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Toney AM, Pineros-Leano M, Pérez-Flores NJ, Gomez D, Aguayo L. 'It is in our hands-Why wait until you are sick?': Perceptions about diabetes prevention of Latina mothers in Mexico and the United States. Diabet Med 2023; 40:e15060. [PMID: 36751972 PMCID: PMC10655807 DOI: 10.1111/dme.15060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/12/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
AIMS This study aimed to understand the perceptions driving type 2 diabetes mellitus prevention and management behaviours of Mexican and Latina mothers in Mexico and the United States. METHODS Low-income Mexican mothers in San Luis Potosí, Mexico and Latina mothers in Illinois, United States, were recruited by the Holistic Obesity Prevention Study (HOPS). Verbatim transcripts of the semistructured interviews conducted in Spanish (n = 24) and English (n = 1) were analysed using the Health Belief Model (HBM) framework. RESULTS Of the 25 participants, 22 (88%) indicated 'knowing someone with diabetes'-specifically a father (n = 8), mother (n = 6) or grandparent (n = 7). Using the HBM, themes showed that mothers perceived: that Type 2 diabetes can happen to anyone, are attributable to genetic predisposition and may be driven by strong emotions (perceived susceptibility). Type 2 diabetes introduces severe comorbidities and emotional difficulties for people and their families (perceived severity). Adopting a healthier diet, exercising and staying in good spirits were recognized as benefits of Type 2 diabetes prevention (perceived benefits). The costs of food, challenges of exercising, dieting, modifying habits and time limitations were recognized as perceived costs. Cues to action included doctors' recommendations (external) and fear (internal). Mothers acknowledged they could live a healthy life by controlling their weight, exercising, adhering to treatments/medications and having the determination to carry-on (self-efficacy). CONCLUSIONS Mothers sought to prevent Type 2 diabetes and live healthy lives, particularly, after receiving a diagnosis of gestational diabetes or when learning about their children's risks for Type 2 diabetes but perceived significant barriers to Type 2 diabetes prevention.
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Affiliation(s)
- Ashley Mulcahy Toney
- UTHealth Center for Community Health Impact, University of Texas Health Science Center at Houston, School of Public Health, El Paso, Texas, USA
| | | | | | - Diana Gomez
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
| | - Liliana Aguayo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Magaña-Guerrero FS, Aguayo-Flores JE, Buentello-Volante B, Zarco-Ávila K, Sánchez-Cisneros P, Castro-Salas I, De la Torre-Galván E, Rodríguez-Loaiza JL, Jiménez-Corona A, Garfias Y. Spontaneous Neutrophil Extracellular Traps Release Are Inflammatory Markers Associated with Hyperglycemia and Renal Failure on Diabetic Retinopathy. Biomedicines 2023; 11:1791. [PMID: 37509431 PMCID: PMC10376331 DOI: 10.3390/biomedicines11071791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/30/2023] Open
Abstract
Diabetic retinopathy (DR) is the major microvascular complication of diabetes and causes vitreous traction and intraretinal hemorrhages leading to retinal detachment and total blindness. The evolution of diabetes is related to exacerbating inflammation caused by hyperglycemia and activation of inflammatory cells. Neutrophils are cells able to release structures of extracellular DNA and proteolytic enzymes called extracellular traps (NETs), which are associated with the persistence of inflammation in chronic pathologies. The purpose of the study was to determine the usefulness of neutrophil traps as indicators of DR progression in patients with type 2 diabetes (T2DM). We performed a case-control study of seventy-four cases classified into five groups (non-proliferative DR, mild, moderate, severe, and proliferative) and fifteen healthy controls. We found correlations between NETs and a diagnostic time of T2DM (r = 0.42; p < 0.0001), fasting glucose (r = 0.29; p < 0.01), glycated hemoglobin (HbA1c) (r = 0.31; p < 0.01), estimated glomerular filtration rate (eGFR) (r = -0.29; p < 0.01), and plasma osmolarity (r = 0.25; p < 0.01). These results suggest that due to NETs being associated with clinical indicators, such as HbA1c and eGFR, and that NETs are also associated with DR, clinical indicators might be explained in part through an NET-mediated inflammation process.
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Affiliation(s)
- Fátima Sofía Magaña-Guerrero
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - José Eduardo Aguayo-Flores
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - Beatriz Buentello-Volante
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - Karla Zarco-Ávila
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - Paola Sánchez-Cisneros
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - Ilse Castro-Salas
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | - Enya De la Torre-Galván
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
| | | | - Aida Jiménez-Corona
- Department of Ocular Epidemiology and Visual Health, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
- General Directorate of Epidemiology, Health Secretariat, Mexico City 01480, Mexico
| | - Yonathan Garfias
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City 06800, Mexico
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Jin L, Tong LY, Sha L, Cao MM, Shen CQ, Du LF, Li ZJ. Handheld versus conventional ultrasound for assessing carotid artery in routine volunteers. Clin Hemorheol Microcirc 2022; 82:255-263. [PMID: 35848014 DOI: 10.3233/ch-221521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM Carotid ultrasound is a key tool for the diagnosis and evaluation of cardio disease, and the measurement of carotid intima-media thickness (CIMT) and hemodynamic parameters is of paramount importance for the imaging method. The aim of this study was to evaluate the feasibility and accuracy of handheld ultrasound devices for measuring carotid parameters. METHODS We performed a carotid ultrasound on 25 participants using a handheld ultrasound device and a conventional ultrasound machine. For each participant, max and mean CIMT of common carotid artery (CCA) and peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of CCA, bilateral external carotid artery (ECA), internal carotid artery (ICA) and the vertebral artery were measured. Agreement and repeatability were evaluated by linear regression and Bland-Altman analysis. RESULTS We found a good repeatability and consistent of handheld ultrasound device in measuring mean CIMT (r = 0.68, P < 0.01). Furthermore, there was a moderate to good agreement between handheld and conventional ultrasound systems in measuring max IMT, mean IMT, PSV, EDV and RI of CCA (0.73, 0.79, 0.52, 0.58 and 0.84, respectively). CONCLUSION Handheld ultrasound devices were able to provide carotid IMT and hemodynamic parameters measurements similar to those of conventional ultrasound. Such capabilities of handheld ultrasound devices might be useful for the primary assessment of carotid in clinical work.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Lan-Yue Tong
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lei Sha
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meng-Meng Cao
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cui-Qin Shen
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lian-Fang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhao-Jun Li
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Tesfay FH, Zorbas C, Alston L, Backholer K, Bowe SJ, Bennett CM. Prevalence of chronic non-communicable diseases in Ethiopia: A systematic review and meta-analysis of evidence. Front Public Health 2022; 10:936482. [PMID: 35991039 PMCID: PMC9385028 DOI: 10.3389/fpubh.2022.936482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNon-communicable diseases (NCDs) are a growing global health challenge disproportionately impacting low- and middle-income settings, including Ethiopia. Currently, the body of evidence describing the burden of NCDs is fragmented, inconsistent, health facility- or institution-based, and out-dated in Ethiopia. We conducted a systematic review of the literature and meta-analysis of the prevalence of NCDs in community settings in Ethiopia.Review methodologyCommunity-based quantitative studies published in English between January 1st, 2012, and June 30th, 2022, that reported on the prevalence of NCDs in Ethiopia were included. A systematic search of Medline, Embase, Scopus, CINAHL, and Global Health using pretested search terms related to NCDs was conducted, and data were extracted using a piloted data extraction proforma adapted from the Joanna Briggs Institute tool. Meta-analysis was performed using Stata 16. While the pooled prevalence of Diabetes Mellitus (DM) and undiagnosed (DM) was computed and presented using forest plots, then overall prevalence of NCDs and other various types of NCDs were narratively synthesized. I2 was used to assess heterogeneity. Studies that did not fulfill the criteria (used similar tool to measure the types of NCDs) for meta-analysis were narratively synthesized.ResultsTwenty-two studies met the inclusion criteria. Five studies measured the prevalence of NCDs (all NCDs together), ranging from 29 to 35% (prevalence estimates not pooled). The pooled prevalence of Diabetes Mellitus (DM) across ten studies was 5% (95% CI: 4–7%). Three studies each reported on the prevalence of undiagnosed DM (pooled prevalence 5%, 95% CI: 4–7%) and pre-DM (pooled prevalence 7%, 95% CI: 3–14%%). In a narrative analysis the prevalence of cardiovascular conditions ranged from 13.4 to 32.2% (n = 3 studies), cancer mortality ranged from 4 to 18% (n = 3 studies) and respiratory conditions ranged from 1 to 18% (n = 3 studies). Some studies have determined more than one NCDs and that is why the total number of studies are exceeding more than twenty studies.Conclusion and recommendationsOur analysis found that approximately one-third of Ethiopians have an NCD, with cardiovascular diseases the most common of all NCDs. The prevalence of respiratory conditions also appears high, but there are insufficient data for a pooled estimate. Whilst the prevalence of DM appears relatively low, there is evidence that the magnitude is increasing. Public health actions to address the high burden of cardiovascular and respiratory diseases, as well as the increasing magnitude of DM in Ethiopia, must be prioritized.Systematic review registrationPROSPERO [CRD42020196815].
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Affiliation(s)
- Fisaha Haile Tesfay
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- College of Medicine and Health Sciences, School of Public Health, Mekelle University, Mekelle, Ethiopia
- *Correspondence: Fisaha Haile Tesfay
| | - Christina Zorbas
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Laura Alston
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Kathryn Backholer
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Steven J. Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Quintal Martínez JP, Segura Campos MR. Cnidoscolus Aconitifolius (Mill.) I.M. Johnst.: A Food Proposal Against Thromboembolic Diseases. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1934002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Peng W, Mu Y, Hu Y, Li B, Raman J, Sui Z. Double Burden of Malnutrition in the Asia-Pacific Region-A Systematic Review and Meta-analysis. J Epidemiol Glob Health 2021; 10:16-27. [PMID: 32175706 PMCID: PMC7310807 DOI: 10.2991/jegh.k.191117.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/27/2019] [Indexed: 01/02/2023] Open
Abstract
Background: Double Burden of Malnutrition (DBM)—the coexistence of undernutrition along with overnutrition—is a significant public health issue in the Asia-Pacific region. The scope of the DBM in this region is largely unknown. This review aims to determine the prevalence of under- and overnutrition as major DBM components and to investigate whether there has been a shift from under- to overnutrition in the Asia-Pacific region. Methods: Online databases including PubMed and Web of Science were searched for original studies on DBM prevalence in the Asia-Pacific region; particularly, those published from January 2008 to December 2018 were screened for eligibility. We collected data on indicators of under- and overnutrition on the population level and adapted the ratio of prevalence of overweight/obesity versus prevalence of underweight as the main outcome indicator. Pooled prevalence estimates of DBM and the ratio of overnutrition versus undernutrition were generated using R (3.4.0). Results: In total, 33 studies were included in this review. Pooled analysis demonstrated that DBM was generally presented among countries/areas in the Asia-Pacific region except in high-income countries (HICs). Overall, the prevalence of undernutrition was 8.8% (95% CI 7.3–10.6%) while overnutrition among the same population reached 23.0% (95% CI 20.3–26.0%). Countries in the Oceania region or HICs reported low level of undernutrition (less than 3%). All subgroup analysis (geolocation, income level, sex, age) reported pooled prevalence of overweight/obesity as more than 18%. Overall, the whole region and all subgroups were more likely to experience a higher prevalence of overnutrition than undernutrition, except that low- and lower-middle-income countries (L-MICs) had similar prevalence for over- and undernutrition. Conclusion: DBM in the Asia-Pacific region is alarmingly high and is titled toward overnutrition. As a result, future interventions/policy targeting to maintain a healthy weight for the population should not just focus on prevention and treatment toward one direction.
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Affiliation(s)
- Wen Peng
- Department of Public Health, Medical School, Qinghai University, Qinghai, China
| | - Yuhan Mu
- Department of Public Health, Medical School, Qinghai University, Qinghai, China
| | - Yang Hu
- Department of Public Health, Medical School, Qinghai University, Qinghai, China
| | - Bin Li
- Department of Public Health, Medical School, Qinghai University, Qinghai, China
| | - Jayanthi Raman
- Clinical Psychology, Australian College of Applied Psychology, Sydney, NSW 2000, Australia
| | - Zhixian Sui
- School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW 2052, Australia.,The BMI Clinic, Double Bay, NSW 2028, Australia
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7
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Martínez-García M, Gutiérrez-Esparza GO, Roblero-Godinez JC, Marín-Pérez DV, Montes-Ruiz CL, Vallejo M, Hernández-Lemus E. Cardiovascular Risk Factors and Social Development Index. Front Cardiovasc Med 2021; 8:631747. [PMID: 33708806 PMCID: PMC7940205 DOI: 10.3389/fcvm.2021.631747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality worldwide. The complex etiology of CVD is known to be significantly affected by environmental and social factors. There is, however, a lag in our understanding of how population level components may be related to the onset and severity of CVD, and how some indicators of unsatisfied basic needs might be related to known risk factors. Here, we present a cross-sectional study aimed to analyze the association between cardiovascular risk factors (CVRF) and Social Development Index (SDI) in adult individuals within a metropolitan urban environment. The six components of SDI as well as socioeconomic, anthropometric, clinical, biochemical, and risk behavior parameters were explored within the study population. As a result, several CVRF (waist circumference, waist-to-height ratio, body mass index, systolic blood pressure, glucose, lower high-density lipoprotein cholesterol, triglycerides, and sodium) were found in a higher proportion in the low or very low levels of the SDI, and this pattern occurs more in women than in men. Canonical analysis indicates a correlation between other socioeconomic features and anthropometric, clinical, and biochemical factors (canonical coefficient = 0.8030). Further studies along these lines are needed to fully establish how to insert such associations into the design of health policy and interventions with a view to lessen the burden of cardiovascular diseases, particularly in metropolitan urban environments.
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Affiliation(s)
| | | | | | | | | | - Maite Vallejo
- Sociomedical Research, National Institute of Cardiology, Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
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Are Changes in Walking for Transportation in Brazilian Older Adults Associated With Attributes of the Neighborhood Environment? J Aging Phys Act 2021; 29:686-694. [PMID: 33412517 DOI: 10.1123/japa.2020-0120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/18/2022]
Abstract
This study aims to examine the association between neighborhood environment attributes and changes in walking for transportation among older adults. Longitudinal analysis was performed considering a population-based study (EpiFloripa Idoso), carried out in 2009-2010 with follow-up in 2013-2014. Changes in walking, obtained with the International Physical Activity Questionnaire during both waves were associated with data from the environment perception, evaluated using individual items from the Neighborhood Environment Walkability Scale (baseline only) performing multinomial logistic regression. A total of 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Those who reported the presence of parks and squares (OR = 2.44, 95% confidence interval [CI; 1.70, 3.51]), sidewalks (OR = 1.66, 95% CI [1.03, 2.70]), crosswalks (OR = 1.69, 95% CI [1.05, 2.72]), illuminated streets (OR = 2.80, 95% CI [1.24, 6.33]), and safety for day walks (OR = 1.93, 95% CI [1.14, 3.24]) were more likely to remain active or become active when commuting (≥150 min/week). Older adults are more active in neighborhoods that present more favorable attributes regarding walking for transportation.
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Chikafu H, Chimbari MJ. Levels and Correlates of Physical Activity in Rural Ingwavuma Community, uMkhanyakude District, KwaZulu-Natal, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186739. [PMID: 32947853 PMCID: PMC7559597 DOI: 10.3390/ijerph17186739] [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] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/27/2020] [Accepted: 07/05/2020] [Indexed: 01/25/2023]
Abstract
Physical activity, among others, confers cardiovascular, mental, and skeletal health benefits to people of all age-groups and health states. It reduces the risks associated with cardiovascular disease and therefore, could be useful in rural South Africa where cardiovascular disease (CVD) burden is increasing. The objective of this study was to examine levels and correlates of physical activity among adults in the Ingwavuma community in KwaZulu-Natal (KZN). Self-reported data on physical activity from 392 consenting adults (female, n = 265; male, n = 127) was used. We used the one-sample t-test to assess the level of physical activity and a two-level multiple linear regression to investigate the relationship between total physical activity (TPA) and independent predictors. The weekly number of minutes spent on all physical activities by members of the Ingwavuma community was 912.2; standard deviation (SD) (870.5), with males having 37% higher physical activity (1210.6 min, SD = 994.2) than females (769.2, SD = 766.3). Livelihood activities constituted 65% of TPA, and sport and recreation contributed 10%. Participants without formal education (20%), those underweight (27%), and the obese (16%) had low physical activity. Notwithstanding this, in general, the Ingwavuma community significantly exceeded the recommended weekly time on physical activity with a mean difference of 762.1 (675.8–848.6) minutes, t (391) = 17.335, p < 0.001. Gender and age were significant predictors of TPA in level 1 of the multiple regression. Males were significantly more active than females by 455.4 min (β = −0.25, p < 0.001) and participants of at least 60 years were significantly less active than 18–29-year-olds by 276.2 min (β = −0.12, p < 0.05). Gender, marital status, and health awareness were significant predictors in the full model that included education level, employment status, body mass index (BMI), and physical activity related to health awareness as predictors. The high prevalence of insufficient physical activity in some vulnerable groups, notably the elderly and obese, and the general poor participation in sport and recreation activities are worrisome. Hence we recommend health education interventions to increase awareness of and reshape sociocultural constructs that hinder participation in leisure activities. It is important to promote physical activity as a preventive health intervention and complement the pharmacological treatment of CVDs in rural South Africa. Physical activity interventions for all sociodemographic groups have potential economic gains through a reduction in costs related to the treatment of chronic CVD.
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Davis JN, Oaks BM, Engle-Stone R. The Double Burden of Malnutrition: A Systematic Review of Operational Definitions. Curr Dev Nutr 2020; 4:nzaa127. [PMID: 32885132 PMCID: PMC7456307 DOI: 10.1093/cdn/nzaa127] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite increasing research on the double burden of malnutrition (DBM; i.e., coexisting over- and undernutrition), there is no global consensus on DBM definitions. OBJECTIVES To identify published operational DBM definitions, measure their frequency of use, and discuss implications for future assessment. METHODS Following a structured search of peer-reviewed articles with terms describing "overnutrition" [e.g., overweight/obesity (OW/OB)] and "undernutrition" (e.g., stunting, micronutrient deficiency), we screened 1920 abstracts, reviewed 500 full texts, and extracted 623 operational definitions from 239 eligible articles. RESULTS We organized three identified DBM dimensions (level of assessment, target population, and forms of malnutrition) into a framework for building operational DBM definitions. Frequently occurring definitions included coexisting: 1) OW/OB and thinness, wasting, or underweight (n = 289 occurrences); 2) OW/OB and stunting (n = 161); 3) OW/OB and anemia (n = 74); and 4) OW/OB and micronutrient deficiency (n = 73). CONCLUSIONS Existing DBM definitions vary widely. Putting structure to possible definitions may facilitate selection of fit-for-purpose indicators to meet public health priorities.
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Affiliation(s)
- Jennie N Davis
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Brietta M Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Reina Engle-Stone
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
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García-Chávez CG, Rivera JA, Monterrubio-Flores E, Rodríguez-Ramírez S. Dietary patterns are associated with obesity in Mexican schoolchildren. Eur J Clin Nutr 2020; 74:1201-1209. [PMID: 32152510 DOI: 10.1038/s41430-020-0598-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The prevalence of overweight and obesity in Mexican schoolchildren has increased in the past three decades. Dietary pattern approaches to assess diet have been used to study the relation between nutrition and chronic conditions. OBJECTIVE The objective of this study is to analyze the association between dietary patterns (DP) and overweight and obesity in Mexican schoolchildren. METHODS We analyzed information from schoolchildren who participated in the National Health and Nutrition Survey 2012 (ENSANUT-2012). Dietary information was obtained through a 24-h recall of 2751 children (5-11 year). Foods were classified into 33 groups, and the DPs were identified by cluster analysis (k-means method). Weight and height were measured to estimate the body mass index (BMI), by classifying overweight if the Z score was >1 and ≤2 standard deviations (SD), and obesity when the Z score was >2SD. To analyze the association, a Poisson regression model was used, adjusting by age, region, area of residence, socioeconomic status (SES), and the survey design. RESULTS Four DPs were identified: "Traditional", "Industrialized", "Varied", and "Modern". The "Modern" DP was associated with obesity (PR = 1.7) (p < 0.05) compared with the "Traditional" DP. CONCLUSIONS The "Modern" DP could be influencing the development of obesity in Mexican schoolchildren. The promotion of healthy food and public health strategies to those food groups that should be discouraged are necessary to reverse the obesity epidemic in Mexican children.
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Affiliation(s)
- Claudia Gabriela García-Chávez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Juan A Rivera
- Dirección General, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Eric Monterrubio-Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Sonia Rodríguez-Ramírez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
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Chilet-Rosell E, Piay N, Hernández-Aguado I, Lumbreras B, Barrera-Guarderas F, Torres-Castillo AL, Caicedo-Montaño C, Montalvo-Villacis G, Blasco-Blasco M, Rivadeneira MF, Pastor-Valero M, Márquez-Figueroa M, Vásconez JF, Parker LA. Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part I: A Mixed-Methods Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020569. [PMID: 31963116 PMCID: PMC7013726 DOI: 10.3390/ijerph17020569] [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] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/11/2022]
Abstract
Challenges remain for policy adoption and implementation to tackle the unprecedented and relentless increase in obesity, diabetes and other non-communicable diseases (NCDs), especially in low- and middle-income countries. The aim of this mixed-methods study is to analyse the contextual relevance and applicability to low-resource settings of a sample of evidence-based healthy public policies, using local knowledge, perceptions and pertinent epidemiological data. Firstly, we will identify and prioritise policies that have the potential to reduce the burden of diabetes in low-resource settings with a scoping review and modified Delphi method. In parallel, we will undertake two cross-sectional population surveys on diabetes risk and morbidity in two low-resource settings in Ecuador. Patients, community members, health workers and policy makers will analyse the contextual relevance and applicability of the policy actions and discuss their potential for the reduction in inequities in diabetes risk and morbidity in their population. This study tackles one of the greatest challenges in global health today: how to drive the implementation of population-wide preventative measures to fight NCDs in low resource settings. The findings will demonstrate how local knowledge, perceptions and pertinent epidemiological data can be used to analyse the contextual relevance and applicability of potential policy actions.
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Affiliation(s)
- Elisa Chilet-Rosell
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | - Nora Piay
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | - Ildefonso Hernández-Aguado
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | - Blanca Lumbreras
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | | | - Ana Lucía Torres-Castillo
- Institute of Public Health, Pontificia Universidad Católica del Ecuador (PUCE), Quito 170143, Ecuador
| | - Cintia Caicedo-Montaño
- Centre of Community Epidemiology and Tropical Medicine (CECOMET), Esmeraldas 0801265, Ecuador
| | - Gregorio Montalvo-Villacis
- School of Medical Specialities, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito (USFQ), Quito 170901, Ecuador
| | - Mar Blasco-Blasco
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | | | - María Pastor-Valero
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
| | - Mónica Márquez-Figueroa
- Centre of Community Epidemiology and Tropical Medicine (CECOMET), Esmeraldas 0801265, Ecuador
| | - Juan Francisco Vásconez
- Faculty of Nursing, Pontificia Universidad Católica del Ecuador (PUCE), Quito 170143, Ecuador;
| | - Lucy Anne Parker
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Public Health, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
- Correspondence: ; Tel.: +34-96-591-9516
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Mendoza-Herrera K, Pedroza-Tobías A, Hernández-Alcaraz C, Ávila-Burgos L, Aguilar-Salinas CA, Barquera S. Attributable Burden and Expenditure of Cardiovascular Diseases and Associated Risk Factors in Mexico and other Selected Mega-Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4041. [PMID: 31652519 PMCID: PMC6843962 DOI: 10.3390/ijerph16204041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/13/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets. METHODS Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored. RESULTS Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990-2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come. CONCLUSIONS Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.
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Affiliation(s)
- Kenny Mendoza-Herrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Andrea Pedroza-Tobías
- Institute for Global Health Sciences, University of California, San Francisco, CA 94158, USA.
| | - César Hernández-Alcaraz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Leticia Ávila-Burgos
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación de Enfermedades Metabolicas, Mexico City 14080, Mexico.
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City 14080, Mexico.
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, N.L., Mexico.
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
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Double burden of underweight and overweight among women of reproductive age in Bangladesh. Public Health Nutr 2019; 22:3163-3174. [PMID: 31544733 DOI: 10.1017/s1368980019002611] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Bangladesh, like many emerging economies of South-East Asia, has started to experience a double burden of continuing high rates of undernutrition and increasing rates of overweight and obesity. A lack of assessment of the nutritional shift leaves a gap in current policies: the growing overweight and obesity is yet to be addressed. The present paper investigates the change in nutritional status, particularly the shift in BMI, of Bangladeshi women of reproductive age (15-49 years) and characterizes the vulnerable households for both underweight and overweight status during a period of 10 years (2004-2014). DESIGN Generalized linear mixed-effect models were fitted for both urban and rural residents to assess underweight and overweight status. SETTING Bangladesh Demographic and Health Surveys. PARTICIPANTS Women aged 15-49 years (n 53 077). RESULTS The proportion of overweight increased during 2004-2014 from 10·7 to 25·1 % and the proportion of underweight decreased from 32·6 to 18·2 %. Prevalence of underweight status remained high in rural areas and prevalence of overweight increased rapidly in both rural and urban areas, creating a double burden. The significant contributors to this double burden were the change in women's level of education, increased household wealth, divisional location and rapid urbanization. CONCLUSIONS The findings indicate that specific cohort- or area-based intervention policy studies in line with the UN Decade of Action on Nutrition are required to address the nutritional double burden in Bangladesh.
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Leandro CG, Fonseca EVDSD, de Lim CR, Tchamo ME, Ferreira-E-Silva WT. Barriers and Enablers That Influence Overweight/Obesity/Obesogenic Behavior in Adolescents From Lower-Middle Income Countries: A Systematic Review. Food Nutr Bull 2019; 40:562-571. [PMID: 31272220 DOI: 10.1177/0379572119853926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Overweight/obesity during adolescence in lower-middle income countries has become a public health problem with consequences in adulthood. Inadequate dietary habits, poor diet quality, sedentary behavior, and parental obesity have been reported. OBJECTIVE To describe management of obesity-like food habits and behavior of adolescents from lower-middle income countries with respect to what keeps them using this diet (barriers) and what helps them avoid it (enablers). METHODS Systematic review of the literature related to obesity and food intake of adolescents conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS We classified 11 eligible studies describing the barriers to and enablers of the management of obesity-like food intake and obesity lifestyle. The dual burdens of malnutrition and increased urbanization have been observed. There is preference for processed food, dietary habits, and obesity-like food intake and sedentary behavior. Barriers to managing body weight gain included mostly consumption of fast-food and snack food, less vegetable and fruit intake, skipping meals, and sedentary behavior. Enablers of managing body weight gain included changes in nutritional habits, perception of the consumption of healthy food, physical activity, and engagement in programs to change lifestyle. CONCLUSION The globalization of the fast food industry has provided an obesogenic environmental stimulus for adolescents in lower-middle income countries.
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Affiliation(s)
- Carol Góis Leandro
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil.,Department of Physical Education and Sports Science, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | | | - Cybelle Rolim de Lim
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | - Mario Eugénio Tchamo
- Faculty of Physical Education and Sports, Pedagogic University, Maputo, Mozambique
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16
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Pava-Cárdenas A, Vincha KRR, Vieira VL, Cervato-Mancuso AM. Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America. BMC Nutr 2018; 4:34. [PMID: 32153895 PMCID: PMC7050942 DOI: 10.1186/s40795-018-0244-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/12/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Educational interventions designed to promote healthy eating are essential in primary health care. Nevertheless, given the nutrition controversies about what is healthy, the contradictions created by the media, and the situation of users with complex needs, the prioritization of the themes to be addressed in the services has scarcely been described in the planning process. This study aimed to identify the process of implementing the themes discussed by health professionals in nutrition education groups in two primary health care models. METHODS Our study followed a qualitative comparative approach. It included the systematic observation of nutrition education group meetings to identify the key messages addressed and semi-structured interviews with health professionals in São Paulo, Brazil, and in Bogotá, Colombia. We used thematic networks to classify the messages and the collective subject discourse technique to organize the information obtained from interviews. We observed 28 nutrition education groups in São Paulo, and 13 in Bogotá, and conducted 27 interviews with nutritionists in each city. RESULTS The messages identified were grouped into four global themes: feeding habits, life cycle, disease, and "being a multiplier". The process of implementing the themes, understood as identification, selection, consultation, and application of themes, is intermediated by social representations of the health professionals about service requirements, training and professional performance, and the relationship with users. Two notions shape these representations: Control, although the time and the physical space dedicated to health services are restricted to the disease in São Paulo, in Bogotá only limited health promotion is provided; and specificity, which is portrayed as therapeutic support within a more educational model in São Paulo and as health promotion training courses within a prescriptive model in Bogotá. CONCLUSIONS Understanding the process of implementing the themes discussed in nutrition education groups can reveal mechanisms that support the approach to themes on healthy eating, including communicative and educational adaptations of health professionals. This study contributes to the discussion about educational models in health care and their effects on the qualifications of health professionals within the service, especially those included in the context of low- and middle-income settings.
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Affiliation(s)
- Alexandra Pava-Cárdenas
- Nutrition Department, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 –, São Paulo, SP 01246-904 Brazil
| | - Kellem Regina Rosendo Vincha
- Nutrition Department, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 –, São Paulo, SP 01246-904 Brazil
| | | | - Ana Maria Cervato-Mancuso
- Nutrition Department, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 –, São Paulo, SP 01246-904 Brazil
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17
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Barquera S, Schillinger D, Aguilar-Salinas CA, Schenker M, Rodríguez LA, Hernández-Alcaraz C, Sepúlveda-Amor J. Collaborative research and actions on both sides of the US-Mexico border to counteract type 2 diabetes in people of Mexican origin. Global Health 2018; 14:84. [PMID: 30134925 PMCID: PMC6104005 DOI: 10.1186/s12992-018-0390-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/29/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type 2 Diabetes (T2D) is now a massive epidemic in both California and Mexico, with serious consequences for social and economic well-being. A large proportion of these populations share common ethnic backgrounds. Yet diverse environmental and social conditions across regions create unique opportunities to explore the ways that T2D risk, incidence, management and outcomes manifest. MAIN TEXT An action-oriented research consortium headed up by the University of California and Universidad Nacional Autónoma de Mexico was constituted to set priorities for bi-national translational research, in an attempt to implement and evaluate clinical, public health and policy actions to decrease the burden of T2D for people of Mexican origin. In this paper, we describe the epidemiology of T2D in Mexico and California, review current efforts to combat the epidemic, highlight gaps in knowledge and identify urgent areas of opportunity for collaboration. The group has developed a common research agenda and funding has been obtained to evaluate biological samples from the 2016 Mexican Health Survey, collaborate in a telemedicine-based retinopathy project, implement interventions in food banks, promote a communications campaign, and design a large-scale diabetes prevention effectiveness trial. CONCLUSIONS T2D has caused a state of emergency in Mexico and is a major health problem among Mexican populations on both sides of the border. Understanding the commonalities and differences between California and Mexico for those of Mexican origin with respect to T2D, when combined with a sharing of knowledge and advances, can produce a bi-national translational research agenda to inform relevant policy and practice. Amidst economic and political uncertainty and limited healthcare budgets, this collaboration can contribute to the development of scientific evidence to inform policies and interventions. This may provide a promising collaborative model that could be expanded to other health conditions and regions of the world.
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Affiliation(s)
- Simón Barquera
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Dean Schillinger
- UCSF Division of General Internal Medicine at San Francisco General Hospital, 1545 Divisadero St., First and Second Floors, San Francisco, CA 94115 USA
- UCSF Center for Vulnerable Populations, School of Medicine, Department of Medicine, 1001 Potrero Ave, San Francisco, CA 94110 USA
| | - Carlos A. Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan C.P, 14080 Ciudad de Mexico, Mexico
| | - Marc Schenker
- UC Davis School of Medicine, Department of Public Health Sciences, University of California Davis Medical Sciences 1-C, One Shields Avenue, Davis, CA 95616 USA
| | - Luis A. Rodríguez
- UCSF School of Medicine, Department of Epidemiology & Biostatistics, 550 16th St, San Francisco, CA 94158 USA
| | - Cesar Hernández-Alcaraz
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Jaime Sepúlveda-Amor
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- UCSF School of Medicine, Department of Epidemiology & Biostatistics, 550 16th St, San Francisco, CA 94158 USA
- UCSF Institute for Global Health Sciences, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, CA 94158 USA
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18
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Medina C, Janssen I, Barquera S, Bautista-Arredondo S, González ME, González C. Occupational and leisure time physical inactivity and the risk of type II diabetes and hypertension among Mexican adults: A prospective cohort study. Sci Rep 2018; 8:5399. [PMID: 29599426 PMCID: PMC5876361 DOI: 10.1038/s41598-018-23553-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/14/2018] [Indexed: 01/09/2023] Open
Abstract
There is a lack of longitudinal data linking physical inactivity and chronic diseases among Mexicans. Objective. To examine the relationship between total, leisure and occupational moderate-to-vigorous physical activity (MVPA) and incidence of type II diabetes (T2D) and hypertension in the Mexico City Diabetes Study. Study design and population. A prospective cohort study was conducted from 1989 to 2009 among 2282 men and non-pregnant women residing in six low-income neighborhoods in Mexico City. Main outcome. Incidence of T2D and hypertension. Results. After controlling for confounders, <1 MET/min/week of MVPA during leisure time was associated with higher risk of hypertension (HR 1.29, CI 95% 1.01, 1.66) and T2D (HR 1.31 CI 95% 1.00, 1.74). In addition, accumulating <1 MET/min/week of occupational MVPA was associated with higher risk of hypertension (HR 1.47, CI 95% 1.13, 1.90). Conclusion. The absence of leisure and occupational MVPA was associated with an increased risk of hypertension. However, no associations were found between occupational MVPA and T2D.
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Affiliation(s)
- C Medina
- Mexican National Institute of Public Health, Health and Nutrition Research Center, Cuernavaca, Mexico.,Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - I Janssen
- Queen's University, School of Kinesiology and Health Studies, Kingston, Canada
| | - S Barquera
- Mexican National Institute of Public Health, Health and Nutrition Research Center, Cuernavaca, Mexico
| | - S Bautista-Arredondo
- Mexican National Institute of Public Health, Division of Health Economics, Cuernavaca, Mexico
| | - M E González
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - C González
- Mexican National Institute of Public Health, Unit for Research in Diabetes and Cardiovascular Risk, Cuernavaca, Mexico. .,Centro de Estudios en Diabetes, Mexico City, Mexico.
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19
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Ferreira RM, Salis LHA, de Souza E Silva NA. Socioeconomic Development and Cardiovascular Disease. Glob Heart 2018. [PMID: 29525286 DOI: 10.1016/j.gheart.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Ayisi Addo S, Steiner-Asiedu M. Telephone based weight loss intervention: Relevance for developing countries. Crit Rev Food Sci Nutr 2018; 59:2095-2101. [PMID: 29420054 DOI: 10.1080/10408398.2018.1437536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.
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Affiliation(s)
- Sandra Ayisi Addo
- a Department of Nutrition and Food Science , University of Ghana , Legon , Accra , Ghana
| | - Matilda Steiner-Asiedu
- a Department of Nutrition and Food Science , University of Ghana , Legon , Accra , Ghana
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21
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Min J, Zhao Y, Slivka L, Wang Y. Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev 2018; 19:49-61. [PMID: 28940822 PMCID: PMC5962023 DOI: 10.1111/obr.12605] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/13/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This systematic examination and meta-analysis examined the scope and variation of the worldwide double burden of diseases and identified related socio-demographic factors. DESIGN We searched PubMed for studies published in English from January 1, 2000, through September 28, 2016, that reported on double disease burden. Twenty-nine studies from 18 high-income, middle-income and low-income countries met inclusion criteria and provided 71 obesity-undernutrition ratios, which were included in meta-regression analysis. RESULTS All high-income countries had a much higher prevalence of obesity than undernutrition (i.e. all the obesity/undernutrition ratios >1); 55% of the ratios in lower middle-income and low-income countries were <1, but only 28% in upper middle-income countries. Meta-analysis showed a pooled obesity-undernutrition ratio of 4.3 (95% CI = 3.1-5.5), which varied by country income level, subjects' age and over time. The average ratio was higher in high-income rather than that in lower middle-income and low-income countries (β [SE] = 10.8 [2.6]), in adults versus children (7.1 [2.2]) and in data collected since 2000 versus before 2000 (5.2 [1.5]; all P values < 0.05). CONCLUSIONS There are considerable differences in the obesity versus undernutrition ratios and in their prevalence by country income level, age groups and over time, which may be a consequence of the cumulative exposure to an obesogenic environment.
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Affiliation(s)
- Jungwon Min
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA
| | - Yaling Zhao
- Global Health Institute, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lauren Slivka
- School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Youfa Wang
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA.,Global Health Institute, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA
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22
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Medina C, Tolentino-Mayo L, López-Ridaura R, Barquera S. Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes. PLoS One 2017; 12:e0188518. [PMID: 29194458 PMCID: PMC5711014 DOI: 10.1371/journal.pone.0188518] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/08/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Sedentary behaviors such as sitting time are associated with obesity and diabetes independently of total reported physical activity. This study aimed to describe the current sitting time/day prevalence and trends and to examine the association of sitting time with sociodemographic and clinical variables in Mexico City. METHODS Two cross-sectional representative surveys in Mexico City were used for this analysis (2006: n = 1148 and 2015: n = 1329). Sedentary behavior questions from the International Physical Activity Questionnaire included time spent sitting on a weekday in the last week or on a Wednesday. Sitting time /day was divided into deciles, and participants in the highest decile (≥ 420 minutes/day) were classified within the high sitting category; others were classified in the low sitting time category. Multivariate logistic regression was used to evaluate the associations of sitting time with sociodemographic and clinical indicators, controlling for confounders and testing for potential interactions. RESULTS A total of 13.7% (2006) and 14.8% (2015) adults were classified in the highest sitting time category (≥ 420 minutes/day). There was a significant increase in the average sitting time/day between the surveys (216.0 minutes in 2006 vs. 233.3 minutes in 2015, p < 0.001). In 2015, men, those aged 20-49 years, those in low-intensity jobs, students, and those with a high socioeconomic level were more likely to be in the highest sitting time category. Participants with overweight/obesity (OR = 2.37, 95% CI: 1.11, 5.09) and those with high glucose levels (survey finding) (OR = 2.34, 95% CI: 1.04, 5.25) were more likely to report sitting time in the highest category. DISCUSSION Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006-2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico.
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Affiliation(s)
- Catalina Medina
- Mexican National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Ruy López-Ridaura
- Mexican National Institute of Public Health, Cuernavaca, Morelos, México
| | - Simón Barquera
- Mexican National Institute of Public Health, Cuernavaca, Morelos, México
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Mendoza-Herrera K, Quezada AD, Pedroza-Tobías A, Hernández-Alcaraz C, Fromow-Guerra J, Barquera S. A Diabetic Retinopathy Screening Tool for Low-Income Adults in Mexico. Prev Chronic Dis 2017; 14:E95. [PMID: 29023230 PMCID: PMC5645201 DOI: 10.5888/pcd14.170157] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION A national diabetic retinopathy screening program does not exist in Mexico as of 2017. Our objective was to develop a screening tool based on a predictive model for early detection of diabetic retinopathy in a low-income population. METHODS We analyzed biochemical, clinical, anthropometric, and sociodemographic information from 1,000 adults with diabetes in low-income communities in Mexico (from 11,468 adults recruited in 2014-2016). A comprehensive ophthalmologic evaluation was performed. We developed the screening tool through the following stages: 1) development of a theoretical predictive model, 2) performance assessment and validation of the model using cross-validation and the area under the receiver operating characteristic curve (AUC ROC), and 3) optimization of cut points for the classification of diabetic retinopathy. We identified points along the AUC ROC that minimized the misclassification cost function and considered various scenarios of misclassification costs and diabetic retinopathy prevalence. RESULTS Time since diabetes diagnosis, high blood glucose levels, systolic hypertension, and physical inactivity were considered risk factors in our screening tool. The mean AUC ROC of our model was 0.780 (validation data set). The optimized cut point that best represented our study population (z = -0.640) had a sensitivity of 82.9% and a specificity of 61.9%. CONCLUSION We developed a low-cost and easy-to-apply screening tool to detect people at high risk of diabetic retinopathy in Mexico. Although classification performance of our tool was acceptable (AUC ROC > 0.75), error rates (precision) depend on false-negative and false-positive rates. Therefore, confirmatory assessment of all cases is mandatory.
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Affiliation(s)
- Kenny Mendoza-Herrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Amado D Quezada
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Andrea Pedroza-Tobías
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Cesar Hernández-Alcaraz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Jans Fromow-Guerra
- Association for the Prevention of Blindness in Mexico, México City, México
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México.,Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México, Avenida Universidad #655 Col. Sta. Ma. Ahuacatitlán, CP 62100.
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The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr 2017; 21:94-102. [DOI: 10.1017/s1368980017001434] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo estimate the dietary share of ultra-processed foods and to determine its association with the overall nutritional quality of diets in Brazil.DesignCross-sectional.SettingBrazil.SubjectsA representative sample of 32 898 Brazilians aged ≥10 years was studied. Food intake data were collected. We calculated the average dietary content of individual nutrients and compared them across quintiles of energy share of ultra-processed foods. Then we identified nutrient-based dietary patterns, and evaluated the association between quintiles of dietary share of ultra-processed foods and the patterns’ scores.ResultsThe mean per capita daily dietary energy intake was 7933 kJ (1896 kcal), with 58·1 % from unprocessed or minimally processed foods, 10·9 % from processed culinary ingredients, 10·6 % from processed foods and 20·4 % from ultra-processed foods. Consumption of ultra-processed foods was directly associated with high consumption of free sugars and total, saturated and trans fats, and with low consumption of protein, dietary fibre, and most of the assessed vitamins and minerals. Four nutrient-based dietary patterns were identified. ‘Healthy pattern 1’ carried more protein and micronutrients, and less free sugars. ‘Healthy pattern 2’ carried more vitamins. ‘Healthy pattern 3’ carried more dietary fibre and minerals and less free sugars. ‘Unhealthy pattern’ carried more total, saturated and trans fats, and less dietary fibre. The dietary share of ultra-processed foods was inversely associated with ‘healthy pattern 1’ (−0·16; 95 % CI −0·17, −0·15) and ‘healthy pattern 3’ (−0·18; 95 % CI −0·19, −0·17), and directly associated with ‘unhealthy pattern’ (0·17; 95 % CI 0·15, 0·18).ConclusionsDietary share of ultra-processed foods determines the overall nutritional quality of diets in Brazil.
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Abstract
Noncommunicable and chronic disease are interchangeable terms. According to the World Health Organization, "they are of long duration and generally slow progression. The 4 main types of chronic diseases are cardiovascular diseases (ie, heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes." We have known about the benefits of physical activity (PA) for thousands of years. Perhaps our approach, from public health messaging to the individual clinical encounter, as to how PA and exercise are discussed and prescribed can be improved upon, with the ultimate goal of increasing the likelihood that an individual moves more; ultimately moving more should be the goal. In fact, there is an incongruence between the evidence for the benefits of physical movement and how we message and integrate PA and exercise guidance into health care, if it is discussed at all. Specifically, evidence clearly indicates any migration away from the sedentary phenotype toward a movement phenotype is highly beneficial. As we necessarily move to a proactive, preventive healthcare model, we must reconceptualize how we evaluate and treat conditions that pose the greatest threat, namely chronic disease; there is a robust body of evidence supporting the premise of movement as medicine. The purpose of this perspective paper is to propose an alternate model for promoting, assessing, discussing, and prescribing physical movement.
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Romieu I, Dossus L, Barquera S, Blottière HM, Franks PW, Gunter M, Hwalla N, Hursting SD, Leitzmann M, Margetts B, Nishida C, Potischman N, Seidell J, Stepien M, Wang Y, Westerterp K, Winichagoon P, Wiseman M, Willett WC. Energy balance and obesity: what are the main drivers? Cancer Causes Control 2017; 28:247-258. [PMID: 28210884 PMCID: PMC5325830 DOI: 10.1007/s10552-017-0869-z] [Citation(s) in RCA: 387] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/06/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE The aim of this paper is to review the evidence of the association between energy balance and obesity. METHODS In December 2015, the International Agency for Research on Cancer (IARC), Lyon, France convened a Working Group of international experts to review the evidence regarding energy balance and obesity, with a focus on Low and Middle Income Countries (LMIC). RESULTS The global epidemic of obesity and the double burden, in LMICs, of malnutrition (coexistence of undernutrition and overnutrition) are both related to poor quality diet and unbalanced energy intake. Dietary patterns consistent with a traditional Mediterranean diet and other measures of diet quality can contribute to long-term weight control. Limiting consumption of sugar-sweetened beverages has a particularly important role in weight control. Genetic factors alone cannot explain the global epidemic of obesity. However, genetic, epigenetic factors and the microbiota could influence individual responses to diet and physical activity. CONCLUSION Energy intake that exceeds energy expenditure is the main driver of weight gain. The quality of the diet may exert its effect on energy balance through complex hormonal and neurological pathways that influence satiety and possibly through other mechanisms. The food environment, marketing of unhealthy foods and urbanization, and reduction in sedentary behaviors and physical activity play important roles. Most of the evidence comes from High Income Countries and more research is needed in LMICs.
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Affiliation(s)
- Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France.
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Hervé M Blottière
- Micalis Institute, MGP MetagenoPolis, INRA, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Paul W Franks
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, CRC, University hospital Malmö, Malmö, Sweden
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Nahla Hwalla
- Faculty of Agricultural and Food Science, American University of Beirut, Beirut, Lebanon
| | - Stephen D Hursting
- Department of Nutrition and the Nutrition Research Institute, The University of North Carolina, Chapel Hill, USA
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Barrie Margetts
- Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Chizuru Nishida
- Nutrition Policy and Scientific Advice (NPU), Department of Nutrition for Health and Development (NHD), World Health Organization (WHO), Geneva, Switzerland
| | - Nancy Potischman
- Office of the Associate Director, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA
| | - Jacob Seidell
- Faculty of Earth and Life Sciences, Department of Health Sciences, University Amsterdam, Amsterdam, The Netherlands
| | - Magdalena Stepien
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Youfa Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, Joint Appointments, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, USA
| | - Klaas Westerterp
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | | | | | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
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Welcome to Progress in Preventive Medicine from the Editorial Board. PROGRESS IN PREVENTIVE MEDICINE 2016. [DOI: 10.1097/pp9.0000000000000001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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