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Mackay S, Gerritsen S, Sing F, Vandevijvere S, Swinburn B. Implementing healthy food environment policies in New Zealand: nine years of inaction. Health Res Policy Syst 2022; 20:8. [PMID: 35033119 PMCID: PMC8760574 DOI: 10.1186/s12961-021-00809-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 12/16/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The INFORMAS [International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support] Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. METHODS In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 "good practice" policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritized concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. RESULTS In 2020, 60% of the indicators were rated as having "low" or "very little, if any" implementation compared to international benchmarks: less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multisectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. CONCLUSIONS There has been little to no progress in the past three terms of government (9 years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many government entities to overcome the existing policy inertia. The increase in food insecurity due to COVID-19 lockdowns may provide the impetus to stimulate action on food polices.
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Affiliation(s)
- Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, 1023, New Zealand.
| | - Sarah Gerritsen
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, 1023, New Zealand
- Centre for Longitudinal Research He Ara Ki Mua, School of Population Health, University of Auckland, Auckland, 1743, New Zealand
| | - Fiona Sing
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, 1023, New Zealand
| | - Stefanie Vandevijvere
- Sciensano (Scientific Institute of Public Health), Epidemiology and Public Health, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Boyd Swinburn
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, 1023, New Zealand
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Ramadan FA, Bea JW, Garcia DO, Ellingson KD, Canales RA, Raichlen DA, Klimentidis YC. Association of sedentary and physical activity behaviours with body composition: a genome-wide association and Mendelian randomisation study. BMJ Open Sport Exerc Med 2022; 8:e001291. [PMID: 35990758 PMCID: PMC9351346 DOI: 10.1136/bmjsem-2021-001291] [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] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Studies suggest that body composition can be independently improved through physical activity (PA). We performed a Mendelian randomisation (MR) study to test the incremental benefits of sedentary behaviour and various PA exposures on body composition outcomes as assessed by anthropometric indices, lean body mass (kg), body fat (%) and visceral adipose tissue (VAT) (kg). Methods Genetic instruments were identified for both self-reported and accelerometer-measured sedentary behaviour and PA. Outcomes included anthropometric and dual-energy X-ray absorptiometry measures of adiposity, extracted from the UK Biobank and the largest available consortia. Multivariable MR (MVMR) included educational attainment as a covariate to address potential confounding. Sensitivity analyses were evaluated for weak instrument bias and pleiotropic effects. Results We did not identify consistent associations between genetically predicted self-reported and accelerometer-measured sedentary behaviour and body composition outcomes. All analyses for self-reported moderate PA were null for body composition outcomes. Genetically predicted PA at higher intensities was protective against VAT in MR and MVMR analyses of both accelerometer-measured vigorous PA (MVMR β=-0.15, 95% CI: -0.24 to -0.07, p<0.001) and self-reported participation in strenuous sports or other exercises (MVMR β=-0.27, 95% CI: -0.52 to -0.01, p=0.034) was robust across several sensitivity analyses. Conclusions We did not identify evidence of a causal relationship between genetically predicted PA and body composition, with the exception of a putatively protective effect of higher-intensity PA on VAT. Protective effects of PA against VAT may support prior evidence of biological pathways through which PA decreases risk of downstream cardiometabolic diseases.
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Affiliation(s)
- Ferris A Ramadan
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, USA
| | - Jennifer W Bea
- Department of Medicine, The University of Arizona, Tucson, Arizona, USA.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona, USA
| | - Katherine D Ellingson
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, USA
| | - Robert A Canales
- Milken Institute of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - David A Raichlen
- Department of Biological Sciences, University of Southern California, Los Angeles, California, USA
| | - Yann C Klimentidis
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, USA
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Fisher L, Dahal M, Hawkes S, Puri M, Buse K. Barriers and opportunities to restricting marketing of unhealthy foods and beverages to children in Nepal: a policy analysis. BMC Public Health 2021; 21:1351. [PMID: 34238256 PMCID: PMC8268610 DOI: 10.1186/s12889-021-11257-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Marketing of foods and non-alcoholic beverages high in saturated fats, trans-fatty acids, free sugars, or salt ("unhealthy foods") to children is contributing to increasing child obesity. However, many countries have not implemented WHO recommendations to restrict marketing of unhealthy foods to children. We sought to understand the absence of marketing restrictions and identify potential strategic actions to develop and implement such restrictions in Nepal. METHODS Eighteen semi-structured interviews were conducted. Thematic analysis was based on Baker et al.'s 18 factor-framework for understanding what drives political commitment to nutrition, organised by five categories: Actors; Institutions; Political and societal contexts; Knowledge, evidence and framing; Capacities and resources. RESULTS All factors in Baker et al.'s framework were reported to be acting largely as barriers to Nepal developing and implementing marketing restrictions. Six factors were identified by the highest number of respondents: the threat of private sector interference in policy-making; lack of international actor support; absence of well-designed and enacted policies and legislation; lack of political commitment to regulate; insufficient mobilisation of existing evidence to spur action and lack of national evidence to guide regulatory design; and weak implementation capacity. Opportunities for progress were identified as Nepal's ability to combat private sector interference - as previously demonstrated in tobacco control. CONCLUSIONS This is the first study conducted in Nepal examining the lack of restrictions on marketing unhealthy foods to children. Our findings reflect the manifestation of power in the policy process. The absence of civil society and a multi-stakeholder coalition demanding change on marketing of unhealthy food to children, the threat of private sector interference in introducing marketing restrictions, the promotion of norms and narratives around modernity, consumption and the primary role of the individual in regulating diet - all have helped create a policy vacuum on marketing restrictions. We propose that stakeholders focus on five strategic actions, including: developing a multi-stakeholder coalition to put and keep marketing restrictions on the health agenda; framing the need for marketing restrictions as critical to protect child rights and government regulation as the solution; and increasing support, particularly through developing more robust global policy guidance.
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Affiliation(s)
- Laura Fisher
- Indo-Pacific Centre for Health Security, Canberra, Australia
| | - Minakshi Dahal
- Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal
| | - Sarah Hawkes
- Institute for Global Health, Faculty of Population Health Sciences, University College London, London, England.
| | - Mahesh Puri
- Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal
| | - Kent Buse
- Global Healthier Societies Program, The George Institute, Newtown, Australia
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Alaba OA, Hongoro C, Thulare A, Lukwa AT. Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7114. [PMID: 34281051 PMCID: PMC8296912 DOI: 10.3390/ijerph18137114] [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: 04/13/2021] [Revised: 06/01/2021] [Accepted: 06/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The United Nations' 2030 Agenda for Sustainable Development argues for the combating of health inequalities within and among countries, advocating for "leaving no one behind". However, child mortality in developing countries is still high and mainly driven by lack of immunization, food insecurity and nutritional deficiency. The confounding problem is the existence of socioeconomic inequalities among the richest and poorest. Thus, comparing South Africa's and India's Demographic and Health Surveys (DHS) of 2015/16, this study examines socioeconomic inequalities in under-five children's health and its associated factors using three child health indications: full immunization coverage, food insecurity and malnutrition. METHODS Erreygers Normalized concentration indices were computed to show how immunization coverage, food insecurity and malnutrition in children varied across socioeconomic groups (household wealth). Concentration curves were plotted to show the cumulative share of immunization coverage, food insecurity and malnutrition against the cumulative share of children ranked from poorest to richest. Subsequent decomposition analysis identified vital factors underpinning the observed socioeconomic inequalities. RESULTS The results confirm a strong socioeconomic gradient in food security and malnutrition in India and South Africa. However, while full childhood immunization in South Africa was pro-poor (-0.0236), in India, it was pro-rich (0.1640). Decomposed results reported socioeconomic status, residence, mother's education, and mother's age as primary drivers of health inequalities in full immunization, food security and nutrition among children in both countries. CONCLUSIONS The main drivers of the socioeconomic inequalities in both countries across the child health outcomes (full immunization, food insecurity and malnutrition) are socioeconomic status, residence, mother's education, and mother's age. In conclusion, if socioeconomic inequalities in children's health especially food insecurity and malnutrition in South Africa; food insecurity, malnutrition and immunization in India are not addressed then definitely "some under-five children will be left behind".
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Affiliation(s)
- Olufunke A. Alaba
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
| | - Charles Hongoro
- Developmental, Capable and Ethical State, Human Sciences Research Council, Pretoria 0001, South Africa;
- School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Aquina Thulare
- National Department of Health, Pretoria 0001, South Africa;
| | - Akim Tafadzwa Lukwa
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
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Cerf ME. Healthy lifestyles and noncommunicable diseases: Nutrition, the life‐course, and health promotion. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Marlon E. Cerf
- Grants, Innovation and Product Development South African Medical Research Council Cape Town South Africa
- Biomedical Research and Innovation Platform South African Medical Research Council Cape Town South Africa
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Liu X, Li W, Wen Y, Xu G, Zhou G, Qu Q, Hu Y, Saitierding Y, Mohetaer M, Buerlan Y, Zhong X, Xi H. Obesity and Heath-Carter Somatotyping of 3438 Adults in the Xinjiang Uygur Autonomous Region of China by Multivariate Analysis. Diabetes Metab Syndr Obes 2021; 14:659-670. [PMID: 33623401 PMCID: PMC7894874 DOI: 10.2147/dmso.s287954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION This study aimed to investigate the somatotype and obesity of adults in the Xinjiang Uygur Autonomous Region of China and to explore multivariate path analysis for the feasibility and scientificity of using somatotypes to evaluate obesity. SUBJECTS AND METHODS According to anthropometric methods, a cross-sectional study was performed on 10 indexes of 3438 adults (1690 men and 1748 women, aged > 20 years) living in the Xinjiang Uygur Autonomous Region of China (including Kazakh, Kyrgyz, Xibe, Uzbek, Tatar and Tajik). The Heath-Carter anthropometric method and body mass index (BMI) were used to evaluate somatotype and obesity, respectively. The feasibility and scientificity of using somatotypes to evaluate obesity were analysed by correspondence analysis. RESULTS Among the six populations, the somatotypes were mainly distributed as endomorphic mesomorph, mesomorph-endomorph and mesomorphic endomorph populations, accounting for 66.5% of males and 78.8% of females. The obesity rate (27.4% in males, 27.8% in females) of the six populations in the Xinjiang Uygur Autonomous Region of China was much higher than the average Chinese adult obesity rate (12.1%) and the global adult obesity rate (male: 11%, female: 15%). The distribution of BMI was significantly different (male: P=0.000, female: P=0.033) in different populations, and the incidence of overweight and obesity in the Xinjiang Uygur Autonomous Region of China increased gradually. This study found that there were significant differences in somatotype distribution among different obesity groups in the Xinjiang Uygur Autonomous Region of China (P=0.000). There was a strong correlation between overweight or obesity and endomorph-mesomorph, endomorphic mesomorph and mesomorphic endomorph. Furthermore, this study indicated that using somatotypes to evaluate obesity was reliable and scientific. CONCLUSION This study concluded that the somatotype of overweight or obese people was mainly related to endomorphic mesomorph, mesomorph-endomorph, and mesomorphic endomorph.
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Affiliation(s)
- Xiaoyuan Liu
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
- Department of Prosthodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Wenhui Li
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Youfeng Wen
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
- Correspondence: Youfeng Wen Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, 121001, People’s Republic of ChinaTel +86 18641602627 Email
| | - Guochang Xu
- Institute of Anthropology, Nanyang Institute of Technology, Nanyang, People’s Republic of China
| | - Guojian Zhou
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Quanying Qu
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Ying Hu
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Yueriguli Saitierding
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Maierdanjang Mohetaer
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Yeerkenbieke Buerlan
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Xuejun Zhong
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Huanjiu Xi
- Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China
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Socioeconomic inequalities in food insecurity and malnutrition among under-five children: within and between-group inequalities in Zimbabwe. BMC Public Health 2020; 20:1199. [PMID: 32753035 PMCID: PMC7406388 DOI: 10.1186/s12889-020-09295-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background Food insecurity and malnutrition in children are pervasive public health concerns in Zimbabwe. Previous studies only identified determinants of food insecurity and malnutrition with very little efforts done in assessing related inequalities and decomposing the inequalities across household characteristics in Zimbabwe. This study explored socioeconomic inequalities trend in child health using regression decomposition approach to compare within and between group inequalities. Methods The study used Demographic Health Survey (DHS) data sets of 2010\11 and 2015. Food insecurity in under-five children was determined based on the WHO dietary diversity score. Minimum dietary diversity was defined by a cut- off point of > 4 therefore, children with at least 3 of the 13 food groups were defined as food insecure. Malnutrition was assessed using weight for age (both acute and chronic under-nutrition) Z-scores. Children whose weight-for-age Z-score below minus two standard deviations (− 2 SD) from the median were considered malnourished. Concentration curves and indices were computed to understand if malnutrition was dominant among the poor or rich. The study used the Theil index and decomposed the index by population subgroups (place of residence and socioeconomic status). Results Over the study period, malnutrition prevalence increased by 1.03 percentage points, while food insecurity prevalence decreased by 4.35 percentage points. Prevalence of malnutrition and food insecurity increased among poor rural children. Theil indices for nutrition status showed socioeconomic inequality gaps to have widened, while food security status socioeconomic inequality gaps contracted for the period under review. Conclusion The study concluded that unequal distribution of household wealth and residence status play critical roles in driving socioeconomic inequalities in child food insecurity and malnutrition. Therefore, child food insecurity and malnutrition are greatly influenced by where a child lives (rural/urban) and parental wealth.
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Popkin BM. Odyssey of a small-town midwestern boy to a scholarly path. Eur J Clin Nutr 2020; 74:979-982. [PMID: 32042134 PMCID: PMC7340620 DOI: 10.1038/s41430-020-0577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 11/30/2022]
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Mierzejewska E, Honorato-Rzeszewicz T, Świątkowska D, Jurczak-Czaplicka M, Maciejewski T, Fijałkowska A, Szulc-Kamińska J, Czach A, Nałecz H, Szostak-Węgierek D, Szamotulska K. Evaluation of questionnaire as an instrument to measure the level of nutritional and weight gain knowledge in pregnant women in Poland. A pilot study. PLoS One 2020; 15:e0227682. [PMID: 31940402 PMCID: PMC6961901 DOI: 10.1371/journal.pone.0227682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/26/2019] [Indexed: 11/18/2022] Open
Abstract
Pregnancy is a period in life in which women are willing to improve their lifestyle. Providing proper information for these women is crucial for their health and the health of their offspring. Clear information about weak points in their nutritional and weight gain knowledge is the first step for proper health care assistance. There are a few previous studies evaluating the nutritional and weight gain knowledge of pregnant women. In the few studies available, different approaches were taken and there was no wider discussion on the content of the questionnaires attempting to measure level of knowledge. The aim of this study, designed in a pilot fashion, was to test the adequacy of the questionnaire as a research instrument in a group of 139 pregnant Polish women. The developed instrument is a 33-item questionnaire comprising four domains: weight gain, importance of nutrients, quality and quantity of food intake. The results of this study indicate that the questionnaire is stable and internal consistency is acceptable (Cronbach’s alpha > 0.7) for dimensions with more than four items. For dimensions with less than four items, internal consistency was poor (Cronbach’s alpha < 0.7). The cumulative explained variance for domains weight gain, importance of nutrients, quantity and quality of food intake was 54.74%, 42.74%, 54.42% and 48.99% respectively. Results from validity, reliability and factor analysis indicate that the questionnaire is adequate for its purpose.
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Affiliation(s)
- Ewa Mierzejewska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland
| | | | - Dorota Świątkowska
- Obstetrics and Gynecology Clinic, Institute of Mother and Child, Warsaw, Poland
| | | | - Tomasz Maciejewski
- Obstetrics and Gynecology Clinic, Institute of Mother and Child, Warsaw, Poland
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | | | - Anna Czach
- Obstetrics and Gynecology Clinic, Institute of Mother and Child, Warsaw, Poland
| | - Hanna Nałecz
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | | | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland
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Reyes Matos U, Mesenburg MA, Victora CG. Socioeconomic inequalities in the prevalence of underweight, overweight, and obesity among women aged 20-49 in low- and middle-income countries. Int J Obes (Lond) 2019; 44:609-616. [PMID: 31852998 PMCID: PMC7046525 DOI: 10.1038/s41366-019-0503-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 11/08/2019] [Accepted: 12/01/2019] [Indexed: 11/09/2022]
Abstract
Objective To analyze socioeconomic inequalities in the prevalence of underweight and overweight or obesity in women from low and middle-income countries (LMICs). Methods Using the last available Demographic Health Survey between 2010 and 2016 from 49 LMICs, we estimated the prevalence of underweight (BMI < 18.5 kg/m2) and overweight or obesity combined (BMI ≥ 25 kg/m2) for women aged 20–49 years. We used linear regression to explore the associations between the two outcomes and gross national income (GNI). We assess within-country socioeconomic inequalities using wealth deciles. The slope index of inequality (SII) and the inequality pattern index (IPI) were calculated for each outcome. Negative values of the latter express bottom inequality (when inequality is driven by the poorest deciles) while positive values express top inequality (driven by the richest deciles). Results In total, 931,145 women were studied. The median prevalence of underweight, overweight or obesity combined, and obesity were 7.3% (range 0.2–20.5%), 31.5% (8.8–85.3%), and 10.2% (1.9–48.8%), respectively. Pearson correlation coefficients with log GNI were −0.33 (p = 0.006) for underweight, 0.72 (p < 0.001) for overweight or obesity, and 0.66 (p < 0.001) for obesity. For underweight, the SII was significantly negative in 38 of the 49 countries indicating a higher burden among poor women. There was no evidence of top or bottom inequality. Overweight or obesity increased significantly with wealth in 44 of the 49 countries. Top inequality was observed in low-prevalence countries, and bottom inequality in high-prevalence countries. Conclusion Underweight remains a problem among the poorest women in poor countries, but overweight and obesity are the prevailing problem as national income increases. In low-prevalence countries, overweight or obesity levels are driven by the higher prevalence among the richest women; as national prevalence increases, only the poorest women are relatively preserved from the epidemic.
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Affiliation(s)
- Ursula Reyes Matos
- International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro 1160, Pelotas, Rio Grande do Sul, Brazil.
| | - Marilia Arndt Mesenburg
- International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro 1160, Pelotas, Rio Grande do Sul, Brazil
| | - Cesar G Victora
- International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro 1160, Pelotas, Rio Grande do Sul, Brazil
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Jayawardene W, Pınar S, Torabi M, Xun P, Özer M. Obesity perception survey among youth in Turkey: instrument development and test-retest reliability. Turk J Med Sci 2019; 49:1228-1235. [PMID: 31287249 PMCID: PMC7018321 DOI: 10.3906/sag-1811-56] [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] [Indexed: 11/10/2022] Open
Abstract
Background/aim We aimed to develop an instrument that can assess the perceptions and opinions of young people regarding the causes and consequences of obesity and the role of individuals, families, communities, and government in addressing obesity. Materials and methods A 36-question (101-item) survey was developed by adopting, translating, and revising multiple-choice or Likert-scale questions from existing surveys to assure construct cross-cultural validity. A two-factor mixed-effects model estimated the intraclass correlation coefficient (ICC) to measure the test-retest reliability of questions administered 2 weeks apart to a convenient sample of İstanbul high school and university students, aged 15–25 years (n = 122). Results The mean ICC for university and high school was 0.70 and 0.63, respectively. University students were more consistent in relating the problem to society and public policy preferences. High school students were more consistent in relating the problem and solution to themselves and their immediate environments. Using a 0.5 cutoff for the ICC’s lower 95% confidence limit, followed by reevaluation of the question flow, a 19-question (36-item) survey was retained for adolescents and a 26-question (52-item) survey for young adults. Conclusion While the survey items have moderate to excellent reliability for high school and university students, it can be administered longitudinally to suggest changes to policies and interventions, and after cross-cultural validation, it can be utilized to compare obesity perceptions across different populations.
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Affiliation(s)
- Wasantha Jayawardene
- School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Salih Pınar
- Faculty of Sports Science, Marmara University, İstanbul, Turkey
| | - Mohammad Torabi
- School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Pengcheng Xun
- School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Mustafa Özer
- Faculty of Sports Science, İstanbul Gedik University, İstanbul, Turkey
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Abstract
The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies - both at the individual and population level - have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.
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Affiliation(s)
- Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany.
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Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed A, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019; 393:791-846. [PMID: 30700377 DOI: 10.1016/s0140-6736(18)32822-8] [Citation(s) in RCA: 1191] [Impact Index Per Article: 238.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia.
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Steven Allender
- Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia
| | | | - Phillip I Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Jessica R Bogard
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | | | | | - Olivier De Schutter
- Institute for Interdisciplinary Research in Legal Sciences, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Raji Devarajan
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, ACT, Australia
| | - Shifalika Goenka
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Ross A Hammond
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA; Public Health & Social Policy Department, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Gerard Hastings
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University, University of London, London, UK
| | - Mario Herrero
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Peter S Hovmand
- Social System Design Lab, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Mark Howden
- Climate Change Institute, Australian National University, Canberra, ACT, Australia
| | - Lindsay M Jaacks
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ariadne B Kapetanaki
- Department of Marketing and Enterprise, Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
| | - Matt Kasman
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Michael W Long
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Victor K R Matsudo
- Physical Fitness Research Laboratory of São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
| | - Susanna D H Mills
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Alexandra Morshed
- Prevention Research Center, Brown School, Washington University in St Louis, St Louis, MO, USA
| | | | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Meera Shekar
- Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA
| | | | - Warren Smit
- African Centre for Cities, University of Cape Town, Cape Town, South Africa
| | - Ali Tootee
- Diabetes Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Stefanie Vandevijvere
- School of Population Health, University of Auckland, Auckland, New Zealand; Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Wilma E Waterlander
- Department of Public Health Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - William H Dietz
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Bergallo P, Castagnari V, Fernández A, Mejía R. Regulatory initiatives to reduce sugar-sweetened beverages (SSBs) in Latin America. PLoS One 2018; 13:e0205694. [PMID: 30339667 PMCID: PMC6195269 DOI: 10.1371/journal.pone.0205694] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/28/2018] [Indexed: 11/18/2022] Open
Abstract
Background and objectives Latin American (LA) countries have begun to adopt a variety of regulations targeting sugar-sweetened beverages (SSBs) for public health reasons. Our objective was to characterize the regulatory strategies designed to reduce SSB consumption over the last decade, and assess the available evidence on their enforcement and impact. Methods We searched legal and public health databases for public and private SSBs regulations in 14 LA countries and then conducted a systematic review of the available literature. We tracked comparative variations in the type of body issuing the regulations, their scope, and binding status. We present data following a 5-category framework we named NUTRE that classifies SSBs regulations as: (1) restrictions to SSB availability in schools (N), (2) taxes and other economic incentives to discourage consumption (U), (3) restrictions on advertising and marketing (T), (4) regulations on government procurement and subsidies (R), and (5) product labeling rules (E). Results Since 2006, 14 LA countries have adopted at least 39 public and private SSB regulatory initiatives across the NUTRE framework. Comprehensive efforts have only been approved by Chile, México and Ecuador, while the rest have comparatively few initiatives. 28 out of the 39 regulatory initiatives were passed by legislative and executive bodies; 11 initiatives represent self-regulatory undertakings by the beverage industries. An 86% (24/28) of public sector regulations are binding; 56% (22/39) contain explicit monitoring or evaluation methods; and 62% (24/39) provide for sanctions. Moreover, 23 regulations specify the body in charge of monitoring the new rules and standards. Conclusions LA countries are targeting SSB consumption through a variety of mechanisms, particularly via restrictions to availability in schools and through taxes. Interdisciplinary evidence comparing alternative regulatory strategies is scarce, and few studies offer data on impact and implementation challenges. More evidence and further comparative assessments are needed to support future decision-making.
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Affiliation(s)
- Paola Bergallo
- Law Department, Universidad Torcuato Di Tella, Ciudad Autónoma de Buenos Aires, Argentina
- * E-mail:
| | - Valentina Castagnari
- Law Department, Universidad Torcuato Di Tella, Ciudad Autónoma de Buenos Aires, Argentina
| | - Alicia Fernández
- University of California San Francisco, San Francisco, California, United States of America
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina
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15
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Barquera S, García-Chávez CG, Navarro-Rosenblatt D, Uauy R, Pérez-Escamilla R, Martorell R, Ramírez-Zea M, Sánchez-Bazán K. Postura de la Sociedad Latinoamericana de Nutrición (SLAN) sobre el manejo de conflicto de intereses. ACTA ACUST UNITED AC 2018; 60:592-597. [DOI: 10.21149/9657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/29/2018] [Indexed: 01/26/2023]
Abstract
Existe evidencia sólida de la existencia de relaciones entre la industria de alimentos y bebidas y la academia. Ésta sugiere que la investigación patrocinada por la industria es susceptible de conferir sesgos a su favor en los resultados. En América Latina, se han documentado ejemplos de estas situaciones en México, Brasil, Chile, Perú, Colombia y Ecuador, por citar a algunos países. Ante la necesidad urgente de estudiar y gestionar las relaciones entre la industria de alimentos y bebidas y el campo de investigación en salud y nutrición, en 2017 el Presidente de la Sociedad Latinoamericana de Nutrición (SLAN) designó a un Comité de Conflicto de Intereses (CCI). El CCI tuvo la encomienda de hacer una propuesta de postura sobre manejo de conflicto de intereses (CDI) de la SLAN. El presente artículo refleja los trabajos del CCI y la postura que adoptó la SLAN.
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16
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Visscher TL, Lakerveld J, Olsen N, Küpers L, Ramalho S, Keaver L, Brei C, Bjune JI, Ezquerro S, Yumuk V. Perceived Health Status: Is Obesity Perceived as a Risk Factor and Disease? Obes Facts 2017; 10:52-60. [PMID: 28278496 PMCID: PMC5644964 DOI: 10.1159/000457958] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
One might expect that a perception of obesity being a risk factor and disease, contributes to effective obesity prevention and management strategies. However, obesity rates continue to increase worldwide. The question arises whether obesity is truly perceived as a risk factor and a disease. This paper aims at describing perception of obesity as risk factor and disease among individuals seeking care, individuals not seeking care, the society, and different professionals having a role in the field of obesity. The paper is a reflection of the lecture on the topic that was given at the EASO's New Investigators United's Summer School 2016 in Portugal and the discussion with the new investigators and other senior speakers. Individual obese patients seeking help are very much aware of obesity being a risk factor and disease, but perceptions regarding obesity seem to be flawed among those who do not seek help for obesity. Also, misperceptions regarding obesity play a role at different levels, including society, different political levels, the fields of health care and social work, prevention organizations, and the food and marketing industry. The food and marketing industry has an enormous role in changing perceptions by the society and policy makers. Obesity rates will continue to increase as long as individuals, the society, and professionals at different levels have false interpretations of the severity of obesity. Severe action is needed against those who are playing a role in maintaining false perceptions of obesity as a risk factor and disease.
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Affiliation(s)
- Tommy L.S. Visscher
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Research Centre for Healthy Cities, Windesheim University of Applied Sciences, Zwolle, The Netherlands, Istanbul, Turkey
- European Association for the Study of Obesity, Patient Council and Prevention and Public Health Taskforce, Founding Chair New Investigators United, London, UK, Istanbul, Turkey
| | - Jeroen Lakerveld
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands, Istanbul, Turkey
| | - Nanna Olsen
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, the Capital Region, Copenhagen, Denmark, Istanbul, Turkey
| | - Leanne Küpers
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Istanbul, Turkey
| | - Sofia Ramalho
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- School of Psychology, University of Minho, Braga, Portugal, Istanbul, Turkey
| | - Laura Keaver
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Department of Life Sciences, Institute of Technology Sligo, Sligo, Ireland, Istanbul, Turkey
| | - Christina Brei
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Else Körner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, Istanbul, Turkey
| | - Jan-Inge Bjune
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway, Istanbul, Turkey
- Department of Clinical Science K2 and KG Jebsen Center for Diabetes Research, University of Bergen, Bergen, Norway, Istanbul, Turkey
| | - Silvia Ezquerro
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Metabolic Research Laboratory, Clínica Universidad de Navarra, CIBEROBN, Pamplona, Spain, Istanbul, Turkey
| | - Volkan Yumuk
- European Association for the Study of Obesity, New Investigators United, London, UK, Istanbul, Turkey
- Istanbul University Cerrahpasa Medical Faculty, Division of Endocrinology, Metabolism and Diabetes, Istanbul, Turkey
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17
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[The right to food in obesogenic environments: Reflections on the role of health professionals]. Salud Colect 2017; 12:605-619. [PMID: 28273266 DOI: 10.18294/sc.2016.934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/02/2016] [Indexed: 11/24/2022] Open
Abstract
Faced with the current obesity epidemic, this article problematizes the way the right to food is often circumscribed to situations of nutritional deficit. It is argued that the right to adequate food is violated in obesogenic environments and that protection of the right requires the establishment of measures to regulate advertising and marketing practices regarding ultra-processed products. The work suggests that the main barriers to the implementation of such measures are the strategies employed by Big Food; among these, strategies that have the scientific community as a target and/or means are highlighted. Certain basic underlying assumptions are identified in the discourse of health professionals that contribute to create a framework of legitimacy regarding the consumption of ultra-processed products. The adoption of an ethical position that is free of conflicts of interest is suggested, so as to advocate for needed regulatory measures of a statutory nature.
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18
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Family Food Providers' Perceptions of the Causes of Obesity and Effectiveness of Weight Control Strategies in Five Countries in the Asia Pacific Region: A Cross-Sectional Survey. Nutrients 2017; 9:nu9010078. [PMID: 28106781 PMCID: PMC5295122 DOI: 10.3390/nu9010078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/30/2016] [Accepted: 01/12/2017] [Indexed: 11/24/2022] Open
Abstract
The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group’s awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity (Unhealthy food behaviours, influences Beyond personal control and Environmental influences) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less, and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations.
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19
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Programming maternal and child overweight and obesity in the context of undernutrition: current evidence and key considerations for low- and middle-income countries. Public Health Nutr 2017; 20:1286-1296. [PMID: 28065195 PMCID: PMC5468800 DOI: 10.1017/s1368980016003323] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The goals of the present targeted review on maternal and child overweight and obesity were to: (i) understand the current situation in low- and middle-income countries (LMIC) with regard to recent trends and context-specific risk factors; and (ii) building off this, identify entry points for leveraging existing undernutrition programmes to address overweight and obesity in LMIC. Trends reveal that overweight and obesity are a growing problem among women and children in LMIC; as in Ghana, Kenya, Niger, Sierra Leone, Tanzania and Zimbabwe, where the prevalence among urban women is approaching 50 %. Four promising entry points were identified: (i) the integration of overweight and obesity into national nutrition plans; (ii) food systems (integration of food and beverage marketing regulations into existing polices on the marketing of breast-milk substitutes and adoption of policies to promote healthy diets); (iii) education systems (integration of nutrition into school curricula with provision of high-quality foods through school feeding programmes); and (iv) health systems (counselling and social and behaviour change communication to improve maternal diet, appropriate gestational weight gain, and optimal infant and young child feeding practices). We conclude by presenting a step-by-step guide for programme officers and policy makers in LMIC with actionable objectives to address overweight and obesity.
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20
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Early rapid weight gain and subsequent overweight and obesity in middle childhood in Peru. BMC OBESITY 2016; 3:55. [PMID: 27999679 PMCID: PMC5155392 DOI: 10.1186/s40608-016-0135-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 12/02/2016] [Indexed: 12/17/2022]
Abstract
Background Rapid postnatal weight gain is associated with risk of overweight and obesity, but it’s unclear whether this holds in populations exposed to concurrent obesogenic risk factors and for children who have been extensively breastfed. This study investigates whether an increase in weight for age from birth to 1 year (infancy) and from 1 to 5 years (early childhood) predicts overweight and obesity, and waist circumference at 8 years, using data from a longitudinal cohort study in Peru. Methods Generalized estimating equations (GEE) models were constructed for overweight and obesity, obesity alone and waist circumference at 8 years versus rapid weight gain in infancy, and early childhood including adjusted models to account for confounders. Results Rapid weight gain in both periods was associated with double the risk of overweight and obesity, obesity alone at 8 years and increased waist circumference even after controlling for maternal BMI and education level, sex of child, height-for-age at 8 years, consumption of “fast food” and number of days of active exercise. The association was significant, with some differences, for children in both rural and urban environments. Conclusions Rapid weight gain in infancy and in early childhood in Peru is associated with overweight and obesity at age 8 years even when considering other determinants of childhood obesity. Electronic supplementary material The online version of this article (doi:10.1186/s40608-016-0135-z) contains supplementary material, which is available to authorized users.
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21
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Barquera S, Pedroza-Tobias A, Medina C. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol 2016; 27:329-44. [PMID: 27389629 PMCID: PMC4947537 DOI: 10.1097/mol.0000000000000320] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. RECENT FINDINGS Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. SUMMARY Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.
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Affiliation(s)
- Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
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22
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Naughton SS, Mathai ML, Hryciw DH, McAinch AJ. Linoleic acid and the pathogenesis of obesity. Prostaglandins Other Lipid Mediat 2016; 125:90-9. [PMID: 27350414 DOI: 10.1016/j.prostaglandins.2016.06.003] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/15/2016] [Accepted: 06/23/2016] [Indexed: 12/11/2022]
Abstract
The modern Western diet has been consumed in developed English speaking countries for the last 50 years, and is now gradually being adopted in Eastern and developing countries. These nutrition transitions are typified by an increased intake of high linoleic acid (LA) plant oils, due to their abundance and low price, resulting in an increase in the PUFA n-6:n-3 ratio. This increase in LA above what is estimated to be required is hypothesised to be implicated in the increased rates of obesity and other associated non-communicable diseases which occur following a transition to a modern Westernised diet. LA can be converted to the metabolically active arachidonic acid, which has roles in inducing inflammation and adipogenesis, and endocannabinoid system regulation. This review aims to address the possible implications of excessive LA and its metabolites in the pathogenesis of obesity.
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Affiliation(s)
- Shaan S Naughton
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia
| | - Michael L Mathai
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia; Florey Neuroscience Institutes, The University of Melbourne, Melbourne, Australia
| | - Deanne H Hryciw
- Department of Physiology, The University of Melbourne, Melbourne, Australia
| | - Andrew J McAinch
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia.
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23
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Apostolopoulos Y, Lemke M, Sönmez S, Hege A. The Obesogenic Environment of Commercial Trucking: A Worksite Environmental Audit and Implications for Systems-Based Interventions. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2015.1133339] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Stewart BW, Bray F, Forman D, Ohgaki H, Straif K, Ullrich A, Wild CP. Cancer prevention as part of precision medicine: 'plenty to be done'. Carcinogenesis 2016; 37:2-9. [PMID: 26590901 PMCID: PMC4700936 DOI: 10.1093/carcin/bgv166] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/30/2015] [Accepted: 11/12/2015] [Indexed: 02/06/2023] Open
Abstract
Cancer burden worldwide is projected to rise from 14 million new cases in 2012 to 24 million in 2035. Although the greatest increases will be in developing countries, where cancer services are already hard pressed, even the richest nations will struggle to meet demands of increasing patient numbers and spiralling treatment costs. No country can treat its way out of the cancer problem. Consequently, cancer control must combine improvements in treatment with greater emphasis on prevention and early detection. Cancer prevention is founded on describing the burden of cancer, identifying the causes and evaluating and implementing preventive interventions. Around 40-50% of cancers could be prevented if current knowledge about risk factors was translated into effective public health strategies. The benefits of prevention are attested to by major successes, for example, in tobacco control, vaccination against oncogenic viruses, reduced exposure to environmental and occupational carcinogens, and screening. Progress is still needed in areas such as weight control and physical activity. Fresh impetus for prevention and early detection will come through interdisciplinary approaches, encompassing knowledge and tools from advances in cancer biology. Examples include mutation profiles giving clues about aetiology and biomarkers for early detection, to stratify individuals for screening or for prognosis. However, cancer prevention requires a broad perspective stretching from the submicroscopic to the macropolitical, recognizing the importance of molecular profiling and multisectoral engagement across urban planning, transport, environment, agriculture, economics, etc., and applying interventions that may just as easily rely on a legislative measure as on a molecule.
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Affiliation(s)
| | - Freddie Bray
- International Agency for Research on Cancer, 69008 Lyon, France and
| | - David Forman
- International Agency for Research on Cancer, 69008 Lyon, France and
| | - Hiroko Ohgaki
- International Agency for Research on Cancer, 69008 Lyon, France and
| | - Kurt Straif
- International Agency for Research on Cancer, 69008 Lyon, France and
| | - Andreas Ullrich
- Noncommunicable Diseases and Mental Health, World Health Organization, 1121 Geneva 27, Switzerland
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25
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Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R, Zulyniak MA, Weis T, Bernstein AM, Krauss RM, Kromhout D, Jenkins DJA, Malik V, Martinez-Gonzalez MA, Mozaffarian D, Yusuf S, Willett WC, Popkin BM. Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. J Am Coll Cardiol 2015; 66:1590-1614. [PMID: 26429085 PMCID: PMC4597475 DOI: 10.1016/j.jacc.2015.07.050] [Citation(s) in RCA: 283] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/16/2015] [Accepted: 07/20/2015] [Indexed: 02/07/2023]
Abstract
Major scholars in the field, on the basis of a 3-day consensus, created an in-depth review of current knowledge on the role of diet in cardiovascular disease (CVD), the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries and age/race/ethnicity/socioeconomic groups suggesting the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps is highlighted. Large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however, major gaps exist both in dietary pattern research and ways to change diets and food systems. On the basis of the current evidence, the traditional Mediterranean-type diet, including plant foods and emphasis on plant protein sources provides a well-tested healthy dietary pattern to reduce CVD.
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Affiliation(s)
- Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Corinna Hawkes
- Centre for Food Policy, City University, London, United Kingdom
| | - Russell J de Souza
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Mente
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Mahshid Dehghan
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington
| | | | - Tony Weis
- Department of Geography, University of Western Ontario, London, Ontario, Canada
| | - Adam M Bernstein
- Center for Lifestyle Medicine, Cleveland Clinic, Lyndhurst, Ohio
| | - Ronald M Krauss
- Children's Hospital Oakland Research Institute, Oakland, California
| | - Daan Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - David J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Vasanti Malik
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | | | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Walter C Willett
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Navarra-CIBEROBN, Pamplona, Spain
| | - Barry M Popkin
- Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, North Carolina.
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Roberto CA, Swinburn B, Hawkes C, Huang TTK, Costa SA, Ashe M, Zwicker L, Cawley JH, Brownell KD. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet 2015; 385:2400-9. [PMID: 25703111 DOI: 10.1016/s0140-6736(14)61744-x] [Citation(s) in RCA: 540] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite isolated areas of improvement, no country to date has reversed its obesity epidemic. Governments, together with a broad range of stakeholders, need to act urgently to decrease the prevalence of obesity. In this Series paper, we review several regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the scarce and fitful progress. Additionally, we preview the papers in this Lancet Series, which each identify high-priority actions on key obesity issues and challenge some of the entrenched dichotomies that dominate the thinking about obesity and its solutions. Although obesity is acknowledged as a complex issue, many debates about its causes and solutions are centred around overly simple dichotomies that present seemingly competing perspectives. Examples of such dichotomies explored in this Series include personal versus collective responsibilities for actions, supply versus demand-type explanations for consumption of unhealthy food, government regulation versus industry self-regulation, top-down versus bottom-up drivers for change, treatment versus prevention priorities, and a focus on undernutrition versus overnutrition. We also explore the dichotomy of individual versus environmental drivers of obesity and conclude that people bear some personal responsibility for their health, but environmental factors can readily support or undermine the ability of people to act in their own self-interest. We propose a reframing of obesity that emphasises the reciprocal nature of the interaction between the environment and the individual. Today's food environments exploit people's biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthy foods. This reinforces preferences and demands for foods of poor nutritional quality, furthering the unhealthy food environments. Regulatory actions from governments and increased efforts from industry and civil society will be necessary to break these vicious cycles.
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Affiliation(s)
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Terry T-K Huang
- City University of New York, School of Public Health, New York, NY, USA; University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA
| | - Sergio A Costa
- City University of New York, School of Public Health, New York, NY, USA; University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA
| | | | - Lindsey Zwicker
- ChangeLab Solutions, Oakland, CA, USA; Law Center to Prevent Gun Violence, San Francisco, CA, USA
| | | | - Kelly D Brownell
- Sanford School of Public Policy, Duke University, Durham, NC, USA
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Mandle J, Tugendhaft A, Michalow J, Hofman K. Nutrition labelling: a review of research on consumer and industry response in the global South. Glob Health Action 2015; 8:25912. [PMID: 25623608 PMCID: PMC4306755 DOI: 10.3402/gha.v8.25912] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/06/2014] [Accepted: 12/07/2014] [Indexed: 11/14/2022] Open
Abstract
Background To identify peer-reviewed research on consumers’ usage and attitudes towards the nutrition label and the food industry's response to labelling regulations outside Europe, North America, and Australia and to determine knowledge gaps for future research. Design Narrative review. Results This review identified nutrition labelling research from 20 countries in Asia, Africa, the Middle East, and Latin America. Consumers prefer that pre-packaged food include nutrition information, although there is a disparity between rates of use and comprehension. Consumer preference is for front-of-pack labelling and for information that shows per serving or portion as a reference unit, and label formats with graphics or symbols. Research on the food and beverage industry's response is more limited but shows that industry plays an active role in influencing legislation and regulation. Conclusions Consumers around the world share preferences with consumers in higher income countries with respect to labelling. However, this may reflect the research study populations, who are often better educated than the general population. Investigation is required into how nutrition labels are received in emerging economies especially among the urban and rural poor, in order to assess the effectiveness of labelling policies. Further research into the outlook of the food and beverage industry, and also on expanded labelling regulations is a priority. Sharing context-specific research regarding labelling between countries in the global South could be mutually beneficial in evaluating obesity prevention policies and strategies.
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Affiliation(s)
- Jessie Mandle
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Aviva Tugendhaft
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Julia Michalow
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Karen Hofman
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa;
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Abstract
Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.
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Rivera JA, Pedraza LS, Martorell R, Gil A. Introduction to the double burden of undernutrition and excess weight in Latin America. Am J Clin Nutr 2014; 100:1613S-6S. [PMID: 25411302 DOI: 10.3945/ajcn.114.084806] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Juan A Rivera
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Lilia S Pedraza
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Reynaldo Martorell
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Angel Gil
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
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Sivaram S, Sanchez MA, Rimer BK, Samet JM, Glasgow RE. Implementation science in cancer prevention and control: a framework for research and programs in low- and middle-income countries. Cancer Epidemiol Biomarkers Prev 2014; 23:2273-84. [PMID: 25178984 PMCID: PMC4221499 DOI: 10.1158/1055-9965.epi-14-0472] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Implementation science is a set of tools, principles, and methodologies that can be used to bring scientific evidence into action, improve health care quality and delivery, and improve public health. As the burden of cancer increases in low- and middle-income countries, it is important to plan cancer control programs that are both evidence based and delivered in ways that are feasible, cost-effective, contextually appropriate, and sustainable. This review presents a framework for using implementation science for cancer control planning and implementation and discusses potential areas of focus for research and programs in low- and middle-income countries interested in integrating research into practice and policy.
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Affiliation(s)
- Sudha Sivaram
- Center for Global Health, National Cancer Institute, , Phone: 2402765804
| | - Michael A. Sanchez
- Division of Cancer Control and Population Sciences, National Cancer Institute,
| | | | - Jonathan M. Samet
- Department of Preventive Medicine, Keck School of Medicine, Director, Institute for Global Health, University of Southern California,
| | - Russell E. Glasgow
- Colorado Health Outcomes Program, Department of Family Medicine, University of Colorado School of Medicine,
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Lobstein T, Brinsden H. Symposium report: the prevention of obesity and NCDs: challenges and opportunities for governments. Obes Rev 2014; 15:630-9. [PMID: 24888259 DOI: 10.1111/obr.12193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/08/2014] [Accepted: 04/23/2014] [Indexed: 11/29/2022]
Abstract
This paper is written as a briefing document with the aim of providing support to policy-makers and government officials tackling obesity and related non-communicable diseases. It is based on a symposium Obesity and non-communicable diseases: Learning from international experiences convened by the International Association for the Study of Obesity (now the World Obesity Federation) and its policy section, the International Obesity TaskForce (now World Obesity - Policy and Prevention). The symposium discussed a wide range of proposals to tackle the consumption of unhealthy food products, including interventions in the market through fiscal policies and marketing restrictions, measures to strengthen public health legislation and measures to limit agri-food company lobbying activities. It recognized the need for government leadership and action in order to reduce preventable deaths while improving economic performance and identified a need for governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress.
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Affiliation(s)
- Tim Lobstein
- World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK
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Abstract
This paper provides a comprehensive overview of the recent obesity prevention-related food policies initiated in countries worldwide. We searched and reviewed relevant research papers and government documents, focusing on those related to dietary guidelines, food labeling, regulation of food marketing, and policies affecting food prices. We also commented on the effects and challenges of some of the related policy options. There are large variations regarding what, when, and how policies have been implemented across countries. Clearly, developed countries are leading the effort, and developing countries are starting to develop some related policies. The encouraging message is that many countries have been adopting policies that might help prevent obesity and that the support for more related initiatives is strong and continues to grow. Communicating information about these practices will help researchers, public health professionals, and policy makers around the world to take action to fight the growing epidemic of obesity and other nutrition-related diseases.
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Affiliation(s)
- Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA
| | - Shiyong Liu
- Department of Epidemology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY 14214-8001, USA; Research Institute of Economics and Management, Southwestern University of Finance and Economics, #55 Guanghuacun Street, Chengdu, Sichuan, China 610074
| | - Ruicui Liu
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA
| | - Hong Xue
- Department of Epidemology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY 14214-8001, USA
| | - Youfa Wang
- Department of Epidemology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY 14214-8001, USA
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Kain J, Hernández Cordero S, Pineda D, de Moraes AF, Antiporta D, Collese T, Costa de Oliveira Forkert E, González L, Miranda JJ, Rivera J. Obesity Prevention in Latin America. Curr Obes Rep 2014; 3:150-5. [PMID: 26626601 DOI: 10.1007/s13679-014-0097-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those <5 years), respectively. In adults, Mexico and Chile present similar high rates of obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.
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Affiliation(s)
| | | | | | | | - Daniel Antiporta
- Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Tatiana Collese
- Growth, Exercise, Nutrition and Development, University of Zaragoza, Zaragoza, Spain.
| | | | | | - Juan Jaime Miranda
- Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Juan Rivera
- National Institute of Public Health, Cuernavaca, Mexico.
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Ozkan Y, Timurkan ES, Aydin S, Sahin İ, Timurkan M, Citil C, Kalayci M, Yilmaz M, Aksoy A, Catak Z. Acylated and desacylated ghrelin, preptin, leptin, and nesfatin-1 Peptide changes related to the body mass index. Int J Endocrinol 2013; 2013:236085. [PMID: 24371438 PMCID: PMC3858877 DOI: 10.1155/2013/236085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/17/2013] [Accepted: 11/05/2013] [Indexed: 01/18/2023] Open
Abstract
This study examines the levels of acylated and desacylated ghrelin, preptin, leptin, and nesfatin-1 peptide changes related to the body mass index (BMI). The subjects were allocated to 5 groups depending on their BMIs as follows: Group I (BMI <18.5 kg/m(2)); Group II (BMI 18.5-24.9 kg/m(2)); Group III (BMI 25-29.9 kg/m(2)); Group IV (BMI 30-39.9 kg/m(2)); Group V (BMI >40 kg/m(2)). Serum acylated and desacylated ghrelin, preptin, and leptin levels were measured by the enzyme-linked immunosorbent assay (ELISA) and nesfatin-1 was measured by the enzyme immunoassay (EIA). Desacylated ghrelin levels showed a gradual and statistically significant drop from Group I to Group V, while preptin and leptin levels exhibited a gradual and significant increase from Group I to Group IV. Serum nesfatin-1 levels gradually, but not significantly, increased from Group I to Group III and showed a significant decrease in Groups IV and V. In conclusion, leptin, preptin, and acylated ghrelin (AG) levels increased with higher BMI, whereas desacylated ghrelin (DAG) decreased and nesfatin-1 showed no clear relationship to BMI.
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Affiliation(s)
- Yusuf Ozkan
- Department of Endocrinology and Metabolism, Firat University Hospital, 23119 Elazig, Turkey
| | - Esra Suay Timurkan
- Department of Endocrinology and Metabolism, Firat University Hospital, 23119 Elazig, Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
- *Suleyman Aydin:
| | - İbrahim Sahin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
- Department of Histology and Embryology, Medical School, Erzincan University, 24100 Erzincan, Turkey
| | - Mustafa Timurkan
- Department of Endocrinology and Metabolism, Firat University Hospital, 23119 Elazig, Turkey
| | - Cihan Citil
- Atatürk Vocational School of Health Science, Kafkas University, 36040 Kars, Turkey
| | - Mehmet Kalayci
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
| | - Musa Yilmaz
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
| | - Aziz Aksoy
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
- Department of Nutrition and Dietetic, Bitlis Eren University, 13000 Bitlis, Turkey
| | - Zekiye Catak
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Firat University Hospital, 23119 Elazig, Turkey
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