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Nikolic Turnic T, Jakovljevic V, Strizhkova Z, Polukhin N, Ryaboy D, Kartashova M, Korenkova M, Kolchina V, Reshetnikov V. The Association between Marital Status and Obesity: A Systematic Review and Meta-Analysis. Diseases 2024; 12:146. [PMID: 39057117 PMCID: PMC11276062 DOI: 10.3390/diseases12070146] [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: 05/08/2024] [Revised: 06/07/2024] [Accepted: 06/09/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Obesity was included in the International Classification of Diseases in 1990 as a chronic disease characterized by the excessive accumulation of body fat and a body mass index (BMI) greater than 30 kg/m2. AIM This systematic review was aimed to examine the role of marital status in determining body mass index and the risk of obesity. METHODS We performed a systematic literature search using three databases (PubMed (Medline), Embase, and Google Scholar) with the search query. RESULTS Of the 105 studies included in the systematic review, 76 studies (72%) reported a greater risk of obesity in married individuals compared to unmarried individuals. A meta-analysis of 24 studies included a total population of 369,499 participants: 257,257 married individuals (40,896 of whom had obesity) and 112,242 comparison subjects (single, divorced, or widowed individuals, 15,084 of whom had obesity). Odds ratios for obesity found a significant pooled odds ratio for obesity in married individuals compared with controls (OR 1.70; 95% CI 1.38-2.10). The socioeconomic environment was not the same throughout the period of studies analyzed. The odds of obesity in married individuals during economic crises was greater than during the period between crises: OR 2.56 (95% CI 2.09-3.13) during crises vs. OR 1.55 (95% CI 1.24-1.95) between crises. CONCLUSION The results of this review confirm the importance of considering marital status in determining the risk of obesity.
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Affiliation(s)
- Tamara Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- 1st Moscow State Medical, Department of Human Pathology, University IM Sechenov, Trubetskaya Street 8, Str. 2, 119991 Moscow, Russia
| | - Zulfiya Strizhkova
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Nikita Polukhin
- Department of Public Health and Medical Social Sciences, Synergy University, Leningradskiy Prospect 80k46, 125315 Moscow, Russia;
| | - Dmitry Ryaboy
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Mariia Kartashova
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Margarita Korenkova
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Valeriia Kolchina
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
| | - Vladimir Reshetnikov
- N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (Z.S.); (D.R.); (M.K.); (M.K.); (V.K.); (V.R.)
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Westbury S, Ghosh I, Jones HM, Mensah D, Samuel F, Irache A, Azhar N, Al-Khudairy L, Iqbal R, Oyebode O. The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review. BMJ Glob Health 2021; 6:e006358. [PMID: 34635553 PMCID: PMC8506857 DOI: 10.1136/bmjgh-2021-006358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions. METHODS We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively. RESULTS 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap. CONCLUSION 'Zoning' or 'healthy food cart' interventions to alter food availability may be appropriate in urban LMIC. PROSPERO REGISTRATION NUMBER CRD42020207475.
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Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Daniel Mensah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Folake Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nida Azhar
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Romaina Iqbal
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
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Russell S, Sturua L, Li C, Morgan J, Topuridze M, Blanton C, Hagan L, Salyer SJ. The burden of non-communicable diseases and their related risk factors in the country of Georgia, 2015. BMC Public Health 2019; 19:479. [PMID: 32326912 PMCID: PMC6696664 DOI: 10.1186/s12889-019-6785-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Non-communicable diseases (NCDs), mainly cardiovascular diseases, are a substantial cause of mortality in the country of Georgia, accounting for approximately 93% of all deaths (standardized mortality rate 630.7 deaths per 100,000 persons per year) and an important threat to health security. We conducted a nationally representative survey examining the prevalence of NCDs and their risk factors as part of a 2015 Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) serosurvey. Methods We conducted a cross-sectional serosurvey among adults aged ≥18 years using a stratified, multi-stage cluster design (n = 7000). We asked participants standardized questions from the Global Adult Tobacco Survey and the WHO STEPwise approach to Surveillance (STEPS) Survey. We also measured blood pressure and Body Mass Index for each participant. Weighted frequencies were computed for NCD and risk factor prevalence and compared to 2010 STEPS results. Results Georgians reported high rates of smoking, alcohol use, elevated blood pressure, obesity, diabetes and cardiovascular disease. An estimated 27.1% (95% confidence interval [CI]: 25.3, 28.8%) of adults (51.5% of men and 6.0% of women) reported daily use of tobacco products and 27.5% (95% CI: 25.7, 29.2%) of adults (52.1% of men and 7.0% of women) reported binge drinking within the last 30 days. Physical measurements revealed that 37.5% (95% CI: 35.8, 39.3%) of adults had elevated blood pressure and 33.4% (95% CI: 31.8, 35.0%) had obesity. 5.4% (95% CI: 4.6, 6.2%) of adults had self-reported diagnosed diabetes and 15.3% (95% CI: 14.1, 16.6%) had self-reported diagnosed cardiovascular disease. From 2010 to 2015, the prevalence of obesity increased by 8.3 percentage points (95% CI: 5.9, 10.7%; p < 0.01) and the prevalence of elevated blood pressure increased by 4.1 percentage points (95% CI: 1.4, 6.8%; p < 0.01). Conclusions Georgia has a high NCD burden, and results from the survey showed an increase in obesity and elevated blood pressure since 2010. The prevalence of other major NCDs have remained near levels reported in the 2010 STEPs survey. Comprehensive public health interventions are needed to control the heath security threats of major NCDs and their risk factors in the future. Electronic supplementary material The online version of this article (10.1186/s12889-019-6785-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Steven Russell
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Chaoyang Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Juliette Morgan
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.,Global Disease Detection - South Caucasus Regional Center, Centers for Disease Control and Prevention, Tbilisi, Georgia
| | - Marina Topuridze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Curtis Blanton
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3005 Chamblee Tucker Rd, Atlanta, GA, 30341, USA
| | - Liesl Hagan
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 3 Corporate Blvd NE, Atlanta, GA, 30329, USA
| | - Stephanie J Salyer
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
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Kahan D. Prevalence and correlates of adult overweight in the Muslim world: analysis of 46 countries. Clin Obes 2015; 5:87-98. [PMID: 25755091 DOI: 10.1111/cob.12089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/14/2015] [Accepted: 02/02/2015] [Indexed: 12/17/2022]
Abstract
The primary objectives of the study were to calculate overweight prevalence (body mass index ≥ 25.0) and simple correlations between 10 demographic, social welfare and behavioural variables and overweight prevalence for Muslim countries (populations >50% Muslim; N = 46). Overweight data for a country's total, male and female populations were extracted from the World Health Organization's (WHO) STEPwise country reports and relevant publications. Country-level data for potential correlates were extracted from multiple sources: Central Intelligence Agency (literacy), Gallup Poll (religiosity), United Nations (agricultural employment, food supply, gender inequality, human development), World Bank (automobile ownership, Internet, labour force) and WHO (physical inactivity). The overall, male and female overweight prevalence was 37.4, 33.0 and 42.1%, respectively. Prevalence estimates significantly differed by economic classification, gender and ethnicity. Middle- and upper income countries were 1.54-7.76 (95% confidence interval [CI]: 1.49-8.07) times more likely overweight than low-income countries, females were 1.48 (CI: 1.45-1.50) times more likely overweight than males and Arab countries were 2.92 (CI: 2.86-2.97) times more likely overweight than non-Arab countries. All 10 of the potential correlates were significantly associated with overweight for at least one permutation (total, economic classification, gender, ethnicity). The greater percentage of poorer countries among non-Arab Muslim countries, which compared with Arab countries have not as rapidly been transformed by globalization, nutrition transition and urbanization, may partially explain prevalence differences. Evaluation of correlational data generally followed associations seen in non-Muslim countries but more complex analysis of subnational data is needed. Arab women are a particularly vulnerable subgroup and governments should act within religious and cultural parameters to provide environments that are conducive to negative energy balance.
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Affiliation(s)
- D Kahan
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
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Fruit and vegetable consumption in the former Soviet Union: the role of individual- and community-level factors. Public Health Nutr 2015; 18:2825-35. [PMID: 25686483 PMCID: PMC4595861 DOI: 10.1017/s1368980015000105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To explain patterns of fruit and vegetable consumption in nine former Soviet Union countries by exploring the influence of a range of individual- and community-level determinants. DESIGN Cross-sectional nationally representative surveys and area profiles were undertaken in 2010 in nine countries of the former Soviet Union as part of the Health in Times of Transition (HITT) study. Individual- and area-level determinants were analysed, taking into account potential confounding at the individual and area level. SETTING Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS Adult survey respondents (n 17 998) aged 18-95 years. RESULTS Being male, increasing age, lack of education and lack of financial resources were associated with lower probability of consuming adequate amounts of fruit or vegetables. Daily fruit or vegetable consumption was positively correlated with the number of shops selling fruit and vegetables (for women) and with the number of convenience stores (for men). Billboard advertising of snacks and sweet drinks was negatively related to daily fruit or vegetable consumption, although the reverse was true for billboards advertising soft drinks. Men living near a fast-food outlet had a lower probability of fruit or vegetable consumption, while the opposite was true for the number of local food restaurants. CONCLUSIONS Overall fruit and vegetable consumption in the former Soviet Union is inadequate, particularly among lower socio-economic groups. Both individual- and community-level factors play a role in explaining inadequate nutrition and thus provide potential entry points for policy interventions, while the nuanced influence of community factors informs the agenda for future research.
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Chow CK, Corsi DJ, Lock K, Madhavan M, Mackie P, Li W, Yi S, Wang Y, Swaminathan S, Lopez-Jaramillo P, Gomez-Arbelaez D, Avezum Á, Lear SA, Dagenais G, Teo K, McKee M, Yusuf S. A novel method to evaluate the community built environment using photographs--Environmental Profile of a Community Health (EPOCH) photo neighbourhood evaluation tool. PLoS One 2014; 9:e110042. [PMID: 25369366 PMCID: PMC4219679 DOI: 10.1371/journal.pone.0110042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 09/16/2014] [Indexed: 11/18/2022] Open
Abstract
Background Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument. Methods/Principal Findings A minimum of 5 photos were taken per community in 86 communities in 5 countries according to a standard set of instructions from a designated central point of each community by researchers at each site. A standard pro forma derived from reviewing existing instruments to assess the built environment was developed and used to score the characteristics of each community. Photo sets from each community were assessed independently by three observers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-class correlation (ICC). Overall 87% (53 of 60) items had an ICC of ≥0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3 of 60) items had an ICC ≤0.50. Conclusions/Significance Analysis of photos using a standardized protocol as described in this study offers a means to obtain reliable and reproducible information on the built environment in communities in very diverse locations around the world. The collection of the photographic data required minimal training and the analysis demonstrated high reliability for the majority of items of interest.
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Affiliation(s)
- Clara K Chow
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada; The George Institute for Global Health and Westmead Hospital Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Daniel J Corsi
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada; Harvard Center for Population & Development Studies, Cambridge, MA, United States of America
| | - Karen Lock
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Manisha Madhavan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Pam Mackie
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Wei Li
- Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sun Yi
- Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Wang
- Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sumathi Swaminathan
- St. John's Research Institute, St John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Patricio Lopez-Jaramillo
- Research Direction, Fundacion Oftalmologica de Santander-Clinica Carlos Arila Lulle and Medical School, Universidad de Santander, Bucaramanga, Colombia
| | - Diego Gomez-Arbelaez
- Research Direction, Fundacion Oftalmologica de Santander-Clinica Carlos Arila Lulle and Medical School, Universidad de Santander, Bucaramanga, Colombia
| | - Álvaro Avezum
- Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University and Division of Cardiology, Providence Health Care, Vancouver, B.C., Canada
| | - Gilles Dagenais
- Institut universitaire de cardiologie et de pneumologie de Québec (Université Laval), Quebec City, Quebec, Canada
| | - Koon Teo
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Roberts B, Murphy A, Chikovani I, Makhashvili N, Patel V, McKee M. Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia. PLoS One 2014; 9:e98299. [PMID: 24865450 PMCID: PMC4035315 DOI: 10.1371/journal.pone.0098299] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 04/30/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia. METHODS A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs) and former IDPs. Two alcohol use disorder outcomes were measured: (i) having at least hazardous alcohol use (AUDIT score ≥ 8); (ii) episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week). Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only). RESULTS Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386), 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use). CONCLUSION The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for stronger alcohol control policies in Georgia.
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Affiliation(s)
- Bayard Roberts
- European Centre on Health of Societies in Transition (ECOHOST), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Adrianna Murphy
- European Centre on Health of Societies in Transition (ECOHOST), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Nino Makhashvili
- Global Initiative on Psychiatry – Tbilisi, Georgia, Ilia State University, Tbilisi, Georgia
| | - Vikram Patel
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Martin McKee
- European Centre on Health of Societies in Transition (ECOHOST), London School of Hygiene and Tropical Medicine, London, United Kingdom
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Changing patterns of fruit and vegetable intake in countries of the former Soviet Union. Public Health Nutr 2013; 16:1924-32. [PMID: 23701712 DOI: 10.1017/s1368980013001316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess how the frequency of low fruit and vegetable consumption has changed in countries of the former Soviet Union (FSU) between 2001 and 2010 and to identify factors associated with low consumption. DESIGN Cross-sectional surveys. A standard questionnaire was administered at both time points to examine fruit and vegetable consumption frequency. Logistic regression analysis was used to examine the relationship between demographic, socio-economic and health behavioural variables and low fruit and vegetable consumption in 2010. SETTING Nationally representative population samples from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS Adults aged 18 years and older. RESULTS Between 2001 and 2010 notable changes occurred in fruit and vegetable consumption in many countries resulting in a slight overall deterioration in diet. By 2010 in six countries about 40% of the population was eating fruit once weekly or less often, while for vegetables the corresponding figure was in excess of 20% in every country except Azerbaijan. A worse socio-economic situation, negative health behaviours (smoking and alcohol consumption) and rural residence were all associated with low levels of fruit and vegetable consumption. CONCLUSIONS International dietary guidelines emphasise the importance of fruit and vegetable consumption. The scale of inadequate consumption of these food groups among much of the population in many FSU countries and its link to socio-economic disadvantage are deeply worrying. This highlights the urgent need for a greater focus to be placed on population nutrition policies to avoid nutrition-related diseases in the FSU countries.
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