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Berti TL, Cunha DB, Sichieri R, Brandão JM, Faerstein E. Income and education level trajectories and changes in the daily consumption of vegetables after thirteen years of follow-up: the Pró-Saúde Study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240043. [PMID: 39230101 PMCID: PMC11383517 DOI: 10.1590/1980-549720240043] [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: 09/26/2023] [Accepted: 06/04/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE This study aimed to examine whether education level and income trajectories influence vegetable consumption changes over 13 years among civil servants at different campuses of a university in the state of Rio de Janeiro, Brazil. METHODS Vegetable intake frequency (daily and non-daily consumption), income (per capita), and education level (maintenance of low schooling/ upward mobility/maintenance of high schooling) were assessed at baseline (1999) and in the fourth wave (2011-12) of the Pró-Saúde (Pro-Health) cohort study. A total of 2,381 participants were analyzed. The association between educational and income trajectories and variation in vegetable consumption was assessed via crude and age-adjusted generalized linear models, stratified by sex. RESULTS Men in upward educational mobility showed a 0.5% increase in vegetable consumption (p=0.01), while women in this group demonstrated a 2.5% increase (p=0.05). Adjusted models showed that women who reduced their income had a lower likelihood of consuming vegetables (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.89-0.97). CONCLUSIONS The findings highlight the influence of social inequalities on vegetable consumption in adults.
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Affiliation(s)
- Talita Lelis Berti
- Universidade Estadual do Rio de Janeiro, Social Medicine Institute, Department of Epidemiology, - Rio de Janeiro (RJ), Brazil
| | - Diana Barbosa Cunha
- Universidade Estadual do Rio de Janeiro, Social Medicine Institute, Department of Epidemiology, - Rio de Janeiro (RJ), Brazil
| | - Rosely Sichieri
- Universidade Estadual do Rio de Janeiro, Social Medicine Institute, Department of Epidemiology, - Rio de Janeiro (RJ), Brazil
| | - Joana Maia Brandão
- Universidade Estadual do Rio de Janeiro, Social Medicine Institute, Department of Epidemiology, - Rio de Janeiro (RJ), Brazil
| | - Eduardo Faerstein
- Universidade Estadual do Rio de Janeiro, Social Medicine Institute, Department of Epidemiology, - Rio de Janeiro (RJ), Brazil
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Jacquier EF, Kassis A, Marcu D, Contractor N, Hong J, Hu C, Kuehn M, Lenderink C, Rajgopal A. Phytonutrients in the promotion of healthspan: a new perspective. Front Nutr 2024; 11:1409339. [PMID: 39070259 PMCID: PMC11272662 DOI: 10.3389/fnut.2024.1409339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/12/2024] [Indexed: 07/30/2024] Open
Abstract
Considering a growing, aging population, the need for interventions to improve the healthspan in aging are tantamount. Diet and nutrition are important determinants of the aging trajectory. Plant-based diets that provide bioactive phytonutrients may contribute to offsetting hallmarks of aging and reducing the risk of chronic disease. Researchers now advocate moving toward a positive model of aging which focuses on the preservation of functional abilities, rather than an emphasis on the absence of disease. This narrative review discusses the modulatory effect of nutrition on aging, with an emphasis on promising phytonutrients, and their potential to influence cellular, organ and functional parameters in aging. The literature is discussed against the backdrop of a recent conceptual framework which describes vitality, intrinsic capacity and expressed capacities in aging. This aims to better elucidate the role of phytonutrients on vitality and intrinsic capacity in aging adults. Such a review contributes to this new scientific perspective-namely-how nutrition might help to preserve functional abilities in aging, rather than purely offsetting the risk of chronic disease.
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Affiliation(s)
| | | | - Diana Marcu
- School of Molecular Biosciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Jina Hong
- Amway Innovation and Science, Ada, MI, United States
| | - Chun Hu
- Amway Innovation and Science, Ada, MI, United States
| | - Marissa Kuehn
- Amway Innovation and Science, Ada, MI, United States
| | | | - Arun Rajgopal
- Amway Innovation and Science, Ada, MI, United States
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3
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Mititelu M, Popovici V, Neacșu SM, Musuc AM, Busnatu ȘS, Oprea E, Boroghină SC, Mihai A, Streba CT, Lupuliasa D, Gheorghe E, Kebbewar N, Lupu CE. Assessment of Dietary and Lifestyle Quality among the Romanian Population in the Post-Pandemic Period. Healthcare (Basel) 2024; 12:1006. [PMID: 38786417 PMCID: PMC11121699 DOI: 10.3390/healthcare12101006] [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: 04/04/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The pandemic caused by the SARS-CoV-2 virus demonstrated the importance of prevention through a healthy diet and lifestyle, the most vulnerable people being those with severe chronic conditions, those who are overweight, and those with an unbalanced immune system. This study aims to examine the nutritional status and lifestyle behaviors of the Romanian population. METHODS The evaluation of the eating habits and lifestyle of the Romanian population in the post-pandemic period was carried out based on a cross-sectional observational study with the help of a questionnaire. RESULTS A total of 4704 valid answers were registered (3136 female and 1568 male respondents). Among the respondents, most of them belong to the young population, 2892 between the ages of 18 and 40, i.e., 61.5%. Most male respondents are overweight (1400) and obese (780). Most respondents indicated a tendency to consume 1-2 meals per day irregularly (p = 0.617). Only 974 respondents adopted a healthy diet, and 578 a healthy lifestyle. CONCLUSIONS The present study reports low adherence to a healthy diet (20.7%) and healthy lifestyle (12.28%), especially among the young population (<30 years). In the current context, it reports a reduced tendency to consume vegetables and fruits among the population, below the daily average recommended by the nutrition guidelines, a tendency towards sedentary behavior, and even deficient hydration of some of the respondents; these negative aspects can create a long-term series of nutritional and psycho-emotional imbalances. Our results evidence that complex surveys among the population are regularly required to investigate nutritional or lifestyle deficiencies; moreover, it could be helpful in further educational measures in nutrition, food, and environmental safety.
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Affiliation(s)
- Magdalena Mititelu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania; (M.M.); (N.K.)
| | - Violeta Popovici
- Center for Mountain Economics, “Costin C. Kiriţescu” National Institute of Economic Research (INCE-CEMONT), Romanian Academy, 725700 Vatra-Dornei, Romania;
| | - Sorinel Marius Neacșu
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Adina Magdalena Musuc
- Institute of Physical Chemistry—Ilie Murgulescu, Romanian Academy, 060021 Bucharest, Romania
| | - Ștefan Sebastian Busnatu
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Eliza Oprea
- Microbiology Department, Faculty of Biology, University of Bucharest, 060101 Bucharest, Romania;
| | - Steluța Constanța Boroghină
- Department of Complementary Sciences, History of Medicine and Medical Culture, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Andreea Mihai
- Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.M.); (C.T.S.)
| | - Costin Teodor Streba
- Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.M.); (C.T.S.)
| | - Dumitru Lupuliasa
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Emma Gheorghe
- Department of Preclinical Sciences I—Histology, Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
| | - Nadin Kebbewar
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania; (M.M.); (N.K.)
| | - Carmen Elena Lupu
- Department of Mathematics and Informatics, Faculty of Pharmacy, “Ovidius” University of Constanta, 900001 Constanta, Romania;
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4
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Frank SM, Jaacks LM, Meyer K, Rose D, Adair LS, Avery CL, Taillie LS. Dietary quality and dietary greenhouse gas emissions in the USA: a comparison of the planetary health diet index, healthy eating index-2015, and dietary approaches to stop hypertension. Int J Behav Nutr Phys Act 2024; 21:36. [PMID: 38566176 PMCID: PMC10988877 DOI: 10.1186/s12966-024-01581-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: 06/24/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The Planetary Health Diet Index (PHDI) measures adherence to the dietary pattern presented by the EAT-Lancet Commission, which aligns health and sustainability targets. There is a need to understand how PHDI scores correlate with dietary greenhouse gas emissions (GHGE) and how this differs from the carbon footprints of scores on established dietary recommendations. The objectives of this study were to compare how the PHDI, Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to (a) dietary GHGE and (b) to examine the influence of PHDI food components on dietary GHGE. METHODS We used life cycle assessment data from the Database of Food Recall Impacts on the Environment for Nutrition and Dietary Studies to calculate the mean dietary GHGE of 8,128 adult participants in the 2015-2016 and 2017-2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Poisson regression was used to estimate the association of (a) quintiles of diet score and (b) standardized dietary index Z-scores with dietary GHGE for PHDI, HEI-2015, and DASH scores. In secondary analyses, we used Poisson regression to assess the influence of individual PHDI component scores on dietary GHGE. RESULTS We found that higher dietary quality on all three indices was correlated with lower dietary GHGE. The magnitude of the dietary quality-dietary GHGE relationship was larger for PHDI [-0.4, 95% CI (-0.5, -0.3) kg CO2 equivalents per one standard deviation change] and for DASH [-0.5, (-0.4, -0.6) kg CO2-equivalents] than for HEI-2015 [-0.2, (-0.2, -0.3) kg CO2-equivalents]. When examining PHDI component scores, we found that diet-related GHGE were driven largely by red and processed meat intake. CONCLUSIONS Improved dietary quality has the potential to lower the emissions impacts of US diets. Future efforts to promote healthy, sustainable diets could apply the recommendations of the established DASH guidelines as well as the new guidance provided by the PHDI to increase their environmental benefits.
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Affiliation(s)
- Sarah M Frank
- Global Academy of Agriculture and Food Systems, Royal (DICK) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Systems, Royal (DICK) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland
| | - Katie Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christy L Avery
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA.
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Okekunle AP, Asowata OJ, Akpa OM, Fakunle AG, Chikowore T, Mohamed SF, Obiako R, Komolafe M, Osaigbovo GO, Ogbole G, Arulogun O, Sarfo FS, Wahab K, Owolabi L, Akinyemi J, Akpalu A, Uvere E, Akinyemi R, Jenkins C, Arnett DK, Lackland D, Ovbiagele B, Ramsay M, Owolabi M. Factors associated with frequency of fruit and vegetable consumption among selected sub-Saharan African populations: evidence from the Cardiovascular H3Africa Innovation Resource Project. Int J Epidemiol 2024; 53:dyad171. [PMID: 38199785 PMCID: PMC10859155 DOI: 10.1093/ije/dyad171] [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: 02/15/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Frequent fruit and vegetable consumption is considered a promising dietary behaviour that protects health. However, most existing studies about the factors associated with this phenomenon among Africans are based on single-country reports, apart from one meta-regression combining smaller studies. This study harmonized large datasets and assessed factors associated with the frequency of fruit and vegetable consumption in this population. METHODS Individual-level data on sociodemographics, lifestyle and diet from 20 443 participants across five African countries (Burkina Faso, Ghana, Kenya, South Africa and Nigeria), from the Stroke Investigative Research and Educational Network (SIREN) and Africa Wits-INDEPTH partnership for Genomic Research (AWI-Gen) studies, were harmonized. Total frequency of fruit and vegetable consumption (in portions/week) was classified as 'low' (≤6), 'moderate' (7-14) and 'high' (≥15). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with the total frequency of fruit and vegetable consumption (using 'low' consumption as the reference) were estimated using multinomial regression models. RESULTS Mean age of participants was 54.3 ± 11.8 years, 10 641 (52.1%) were female, and the median (interquartile range) frequency of total fruit and vegetable consumption was 10.0 (4.0, 21.0) portions/week. Participants with a family history of cardiovascular disease [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.85; 95% CI, 0.78, 0.92)], current smokers [moderate (aOR, 0.83; 95% CI, 0.74, 0.94) and high (aOR, 0.78; 95% CI, 0.69, 0.88)], current alcohol users [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.82; 95% CI, 0.76, 0.89)] and physically inactive participants [moderate (aOR, 0.85; 95% CI, 0.75, 0.96) and high (aOR, 0.80; 95% CI, 0.70, 0.90)] were less likely to consume fruits and vegetables frequently. CONCLUSION Africans with lifestyle risk factors for cardiovascular disease were less likely to consume fruit and vegetables frequently.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Adekunle Gregory Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Public Health, College of Health Sciences, Osun State University, Osogbo, Nigeria
| | - Tinashe Chikowore
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular, Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shukri F Mohamed
- Health and Well-Being Program, African Population and Health Research Center, Nairobi, Kenya
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Morenikeji Komolafe
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Godwin Ogbole
- Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Fred Stephen Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Lukman Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | - Ezinne Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Carolyn Jenkins
- Department of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Donna K Arnett
- Office of the Provost, University of South Carolina, Charleston, SC, USA
| | - Daniel Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular, Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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6
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Saaka M, Awini S, Kizito F, Nang E. Relationship between home garden ownership and the consumption of fruits and vegetables. Public Health Nutr 2024; 27:e46. [PMID: 38253554 PMCID: PMC10882533 DOI: 10.1017/s1368980024000272] [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: 01/24/2024]
Abstract
OBJECTIVE This study assessed the extent to which access to home gardens associate with the frequency of fruit and vegetable (FV) consumption. SETTING The study was carried out in fifty rural communities in Northern Ghana where food insecurity and malnutrition including micronutrient deficiencies are prevalent. DESIGN A community-based comparative analytical cross-sectional study. PARTICIPANTS A sample of 847 randomly selected rural households. RESULTS The proportion of households that consumed FV at least 3 d in a week was 45 %. Members in households who owned a home garden were 1·5 times more likely to consume FV at least 3 d in a week (adjusted OR (AOR) = 1·46 (95 % CI 1·06-2·0)), compared with their counterparts who had no home gardens. Furthermore, households in which mothers had a positive attitude towards FV consumption were 1·6 times more likely to consume FV (AOR = 1·63 (95 % CI 1·17-2·27)) compared with mothers who were less positive. CONCLUSIONS Our results suggest that food and nutrition policy measures that promote home gardens can improve consumption of diversified diets including FV among vulnerable rural households in Northern Ghana. Additionally, households with lower income may benefit from nutrition behaviour change communication campaigns directed towards increasing a positive attitude to FV intake.
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Affiliation(s)
- Mahama Saaka
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
| | - Simon Awini
- Ghana Health Service, Wa West District Health Administration, Wechau, Ghana
| | - Fred Kizito
- International Institute of Tropical Agriculture (IITA), Tamale, Ghana
| | - Eric Nang
- Ghana Health Service, Nadowli-Kaleo District Health Administration, Nadowli, Ghana
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7
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Frank SM, Jaacks LM, Avery CL, Adair LS, Meyer K, Rose D, Taillie LS. Dietary quality and cardiometabolic indicators in the USA: A comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension. PLoS One 2024; 19:e0296069. [PMID: 38198440 PMCID: PMC10781024 DOI: 10.1371/journal.pone.0296069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objectives of this study were to compare the how the Planetary Health Diet Index (PHDI), the Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to cardiometabolic risk factors. METHODS AND FINDINGS Participants from the National Health and Nutrition Examination Survey (2015-2018) were assigned a score for each dietary index. We examined disparities in dietary quality for each index. We used linear and logistic regression to assess the association of standardized dietary index values with waist circumference, blood pressure, HDL-C, fasting plasma glucose (FPG) and triglycerides (TG). We also dichotomized the cardiometabolic indicators using the cutoffs for the Metabolic Syndrome and used logistic regression to assess the relationship of the standardized dietary index values with binary cardiometabolic risk factors. We observed diet quality disparities for populations that were Black, Hispanic, low-income, and low-education. Higher diet quality was associated with improved continuous and binary cardiometabolic risk factors, although higher PHDI was not associated with high FPG and was the only index associated with lower TG. These patterns remained consistent in sensitivity analyses. CONCLUSIONS Sustainability-focused dietary recommendations such as the PHDI have similar cross-sectional associations with cardiometabolic risk as HEI-2015 or DASH. Health-focused dietary guidelines such as the forthcoming 2025-2030 Dietary Guidelines for Americans can consider the environmental impact of diet and still promote cardiometabolic health.
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Affiliation(s)
- Sarah M. Frank
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
| | - Christy L. Avery
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Linda S. Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Katie Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, United States of America
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Los Angeles, United States of America
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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8
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Pastori G, Brouwer ID, Siemonsma M, Verhoef H, Huong LT, Le Xuan TT, Mai TT, Samuel FO, Shittu OF, Eyinla TE, Even B, Hernandez R, Lundy M, de Brauw A, Wertheim-Heck S, Ambler K, Meldrum G, De Filippo A, Talsma EF. Fruit and Vegetable Intake of Females Before, During, and After Introduction of 3 Bundled Food System Interventions in Urban Vietnam and Nigeria. Curr Dev Nutr 2024; 8:102050. [PMID: 38156343 PMCID: PMC10751831 DOI: 10.1016/j.cdnut.2023.102050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023] Open
Abstract
Background Low fruit and vegetable (FV) intake in low- and middle-income countries, which is associated with noncommunicable diseases and micronutrient deficiencies, requires food system interventions addressing FV accessibility, affordability, and acceptability. Periodic FV intake monitoring during interventions informs progress toward achieving increased intakes and contributes to understanding the effectiveness of these interventions. Objectives This study evaluates the trend in FV intake before, during, and after implementation of a set of nutrition-sensitive food system interventions addressing accessibility, affordability, and acceptability to increase FV consumption over a 1-y period in Vietnamese and Nigerian low-income urban and periurban females. Methods We used the Diet Quality Questionnaire to assess FV food group consumption among 600 Vietnamese (Hanoi) and 610 Nigerian (Ibadan) females before, during, and after the interventions (Vietnam: July 2020-September 2021; Nigeria: November 2020-December 2021). A FV score was compared between exposure groups with (mixed) count modeling. The trend in consumption of individual FV groups was analyzed with mixed logistic regression. Results The FV score was stable over time, and a small increase was observed after the intervention period especially in Nigeria and in urban Vietnam. A decrease in the total score was observed in periurban Vietnam. Fluctuations were detected in the probability of consumption of individual FV groups over time especially within the fruit groups, probably due to seasonal availability. The degree of exposure could not explain differences in FV intake. Conclusions We found a marginal increase in the proportion of females consuming FV during the interventions in both countries. The FV score appeared to be a simple, quick, and easy-to-use indicator for monitoring diversity, variety, and consumption.
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Affiliation(s)
- Giulia Pastori
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Inge D Brouwer
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
- International Food Policy Research Institute, United States
| | - Meike Siemonsma
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Hans Verhoef
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Le Thi Huong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam
| | - Thi Thanh Le Xuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam
| | | | - Folake O Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
| | - Oluyemisi F Shittu
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
| | | | - Brice Even
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Ricardo Hernandez
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Mark Lundy
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Alan de Brauw
- International Food Policy Research Institute, United States
| | - Sigrid Wertheim-Heck
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Kate Ambler
- International Food Policy Research Institute, United States
| | - Gennifer Meldrum
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Amanda De Filippo
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Elise F Talsma
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
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9
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Lee YR, Lee HB, Oh MJ, Kim Y, Park HY. Thyme Extract Alleviates High-Fat Diet-Induced Obesity and Gut Dysfunction. Nutrients 2023; 15:5007. [PMID: 38068865 PMCID: PMC10708554 DOI: 10.3390/nu15235007] [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: 11/02/2023] [Revised: 11/24/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Prolonged intake of a high-fat diet (HFD) disturbs the composition of gut microbiota, contributing to the development of metabolic diseases, notably obesity and increased intestinal permeability. Thyme (Thymus vulgaris L.), an aromatic plant, is known for its several therapeutic properties. In this study, we explored the potential of thyme extract (TLE) to mitigate HFD-induced metabolic derangements and improve the gut environment. Eight-week-old C57BL/6 mice were administered 50 or 100 mg/kg TLE for eight weeks. Administration of 100 mg/kg TLE resulted in decreased weight gain and body fat percentage, alongside the regulation of serum biomarkers linked to obesity induced by a HFD. Moreover, TLE enhanced intestinal barrier function by increasing the expression of tight junction proteins and ameliorated colon shortening. TLE also altered the levels of various metabolites. Especially, when compared with a HFD, it was confirmed that 2-hydroxypalmitic acid and 3-indoleacrylic acid returned to normal levels after TLE treatment. Additionally, we investigated the correlation between fecal metabolites and metabolic parameters; deoxycholic acid displayed a positive correlation with most parameters, except for colon length. In contrast, hypoxanthine was negatively correlated with most parameters. These results suggest a promising role for thyme in ameliorating obesity and related gut conditions associated with a HFD.
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Affiliation(s)
- Yu Ra Lee
- Food Functionality Research Division, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; (Y.R.L.); (H.-B.L.); (M.-J.O.); (Y.K.)
| | - Hye-Bin Lee
- Food Functionality Research Division, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; (Y.R.L.); (H.-B.L.); (M.-J.O.); (Y.K.)
| | - Mi-Jin Oh
- Food Functionality Research Division, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; (Y.R.L.); (H.-B.L.); (M.-J.O.); (Y.K.)
| | - Yoonsook Kim
- Food Functionality Research Division, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; (Y.R.L.); (H.-B.L.); (M.-J.O.); (Y.K.)
| | - Ho-Young Park
- Food Functionality Research Division, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea; (Y.R.L.); (H.-B.L.); (M.-J.O.); (Y.K.)
- Department of Food Biotechnology, Korea National University of Science and Technology, Daejeon 34113, Republic of Korea
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10
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Kaur S. Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review. Nutr Res Rev 2023; 36:420-447. [PMID: 36004512 DOI: 10.1017/s0954422422000166] [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: 11/06/2022]
Abstract
This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab141004, India
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11
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Hizli-Guldemir H, Saleki N, Sezer FE, Yoldas-Ilktac H, Akman C, Ersoy G, Garipagaoglu M. Vegetable and Fruit Consumption and Its Relationship with Body Mass Index in Adults: A Cross-Sectional and Seasonal Research from Türkiye. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1168-1179. [PMID: 37199339 DOI: 10.1080/09603123.2023.2214504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023]
Abstract
This study examines the relationship between fruit and vegetable consumption and the BMI in Türkiye. In this cross-sectional study, which 6332 adults were included, fruit and vegetable consumption, and preferences were collected. The quantities of vegetables and fruits were classified based on the WHO and the national recommendations. Of the adults (33.39 ± 12.59 years), 52.9% of men and 39.7% of women had an above-normal BMI. Based on WHO recommendations, overweight and obese people consumed less vegetables and fruits compared to their counterparts (ORs for women, overweight: 1.2, obese: 1.3; ORs for men, overweight: 1.3, obese: 1.5; 95% CI). The regression analysis revealed that the quantities of vegetable and fruit intake were higher in young individuals, men, and married people. Although the majority consume more than 400 g/day of vegetables and fruits, the intake is inadequate in people with obesity.
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Affiliation(s)
- Hilal Hizli-Guldemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Anadolu University, Eskisehir, Turkey
| | - Neda Saleki
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Fatma Elif Sezer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Havvanur Yoldas-Ilktac
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Cansu Akman
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Gulgun Ersoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Muazzez Garipagaoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey
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12
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Yamaguchi Y, Palileo-Villanueva LM, Tubon LS, Mallari E, Matsuo H. The Experiences of Community Health Workers in Preventing Noncommunicable Diseases in an Urban Area, the Philippines: A Qualitative Study. Healthcare (Basel) 2023; 11:2424. [PMID: 37685457 PMCID: PMC10487527 DOI: 10.3390/healthcare11172424] [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: 08/02/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: Barangay health workers (BHWs) play important roles as community health workers in preventing noncommunicable diseases (NCDs), where the shortage of health professionals is felt more acutely in the Philippines. However, there is little research on the experiences of BHWs as community health workers in preventing NCDs. This study aimed to clarify the roles and difficulties of BHWs in conducting activities for the prevention of NCDs. (2) Methods: Qualitative data were collected from 25 BHWs. (3) Results: The mean age of the participants was 50.4 ± 9.5 years, 23 were women, and the mean length of time as a BHW was 9.1 ± 7.7 years. Three major themes about the role of BHWs in preventing NCDs-"screening for NCDs", "assisting patients with management of their conditions", and "promoting healthy behaviors"-and four major themes about the difficulties-"insufficient awareness of preventative behaviors", "economic burdens", "lack of resources for managing NCDs", and "difficulty of access to medical care facilities"-were identified. (4) Conclusions: Through the findings of this study, focusing interventions aimed at addressing the difficulties for the prevention of NCDs among BHWs may help reduce health inequities.
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Affiliation(s)
- Yuko Yamaguchi
- Department of Nursing, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Lia M. Palileo-Villanueva
- Department of Medicine, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines; (L.M.P.-V.); (E.M.)
| | | | - Eunice Mallari
- Department of Medicine, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines; (L.M.P.-V.); (E.M.)
| | - Hiroya Matsuo
- Department of Nursing, Osaka Shin-Ai College, Osaka 538-0053, Japan;
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13
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Hoogstoel F, Samadoulougou S, Diouf A, Savoye I, Donnen P, Van der Heyden J, Kirakoya-Samadoulougou F. Adherence to '5-2-1-0' guidelines and multiple risky behaviours among adolescents in nine sub-Saharan African countries: evidence from Global School-based Student Health Survey 2012-2017. BMJ Nutr Prev Health 2023; 6:91-99. [PMID: 37559967 PMCID: PMC10407405 DOI: 10.1136/bmjnph-2022-000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/02/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Overweight and obesity constitute a new challenge in low-income and middle-countries. The obesity prevention programme, called '5-2-1-0', promotes healthy eating habits, physical activity and limited screen time among young people.This study aimed to assess adherence to the '5-2-1-0' recommendations and to study multiple risky behaviours among adolescents in nine countries in sub-Saharan Africa. METHODS Meta-analyses with a random effect were used to calculate overall prevalence. Non-random patterns of the co-occurrence of the four risky behaviours were explored using observed/expected prevalence ratios. Data came from the Global School-based Health Survey and 18 314 adolescents were considered. RESULTS Among the participants, 12.7% (95% CI 7.5% to 19.0%) had overweight and 3.2% (95% CI 1.1% to 6.1%) had obesity. In almost all countries studied, girls were more affected by overweight and obesity than boys.While only 0.2% (95% CI 0.1% to 0.4%) of the adolescents fully complied with the recommendations, 4.8% (95% CI 3.1% to 6.9%), 28.4% (95% CI 22.4% to 34.8%), 43.8% (95% CI 41.9% to 45.8%) and 17.0% (95% CI 11.8% to 23.0%), respectively, combined 1, 2, 3 and 4 risky behaviours among the four '5-2-1-0' criteria. The most observed combination was found for co-occurrence of three risky behaviours: insufficient fruit/vegetables consumption, physical activity and non-zero consumption of sugar-sweetened beverages. CONCLUSION In conclusion, the insufficient adherence to '5-2-1-0' recommendations and the high prevalence of the co-occurrence of risky behaviours underscore the need to strengthen health interventions and programmes to prevent obesity among adolescents in sub-Saharan Africa.
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Affiliation(s)
- Fanny Hoogstoel
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
- Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA), Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Quebec, Montreal, Canada
- Centre for Research on Planning and Development (CRAD), Laval University, Quebec, Montreal, Canada
| | - Adama Diouf
- Département de Biologie Animale, UCAD, Dakar, Senegal
| | - Isabelle Savoye
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Philippe Donnen
- Centre de Recherche 'Politiques et Systèmes de Santé-Santé Internationale’, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
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14
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Stadlmayr B, Trübswasser U, McMullin S, Karanja A, Wurzinger M, Hundscheid L, Riefler P, Lemke S, Brouwer ID, Sommer I. Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review. Front Nutr 2023; 10:1113013. [PMID: 37113298 PMCID: PMC10126510 DOI: 10.3389/fnut.2023.1113013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.
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Affiliation(s)
- Barbara Stadlmayr
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- World Agroforestry (ICRAF), Nairobi, Kenya
| | - Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | | | | - Maria Wurzinger
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Laura Hundscheid
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Petra Riefler
- Institute for Marketing and Innovation, Department of Economics and Social Science, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Stefanie Lemke
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- Center for Agroecology, Water and Resilience, Coventry University, Coventry, United Kingdom
| | - Inge D. Brouwer
- Division of Human Nutrition and Health/CGIAR Initiative Sustainable Healthy Diets (SHiFT), Wageningen University, Wageningen, Netherlands
| | - Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education, Krems, Austria
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15
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Tang Y, Dong J, Gruda N, Jiang H. China Requires a Sustainable Transition of Vegetable Supply from Area-Dependent to Yield-Dependent and Decreased Vegetable Loss and Waste. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1223. [PMID: 36673990 PMCID: PMC9859069 DOI: 10.3390/ijerph20021223] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
China, the largest country in vegetable supply, faces a transition to sustainable vegetable production to counteract resource waste and environmental pollution. However, there are knowledge gaps on the main constraints and how to achieve sustainable vegetable supply. Herein, we integrated the vegetable production and supply data in China, compared its current status with five horticulture-developed countries US, the Netherlands, Greece, Japan and South Korea, using data from the Food and Agriculture Organization (FAO) and National Bureau of Statistics of China, and predicted the vegetable supply in 2030 and 2050 by a model prediction. The vegetable supply in China increased from 592 g capita-1 d-1 in 1995 to 1262 g capita-1 d-1 in 2018 and will keep constant in 2030 and 2050. Compared to the five countries, the greater vegetable supply is primarily achieved by higher harvested areas rather than higher yield. However, it is predicted that the harvested areas will decrease by 13.6% and 24.7% in 2030 and 2050. Instead, steady increases in vegetable yield by 11.8% and 28.3% are predicted for this period. The high vegetable supply and greater vegetable preference indicated by the high vegetable-to-meat production ratio cannot guarantee recommended vegetable intake, potentially due to the high rate of vegetable loss and waste. Under the scenarios of decreased vegetable loss and waste, the harvested area will decrease by 37.3-67.2% in 2030 and 2050. This study points out that the sustainable transition of Chinese vegetable supply can be realized by enhancing yield and limiting vegetable loss and waste instead of expanding the harvested area.
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Affiliation(s)
- Ying Tang
- Department of Agronomy and Horticulture, Jiangsu Vocational College of Agriculture and Forestry, Jurong 212400, China
| | - Jinlong Dong
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008, China
| | - Nazim Gruda
- Institute of Crop Science and Resource Conservation, Division of Horticultural Sciences, University of Bonn, 53121 Bonn, Germany
| | - Haibo Jiang
- Jiangsu Station for Protection of Arable Land Quality and Agricultural Environment, Nanjing 210029, China
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16
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Oh MJ, Lee HB, Yoo G, Park M, Lee CH, Choi I, Park HY. Anti-obesity effects of red pepper ( Capsicum annuum L.) leaf extract on 3T3-L1 preadipocytes and high fat diet-fed mice. Food Funct 2023; 14:292-304. [PMID: 36504043 DOI: 10.1039/d2fo03201e] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with obesity mostly have metabolic syndrome and this can lead to multiple health problems. In the present study, we evaluated the anti-obesity effect of water-soluble red pepper (Capsicum annuum L.) leaf extract (PLE) on 3T3-L1 adipocytes and high-fat diet (HFD)-fed mice. The adipocyte lipid content was determined using Oil Red O staining, which revealed that 100 μg mL-1 PLE markedly reduced fat accumulation without affecting the cell viability. PLE exhibited high prebiotic activity scores by modulating probiotic strains, contributing to host health improvement. In vivo investigation in HFD-fed mice revealed that PLE supplementation significantly decreased the HFD-induced increases in the body weight, amount of white adipose tissue, and serum triglyceride, total cholesterol, leptin, and insulin levels. Consistent with its effects on reduced lipid droplet formation in the liver, PLE supplementation suppressed the expression of lipid synthesis-related proteins including SREBP-1, FAS, and PPAR-γ in the liver and increased that of PGC-1α, CPT1, and adiponectin in epididymal WAT. PLE treatment improved intestinal barrier function and inflammation and reduced harmful intestinal enzyme activities in the feces. Collectively, these results indicate that PLE inhibits fat accumulation in HFD-fed mice via the suppression of adipogenesis and lipogenesis, suggesting its potential in preventing obesity.
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Affiliation(s)
- Mi-Jin Oh
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
| | - Hye-Bin Lee
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
| | - Guijae Yoo
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
| | - Miri Park
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
| | - Chang-Hyun Lee
- Department of Anatomy, Woosuk University, Jeollabuk-do 55338, Republic of Korea
| | - Inwook Choi
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
| | - Ho-Young Park
- Research Division of Food Functionality, Korea Food Research Institute, Jeollabuk-do 55365, Republic of Korea.
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17
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Patterson AC. Is Economic Growth Good for Population Health? A Critical Review. CANADIAN STUDIES IN POPULATION 2023; 50:1. [PMID: 36938118 PMCID: PMC10009865 DOI: 10.1007/s42650-023-00072-y] [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: 09/01/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
A large multidisciplinary literature discusses the relationship between economic growth and population health. The idea that economic growth is good for societies has inspired extensive academic debate, but conclusions have been mixed. To help shed light on the subject, this paper focuses on opportunities for consensus in this large literature. Much scholarship finds that the health-growth relationship varies according to (1) which aspect of "health" is under consideration, (2) shape (e.g., positive linear or logarithmic), (3) issues of timing (e.g., growth over the short or long term), (4) a focus on health inequalities as opposed to population averages, and (5) multivariable relationships with additional factors. After reflecting upon these findings, I propose that economic growth promotes health in some respects, for some countries, and in conjunction with other life-supporting priorities, but does not by itself improve population health generally speaking. I then argue there is already wide, interdisciplinary consensus to support this stance. Moreover, policies focusing exclusively on economic growth threaten harm to both population health and growth, which is to say that political dynamics are also implicated. Yet multivariable approaches can help clarify the bigger picture of how growth relates to health. For moving this literature forward, the best opportunities may involve the simultaneous analysis of multiple factors. The recognition of consensus around these issues would be welcome, and timely. Supplementary Information The online version contains supplementary material available at 10.1007/s42650-023-00072-y.
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18
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Zeng Y, Rao Y, Xu Z. Anticipated cancer burden of low individual fruit and vegetable consumption under climate change: A modelling study in China. Int J Health Plann Manage 2023; 38:149-161. [PMID: 36086801 DOI: 10.1002/hpm.3575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Dietary patterns with a high intake of fruits and vegetables (FV) are associated with a reduced risk of various cancers. It is not yet clear where and to what extent a decline in crop productivity caused by climate change may modify the distribution of related cancer burdens through reducing FV consumption in China. To design policies and interventions aimed at improving FV intake, regional monitoring is required on how consumption-changing factors might impact the associated cancer burdens by socio-demographic subpopulations. METHODS A microsimulation study was conducted from a societal perspective to project the effects of cancers associated with inadequate FV intake attributable to climate change. We linked the International Model for Policy Analysis of Agricultural Commodities and Trade to a health modelling framework for obesity, gastric cancer, lung cancer, and oesophageal cancer in a close-to-reality synthetic population. RESULTS In the presence of climate constantly change, the relative reduction in FV consumption would induce an additional 9.73 million disability-adjusted life years (DALYs) nationally over the period 2010-2050 ([CrI]: 7.83-12.13). The climate change-induced cancer burden is projected to disproportionately affect socio-demographic index regions from 0.65 to 5.06 million DALYs. CONCLUSIONS Effects of climate change on FV consumption are anticipated to exacerbate intra-regional inequalities in the associated cancer burdens of China by 2050. By quantitatively analysing the impact of such dietary changes on regional health in light of climate change, our research can inform the design of public health interventions for heterogeneous populations, as health impact assessments based solely on the population as a whole cannot reflect significant differences across subpopulations.
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Affiliation(s)
- Yiping Zeng
- Business School, Sichuan University, Chengdu, China
| | - Yu Rao
- Food Science and Bioengineering School, Xihua University, Chengdu, China
| | - Zeshui Xu
- Business School, Sichuan University, Chengdu, China
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19
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Manne-Goehler J, Theilmann M, Flood D, Marcus ME, Andall-Brereton G, Agoudavi K, Arboleda WAL, Aryal KK, Bicaba B, Bovet P, Brant LCC, Brian G, Chamberlin G, Chen G, Damasceno A, Dorobantu M, Dunn M, Ebert C, Farzadfar F, Gurung MS, Guwatudde D, Houehanou C, Houinato D, Hwalla N, Jorgensen JMA, Karki KB, Labadarios D, Lunet N, Malta DC, Martins JS, Mayige MT, McClure RW, Saeedi Moghaddam S, Mwangi KJ, Mwalim O, Norov B, Quesnel-Crooks S, Rhode S, Seiglie JA, Sibai A, Silver BK, Sturua L, Stokes A, Supiyev A, Tsabedze L, Zhumadilov Z, Jaacks LM, Atun R, Davies JI, Geldsetzer P, Vollmer S, Bärnighausen TW. Data Resource Profile: The Global Health and Population Project on Access to Care for Cardiometabolic Diseases (HPACC). Int J Epidemiol 2022; 51:e337-e349. [PMID: 35762972 DOI: 10.1093/ije/dyac125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/24/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
- Jennifer Manne-Goehler
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA.,Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michaela Theilmann
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | | | - Maja E Marcus
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
| | | | | | - William Andres Lopez Arboleda
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Krishna K Aryal
- Nepal Health Sector, Programme 3, Monitoring Evaluation and Operational Research Project, Abt Associates, Kathmandu, Nepal
| | - Brice Bicaba
- Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | - Pascal Bovet
- Ministry of Health, Victoria, Seychelles.,University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Luisa Campos Caldeira Brant
- Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Garry Brian
- The Fred Hollows Foundation New Zealand, Auckland, New Zealand
| | - Grace Chamberlin
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Geoffrey Chen
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Albertino Damasceno
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Maria Dorobantu
- Department of Cardiology, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Cara Ebert
- RWI-Leibniz Institute for Economic Research, Essen (Berlin, Office), Germany
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - David Guwatudde
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Corine Houehanou
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Godomey, Benin
| | - Dismand Houinato
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Godomey, Benin
| | - Nahla Hwalla
- Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Khem B Karki
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Demetre Labadarios
- Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Nuno Lunet
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Deborah Carvalho Malta
- Department of Maternal-Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Graduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - João S Martins
- Faculty of Medicine and Health Sciences, National University of East Timor, Rua, Jacinto Candido, Dili, Timor-Leste
| | - Mary T Mayige
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Roy Wong McClure
- Epidemiology Office and Surveillance, Caja Costarricense de Seguro Social, San Jose, Costa Rica
| | - Sahar Saeedi Moghaddam
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kibachio J Mwangi
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.,Faculté de médecine, Université de Genève, Geneva, Switzerland
| | - Omar Mwalim
- Zanzibar Ministry of Health, Mnazi Mmoja, Zanzibar
| | - Bolormaa Norov
- Nutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia
| | | | - Sabrina Rhode
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Jacqueline A Seiglie
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA
| | - Abla Sibai
- Epidemiology and Population Health Department, Faculty of Health Sciences American University of Beirut, Beirut, Lebanon
| | - Bahendeka K Silver
- St. Francis Hospital, Nsambya, Kampala, Uganda.,Uganda Martyrs University, Kampala, Uganda
| | - Lela Sturua
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi, Georgia.,Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Andrew Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Adil Supiyev
- Laboratory of Epidemiology and Public Health, Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan
| | | | | | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Security, The University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, UK.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.,Public Health Foundation of India, New Delhi, India
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Justine I Davies
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.,Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Pascal Geldsetzer
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
| | - Till W Bärnighausen
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.,Africa Health Research Institute, Somkhele and Durgban, South Africa
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20
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Kagaruki GB, Mahande MJ, Kreppel KS, Mbata D, Kilale AM, Shayo EH, Mfinanga SG, Bonfoh B. Barriers to the implementation, uptake and scaling up of the healthy plate model among regular street food consumers: a qualitative inquiry in Dar-es-Salaam city, Tanzania. BMC Nutr 2022; 8:110. [PMID: 36203200 PMCID: PMC9541087 DOI: 10.1186/s40795-022-00589-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The healthy plate model is considered one of the practical approaches to reduce the average portion of staple food in main meals, consequently reducing the risks associated with diabetes and other Non-communicable Diseases (NCDs). Despite its potential benefits, studies on the implementation of the healthy plate model are limited in Africa. An inquiry explored barriers to implementation, uptake, and scaling up of the healthy plate model among street food vendors and consumers in three districts of Dar-es-Salaam city in Tanzania. METHODS A qualitative research design was adopted. Qualitative data collection techniques were employed including; Key Informant Interviews (KIIs) with purposefully selected food and nutrition stakeholders at the National, Regional, District and Ward levels. Focus Group Discussions (FGDs) were conducted with purposefully selected street food consumers and vendors. A total of (13) KIIs were conducted as well as (6) FGDs with street food vendors (2 FGDs) and consumers (4 FGDs). Interview data was managed using Nvivo 12 Software and analyzed thematically. RESULTS Three key themes emerged from participants' accounts: (i) strategic policy barriers, (ii) food production and preparation environment barriers (producers and vendors), and (iii) individual barriers (consumers and vendors). The strategic policy barriers included absence of guidelines and regulations that focus on NCDs linked to nutrition and lack of education guidance for vendors and consumers. The food production and preparation environment barriers included safety and risks concerns regarding the quality of water used for irrigation and washing fruits and vegetables and the areas where vegetables and fruits are grown and prepared. Individual barriers included low consumer income, knowledge on nutrition, unhealthy eating practices and; low vendors' knowledge as well as low investment capital. CONCLUSION Implementation, uptake and scaling up of the healthy plate model for street food consumers in Dar es Salaam City continues to be constrained by barriers in policy, food production and preparation environment, and individual obstacles. Strengthening of food and nutrition policies, ensuring safety of the food production and preparation environment and, consumer and vendor awareness creation and income generation efforts, provide useful entry points for the successful scaling up of a healthy plate model. This could consequently contribute towards prevention of diet related NCDs, including diabetes.
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Affiliation(s)
- Gibson B. Kagaruki
- Research Programs, National Institute for Medical Research, Tukuyu Medical Research Centre, Tukuyu, Box 538, Mbeya, Tanzania
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | - Michael J. Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | - Katharina S. Kreppel
- School of Life Science and Bioengineering, the Nelson Mandela African Institution of Science and Technology, Box 447, Arusha, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerp Belgium, Antwerp, Belgium
| | - Doris Mbata
- Research Programs, National Institute for Medical Research, Headquarters, Box 9653, Dar es Salaam, Tanzania
| | - Andrew M. Kilale
- Research Programs, National Institute for Medical Research, Muhimbili Centre, Box 3436, Dar es Salaam, Tanzania
| | - Elizabeth H. Shayo
- Research Programs, National Institute for Medical Research, Headquarters, Box 9653, Dar es Salaam, Tanzania
| | - Sayoki G. Mfinanga
- Research Programs, National Institute for Medical Research, Muhimbili Centre, Box 3436, Dar es Salaam, Tanzania
- Department of Epidemiology & Biostatistics, Public Health Muhimbili University of Health and Allied Sciences, Box 65001, Dar es Salaam, Tanzania
| | - Bassirou Bonfoh
- Departiment of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d’Ivoir, Abidjan, Côte d’Ivoire
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21
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Hernández-Vásquez A, Visconti Lopez FJ, Vargas-Fernández R. Socio-economic inequalities in the consumption of fruits and vegetables in Peru between 2014 and 2019. Public Health Nutr 2022; 25:1-11. [PMID: 36073028 PMCID: PMC9991701 DOI: 10.1017/s1368980022001860] [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: 10/15/2021] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To estimate the prevalence and socio-economic inequalities in adequate consumption of fruits and vegetables in Peru between 2014 and 2019. DESIGN Analytical cross-sectional study. The outcome variable was adequate consumption of fruits and vegetables, defined as the consumption of five or more servings of fruits and vegetables per d (yes/no). We used concentration curves and Erreygers concentration index to describe socio-economic inequalities and a microeconometric approach to determine the contribution of each variable to inequality. SETTING Peru. PARTICIPANTS Data from Peruvians aged 18 years or older collected by the Demographic and Family Health Survey. RESULTS The prevalence of adequate fruit and vegetable consumption did not change between 2014 (10·7 %; 95 % CI (10·0, 11·4)) and 2019 (11 %; 95 % CI (10·4, 11·7)). We found socio-economic inequalities in the adequate consumption of fruits and vegetables, with wealthier individuals having a higher prevalence of adequate consumption compared to poorer individuals in 2014 (19·2 % v. 3·5 %) and 2019 (18·6 % v. 4·7 %). The decomposition analysis found that education, urban areas and being wealthy were the main factors associated with socio-economic inequality in adequate fruit and vegetable consumption, being structural problems of society. CONCLUSION Despite the current regulations on healthy eating in Peru, adequate consumption of fruits and vegetables remains low, and there are socio-economic inequalities between the poorest and wealthiest individuals. Our findings suggest that more efforts are needed to increase the intake and assess the disparities in adequate fruit and vegetable consumption.
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Affiliation(s)
- Akram Hernández-Vásquez
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, 550 La Fontana Av., La Molina, Lima15024, Peru
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22
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Reeve E, Lamichhane P, McKenzie B, Waqa G, Webster J, Snowdon W, Bell C. The tide of dietary risks for noncommunicable diseases in Pacific Islands: an analysis of population NCD surveys. BMC Public Health 2022; 22:1521. [PMID: 35948900 PMCID: PMC9364577 DOI: 10.1186/s12889-022-13808-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe changes over time in dietary risk factor prevalence and non-communicable disease in Pacific Island Countries (PICTs). METHODS Secondary analysis of data from 21,433 adults aged 25-69, who participated in nationally representative World Health Organization STEPs surveys in 8 Pacific Island Countries and Territories between 2002 and 2019. Outcomes of interest were changes in consumption of fruit and vegetables, hypertension, overweight and obesity, and hypercholesterolaemia over time. Also, salt intake and sugar sweetened beverage consumption for those countries that measured these. RESULTS Over time, the proportion of adults consuming less than five serves of fruit and vegetables per day decreased in five countries, notably Tonga. From the most recent surveys, average daily intake of sugary drinks was high in Kiribati (3.7 serves), Nauru (4.1) and Tokelau (4.0) and low in the Solomon Islands (0.4). Average daily salt intake was twice that recommended by WHO in Tokelau (10.1 g) and Wallis and Futuna (10.2 g). Prevalence of overweight/obesity did not change over time in most countries but increased in Fiji and Tokelau. Hypertension prevalence increased in 6 of 8 countries. The prevalence of hypercholesterolaemia decreased in the Cook Islands and Kiribati and increased in the Solomon Islands and Tokelau. CONCLUSIONS While some Pacific countries experienced reductions in diet related NCD risk factors over time, most did not. Most Pacific adults (88%) do not consume enough fruit and vegetables, 82% live with overweight or obesity, 33% live with hypertension and 40% live with hypercholesterolaemia. Population-wide approaches to promote fruit and vegetable consumption and reduce sugar, salt and fat intake need strengthening.
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Affiliation(s)
- Erica Reeve
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Prabhat Lamichhane
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Briar McKenzie
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Jacqui Webster
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Wendy Snowdon
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Colin Bell
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
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23
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Nyanchoka MA, van Stuijvenberg ME, Tambe AB, Zuma MK, Mbhenyane XG. Fruit and Vegetable Consumption Patterns and Risk of Chronic Diseases of Lifestyle among University Students in Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126965. [PMID: 35742215 PMCID: PMC9222637 DOI: 10.3390/ijerph19126965] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/03/2023]
Abstract
This study assesses the fruit and vegetable consumption patterns and risk factors for chronic diseases of lifestyle (CDL) among young adults attending Kenyatta University, Kenya. Four hundred and twenty-three young adults aged 19–30 years participated in the cross-sectional study. Males were 75.0% less likely to be overweight than females (OR = 0.25; 0.13–0.47). The mean overall consumption of fruit and/or vegetables amounted to 3.6 servings in a typical day. Eight in ten participants consumed lower amounts of fruits and vegetables than recommended by the WHO. At least one combined risk factor of CDL was observed among 91.3% of the young adults. About 8.7% of the participants were classified as low risk for CDL (having none of the five risk factors), 48.9% had one risk factor, 32.9% had two risk factors, 8.5% had three risk factors, while 0.9% had four risk factors. A significant relationship between daily fruit consumption and waist circumference was observed. These findings show the dire need to develop public health nutrition activities aimed at increasing the intake of fruit and vegetables and sensitizing young adults, and the general population, to the risk factors of CDL.
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Affiliation(s)
- Moriasi Abednego Nyanchoka
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | | | - Ayuk Betrand Tambe
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | - Mthokozisi Kwazi Zuma
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | - Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
- Correspondence:
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24
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Harris J, Tan W, Raneri JE, Schreinemachers P, Herforth A. Vegetables for Healthy Diets in Low- and Middle-Income Countries: A Scoping Review of the Food Systems Literature. Food Nutr Bull 2022; 43:232-248. [PMID: 34991377 PMCID: PMC9118491 DOI: 10.1177/03795721211068652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Vegetables are an essential element in healthy diets, but intakes are low around the world and there is a lack of systematic knowledge on how to improve diets through food system approaches. METHODS This scoping review assessed how studies of food systems for healthy diets have addressed the role of vegetables in low- and middle-income countries. We apply the PRISMA guidelines for scoping reviews to narratively map the literature to an accepted food systems framework and identify research gaps. RESULTS We found 1383 relevant articles, with increasing numbers over 20 years. Only 6% of articles looked at low-income countries, and 93% looked at single-country contexts. Over half of articles assessed vegetables as a food group, without looking at diversity within the food group. 15% looked at traditional vegetables. Issues of physical access to food were among the least studied food system topics in our review (7% of articles). Only 15% of articles used a comprehensive food system lens across multiple dimensions. There is also a research gap on the impacts of different policy and practice interventions (13% of articles) to enable greater vegetable consumption. CONCLUSIONS Food system studies necessarily drew on multiple disciplines, methods and metrics to describe, analyze, and diagnose parts of the system. More work is needed across disciplines, across contexts, and across the food system, including understanding interventions and trade-offs, and impacts and change for diets particularly of marginalized population groups. Filling these gaps in knowledge is necessary in order to work toward healthy vegetable-rich diets for everyone everywhere.
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Affiliation(s)
- Jody Harris
- World Vegetable Center, Bangkok, Thailand
- Institute of Development Studies, Brighton, United Kingdom
| | - Winson Tan
- Institute of Development Studies, Brighton, United Kingdom
| | - Jessica E. Raneri
- Senior Nutrition Sensitive Agriculture Advisor to the Australian Centre for International Agricultural Research, Canberra, Australia
- Senior Nutrition Sensitive Agriculture Advisor, Agricultural Development and Food Security Section, Department of Foreign Affairs and Trade, Canberra, Australia
| | | | - Anna Herforth
- Wageningen University, Wageningen, Netherlands
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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25
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Atorkey P, Asante KO. Clustering of multiple health risk factors among a sample of adolescents in Liberia: a latent class analysis. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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26
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Pengpid S, Peltzer K. National Cross-Sectional Data on Ideal Cardiovascular Health Among Adults in Mongolia in 2019. Glob Heart 2022; 17:34. [PMID: 35837357 PMCID: PMC9165669 DOI: 10.5334/gh.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20-69 years) in Mongolia. Method Cross-sectional data were analyzed from 4,516 individuals (20-69 years, mean age = 42.3 years) who participated in the Mongolia STEPS survey in 2019, who had complete measurement of CVH metrics and no history of cardiovascular disease. Ideal CVH measures included non-smoking, healthy diet, physical activity, fasting blood glucose <100 mg/dL, body mass index (<23 kg/m2), total cholesterol <200 mg/dL, and blood pressure <120/<80 mmHg). Results The prevalence of five to seven ideal CVH metrics was 27.7% in 2019. Most Mongolians had ideal total cholesterol (77.4%), ideal smoking (67.8%), ideal fasting glucose (73.8%) and ideal physical activity (66.0%), while a lower prevalence was found for ideal blood pressure (42.4%), ideal body mass index (31.4%), and ideal healthy diet (1.8%). The prevalence of poor smoking, poor fruit/vegetable intake, poor fasting glucose, poor blood pressure, and poor total cholesterol was higher in men than in women, while poor physical activity was higher in women than in men, and poor BMI did not differ by sex. In the adjusted logistic regression analysis, older age, male sex, and belonging to the Khalkh ethnic group were negatively associated, and a higher number of adult household members was positively associated with meeting the ideal 5-7 CVH metrics. Conclusions The proportion of meeting 5-7 ideal CVH metrics was moderate among adults in Mongolia. Primary and secondary prevention programmes should be strengthened to improve CVH in Mongolia, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, TH
- Department of Research Administration and Development, University of Limpopo, Polokwane, ZA
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, TW
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27
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Albuquerque G, Lança de Morais I, Gelormini M, Sousa S, Casal S, Pinho O, Damasceno A, Moreira P, Breda J, Lunet N, Padrão P. Availability and Nutritional Composition of Street Food in Urban Central Asia: Findings From Almaty, Kazakhstan. Int J Public Health 2022; 67:1604558. [PMID: 35548684 PMCID: PMC9081345 DOI: 10.3389/ijph.2022.1604558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/24/2022] [Indexed: 01/13/2023] Open
Abstract
Objective: To describe the availability and nutritional composition of commonly available street foods in Almaty, Kazakhstan. Methods: 384 street food vending sites (in 10 public markets) were assessed; information on vending sites' characteristics and food availability and samples of the most commonly available street foods (81 homemade; 40 industrial) were collected for chemical analysis. Results: Fruit, beverages and food other than fruit were available in 1.0%, 47.4% and 92.7% of all vending sites. Homemade food other than fruit (e.g., bread, main dishes, snacks, pastries, sandwiches, and cakes) were available in 63.4% of stationary vending sites, while industrial (e.g., snacks, chocolate, cakes, and cookies) in 45.6% of them. Industrial foods were the most energy-dense [median kcal/100 g: 438.8 vs. 267.2, p < 0.001 (homemade)]. Traditional homemade dishes were high in sodium, reaching 2,248 mg/serving (lagman) and major contributors of protein and fat to energy content (shashlik: 22.8% from protein, 68.3% from fat). Industrial chocolate and homemade cake presented the highest saturated (14.6 g/serving) and trans-fat (3.20 g/serving) contents. Conclusion: These findings advocate for the implementation of health promotion strategies targeted at vendors, consumers and other stakeholders.
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Affiliation(s)
- Gabriela Albuquerque
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,*Correspondence: Gabriela Albuquerque,
| | - Inês Lança de Morais
- Nutrition, Physical Activity and Obesity Programme, Division of Noncommunicable Diseases and Life-Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Marcello Gelormini
- Nutrition, Physical Activity and Obesity Programme, Division of Noncommunicable Diseases and Life-Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Sofia Sousa
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Susana Casal
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,REQUIMTE, Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Olívia Pinho
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal,REQUIMTE, Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Albertino Damasceno
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Pedro Moreira
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal,Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - João Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russia
| | - Nuno Lunet
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- EPIUnit—Instituto de Saúde Pública, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
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Pengpid S, Peltzer K. National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019. Sci Rep 2022; 12:5660. [PMID: 35383251 PMCID: PMC8983656 DOI: 10.1038/s41598-022-09688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) across three cross-sectional surveys in 2007, 2014 and 2019 in Bhutan. Cross-sectional data were analysed from 9712 individuals (20–69 years, mean age = 37.6 years) who participated in the 2007, 2014 or 2019 Bhutan STEPS surveys, had complete measurement of CVH metrics, and had no history of a cardiovascular disease in 2014 and 2019. Ideal CVH measures included non-smoking, healthy diet, physical activity, body mass index (< 23 kg/m2), blood pressure < 120/ < 80 mmHg, total cholesterol < 200 mg/dL, and fasting blood glucose < 100 mg/dL). The prevalence of five to seven ideal CVH metrics increased from 11.6% in 2007 to 37.9% in 2019. Trend analyses showed that ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal fasting glucose increased from 2007 to 2019, while ideal fruit and vegetable intake, ideal smoking, and ideal body mass index decreased from 2007 to 2019. Five to seven ideal CVH metrics, 0–7 ideal CVH metrics, and 0–14 poor, intermediate, and ideal CVH metrics increased from 2007 to 2019. In the adjusted logistic regression analysis, older age decreased the odds of having 5–7 ideal CVH metrics in all three study years. Male sex increased the odds, and employment decreased the odds of 5–7 ideal CVH metrics in 2007, and urban residence increased the odds of 5–7 ideal CVH metrics in 2014 and decreased the odds in 2019. The proportion of meeting 5–7 ideal CVH metrics increased in Bhutan. Primary and secondary prevention programmes must be strengthened to improve CVH in Bhutan, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public, Health Mahidol University, Bangkok, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Oladele CR, Colón-Ramos U, Galusha D, Tran E, Adams OP, Maharaj RG, Nazario CM, Nunez M, Pérez-Escamilla R, Nunez-Smith M. Perceptions of the local food environment and fruit and vegetable intake in the Eastern Caribbean Health Outcomes research Network (ECHORN) Cohort study. Prev Med Rep 2022; 26:101694. [PMID: 35242499 PMCID: PMC8861285 DOI: 10.1016/j.pmedr.2022.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 12/26/2021] [Accepted: 01/15/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health.However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated with fruit and vegetable (FV) intake in the Eastern Caribbean, where daily FV intake remains below recommended levels. METHODS Cross-sectional analysis of Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) baseline data (2013-2016) from Barbados, Puerto Rico, Trinidad and Tobago, and US Virgin Islands was conducted in 2020. The National Cancer Institute Dietary Screener Questionnaire was adapted to measure daily servings of FV. Existing scales were used to assess participant perceptions of the food environment (availability, affordability, and quality). Chi-square tests and Poisson regression were used for analyses. RESULTS Participants reported eating one mean daily serving of FV. Mean daily intake was higher among those who perceived FV as usually/always affordable, available, and high quality. Multivariate results showed statistically significant associations between FV and affordability. Persons who perceived FV as affordable had 0.10 more daily servings of FV compared to those who reported FV as not always affordable (p = 0.02). Food insecurity modified the association between affordability and FV intake. CONCLUSIONS This study highlights the importance of affordability in consumption of FV in the Eastern Caribbean, and how this relationship may be modified by food insecurity.
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Affiliation(s)
- Carol R Oladele
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Uriyoán Colón-Ramos
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC 20052, USA
| | - Deron Galusha
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Emma Tran
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Oswald P Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Rohan G Maharaj
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - Cruz M Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Maxine Nunez
- University of the Virgin Islands, School of Nursing, St. Thomas, US VI, USA
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, 135 College Street, Suite 216, New Haven, CT 06520, USA
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
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Yi S, Kanetkar V, Brauer P. Nudging food service users to choose fruit- and vegetable-rich items: Five field studies. Appetite 2022; 173:105978. [PMID: 35247476 DOI: 10.1016/j.appet.2022.105978] [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: 10/06/2021] [Revised: 01/18/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022]
Abstract
Although nudging has been found to promote the choice of healthy foods in lab studies and ad-hoc field studies, relatively little research is available regarding effectiveness in real food venues that operate for profit. The paucity of empirical studies providing "proof of implementation" reveals the difficulty of applying previous empirical findings on nudging to mass-eating food services contexts, which serve meals to a lot of individuals daily. Based on the typology of choice architecture in food choice contexts, we closely collaborated with the in-house food service operator to devise and implement five nudge interventions to promote fruits and vegetables (FV) in university cafeterias. Each study was conducted for one 12-week semester or more over a three-year period. In the first two studies, non-verbal point-of-purchase prompting increased the choice of kale/spinach supplemented smoothies and whole fruits from baskets. In Study 3, the combination of sizing and point-of-purchase non-verbal prompting increased the sale of large size vegetable-rich bowls from a stir-fry grill. In Study 4, the proximity type of nudging by altering the position of the healthier option in a sandwich bar in combination with non-verbal prompting increased the sale of sandwiches containing spinach. In Study 5, the combination of sizing and proximity of large vs. small sized plates and serving spoons had no effect on sale of self-serve items in a salad bar. All the interventions except for Study 5 produced a moderate effect in increasing the choice of FV-rich items. We recommend that hospitality and food service operators consider operational parameters and simultaneously adopt more than one nudging components to achieve a sizable effect. Future randomized controlled trials are needed to implement choice architecture techniques in collaboration with food service companies.
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Affiliation(s)
- Sunghwan Yi
- Department of Marketing & Consumer Studies, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Vinay Kanetkar
- Department of Marketing & Consumer Studies, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Paula Brauer
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada.
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Dev R, Raparelli V, Pilote L, Azizi Z, Kublickiene K, Kautzky-Willer A, Herrero MT, Norris CM. Cardiovascular health through a sex and gender lens in six South Asian countries: Findings from the WHO STEPS surveillance. J Glob Health 2022; 12:04020. [PMID: 35265330 PMCID: PMC8876159 DOI: 10.7189/jogh.12.04020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. The main aim of this study was to examine how sex and gender-related factors are associated with cardiovascular risk factors of people in South Asian countries. Methods We conducted a retrospective analysis of the World Health Organization’s “STEPwise approach to surveillance of risk factors for non-communicable disease” or “STEPS” from six South Asian countries, surveys conducted between 2014-2019. The main outcomes were CVH as measured by a composite measure of STEPS-HEART health index (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes and hypertension), values ranging from 0 (worst) to 6 (best or ideal) and self-reported occurrence of cardiovascular disease (ie, heart attack and stroke). Multivariate linear and logistic regression models were performed. Multiple imputation with chained equations was performed. Results The final analytic sample consisted of 33 106 participants (57.5% females). The mean STEPS-HEART index score in the South Asian population was 3.43 [SD: 0.92]. Female sex (β: 0.05, 95% confidence interval (CI) = 0.01-0.08, P < 0.05) was significantly associated with better CVH compared to males. Being married (βmale = -0.30, 95% CI = -0.37, -0.23 vs βfemale = -0.23, 95% CI = -0.29, -0.17; P < 0.001) and having a household size ≥5 (βmale = -0.15, 95% CI = -0.24, -0.06 vs βfemale = -0.11, 95% CI = -0.16, -0.04; P < 0.01) were associated with poorer CVH, more so in males. Being married was also associated with high risk of CVD (ORmale = 2.54, 95% CI = 1.68-3.86, P < 0.001 vs ORfemale = 1.19, 95% CI = 0.84-1.68, P = 0.31), significant in males. Conclusions Among the South Asian population, being female may be advantageous in having an ideal CVH. However, gender-related factors such as marital status and large household size were associated with poorer CVH and greater risk of CVD, regardless of sex.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Karolina Kublickiene
- Department of Clinical Science, Intervention & Technology (CLINTEC), Section for Renal Medicine, Karolinska Institute and Karolinska University hospital, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, and Gender Institute, Iapura, Gars am Kamp, Austria
| | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine. University of Murcia, Murcia, Spain
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Guo H, Phung D, Chu C. Sociodemographic, lifestyle, behavioral, and parental factors associated with sugar-sweetened beverage consumption in children in China. PLoS One 2021; 16:e0261199. [PMID: 34890424 PMCID: PMC8664181 DOI: 10.1371/journal.pone.0261199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Evidence shows sugar-sweetened beverage (SSB) consumption is a risk factor for obesity and non-communicable diseases (NCDs) in children. Investigating the influential profiles, which have been examined insufficiently, will help to inform the reduction of SSB consumption. The present research examines the current trend in SSB consumption and associated factors among children in China, in order to inform policy development. Methods Secondary data was extracted from China’s Health and Nutrition Survey (CHNS; 2004, 2006, 2009, and 2011), a repeated cross-sectional research, and a Chi-squared test was applied to compare SSB consumption in the last year, queried by social demographical, `environmental, behavioral, and parental factors. Multilevel mixed-effects logistic regression was employed to examine the trend and effects of the multiple factors. Results A total of 6015 Chinese children aged 6–17 years were investigated. From 2004 to 2011, the percentage of SSB consumption in children increased from 72.6% to 90.3%. The prevalence in urban areas was higher than the prevalence in rural areas, higher in high schools than primary and middle schools, higher in east coast affluent provinces than other provinces, and higher in high-income households than low-income households. Other associated factors include children’s fast food and salty snacks preference, level of physical activity, sedentariness, and parental education. The strongest association with SSB consumption in children was the mother’s SSB consumption (adjusted odds ratio: 5.54, 95% CI: 3.17–9.67). Conclusion Children’s SSB consumption has increased significantly in China, and is associated with socio-economic, demographic, level of physical activity, food preference, and parental factors. Future strategies aimed at reducing SSB consumption among children need to consider these factors.
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Affiliation(s)
- Haijun Guo
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
- * E-mail:
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
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Rahul A, Chintha S, Anish TS, Prajitha KC, Indu PS. Effectiveness of a Non-pharmacological Intervention to Control Diabetes Mellitus in a Primary Care Setting in Kerala: A Cluster-Randomized Controlled Trial. Front Public Health 2021; 9:747065. [PMID: 34869163 PMCID: PMC8636158 DOI: 10.3389/fpubh.2021.747065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite being the first Indian state with a dedicated Non-Communicable Disease (NCD) program, glycemic control among a large proportion of patients is low in Kerala. This study tries to find evidence for a standardized non-pharmacological strategy delivered through Junior Public Health Nurses (JPHNs) in achieving and maintaining glycemic control among diabetic patients registered with NCD clinics of primary health care settings. Design: A cluster randomized controlled trial was conducted among adult patients with Diabetes Mellitus attending NCD clinics of primary care settings of South Kerala, India. JPHNs of the intervention group received additional module-based training while standard management continued in the control group. Sequence generation was done by random permuted blocks method and a cluster of 12 patients was selected from each of the 11 settings by computer-generated random numbers. Patients were followed up for 6 months with monthly monitoring of Fasting Blood Sugar (FBS), Post-Prandial Blood Sugar (PPBS), blood pressure, Body Mass Index (BMI), and health-related behaviors. Knowledge and skills/practice of JPHNs were also evaluated. Analysis of Covariance was done to study the final outcome adjusting for the baseline values and a model for glycemic control was predicted using multilevel modeling. Results: We analyzed 72 participants in the intervention group and 60 participants in the control group according to the intention-to-treat principle. The intervention was associated with a significant reduction in FBS (p < 0.001) and PPBS (p < 0.001) adjusting for the baseline values. The achievement of glycemic control was 1.5 (95% CI: 1.05-2.3) times better with intervention and they showed a better trend of maintenance of glycemic control (FBS, p = 0.003 and PPBS, p = 0.039). Adjusting for clustering and the baseline values, the intervention showed a significant effect on FBS (B = -3.1, SE = 0.57; p < 0.001) and PPBS (B = -0.81, SE = 0.3; p < 0.001) with time. Drug adherence score (p < 0.001), hours of physical activity (p < 0.001), BMI (p = 0.002), fruit intake (p = 0.004), and green leafy vegetable intake (p = 0.01) were the major predictors of FBS control. The practice/skills score of the JPHNs significantly improved with intervention (p < 0.001) adjusting for baseline values. Conclusion: A well-designed health worker intervention package incorporated into the existing health system can translate into attitude change and skill development in the health workers which can reflect in the improvement of glycemic control among the patients. Trial registration: [URL: http://www.ctri.nic.in], identifier [CTRI/2017/11/010622].
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Affiliation(s)
- Arya Rahul
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, India
| | - Sujatha Chintha
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, India
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Cooper GS, Shankar B, Rich KM, Ratna NN, Alam MJ, Singh N, Kadiyala S. Can fruit and vegetable aggregation systems better balance improved producer livelihoods with more equitable distribution? WORLD DEVELOPMENT 2021; 148:105678. [PMID: 34866757 PMCID: PMC8520944 DOI: 10.1016/j.worlddev.2021.105678] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 05/03/2023]
Abstract
The need for food systems to generate sustainable and equitable benefits for all is a global imperative. However, whilst ample evidence exists linking smallholder farmer coordination and aggregation (i.e. the collective transport and marketing of produce on behalf of multiple farmers) to improved market participation and farmer incomes, the extent to which interventions that aim to improve farmer market engagement may co-develop equitable consumer benefits remains uncertain. This challenge is pertinent to the horticultural systems of South Asia, where the increasing purchasing power of urban consumers, lengthening urban catchments, underdeveloped rural infrastructures and inadequate local demands combine to undermine the delivery of fresh fruits and vegetables to smaller, often rural or semi-rural markets serving nutritionally insecure populations. To this end, we investigate the potential for aggregation to be developed to increase fruit and vegetable delivery to these neglected smaller markets, whilst simultaneously improving farmer returns. Using an innovative system dynamics modelling approach based on an aggregation scheme in Bihar, India, we identify potential trade-offs between outcomes relating to farmers and consumers in smaller local markets. We find that changes to aggregation alone (i.e. scaling-up participation; subsidising small market transportation; mandating quotas for smaller markets) are unable to achieve significant improvements in smaller market delivery without risking reduced farmer participation in aggregation. Contrastingly, combining aggregation with the introduction of market-based cold storage and measures that boost demand improves fruit and vegetable availability significantly in smaller markets, whilst avoiding farmer-facing trade-offs. Critically, our study emphasises the benefits that may be attained from combining multiple nutrition-sensitive market interventions, and stresses the need for policies that narrow the fruit and vegetable cold storage deficits that exist away from more lucrative markets in developing countries. The future pathways and policy options discovered work towards making win-win futures for farmers and disadvantaged consumers a reality.
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Affiliation(s)
- G S Cooper
- Institute for Sustainable Food and Department of Geography, University of Sheffield, Sheffield, United Kingdom
| | - B Shankar
- Institute for Sustainable Food and Department of Geography, University of Sheffield, Sheffield, United Kingdom
| | - K M Rich
- Ferguson College of Agriculture, Oklahoma State University, Stillwater, OK, USA
- International Livestock Research Institute (ILRI), West Africa Regional Office, Dakar, Senegal
| | - N N Ratna
- Department of Global Value Chain & Trade, Faculty of Agribusiness and Commerce, Lincoln University, Christchurch, New Zealand
| | - M J Alam
- Department of Agribusiness and Marketing, Bangladesh Agricultural University (BAU), Mymensingh, Bangladesh
| | - N Singh
- Digital Green, North India Office, New Delhi, India
| | - S Kadiyala
- Department for Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
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Lomira BKB, Nassanga P, Okello DM, Ongeng D. Non-attitudinal and non-knowledge based factors constrain households from translating good nutritional knowledge and attitude to achieve the WHO recommended minimum intake level for fruits and vegetables in a developing country setting: evidence from Gulu district, Uganda. BMC Nutr 2021; 7:68. [PMID: 34749820 PMCID: PMC8576922 DOI: 10.1186/s40795-021-00469-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high level of incidence of mortality attributed to non-communicable diseases such as cancer, diabetes and hypertension being experienced in developing countries requires concerted effort on investment in strategies that can reduce the risks of development of such diseases. Fruits and vegetables (FV) contain natural bioactive compounds, and if consumed at or above 400 g per day (RDMIL) as recommended by World Health Organization (WHO) is believed to contribute to reduced risk of development of such diseases. The objective of this study was to determine in a developing country set-up, the extent to which rural and urban households conform to RDMIL, the status of nutritional attitude (NA) and knowledge (NK) associated with consumption of FV, and to delineate non-attitudinal and non-knowledge-based factors (NANK) that hinder achievement of RDMIL. METHOD A cross-sectional survey of 400 randomly selected households and 16 focus group discussions (FGD) were conducted using Gulu district of Uganda as a microcosm for a developing country setting. Level of consumption of FV was assessed using 24-h dietary recall and compared to RDMIL as a fraction (%). The status of NK and NA were determined using sets of closed-ended questions anchored on a three-point Likert scale. Further quantitative statistical analyses were conducted using t-test, chi-square, Pearson's correlation and multiple linear regression. FGD provided data on NANK factors and were analysed using qualitative content analysis procedure. RESULTS Urban and rural inhabitants met up to 72.0 and 62.4% of the RMDIL, respectively, with absolute intake being higher among urban than rural households by 37.54 g. NK and NA were good but the intensity of NK was higher among urban respondents by 11%. RDMIL was positively correlated with NA while socio-demographic predictors of RDMIL varied with household location. FGD revealed that primary agricultural production constraints, market limitations, postharvest management limitations, health concerns, social discomfort and environmental policy restrictions were the major NANK factors that hindered achievement of the RDMIL. CONCLUSIONS These results indicate that NANK factors constrain households from translating good NA and NK to achieve the RMDIL.
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Affiliation(s)
- Benjamin Kenyi Bendere Lomira
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and Environment, Gulu University, Gulu, Uganda
| | - Prossy Nassanga
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and Environment, Gulu University, Gulu, Uganda
| | - Daniel Micheal Okello
- Department of Rural Development and Agribusines, Faculty of Agriculture and Environment, Gulu University, Gulu, Uganda
| | - Duncan Ongeng
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and Environment, Gulu University, Gulu, Uganda.
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Siegel KR, Albright AL. Population-Level Approaches to Preventing Type 2 Diabetes Globally. Endocrinol Metab Clin North Am 2021; 50:401-414. [PMID: 34399953 DOI: 10.1016/j.ecl.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes (T2DM) is increasingly considered an epidemic rooted in modern society as much as in individual behavior. Addressing the T2DM burden thus involves a dual approach, simultaneously addressing high-risk individuals and whole populations. Within this context, this article summarizes the evidence base, in terms of effectiveness and cost-effectiveness, for population-level approaches to prevent T2DM: (1) modifications to the food environment; (2) modifications to the built environment and physical activity; and (3) programs and policies to address social and economic factors. Existing knowledge gaps are also discussed.
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Affiliation(s)
- Karen R Siegel
- Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway Northeast, Atlanta, GA 30341, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Ann L Albright
- Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway Northeast, Atlanta, GA 30341, USA
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Schreinemachers P, Shrestha RM, Gole B, Bhattarai DR, Ghimire PL, Subedi BP, Brück T, Baliki G, Gautam IP, Blake CE. Drivers of Food Choice among Children and Caregivers in Post-earthquake Nepal. Ecol Food Nutr 2021; 60:826-846. [PMID: 34420456 DOI: 10.1080/03670244.2021.1969925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Food systems in many countries are experiencing a shift from traditional foods toward processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack foods while an increased consumption of fruit and vegetables is not evident. It identifies cash availability is the main driver of increased rice, meat and snack food consumption. The second driver is the 2015 Nepal earthquake, which accelerated the transition from homegrown food to purchased food as people got habituated to eating more meat and snack foods while reconstruction tripled local wages and changed the food environment. This shows how humanitarian assistance in the wake of extreme shocks can unintentionally contribute to unhealthy eating habits. An integrated school and home garden intervention appears to contribute to healthier diets.
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Affiliation(s)
| | - Rachana Manandhar Shrestha
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Dhruba Raj Bhattarai
- Outreach Research Division, Nepal Agricultural Research Council, Lalitpur, Nepal
| | - Puspa Lal Ghimire
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Kathmandu, Nepal
| | - Bhishma P Subedi
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Kathmandu, Nepal
| | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany.,Natural Resources Institute, University of Greenwich, Kent, UK.,ISDC - International Security and Development Center, Berlin, Germany
| | - Ghassan Baliki
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany.,ISDC - International Security and Development Center, Berlin, Germany
| | - Ishwori P Gautam
- Horticulture Research Division, Nepal Agricultural Research Council, Lalitpur, Nepal
| | - Christine E Blake
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Low Daily Intake of Fruits and Vegetables in Rural and Urban Bangladesh: Influence of Socioeconomic and Demographic Factors, Social Food Beliefs and Behavioural Practices. Nutrients 2021; 13:nu13082808. [PMID: 34444968 PMCID: PMC8400088 DOI: 10.3390/nu13082808] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
Bangladesh is facing a large burden of non-communicable diseases. As a possible remedy, the WHO/FAO recommends consuming 400 g or five servings of fruits and vegetables every day; however, only a small proportion of the population practices this. The present study sets out to determine the sociodemographic factors that affect this low intake of fruits and vegetables, and the roles that beliefs and behavioural practices play in influencing food consumption. Logistic and ordered logistic regressions were used to identify what sociodemographic factors are significantly influencing fruit and vegetable intake, and to explain the role of social food beliefs. It was found that in Bangladesh 75% of urban and 92% of rural populations consume less than five servings a day. While gender was not found to be a significant factor, housewives appeared to be more at risk of a lower intake of fruits and vegetables. People with higher income, higher education, and who are older were all less likely to have problems with a low intake of fruits and vegetables. Higher education assisted in attaining positive beliefs and behavioural practices regarding food, while residing in a rural community was found to be a significant constraint.
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López-Espinoza MÁ, Lozano-Lozano JA, Prieto-Merino D. A Method to Estimate the Efficacy vs. Effectiveness in Meta-Analysis of Clinical Trials with Different Adherence Scenarios: A Monte Carlo Simulation Study in Nutrition. Nutrients 2021; 13:2352. [PMID: 34371861 PMCID: PMC8308700 DOI: 10.3390/nu13072352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Randomized clinical trials (RCTs) evaluating the effectiveness of interventions to promote fruit and vegetable (FV) consumption usually report intention-to-treat (ITT) analysis as the main outcome. These analyses compare the randomly assigned groups and accept that some individuals may not follow the recommendations received in their group. The ITT analysis is useful to quantify the global effect of promoting the consumption of FV in a population (effectiveness) but, if non-adherence is significant in the RCT, they cannot estimate the specific effect in the individuals that increased their FV consumption (efficacy). To calculate the efficacy of FV consumption, a per protocol analysis (PP) would have to be carried out, in which groups of individuals are compared according to their actual adherence to FV consumption, regardless of the group to which they were assigned; unfortunately, many RCTs do not report the PP analysis. The objective of this article is to apply a new method to estimate the efficacy of Meta-analysis (MA) PP which include RCTs of effectiveness by ITT, without estimates of adherence. The method is based on generating Monte Carlo simulations of percentages of adherence in each allocation group from prior distributions informed by expert knowledge. We illustrate the method reanalyzing a Cochrane Systematic Review (SR) of RCTs on increased FV consumption reported with ITT, simulating 1000 times the estimation of a PP meta-analyses, and obtaining means and ranges of the potential PP effects. In some cases, the range of estimated PP effects was clearly more favourable than the effect calculated with the original ITT assumption, and therefore this corrected analysis must be considered when estimating the true effect of the consumption of a certain food.
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Affiliation(s)
| | - José Antonio Lozano-Lozano
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile (Chile), Santiago 7500912, Región Metropolitana, Chile;
| | - David Prieto-Merino
- Cátedra Internacional de Análisis Estadístico y Big Data, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain;
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Zhao CM, Du T, Li P, Du XJ, Wang S. Production and Characterization of a Novel Low-Sugar Beverage from Red Jujube Fruits and Bamboo Shoots Fermented with Selected Lactiplantibacillus plantarum. Foods 2021; 10:foods10071439. [PMID: 34206242 PMCID: PMC8303220 DOI: 10.3390/foods10071439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022] Open
Abstract
Red jujube fruits and bamboo shoots are rich in many nutrients and have the advantage of high yield in China. However, the storage of fresh fruits is difficult, and there are no fermented products using both as raw materials. In order to develop the two raw materials into novel products and improve their nutritional value, this study reports the production and characterization of a beverage via fermentation of red jujube fruits and bamboo shoots with Lactiplantibacillus plantarum. L. plantarum TUST-232 was selected as the starter from several different strains by comparing pH value and the number of viable cells, which reached 8.91 log CFU/mL in the beverage fermented for 14 h at 37 °C with 0.3% inoculation. After fermentation, the beverage showed improvement in the contents of several nutrients and antioxidant indices, with a decrease of 44.10% in sucrose content, along with increases of 11.09%, 12.30%, and 59.80% in total phenolic content, total antioxidant capacity, and superoxide anion scavenging ability, respectively. These results indicate that L. plantarum fermentation of red jujube fruits and bamboo shoots could be an effective way to develop a new beverage with high nutritional value, high antioxidant capacity, and high dietary fiber content. This research provided experimental support for the development of new fermentation products with the functions of improving health and body functions.
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Affiliation(s)
- Chu-Min Zhao
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China; (C.-M.Z.); (T.D.); (P.L.)
| | - Ting Du
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China; (C.-M.Z.); (T.D.); (P.L.)
| | - Ping Li
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China; (C.-M.Z.); (T.D.); (P.L.)
| | - Xin-Jun Du
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China; (C.-M.Z.); (T.D.); (P.L.)
- Correspondence: (X.-J.D.); (S.W.); Tel.: +86-22-60912484 (X.-J.D. & S.W.)
| | - Shuo Wang
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China; (C.-M.Z.); (T.D.); (P.L.)
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China
- Correspondence: (X.-J.D.); (S.W.); Tel.: +86-22-60912484 (X.-J.D. & S.W.)
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Anyega AO, Korir NK, Beesigamukama D, Changeh GJ, Nkoba K, Subramanian S, van Loon JJA, Dicke M, Tanga CM. Black Soldier Fly-Composted Organic Fertilizer Enhances Growth, Yield, and Nutrient Quality of Three Key Vegetable Crops in Sub-Saharan Africa. FRONTIERS IN PLANT SCIENCE 2021; 12:680312. [PMID: 34149781 PMCID: PMC8207193 DOI: 10.3389/fpls.2021.680312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/03/2021] [Indexed: 05/25/2023]
Abstract
Worldwide, French beans (Phaseolus vulgaris L.), tomato (Solanum lycopersicum L.), and kales (Brassica oleracea L. var. acephala) are considered economically important food crops. There is a rapid decline in their yield due to severe soil degradation. Thus, high commercial fertilizer inputs are crucial, though they remain expensive and inaccessible to resource poor farmers. We investigated the comparative performance of composted black soldier fly frass fertilizer (BSFFF), conventionally composted brewer's spent grain (BSG), commercial organic fertilizer (Evergrow), and mineral [nitrogen, phosphorus, and potassium (NPK)] fertilizer on growth, yield, N use efficiency, and nutritional quality (crude protein, crude fiber, crude fats, ash, and carbohydrate concentrations) of tomatoes, kales, and French beans under greenhouse and open-field conditions for two seasons. The fertilizers were applied at rates equivalent to 371 kg of N ha-1. For each crop, the plots were treated with sole rates of BSFFF, BSG, Evergrow, and NPK to supply 100% of the N required. Additional treatments included a combination of BSFFF and NPK, and BSG and NPK so that each fertilizer supplies 50% of the N required. The control treatment consisted of unfertilized soil. Results show that vegetable yields achieved using a combination of BSFFF and NPK were 4.5, 2.4, and 5.4-folds higher than the yield from the control treatment for tomatoes, kales, and French beans, respectively. The combined application of BSFFF and NPK produced 22-135%, 20-27%, and 38-50% higher yields than sole NPK for tomatoes, kales, and French beans, respectively, under both greenhouse and open-field conditions. The highest agronomic N use efficiency was achieved in sole BSFFF-treated plots compared to sole BSG and Evergrow. The N taken up by the vegetables was significantly higher when BSFFF and NPK were integrated. Vegetables grown using a combination of BSFFF and NPK had the highest crude protein and ash concentrations. Our findings demonstrate that the integration of BSFFF and NPK in vegetable cropping systems at the recommended rate of 1.24 t ha-1 BSFFF and 322 kg ha-1 NPK would improve soil health, boost yield, and nutritional quality of vegetable crops.
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Affiliation(s)
- Abel O. Anyega
- International Centre for Insect Physiology and Ecology, Nairobi, Kenya
- Department of Agricultural Science and Technology, Kenyatta University, Nairobi, Kenya
| | - Nicholas K. Korir
- Department of Agricultural Science and Technology, Kenyatta University, Nairobi, Kenya
| | - Dennis Beesigamukama
- International Centre for Insect Physiology and Ecology, Nairobi, Kenya
- Department of Crop Production and Management, Busitema University, Tororo, Uganda
| | | | - Kiatoko Nkoba
- International Centre for Insect Physiology and Ecology, Nairobi, Kenya
| | | | - Joop J. A. van Loon
- Laboratory of Entomology, Plant Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Marcel Dicke
- Laboratory of Entomology, Plant Sciences Group, Wageningen University, Wageningen, Netherlands
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Cooper GS, Rich KM, Shankar B, Rana V, Ratna NN, Kadiyala S, Alam MJ, Nadagouda SB. Identifying 'win-win-win' futures from inequitable value chain trade-offs: A system dynamics approach. AGRICULTURAL SYSTEMS 2021; 190:103096. [PMID: 34025008 PMCID: PMC8121761 DOI: 10.1016/j.agsy.2021.103096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 05/19/2023]
Abstract
CONTEXT There is growing recognition that food systems must adapt to become more sustainable and equitable. Consequently, in developing country contexts, there is increasing momentum away from traditional producer-facing value chain upgrades towards efforts to increase both the availability and affordability of nutritious foods at the consumer level. However, such goals must navigate the inherent complexities of agricultural value chains, which involve multiple interactions, feedbacks and unintended consequences, including important but often surprising trade-offs between producers and consumers. OBJECTIVE AND METHODS Based around the 'Loop' horticultural aggregation scheme of Digital Green in Bihar, India, we develop a system dynamics modelling framework to survey the value chain trade-offs emerging from upgrades that aim to improve the availability of fruits and vegetables in small retail-oriented markets. We model the processes of horticultural production, aggregation, marketing, and retailing - searching for futures that are 'win-win-win' for: (i) the availability of fruits and vegetables in small retail markets, (ii) the profits of farmers participating in aggregation, and (iii) the sustainability of the initial scheme for Digital Green as an organisation. We simulate two internal upgrades to aggregation and two upgrades to the wider enabling environment through a series of 5000 Monte Carlo trajectories - designed to explore the plausible future dynamics of the three outcome dimensions relative to the baseline. RESULTS We find that 'win-win-win' futures cannot be achieved by internal changes to the aggregation scheme alone, emerging under a narrow range of scenarios that boost supplies to the small retail market whilst simultaneously supporting the financial takeaways of farmers. In contrast, undesirable producer versus consumer trade-offs emerge as unintended consequences of scaling-up aggregation and the introduction of market-based cold storage. SIGNIFICANCE This approach furthers ongoing efforts to capture complex value chain processes, outcomes and upgrades within system dynamics modelling frameworks, before scanning the horizon of plausible external scenarios, internal dynamics and unintended trade-offs to identify 'win-win-win' futures for all.
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Affiliation(s)
- Gregory S. Cooper
- Centre for Development, Environment and Policy (CeDEP), School of Oriental and African Studies (SOAS), London, United Kingdom
| | - Karl M. Rich
- International Livestock Research Institute (ILRI), West Africa Regional Office, Dakar, Senegal
| | - Bhavani Shankar
- Institute for Sustainable Food, University of Sheffield, Sheffield, United Kingdom
| | - Vinay Rana
- Transform Rural India Foundation (TRIF), Raipur, Chhattisgarh, India
| | - Nazmun N. Ratna
- Department of Global Value Chain & Trade, Faculty of Agribusiness and Commerce, Lincoln University, Christchurch, New Zealand
| | - Suneetha Kadiyala
- Department for Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Mohammad J. Alam
- Department of Agribusiness and Marketing, Bangladesh Agricultural University (BAU), Mymensingh, Bangladesh
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Yamaguchi Y, Tuliao MTR, Matsuo H. Factors associated with the progression and prevention of noncommunicable diseases in community-dwelling Filipino adults: A cross-sectional study. Medicine (Baltimore) 2021; 100:e25082. [PMID: 33832075 PMCID: PMC8036101 DOI: 10.1097/md.0000000000025082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/16/2021] [Indexed: 01/05/2023] Open
Abstract
Noncommunicable diseases (NCDs) are an important cause of disability and death in Muntinlupa, Manila, Philippines. However, there is little community-based research on lifestyle behaviors that affect the progression of NCDs or on the hindrances to NCD prevention.This cross-sectional study investigated the lifestyle behaviors associated with the progression and prevalence of NCDs and clarified factors associated with health promotion for the NCDs prevention among 168 Filipino adults aged 50 years and above in the community setting.The prevalence of diabetes, cardiovascular disease, cancer, chronic respiratory disease, hypertension, and overweight/obesity found 13.1%, 8.9%, 1.8%, 4.2%, 59.5%, and 36.9%, respectively. Of 63 adults who underwent blood tests, high blood glucose and abnormal lipids found 20.6% and 80.9%, respectively. Filipino adults ate breakfast, lunch, and dinner more than 5 days a week, Merienda 4.2 days a week, and a midnight snack 1.7 days a week. The mean frequencies of physical activity at vigorous, moderate, and light intensity levels were 2.6 times a week, 1.9 times a week, and 3.8 times a week, respectively. Men were more likely to be smokers than women. Mean frequencies of alcohol consumption were 0.6 days a week. Filipino adults who practiced diet control, regular physical activities, no smoking, limited alcohol intake, stress control, and regular health checkups were 68.3%, 34.1%, 35.9%, 35.3%, 32.9%, and 24.6%, respectively. Hypertension was positively associated with the duration of tobacco use and frequency of salt intake. Overweight/obesity was positively associated with the frequency of Merienda. Diet control was positively related with internal Multidimensional Health Locus of Control scale. Smoking and alcohol control were significantly related with income level.Community-dwelling Filipino adults in this study had a high prevalence of NCD progression and insufficient awareness of preventative behaviors. Diet control is associated with self-awareness of health and smoking and alcohol control are associated with economic status. These findings ought to contribute to develop the effective strategies for NCD prevention in community-dwelling Filipino adults.
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Affiliation(s)
- Yuko Yamaguchi
- Department of Nursing, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | | | - Hiroya Matsuo
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Mohd Suhaimi NI, Mat Ropi AA, Shaharuddin S. Safety and quality preservation of starfruit ( Averrhoa carambola) at ambient shelf life using synergistic pectin-maltodextrin-sodium chloride edible coating. Heliyon 2021; 7:e06279. [PMID: 33681497 PMCID: PMC7910501 DOI: 10.1016/j.heliyon.2021.e06279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/18/2020] [Accepted: 02/10/2021] [Indexed: 11/24/2022] Open
Abstract
The demand for fresh, safe, and healthy fruits by consumers has increased, which concurrently occurs with an increase in initiatives on reducing food wastage. Starfruit consists of good nutrition and valuable sensory attributes, but its shelf life is short and can only be preseved for a few days at ambient storage. This research was conducted to determine the effectiveness of synergistic edible coatings (pectin [Pe] and maltodextrin [M] and 100, 200, and 300 ppm of sodium chloride [SC]) on the quality and safety criterion of starfruits throughout a shelf life analysis of 14 days at ambient temperature. Consumer acceptability of the edible-coated starfruit was also evaluated. The coating process was performed using a dipping method. The uncoated (control) and coated samples were evaluated for the characteristics of weight, pH, total soluble solids (TSS), water activity, color, texture, microbial growth, FTIR, and sensory evaluation. From the results, the starfruit coated with Pe + M + 100 ppm SC had a significantly lower weight-loss trend compared to the other samples. On day 14, pH of the coated starfruits were 3.02, 3.14, and 3.31 for 100, 200, and 300 ppm of SC, respectively, were found to be significantly different (p < 0.05) from the control (pH 3.49). The control had a significantly higher value of total soluble solids (6.00 ⁰Brix) compared to the coated starfruits (6.00, 5.47, and 5.33 ⁰Brix, respectively). The coated samples have significantly higher values of firmness than control especially in initial days of storage. It was observed that Pe + M + 100 ppm SC could minimize the spoilage of fruits by reducing the growth of yeast and mold, as well as bacteria, up to 0.86 and 2.02 log CFU/ml, respectively. FTIR results confirmed the presence of the coating on the starfruit. In the sensory evaluation, no significance different (p > 0.05) were obtained for all the sensory attributes and overall acceptability for day 0 and 3. In conclusion, starfruit coated with synergistic Pe + M + 100 ppm SC appeared to be the best sample in extending its shelf life and maintaining the physicochemical characteristics of starfruits up to more than 14 days.
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Affiliation(s)
- Nurul Izzati Mohd Suhaimi
- Section of Food Engineering Technology, Universiti Kuala Lumpur, Branch Campus Malaysian Institute of Chemical and Bioengineering Technology, Lot 1988 Vendor City, Taboh Naning, 78000 Alor Gajah, Melaka, Malaysia
| | - Anis Alysha Mat Ropi
- Section of Food Engineering Technology, Universiti Kuala Lumpur, Branch Campus Malaysian Institute of Chemical and Bioengineering Technology, Lot 1988 Vendor City, Taboh Naning, 78000 Alor Gajah, Melaka, Malaysia
| | - Shahrulzaman Shaharuddin
- Section of Food Engineering Technology, Universiti Kuala Lumpur, Branch Campus Malaysian Institute of Chemical and Bioengineering Technology, Lot 1988 Vendor City, Taboh Naning, 78000 Alor Gajah, Melaka, Malaysia
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Abdelmenan S, Berhane HY, Jirström M, Trenholm J, Worku A, Ekström EC, Berhane Y. The Social Stratification of Availability, Affordability, and Consumption of Food in Families with Preschoolers in Addis Ababa; The EAT Addis Study in Ethiopia. Nutrients 2020; 12:nu12103168. [PMID: 33081262 PMCID: PMC7603009 DOI: 10.3390/nu12103168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to understand the quality of diet being consumed among families in Addis Ababa, and to what extent social stratification and perceptions of availability and affordability affect healthy food consumption. Data were collected from 5467 households in a face-to-face interview with mothers/caretakers and analyzed using mixed effect logistic regression models. All family food groups, except fish were perceived to be available by more than 90% of the participants. The food groups cereals/nuts/seeds, other vegetables, and legumes were considered highly affordable (80%) and were the most consumed (>75%). Households with the least educated mothers and those in the lowest wealth quintile had the lowest perception of affordability and also consumption. Consumption of foods rich in micronutrients and animal sources were significantly higher among households with higher perceived affordability, the highest wealth quintile, and with mothers who had better education. Households in Addis Ababa were generally seen to have a monotonous diet, despite the high perceived availability of different food groups within the food environment. There is a considerable difference in consumption of nutrient-rich foods across social strata, hence the cities food policies need to account for social differences in order to improve the nutritional status of the community.
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Affiliation(s)
- Semira Abdelmenan
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
- Correspondence: ; Tel.: +251-116-390026
| | - Hanna Y. Berhane
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Jill Trenholm
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- School of Public Health, College of Health Sciences, Addis Ababa University, 1176 Addis Ababa, Ethiopia
| | - Eva-Charlotte Ekström
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
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Schreinemachers P, Baliki G, Shrestha RM, Bhattarai DR, Gautam IP, Ghimire PL, Subedi BP, Brück T. Nudging children toward healthier food choices: An experiment combining school and home gardens. GLOBAL FOOD SECURITY 2020; 26:100454. [PMID: 33324538 PMCID: PMC7726313 DOI: 10.1016/j.gfs.2020.100454] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/22/2023]
Abstract
School gardens have become a widely used approach to influence children's food knowledge, preferences and choices in low- and high-income countries alike. However, evidence indicates that such programs are more effective at influencing food knowledge and preferences than actual food choices. Such finding may occur because school gardens insufficiently influence the food behavior of parents and because healthy food items are not always available in children's homes. We tested this hypothesis using a one-year cluster randomized controlled trial in Nepal with 15 treatment and 15 control schools and a matched sample of 779 schoolchildren (aged 8-12) and their caregivers. Data were collected before and after the intervention during the 2018-2019 school year. In addition, children's food consumption was monitored using a monthly food logbook. Average treatment effects were quantified with a double-difference estimator. For caregivers, the intervention led to a 26% increase in their food and nutrition knowledge (p < 0.001), a 5% increase in their agricultural knowledge (p = 0.022), a 10% increase in their liking for vegetables (p < 0.001), and a 15% increase in home garden productivity (p = 0.073). For children, the intervention had no discernible effect on food and nutrition knowledge (p = 0.666) but led to a 6% increase in their liking for vegetables (p = 0.070), healthy food practices (p < 0.001), and vegetable consumption (October-December +15%; p = 0.084; January-March +26%; p = 0.017; April-June +26%; p = 0.088). The results therefore indicate both schools and parents matter for nudging children toward healthier food choices.
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Affiliation(s)
| | - Ghassan Baliki
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
| | | | - Dhruba Raj Bhattarai
- Outreach Research Division, Nepal Agricultural Research Council, Khumaltar, Lalitpur, Nepal
| | - Ishwori P. Gautam
- National Horticulture Research Centre, Nepal Agricultural Research Council, Khumaltar, Lalitpur, Nepal
| | - Puspa Lal Ghimire
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Baneshwor, Kathmandu, Nepal
| | - Bhishma P. Subedi
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Baneshwor, Kathmandu, Nepal
| | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, UK
- ISDC – International Security and Development Center, Berlin, Germany
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Koyanagi A, Veronese N, Solmi M, Oh H, Shin JI, Jacob L, Yang L, Haro JM, Smith L. Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries. Nutrients 2020; 12:nu12030706. [PMID: 32155879 PMCID: PMC7146581 DOI: 10.3390/nu12030706] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/27/2020] [Accepted: 03/04/2020] [Indexed: 12/25/2022] Open
Abstract
Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.4) years; 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60; 95% CI = 0.42−0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42; 95% CI = 0.24−0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; (L.J.); (J.M.H.)
- ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
- Correspondence: ; Tel.: +34-9360-0268-5
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy;
| | - Marco Solmi
- Department of Neurosciences, University of Padova, 90133 Padova, Italy;
- Padova Neuroscience Center, University of Padova, 90133 Padova, Italy
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA;
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03372, Korea;
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; (L.J.); (J.M.H.)
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; (L.J.); (J.M.H.)
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK;
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McKenzie BL, Santos JA, Geldsetzer P, Davies J, Manne-Goehler J, Gurung MS, Sturua L, Gathecha G, Aryal KK, Tsabedze L, Andall-Brereton G, Bärnighausen T, Atun R, Vollmer S, Woodward M, Jaacks LM, Webster J. Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries. Nutr J 2020; 19:3. [PMID: 31928531 PMCID: PMC6956488 DOI: 10.1186/s12937-019-0517-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading causes of death for men and women in low-and-middle income countries (LMIC). The nutrition transition to diets high in salt, fat and sugar and low in fruit and vegetables, in parallel with increasing prevalence of diet-related CVD risk factors in LMICs, identifies the need for urgent action to reverse this trend. To aid identification of the most effective interventions it is crucial to understand whether there are sex differences in dietary behaviours related to CVD risk. METHODS From a dataset of 46 nationally representative surveys, we included data from seven countries that had recorded the same dietary behaviour measurements in adults; Bhutan, Eswatini, Georgia, Guyana, Kenya, Nepal and St Vincent and the Grenadines (2013-2017). Three dietary behaviours were investigated: positive salt use behaviour (SUB), meeting fruit and vegetable (F&V) recommendations and use of vegetable oil rather than animal fats in cooking. Generalized linear models were used to investigate the association between dietary behaviours and waist circumference (WC) and undiagnosed and diagnosed hypertension and diabetes. Interaction terms between sex and dietary behaviour were added to test for sex differences. RESULTS Twenty-four thousand three hundred thirty-two participants were included. More females than males reported positive SUB (31.3 vs. 27.2% p-value < 0.001), yet less met F&V recommendations (13.2 vs. 14.8%, p-value< 0.05). The prevalence of reporting all three dietary behaviours in a positive manner was 2.7%, varying by country, but not sex. Poor SUB was associated with a higher prevalence of undiagnosed hypertension for females (13.1% vs. 9.9%, p-value = 0.04), and a higher prevalence of undiagnosed diabetes for males (2.4% vs. 1.5%, p-value = 0.02). Meeting F&V recommendations was associated with a higher prevalence of high WC (24.4% vs 22.6%, p-value = 0.01), but was not associated with undiagnosed or diagnosed hypertension or diabetes. CONCLUSION Interventions to increase F&V intake and positive SUBs in the included countries are urgently needed. Dietary behaviours were not notably different between sexes. However, our findings were limited by the small proportion of the population reporting positive dietary behaviours, and further research is required to understand whether associations with CVD risk factors and interactions by sex would change as the prevalence of positive behaviours increases.
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Affiliation(s)
- Briar L McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, USA
| | - Justine Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Lela Sturua
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Gladwell Gathecha
- Division of Non-Communicable Diseases, Kenya Ministry of Health, Nairobi, Kenya
| | | | | | - Glennis Andall-Brereton
- Non-Communicable Diseases, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele an Durban, Durban, South Africa
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, University of Oxford, Oxford, UK
- Department of Epidemiology, Johns Hopkins University, Baltimore, USA
| | - Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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49
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Kirk B, Melloy B, Iyer V, Jaacks LM. Variety, Price, and Consumer Desirability of Fresh Fruits and Vegetables in 7 Cities around the World. Curr Dev Nutr 2019; 3:nzz085. [PMID: 31463423 PMCID: PMC6704388 DOI: 10.1093/cdn/nzz085] [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] [Received: 04/19/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 01/04/2023] Open
Abstract
Few studies have attempted to quantify the variety, price, and consumer desirability of fruits and vegetables (F&Vs) across a diversity of cities. We implemented a market basket survey of F&Vs from December 2018 to February 2019 in middle-income neighborhoods of the following cities: Visakhapatnam, India; Kathmandu, Nepal; Addis Ababa, Ethiopia; Dar es Salaam, Tanzania; Mexico City, Mexico; Bangkok, Thailand; and Brookline, United States. The total variety of fruits ranged from 4.1 in Visakhapatnam to 17.3 in Brookline, and of vegetables from 6.1 in Dar es Salaam to 20.3 in Brookline. Of the 3 fruits for which price data were collected, apples tended to be the most expensive, and bananas the least expensive. For vegetables, capsicum tended to be the most expensive and eggplants the least expensive. Tablet-based market basket surveys are a useful tool for evaluating food environments. These pilot data provide further evidence of the homogenization of global diets.
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Affiliation(s)
- Brenna Kirk
- Harvard TH Chan School of Public Health, Boston, MA
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50
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Siegel KR. Insufficient Consumption of Fruits and Vegetables among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries: What Can Be Done? J Nutr 2019; 149:1105-1106. [PMID: 31162579 DOI: 10.1093/jn/nxz123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/13/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karen R Siegel
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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