Globalisation and public health-overview and a Swedish perspective

Exercise in the Park or Gym? The Physiological and Mental Responses of Obese People Walking in Different Settings at Different Speeds: A Parallel Group Randomized Trial

Evidence shows that physical activity has multiple health benefits for the body and mind of oneself, but little is known about the impacts of the setting and the intensity on exercise experience, especially for obese people. This study investigated the physiological and psychological effects of four walking conditions with different settings (park vs. gym) and intensity (slow vs. fast) on young obese adults. Subjects were 18–21 years old Chinese university students (N = 77), who were diagnosed as obese. They were randomly assigned to participate in one of the four activities in the field: slow walk in the park (2.8 km/h), fast walk in the park (5.5 km/h), slow walk in the gym, and fast walk in the gym. Physiological indices, including blood pressure and heart rate, were measured before and after the walk. Psychological responses were measured by the Symbol Digit Modalities Test, the mood states scale, and the semantic differential scale. This study of obese people aged 18–21 years confirmed the previous findings that exercising in natural environments better relieved stress and restored attentional level than indoor activities. The results suggested that the mood states of the participants and their environmental perceptions may be influenced by the walking conditions with different setting and speed. The findings can be used in planning and designing urban green spaces for promoting physical activity and making exercise plans for obese people.

Relaxed natural selection contributes to global obesity increase more in males than in females due to more environmental modifications in female body mass

OBJECTIVE

Relaxed natural selection, measured by Biological State Index (Ibs), results in unfavourable genes/mutations accumulation in population. Obesity is partly heritable. We aim to examine and compare the effects of relaxed natural selection on male and female obesity prevalence.

METHODS

Data for 191 countries of the world were captured for this ecological study. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between Ibs and sex-specific obesity prevalence. Per capita GDP, urbanization and caloric intake were controlled for as the confounding factors. Fisher r-to-z transformation, R2 increment in multivariate regression and F-test were used to compare the correlations.

RESULTS

Curvilinear regressions, bivariate and partial correlations (controlled for GDP, urbanization and calories) revealed that Ibs was significantly correlated to obesity prevalence of both sexes, but significantly stronger to male than to female obesity prevalence. Curvilinear regression models also showed strong correlations. Mixed linear models, with effects of GDP, urbanisation and caloric intake controlled for, showed that male and female average obesity prevalence rates were significantly higher in countries with greater Ibs value than their equivalents in countries with lower Ibs. Between higher and lower Ibs countries, the gap of male obesity prevalence is 60% greater than the gap of female obesity prevalence. Stepwise multiple regression identified that Ibs was a significant predictor of obesity prevalence of both sexes. Multivariate regression showed that, adding Ibs as an obesity predictor, R2 increment in male model was significantly greater than in female model.

CONCLUSIONS

Relaxed natural selection may drive males and females to accumulate metabolic faulty genes equally. Probably due to greater environmental, personal intervention in regulating female body mass, relaxed natural selection shows less contributing effects to female obesity prevalence than to male obesity prevalence. Gene therapy to prevent obesity may need to be also taken into account.

Is small town India falling into the nutritional trap of metro cities? A study in school-going adolescents

INTRODUCTION

There has been an increasing secular trend in the prevalence of overweight and obesity in developing countries. The prevalence reported among children and adolescents of some metro cities in India are comparable to that in some developed countries. Westernization of culture, rapid mushrooming of fast food joints, lack of physical activity, and increasing sedentary pursuits in the metro cities are some of the reasons implicated for this. The nutritional changes in small town school children might be following the same pattern of larger cities.

AIMS AND OBJECTIVES

To study the prevalence of overweight and obesity among school-going adolescents of Aligarh and to study the sociodemographic and behavioral correlates of the same.

MATERIALS AND METHODS

A cross-sectional study done in two affluent and two nonaffluent schools in Aligarh, taking 330 adolescents from each group (total-660). Study tools included a predesigned and pretested questionnaire, Global Physical Activity Questionnaire, and anthropometric measurement. Overweight and obesity were defined based on World Health Organization 2007 Growth Reference. Chi-square test and multiple logistic regression analysis were done.

RESULTS

Prevalence of overweight and obesity was 9.8% and 4.8% among school-going adolescents. The difference in prevalence of overweight and obesity among affluent schools (14.8% and 8.2%) and nonaffluent schools (4.8% and 1.5%) was significant. Risk factors for overweight and obesity were affluence, higher maternal education, parental history of obesity, frequent fast food intake, and television (TV) viewing more than 2 h/day.

CONCLUSION

Overweight and obesity among school-going adolescents is a crisis facing even smaller cities in India. Behavior change communication should be focused to adolescents, especially of the affluent section, toward restricting fast food intake, and TV viewing.

Global obesity: trends, risk factors and policy implications

The worldwide increase in obesity and related chronic diseases has largely been driven by global trade liberalization, economic growth and rapid urbanization. These factors continue to fuel dramatic changes in living environments, diets and lifestyles in ways that promote positive energy balance. Nutritional transitions in low-income and middle-income countries are typically characterized by increases in the consumption of animal fat and protein, refined grains, and added sugar. This change is coupled with reductions in physical activity owing to more mechanized and technologically driven lifestyles. Given the high costs of obesity and comorbidities in terms of health-care expenditure and quality of life, prevention strategies are paramount, particularly in low-income and middle-income countries that must manage coexisting infectious diseases and undernutrition in addition to the obesity epidemic. As countries become increasingly urbanized, undernutrition and obesity can exist side by side within the same country, community or household, which is a particular challenge for health systems with limited resources. Owing to the scope and complexity of the obesity epidemic, prevention strategies and policies across multiple levels are needed in order to have a measurable effect. Changes should include high-level global policies from the international community and coordinated efforts by governments, organizations, communities and individuals to positively influence behavioural change.

Fair and Ethical Trade in Health: Lessons from Surgical Instruments

The NHS spends £20 billion on procuring a wide range of medical goods every year. Worldwide, the amount traded in products for health care runs into trillions of dollars. With such large sums of money we quite rightly ask about value for money as well as the quality of the goods we buy. But in addition to quality we should, but don't, ask about the conditions under which those goods are made. Unfortunately, recent research has found that some of the products we are using to promote health in the UK may actually be damaging health elsewhere, through unethical labour practices in their manufacture.