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Novinbahador T, Abroon S, Motlagh K, Abbasi K, Mehdizadeh A, Nejabati HR, Yousefi M. Surface markers on microparticles involved in obesity-derived diseases. Life Sci 2024; 352:122876. [PMID: 38942357 DOI: 10.1016/j.lfs.2024.122876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
AIMS This review aimed to investigate the different types of microparticles playing role in obesity-related diseases. Additionally, the factors participating in changing the microparticles amount in obese people will also be discussed. MATERIAL & METHODS The authors collected the relevant articles published until 2023 and these are carefully selected from three scientific databases based on keywords. KEY FINDINGS It has been revealed that exercise might change the microparticle content in the body. The other factor which participates in obesity process is the oxidative stress which is increased in microparticles. Moreover, the obesity is implicated in metabolic conditions including diabetes and cardiovascular diseases. SIGNIFICANCE More than one-third of people on the planet today are known as overweight individuals. Microparticles (MPs) are small membrane-bound vesicles that are found in healthy people's blood and are elevated in patients with pathological conditions such as obesity. MPs mostly come from platelets, leukocytes, endothelial cells, and vascular smooth muscle cells. Considering the effect of obesity on microparticles, these small membrane-bound vesicles might play a crucial role in preventing or treatment of obesity.
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Affiliation(s)
- Tannaz Novinbahador
- Department of Biology, Faculty of Naturexoal Sciences, University of Tabriz, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Abroon
- Department of Biology, Faculty of Naturexoal Sciences, University of Tabriz, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kimia Motlagh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khadijeh Abbasi
- Student Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | - Amir Mehdizadeh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Nejabati
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Chiou A, Hermel M, Chai Z, Eiseman A, Jeschke S, Mehta S, Khan U, Hoodbhoy Z, Safdar N, Khoja A, Junaid V, Vaughan E, Merchant AT, Iqbal J, Almas A, Virani SS, Sheikh S. Going from Primary to Primordial Prevention: Is the Juice Worth the Squeeze? Curr Cardiol Rep 2024:10.1007/s11886-024-02109-3. [PMID: 39073507 DOI: 10.1007/s11886-024-02109-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE OF REVIEW While primary prevention strategies target individuals who are at high risk of cardiovascular disease, there is rising interest towards primordial prevention that focuses on preventing the development of risk factors upstream of disease detection. Therefore, we review the advantages of primordial prevention interventions on minimizing future cardiovascular events. RECENT FINDINGS Primordial prevention of atherosclerotic cardiovascular disease involves behavioral, genetic, and environmental strategies, starting from fetal/infant health and continuing throughout childhood and young adulthood. Early interventions focusing on modifiable risk factors such as physical inactivity, non-ideal body weight, smoking, and environmental pollutants are important towards preventing the initial occurrence of risk factors such as hypertension, dyslipidemia, and diabetes to ultimately reduce cardiovascular disease. Implementing primordial prevention strategies early on in life can minimize cardiovascular events and lead to healthy aging in the population. Future studies can further evaluate the effectiveness of various primordial prevention strategies.
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Affiliation(s)
- Andrew Chiou
- Department of Cardiology, Scripps Clinic, La Jolla, San Diego, CA, USA
| | - Melody Hermel
- Department of Cardiology, United Medical Doctors, La Jolla, San Diego, CA, USA
| | - Zohar Chai
- Department of Biological Sciences, University of California, San Diego, San Diego, CA, USA
| | - Ariana Eiseman
- Northeastern University Bouvé College of Health Science, Boston, MA, USA
| | - Sheila Jeschke
- Department of Cardiology, Scripps Clinic, La Jolla, San Diego, CA, USA
| | - Sandeep Mehta
- Department of Cardiology, Loyola University Medical Center, Chicago, IL, USA
| | - Unab Khan
- Department of Family Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zahra Hoodbhoy
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Nilofer Safdar
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Adeel Khoja
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | | | | | - Anwar T Merchant
- Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Junaid Iqbal
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Aysha Almas
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | | | - Sana Sheikh
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan.
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Zarei I, Eloranta AM, Klåvus A, Väistö J, Lehtonen M, Mikkonen S, Koistinen VM, Sallinen T, Haapala EA, Lintu N, Soininen S, Haikonen R, Atalay M, Schwab U, Auriola S, Kolehmainen M, Hanhineva K, Lakka TA. Eight-year diet and physical activity intervention affects serum metabolites during childhood and adolescence: A nonrandomized controlled trial. iScience 2024; 27:110295. [PMID: 39055945 PMCID: PMC11269805 DOI: 10.1016/j.isci.2024.110295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/16/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Long-term lifestyle interventions in childhood and adolescence can significantly improve cardiometabolic health, but the underlying molecular mechanisms remain poorly understood. To address this knowledge gap, we conducted an 8-year diet and physical activity intervention in a general population of children. The research revealed that the intervention influenced 80 serum metabolites over two years, with 17 metabolites continuing to be affected after eight years. The intervention primarily impacted fatty amides, including palmitic amide, linoleamide, oleamide, and others, as well as unsaturated fatty acids, acylcarnitines, phospholipids, sterols, gut microbiota-derived metabolites, amino acids, and purine metabolites. Particularly noteworthy were the pronounced changes in serum fatty amides. These serum metabolite alterations could represent molecular mechanisms responsible for the observed benefits of long-term lifestyle interventions on cardiometabolic and overall health since childhood. Understanding these metabolic changes may provide valuable insights into the prevention of cardiometabolic and other non-communicable diseases since childhood.
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Affiliation(s)
- Iman Zarei
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Anton Klåvus
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Marko Lehtonen
- School of Pharmacy, Faculty of Health Science, University of Eastern Finland, Kuopio, Finland
- LC-MS Metabolomics Center, Biocenter Kuopio, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ville M. Koistinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Food Chemistry and Food Development Unit, Department of Biochemistry, University of Turku, Turku, Finland
| | - Taisa Sallinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Eero A. Haapala
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sonja Soininen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Physician and Nursing Services, Health and Social Services Centre, Wellbeing Services County of North Savo, Varkaus, Finland
| | - Retu Haikonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, Faculty of Health Science, University of Eastern Finland, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Hanhineva
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Food Chemistry and Food Development Unit, Department of Biochemistry, University of Turku, Turku, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Hobbs S, Bellows LL, Coatsworth JD, Johnson SL. Using Plan, Do, Study, Act Cycles to Improve a Maternal Self-Care Intervention With Audience Input. Health Promot Pract 2024; 25:666-676. [PMID: 37272068 DOI: 10.1177/15248399231177305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Maternal self-care, including healthy eating, physical activity, and stress management behaviors, is influenced by environmental, social, and individual factors. Plan-Do-Study-Act (PDSA) Cycling is an effective quality improvement process using rapid cycling to refine interventions to fit audience-specific contexts and to address socioecological influences on behavior change. To refine components of the Healthy EnviROnmentS Self-Care intervention, a mindful self-care program for mothers of preschool-aged children in rural communities, PDSA cycles were used to examine: (A) acceptability of content, (B) suitability of implementation strategies, and (C) feasibility of digital supports across three stages of program development. Stage 1 included a group discussion with an expert panel (n = 8). Stage 2 used brief interviews and group discussion with a convenience sample (n = 5). Stage 3 included in-depth interviews with the focal population (n = 6). In-depth interviews were transcribed and analyzed using a directed approach, and data were compiled from group discussion notes and assessed for congruence and analyzed for emergent themes. PDSA cycles relating to content led to the addition of activities to introduce mindfulness and foster social support and the revision of handouts. Implementation strategies were refined with respect to workshop duration, activity order, and meeting type. Digital supports resulted in refinement to the study website and tablet applications. Utilization of PDSA cycles allowed for input from the focus population at every point of intervention design and considered socioecological factors that can influence behavior change.
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Affiliation(s)
| | | | | | - Susan L Johnson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Middel CN, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JE. A Systems Innovation Perspective on Implementation and Sustainment Barriers for Healthy Food Store Interventions: A Reflexive Monitoring in Action Study in Dutch Supermarkets. Int J Health Policy Manag 2024; 13:8036. [PMID: 39099507 PMCID: PMC11270604 DOI: 10.34172/ijhpm.2024.8036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 03/24/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Healthy food store interventions (HFIs) are an important health-promotion tool, but face implementation and sustainment barriers. This paper aims to explore the underlying factors that produce these barriers using an innovative systems innovation perspective, through the case study of a multi-component HFI. The HFI was implemented in a minor, national, cooperative supermarket chain, in the Netherlands, a competitive market where price-based competition is the norm. METHODS The HFI was implemented for 6-12 months, in six stores. It was implemented by the researchers, and maintained by store employees. The study applied a Reflexive Monitoring in Action (RMA) approach, meaning that the researchers monitored stores' adherence to the HFI, via store visits, to identify potential issues. Subsequently, the researchers interviewed the store managers responsible for the intervention, to have them reflect upon the barriers leading to these adherence issues, underlying systemic factors, and potential solutions. The stores implemented these solutions, and during the next monitoring visit the researchers evaluated whether the barrier had been resolved. RESULTS We found that the HFI often clashed with regular activities of the stores (eg, competing over the same spaces) and that store managers generally prioritized these regular activities. This prioritization was based on the greater commercial value of those regular activities (eg, selling unhealthy products) according to store managers, based on their beliefs and assumptions about commerce, health, and consumer preferences. Due to the limited resources of supermarkets (eg, people, time, space), and the HFI often not fitting within the existing structures of the stores as easily as traditional practices, store managers often neglected the HFI components in favor of regular store activities. CONCLUSION Our findings illustrate the systemic factors that produce implementation barriers for HFIs, and the dynamics by which this production occurs. These insights help future researchers to anticipate and respond to such barriers.
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Affiliation(s)
- Cédric N.H. Middel
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, The Netherlands
| | | | - Joreintje D. Mackenbach
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, The Netherlands
| | - Jacqueline E.W. Broerse
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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6
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Dadras O, Nyaboke Ongosi A, Wang CW. Prevalence and correlates of diabetes and impaired fasting glucose among adults in Afghanistan: Insights from a national survey. SAGE Open Med 2024; 12:20503121241238147. [PMID: 38516644 PMCID: PMC10956149 DOI: 10.1177/20503121241238147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives Afghanistan is experiencing an escalating burden of noncommunicable diseases, with diabetes and impaired fasting glucose being of particular concern. To explore the prevalence of diabetes and impaired fasting glucose and associated factors among adult Afghans. Methods This cross-sectional study used secondary data from a nationally representative survey, conducted in 2018 in Afghanistan. A blood sample was collected from the fingertip and tested through a strip to measure blood glucose. The complex sampling design and sampling weights were accounted for in all analyses to produce representative estimates of the target population in Afghanistan. Results Of 3890 Afghan adults aged 18-69 years who participated in this survey, 11.07% and 10.32% had diabetes and impaired fasting glucose, respectively. For overweight individuals with abdominal obesity, the risk for diabetes became significantly elevated, with an adjusted relative risk ratio of 2.12 (95% CI: 1.10-4.09). However, the most pronounced effect was observed among individuals classified as having obesity with abdominal obesity with an adjusted relative risk ratio of 2.54 (95% CI: 1.37-4.70). Moreover, high cholesterol level was significantly associated with both impaired fasting glucose (ARRR: 2.52, 95% CI: 1.55-4.12) and diabetes (ARRR: 4.12, 95% CI: 2.59-6.56), whereas high blood pressure was significantly associated with only diabetes (ARRR: 1.82, 95% CI: 1.16-2.86). Conclusions This investigation provides critical insight into the prevalence of diabetes and IFG among Afghan adults aged 18-69 years. Relative to the global average, the higher prevalence observed calls for specifically designed interventions targeting individuals with cardiometabolic risk factors, such as elevated body mass index, abdominal obesity, hypertension, and hypercholesterolemia.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Chia-Wen Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Lloyd’s Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
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7
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Chen J, Fan Y, Zhang M, Wu S, Li H. The neural model of front-of-package label processing. Nutr Rev 2024; 82:374-388. [PMID: 37604108 DOI: 10.1093/nutrit/nuad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
Front-of-package (FOP) labels have been adopted in many countries to battle the obesity pandemic and its serious health consequences by providing clearer and easier-to-understand nutrition and health information. The effectiveness of FOP labels has been generally confirmed, with some contextual and individual factors modifying their effectiveness. Existing theories (eg, the dual-process theory) and shifting priorities for self-control, provide some explanations for the FOP label effect. However, the cognitive and neural mechanisms underlying the processing of FOP labels remain unknown. Here, a new model, namely, the neural model of FOP label processing, has been proposed to fill this gap by providing an integrated account of FOP label processing while simultaneously considering multiple important situational and individual factors in the same framework. This neural model is built on the core eating network (ie, the ventral reward pathway and the dorsal control pathway) for food cue processing and actual food consumption. The new model explains how FOP labels may facilitate attention, influence the core eating network, and thus alter food choices. It also demonstrates how motivation may modify FOP label processing in 2 ways: affecting attention (the indirect way) and changing the process of evaluating the food (the direct way). It further explains how some contextual and individual factors (eg, ego depletion, time pressure, and health knowledge) influence the process. Thus, the neural model integrates evidence from behavioral, eye-tracking, and neuroimaging studies into a single, integrated account, deepening understanding of the cognitive and neural mechanisms of FOP label processing. This model might facilitate consensus on the most successful FOP label. Moreover, it could provide insights for consumers, food industries, and policy makers and encourage healthy eating behaviors.
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Affiliation(s)
- Jing Chen
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Yixuan Fan
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Manlu Zhang
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Shuhuan Wu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Huiyan Li
- School of Psychology, Beijing Sport University, Beijing 100084, China
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E R, J T, Ek Q, Ss F, E H, G P, Ce P. Canadians' knowledge of cancer risk factors and belief in cancer myths. BMC Public Health 2024; 24:329. [PMID: 38291409 PMCID: PMC10829248 DOI: 10.1186/s12889-024-17832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 01/20/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Many untrue statements about cancer prevention and risks are circulating. The objective of this study was to assess Canadians' awareness of known cancer risk factors and cancer myths (untruths or statements that are not completely true), and to explore how awareness may vary by sociodemographic and cognitive factors. METHODS Cancer myths were identified by conducting scans of published, grey literature, and social media. Intuitive-analytic thinking disposition scores included were actively open- and close-minded thinking, as well as preference for intuitive and effortful thinking. A survey was administered online to participants aged 18 years and older through Prolific. Results were summarized descriptively and analyzed using chi-square tests, as well as Spearman rank and Pearson correlations. RESULTS Responses from 734 Canadians were received. Participants were better at identifying known cancer risk factors (70% of known risks) compared to cancer myths (49%). Bivariate analyses showed differential awareness of known cancer risk factors (p < 0.05) by population density and income, cancer myths by province, and for both by ethnicity, age, and all thinking disposition scores. Active open-minded thinking and preference for effortful thinking were associated with greater discernment. Tobacco-related risk factors were well-identified (> 90% correctly identified), but recognition of other known risk factors was poor (as low as 23% for low vegetable and fruit intake). Mythical cancer risk factors with high support were consuming additives (61%), feeling stressed (52%), and consuming artificial sweeteners (49%). High uncertainty of causation was observed for glyphosate (66% neither agreed or disagreed). For factors that reduce cancer risk, reasonable awareness was observed for HPV vaccination (60%), but there was a high prevalence in cancer myths, particularly that consuming antioxidants (65%) and organic foods (45%) are protective, and some uncertainty whether drinking red wine (41%), consuming vitamins (32%), and smoking cannabis (30%) reduces cancer risk. CONCLUSIONS While Canadians were able to identify tobacco-related cancer risk factors, many myths were believed and numerous risk factors were not recognized. Cancer myths can be harmful in themselves and can detract the public's attention from and action on established risk factors.
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Affiliation(s)
- Rydz E
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Telfer J
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
| | - Quinn Ek
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Fazel Ss
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Holmes E
- Canadian Cancer Society, Toronto, Canada
| | - Pennycook G
- Department of Psychology, Cornell University, New York, USA
| | - Peters Ce
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- BC Centre for Disease Control, Vancouver, BC, Canada.
- BC Cancer, Vancouver, BC, Canada.
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Hayashi D, Edwards C, Emond JA, Gilbert-Diamond D, Butt M, Rigby A, Masterson TD. What Is Food Noise? A Conceptual Model of Food Cue Reactivity. Nutrients 2023; 15:4809. [PMID: 38004203 PMCID: PMC10674813 DOI: 10.3390/nu15224809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
As GLP-1 receptor agonists, like semaglutide, emerge as effective treatments for weight management, anecdotal reports from patients and clinicians alike point to a reduction in what has been colloquially termed "food noise", as patients report experiencing less rumination and obsessive preoccupation about food. In this narrative review, we discuss concepts used in studies to investigate human eating behavior that can help elucidate and define food noise, particularly food cue reactivity. We propose a conceptual model that summarizes the main factors that have been shown to determine the magnitude of the reactivity elicited by external and internal food cues and how these factors can affect short- and long-term behavioral and clinical outcomes. By integrating key research conducted in this field, the Cue-Influencer-Reactivity-Outcome (CIRO) model of food cue reactivity provides a framework that can be used in future research to design studies and interpret findings related to food noise and food cue reactivity.
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Affiliation(s)
- Daisuke Hayashi
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16801, USA (T.D.M.)
| | - Caitlyn Edwards
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16801, USA (T.D.M.)
| | - Jennifer A. Emond
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Diane Gilbert-Diamond
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Melissa Butt
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Andrea Rigby
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
- Penn State Health, Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Travis D. Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16801, USA (T.D.M.)
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Selvakumaran S, Lin CY, Hadgraft N, Chandrabose M, Owen N, Sugiyama T. Area-level socioeconomic inequalities in overweight and obesity: Systematic review on moderation by built-environment attributes. Health Place 2023; 83:103101. [PMID: 37625238 DOI: 10.1016/j.healthplace.2023.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Residents of lower socioeconomic status (SES) areas are at a higher risk of overweight/obesity than those from higher SES areas. Built environment attributes may mitigate such inequalities. This systematic review synthesised findings of studies examining built environment attributes as potential moderators of the associations between area-level SES and overweight/obesity in adults. From five databases, nine eligible studies were identified. The SES-overweight/obesity relationship was stronger in inner areas and suburbs of large cities, while it was weaker in more rural areas. Two studies examined walkability and reported contrasting findings: no moderation in one and marginally significant moderation (less inequality in higher walkability areas) in the other. No evidence of moderation was found for street connectivity, population density, the food environment, access to physical activity facilities and several perceived environmental attributes. Further research is needed on other built environment attributes (e.g., access to, quantity and quality of green spaces, active transport features), and ideally using prospective study designs and objective makers of adiposity.
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Affiliation(s)
- Sungkavi Selvakumaran
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia.
| | - Chien-Yu Lin
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Department of Public Health, College of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 406040, Taiwan; Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa City, Saitama, 359-1192, Japan.
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
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11
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Li CI, Liu CS, Lin CH, Yang SY, Li TC, Lin CC. Association of body indices and risk of mortality in patients with type 2 diabetes. BMJ Open Diabetes Res Care 2023; 11:e003474. [PMID: 37607771 PMCID: PMC10445358 DOI: 10.1136/bmjdrc-2023-003474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION A body shape index (ABSI) is independently associated with mortality in general population, but studies on the predictability of ABSI in the risk of mortality in patients with type 2 diabetes (T2D) are limited. We aimed to examine the independent and joint association of ABSI, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body roundness index (BRI) with mortality in patients with T2D. RESEARCH DESIGN AND METHODS The study included 11 872 patients (46.5% women) aged 30 years and older and who took part in diabetes care management program of a medical center in Taiwan. Body indices were evaluated by anthropometric measurements at baseline between 2001 and 2016, and their death status was followed up through 2021. Multivariate Cox regression models were used to assess the effect of body indices on mortality. RESULTS During a mean follow-up of 10.2 years, 560 cardiovascular disease (CVD) deaths and 3043 deaths were recorded. For ABSI, WC, WHR, WHtR and BRI, all-cause mortality rates were statistically significantly greater in Q4 versus Q2. For BMI and WHtR, all-cause mortality rates were also statistically significantly greater in Q1 versus Q2. The combination of BMI and ABSI exhibited a superiority in identifying risks of all-cause mortality and CVD mortality (HRs: 1.45 and 1.37, both p<0.01). CONCLUSIONS Combined use of ABSI and BMI can contribute to the significant explanation of the variation in death risk in comparison with the independent use of BMI or other indices.
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Affiliation(s)
- Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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12
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Melo G, Aguilar-Farias N, López Barrera E, Chomalí L, Moz-Christofoletti MA, Salgado JC, Swensson LJ, Caro JC. Structural responses to the obesity epidemic in Latin America: what are the next steps for food and physical activity policies? LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100486. [PMID: 37096192 PMCID: PMC10122054 DOI: 10.1016/j.lana.2023.100486] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/12/2023] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
Obesity is among the most complex public health challenges, particularly in Latin America, where obesity rates have increased faster than in any other region. Many countries have proposed or enacted comprehensive policies to promote adequate diet and physical activity under a structural framework. We summarize articles discussing the scope and impact of recently implemented obesity-related interventions in the light of a structural response framework. Overall, we find that: (1) market-based food interventions, including taxes on junk food, nutrition labelling, and marketing restrictions, decrease the consumption of targeted foods, (2) programs directly providing healthy foods are effective in reducing obesity, and (3) the construction of public areas for recreation increases the average frequency of physical activity. Although obesity-related interventions in the region have somewhat improved health behaviours, obesity prevalence remains on an upward trend. We discuss some opportunities to continue tackling the obesity epidemic in LATAM under a structural framework.
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Affiliation(s)
- Grace Melo
- Accountability, Climate, Equity, and Scholarship (ACES), Department of Agricultural Economics, Texas A&M, College Station, TX, USA
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de la Frontera, Chile
| | | | | | | | - Juan Carlos Salgado
- Center for Nutrition and Health Research, National Institute of Public Health and National Council for Science and Technology, Mexico
| | - Luana Joppert Swensson
- Policy and Legal Specialist for Sustainable Public Procurement, Food and Agriculture Organization, Italy
| | - Juan Carlos Caro
- Department of Industrial Engineering, University of Concepción, Chile
- Corresponding author. Department of Industrial Engineering, University of Concepción, Chile, Edmundo Larenas 219, Concepción, Chile.
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13
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Kranjac AW, Kranjac D. Explaining adult obesity, severe obesity, and BMI: Five decades of change. Heliyon 2023; 9:e16210. [PMID: 37251838 PMCID: PMC10213181 DOI: 10.1016/j.heliyon.2023.e16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971-2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall increase in mean BMI, and obesity and severe obesity prevalence. Birth cohort membership (i.e., the CR mechanism) is also influencing mean BMI, and rates of obesity and severe obesity, but in differing ways. Specifically, the large positive IC and the small positive CR effects are amplifying one another, thus creating a steep increase in the observed rates of severe obesity. Conversely, the large positive IC effect is offset by a small negative CR effect, which created a more gradual rise in mean BMI and rates of obesity. Furthermore, we computed total change for models that entered separately sociodemographic, lifestyle, nutritional, and physical activity measures to estimate differences in mean BMI, and rates of obesity and severe obesity, among cohorts and time periods. Adjustment for all the compositional differences among the cohorts during the study period indicate that a combination of a more pronounced IC and a less pronounced CR drove the observed increase in mean BMI, and rates of obesity and severe obesity. Thus, "universal prevention" (i.e., entire community) strategies for healthy weight promotion may need to be combined with "selective prevention" (i.e., at-risk groups) and/or "targeted prevention" (i.e., at-risk individuals) approaches in order to reverse the obesity epidemic.
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Affiliation(s)
- Ashley W. Kranjac
- Department of Sociology, Wilkinson College, Chapman University, Orange, CA, USA
| | - Dinko Kranjac
- Psychology Program, Institute of Mental Health and Psychological Well-Being, College of Health and Community Well-Being, University of La Verne, La Verne, CA, USA
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14
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Luli M, Yeo G, Farrell E, Ogden J, Parretti H, Frew E, Bevan S, Brown A, Logue J, Menon V, Isack N, Lean M, McEwan C, Gately P, Williams S, Astbury N, Bryant M, Clare K, Dimitriadis GK, Finlayson G, Heslehurst N, Johnson B, Le Brocq S, Roberts A, McGinley P, Mueller J, O'Kane M, Batterham RL, Miras AD. The implications of defining obesity as a disease: a report from the Association for the Study of Obesity 2021 annual conference. EClinicalMedicine 2023; 58:101962. [PMID: 37090435 PMCID: PMC10119881 DOI: 10.1016/j.eclinm.2023.101962] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Unlike various countries and organisations, including the World Health Organisation and the European Parliament, the United Kingdom does not formally recognise obesity as a disease. This report presents the discussion on the potential impact of defining obesity as a disease on the patient, the healthcare system, the economy, and the wider society. A group of speakers from a wide range of disciplines came together to debate the topic bringing their knowledge and expertise from backgrounds in medicine, psychology, economics, and politics as well as the experience of people living with obesity. The aim of their debate was not to decide whether obesity should be classified as a disease but rather to explore what the implications of doing so would be, what the gaps in the available data are, as well as to provide up-to-date information on the topic from experts in the field. There were four topics where speakers presented their viewpoints, each one including a question-and-answer section for debate. The first one focused on the impact that the recognition of obesity could have on people living with obesity regarding the change in their behaviour, either positive and empowering or more stigmatising. During the second one, the impact of defining obesity as a disease on the National Health Service and the wider economy was discussed. The primary outcome was the need for more robust data as the one available does not represent the actual cost of obesity. The third topic was related to the policy implications regarding treatment provision, focusing on the public's power to influence policy. Finally, the last issue discussed, included the implications of public health actions, highlighting the importance of the government's actions and private stakeholders. The speakers agreed that no matter where they stand on this debate, the goal is common: to provide a healthcare system that supports and protects the patients, strategies that protect the economy and broader society, and policies that reduce stigma and promote health equity. Many questions are left to be answered regarding how these goals can be achieved. However, this discussion has set a good foundation providing evidence that can be used by the public, clinicians, and policymakers to make that happen.
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Affiliation(s)
- Migena Luli
- Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Giles Yeo
- Department of Clinical Biochemistry, Institute of Metabolic Science, Cambridge University, Cambridge, United Kingdom
| | - Emma Farrell
- School of Education, University College Dublin, Dublin, Ireland
| | - Jane Ogden
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Helen Parretti
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, United Kingdom
| | - Emma Frew
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, United Kingdom
| | - Stephen Bevan
- HR Research Development, Institute for Employment, Brighton, United Kingdom
| | - Adrian Brown
- Department of Experimental and Translational Medicine, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Jennifer Logue
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Vinod Menon
- Department of Upper Gastrointestinal Team, University Hospitals and Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - Nadya Isack
- Obesity Empowerment Network, London, United Kingdom
| | - Michael Lean
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, United Kingdom
| | | | - Paul Gately
- Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | | | - Nerys Astbury
- Nuffield Department of Primary Care Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, University of York, York, United Kingdom
| | - Kenneth Clare
- European Coalition for People Living with Obesity, United Kingdom
| | - Georgios K. Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Graham Finlayson
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Nicola Heslehurst
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Brett Johnson
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Audrey Roberts
- European Coalition for People Living with Obesity, United Kingdom
| | - Patrick McGinley
- Department of Finance, Maidstone & Tunbridge Wells NHS Trust, Kent, United Kingdom
| | - Julia Mueller
- Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Mary O'Kane
- Dietetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Rachel L. Batterham
- School of Life and Medical Sciences, University College London, London, United Kingdom
| | - Alexander Dimitri Miras
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- School of Medicine, Ulster University, United Kingdom
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15
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Bel-Serrat S, Klingenstein P, Marques-Previ M, Hennessy E, Murrin C. Perceived barriers to vegetable intake among urban adolescents from socioeconomically disadvantaged backgrounds: A qualitative study from the perspective of youth workers and teachers. Physiol Behav 2023; 262:114074. [PMID: 36623744 DOI: 10.1016/j.physbeh.2023.114074] [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: 11/08/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
Eating habits established during adolescence have been shown to track into adulthood. Adolescents from lower socioeconomic status groups tend to have lower intakes of vegetables as compared with their more affluent peers. However, there is limited evidence about the determinants of vegetable intake in this population group. Therefore, this study aimed to explore the barriers to vegetable intake in adolescents living in socioeconomically disadvantaged areas through the perspective of school teachers and youth workers. A total of 20 semi-structured interviews were conducted with post-primary school teachers and youth workers from disadvantaged areas in Dublin, Ireland. Thematic analysis was applied to analyze the data. Eleven themes were identified and fitted within the Socioecological Model of Health: adolescent's food preferences, lack of early exposure and familiarity with vegetables, lack of interest, knowledge and skills at the individual and family level, parenting practices around nutrition, living difficulties, peers' influence and social norms around nutrition, dual role of social media, lack of resources and support to promote healthy eating, competition between unhealthy food vs. vegetables, lack of adequate approaches & initiatives at the community and at the public policy levels, and lack of State support to promote healthy eating. Although several actions could be taken at the personal and interpersonal levels, more efforts are needed at the organizational, community and public policy levels to improve dietary choices and vegetable intake among adolescents in socioeconomically deprived areas. These findings will inform the development of tailored intervention strategies and policies for these vulnerable youths.
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Affiliation(s)
- Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Pauline Klingenstein
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maria Marques-Previ
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eilis Hennessy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Celine Murrin
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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16
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Ortega R, Grandes G, Gómez-Cantarino S. [Vulnerability of obesity as defined by body mass index, waist circumference, and body fat percentage]. Aten Primaria 2023; 55:102523. [PMID: 36580708 PMCID: PMC9813526 DOI: 10.1016/j.aprim.2022.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/18/2022] [Accepted: 11/07/2022] [Indexed: 12/28/2022] Open
Abstract
AIM To ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]). DESIGN Longitudinal observational and retrospective study. SITE: Eleven Spanish health centers. PARTICIPANTS Men and women with BMI≥30kg/m2 (n=1246) or general obesity (GO), with WC>102cm and >88cm, respectively (n=2122) or abdominal obesity (AO) and with BFP>25% and >35%, respectively (n=2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80years. MAIN MEASUREMENTS Data from the PEPAF study at baseline and at 6, 12 and 24months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women). RESULTS Of 2054 participants with any type of obesity at baseline and valid data at 2years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95%CI: 17.6-21.4) ceased to have EBF, 12.0% (95%CI: 10.4-13.7) ceased to have AO and 10.5% (95%CI: 8.5-12.7) ceased to have GO. CONCLUSIONS Obesity differs from other chronic diseases in that it can be «cured» by normalizing the amount of body fat.
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Affiliation(s)
- Ricardo Ortega
- Centro de Salud de Santa Bárbara, Servicio de Salud de Castilla-La Mancha, Toledo, España.
| | - Gonzalo Grandes
- Unidad de Investigación en Atención Primaria de Bizkaia, Servicio Vasco de Salud (Otsakidetza), Bilbao, España
| | - Sagrario Gómez-Cantarino
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, España
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17
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Tea Plant ( Camellia sinensis): A Current Update on Use in Diabetes, Obesity, and Cardiovascular Disease. Nutrients 2022; 15:nu15010037. [PMID: 36615695 PMCID: PMC9823498 DOI: 10.3390/nu15010037] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
The tea plant (C. sinensis) has traditionally been consumed worldwide as "tea" for its many health benefits, with the potential for the prevention and therapy of various conditions. Regardless of its long history, the use of tea plants in modern times seems not to have changed much, as the beverage remains the most popular form. This review aimed to compile scientific information about the role and action of tea plants, as well as their status concerning clinical applications, based on the currently available evidence, with a focus on metabolic syndrome, mainly covering obesity, diabetes, and cardiovascular disease. It has been recognized that these diseases pose a significant threat to public health, and the development of effective treatment and prevention strategies is necessary but still challenging. In this article, the potential benefits of tea plants and their derived bioactive components (such as epigallocatechin-3-gallate) as anti-obesity, anti-diabetic, and anti-cardiovascular agents are clearly shown and emphasized, along with their mechanisms of action. However, according to the status of the clinical translation of tea plants, particularly in drug development, more substantial efforts in well-designed, randomized, controlled trials are required to expand their applications in treating the three major metabolic disorders and avoiding the toxicity caused by overconsumption.
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18
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Middel CN, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JE. Designing a Healthy Food-Store Intervention; A Co-Creative Process Between Interventionists and Supermarket Actors. Int J Health Policy Manag 2022; 11:2175-2188. [PMID: 34634882 PMCID: PMC9808264 DOI: 10.34172/ijhpm.2021.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/17/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Without consideration for the food system in which healthy food-store interventions (HFIs) are implemented, their effects are likely to be unsustainable. Co-creation of HFIs by interventionists and food-store actors may improve contextual fit and therefore the effectiveness and sustainability of interventions, but there are few case studies on the topic. This study aims to provide insights into the integration of knowledge from contextual actors into HFI designs, through a co-creative process, to illustrate potential challenges, advantages, and outcomes. METHODS We describe the co-creative design of an HFI in a Dutch supermarket chain, conducted through three increasingly in-depth design phases. Each phase consisted of a cycle of theorizing (gather insights from literature, feedback, and pilot studies), building (develop intervention designs), and evaluating (interviews or workshops with supermarket actors, to explore barriers and facilitators for sustainable implementation), feeding back into the next phase (drafting adapted intervention designs, based on feedback, and research input). Interview transcripts underwent a qualitative content analysis. RESULTS We co-creatively designed four types of interventions to promote healthier food choices in supermarkets: (1) price strategies, (2) product presentation and positioning, (3) signage, and (4) interactive messaging. Interventions were aligned with the culture, structures and practices of the supermarket chain, while simultaneously challenging these system characteristics. For example, the idea of price promotions on healthy foods was well-received and encountered only practical barriers, which were easily resolved. However, the specification of tax-like price increases on unhealthy foods led to substantial resistance on cultural and commercial grounds, which were resolved through support from a key supermarket actor. CONCLUSION Our results illustrate the potential benefits of co-creation approaches in HFI design. We reflect on the value of more easily accepted interventions to develop collaborative momentum and more radical interventions to drive more substantial changes.
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Affiliation(s)
- Cédric N.H. Middel
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Joreintje D. Mackenbach
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Upstream Team, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jacqueline E.W. Broerse
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Tong TJ, Mohammadnezhad M, Alqahtani NS. Determinants of overweight and obesity and preventive strategies in Pacific countries: a systematic review. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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20
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Abstract
Population-based solutions are needed to stabilize and then reverse the continued upward trends in obesity prevalence in the US population and worldwide. This review focuses on the related, urgent issue of disparities in obesity prevalence affecting US racial/ethnic minority and other socially marginalized populations. The review provides background on these disparities from a health equity perspective and highlights evidence of progress in equity-focused obesity efforts. Five recommendations for advancing equity efforts are offered as potential approaches to build on progress to date: (a) give equity issues higher priority, (b) adopt a health equity lens, (c) strengthen approaches by using health equity frameworks, (d) broaden the types of policies considered, and (e) emphasize implementation science concepts and tools. Potential challenges and opportunities are identified, including the prospect of longer-term, transformative solutions that integrate global and national initiatives to address obesity, undernutrition, and climate change.
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Affiliation(s)
- Shiriki K Kumanyika
- Dornsife School of Public Health, Drexel University, and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
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21
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Bopape M, Taillie LS, Swart R. Perceived effect of warning label on parental food purchasing and drivers of food selection among South African parents–An exploratory study. Front Public Health 2022; 10:939937. [PMID: 35991029 PMCID: PMC9388905 DOI: 10.3389/fpubh.2022.939937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Household food purchasing decision is a complex process influenced by factors such as marketing, cost, children food preference and parental choices. Most food products targeted toward children are unhealthy and are aggressively marketed to increase desirability among parents and children making healthier food selection even harder. The warning label (WL) is identified as a simple front-of-package labeling format that assist consumers to easily identify unhealthy foods and reduce their purchasing. This was a qualitative study that aimed to investigate the perceived effect of the warning label (WL) on parental food purchasing and drivers of food selection among parents. The study was conducted in a mainly rural part of South Africa, in Limpopo Province. Data were collected from 44 adult participants, all parents with children aged below 16 years selected using the snowball sampling method. Seven focus groups diversified according to age, literacy, income and urbanicity were utilized for data collection. Using a focus group discussion guide, parents were shown images of six products (crisps, soda, juice, biscuits, cereals, and yogurt) superimposed with the WL and questions asked were based on those images. Thematic analysis revealed that although some parents felt undeterred by the WL, some felt they would alter their food purchasing in the presence of the WL. Other parents felt they would reduce the frequency or the amount purchased or completely stop purchasing labeled products for their children. Motives behind perceived behavior modification included children's health being perceived as a priority and labeled products being viewed as unhealthy. Factors such as pressure from children, taste, poor nutrition knowledge and affordability seemed to influence parental food selection. These findings have important policy implications by providing evidence to policymakers that the WL may alter parental food purchasing and also provide insight into drivers of food selection among South African parents.
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Affiliation(s)
- Makoma Bopape
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Faculty of Community and Health Sciences, School of Public Health, University of the Western Cape, Cape Town, South Africa
- *Correspondence: Makoma Bopape
| | - Lindsey Smith Taillie
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rina Swart
- Department of Dietetics and Nutrition, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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22
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Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families. Eat Behav 2022; 46:101659. [PMID: 35964363 DOI: 10.1016/j.eatbeh.2022.101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.
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The effects of an 8-year individualised lifestyle intervention on food consumption and nutrient intake from childhood to adolescence: the PANIC Study. J Nutr Sci 2022; 11:e40. [PMID: 35720174 PMCID: PMC9171599 DOI: 10.1017/jns.2022.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/15/2022] Open
Abstract
We aimed to investigate the effects of a long-term, individualised, family-based lifestyle intervention on food consumption and nutrient intake from childhood to adolescence. We conducted an 8-year diet and physical activity intervention study in a population sample of children aged 7–9 years at baseline in 2007–2009. We allocated the participants to the intervention group (n 306) and the control group (n 198). We assessed diet by 4-d food records at baseline, 2-year follow-up and 8-year follow-up. We analysed the data using linear mixed-effects models adjusted for age at baseline and sex. The consumption of vegetables and vegetable oil-based spreads (fat ≥60 %) increased in the intervention group but did not change in the control group (P < 0⋅001 for time×group interaction). The consumption of fruits and berries increased in the intervention group but decreased in the control group (P = 0⋅036). The consumption of high-fat cheese (P = 0⋅029), butter-based spreads (P = 0⋅001) and salty snacks (P = 0⋅028) increased less, and the consumption of low-fat cheese (P = 0⋅004) increased more in the intervention group than in the control group. Saturated fat intake (P = 0⋅001) increased less, and the intakes of dietary fibre (P = 0⋅003), vitamin D (P = 0⋅042) and vitamin E (P = 0⋅027) increased more in the intervention group than in the control group. The intakes of vitamin C (P < 0⋅001) and folate (P = 0⋅001) increased in the intervention group but decreased in the control group. To conclude, individualised, family-based lifestyle intervention altered food choices towards more recommended diet and resulted in enhanced diet quality from childhood to adolescence.
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Cummings C, Crochiere R, Lansing AH, Patel R, Stanger C. A Digital Health Program Targeting Physical Activity Among Adolescents With Overweight or Obesity: Open Trial. JMIR Pediatr Parent 2022; 5:e32420. [PMID: 35343903 PMCID: PMC9002597 DOI: 10.2196/32420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Prior studies suggest that mobile health physical activity programs that provide only weekly or daily text-based health coaching evidence limit the efficacy in improving physical activity in adolescents with overweight or obesity. It is possible that incentives, combined with health coaching and daily feedback on goal success, may increase program efficacy; however, such programs have not yet been tested with adolescents with overweight and obesity. OBJECTIVE This study aims to examine the feasibility and acceptability of a 12-week, incentive-based, mobile health physical activity program with text-based health coaching, goal setting, and self-monitoring for adolescents with overweight or obesity. Program adherence and changes in tracked physical activity (ie, steps and active minutes while wearing a Fitbit [Google LLC]), body mass, and body fat are assessed. METHODS A total of 28 adolescents aged 13 to 18 years with a BMI ≥90th percentile participated in the program. Of the 28 participants, 2 (7%) were lost to follow-up; thus, data from 26 (93%) participants were used in analyses. RESULTS Participant-reported acceptability was high, with all mean ratings of text-based coaching, Fitbit use, and the overall program being >5 on a 7-point scale. In addition, 85% (23/26) of participants reported that they would like to continue to wear the Fitbit. Program adherence was also high, as participants wore the Fitbit on 91.1% (SD 12.6%) of days on average and met their weekly goals for an average of 7 (SD 3.5) of 11 possible weeks. There were no demographic (ie, sex, age, and baseline body mass) differences in the percentage of days participants wore their Fitbit. Across the 12-week study, there were significant improvements in tracked daily active minutes (P=.006) and steps (P<.001) and significant pre- to posttest improvements in body fat percentage (P=.04). CONCLUSIONS The pilot program improved adolescent physical activity and physical health. A larger factorial design trial with adaptive daily goals may clarify the role of each program component in driving physical activity.
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Affiliation(s)
- Caroline Cummings
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Rebecca Crochiere
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Amy Hughes Lansing
- Department of Psychological Science, University of Vermont, Burlington, VT, United States
| | - Riya Patel
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Catherine Stanger
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
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Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Murrin C, Stanley I, Romaniuk P, Harrington JM, Poelman MP. Strength of EU-level food environment policies and priority recommendations to create healthy food environments. Eur J Public Health 2022; 32:504-511. [PMID: 35265982 PMCID: PMC9159309 DOI: 10.1093/eurpub/ckac010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Food environments impact on diets, obesity and non-communicable diseases (NCDs). Government policies are essential to create healthy food environments. This study aimed to assess the strength of European Union (EU)-level policies, and identify and prioritize actions for the EU to create healthy food environments. Methods The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI included 26 policy and 24 infrastructure support indicators. Independent experts (n = 31) rated the strength of EU-level policies and infrastructure support for each of these indicators (on a 5-point scale, from very weak to very strong) and identified and prioritized actions to improve food environments. Results For 65% of the 26 policy indicators, EU-level policies were rated as weak and for 23% as very weak. For 63% of the 24 infrastructure support indicators, EU-level policies were rated as moderate and for 33% as weak. The experts recommended 18 policy and 19 infrastructure support actions to the EU. The Top 5 prioritized policy actions included three actions in the food composition domain (e.g. setting mandatory food composition targets), one action in the food prices domain and one action in the food promotion domain. The Top 5 prioritized infrastructure support actions included three actions in the leadership domain (e.g. developing a high-level NCDs Prevention Strategy) and two actions in the monitoring domain. Conclusions There is large potential for the EU to strengthen its policies and infrastructure support in order to improve food environments. This study specifies priority actions for the EU to create healthy food environments.
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Affiliation(s)
- Sanne K Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Stefanie Vandevijvere
- Sciensano, Department of Epidemiology and Public Health, Service of Lifestyle and Chronic Diseases, Brussels, Belgium
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Isobel Stanley
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Piotr Romaniuk
- Department of Health Policy, School of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | | | - Maartje P Poelman
- Chair group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
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Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Poelman MP. How can National Government Policies Improve Food Environments in the Netherlands? Int J Public Health 2022; 67:1604115. [PMID: 35321050 PMCID: PMC8935556 DOI: 10.3389/ijph.2022.1604115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 01/21/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives: Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. Methods: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Results: Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. Conclusion: There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the Netherlands.
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Affiliation(s)
- Sanne K. Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
- *Correspondence: Sanne K. Djojosoeparto,
| | - Carlijn B. M. Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Maartje P. Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Anto EO, Frimpong J, Boadu WIO, Tamakloe VCKT, Hughes C, Acquah B, Acheampong E, Asamoah EA, Opoku S, Appiah M, Tawiah A, Annani-Akollor ME, Wiafe YA, Addai-Mensah O, Obirikorang C. Prevalence of Cardiometabolic Syndrome and its Association With Body Shape Index and A Body Roundness Index Among Type 2 Diabetes Mellitus Patients: A Hospital-Based Cross-Sectional Study in a Ghanaian Population. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 2:807201. [PMID: 36994331 PMCID: PMC10012128 DOI: 10.3389/fcdhc.2021.807201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022]
Abstract
Cardiometabolic syndrome (MetS) is closely linked to type 2 diabetes mellitus (T2DM) and is the leading cause of diabetes complications. Anthropometric indices could be used as a cheap approach to identify MetS among T2DM patients. We determined the prevalence of MetS and its association with sociodemographic and anthropometric indices among T2DM patients in a tertiary hospital in the Ashanti region of Ghana. A comparative cross-sectional study was conducted among 241 T2DM outpatients attending the Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital for routine check-up. Sociodemographic characteristics, clinicobiochemical markers, namely, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1C) were measured. Anthropometric indices, namely, body mass index (BMI), Conicity index (CI), body adiposity index (BAI), A body shape index (ABSI), body roundness index (BRI), Waist-to-hip ratio (WHR), and Waist-to-height ratio (WHtR) were computed based on either the Height, Weight, Waist circumference (WC) or Hip circumference (HC) of the patients. Metabolic syndrome (MetS) was classified using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Data entry and analysis were done using Excel 2016 and SPSS version 25.0 respectively. Of the 241 T2DM patients, 99 (41.1%) were males whereas 144 (58.9%) were females. The prevalence of cardiometabolic syndrome (MetS) was 42.7% with dyslipidemia and hypertension recording a prevalence of 6.6 and 36.1%, respectively. Being a female T2DM patient [aOR = 3.02, 95%CI (1.59-5.76), p = 0.001] and divorced [aOR = 4.05, 95%CI (1.22-13.43), p = 0.022] were the independent sociodemographic predictors of MetS among T2DM patients. The 4th quartile for ABSI and 2nd to 4th quartiles for BSI were associated with MetS on univariate logistic regression (p <0.05). Multivariate logistic regression identified the 3rd quartile (aOR = 25.15 (2.02-313.81), p = 0.012) and 4th quartile (aOR = 39.00, 95%CI (2.68-568.49), p = 0.007) for BRI as the independent predictors of MetS among T2DM. The prevalence of cardiometabolic syndrome is high among T2DM patients and this was influenced by female gender, being divorced, and increased BRI. Integration of BRI as part of routine assessment could be used as early indicator of cardiometabolic syndrome among T2DM patients.
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Affiliation(s)
- Enoch Odame Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wina Ivy Ofori Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Charity Hughes
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benjamin Acquah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Acheampong
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Adu Asamoah
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen Opoku
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Appiah
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Augustine Tawiah
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Amo Wiafe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Andersen CC, de Baca TC, Votruba SB, Stinson EJ, Engel SG, Krakoff J, Gluck ME. Food insecurity moderates the relationship between momentary affect and adherence in a dietary intervention study. Obesity (Silver Spring) 2022; 30:369-377. [PMID: 35088549 PMCID: PMC8820389 DOI: 10.1002/oby.23335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Negative affect and food insecurity have been proposed to impede adherence to weight loss interventions. Therefore, this study examined the role of these variables on dietary adherence using Ecological Momentary Assessment. METHODS A total of 50 participants (19 male participants; age = 49 [SD 14] years) participated in an outpatient dietary study. Lean participants (n = 22; BMI ≤ 25 kg/m2 ) received a weight-maintaining energy needs (WMEN) diet, and participants with obesity (BMI ≥ 30) were randomized to receive either a WMEN diet (n = 14) or a 35% calorie-reduced diet (n = 14). Food insecurity was measured, and, twice daily, Ecological Momentary Assessment captured real-time affect ratings and adherence. Between-person (trait-level) and lagged within-person (state-level) scores were calculated. RESULTS Greater food insecurity and trait-level negative affect were associated with reduced adherence (p = 0.0015, p = 0.0002, respectively), whereas higher trait-level positive affect was associated with greater adherence (p < 0.0001). Significant interactions between affect and food insecurity revealed an association between higher trait positive affect and increased adherence at lower levels of food insecurity. Higher trait negative affect was more strongly associated with decreased adherence in participants with greater levels of food insecurity (-1 SD: B = -0.21, p = 0.22; mean: B = -0.46, SE = 0.13, p = 0.0004; +1 SD: B = -0.71, SE = 0.17, p < 0.0001). CONCLUSIONS Trait-level affect may be crucial in predicting dietary adherence, especially in those with greater food insecurity.
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Affiliation(s)
- Coley C. Andersen
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Tomás Cabeza de Baca
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Susanne B. Votruba
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Emma J. Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | | | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Marci E. Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
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Vidaña-Pérez D, Braverman-Bronstein A, Zepeda-Tello R, Camacho-García-Formentí D, Colchero MA, Rivera-Dommarco JA, Popkin BM, Barrientos-Gutierrez T. Equitability of Individual and Population Interventions to Reduce Obesity: A Modeling Study in Mexico. Am J Prev Med 2022; 62:105-113. [PMID: 34446315 DOI: 10.1016/j.amepre.2021.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Modeling studies have estimated the potential impact and cost effectiveness of interventions to reduce obesity; few have focused on their equity across socioeconomic groups. This study aims to compare the equitability of individual- and population-level interventions to reduce obesity in Mexico. METHODS Mathematical models were implemented to estimate the expected effect of 2 sugar-sweetened beverage tax scenarios (10% and 20%) and bariatric surgery, pharmacotherapy, and dietary advice as individual interventions to reduce body weight. Individual interventions were modeled using meta-analytical weight change, inclusion and exclusion criteria, and the probability of access to healthcare services. For the tax, investigators obtained the baseline consumption of sugar-sweetened beverages from the National Health Survey 2012 and applied the reduction in sales observed in 2016 to estimate the caloric change and weight reduction. Implementation costs and cost per person, per kilogram, and equity were calculated for all interventions over a 1-year timeframe. RESULTS The 20% tax produced the largest estimated increase (4.50%) in normal BMI prevalence, was the most cost effective, and had the largest and most equitable decrease in obesity across socioeconomic categories. Pharmacotherapy and bariatric surgery produced sizable decreases in obesity prevalence (3.68% and 1.18%), particularly among the middle and high socioeconomic groups, whereas dietary advice had the lowest impact on normal and obese categories. CONCLUSIONS Individual interventions were effective in reducing obesity; yet, they were more expensive and less equitable than population interventions. Obesity in Mexico affects all socioeconomic groups; available interventions need to be carefully analyzed to tailor a national strategy that is both effective and equitable.
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Affiliation(s)
- Dèsirée Vidaña-Pérez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Rodrigo Zepeda-Tello
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - M Arantxa Colchero
- Center for Health Services Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Estimating Dietary Intake from Grocery Shopping Data-A Comparative Validation of Relevant Indicators in Switzerland. Nutrients 2021; 14:nu14010159. [PMID: 35011033 PMCID: PMC8747076 DOI: 10.3390/nu14010159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 01/04/2023] Open
Abstract
In light of the globally increasing prevalence of diet-related chronic diseases, new scalable and non-invasive dietary monitoring techniques are urgently needed. Automatically collected digital receipts from loyalty cards hereby promise to serve as an objective and automatically traceable digital marker for individual food choice behavior and do not require users to manually log individual meal items. With the introduction of the General Data Privacy Regulation in the European Union, millions of consumers gained the right to access their shopping data in a machine-readable form, representing a historic chance to leverage shopping data for scalable monitoring of food choices. Multiple quantitative indicators for evaluating the nutritional quality of food shopping have been suggested, but so far, no comparison has validated the potential of these alternative indicators within a comparative setting. This manuscript thus represents the first study to compare the calibration capacity and to validate the discrimination potential of previously suggested food shopping quality indicators for the nutritional quality of shopped groceries, including the Food Standards Agency Nutrient Profiling System Dietary Index (FSA-NPS DI), Grocery Purchase Quality Index-2016 (GPQI), Healthy Eating Index-2015 (HEI-2015), Healthy Trolley Index (HETI) and Healthy Purchase Index (HPI), checking if any of them performs differently from the others. The hypothesis is that some food shopping quality indicators outperform the others in calibrating and discriminating individual actual dietary intake. To assess the indicators' potentials, 89 eligible participants completed a validated food frequency questionnaire (FFQ) and donated their digital receipts from the loyalty card programs of the two leading Swiss grocery retailers, which represent 70% of the national grocery market. Compared to absolute food and nutrient intake, correlations between density-based relative food and nutrient intake and food shopping data are stronger. The FSA-NPS DI has the best calibration and discrimination performance in classifying participants' consumption of nutrients and food groups, and seems to be a superior indicator to estimate nutritional quality of a user's diet based on digital receipts from grocery shopping in Switzerland.
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Opoku-Acheampong AA, Rosenkranz RR, Adhikari K, Muturi N, Logan C, Kidd T. Tools for Assessing Cardiovascular Disease Risk Factors in Underserved Young Adult Populations: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413305. [PMID: 34948914 PMCID: PMC8707965 DOI: 10.3390/ijerph182413305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 01/01/2023]
Abstract
Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).
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Affiliation(s)
- Audrey A. Opoku-Acheampong
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, KS 66506, USA; (A.A.O.-A.); (R.R.R.)
| | - Richard R. Rosenkranz
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, KS 66506, USA; (A.A.O.-A.); (R.R.R.)
| | - Koushik Adhikari
- Department of Food Science and Technology, College of Agricultural & Environmental Sciences, University of Georgia, Griffin, GA 30223, USA;
| | - Nancy Muturi
- A. Q. Miller School of Journalism and Mass Communication, Kansas State University, Manhattan, KS 66506, USA;
| | - Cindy Logan
- Academic Services, Hale Library, Kansas State University, Manhattan, KS 66506, USA;
| | - Tandalayo Kidd
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, KS 66506, USA; (A.A.O.-A.); (R.R.R.)
- Correspondence: ; Tel.: +1-(785)-532-0154
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Anton SS, Bukhari A, Baso AJA, Erika KA, Syarif I. Proximate, Mineral and Vitamin Analysis of Rebon Shrimp Diversification Products as an Indonesian Local Product: Supplementary Food for Malnourished Children. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Rebon shrimp (Acetes sp.) is a local food in the coastal areas of Southeast Asia that has good nutritional potential. It is a nutrient-rich food, high in protein, and beneficial to human health, but the utilization of rebon shrimp is still very low. Aims: This study aims to measure the proximate and mineral analysis of various rebon shrimp products that can be used as supplementary food, expected to be popularly used and consumed by the Indonesian people, particularly those of low economic income. Methods: The diversified products in this study are meatballs, floss, nuggets, fish sticks, and fish cakes made from Rebon Shrimp (Acetes sp.). The proximate levels were analyzed referring to the AOAC method, The mineral content Fe and Zn were analyzed using the AAS method. The Vitamins A and Vitamin C were determined by spectrophotometric methods and titrimetry methods. Results: This study revealed that rebon shrimp could be used in making children's healthy snacks. Snacks with rebon shrimp contributed to moisture (8.79 – 72.58 %), ash (5.06 – 10.29%), crude protein (20.41 – 27.93 %), crude fat (3.09 – 47.16%), and crude fiber (0.35 – 3.36 %). In addition, these foods also contained several important minerals and vitamins for the body, such as iron (9.47– 56.13 ppm), zinc (4.05– 40.02 ppm), Vitamin A (0.016 – 0.045%), and vitamin C (0.11 – 0.19%). Conclusion: Thus, rebon shrimp is potentially used as an alternative to local ingredients to improve the nutritional quality of children's food.
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Prattipati S, Mlangi JJ, Tarimo TG, Kweka GL, Thielman NM, Bettger JP, Mmbaga BT, Sakita FM, Hertz JT. Knowledge, attitudes, and preventive practices regarding ischemic heart disease among HIV-positive individuals in northern Tanzania. Trop Med Int Health 2021; 26:1652-1658. [PMID: 34637597 PMCID: PMC11012094 DOI: 10.1111/tmi.13690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe knowledge, attitudes, and practices (KAP) regarding ischemic heart disease (IHD) among adults with HIV in Tanzania. METHODS Adults presenting for routine HIV care at a clinic in northern Tanzania were consecutively enrolled and were administered a standardised KAP survey. For each participant, an IHD knowledge score was calculated by tallying correct answers to the IHD knowledge questions, with maximum score 10. Individual 5-year risk of cardiovascular event was calculated using the Harvard NHANES model. Associations between participant characteristics and IHD knowledge scores were assessed via Welch's t-test. RESULTS Among the 500 participants, the mean (SD) age was 45.3 (11.4) years and 139 (27.8%) were males. Most participants recognised high blood pressure (n = 313, 62.6%) as a risk factor for IHD, but fewer identified diabetes as a risk factor (n = 241, 48.2%), or knew that aspirin reduces the risk of a secondary cardiovascular event (n = 73, 14.6%). Higher IHD knowledge score was associated with post-primary education (mean 6.27 vs. 5.35, p = 0.001) and with >10% 5-year risk of cardiovascular event (mean 5.97 vs. 5.41, p = 0.045). Most participants believed there were things they could do to reduce their chances of having a heart attack (n = 361, 72.2%). While participants indicated that they adhered to their prescribed medications (n = 488, 97.6%), only 106 (21.2%) attended regular health check-ups. CONCLUSION Efforts are needed to improve gaps in IHD knowledge, and increase uptake of cardiovascular preventative practices among Tanzanian adults with HIV.
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Affiliation(s)
| | | | | | | | - Nathan M Thielman
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Janet P Bettger
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
- Duke-Margolis Center for Health Policy, Duke University, Washington, District of Colombia, USA
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre University College, Moshi, Tanzania
- Kilimanjaro Christian Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Francis M Sakita
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre University College, Moshi, Tanzania
| | - Julian T Hertz
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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Giuliani NR, Kelly NR. Maternal Attentional Control Moderates the Association Between Increased Depression and Controlling Feeding Practices During the COVID-19 Pandemic. JOURNAL OF PREVENTION AND HEALTH PROMOTION 2021; 2:294-310. [PMID: 36873601 PMCID: PMC9980833 DOI: 10.1177/26320770211032346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parental distress is associated with less healthful child feeding practices. In this preliminary study, we examined how changes in distress from before to during the COVID-19 pandemic were associated with similar changes in feeding practices in a sample of mothers of preschool-aged children. In addition, we examined how pre-pandemic laboratory measures of maternal self-regulation moderated this association. A total of 36 mothers from an ongoing study on parent and child self-regulation completed surveys assessing parental distress (i.e., maternal depression, parenting stress) and child feeding practices during pandemic-related stay-at-home orders in May-June 2020. These mothers had completed the same measures approximately 2 years earlier, along with laboratory assessments of inhibitory and attentional control. Pre-pandemic laboratory measures of attentional control significantly moderated the association between increased maternal depression and use of controlling feeding practices, such that mothers with better attentional, but not inhibitory, control scores did not show an effect of increased depression on feeding practices. These results provide preliminary evidence that acute increases in parental distress associated with "stay-at-home" orders affect feeding practices, specifically for mothers with lower levels of attentional control abilities.
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Castaneda C, Marsden K, Maxwell T, Ten Eyck P, Kuwaye D, Kenne KA, Merryman AS, Steffen HA, Swartz SR, Merrill AE, Krasowski MD, Jackson JB, Rysavy MB. Prevalence of maternal obesity at delivery and association with maternal and neonatal outcomes. J Matern Fetal Neonatal Med 2021; 35:8544-8551. [PMID: 34641757 DOI: 10.1080/14767058.2021.1988563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 infected and uninfected patients. METHODS We conducted a prospective cohort study using demographic and clinical data obtained from the electronic medical record. Excess plasma was collected from routine blood samples obtained at delivery admission to determine the seroprevalence of COVID-19 antibody using the DiaSorin and Roche antibody assays. Frequency variables were each calculated separately, and a comparison of maternal and neonatal outcomes was conducted using the generalized linear mixed modeling (GLMM) framework to account for varying distributions (normal and binary). RESULTS 1001 women delivered during the study period and 89.7% met criteria for being overweight or obese; 17.9% met criteria for severe obesity. Women with obesity had 49.8% lower odds of possessing private insurance, and women with severe obesity were less than half as likely to plan to breastfeed at the time of discharge. Women with obesity of any kind had a significantly increased odds of GDM and gHTN, and an increased risk of an infant with macrosomia, hypoglycemia, and NICU admission. No significant association was found between BMI and COVID-19 infection or disease severity. CONCLUSION This study provides insight into obstetric complications facing women with obesity, especially those with severe obesity. This report serves to highlight potential challenges, such as insurance status and labor complications, that impact women of high BMI to a greater degree when compared to their normal-weight counterparts.
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Affiliation(s)
| | | | - Timothy Maxwell
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | - Patrick Ten Eyck
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Daren Kuwaye
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Kimberly A Kenne
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
| | - Abbey S Merryman
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
| | - Haley A Steffen
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Anna E Merrill
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | | | | | - Mary B Rysavy
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
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Wang D, Day EA, Townsend LK, Djordjevic D, Jørgensen SB, Steinberg GR. GDF15: emerging biology and therapeutic applications for obesity and cardiometabolic disease. Nat Rev Endocrinol 2021; 17:592-607. [PMID: 34381196 DOI: 10.1038/s41574-021-00529-7] [Citation(s) in RCA: 162] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 02/06/2023]
Abstract
Growth differentiation factor 15 (GDF15) is a member of the TGFβ superfamily whose expression is increased in response to cellular stress and disease as well as by metformin. Elevations in GDF15 reduce food intake and body mass in animal models through binding to glial cell-derived neurotrophic factor family receptor alpha-like (GFRAL) and the recruitment of the receptor tyrosine kinase RET in the hindbrain. This effect is largely independent of other appetite-regulating hormones (for example, leptin, ghrelin or glucagon-like peptide 1). Consistent with an important role for the GDF15-GFRAL signalling axis, some human genetic studies support an interrelationship with human obesity. Furthermore, findings in both mice and humans have shown that metformin and exercise increase circulating levels of GDF15. GDF15 might also exert anti-inflammatory effects through mechanisms that are not fully understood. These unique and distinct mechanisms for suppressing food intake and inflammation makes GDF15 an appealing candidate to treat many metabolic diseases, including obesity, type 2 diabetes mellitus, non-alcoholic fatty liver disease, cardiovascular disease and cancer cachexia. Here, we review the mechanisms regulating GDF15 production and secretion, GDF15 signalling in different cell types, and how GDF15-targeted pharmaceutical approaches might be effective in the treatment of metabolic diseases.
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Affiliation(s)
- Dongdong Wang
- Centre for Metabolism, Obesity and Diabetes Research and the Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Emily A Day
- Centre for Metabolism, Obesity and Diabetes Research and the Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Logan K Townsend
- Centre for Metabolism, Obesity and Diabetes Research and the Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Djordje Djordjevic
- Global Obesity and Liver Disease Research, Novo Nordisk A/S, Maaloev, Denmark
| | | | - Gregory R Steinberg
- Centre for Metabolism, Obesity and Diabetes Research and the Department of Medicine, McMaster University, Hamilton, ON, Canada.
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Lee JH, Kang MY. The Influence of Chronic Diseases on Self-Reported Work Disability: Evidence From the Korean Labor and Income Panel Study 2003-2018. J Occup Environ Med 2021; 63:e732-e736. [PMID: 34412094 DOI: 10.1097/jom.0000000000002356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the relationship between the types of chronic diseases and self-reported work disability. METHODS We used data from the Korean Labor and Income Panel Study from waves 6 to 21 conducted from 2003 to 2018. New cases of work disability were defined as those who reported that they had work limitations due to their health problems. Information on chronic disease was collected using a questionnaire during the sixth wave of the survey. To evaluate the effects of chronic disease on self-reporting work disability, Cox proportional hazard models were used. RESULTS The three most influential diseases on work disability were ophthalmologic diseases, chronic kidney diseases, and cardiovascular diseases during the 15-year follow-up period. CONCLUSION Work disability is strongly and significantly associated with the aforementioned chronic diseases.
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Affiliation(s)
- June-Hee Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea (Dr Lee); Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (Dr Kang)
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Implementing Food Environment Policies at Scale: What Helps? What Hinders? A Systematic Review of Barriers and Enablers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910346. [PMID: 34639646 PMCID: PMC8507658 DOI: 10.3390/ijerph181910346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
Background: Policies that support healthier food environments, including healthy retail food availability and promotion, are an important strategy for obesity prevention. The aim of this systematic review was to examine the evidence for barriers and enablers to successful implementation of healthy food and drink policies, delivered at scale. Methods: MEDLINE, SCOPUS and INFORMIT were searched to May 2019 for peer-reviewed studies. Google and Google Scholar were searched for grey literature. Studies of any design relating to a healthy food and drink policy delivered at scale (≥10 sites) in non-commercial food settings, for specific retail outlets (e.g., vending machines, cafes, cafeterias, school canteens), and that reported on implementation barriers and/or enablers were included. Studies in commercial food retail environments (e.g., supermarkets) were excluded. Studies were appraised for quality and key information was extracted and summarised. Extracted information on barriers and enablers was further grouped into overarching themes relating to perceptions of the policy itself, organisational and contextual factors influencing policy implementation, stakeholder responses to the implemented policy and perceived policy impacts. Results: Of 19 studies, 16 related to policies implemented in schools, two in hospital/health facilities and one in a sport/recreation setting. Most studies were conducted in North America or Australia, and policy implementation occurred mainly at state/regional or federal levels. The most commonly cited barriers across overarching themes and intervention settings were: lack of stakeholder engagement or prioritisation of the policy (11 studies); resistance to change from school stakeholders or customers (8 studies); and concern over profitability, revenue and/or commercial viability (8 studies). Few studies reported on mitigation of barriers. Enablers most commonly raised were: stakeholder engagement, whole-school approach and/or prioritisation of the policy (9 studies); policy level or higher-level support in the form of information, guidance and/or training (5 studies); and leadership, school/policy champion, management commitment and/or organisational capacity (4 studies). Conclusions: Key considerations for policy implementation ranged from building stakeholder support, prioritising policy implementation within organisations, to implementing strategies that address financial concerns and implementation barriers.
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Dor-Haim H, Katzburg S, Revach P, Levine H, Barak S. The impact of COVID-19 lockdown on physical activity and weight gain among active adult population in Israel: a cross-sectional study. BMC Public Health 2021; 21:1521. [PMID: 34362319 PMCID: PMC8343341 DOI: 10.1186/s12889-021-11523-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak holds public health concerns. The stay-at-home increases sedentary behavior, with unintended adverse outcomes. Since organized recreation and sports facilities were closed, we aimed to study how the crisis of closure affected exercise habits and weight gain among the trainee population in Israel. We examined differences in weight gain among individuals with different PA activities and assessed their ability to adapt to digital media as an alternative training structure. METHODS A cross-sectional survey consisted of a multiple-choice questionnaire obtained using a web-based survey application. Trainees (1202) who exercised steadily anonymously answered the questionnaire sent by their coaches regarding their activity and weight gain during lockdown times. RESULTS Results confirmed that 70% of Israelis trained less than their usual routine, 60% used digital media for training, 55% gained weight. Half of the respondents gained more than 2 kg, with an average increase of 1.2 kg. However, those who exhibited a higher physical activity level gained less weight. Using digital media for training was associated with higher physical activity levels. The aged population was less likely to use digital media. CONCLUSIONS Since increased sedentary behavior could increase the risk for potential worsening of health conditions, health agencies should look for strategies, including digital remote media training to promote physical activity and subsequently, preventing the increased burden of future comorbidities worsening by a sedentary lifestyle. Approval: by the Helsinki ethics committee of Sheba Medical Center (6504-19-SMC).
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Affiliation(s)
- Horesh Dor-Haim
- O2 Health Promotion and Sports Medicine Department, The Howard and Mary Edith Cosell Association for Physical Education, the Safra sports center, Hebrew University, Givat Ram, Jerusalem, Israel.
| | - Sara Katzburg
- O2 Health Promotion and Sports Medicine Department, The Howard and Mary Edith Cosell Association for Physical Education, the Safra sports center, Hebrew University, Givat Ram, Jerusalem, Israel
- Department of Developmental Biology and Cancer Research, Israel-Canada Medical Research Institute, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Polla Revach
- O2 Health Promotion and Sports Medicine Department, The Howard and Mary Edith Cosell Association for Physical Education, the Safra sports center, Hebrew University, Givat Ram, Jerusalem, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Barak
- The Edmond and Lily Safra Children's Hospital, Department of Pediatric Rehabilitation, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Kaye Academic College of Education, Beer-Sheva, Israel
- College of Public Health Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Lei XG, Ruan JQ, Lai C, Sun Z, Yang X. Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2021; 29:985-994. [PMID: 33864346 DOI: 10.1002/oby.23152] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The study objective was to examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight or obesity by meta-analysis and systematic review. METHODS Medical Subject Headings and free-text terms were selected to search for eligible trials in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase up to April 18, 2020. The quality of randomized controlled trials was evaluated by the Cochrane risk-of-bias tool. Meta-analysis was performed using random-effect models. RESULTS Phentermine/topiramate therapy resulted in an average weight loss of 7.73 kg (95% CI: 6.60-8.85) in general compared with placebo. The weight loss was related to the dose of phentermine/topiramate. Compared with placebo, the average weight loss was 3.55 kg (95% CI: 2.22-4.88) for 3.75/23 mg, 7.27 kg (95% CI: 6.40-8.13) for 7.5/46 mg, and 8.25 kg (95% CI: 6.92-9.79) for 15/92 mg. For phentermine/topiramate participants in different weight-loss subgroups, the weight loss of participants with ≥5%, ≥10%, and ≥15% baseline weight loss was 3.18 (95% CI: 2.75-3.67), 5.32 (95% CI: 4.53-6.25), and 5.65 (95% CI: 3.55-9.01), respectively. Compared with placebo, the adverse events associated with the treatment mainly included dysgeusia (odds ratio [OR] = 8.86, 95% CI: 5.65-13.89), paresthesia (OR = 8.51, 95% CI: 6.20-11.67), dry mouth (OR = 6.71, 95% CI: 5.03-8.94), disturbance in attention (OR = 4.48, 95% CI: 2.39-8.41), irritability (OR = 4.10, 95% CI: 2.29-7.33), hypoesthesia (OR = 3.81, 95% CI: 1.32-11.00), constipation (OR = 2.43, 95% CI: 2.02-2.93), and dizziness (OR = 2.26, 95% CI: 1.72-2.98). Phentermine/topiramate also reduced waist circumference, blood pressure, blood sugar levels, and lipid levels. CONCLUSIONS Phentermine/topiramate has considerable benefit in reducing body weight, and the efficacy was closely related to the dosage. However, it increased the risk of nervous system-related adverse events.
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Affiliation(s)
- Xiang-Guo Lei
- Geriatrics Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Precision Medicine in Cardio cerebrovascular Diseases Control and Prevention, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jia-Qi Ruan
- School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Lai
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ziyi Sun
- Geriatrics Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Precision Medicine in Cardio cerebrovascular Diseases Control and Prevention, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xi Yang
- Geriatrics Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Precision Medicine in Cardio cerebrovascular Diseases Control and Prevention, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Almutairi NS, Burns S, Portsmouth L. Identifying factors associated with overweight and obesity among intermediate school students aged 12-15 years in school settings: mixed-methodology protocol. BMJ Open 2021; 11:e045877. [PMID: 34049915 PMCID: PMC8166636 DOI: 10.1136/bmjopen-2020-045877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health concern globally. In Arab countries, the prevalence of overweight and obesity has increased significantly over the last three decades. The level of childhood overweight and obesity in the Kingdom of Saudi Arabia (KSA) is high and continues to increase. This study will explore factors associated with overweight and obesity among adolescents and identify barriers and enablers to the implementation of comprehensive school-based obesity prevention interventions. METHODS AND ANALYSIS Socioecological model will inform this mixed-methods study. The study will include three phases: (1) a scoping review of the literature; (2) the development of a student survey instrument and (3) a mixed-method study comprising a cross-sectional survey targeting students aged 12-15 years with the collection of the students' height and weight measurements; one-on-one interviews with physical education teachers and school principals; and the administration of school climate audits using the Health Promoting School framework. Reliability and validity of the survey instrument will be examined during survey development. Descriptive, inferential and thematic analysis will be employed using appropriate statistical software. ETHICS AND DISSEMINATION Ethical approval has been granted from the Curtin University of Human Research Ethics Committee (HR2020-0337) and from the KSA Ministry of Education (4181827686). School principals will provide permission to conduct the study in individual schools. Individual consent/assent will be obtained from students and their parents, and teachers. Study findings will be disseminated via peer-review publications, reports and conferences.
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Affiliation(s)
- Naif Saleh Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
- Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia
| | - Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Linda Portsmouth
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
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Atakan MM, Koşar ŞN, Güzel Y, Tin HT, Yan X. The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue. Nutrients 2021; 13:nu13051459. [PMID: 33922998 PMCID: PMC8145589 DOI: 10.3390/nu13051459] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022] Open
Abstract
The prevalence of obesity continues to rise worldwide despite evidence-based public health recommendations. The promise to adopt a healthy lifestyle is increasingly important for tackling this global epidemic. Calorie restriction or regular exercise or a combination of the two is accepted as an effective strategy in preventing or treating obesity. Furthermore, the benefits conferred by regular exercise to overcome obesity are attributed not only to reduced adiposity or reduced levels of circulating lipids but also to the proteins, peptides, enzymes, and metabolites that are released from contracting skeletal muscle or other organs. The secretion of these molecules called cytokines in response to exercise induces browning of white adipose tissue by increasing the expression of brown adipocyte-specific genes within the white adipose tissue, suggesting that exercise-induced cytokines may play a significant role in preventing obesity. In this review, we present research-based evidence supporting the effects of exercise and various diet interventions on preventing obesity and adipose tissue health. We also discuss the interplay between adipose tissue and the cytokines secreted from skeletal muscle and other organs that are known to affect adipose tissue and metabolism.
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Affiliation(s)
- Muhammed Mustafa Atakan
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Şükran Nazan Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Yasemin Güzel
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Hiu Tung Tin
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
| | - Xu Yan
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
- Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia
- Correspondence: ; Tel.: +61-3-9919-4024; Fax: +61-3-9919-5615
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Latham S, Finch JE, Reardon S, Waldfogel J. Increases in Income-Related Disparities in Early Elementary School Obesity, 1998-2014. Acad Pediatr 2021; 21:304-311. [PMID: 33279735 DOI: 10.1016/j.acap.2020.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 11/14/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Research shows that population-level rates of obesity, which rose dramatically from the 1970s through the mid-2000s, have since plateaued or even started to decline. However, overall improvements may mask differences in trends for different subgroups. For instance, obesity rates have continued to climb among low-income adolescents, leading to growing income-related gaps in obesity. By comparison, we know little about whether income-related disparities have also changed among elementary school children. To address this gap, we examined two cohorts of the Early Childhood Longitudinal Study - Kindergarten cohort, which followed children entering school in 1998 and 2010. We hypothesized that income-related disparities in obesity have also grown larger over time among young children. METHODS We used data from nationally representative samples of children who entered kindergarten in 1998 and 2010. We documented rates of overweight and obesity from kindergarten through third grade, examined how rates differed for children from high- and low-income families, and tested whether income-related disparities changed over time. RESULTS Rates of overweight and obesity were 2 to 5 percentage points higher in the later cohort, and overall increases masked substantial variation by income. Specifically, these increases were driven by children in lower-income households, resulting in substantially larger income-related disparities in overweight and obesity in the later cohort. CONCLUSIONS As we hypothesized, income-related disparities in young children's obesity grew between 1998 and 2014. This suggests that efforts to curb increasing rates of obesity may have been more successful for higher-income families. We discuss potential mechanisms that may account for increasing disparities.
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Affiliation(s)
- Scott Latham
- Education Research Section (S Latham), Princeton University, Princeton, NJ.
| | - Jenna E Finch
- Department of Psychology (JE Finch), University of Nebraska-Lincoln, Lincoln, Nebr
| | - Sean Reardon
- Center for Education Policy Analysis (S Reardon), Stanford University, Stanford, Calif
| | - Jane Waldfogel
- Columbia University School of Social Work (J Waldfogel), Columbia University, New York, NY
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Alam MT, Echeverria SE, DuPont-Reyes MJ, Vasquez E, Murillo R, Gonzalez T, Rodriguez F. Educational Attainment and Prevalence of Cardiovascular Health (Life's Simple 7) in Asian Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041480. [PMID: 33557415 PMCID: PMC7914420 DOI: 10.3390/ijerph18041480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022]
Abstract
Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.
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Affiliation(s)
- Md Towfiqul Alam
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
- Correspondence:
| | - Sandra E. Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Melissa J. DuPont-Reyes
- Department of Epidemiology & Biostatistics, Texas A&M University, College Station, TX 77843, USA;
| | - Elizabeth Vasquez
- Department of Epidemiology & Biostatistics, University at Albany, Albany, NY 12144, USA;
| | - Rosenda Murillo
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Tailisha Gonzalez
- Department of Community Health, CUNY Graduate School of Public Health & Health Policy, New York, NY 10027, USA;
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Quarry Road, Falk CVRC, Stanford, CA 94305, USA;
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Momin SR, Senn MK, Buckley S, Buist NR, Gandhi M, Hair AB, Hughes SO, Hodges KR, Lange WC, Papaioannou MA, Phan M, Waterland RA, Wood AC. Rationale and design of the Baylor Infant Twin Study-A study assessing obesity-related risk factors from infancy. Obes Sci Pract 2021; 7:63-70. [PMID: 33680493 PMCID: PMC7909590 DOI: 10.1002/osp4.463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Early childhood (0-3 years) is a critical period for obesity prevention, when tendencies in eating behaviors and physical activity are established. Yet, little is understood about how the environment shapes children's genetic predisposition for these behaviors during this time. The Baylor Infant Twin Study (BITS) is a two phase study, initiated to study obesity risk factors from infancy. Data collection has been completed for Phase 1 in which three sub-studies pilot central measures for Phase 2. A novel infant temperament assessment, based on observations made by trained researchers was piloted in Behavior Observation Pilot Protocol (BOPP) study, a new device for measuring infant feeding parameters (the "orometer") in the Baylor Infant Orometer (BIO), and methods for analyzing DNA methylation in twins of unknown chorionicity in EpiTwin. METHODS EpiTwin was a cross-sectional study of neonatal twins, while up to three study visits occurred for the other studies, at 4- (BOPP, BIO), 6- (BOPP), and 12- (BOPP, BIO) of age. Measurements for BOPP and BIO included temperament observations, feeding observations, and body composition assessments while EpiTwin focused on collecting samples of hair, urine, nails, and blood for quantifying methylation levels at 10 metastable epialleles. Additional data collected include demographic information, zygosity, chorionicity, and questionnaire-based measures of infant behaviors. RESULTS Recruitment for all three studies was completed in early 2020. EpiTwin recruited 80 twin pairs (50% monochorionic), 31 twin pairs completed the BOPP protocol, and 68 singleton infants participated in BIO. CONCLUSIONS The psychometric properties of the data from all three studies are being analyzed currently. The resulting findings will inform the development of the full BITS protocol, with the goal of completing assessments at 4-, 6-, 12-, and 14-month of age for 400 twin pairs.
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Affiliation(s)
- Shabnam R. Momin
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | - Mackenzie K. Senn
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | | | - Neil R.M. Buist
- Department of PediatricsOregon Health & Science UniversityPortlandOregonUSA
- Department of Medical GeneticsOregon Health & Science UniversityPortlandOregonUSA
| | - Manisha Gandhi
- Department of Obstetrics and GynecologyDivision of Maternal‐Fetal MedicineTexas Children's HospitalHoustonTexasUSA
| | - Amy B. Hair
- Department of PediatricsSection of NeonatologyBaylor College of MedicineTexas Children's HospitalHoustonTexasUSA
| | - Sheryl O. Hughes
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | - Kelly R. Hodges
- Department of Obstetrics and GynecologyDivision of Gynecologic and Obstetric SpecialistsBaylor College of MedicineHoustonTexasUSA
| | - William C. Lange
- Department of MathematicsIndiana University SoutheastNew AlbanyIndianaUSA
| | - Maria A. Papaioannou
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | - Mimi Phan
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | - Robert A. Waterland
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
| | - Alexis C. Wood
- Department of PediatricsUSDA/ARS Children's Nutrition Research CenterBaylor College of MedicineHoustonTexasUSA
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He ZH, Li MD, Liu CJ, Ma XY. Relationship between body image, anxiety, food-specific inhibitory control, and emotional eating in young women with abdominal obesity: a comparative cross-sectional study. Arch Public Health 2021; 79:11. [PMID: 33494827 PMCID: PMC7831248 DOI: 10.1186/s13690-021-00526-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Abdominal fat deposition is a key component of obesity, which is associated with an increased risk for a number of mental disorders. The current study aims to explore the relationship between body image, anxiety, food-specific inhibitory control, and emotional eating in young women with abdominal obesity. METHOD A total of 224 participants were recruited: 168 were non-abdominal obesity and 56 were abdominal obesity. Participants completed the following questionnaires and behavioral tests: the Body Mass Index (BMI) -based Silhouette-Matching Test (SMT), the State-Trait Anxiety Inventory (STAI), Food Stop Signal Task (SST), the Emotional Eating Scale (EES). RESULTS Abdominal obesity women had significantly higher levels of trait anxiety, cognitive difference, expectational difference in body image but lower self-reported emotional eating level compared to the control group. Anxiety mediated the relationship between cognitive difference of body image and depression eating in young females with abdominal obesity. In addition, only among abdominal obesity individuals, expectational difference of body image were significantly and positively correlated with food-specific inhibitory control and trait/state anxiety. CONCLUSION The findings suggest it is of critical importance to promote a healthy body image recognition and expectation and improve mood regulation for young females with abdominal obesity high in trait anxiety.
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Affiliation(s)
- Zhong-Hua He
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China.
| | - Ming-De Li
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China
| | - Chan-Jun Liu
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China
| | - Xiao-Yue Ma
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China
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Duren-Winfield V, Carr LTB, McCauley GA, Onsomu EO, Roberson K, Williams J, Kizakevich PN, Krzyzanowski M, Price AA. The Development and Pilot Testing of an Evidence-Based Cardiovascular Disease Risk-Prevention Program to Promote Healthy Lifestyle Behaviors Among African-American College Students - Rams Have HEART. JOURNAL OF BEST PRACTICES IN HEALTH PROFESSIONS DIVERSITY : RESEARCH, EDUCATION AND POLICY 2021; 14:44-62. [PMID: 35310081 PMCID: PMC8929670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Cardiovascular disease (CVD) is the leading cause of death in the United States. Among the risk factors for college students, obesity and physical inactivity are disproportionately high among African Americans (AAs), and while studies of the obesity epidemic have increased in recent years, few target AA college-aged students. This study developed and piloted an evidence-based, 15-week, 3-credit hour, CVD risk-prevention and intervention course, Rams Have HEART that used e-learning, web-based technologies, and a mobile application and compared its effects against a control course. METHODS Two cohorts were recruited in a two-year period; 124 AA college students voluntarily consented to participate in the study, with n = 63 representing the control group and n = 61 representing the intervention. CVD risk factors were assessed by examining blood markers and anthropometric measurements. Demographic, clinical, and survey data (physical measures, blood marker investigation, and self-report surveys) were collected at baseline, post-intervention, and follow-up over the academic year. RESULTS The mean blood markers for lipid panel and glucose results were within the established optimal range. Intake of fruits and vegetables increased along with knowledge of CVD risk factors; 86% of students enrolled in the intervention passed the course; 100% (n = 61) would recommend it to future students. CONCLUSION Developing and offering a healthy lifestyle-behavior CVD intervention course to AA college students is feasible and effective in optimizing their awareness of chronic disease risk factors and prompting behavior change.
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Affiliation(s)
- Vanessa Duren-Winfield
- Department of Healthcare Management, Winston-Salem State University, Winston-Salem, North Carolina
| | | | - Georgia A. McCauley
- Department of Clinical Laboratory Science, Winston-Salem State University, Winston-Salem, North Carolina
| | - Elijah O. Onsomu
- Division of Nursing, Winston-Salem State University, Winston-Salem, North Carolina
| | - Kristina Roberson
- Division of Nursing, Winston-Salem State University, Winston-Salem, North Carolina
| | - John Williams
- Department of Health, Physical Education and Sports Studies, Winston-Salem State University, Winston-Salem, North Carolina
| | - Paul N. Kizakevich
- RTI International, Research Triangle Park, 3040 E Cornwallis Rd, Durham, North Carolina
| | - Michelle Krzyzanowski
- RTI International, Research Triangle Park, 3040 E Cornwallis Rd, Durham, North Carolina
| | - Amanda A. Price
- Department of Exercise Physiology, Winston-Salem State University, Winston-Salem, North Carolina
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The impact of state policies for school-based BMI/fitness assessments on children's BMI outcomes in rural versus urban schools: Evidence from a natural experiment. Prev Med 2020; 141:106257. [PMID: 33031869 PMCID: PMC8880824 DOI: 10.1016/j.ypmed.2020.106257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
Childhood obesity remains a public health crisis because of its alarming prevalence and potential for costly long-term health consequences, especially among rural children. Schools are considered natural loci for policies to combat obesity because children spend most of their active hours and consume a substantial share of their calories, at school. Recent state policy efforts have involved measuring children's BMI and/or fitness to notify parents or inform surveillance efforts, but the empirical evidence to date is far from definitive. This study leverages plausibly exogenous assignment of military families as a natural experiment to assess the association of such polices with children's BMI and obesogenic behaviors. The sample is stratified by urbanicity because of the likely differences in obesity prevalence and in environments necessary to support healthy lifestyles. Data were collected in 2013-2014 and analyzed in 2018-9. The policies were associated with lower odds of overweight (OR: 0.422; CI: 0.251-0.708) and at-risk of overweight (OR: 0.360; CI: 0.161-0.801) among children in rural, but not urban, schools. The policies were also associated with greater activity levels and less frequent intake of unhealthy foods, particularly among children attending rural schools. Results were robust to stratification based on urbanicity of the installation versus school, omission of family covariates, and other sensitivity analyses. Falsification checks on children's height, parental BMI outcomes, home food environments and neighborhood environments indicate findings are not driven by selection. BMI assessment policies were associated with children's BMI outcomes and health behaviors in rural, but not urban schools.
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Robbins R, Weaver MD, Quan SF, Rosenberg E, Barger LK, Czeisler CA, Grandner MA. Employee Sleep Enhancement and Fatigue Reduction Programs: Analysis of the 2017 CDC Workplace Health in America Poll. Am J Health Promot 2020; 35:503-513. [PMID: 33172286 DOI: 10.1177/0890117120969091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Poor sleep health, including sleep deficiency and sleep disturbance, is common among employed adults in the U.S. and is associated with undesirable workplace outcomes. Adoption of workplace health promotion programs (WHPPs) is increasing, yet few programs aim to reduce fatigue or improve sleep among employees. OBJECTIVE We analyzed data from the nationally representative 2017 Centers for Disease Control Workplace Health in America poll to identify the prevalence of sleep enhancement or fatigue reduction WHPPs and the characteristics of employers that offer these programs. METHOD A stratified random sample of nationally-representative worksites with ≥10 employees was generated. It comprised 2,843 worksites. Worksite representatives reported workplace characteristics, health promotion activities, and the likelihood of offering WHPPs relating to sleep enhancement or fatigue reduction. Logistic regression analyses were utilized to identify characteristics associated with offering a sleep enhancement or fatigue reduction WHPP, controlling for WHPP budget and size of the company, and contingent on worksites having a comprehensive workplace health plan. RESULTS Less than 1 in 10 worksites (10%) reported offering a sleep enhancement or fatigue reduction WHPP. Worksites most likely to offer a sleep-focused WHPP were those in retail, wholesale, or technology industries (OR = 2.71, 95%CI: 1.08-6.8) vs. those in the finance, information, technology industries; those with a large WHPP budget (>$500,000, OR = 6.85, 95%CI: 2.1-22.35) vs. those with no budget; and those that had visible support of WHPP initiatives from senior leadership (OR = 4.74, 95%CI: 1.91-11.75) vs. those without such support. CONCLUSIONS Our results highlight how few worksites reported offering sleep-focused programs for their employees. Those worksites that did feature such programs, were commonly well-resourced and had senior leadership support for WHPP initiatives in general. Future research should consider working directly with leaders to expand the implementation of employee sleep enhancement and fatigue reduction WHPPs.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, 1861Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, 1861Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, 1861Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Laura K Barger
- Division of Sleep and Circadian Disorders, 1861Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, 1861Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Michael A Grandner
- Department of Psychiatry, 12216University of Arizona College of Medicine, Tucson, AZ, USA
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50
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Macniven R, Esgin T. Exercise motivators, barriers, habits and environment at an Indigenous community facility. MANAGING SPORT AND LEISURE 2020. [DOI: 10.1080/23750472.2020.1810108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rona Macniven
- School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Tuguy Esgin
- Discipline of Exercise, Health and Performance, The University of Sydney, Sydney, Australia
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