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Goon S, Chapman-Novakofski K. Call for Cultural and Language-Concordant Diabetes Care, Nutrition Education, and Self-Management for South Asian Individuals Living in the US. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:905-913. [PMID: 37943229 DOI: 10.1016/j.jneb.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 08/31/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023]
Abstract
Ethnic South Asian Americans have the highest relative risk of type 2 diabetes mellitus in the US. Culturally tailored and language-concordant diabetes care and nutrition interventions can potentially promote South Asian diabetes management and disease progression. From our perspective, the extent of their use and evaluation in the US settings remains limited. This Perspective characterizes and evaluates the necessity and outcomes of culturally and linguistically adapted lifestyle interventions targeted toward type 2 diabetes mellitus indicators among South Asian individuals in the US. Suggestions for how this education could be modified include emphasizing the cultural and linguistic knowledge and self-awareness of diabetes educators and the sociological and historical factors that influence the cultural and linguistic orientation of diabetes care professionals and their clients. Such strategies could ensure better diabetes education and self-management among South Asian individuals.
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Affiliation(s)
- Shatabdi Goon
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
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Rios S, García-Gavilán JF, Babio N, Paz-Graniel I, Ruiz-Canela M, Liang L, Clish CB, Toledo E, Corella D, Estruch R, Ros E, Fitó M, Arós F, Fiol M, Guasch-Ferré M, Santos-Lozano JM, Li J, Razquin C, Martínez-González MÁ, Hu FB, Salas-Salvadó J. Plasma metabolite profiles associated with the World Cancer Research Fund/American Institute for Cancer Research lifestyle score and future risk of cardiovascular disease and type 2 diabetes. Cardiovasc Diabetol 2023; 22:252. [PMID: 37716984 PMCID: PMC10505328 DOI: 10.1186/s12933-023-01912-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/01/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND A healthy lifestyle (HL) has been inversely related to type 2 diabetes (T2D) and cardiovascular disease (CVD). However, few studies have identified a metabolite profile associated with HL. The present study aims to identify a metabolite profile of a HL score and assess its association with the incidence of T2D and CVD in individuals at high cardiovascular risk. METHODS In a subset of 1833 participants (age 55-80y) of the PREDIMED study, we estimated adherence to a HL using a composite score based on the 2018 Word Cancer Research Fund/American Institute for Cancer Research recommendations. Plasma metabolites were analyzed using LC-MS/MS methods at baseline (discovery sample) and 1-year of follow-up (validation sample). Cross-sectional associations between 385 known metabolites and the HL score were assessed using elastic net regression. A 10-cross-validation procedure was used, and correlation coefficients or AUC were assessed between the identified metabolite profiles and the self-reported HL score. We estimated the associations between the identified metabolite profiles and T2D and CVD using multivariable Cox regression models. RESULTS The metabolite profiles that identified HL as a dichotomous or continuous variable included 24 and 58 metabolites, respectively. These are amino acids or derivatives, lipids, and energy intermediates or xenobiotic compounds. After adjustment for potential confounders, baseline metabolite profiles were associated with a lower risk of T2D (hazard ratio [HR] and 95% confidence interval (CI): 0.54, 0.38-0.77 for dichotomous HL, and 0.22, 0.11-0.43 for continuous HL). Similar results were observed with CVD (HR, 95% CI: 0.59, 0.42-0.83 for dichotomous HF and HR, 95%CI: 0.58, 0.31-1.07 for continuous HL). The reduction in the risk of T2D and CVD was maintained or attenuated, respectively, for the 1-year metabolomic profile. CONCLUSIONS In an elderly population at high risk of CVD, a set of metabolites was selected as potential metabolites associated with the HL pattern predicting the risk of T2D and, to a lesser extent, CVD. These results support previous findings that some of these metabolites are inversely associated with the risk of T2D and CVD. TRIAL REGISTRATION The PREDIMED trial was registered at ISRCTN ( http://www.isrctn.com/ , ISRCTN35739639).
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Affiliation(s)
- Santiago Rios
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Jesús F García-Gavilán
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Indira Paz-Graniel
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Miguel Ruiz-Canela
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Clary B Clish
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Estefania Toledo
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
| | - Dolores Corella
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramón Estruch
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Emilio Ros
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Lipid Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Montserrat Fitó
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Fernando Arós
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain
| | - Miquel Fiol
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, Palma de Mallorca, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - José M Santos-Lozano
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Jun Li
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, Palma de Mallorca, Spain
| | - Cristina Razquin
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
| | - Miguel Ángel Martínez-González
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
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Zeinalabedini M, Nasli-Esfahani E, Esmaillzadeh A, Azadbakht L. How is healthy eating index-2015 related to risk factors for cardiovascular disease in patients with type 2 diabetes. Front Nutr 2023; 10:1201010. [PMID: 37305085 PMCID: PMC10248502 DOI: 10.3389/fnut.2023.1201010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 06/13/2023] Open
Abstract
Background Cardiovascular disease (CVD) is the primary cause of mortality and disability among diabetes. The aim of this study is to evaluate how healthy eating index-2015 related to risk factors for cardiovascular disease in patients with type 2 diabetes. Methods This cross-sectional study was conducted on 490 patients with type 2 diabetes in Tehran, Iran. The healthy eating index-2015 (HEI-2015) used as a diet quality indicator. Dietary intake was assessed by a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Four indicators of CVD risk factor [Castelli risk index-1 and 2 (CRI-II), atherogenic index of plasma (AIP), cholesterol index (CI), and lipid accumulation of plasma (LAP)] were calculated. The anthropometric indices [a body shape index (ABSI), abdominal volume index (AVI), and body roundness index (BRI)] were computed. Results After adjusting for potential confounders, it is evident that participants in the highest tertile of HEI had a lower odds ratio of BRI (OR: 0.52; 95% CI: 0.29-0.95; p-trend = 0.03) and AIP (OR:0.56; 95% CI: 0.34-0.94; p-trend = 0.02). Also, HEI and CRI had a marginally significant negative relation (OR: 0.61; 95% CI: 0.38-1; p-trend = 0.05) in crude model, after adjusting the signification disappeared. Conclusion In conclusion, our finding shows that more adherence to HEI reduces about 50% of the odds of AIP, BRI among diabetic patients. Further, large-scale cohort studies in Iran need to confirm these findings, including diabetic patients of various racial, ethnic backgrounds, body composition and different components of HEI.
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Affiliation(s)
- Mobina Zeinalabedini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran
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Carew Tofani A, Taylor E, Pritchard I, Jackson J, Xu A, Kotera Y. Ethnic Minorities' Experiences of Cardiac Rehabilitation: A Scoping Review. Healthcare (Basel) 2023; 11:757. [PMID: 36900762 PMCID: PMC10000677 DOI: 10.3390/healthcare11050757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/11/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Cardiac rehabilitation (CR) can improve cardiovascular risk factors, decrease cardiac mortality, and promote healthy lifestyle behaviours. However, services remain underutilized by groups of ethnic minorities. The purpose of the study was to identify patients' personal CR experiences to identify the differences CR makes towards minorities' lifestyle. An initial electronic search was performed in 2021 for papers ranging from 2008-2020 across specific databases, including PubMed, EMBASE, APA PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Medline. Google Scholar was also used to supplement the search process and to identify studies performed within grey literature. A total of 1230 records were screened, of which 40 were assessed for eligibility. The final sample consisted of seven qualitative design studies that were identified for inclusion in this review. Based on patient personal experiences, this review identified that ethnic minorities continue to remain disadvantaged when accessing healthcare interventions, primarily as a result of cultural behaviours, linguistic barriers, socioeconomic status, religious and fatalistic beliefs, and low physician referral rates. More research is needed to elucidate this phenomenon and address these factors faced by ethnic minorities.
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Affiliation(s)
- Aiesha Carew Tofani
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GD, UK
| | - Elaina Taylor
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GD, UK
| | - Ingrid Pritchard
- School of Health and Social Care, Swansea University, Swansea SA2 8PP, UK
| | - Jessica Jackson
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GD, UK
| | - Alison Xu
- Digital Solutions and Services, University of Derby, Derby DE22 1GD, UK
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
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Subhan FB, Fernando DN, Thorlakson J, Chan CB. Dietary Interventions for Type 2 Diabetes in South Asian Populations-A Systematic Review. Curr Nutr Rep 2023; 12:39-55. [PMID: 36443548 PMCID: PMC9707124 DOI: 10.1007/s13668-022-00446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE South Asians face a high burden of type 2 diabetes (T2D). We systematically summarized current research on the efficacy, cultural relevance, and research gaps of nutrition interventions that could be used for treatment in this population. FINDINGS We identified 18 articles published since 2010. Dietary pattern interventions have focused on low-glycemic index (GI) solutions and consistently reported improvement in glycemic management. Trials of nutrition education and counselling had diverse approaches, with those utilizing more intensive interventions generally eliciting better glycemic outcomes. Many studies developed interventions with cultural relevance by including traditional foods, providing materials in the local language, and acknowledging important food-related customs. These adaptations were seen in South Asian countries as well as Western countries hosting immigrants. Data from South Asian countries support low-GI and intensive counselling approaches for the treatment of T2D. Given the high prevalence of T2D in these populous countries, approaches that can reach large numbers of people are needed. In Western countries, more emphasis on providing culturally relevant nutrition therapy is needed.
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Affiliation(s)
- Fatheema B. Subhan
- Department of Nutrition and Food Science, California Polytechnic State University at Pomona, Pomona, CA 91768 USA
| | - Dineli N. Fernando
- Department of Cell Biology, University of Alberta, Edmonton, AB T6G 2H7 Canada
| | | | - Catherine B. Chan
- Department of Agricultural, Food and Nutritional Science & Department of Physiology, 4-126A Li Ka Shing Centre for Health Innovation Research, University of Alberta, Edmonton, AB T6G 2E1 Canada
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Lee DE, Kim K. Regional Difference in the Effect of Food Accessibility and Affordability on Vegetable and Fruit Acquisition and Healthy Eating Behaviors for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14973. [PMID: 36429690 PMCID: PMC9690073 DOI: 10.3390/ijerph192214973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
The food environment has been determined to affect a range of healthy eating and health indicators, but the study on the regional difference of food environment effects on these outcomes is limited. This study aimed to examine whether food environment factors influence vegetable and fruit acquisition and healthy eating behaviors in urban and rural areas using a nationwide dataset. The study participants were community-dwelling older adults aged 65 years and older (n = 830) who participated in the 2019 Consumer Behavior Survey for Food provided by the Korea Rural Economic Institute. Food environment factors were assessed using questionnaires measuring perceived food accessibility and affordability. The negative perceptions of food environment were related to lower vegetable and fruit acquisitions and poor healthy eating behaviors. The higher risks of low vegetable and fruit acquisitions in older rural adults were related to a negative perception of food accessibility only (odds ratio [OR]: 2.34, 95% confidence interval [CI]: 1.27-4.32 for vegetable; OR: 1.96, 95% CI: 1.02-3.75 for fruit). For older urban adults, negative perceptions of both food accessibility and food affordability were related to the increased risk of low vegetable acquisition (OR: 2.03, 95% CI: 1.07-3.83 for food accessibility; OR: 2.52, 95% CI: 1.26-5.04 for food affordability). In terms of healthy eating behaviors, for those who perceived that either food accessibility or affordability was poor, older urban adults were less likely to have various and healthy food eating behaviors when they had a negative perception of affordability (OR: 0.47, 95% CI: 0.25-0.90 for variety; OR: 0.23, 95% CI: 0.11-0.46 for eating healthy foods); however, older rural adults were less likely to have the behaviors when they had a negative perception of accessibility (OR: 0.49, 95% CI: 0.21-0.97 for variety; OR: 0.28, 95% CI: 0.13-0.63 for eating healthy foods). In conclusion, the negative perceptions of food accessibility and affordability were related to low vegetable acquisition and poor healthy eating behaviors. The effects of food accessibility and affordability on vegetable and fruit acquisitions and healthy eating behaviors were different between urban and rural areas.
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Affiliation(s)
| | - Kirang Kim
- Correspondence: ; Tel.: +82-41-550-3472; Fax: +82-41-559-7955
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Mahmood B, Cox S, Ashe MC, Nettlefold L, Deo N, Puyat JH, Tang TS. ‘We just don’t have this in us…’: Understanding factors behind low levels of physical activity in South Asian immigrants in Metro-Vancouver, Canada. PLoS One 2022; 17:e0273266. [PMID: 36007081 PMCID: PMC9410550 DOI: 10.1371/journal.pone.0273266] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background South Asian immigrants in western countries are at a high risk for metabolic syndrome and associated chronic disease. While a physically active lifestyle is crucial in decreasing this risk, physical activity (PA) levels among this group remain low. The objectives of this study were to explore social and cultural factors that influence PA behavior, investigate how immigration process intersects with PA behaviors to influence PA levels and to engage community in a discussion about what can be done to increase PA in the South Asian community. Methods For this qualitative study, we conducted four Focus Group Discussions (FGDs) among a subset of participants who were part of a larger study. FGD data was coded and analysed using directed content analysis to identify key categories. Results Participants expressed a range of opinions, attitudes and beliefs about PA. Most believed they were sufficiently active. Women talked about restrictive social and cultural norms that discouraged uptake of exercise. Post-immigration levels of PA were low due to change in type of work and added responsibilities. Conclusion Health promoters need to consider social, cultural, and structural contexts when exploring possible behavior change interventions for South Asian immigrants.
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Affiliation(s)
- Bushra Mahmood
- Faculty of Medicine University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - Susan Cox
- The W. Maurice Young Centre for Applied Ethics, University of British Columbia, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maureen C. Ashe
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neha Deo
- Mayo Clinic, Alix School of Medicine, Rochester, Minnesota, United States of America
| | - Joseph H. Puyat
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, Saint Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Tricia S. Tang
- Faculty of Medicine University of British Columbia, Vancouver, British Columbia, Canada
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Bae YJ, Yu KW, Lee KH, Jang KI. Association of the Healthy Eating Index with Metabolic Abnormalities among Middle-Aged Adults Living in Single-Person Households in Korea. Nutrients 2021; 13:3937. [PMID: 34836192 PMCID: PMC8624069 DOI: 10.3390/nu13113937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 01/07/2023] Open
Abstract
This study aimed to analyze the association between the dietary lifestyles and health outcomes among middle-aged (40-64 years old) and elderly (65 years old and older) individuals living alone using the Korean Healthy Eating Index (KHEI). The study was conducted with 1442 participants (475 men and 967 women) aged 40 years and older living in single-person households using the Korea National Health and Nutrition Examination Survey from 2016 to 2018. The KHEI scores were calculated based on the 24-h recall data of dietary intake. Among women living alone, the total KHEI score of the participants aged 40-64 years was 65.92, which was significantly lower than the 70.66 of those aged 65 years and older (p = 0.0152). In addition, the total score in the adequacy domain was significantly lower among the 40~64-year-old group than those aged 65 years and older (p = 0.0011). Among the elderly in single-person households, the odds of diabetes in the T1 group were 2.08 times higher than those in the T3 group according to the KHEI (95% confidence interval: 1.36-3.17). The results of this study are expected to be used as baseline data to establish nutrition, home meal replacement utilization, and health policies for the elderly living alone.
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Affiliation(s)
- Yun-Jung Bae
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea; (K.-W.Y.); (K.-H.L.)
| | - Kwang-Won Yu
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea; (K.-W.Y.); (K.-H.L.)
| | - Kyung-Haeng Lee
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea; (K.-W.Y.); (K.-H.L.)
| | - Keum-Il Jang
- Department of Food Science and Biotechnology, Chungbuk National University, Cheongju 28644, Korea;
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Parastouei K, Sepandi M, Eskandari E. Predicting the 10-year risk of cardiovascular diseases and its relation to healthy diet indicator in Iranian military personnel. BMC Cardiovasc Disord 2021; 21:419. [PMID: 34482840 PMCID: PMC8419937 DOI: 10.1186/s12872-021-02231-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023] Open
Abstract
Background Epidemiological studies indicate increased prevalence of cardiovascular disease (CVD) among military personnel. Accordingly, identification of at-risk individuals and lifestyle modification such as improving diet quality can potentially inhibits the increasing trend of CVD mortality. The aim of this study was predicting the 10-year risk of CVD and its association with healthy diet indicator (HDI) among military personnel. Methods In this cross-sectional study, 400 male military personnel within the age range of 30–75 years were included. HDI score was calculated based on food frequency questionnaire, and the 10-year risk of CVD was evaluated using Framingham risk score (FRS). The FRS items include age, gender, total cholesterol, high density lipoprotein cholesterol (HDL-C), systolic blood pressure, status of diabetes and smoking. Partial correlation test was employed to investigate the relationship between Framingham risk score and HDI score. Results The mean age and body mass index (BMI) of participants were 38.67 ± 5.3 year and 25.28 ± 3.22 kg/m2, respectively. Prediction of FRS was as follows: 96.5% were low risk, 2% were moderate risk, and 1.5% were high risk. The mean HDI score of participants in this study was 5.98 ± 1.36. While HDI score did not show a significant correlation with FRS (r: − 0.009, p:0.860), increased dietary sodium intake had a significant positive correlation with FRS (r: 0.114, p:0.026). Conclusion The most of participants (96.5%) had in low risk of CVD development in the next 10 years. Meanwhile, the FRS showed no significant relationship with HDI score. Further researches are required to confirm the results of the present study.
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Affiliation(s)
- Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mojtaba Sepandi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Eslam Eskandari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Hamedi-Shahraki S, Mir F, Amirkhizi F. Food Insecurity and Cardiovascular Risk Factors among Iranian Women. Ecol Food Nutr 2020; 60:163-181. [PMID: 32869659 DOI: 10.1080/03670244.2020.1812596] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We evaluated whether food insecurity is associated with clinical evidence of diet-sensitive cardiovascular diseases (CVD) risk factors, including obesity, hypertension, dyslipidemia, and diabetes. In this population-based cross-sectional study, 630 women aged 18-50 years under cover of health centers in Iran randomly selected and interviewed face-to-face. Food insecurity was evaluated using a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability was determined in the Iranian population. Logistic regression was used to assess the associations between food insecurity and having CVD risk factors including general and abdominal obesity, hypertension, hypercholesterolemia, high low-density lipoprotein cholesterol (LDL), low high-density lipoprotein cholesterol (HDL), hypertriglyceridemia, and diabetes. The probability of having hypertriglyceridemia (Adjusted OR = 2.04, P = .031), general obesity (Adjusted OR = 2.43, P = .029), abdominal obesity (Adjusted OR = 2.09, P = .024), and hypertension (Adjusted OR = 2.04, P = .038) increased with exacerbation of women's food insecurity condition. The odds ratio of having CVD risk factors became stronger after adjusting for confounders. Food insecurity was associated with increased risk of CVD risk factors among Iranian reproductive-age women. Efforts to improve food security conditions among women might be associated with reductions in the incidence of CVD-related metabolic risks.
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Affiliation(s)
- Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Fatemeh Mir
- Student Research Committee, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
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Park S, Kim HJ, Kim K. Do Where The Elderly Live Matter? Factors Associated with Diet Quality among Korean Elderly Population Living in Urban Versus Rural Areas. Nutrients 2020; 12:E1314. [PMID: 32380737 PMCID: PMC7284551 DOI: 10.3390/nu12051314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 11/17/2022] Open
Abstract
This study aimed to examine whether there is an area difference on diet quality among the Korean elderly population. The effect of personal factors on diet quality is also estimated and compared between rural and urban areas. A cross-sectional data from the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES) was used for this study. The participants were older adults aged ≥ 65 years (n = 3207) who participated in the KNHANES. Urban and rural areas classified the region and the Korean Healthy Eating Index (KHEI) assessed the diet quality. Personal factors that were related to diet quality included socio-demographic factors, health behaviors, and health conditions. This study found that the diet quality was different between urban and rural areas in the Korean elderly population, showing a higher mean of KHEI scores in urban areas than rural areas (67.3 for urban seniors, 63.6 for rural seniors, p < 0.001), and the regional difference was still significant, even after adjusting for the personal factors (p < 0.001). Different sets of personal factors were found to be significant that explain the diet quality of participants between areas, such as economic resources, walking exercise, and perceived oral health status in urban areas, and age and food insecurity in rural areas. In conclusions, this study found that there was a regional disparity in diet quality and some personal factors affecting diet quality were dependent on areas, which implied that regional environment with diverse contexts could influence diet quality. These findings emphasize the need to provide targeted intervention programs that take into account both the characteristics of individuals and local food environments in order to improve the overall diet quality in older adults.
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Affiliation(s)
- Sohyun Park
- Department of Food Science and Nutrition, Hallym University, 24252 Chuncheon, Korea;
| | - Hyun Ja Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, 25457 Gangneung, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, 31116 Cheonan, Korea
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