricular models and supports.
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Affiliation(s)
- Sarah Browne
- Health Sciences Centre, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Clare Corish
- Health Sciences Centre, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Stacia Nordin
- Never Ending Food Permaculture, Lilongwe, Malawi
- International Confederation, of Dietetic Associations, Sustainable, Food Systems Initiative, Acadia University, Nova Scotia, Canada
| | - Liesel Carlsson
- International Confederation, of Dietetic Associations, Sustainable, Food Systems Initiative, Acadia University, Nova Scotia, Canada
- School of Nutrition and Dietetics, Acadia University, Wolfville, Nova Scotia, Canada
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Zhang L, Langlois E, Williams K, Tejera N, Omieljaniuk M, Finglas P, Traka MH. A comparative analysis of nutritional quality, amino acid profile, and nutritional supplementations in plant-based products and their animal-based counterparts in the UK. Food Chem 2024; 448:139059. [PMID: 38531295 DOI: 10.1016/j.foodchem.2024.139059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
Plant-based (PB) food products have surged in popularity over the past decade. Available PB products in the UK market were extracted from NielsenIQ Brandbank and compared with animal-based (AB) counterparts in their nutrient contents and calculated Nutri-Scores. The amino acid contents of four beef products and their PB alternatives were analysed by LC-MS/MS. PB products consistently exhibited significantly higher fibre content across all food groups. Protein was significantly higher in AB products from all food groups except beef and ready meals. PB products were more likely to have higher Nutri-Scores compared to AB counterparts, albeit with greater score variability within each food group. Nutrient fortifications were primarily focused on dairy and ready meals; the most supplemented nutrient was vitamin B12 (found in 15% of all products). A higher proportion of EAAs in relation to total protein content was observed in all beef products.
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Affiliation(s)
- Liangzi Zhang
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom.
| | - Ellie Langlois
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom
| | - Katie Williams
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom
| | - Noemi Tejera
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom.
| | - Maja Omieljaniuk
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom
| | - Paul Finglas
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom.
| | - Maria H Traka
- Food and Nutrition National Bioscience Research Infrastructure, Quadram Institute Bioscience, Norwich Research Park, Rosalind Franklin Rd, Norwich NR4 7UQ, United Kingdom.
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Unar-Munguía M, Cervantes-Armenta MA, Rodríguez-Ramírez S, Bonvecchio Arenas A, Fernández Gaxiola AC, Rivera JA. Mexican national dietary guidelines promote less costly and environmentally sustainable diets. NATURE FOOD 2024; 5:703-713. [PMID: 39107420 DOI: 10.1038/s43016-024-01027-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/08/2024] [Indexed: 08/25/2024]
Abstract
The 2023 Mexican Healthy and Sustainable Dietary Guidelines (HSDG 2023) were developed to include all dimensions of sustainability. Here we compare the environmental impact and cost of diets based on the HSDG 2023, current diets and the Mexican-adapted EAT healthy reference diet. Diets following HSDG 2023 are 21% less expensive, require 30% less land to be produced and have 34% less carbon emissions than current diets-particularly in Mexico City and other urban areas with higher prevalence of Westernized diets. This is driven by reduced animal-source food, especially red meat, and ultra-processed foods. In south-rural areas, the water footprint and cost of diets following HSDG 2023 were higher than those of current diets owing to increased intake of nuts, fruits and vegetables not offset by lower meat consumption (which is already close to recommendations). Diet environmental impact and cost could be further reduced with the Mexican-adapted EAT healthy reference diet compared with the HSDG 2023.
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Affiliation(s)
- Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Sonia Rodríguez-Ramírez
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Juan A Rivera
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Mexico
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Galozzi P, Padoan A, Moretti C, Aita A, Basso D. Plasma lipids paediatric reference intervals: Indirect estimation using a large 14-year database. J Pediatr Gastroenterol Nutr 2024; 79:259-268. [PMID: 38606530 DOI: 10.1002/jpn3.12210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Establishing direct reference intervals (RIs) for paediatric patients is a very challenging endeavour. Indirect RIs can address this problem, using existing clinical laboratory databases from real-world data research. Compared to the traditional direct method, the indirect approach is highly practical, widely applicable, and low-cost. Considering the relevance of dyslipidemia in the paediatric age, to provide better laboratory services to the local paediatric population, we established population-specific lipid RIs via data mining. METHODS Our laboratory information system was searched for cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) of patients aged less than 18 years, performed from January 2009 until December 2022. RIs were estimated using RefineR algorithm. RESULTS Values from 215,594 patients were initially collected. After refining data on the basis of specific exclusion criteria that left 17,933 patients, we determined the RIs for each analyte, including corresponding 95% confidence interval (95% CI). Age and sex partitions were required for proper stratification of the heterogenous subpopulations. Age-related variations in TC and TG values were observed mainly in children until 5 years. RIs were defined for children less than 3 years and for those of 3-18 years. In our population, the obtained RIs were comparable with those of the literature, but the upper TG limit in subjects under the age of 3 (2.03 mmol/L with 95% CI: 1.45-2.86) was lower than that previously reported. CONCLUSIONS Our RIs, necessary for paediatric lipid monitoring, are tailored to the serviced patient population as should be done whenever possible.
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Affiliation(s)
- Paola Galozzi
- Laboratory Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Andrea Padoan
- Laboratory Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Carlo Moretti
- Paediatric Diabetes Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Ada Aita
- Laboratory Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Daniela Basso
- Laboratory Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
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Li L, Zhou Z, Fang J, Liu D, Deng C, Chen Y, Ahasan Z, Zhu W, Cai K. The characterization of metabolic changes in adipose tissues and muscles due to different exercise intensities by Dixon in healthy young men. Eur J Radiol 2024; 177:111559. [PMID: 38865759 DOI: 10.1016/j.ejrad.2024.111559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE To delineate the alterations in adipose and muscle tissue composition and functionality among healthy young men across varying exercise intensities, which help to elucidate the impact of exercise intensity on weight management and inform fitness planning. METHOD 3D Dixon MRI scans were performed on the neck and supraclavicular area in 10 high-intensity exercises (HIE) athletes, 20 moderate intensity exercises (MIE) athletes and 19 low-intensity exercises non-athlete male controls (NCM). Twelve imaging parameters, including the total volume of muscle, white adipose tissue (WAT), brown adipose tissue (BAT), and the mean fat-water fraction (FWF) within these tissues. Additionally, ratios of BAT or WAT to total fat (BATr or WATr) and the proportions of muscle, BAT, or WAT to total tissue volume (Musp, BATp, and WATp) were calculated. Parameters were compared across groups and correlated with Body Mass Index (BMI), waistline, and hipline. RESULTS The HIE group exhibited the highest total muscle (totalMUS) and brown adipose tissue (totalBAT) volumes among the three groups. Conversely, the NCM group had significantly higher fwfFAT and fwfBAT values. The MUSp was higher in the HIE and MIE groups compared to NCM, while the BATp and WATp were lower. Furthermore, the BATr in HIE and MIE groups were higher than NCM group while the WATr were lower. Significant linear relationships were observed between totalBAT, totalWAT, MUSp, BATr, fwfFAT, and BMI, waistline (P < 0.05) across all groups. CONCLUSIONS MIE is sufficient for the purpose of weight control, While HIE helps to further increase the muscle mass. All three physical indexes were significantly associated with the image parameters, with waistline emerging as the most effective indicator for detecting metabolic changes across all groups.
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Affiliation(s)
- Li Li
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Zhiguo Zhou
- Orthopedics Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, HUST, Wuhan, China.
| | - Jicheng Fang
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Dong Liu
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Chenghu Deng
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Yong Chen
- Endocrinology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Zoheb Ahasan
- Radiology Department, Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Wenzhen Zhu
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Kejia Cai
- Radiology Department, Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Berezvai Z, Vitrai J, Tóth G, Brys Z, Bakacs M, Joó T. Long-term impact of unhealthy food tax on consumption and the drivers behind: A longitudinal study in Hungary. Health Policy 2024; 146:105098. [PMID: 38851004 DOI: 10.1016/j.healthpol.2024.105098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/30/2024] [Accepted: 05/24/2024] [Indexed: 06/10/2024]
Abstract
Several countries have introduced public health product taxes with the objective of reducing the absolute amount of consumption of unhealthy food and tackling obesity. This study aims to estimate the long-term impact of the Hungarian public health product tax introduced in 2011. To achieve this, a unique consumer purchase dataset was analysed to examine daily fast-moving consumer goods purchases from a representative sample of 2,000 households from 2010 to 2018. The results indicate that the tax has been fully reflected in consumer prices. A decline in consumption was observed initially, consistent with previous experiences in Hungary and other countries. However, over time, the data suggests a recovery and even an increase in line with the growth of disposable income. The proportion of taxed products in total fast-moving consumer goods purchases increased from 5.9 % (95 % CI: 5.7 % to 6.0 %) in 2010 to 7.4 % (95 % CI: 7.3 % to 7.6 %) in 2018. Furthermore, the tax has contributed to increased inequality as low-income households spend a higher proportion of their total expenditure on it. Although taxes on unhealthy foods have proven effective in the short-term, they may not be adequate for reducing overall consumption in the long-term, particularly as disposable income increases. In conclusion, implementing complex interventions is necessary to achieve sustainable positive changes in dietary habits.
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Affiliation(s)
- Zombor Berezvai
- Institute of Marketing and Communication Sciences, Corvinus University of Budapest, Budapest, Hungary.
| | - József Vitrai
- Faculty of Health and Sport Sciences, Department of Preventive Health Sciences, Széchenyi István University, Győr, Hungary
| | - Gergely Tóth
- Faculty of Humanities and Social Sciences, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
| | - Zoltán Brys
- Institute for Sociology, HUN-REN Centre for Social Sciences, Budapest, Hungary; Doctoral College - Mental Health Sciences Division, Semmelweis University, Budapest, Hungary
| | - Márta Bakacs
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Tamás Joó
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary; Hungarian Healthcare Management Association, Budapest, Hungary
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Burgaz C, Van-Dam I, Garton K, Swinburn BA, Sacks G, Asiki G, Claro R, Diouf A, Bartoletto Martins AP, Vandevijvere S. Which government policies to create sustainable food systems have the potential to simultaneously address undernutrition, obesity and environmental sustainability? Global Health 2024; 20:56. [PMID: 39068420 PMCID: PMC11282665 DOI: 10.1186/s12992-024-01060-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION A transformation of food systems is urgently needed, given their contribution to three ongoing and interlinked global health pandemics: (1) undernutrition and food insecurity, (2) obesity and non-communicable diseases (NCDs), and (3) climate change and biodiversity loss. As policymakers make decisions that shape food systems, this study aimed to identify and prioritise policies with double- or triple-duty potential to achieve healthier and more environmentally sustainable food systems. METHODS This study undertook a 4-step methodological approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation. Policies were identified and prioritised based on their double- or triple-duty potential, synergies and trade-offs. Using participatory and transdisciplinary approaches, policies were identified to have double- or triple-duty potential if they were deemed effective in tackling two or three of the primary outcomes of interest: (1) undernutrition, (2) obesity/NCDs and (3) environmental degradation. RESULTS The desk review identified 291 recommendations for governments, which were merged and classified into 46 initially proposed policies. Based on the results from the online survey, 61% of those policies were perceived to have double- or triple-duty potential. During the workshops, 4 potential synergies and 31 trade-offs of these policies were identified. The final list of 44 proposed policies for healthier and more environmentally sustainable food systems created was divided into two main policy domains: 'food supply chains' and 'food environments'. The outcome with the most trade-offs identified was 'undernutrition', followed by 'environmental sustainability', and 'obesity/NCDs'. Of the top five expert-ranked food supply chain policies, two were perceived to have triple-duty potential: (a) incentives for crop diversification; (b) support for start-ups, and small- and medium-sized enterprises. For food environments, three of the top five ranked policies had perceived triple-duty potential: (a) affordability of healthier and more sustainable diets; (b) subsidies for healthier and more sustainable foods; (c) restrictions on children's exposure to marketing through all media. CONCLUSION This study identified and prioritised a comprehensive list of double- and triple-duty government policies for creating healthier and more environmentally sustainable food systems. As some proposed policies may have trade-offs across outcomes, they should be carefully contextualised, designed, implemented and monitored.
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Affiliation(s)
- Celia Burgaz
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
- Department of Geosciences, Environment and Society, Free University of Brussels (ULB), Brussels, Belgium.
| | - Iris Van-Dam
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kelly Garton
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Deakin University, Melbourne, Australia
| | - Gershim Asiki
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Rafael Claro
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition Alimentation Humaine, Université Cheikh Anta Diop, Dakar, Senegal
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Fliaguine O, Thuot-Jolicoeur A, Poulin F, Denault AS, Robitaille J, Geoffroy MC, Philippe FL. Associations between parental civic engagement, negative beliefs toward civic engagement and youths' future civic attitudes and behaviors. J Adolesc 2024. [PMID: 39058996 DOI: 10.1002/jad.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Civic engagement (CE) in adolescence is associated with a higher level of engagement in adulthood and is reported to be beneficial to youth's development and societal well-being. Parents are among the most influential factors in adolescents' lives. This study examined the associations between parents' own civic participation, their negative beliefs toward youth CE and their child's future CE. While prior research documented positive associations between parental civic behaviors and youth CE, the role of parental negative beliefs has remained unexplored and could act as an additional barrier to adolescents' CE. METHODS A total of 234 adolescents (65% girls; mean age = 13.77) and their parents (79% mothers; mean age = 44.20), residing in the Canadian province of Quebec from 2016 to 2019, were recruited for this cross-sectional study. Parents completed measures of their civic activities and their negative beliefs regarding youth CE. Adolescents completed measures of future civic attitudes and behaviors. RESULTS Hierarchical regressions revealed significant positive cross-sectional associations between parental civic behaviors and their child's future civic attitudes and behaviors. However, parental negative beliefs toward youth CE were negatively associated with youths' future civic attitudes and behaviors, even after considering parental civic behaviors and family socioeconomic status. Adolescents' age did not moderate these relationships. CONCLUSION These findings highlight the significant role that parents could play in shaping CE of future generations. Interventions promoting youth CE should thus target both adolescents and their parents.
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Affiliation(s)
- Olga Fliaguine
- Department of Psychology, University de Québec à Montreal, Montreal, Canada
| | | | - François Poulin
- Department of Psychology, University de Québec à Montreal, Montreal, Canada
| | - Anne-Sophie Denault
- Department of Foundations and Practices in Education, Laval University, Quebec City, Quebec, Canada
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Pineda E, Hernández-F M, Ortega-Avila AG, Jones A, Rivera JA. Mexico's bold new law on adequate and sustainable nutrition. Lancet 2024:S0140-6736(24)01493-4. [PMID: 39068952 DOI: 10.1016/s0140-6736(24)01493-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Affiliation(s)
- Elisa Pineda
- The George Institute for Global Health UK, London W12 7RZ, UK; School of Public Health, Imperial College London, London, UK.
| | - Mauricio Hernández-F
- Research Institute for Equitable Development, Universidad Iberoamericana, Mexico City, Mexico
| | - Ana G Ortega-Avila
- Department of Human Nutritional Science, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alexandra Jones
- The George Institute for Global Health Australia, Sydney, NSW, Australia
| | - Juan A Rivera
- Instituto Nacional de Salud Pública, Mexico City, Mexico
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Caldeira TCM, Vandevijvere S, Swinburn B, Mackay S, Claro RM. Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study. Nutr J 2024; 23:71. [PMID: 38982483 PMCID: PMC11234630 DOI: 10.1186/s12937-024-00973-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets. METHODS Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios. RESULTS We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect. CONCLUSIONS The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.
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Affiliation(s)
- Thaís Cristina Marquezine Caldeira
- Postgraduate Program in Public Health, Medical School, Federal University of Minas Gerais, Avenue Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Brazil.
| | | | - Boyd Swinburn
- Faculty of Medical and Health Sciences, Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- Faculty of Medical and Health Sciences, Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Rafael Moreira Claro
- Nutrition Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Tomassini L, Lancia M, Gambelunghe A, Zahar A, Pini N, Gambelunghe C. Exploring the Nexus of Climate Change and Substance Abuse: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:896. [PMID: 39063473 PMCID: PMC11277026 DOI: 10.3390/ijerph21070896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/28/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION The increase in average air temperature and multiple extreme weather events, such as heatwaves and droughts, pose significant health risks to humans. This scoping review aims to examine the current state of the existing literature concerning the potential relationship between substance abuse and climate change, along with the aspects it encompasses. MATERIAL AND METHODS The review followed PRISMA guidelines for methodological rigor, aiming to identify studies on drug abuse. Searches were conducted across the primary databases using specific search strings. Quality assessment involved evaluating the research question's clarity, search strategy transparency, consistency in applying the inclusion/exclusion criteria, and reliability of data extraction. RESULTS Most studies were conducted in the USA. They included observational and retrospective quantitative studies, as well as qualitative and prospective observational ones. Research examined the correlation between extreme weather and some substance abuse. All studies analyzed the adverse effects of climate change, especially heatwaves, on both physiological and pathological levels. CONCLUSIONS The scoping review notes the scarcity of studies about the correlation between substance abuse and climate change, and emphasizes the threats faced by individuals with substance abuse and mental health disorders due to climate change.
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Affiliation(s)
- Luca Tomassini
- School of Advanced Studies, University of Camerino, 62032 Camerino, Italy;
| | - Massimo Lancia
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Angela Gambelunghe
- Occupational Medicine, Respiratory Diseases and Toxicology Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
| | - Abdellah Zahar
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Niccolò Pini
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Cristiana Gambelunghe
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
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de Carvalho AM, Garcia LMT, Lourenço BH, Verly Junior E, Carioca AAF, Jacob MCM, Gomes SM, Sarti FM. Exploring the Nexus between Food Systems and the Global Syndemic among Children under Five Years of Age through the Complex Systems Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:893. [PMID: 39063469 PMCID: PMC11276875 DOI: 10.3390/ijerph21070893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/02/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
The intricate relationship between food systems and health outcomes, known as the food-nutrition-health nexus, intersects with environmental concerns. However, there's still a literature gap in evaluating food systems alongside the global syndemic using the complex systems theory, especially concerning vulnerable populations like children. This research aimed to design a system dynamics model to advance a theoretical understanding of the connections between food systems and the global syndemic, particularly focusing on their impacts on children under five years of age. The framework was developed through a literature review and authors' insights into the relationships between the food, health, and environmental components of the global syndemic among children. The conceptual model presented 17 factors, with 26 connections and 6 feedback loops, categorized into the following 5 groups: environmental, economic, school-related, family-related, and child-related. It delineated and elucidated mechanisms among the components of the global syndemic encompassing being overweight, suffering from undernutrition, and climate change. The findings unveiled potential interactions within food systems and health outcomes. Furthermore, the model integrated elements of the socio-ecological model by incorporating an external layer representing the environment and its natural resources. Consequently, the development of public policies and interventions should encompass environmental considerations to effectively tackle the complex challenges posed by the global syndemic.
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Affiliation(s)
| | | | | | - Eliseu Verly Junior
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro 20550-013, Brazil;
| | | | | | - Sávio Marcelino Gomes
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa 58051-900, Brazil;
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo 03828-000, Brazil;
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Frühbeck G, Busetto L, Carbone F. The obesity syndemic in the European community: towards a systems thinking approach for preventive policies. Eur Heart J 2024; 45:2181-2182. [PMID: 38339964 DOI: 10.1093/eurheartj/ehae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Affiliation(s)
- Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Avda. Pío XII, 36, 31008 Pamplona, Spain
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Avda. Pío XII, 36, 31008 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra, Irunlarrea, 3, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII, 36, 31008 Pamplona, Spain
| | - Luca Busetto
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padua, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa-Italian Cardiovascular Network, Genoa, Italy
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Kim MS, Shim I, Fahed AC, Do R, Park WY, Natarajan P, Khera AV, Won HH. Association of genetic risk, lifestyle, and their interaction with obesity and obesity-related morbidities. Cell Metab 2024; 36:1494-1503.e3. [PMID: 38959863 DOI: 10.1016/j.cmet.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/26/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024]
Abstract
The extent to which modifiable lifestyle factors offset the determined genetic risk of obesity and obesity-related morbidities remains unknown. We explored how the interaction between genetic and lifestyle factors influences the risk of obesity and obesity-related morbidities. The polygenic score for body mass index was calculated to quantify inherited susceptibility to obesity in 338,645 UK Biobank European participants, and a composite lifestyle score was derived from five obesogenic factors (physical activity, diet, sedentary behavior, alcohol consumption, and sleep duration). We observed significant interaction between high genetic risk and poor lifestyles (pinteraction < 0.001). Absolute differences in obesity risk between those who adhere to healthy lifestyles and those who do not had gradually expanded with an increase in polygenic score. Despite a high genetic risk for obesity, individuals can prevent obesity-related morbidities by adhering to a healthy lifestyle and maintaining a normal body weight. Healthy lifestyles should be promoted irrespective of genetic background.
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Affiliation(s)
- Min Seo Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea; Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Injeong Shim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea; Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Akl C Fahed
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Ron Do
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Pradeep Natarajan
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Amit V Khera
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Verve Therapeutics, Boston, MA 02215, USA.
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul 06351, Republic of Korea.
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Hunter RF, Garcia L, Dagless S, Haines A, Penney T, Clifford Astbury C, Whiting S, Wickramasinghe K, Racioppi F, Galea G, Kluge HHP. The emerging syndemic of climate change and non-communicable diseases. Lancet Planet Health 2024; 8:e430-e431. [PMID: 38969470 DOI: 10.1016/s2542-5196(24)00112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/01/2024] [Indexed: 07/07/2024]
Affiliation(s)
- Ruth F Hunter
- WHO Collaborating Centre for Complex Systems and Network Science for NCD Prevention and Control, Centre for Public Health, Queen's University Belfast, Belfast BT12 6BJ, UK.
| | - Leandro Garcia
- WHO Collaborating Centre for Complex Systems and Network Science for NCD Prevention and Control, Centre for Public Health, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Selina Dagless
- Special Initiative on Noncommunicable Diseases and Innovation
| | - Andy Haines
- Centre on Climate Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tarra Penney
- Global Food System and Policy Research, School of Global Health, York University, York, UK
| | - Chloe Clifford Astbury
- Global Food System and Policy Research, School of Global Health, York University, York, UK
| | - Stephen Whiting
- Special Initiative on Noncommunicable Diseases and Innovation
| | | | | | - Gauden Galea
- Special Initiative on Noncommunicable Diseases and Innovation
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Tizazu W, Laillou A, Hirvonen K, Chitekwe S, Baye K. Child feeding practices in rural Ethiopia show increasing consumption of unhealthy foods. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13401. [PMID: 35852042 PMCID: PMC11258765 DOI: 10.1111/mcn.13401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
The quality of complementary feeding can have both short- and long-term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non-quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra-processed food (UPFs). Up to one-in-five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient-dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes.
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Affiliation(s)
- Woinshet Tizazu
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
| | | | - Kalle Hirvonen
- Development Strategy and Governance DivisionInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
- The United Nations UniversityWorld Institute for Development Economics ResearchHelsinkiFinland
| | | | - Kaleab Baye
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Research Center for Inclusive Development in AfricaAddis AbabaEthiopia
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Hensher M, McCartney G, Ochodo E. Health Economics in a World of Uneconomic Growth. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:427-433. [PMID: 38637451 PMCID: PMC11178562 DOI: 10.1007/s40258-024-00883-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
Multiple, accelerating and interacting ecological crises are increasingly understood as constituting a major threat to human health and well-being. Unconstrained economic growth is strongly implicated in these growing crises, and it has been argued that this growth has now become "uneconomic growth", which is a situation where the size of the economy is still expanding, but this expansion is causing more harm than benefit. This article summarises the multiple pathways by which uneconomic growth can be expected to harm human health. It describes how health care systems-especially through overuse, low value and poor quality care-can themselves drive uneconomic growth. Health economists need to understand not only the consequences of environmental impacts on health care, but also the significance of uneconomic growth, and pay closer attention to the growing body of work by heterodox economists, especially in the fields of ecological and feminist economics. This will involve paying closer heed to the existence and consequences of diminishing marginal returns to health care consumption at high levels; the central importance of inequalities and injustice in health; and the need to remedy health economists' currently limited ability to deal effectively with low value care, overdiagnosis and overtreatment.
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Affiliation(s)
- Martin Hensher
- Henry Baldwin Professorial Research Fellow in Health System Sustainability, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Gerry McCartney
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Eleanor Ochodo
- Stellenbosch University, Stellenbosch, Western Cape, South Africa
- Kenya Medical Research Institute, Nairobi, Kenya
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Rei M, Costa A, Sosa S, da Costa S, Torres D, Sage C, Rodrigues S. Multicriteria Measures to Assess the Sustainability of Diets: A Systematic Review. Nutr Rev 2024:nuae081. [PMID: 38942740 DOI: 10.1093/nutrit/nuae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
CONTEXT Assessing the overall sustainability of a diet is a challenging undertaking requiring a holistic approach capable of addressing the multicriteria nature of this concept. OBJECTIVE The aim was to identify and summarize the multicriteria measures used to assess the sustainability characteristics of diets reported at the individual level by healthy adults. DATA SOURCES Articles were identified via PubMed, Scopus, and Web of Science. The search strategy consisted of key words and MeSH terms, and was concluded in September 2022, covering references in English, Spanish, and Portuguese. DATA EXTRACTION This systematic review followed the PRISMA guidelines. The search identified 5663 references, from which 1794 were duplicates. Two reviewers independently screened the titles and abstracts of each of the 3869 records and the full-text of the 144 references selected. Of these, 7 studies met the inclusion criteria. DATA ANALYSIS A total of 6 multicriteria measures were identified: 3 different Sustainable Diet Indices, the Quality Environmental Costs of Diet, the Quality Financial Costs of Diet, and the Environmental Impact of Diet. All of these incorporated a health/nutrition dimension, while the environmental and economic dimensions were the second and the third most integrated, respectively. A sociocultural sustainability dimension was included in only 1 of the measures. CONCLUSION Despite some methodological concerns in the development and validation process of the identified measures, their inclusion is considered indispensable in assessing the transition towards sustainable diets in future studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022358824.
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Affiliation(s)
- Mariana Rei
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Alexandra Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia Sosa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia da Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Duarte Torres
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
| | - Colin Sage
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
| | - Sara Rodrigues
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
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Zhou R, Liu Y, Hu W, Yang J, Lin B, Zhang Z, Chen M, Yi J, Zhu C. Lycium barbarum polysaccharide ameliorates the accumulation of lipid droplets in adipose tissue via an ATF6/SIRT1-dependent mechanism. Acta Biochim Biophys Sin (Shanghai) 2024; 56:844-856. [PMID: 38606478 PMCID: PMC11214951 DOI: 10.3724/abbs.2024046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/03/2024] [Indexed: 04/13/2024] Open
Abstract
Lipid droplets (LDs) are dynamic organelles that store neutral lipids and are closely linked to obesity. Previous studies have suggested that Lycium barbarum polysaccharide (LBP) supplements can ameliorate obesity, but the underlying mechanisms remain unclear. In this study, we hypothesize that LBP alleviates LD accumulation in adipose tissue (AT) by inhibiting fat-specific protein 27 (Fsp27) through an activating transcription factor-6 (ATF6)/small-molecule sirtuin 1 (SIRT1)-dependent mechanism. LD accumulation in AT is induced in high-fat diet (HFD)-fed mice, and differentiation of 3T3-L1 preadipocytes (PAs) is induced. The ability of LBP to alleviate LD accumulation and the possible underlying mechanism are then investigated both in vivo and in vitro. The influences of LBP on the expressions of LD-associated genes ( ATF6 and Fsp27) are also detected. The results show that HFD and PA differentiation markedly increase LD accumulation in ATs and adipocytes, respectively, and these effects are markedly suppressed by LBP supplementation. Furthermore, LBP significantly activates SIRT1 and decreases ATF6 and Fsp27 expressions. Interestingly, the inhibitory effects of LBP are either abolished or exacerbated when ATF6 is overexpressed or silenced, respectively. Furthermore, SIRT1 level is transcriptionally regulated by LBP through opposite actions mediated by ATF6. Collectively, our findings suggest that LBP supplementation alleviates obesity by ameliorating LD accumulation, which might be partially mediated by an ATF6/SIRT1-dependent mechanism.
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Affiliation(s)
- Rui Zhou
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Yajing Liu
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Weiqian Hu
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Jing Yang
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Bing Lin
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Zhentian Zhang
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Mingyan Chen
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Jingwen Yi
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
| | - Cuifeng Zhu
- />Department of Clinical NutritionShenzhen Hospital of Southern Medical UniversityShenzhen518000China
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Lai WK, Palaniveloo L, Mohd Sallehuddin S, Ganapathy SS. Double burden of malnutrition and its socio-demographic determinants among children and adolescents in Malaysia: National Health And Morbidity Survey 2019. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:94. [PMID: 38915044 PMCID: PMC11197233 DOI: 10.1186/s41043-024-00583-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/09/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Malaysia faces the threat of a double burden of malnutrition where undernutrition and overweight (including obesity) coexist in the same population. This study aimed to determine the anthropometric assessment among children and adolescents aged 5 to 17 years and its association with socio-demographic factors. METHODS Data were extracted from the National Health and Morbidity Survey conducted in 2019. This cross-sectional survey applied a two-stage stratified sampling design. Socio-demographic characteristics were obtained. Weight and height were measured, age- and sex-specific standard scores for height and BMI were calculated to establish individual's anthropometric assessment. Having either stunting or thinness was considered undernutrition, while being overweight (including obesity) was considered overnutrition. If someone had undernutrition and/or overnutrition, they were classified as having malnutrition. The prevalence was determined using complex sampling analysis, while the association was assessed through logistic regression. The analysis included a total of 3,185 respondents. RESULTS The prevalence of stunting, thinness, overweight and obesity among the respondents aged 5 to 17 years was 12.7%, 10.0%, 15.0% and 14.8%, respectively. The overall prevalence of malnutrition was 48.3%. Respondents residing in rural had 1.35 times more likelihood of experiencing undernutrition [AOR = 1.35, 95% CI (1.04, 1.77)] compared to their urban counterparts. Boys exhibited a greater likelihood of being overweight and obese than girls [AOR = 1.40, 95% CI (1.13, 1.73)]. Respondents aged 10 to 14 years were 1.37 times more likely to be overnutrition than those aged 5 to 9 years old [AOR = 1.37, 95% CI (1.09, 1.73)]. CONCLUSION There is growing evidence of the increasing prevalence of coexistence of undernutrition along with overweight and obesity among children and adolescents in Malaysia. Moving forward, greater initiatives and efforts are required to formulate strategies for planning and implementing programs and policies to expedite progress in improving nutrition.
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Affiliation(s)
- Wai Kent Lai
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia.
- Raub Health District Office, Pahang State Health Deparment, Ministry of Health, Raub, Malaysia.
| | - Lalitha Palaniveloo
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
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Brink SM, Wortelboer HM, Hoff AFT, Emmelot CH, Visscher TLS, van Wietmarschen HA. Two-Year Results of a Five-Year Personalized Integrative Obesity Coaching Program (IBO) Based upon a Systems Health Perspective and an Evolutionary Longitudinal Study Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:807. [PMID: 38929053 PMCID: PMC11203432 DOI: 10.3390/ijerph21060807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
This study presents the outcomes of a 5-year personalized integrative coaching program for adults with obesity (body mass index BMI ≥ 30 kg/m2), based upon a systems health perspective, during the first 2 years. This longitudinal study, which had an evolutionary design, included all adults who enrolled in the program. Health-related quality of life (HRQoL) was measured with the Short Form-36 (SF-36), and physical outcomes included weight, waist circumference, aerobic capacity, lipid profile, and HbA1c. Subsequently, participants completed questionnaires (e.g., the Symptom Checlist-90 (SCL-90) and the Checklist Individual Strength (CIS)). Seventy-nine adults with a mean BMI of 39.5 kg/m2 (SD 5.3) were included. Forty-four participants completed 2 years in the program. Compared to baseline, there were significant improvements in the SF-36 subscales 'physical functioning' (MD 9.9 points, 95% CI: 2.1-17.5, p = 0.013) and 'general health perceptions' (MD 9.3 points, 95% CI 2.9-15.7, p = 0.006). Furthermore, significant improvements in physical outcomes and psychosocial questionnaires (e.g., weight loss (MD 3.5 kg, 95% CI: 1.2-5.7, p = 0.003), waist circumference (MD 5.1 cm, 95% CI: 2.4-7.8, p < 0.001), and CIS fatigue (MD 6.8, 95% CI: 3.1-10.5, p = 0.001) were observed. This study highlights the importance of a systems health perspective supporting the development of a personalized integrative coaching program for adults with obesity in a 'real-world' setting.
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Affiliation(s)
- Sander M. Brink
- Vogellanden, Center of Rehabilitation Medicine & Special Dentistry, 8001 BB Zwolle, The Netherlands; (A.F.t.H.); (C.H.E.)
| | - Heleen M. Wortelboer
- The Netherlands Organization for Applied Scientific Research (TNO), Department Work Health and Technology, 2333 BE Leiden, The Netherlands;
| | - Ard F. ten Hoff
- Vogellanden, Center of Rehabilitation Medicine & Special Dentistry, 8001 BB Zwolle, The Netherlands; (A.F.t.H.); (C.H.E.)
| | - Cornelis H. Emmelot
- Vogellanden, Center of Rehabilitation Medicine & Special Dentistry, 8001 BB Zwolle, The Netherlands; (A.F.t.H.); (C.H.E.)
| | - Tommy L. S. Visscher
- Knowledge Centre Societal Innovations, Windesheim University of Applied Sciences, 1315 RC Almere, The Netherlands;
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Tapkigen J, Harding S, Pulkki J, Atkins S, Koivusalo M. Climate change-induced shifts in the food systems and diet-related non-communicable diseases in sub-Saharan Africa: a scoping review and a conceptual framework. BMJ Open 2024; 14:e080241. [PMID: 38890143 PMCID: PMC11191816 DOI: 10.1136/bmjopen-2023-080241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/27/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES To determine the relationship between climate change, food systems and diet-related non-communicable diseases (DR-NCDs) in sub-Saharan Africa (SSA) and propose a conceptual framework for food systems in SSA. DESIGN A scoping review. ELIGIBILITY CRITERIA Studies included investigated the relationship between climate change and related systemic risks, food systems, DR-NCDs and its risk factors in SSA. Studies focusing on the association between climate change and DR-NCDs unrelated to food systems, such as social inequalities, were excluded. SOURCES OF EVIDENCE A comprehensive search was conducted in ProQuest (nine databases), Google Scholar and PubMed in December 2022. CHARTING METHODS Data extracted from studies included author, study type, country of study, climate change component, DR-NCD outcomes and risk factors, and impacts of climate change on DR-NCDs. A narrative approach was used to analyse the data. Based on the evidence gathered from SSA, we modified an existing food system conceptual framework. RESULTS The search retrieved 19 125 studies, 10 of which were included in the review. Most studies used a cross-sectional design (n=8). Four explored the influence of temperature on liver cancer through food storage while four explored the influence of temperature and rainfall on diabetes and obesity through food production. Cross-sectional evidence suggested that temperature is associated with liver cancer and rainfall with diabetes. CONCLUSION The review highlights the vulnerability of SSA's food systems to climate change-induced fluctuations, which in turn affect dietary patterns and DR-NCD outcomes. The evidence is scarce and concentrates mostly on the health effects of temperature through food storage. It proposes a conceptual framework to guide future research addressing climate change and DR-NCDs in SSA.
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Affiliation(s)
- Janet Tapkigen
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course & Population Sciences, Kings College London, London, UK
| | - Jutta Pulkki
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Salla Atkins
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Meri Koivusalo
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- WHO Collaborating Centre on Health in All Policies and the Social Determinants of Health, Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Chen Z, Chen L, Tan J, Mao Y, Hao M, Li Y, Wang Y, Li J, Wang J, Jin L, Zheng HX. Natural selection shaped the protective effect of the mtDNA lineage against obesity in Han Chinese populations. J Genet Genomics 2024:S1673-8527(24)00129-2. [PMID: 38880354 DOI: 10.1016/j.jgg.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/18/2024]
Abstract
Mitochondria play a key role in lipid metabolism, and mitochondrial DNA (mtDNA) mutations are thus considered to affect obesity susceptibility by altering oxidative phosphorylation and mitochondrial function. In this study, we investigated mtDNA variants that may affect obesity risk in 2877 Han Chinese individuals from three independent populations. The association analysis of 16 basal mtDNA haplogroups with body mass index, waist circumference, and waist-to-hip ratio revealed that only haplogroup M7 was significantly negatively correlated with all three adiposity-related anthropometric traits in the overall cohort, verified by the analysis of a single population, i.e., the Zhengzhou population. Furthermore, subhaplogroup analysis suggested that M7b1a1 was the most likely haplogroup associated with a decreased obesity risk, and the variation T12811C (causing Y159H in ND5) harbored in M7b1a1 may be the most likely candidate for altering the mitochondrial function. Specifically, we found that proportionally more nonsynonymous mutations accumulated in M7b1a1 carriers, indicating that M7b1a1 was either under positive selection or subject to a relaxation of selective constraints. We also found that nuclear variants, especially in DACT2 and PIEZO1, may functionally interact with M7b1a1.
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Affiliation(s)
- Ziwei Chen
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China
| | - Lu Chen
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai 200438, China
| | - Jingze Tan
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China
| | - Yizhen Mao
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai 200438, China
| | - Meng Hao
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China
| | - Yi Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China
| | - Yi Wang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China; Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai 200438, China
| | - Jinxi Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China
| | - Jiucun Wang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China; Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai 200438, China; Research Unit of Dissecting Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Li Jin
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China; Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai 200438, China; Research Unit of Dissecting Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Hong-Xiang Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute and Center for Evolutionary Biology, Fudan University, Shanghai 200438, China; Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai 200438, China.
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