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Park SE, Jang S, So WY, Kim J. Epidemiological Association of Current Smoking Status with Hypertension and Obesity among Adults Including the Elderly in Korea: Multivariate Analysis of a Nationwide Cross-Sectional Study Excluding Grades 2-3 Hypertension Cases. J Cardiovasc Dev Dis 2024; 11:212. [PMID: 39057632 PMCID: PMC11278024 DOI: 10.3390/jcdd11070212] [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: 06/07/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Smoking is a major global health issue that contributes to various chronic diseases, while hypertension and obesity are considered significant health concerns due to their associated complications, such as cardiovascular diseases and metabolic disorders. In this study, we investigated the associations between current smoking status, hypertension, and obesity among the Korean population, excluding individuals with high blood pressure (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg) and those taking antihypertensive medications. Data from the 2015 Korea National Fitness Assessment, encompassing 3457 individuals, were analyzed. Logistic regression analysis was used to examine the effects of current smoking and other variables on hypertension and obesity. The results showed that, among the population that excludes specific hypertension criteria, current smoking status was not significantly associated with hypertension or obesity. However, sex and body mass index were significantly associated with hypertension, and age, sex, and blood pressure were significantly associated with obesity. Future research should utilize larger sample sizes and longitudinal designs to confirm these findings and include a broader range of hypertensive participants to better control for potential confounding variables.
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Affiliation(s)
- Sung-Eun Park
- Sport Medicine Major, Korea National Sport University, Seoul 05541, Republic of Korea;
| | - Seyong Jang
- Department of Taekwondo, College of Arts and Physical Education, Gachon University, Seongnam 13120, Republic of Korea;
| | - Wi-Young So
- Sport Medicine Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si 27469, Republic of Korea
| | - Junsu Kim
- Department of Sports and Outdoors, College of Bio Convergence, Eulji University, Seongnam 13135, Republic of Korea
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Barros B, Paiva AM, Oliveira M, Alves S, Esteves F, Fernandes A, Vaz J, Slezakova K, Costa S, Teixeira JP, Morais S. Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefighters. Front Public Health 2024; 12:1338435. [PMID: 38510349 PMCID: PMC10950961 DOI: 10.3389/fpubh.2024.1338435] [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: 11/14/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 μg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.
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Affiliation(s)
- Bela Barros
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Ana Margarida Paiva
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Sara Alves
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical School, Faculty of Medicine, University of Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Adília Fernandes
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Josiana Vaz
- CIMO, Instituto Politécnico de Bragança, Bragança, Centro de Investigação de Montanha Campus Santa Apolónia, Bragança, Portugal
- SusTEC, Instituto Politécnico de Bragança, Bragança, Sustec – Associate Laboratory for Sustainability and Technology in Inland Regions – Campus Santa Apolónia, Bragança, Portugal
| | - Klara Slezakova
- LEPABE-ALiCE, Departamento de Engenharia Química, Faculdade de Engenharia, Rua Dr. Roberto Frias, Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
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Maheshwari V, Sodhi B, Sharma R, Basu S. Determinants of tobacco use patterns and predictors
of quit among older women in India: Findings from
the study on global aging and adult health. PNEUMON 2024; 37:1-10. [DOI: 10.18332/pne/175144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/13/2023] [Indexed: 07/24/2024]
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Kar D, Roy S. Factors associated with the CVD risk factors and body fat pattern of postmenopausal Hindu caste and Lodha tribal populations living in India: An exploratory study. Womens Midlife Health 2023; 9:4. [PMID: 37095574 PMCID: PMC10127089 DOI: 10.1186/s40695-023-00087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Loss in ovarian function during mid-life results in adverse changes in the cardiovascular profile of women. The association between CVD risk factors and menopause differ cross-culturally since several modifiable factors play significant roles in explaining CVD mortality in addition to differences in endogenous estrogen. Very few of the studies from the Indian subcontinent have been concerned with the menopause-specific CVD risk factors, particularly among the tribal groups. Thus, we intended to study the variations in body fat pattern and CVD risk factors between Hindu caste and Lodha tribal postmenopausal women and how these risk factors were associated with differential socio-economic, reproductive and menstrual characteristics and lifestyle variables. The Lodha tribal populations is considered a Particularly Vulnerable Group (PVTG) in this country. METHODS This cross-sectional study was conducted among the Bengali Hindu caste and Lodha tribal populations of the State of West Bengal, India covering three districts namely Howrah, Jhargram and East Midnapure. A total of 197 postmenopausal participants were recruited for this study (urban caste 69, rural caste 65 and rural Lodha 63). Data on blood glucose and total cholesterol levels, blood pressure, muscle mass, body fat distribution and sociodemographic, reproductive and menstrual history and lifestyle variables were collected following standard protocols. Analysis of variance (ANOVA) was applied to compare blood glucose, total cholesterol and blood pressure levels and body fat measures across the three populations. Stepwise multiple linear regression analysis was performed to find out the factors associated with CVD risk factors. The data were analyzed with the Statistical Package for Social Science version 20.0(IBM corporation, 2011). RESULTS This cross-sectional comparison of women at midlife, though exploratory in nature showed significant differences in body fat pattern and CVD risk factors between caste and tribal groups owing to socioeconomic disparities and, differences in reproductive characteristics and lifestyle factors. CONCLUSION The caste and tribal populations differed significantly in body fat pattern and CVD risk factors and in the factors associated with CVD risk suggesting interplay between menopause and modifiable factors in explaining CVD risk factors during mid-life.
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Affiliation(s)
- Debasmita Kar
- Department of Anthropolgy, University of Calcutta, 35 Ballygunge Circular Road, 700019 Ballygunge, Kolkata, India
| | - Subho Roy
- Department of Anthropolgy, University of Calcutta, 35 Ballygunge Circular Road, 700019 Ballygunge, Kolkata, India
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Saxena S, Singh PK, Singh L, Kashyap S, Singh S. Smokeless tobacco use and public health nutrition: a global systematic review. Public Health Nutr 2023; 26:46-55. [PMID: 35618706 PMCID: PMC11077452 DOI: 10.1017/s1368980022001331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/26/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Tobacco consumption among low- and middle-income countries where food insecurity remains a challenge poses several concerns. This review examines the available global evidence linking smokeless tobacco (SLT) use with public health nutrition and its implications. DESIGN Systematic review of articles extracted from PubMed and Scopus from January 2000 to December 2020. SETTING Included studies that demonstrated the relationship between SLT and nutrition-related factors, that is, BMI, malnutrition, anaemia, poor birth outcomes and metabolic disorders. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines have been followed to conduct the systematic evidence review. PARTICIPANTS A total of thirty-four studies were finally used in the systematic review, which included cross-sectional (thirty-one) and cohort (three). RESULTS SLT use has a huge impact on body weight, alteration in taste, poor oral health, and consumption of fruits and vegetables leading to malnutrition. Maternal use of SLT not only leads to anaemia but also hampers birth outcomes. Increased risk of metabolic syndrome and gallstone disease among SLT users are also well documented in the studies. CONCLUSION The review highlights the linkages between SLT usage and poor nutritional outcomes. Tobacco control efforts should be convergent with public health nutrition to achieve overall health benefits. Attention is also required to explore suitable mechanisms for SLT cessation combined with enhancing food and nutrition security at the community level in sync with investments in public health nutrition intervention.
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Affiliation(s)
- Shikha Saxena
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
| | - Prashant Kumar Singh
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
| | - Lucky Singh
- ICMR National Institute of Medical Statistics, New Delhi, India
| | - Shekhar Kashyap
- Department of Cardiology, Army Research & Referral Hospital, New Delhi, India
| | - Shalini Singh
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
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Suragimath G, Patel JN, Mhatre TS, SR A, Mane DA. Effect of Smokeless Tobacco (Mishri) Application on Periodontal Health and Correlation to the Duration of Use. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2023. [DOI: 10.51847/mruppt7fxo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Olszowy KM, Roome AB, Standard E, Tarivonda L, Taleo G, Dancause KN. Relationships of Tobacco Use and Kava Consumption to Sex-Associated Variation in Body Composition and Obesity Risk in Melanesian Adults From Vanuatu. Asia Pac J Public Health 2022; 34:634-642. [DOI: 10.1177/10105395221108593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity prevalence has increased in low- and middle-income countries (LMICs) over the past several decades, with generally greater occurrence among adult females compared with males. Gendered variation in health behaviors, such as substance use, may play a role in how differences in obesity, body size, and composition manifest in association with sex. This study examines sex-moderated relationships of tobacco smoking and kava consumption with body composition and obesity among 301 Ni-Vanuatu (local self-identification meaning “of Vanuatu”) adults. Data collected included self-reported frequency of substance use as well as anthropometric measurements to assess body mass, composition, and obesity. Tobacco and kava use were associated with reduced measurements of body mass and adiposity in males, and kava use was associated with some elevated measurements of body mass and hip circumference in females. Kava use was also negatively associated with obesity based on waist-to-height ratio among males. These results have implications for evaluation and future research on substance control programs in this population.
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Affiliation(s)
- Kathryn M. Olszowy
- Department of Anthropology, New Mexico State University, Las Cruces, NM, USA
| | - Amanda B. Roome
- Bassett Research Institute, Mary Imogene Bassett Hospital, Cooperstown, NY, USA
| | | | | | | | - Kelsey N. Dancause
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
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Santolia DD, Dahiya DS, Sharma DS, Khan DMA, Mohammed DN, Priya DH, Gupta DSR, Bhargava DS, Gupta DSR. Fractal Dimension and Radiomorphometric analysis of Orthopantomographs in patients with tobacco and areca nut associated oral mucosal lesions: a pilot in- vivo study in a North Indian cohort. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:627-638. [DOI: 10.1016/j.oooo.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 11/24/2022]
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9
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Mohammed Ali M, Helou M, Al-Sayed Ahmad M, Al Ali R, Damiri B. Risk of Tobacco Smoking and Consumption of Energy Drinks on Obesity and Central Obesity Among Male University Students. Cureus 2022; 14:e21842. [PMID: 35291543 PMCID: PMC8896566 DOI: 10.7759/cureus.21842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background Obesity is one of the leading causes of morbidity and premature death. The prevalence of obesity and being overweight in young adulthood is increasing exponentially globally, including Palestine. Consumption of energy drinks (EDs) and tobacco smoking are highly prevalent among Palestinian young adults. Although different studies have demonstrated that the use of caffeine and tobacco products is highly prevalent among Palestinians, especially university students, the adverse effects of these products on obesity have not been thoroughly investigated. Methodology Male students from An-Najah National University in the West Bank were recruited to fill out a self-administrated questionnaire in this cross-sectional study conducted in 2021. Obesity was measured as total adiposity by calculating body mass index (BMI) and as central obesity by measuring waist circumference. To determine the association between obesity and ED consumption and tobacco smoking, we used adjusted multiple logistic regression models. Shapiro-Wilk’s test was used to assess the normality of the data. Results A total of 396 students filled the questionnaire, with a response rate of 89.4%. The prevalence of obesity and central obesity was 42% and 35.75%, respectively. The prevalence of ED consumption, cigarette smoking, and waterpipe smoking was 59.6%, 39.6%, and 43.2%, respectively. ED consumers were more likely to be cigarette smokers (odds ratio (OR) = 3.827, P < 0.001), waterpipe smokers (OR = 4.578, P < 0.001), and chocolate consumers (OR = 3.524, P = 0.001). Central obesity was associated with waterpipe smoking (OR = 2.126, P = 0.044), increased age (OR = 1.367, P = 0.001), and increased BMI (OR = 1.927, P < 0.001). On the other hand, cigarette smokingincreased the risk of being underweight (OR = 6.255, P = 0.012), and ED consumption decreased the risk of being obese (OR = 0.183, P = 0.017). Conclusions Waterpipe smoking was a risk factor for increased central obesity, and ED consumption was associated with decreased; however, smoking was associated with the underweight BMI category. Given the undesirable health consequences of consuming the closely associated tobacco and EDs, stricter measures are needed to prevent access to these products.
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Ghosal S, Sinha A, Kanungo S, Pati S. Declining trends in smokeless tobacco use among Indian women: findings from global adult tobacco survey I and II. BMC Public Health 2021; 21:2047. [PMID: 34753440 PMCID: PMC8576912 DOI: 10.1186/s12889-021-12089-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smokeless Tobacco (SLT) use is culturally rooted and more acceptable among women in India. SLT is a significant risk for oral cancers and has other adverse health outcomes on women's general as well as reproductive health. This study aimed to estimate and compare the prevalence and correlates of SLT among adult females in India using Global Adult Tobacco Survey (GATS), 2009-2010 (GATS 1) and 2016-2017 (GATS 2). METHODS Data from a nationally representative cross-sectional study GATS 1 (n = 35,529) and GATS 2 (n = 40,265) were analysed for adult female smokeless tobacco users. Correlates of SLT exposure were assessed separately using binary logistic regression. Multivariable logistic regression analysis was done for the variables which computed p < 0.1. The association was expressed as Adjusted Odds ratio with 95% confidence intervals. RESULTS There was a reduction in prevalence of SLT use among women in India between GATS 1 (18.4%) and GATS 2 (12.8%). SLT use was highest among the North-Eastern women in both rounds [AOR: 4.567 (3.942-5.292) during GATS-1 and 9.149 (7.722-10.839) during GATS-2]. Odisha had highest prevalence of 56.53% while Himachal Pradesh had lowest 0.14% during the recent GATS 2 survey. 33.3% vs. 34.80% of the participants were willing to quit tobacco in Central region across both rounds of survey. CONCLUSIONS Although, smokeless tobacco prevalence among females has reduced between 2009 and 2016 in India, yet tobacco control strategies need further pace. Hence, more focused gender-based tobacco control programs and policies are the need of time.
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Affiliation(s)
- Shishirendu Ghosal
- Division of Public Health, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha -751023 India
| | - Abhinav Sinha
- Division of Public Health, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha -751023 India
| | - Srikanta Kanungo
- Division of Public Health, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha -751023 India
| | - Sanghamitra Pati
- Division of Public Health, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha -751023 India
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Muhammad T, Maurya P, Sharma P. Prevalence and correlates of bone and joint diseases and its association with falls among older adults in India: Evidence from LASI, 2017-18. Geriatr Nurs 2021; 42:1143-1150. [PMID: 34404017 DOI: 10.1016/j.gerinurse.2021.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
This study explores the prevalence and correlates of bone and joint diseases and its association with falls among older adults in India. Data from the Longitudinal Aging Study in India (2017-18) were utilized for analysis (n = 31,464). Bivariate and logistic regression was used to fulfill the study objectives. The findings revealed that 19.71% of older adults had bone and joint disease, which was higher among women (22.79%) than men (16.25%). The strongest predictors of such diseases included being currently employed, physically inactive, having difficulties in performing functional activities and higher economic status. The fall in the last two years was reported by 12.63% of older adults, and bone and joints diseases were significantly associated with falls (AOR = 1.287; 95% CI: 1.117-1.483) after adjusting for several socio-demographic and health covariates. These findings imply that policymakers and providers must implement interventions designed to reduce the risk of those diseases and associated falls.
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Affiliation(s)
- T Muhammad
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Priya Maurya
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Palak Sharma
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
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Double burden of underweight and overweight among Indian adults: spatial patterns and social determinants. Public Health Nutr 2021; 24:2808-2822. [PMID: 33875031 PMCID: PMC9884774 DOI: 10.1017/s1368980021001634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current study explores the spatial patterns of underweight and overweight among adult men and women in districts of India and identifies the micro-geographical locations where the risks of underweight and overweight are simultaneously prevalent, after accounting for demographic and socio-economic factors. DESIGN We relied on BMI (weight (kg)/height squared (m2)), a measure of nutritional status among adult individuals, from the 2015-2016 National Family and Health Survey. Underweight was defined as <18·5 kg/m2 and overweight as ≥25·0 kg/m2. SETTING We adopted Bayesian structured additive quantile regression to model the underlying spatial structure in underweight and overweight burden. PARTICIPANTS Men aged 15-54 years (sample size: 108 092) and women aged 15-49 years (sample size: 642 002). RESULTS About 19·7 % of men and 22·9 % of women were underweight, and 19·6 % of men and 20·6 % of women were overweight. Results indicate that malnutrition burden in adults exhibits geographical divides across the country. Districts located in the central, western and eastern regions show higher risks of underweight. There is evidence of substantial spatial clustering of districts with higher risk of overweight in southern and northern India. While finding a little evidence on double burden of malnutrition among population groups, we identified a total of sixty-six double burden districts. CONCLUSIONS The current study demonstrates that the geographical burden of overweight in Indian adults is yet to surpass that of underweight, but the coexistence of double burden of underweight and overweight in selected regions presents a new challenge for improving nutritional status and necessitates specialised policy initiatives.
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Singh S, Jain P, Singh PK, Reddy KS, Bhargava B. White paper on smokeless tobacco & women's health in India. Indian J Med Res 2021; 151:513-521. [PMID: 32719223 PMCID: PMC7602932 DOI: 10.4103/ijmr.ijmr_537_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Smokeless tobacco (SLT) use is widespread across many nations and populations, and India shares more than three-quarters of the global burden of SLT consumption. Tobacco use in India has been largely viewed as a male-dominant behaviour. However, evidence from medical, social and behavioural sciences show significant SLT use among women and young girls. This paper highlights key dimensions of SLT use among women in India including prevalence and determinants, the health effects arising from SLT use and cessation behaviours. The paper concludes by providing recommendations with the aim of setting research priorities and policy agenda to achieve a tobacco-free society. The focus on women and girls is essential to achieve the national targets for tobacco control under the National Health Policy, 2017, and Sustainable Development Goals 3 of ensuring healthy lives and promote well-being for all.
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Affiliation(s)
- Shalini Singh
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Pankhuri Jain
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Prashant Kumar Singh
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | | | - Balram Bhargava
- Department of Health Research (ICMR), Ministry of Health and Family Welfare, New Delhi, India
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Lee BN, Bae SW, Oh SY, Yoon JH, Roh J, Won JU. Effects of military life on changes in body mass index of enlisted men: a cross-sectional study. BMJ Mil Health 2020; 168:218-223. [PMID: 32409616 PMCID: PMC9132859 DOI: 10.1136/bmjmilitary-2019-001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/02/2022]
Abstract
Background Obesity is a serious health problem with an incidence that is increasing rapidly. Enlisted men are a distinctive group characterised by 24-hour community-living and are likely to experience changes in body weight as a result of regular diet and exercise during enlistment. Methods This study reviewed data from the Second Military Health Survey. Changes in body mass index (BMI) before and during military service were analysed using paired t-test. We calculated OR and 95% CI for factors affecting weight improvement during military service through logistic regression. Results The mean BMI in the underweight group increased by 5.87 kg/m2 during service, while that in the normal weight group increased by 1.18 kg/m2. In contrast, the mean BMI in the overweight group decreased by 5.47 kg/m2 during service. The OR for an improved BMI in the subjective good health group compared with the subjective poor health group was statistically significant (OR=1.71, 95% CI 1.02 to 2.87). The OR for an improved BMI was significantly higher in the group with three or more times per week of strength training than in the group with one to two times per week of strength training, and was higher among the marines compared with the Army soldiers (OR=1.48, 95% CI 1.03 to 2.12 and OR=2.15, 95% CI 1.07 to 4.32, respectively). Conclusions Strength training showed a statistically significant increase in BMI during military service. Furthermore, the BMI of men who were underweight before their service increased, while it decreased among those who were overweight.
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Affiliation(s)
- Bb Ni Lee
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - S W Bae
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - S Y Oh
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - J H Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
| | - J Roh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
| | - J U Won
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
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Dutta M, Selvamani Y, Singh P, Prashad L. The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16). Epidemiol Health 2019; 41:e2019050. [PMID: 31962037 PMCID: PMC6976728 DOI: 10.4178/epih.e2019050] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 12/18/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49. METHODS Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity. RESULTS The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight. CONCLUSIONS In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.
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Affiliation(s)
- Mili Dutta
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - Y Selvamani
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Pushpendra Singh
- Department of Humanities and Social Sciences, Indian Institute of Technology Roorkee, Roorkee, India
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Shrestha S, Mishra DR, Dhakal N, Bhandari S, Khanal S, Lamsal M. Correlation of urinary cotinine with cardiovascular risk factors in pan masala tobacco users. Indian Heart J 2019; 71:459-463. [PMID: 32248918 PMCID: PMC7136352 DOI: 10.1016/j.ihj.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/03/2019] [Accepted: 10/12/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco. METHODS This comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ2 test for categorical variable, independent t-test, Mann-Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05. RESULT Mean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls (p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users (p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users (p < 0.001). CONCLUSION PMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.
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Affiliation(s)
- Sanjeeb Shrestha
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Deebya Raj Mishra
- Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Niraj Dhakal
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Suresh Bhandari
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Sagar Khanal
- Department of Biochemistry, Lumbini Medical College, Lumbini, Nepal.
| | - Madhab Lamsal
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
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Mitra DK, Mistry SK, Afsana K, Rahman M. Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study. J Epidemiol Glob Health 2019; 8:134-142. [PMID: 30864754 PMCID: PMC7377563 DOI: 10.2991/j.jegh.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/31/2018] [Indexed: 12/31/2022] Open
Abstract
Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50–22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 2.27 (1.93–2.68), for second highest quintile 1.67 (1.44–1.94), for middle quintile 1.26 (1.10–1.46) and for second lowest quintile 1.07 (0.93–1.24), excess food availability [compared to food shortage, ARRR (95% CI) for excess food in the household is 1.29 (1.12–1.47) and for no shortage/no excess is 1.23 (1.09–1.38) and more frequent fruits consumption [compared to no fruits, ARRR (95% CI) for 5–7 days per week consumption is 1.61 (1.41–1.83) and for 3–4 days per week is 1.28 (1.16–1.41) and factors significantly associated with decreased risk of overweight included older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 0.77 (0.64–0.93), for 60–69 years is 0.82 (0.71–0.94), for 50–59 years 0.91 (0.80–1.04) and for 40–49 years 1.01 (0.89–1.15)] and smoking (ARRR-0.76, 95% CI: 0.68–0.86). Both underweight and overweight are prevalent in Bangladeshi adult population. Several demographic, socio-economic, dietary and lifestyle factors are associated with underweight and overweight in Bangladesh. Population level impact of these factors should be examined to design suitable public health and nutrition interventions to address this dual challenge.
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Affiliation(s)
- Dipak K Mitra
- School of Public Health, North South University, Bangladesh
| | - Sabuj Kanti Mistry
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
| | - Kaosar Afsana
- Health Nutrition and Population Programme, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
| | - Mahfuzar Rahman
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
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Rai RK, Jaacks LM, Bromage S, Barik A, Fawzi WW, Chowdhury A. Prospective cohort study of overweight and obesity among rural Indian adults: sociodemographic predictors of prevalence, incidence and remission. BMJ Open 2018; 8:e021363. [PMID: 30166296 PMCID: PMC6119421 DOI: 10.1136/bmjopen-2017-021363] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To assess sociodemographic predictors of prevalence, incidence and remission of overweight including obesity among adults (aged ≥18 years) in rural Eastern India. DESIGN Prospective cohort study. SETTING Birbhum Health and Demographic Surveillance System, West Bengal, India. PARTICIPANTS Self-weighted sample of 24 115 adults (men: 10915, women: 13200) enrolled in 2008 were followed up for body mass index (BMI) reassessment in 2017. PRIMARY AND SECONDARY OUTCOME MEASURES Measured BMI was categorised as: underweight (<18.5 kg/m2), normal weight (18.5-22.9 kg/m2) and overweight including obesity (≥23 kg/m2; hereinafter overweight). Incident overweight was defined as transition from normal weight in 2008 to overweight in 2017, whereas if overweight individuals in 2008 measured normal BMI in 2017, it was classified as remission from overweight. RESULTS In 2008, 10.1% of men and 14.6% of women were overweight, whereas 17.3% of men and 24.7% of women were overweight in 2017. At the same time, in 2017, 35.6% of men and 33.3% of women were underweight. Incident overweight was 19.0% among men and 27.2% among women, whereas remission among men was higher (15.4%) than women (11.5%). Women were more likely to be overweight in 2008 and to experience incident overweight than men. For men and women, education level and wealth were positively associated with prevalence and incidence of overweight. Remission from overweight was less likely in Sainthia, a business hub in the district, as compared with Mohammad Bazar, a more rural area. CONCLUSION A nutrition transition to higher risk of overweight is evident in this rural setting in India, especially among women and individuals with high socioeconomic status. At the same time, a high prevalence of underweight persists, resulting in a significant double burden. Culturally sensitive interventions that address both ends of the malnutrition spectrum should be prioritised.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
| | - Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
- Suri District Hospital and Niramoy TB Sanatorium, Birbhum, West Bengal, India
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Selvamani Y, Singh P. Socioeconomic patterns of underweight and its association with self-rated health, cognition and quality of life among older adults in India. PLoS One 2018. [PMID: 29513768 PMCID: PMC5841798 DOI: 10.1371/journal.pone.0193979] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Underweight defined as body mass index (BMI) < 18.5 is associated with negative health and quality of life outcomes including mortality. Yet, little is known about the socioeconomic differentials in underweight and its association with health and well-being among older adults in India. This study examined the socioeconomic differentials in underweight among respondents aged ≥50 in India. Consequently, three outcomes of the association of underweight were studied. These are poor self-rated health, cognition and quality of life. METHODS Cross-sectional data on 6,372 older adults derived from the first wave of the WHO's Study on global AGEing and adult health (SAGE), a nationally representative survey conducted in six states of India during 2007-8, were used. Bivariate and multivariate regression analyses were applied to fulfil the objectives. RESULTS The overall prevalence of underweight was 38 percent in the study population. Further, socioeconomic status showed a significant and negative association with underweight. The association of underweight with poor self-rated health (OR = 1.60; p < .001), cognition (β = -0.95; p < .001) and quality of life (β = -1.90; p < .001) were remained statistically significant after adjusting for age, sex, place of residence, marital status, years of schooling, wealth quintile, sleep problems, chronic diseases, low back pain and state/province. CONCLUSION The results indicated significant socioeconomic differentials in underweight and its association with poor self-rated health, cognition and quality of life outcomes. Interventions focussing on underweight older adults are important to enhance the overall wellbeing of the growing older population in India.
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Affiliation(s)
- Y. Selvamani
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
- * E-mail:
| | - Pushpendra Singh
- Department of Humanities & Social Sciences, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
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Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study. J Epidemiol Glob Health 2018. [DOI: 10.1016/j.jegh.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Underweight among rural Indian adults: burden, and predictors of incidence and recovery. Public Health Nutr 2017; 21:669-678. [PMID: 29122038 DOI: 10.1017/s1368980017003081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To study the magnitude and predictors of underweight, incident underweight and recovery from underweight among rural Indian adults. DESIGN Prospective cohort study. Each participant's BMI was measured in 2008 and 2012 and categorized as underweight (BMI<18·5 kg/m2), normal (BMI=18·5-22·9 kg/m2) or overweight/obese (BMI ≥23·0 kg/m2). Incident underweight was defined as a transition from normal weight or overweight/obese in 2008 to underweight in 2012, and recovery from underweight as a transition from underweight in 2008 to normal weight in 2012. Bivariate and multivariable logistic regression analyses were employed. SETTING The Birbhum Health and Demographic Surveillance System, West Bengal, India. SUBJECTS Predominantly rural individuals (n 6732) aged ≥18 years enrolled in 2008 were followed up in 2012. RESULTS In 2008, the prevalence of underweight was 46·5 %. From 2008 to 2012, 25·8 % of underweight persons transitioned to normal BMI, 12·9 % of normal-weight persons became underweight and 0·1 % of overweight/obese persons became underweight. Multivariable models reveal that people aged 25-49 years, educated and wealthier people, and non-smokers had lower odds of underweight in 2008 and lower odds of incident underweight. Odds of recovery from underweight were lower among people aged ≥36 years and higher among educated (Grade 6 or higher) individuals. CONCLUSIONS The current study highlights a high incidence of underweight and important risk factors and modifiable predictors of underweight in rural India, which may inform the design of local nutrition interventions.
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A retrospective analysis of hypertension screening at a mass gathering in India: implications for non-communicable disease control strategies. J Hum Hypertens 2017; 31:750-753. [PMID: 28726795 DOI: 10.1038/jhh.2017.54] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 06/08/2017] [Accepted: 06/14/2017] [Indexed: 01/25/2023]
Abstract
Cardiovascular disease is the leading case of mortality from non-communicable diseases (NCD) in India. The government's National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening, referral and management of NCDs across India, and includes community-based outreach and screening programmes. The government in India routinely provides basic care at religious mass gatherings. However, in 2015, at the Kumbh Mela in Nashik and Trimbakeshwar, the state government extended its services to include a hypertension screening programme. We examine here the value and implications of such opportunistic screening at mass gatherings. At the Kumbh, 5760 persons voluntarily opted for hypertension screening, and received a single blood pressure measurement. In all, 1783 (33.6%) screened positive, of whom, 1580 were previously unaware of their diagnosis. Of the 303 that had previously known hypertension, 240 (79%) were prescribed medications, and 160 were compliant (that is, 52.8% under treatment). Fifty-five (18%) had normal blood pressure readings (BP under control). The data also demonstrated higher prevalence (39%) of hypertension among tobacco users compared to non-users (28%) (P<0.001). Poor recording of phone numbers (0.01%) precluded any phone-based follow-up. The low rates of hypertension awareness, treatment and control underscore the ongoing challenge of both hypertension screening and management in India.
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Ladusingh L, Singh A. Contextual correlates of intensity of smoking in northeast India. Int J Public Health 2015; 60:317-26. [PMID: 25603984 DOI: 10.1007/s00038-015-0652-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/29/2014] [Accepted: 01/05/2015] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study assessed the significance of socio-demographic and contextual factors on the number of daily cigarette and bidi smoking in northeast India. METHODS This study is based on the data from the Global Adult Tobacco Survey-India (2009-2010). Community asset is measured as the totality of all households' durables and community affinity to smoking as the proportion of households which allowed smoking in the house. RESULTS High daily cigarette and bidi smokers constitute 20 and 30 % of the respective smokers and they smoke 35.8 cigarettes and 14.6 bidis daily, respectively, on the average. The higher is the community affinity to smoking, the higher is the intensity of smoking among the high daily cigarette smokers. Advancing age and educational attainment have significant deterrent effect on the intensity of cigarette and bidi smoking. CONCLUSIONS Contextual factors are found to be important for regional tobacco control programmes. The need for reaching out to communities and the importance of promotion of public-private partnership under the provision of corporate social responsibility for effectiveness of tobacco control programme is recommended.
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Affiliation(s)
- Laishram Ladusingh
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India,
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Reddy MGS, Kakodkar PV, Singh A. Tobacco use, Body Mass Index, and Potentially Malignant Disorders Among petrol fillers in Pimpri-Pune (India): A descriptive study. South Asian J Cancer 2014; 3:196-9. [PMID: 25422802 PMCID: PMC4236694 DOI: 10.4103/2278-330x.142954] [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] [Indexed: 12/03/2022] Open
Abstract
Background: Since petrol is combustible and smoking is banned at the petrol pumps, it may be predicted that use of smokeless tobacco is more prevalent among the petrol fillers. Also, smokeless tobacco is a major risk factor for developing oral potentially malignant disorders. The present study was conducted to determine the tobacco use, body mass index (BMI), and potentially malignant disorders among a cohort of petrol fillers and also to evaluate the interaction of tobacco use and BMI with the presence of potentially malignant disorders. Settings and Design: The study was conducted at 45 petrol stations located at Pimpri-Pune, India. A descriptive study design was used. Materials and Method: Four hundred and ten petrol fillers aged 17-64 years participated in the study. General information and tobacco history was obtained by interview. Height and weight were recorded to obtain BMI. Oral examination was conducted to identify the potentially malignant disorders. Statistical analysis: Chi-square test, Z test, and logistic regression were used. The level of significance was fixed at 5%. Results and Conclusions: It was found that 242 (59.02%) used tobacco in different forms. 77.68% were tobacco chewers, and 8.26% were smokers. Leukoplakia was prevalent among 68.47%, oral submucous fibrosis among 27.45%, and 5.08% had erythroplakia. Age (χ2 = 11.46, P < 0.05), duration (χ2 = 17.46, P < 0.05), and frequency of tobacco chewing (χ2 = 14.16, P < 0.05) were significantly associated with potentially malignant disorders. Tobacco chewing was more prevalent as compared to smoking. It can be concluded that the petrol fillers are at a high risk for developing oral potentially malignant disorders.
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Affiliation(s)
- Mamatha G S Reddy
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil University's, Dr. D. Y. Patil Dental College and Hospital, Pimpri, India
| | - Pradnya V Kakodkar
- Medilinkers Research Consultancy. Department of Public Health Dentistry, Pune, Maharashtra, India
| | - Akanksha Singh
- Dental Student, Dr. D. Y. Patil University's, Dr. D. Y. Patil Dental College and Hospital, Pimpri, India
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CIBIČKOVÁ Ľ, KARÁSEK D, LANGOVÁ K, VAVERKOVÁ H, ORSÁG J, LUKEŠ J, NOVOTNÝ D. Correlation of Lipid Parameters and Markers of Insulin Resistance: Does Smoking Make a Difference? Physiol Res 2014; 63:S387-93. [DOI: 10.33549/physiolres.932869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance associated with dyslipidemia enhances cardiovascular risk. Several atherogenic indexes have been suggested to give more precise information about the risk. The aim of our study was to estimate, which atherogenic index correlates better with parameters of insulin resistance. Furthermore, we compared the parameters of lipid metabolism and insulin resistance between smokers and non-smokers. In our cross-sectional study we enrolled 729 patients with dyslipidemia which were divided into two groups – non-smokers (586) and smokers (143). We measured lipid profile, parameters of insulin resistance (fasting glycemia, insulin, HOMA-IR, C-peptide, proinsulin) and calculated atherogenic indexes – atherogenic index of plasma (log (TAG/HDL-C), AIP), ApoB/ApoA1 index and nonHDL-C. AIP was found out to show stronger correlations with parameters of insulin resistance (p<0.001, correlation coefficients ranging between 0.457 and 0.243) than other indexes (ApoB/ApoA1 or nonHDL cholesterol). AIP correlated with parameters of insulin resistance both in smokers and non-smokers, but after adjustment (for age, body mass index, waist circumference) persisting only in non-smokers. Smokers had a wider waist circumference and a proatherogenic lipid profile. Smoking increases the risk of developing metabolic syndrome. AIP can be used in daily praxis for predicting insulin resistance in patients with dyslipidemia, predominantly in non-smokers.
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Affiliation(s)
- Ľ. CIBIČKOVÁ
- Third Department of Internal Medicine – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
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Msyamboza KP, Kathyola D, Dzowela T. Anthropometric measurements and prevalence of underweight, overweight and obesity in adult Malawians: nationwide population based NCD STEPS survey. Pan Afr Med J 2013; 15:108. [PMID: 24244794 PMCID: PMC3828071 DOI: 10.11604/pamj.2013.15.108.2622] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 07/17/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Overweight and obesity are significant causes of increased morbidity and premature mortality from non-communicable diseases, particularly in sub-Saharan Africa, although local high quality population-based data to inform policies and strategies are lacking. METHODS Using the WHO STEPwise approach to chronic disease risk factor surveillance, population-based nationwide survey was conducted on participants aged 25-64 years in Malawi. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range. RESULTS A total of 4845 participants (65.7% females, 87.6% from rural areas) had complete anthropometric data and included in this analysis. Overall (both sexes) population-based mean body weight, height, systolic blood pressure, diastolic blood pressure, blood glucose and cholesterol were estimated at 58.7 kg, 159.9 cm, 133.4 mmHg, 79.5 mmHg, 4.3 mmol/L, 4.4 mmol/L respectively. Prevalence of underweight, overweight, obesity, overweight and/ or obesity and central adiposity were 6.5%, 17.3%, 4.6%, 21.9% and 28.8% respectively. Overweight, obesity, overweight and/ or obesity and central adiposity were more frequent in females than males (20.7% vs 14.1%, 7.4% vs 2.0%, 28.1% vs 16.1% and 52.8% vs 5.6%), in urban than rural areas (23.2% vs 16.6%, 12.0% vs 3.7%, 35.2% vs 20.2%) respectively. CONCLUSION This study demonstrated that overweight and/ or obesity is the major public health problem affecting at least one in five adults in Malawi. The problem is more frequent in females than males and urban than rural. Implementation of primary health care approaches such as WHO package for essential non-communicable diseases could reduce the problem.
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Black M, Bhattacharya S, Fairley T, Campbell DM, Shetty A. Outcomes of pregnancy in women using illegal drugs and in women who smoke cigarettes. Acta Obstet Gynecol Scand 2013; 92:47-52. [PMID: 22913319 DOI: 10.1111/j.1600-0412.2012.01519.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 08/01/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare obstetric outcomes in women using illegal drugs with women who smoke cigarettes. DESIGN Retrospective cohort study. SETTING Aberdeen, UK. POPULATION All deliveries in Aberdeen in women using illegal drugs and women who smoked cigarettes during 1997-2007. MATERIAL AND METHODS The women who used illegal drugs were identified from a database of affected pregnant women in Aberdeen. The Aberdeen Maternity and Neonatal Databank was used to identify women who smoke cigarettes and to obtain pregnancy outcome information. Sociodemographic characteristics, maternal and perinatal outcomes were compared using chi-squared test, independent sample t-test and logistic regression analysis. MAIN OUTCOME MEASURES Preterm delivery, low birthweight (standardized birthweight score <-2) and admission to the neonatal unit. RESULTS Of the 561 illegal drug users, 96% were also cigarette smokers. Compared with women who smoke cigarettes with no reported illegal drug use, they were significantly more likely to have a preterm delivery [adjusted odds ratio (aOR) 1.6 (95% confidence interval (CI) 1.3-2.1)], low birthweight baby [aOR 1.9 (95%CI 1.4-2.6)], baby admitted to the neonatal unit [aOR 13.3 (95%CI 10.9-16.3)], deep vein thrombosis [aOR (95%CI 8.8-50.8)] and antepartum hemorrhage [aOR (95%CI 1.2-2.1)]. They were less likely to be at the extremes of age, or to develop pregnancy-induced hypertension [aOR 0.3 (95%CI 0.2-0.4)]. CONCLUSION Illegal drug use in pregnancy appears to increase the risk of adverse outcomes, over and above that related to cigarette smoking, but appears to be associated with lower prevalence of gestational hypertension.
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Affiliation(s)
- Mairead Black
- University Department of Obstetrics and Gynaecology, Aberdeen, UK.
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Pednekar MS, Hakama M, Gupta PC. Tobacco use or body mass--do they predict tuberculosis mortality in Mumbai, India? Results from a population-based cohort study. PLoS One 2012; 7:e39443. [PMID: 22848354 PMCID: PMC3407144 DOI: 10.1371/journal.pone.0039443] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 05/24/2012] [Indexed: 11/26/2022] Open
Abstract
Tobacco use and under-nutrition are major public health concerns and tuberculosis is a major cause of morbidity and mortality in India. Using a cohort of 148,173 persons (recruited 1991-1997 and followed-up 1997-2003) the joint effects of tobacco use and BMI on tuberculosis mortality was studied. Tobacco use in any form and low-BMI had joint effect on tuberculosis mortality and the interaction effect was synergistic in men and antagonistic in women. Self-reported tuberculosis was associated with increased risk of tuberculosis mortality. In contrast, no such association was observed for self-reported diabetes persons. The risk pattern remained unchanged even after excluding tuberculosis deaths occurred within 1(st) two years of follow-up. This study highlights importance of age consideration of individual while excluding early deaths. Around 27% male tuberculosis deaths were attributable to their being underweight and smoker, while 22% male and 37% female deaths were attributable to their being underweight and smokeless tobacco user.
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Jeemon P, Prabhakaran D, Goenka S, Ramakrishnan L, Padmanabhan S, Huffman M, Joshi P, Sivasankaran S, Mohan B, Ahmed F, Ramanathan M, Ahuja R, Sinha N, Thankappan K, Reddy K. Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population. Indian J Med Res 2012; 135:485-93. [PMID: 22664495 PMCID: PMC3385231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions. METHODS Data from 10543 individuals collected in a nation-wide surveillance programme in India were analysed. The burden of risk factors clustering with blood pressure and coronary heart disease (CHD) was assessed. The impact of a risk reduction programmme on risk factors clustering was prospectively studied in a sub-group. RESULTS Mean age of participants was 40.9 ± 11.0 yr. A significant linear increase in number of risk factors with increasing blood pressure, irrespective of stratifying using different risk factor thresholds was observed. While hypertension occurred in isolation in 2.6 per cent of the total population, co-existence of hypertension and >3 risk factors was observed in 12.3 per cent population. A comprehensive risk reduction programme significantly reduced the mean number of additional risk factors in the intervention population across the blood pressure groups, while it continued to be high in the control arm without interventions (both within group and between group P<0.001). The proportion of 'low risk phenotype' increased from 13.4 to 19.9 per cent in the intervention population and it was decreased from 27.8 to 10.6 per cent in the control population (P<0.001). The proportion of individuals with hypertension and three more risk factors decreased from 10.6 to 4.7 per cent in the intervention arm while it was increased from 13.3 to 17.8 per cent in the control arm (P<0.001). INTERPRETATION & CONCLUSIONS Our findings showed that cardiovascular risk factors clustered together with elevated blood pressure and a risk reduction programme significantly reduced the risk factors burden.
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Affiliation(s)
- Panniyammakal Jeemon
- Centre for Chronic Disease Control, New Delhi, India,Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK,Public Health Foundation of India, New Delhi, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India,Center of Excellence - Center for Cardio-metabolic Risk Reduction in South Asia, New Delhi, India,Public Health Foundation of India, New Delhi, India,Reprint requests: Dr Dorairaj Prabhakaran, Director, Centre for Chronic Disease Control, C1/52, Level 2, Safdarjung Development Area, New Delhi 110 016, India e-mail:
| | - Shifalika Goenka
- Centre for Chronic Disease Control, New Delhi, India,Public Health Foundation of India, New Delhi, India
| | | | - Sandosh Padmanabhan
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mark Huffman
- Centre for Chronic Disease Control, New Delhi, India,Feinberg School of Medicine, Northwestern University, Chicago, US
| | | | | | - B.V.M. Mohan
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - F. Ahmed
- KPC Medical College, Jadavpur, Kolkata, India
| | | | - R. Ahuja
- King George Medical College, Lucknow, India
| | - Nakul Sinha
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - K.R. Thankappan
- Sree Chitra Tirunal Institute of Medical Sciences & Technology, Thiruvananthapuram, India
| | - K.S. Reddy
- Public Health Foundation of India, New Delhi, India
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Jitnarin N, Kosulwat V, Rojroongwasinkul N, Boonpraderm A, Haddock CK, Poston WSC. The relationship between smoking, body weight, body mass index, and dietary intake among Thai adults: results of the national Thai Food Consumption Survey. Asia Pac J Public Health 2011; 26:481-93. [PMID: 22186385 DOI: 10.1177/1010539511426473] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study examined the relationship between dietary intake, body weight, and body mass index (BMI) in adult Thais as a function of smoking status. A cross-sectional, nationally representative survey using health and dietary questionnaires and anthropometric measurements were used. Participants were 7858 Thai adults aged 18 years and older recruited from 17 provinces in Thailand. Results demonstrated that smoking is associated with lower weights and BMI. However, when smokers were stratified by smoking intensity, there was no dose-response relationship between smoking and body weight. There is no conclusive explanation for weight differences across smoking groups in this sample, and the results of the present study did not clearly support any of the purported mechanisms for the differences in body weight or BMI. In addition, because the substantial negative health consequences of smoking are far stronger than those associated with modest weight differences, smoking cannot be viewed as an appropriate weight management strategy.
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Affiliation(s)
- Nattinee Jitnarin
- National Development and Research Institutes, Inc, Public Health Solutions of NYC, New York, NY, USA
| | - Vongsvat Kosulwat
- Asia Pacific R&D, Mead Johnson Nutrition (Thailand) Ltd, Bangkok, Thailand
| | | | | | - Christopher K Haddock
- Institute for Biobehavioral Health Research, National Development and Research Institutes, Inc, KS, USA
| | - Walker S C Poston
- Institute for Biobehavioral Health Research, National Development and Research Institutes, Inc, KS, USA
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Chakrabarti B, Purkait S, Gun P, Moore VC, Choudhuri S, Zaman MJ, Warburton CJ, Calverley PMA, Mukherjee R. Chronic airflow limitation in a rural Indian population: etiology and relationship to body mass index. Int J Chron Obstruct Pulmon Dis 2011; 6:543-9. [PMID: 22069366 PMCID: PMC3206771 DOI: 10.2147/copd.s24113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Respiratory conditions remain a source of morbidity globally. As such, this study aimed to explore factors associated with the development of airflow obstruction (AFO) in a rural Indian setting and, using spirometry, study whether underweight is linked to AFO. Methods Patients > 35 years old attending a rural clinic in West Bengal, India, took a structured questionnaire, had their body mass index (BMI) measured, and had spirometry performed by an ancillary health care worker. Results In total, 416 patients completed the study; spirometry was acceptable for analysis of forced expiratory volume in 1 second in 286 cases (69%); 16% were noted to exhibit AFO. Factors associated with AFO were: increasing age (95% confidence interval (CI) 0.004–0.011; P = 0.005), smoking history (95% CI 0.07–0.174; P = 0.006), male gender (95% CI 0.19–0.47; P = 0.012), reduced BMI (95% CI 0.19–0.65; P = 0.02), and occupation (95% CI 0.12–0.84; P = 0.08). The mean BMI in males who currently smoked (n = 60; 19.29 kg/m2; standard deviation [SD] 3.46) was significantly lower than in male never smokers (n = 33; 21.15 kg/m2 SD 3.38; P < 0.001). AFO was observed in 27% of subjects with a BMI <18.5 kg/m2, falling to 13% with a BMI ≥18.5 kg/m2 (P = 0.013). AFO was observed in 11% of housewives, 22% of farm laborers, and 31% of cotton/jute workers (P = 0.035). Conclusion In a rural Indian setting, AFO was related to advancing age, current or previous smoking, male gender, reduced BMI, and occupation. The data also suggest that being under-weight is linked with AFO and that a mechanistic relationship exists between low body weight, smoking tobacco, and development of AFO.
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Trends in breast, ovarian and cervical cancer incidence in Mumbai, India over a 30-year period, 1976-2005: an age-period-cohort analysis. Br J Cancer 2011; 105:723-30. [PMID: 21829198 PMCID: PMC3188937 DOI: 10.1038/bjc.2011.301] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Demographic, socioeconomic and cultural changes in India have increased longevity, delayed childbearing, decreased parity and resulted in a more westernised lifestyle, contributing to the increasing burden of cancer, especially among women. Methods: We evaluated secular changes in the incidence of breast, cervical and ovarian cancer in Mumbai women aged 30–64 between 1976 and 2005. Age-standardised incidence rates were calculated and presented by site and calendar period. An age–period–cohort (APC) analysis quantified recent time trends and the significance of birth cohort and calendar period effects. The estimated annual percent change (EAPC) was obtained from the drift parameter, expressing the linear time trend common to both calendar period and birth cohort. Results: Over the 30-year study period, the age-standardised rates significantly increased for breast cancer (EAPC: 1.1% (95% confidence interval (CI): 1.0, 1.3)), significantly decreased for cervical cancer (EAPC: −1.8% (95% CI: −2.0, −1.6)) and there was no statistically significant change for ovarian cancer (EAPC: 0.3% (95% CI: −0.1, 0.6)). For breast and cervical cancer, the best-fitting model was the APC model. Conclusions: The rates of breast, cervical and ovarian cancer remain low in comparison with western countries, and the divergent trends of breast (increasing) and cervical cancer (decreasing) in Mumbai were similar to those observed in several other Asian countries. The changing risk profile in successive generations – improved education, higher socioeconomic status, later age at marriage and at first child, and lower parity – may in combination partially explain the diverging generational changes in breast and cervical cancer in Mumbai in the last decades.
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Mitchell E, Frisbie S, Sarkar B. Exposure to multiple metals from groundwater-a global crisis: geology, climate change, health effects, testing, and mitigation. Metallomics 2011; 3:874-908. [PMID: 21766119 DOI: 10.1039/c1mt00052g] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This paper presents an overview of the global extent of naturally occurring toxic metals in groundwater. Adverse health effects attributed to the toxic metals most commonly found in groundwater are reviewed, as well as chemical, biochemical, and physiological interactions between these metals. Synergistic and antagonistic effects that have been reported between the toxic metals found in groundwater and the dietary trace elements are highlighted, and common behavioural, cultural, and dietary practices that are likely to significantly modify health risks due to use of metal-contaminated groundwater are reviewed. Methods for analytical testing of samples containing multiple metals are discussed, with special attention to analytical interferences between metals and reagents. An overview is presented of approaches to providing safe water when groundwater contains multiple metallic toxins.
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Pednekar MS, Gupta PC, Yeole BB, Hébert JR. Association of tobacco habits, including bidi smoking, with overall and site-specific cancer incidence: results from the Mumbai cohort study. Cancer Causes Control 2011; 22:859-68. [PMID: 21431915 PMCID: PMC3756904 DOI: 10.1007/s10552-011-9756-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 03/05/2011] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Bidis are hand-rolled cigarettes commonly smoked in South Asia and are marketed to Western populations as a safer alternative to conventional cigarettes. This study examined the association between bidis and other forms of tobacco use and cancer incidence in an urban developing country population. METHODS Using data from the large, well-characterized Mumbai cohort study, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed from Cox proportional hazards regression models in order to compare the relative effect of various forms of tobacco use on cancer incidence. RESULTS During 649,228 person-years of follow-up 1,267 incident cancers occurred in 87,222 male cohort members. Incident oral cancer in bidi smokers (HR = 3.55; 95% CI = 2.40,5.24) was 42% higher than in cigarette smokers (HR = 2.50;95% CI = 1.65,3.78). For all respiratory and intrathoracic organs combined, the increase was 69% (HR = 5.54; 95% CI = 3.46,8.87 vs. HR = 3.28; 95% CI = 1.99,5.39); for lung and larynx, the increases were 35 and 112%, respectively. Smokeless tobacco use was associated with cancers of the lip, oral cavity, pharynx, digestive, respiratory, and intrathoracic organs. CONCLUSIONS Despite marketing claims to the contrary, we found that smokeless tobacco use and bidi smoking are at least as harmful as cigarette smoking for all incident cancers and are associated with increased risk of oral and respiratory/intrathoracic cancers.
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Affiliation(s)
- Mangesh S Pednekar
- Healis, Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India.
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Reséndiz E, Aguilera P, Rocher ME. Lifestyle and Body Mass Index of an Adult Population in Southern Tamaulipas, Mexico. AQUICHAN 2010. [DOI: 10.5294/aqui.2010.10.3.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
La obesidad es una enfermedad multifactorial que involucra aspectos genéticos y ambientales. Objetivo: valorar la influencia del estilo de vida en el índice de masa corporal de una población de adultos. Método: este estudio descriptivo transversal se deriva del proyecto "Hábitos alimentarios y composición corporal (IMC) de adultos con sobrepeso y obesidad"; cuya fase de recolección se realizó entre enero y julio de 2009; preliminarmente se presentan resultados relativos al estilo de vida. Se aplicó una cédula de datos personales y se realizaron mediciones antropométricas. Para el análisis estadístico se utilizaron medidas de tendencia central y se construyeron modelos de regresión lineal múltiple. Resultados: las mayores proporciones tanto del grupo de hombres como del de mujeres, señalaron no fumar, ni realizar algún deporte o ejercicio. En el caso del consumo de alcohol, la mayor proporción del grupo de hombres dijo consumirlo. Los modelos de regresión mostraron que en el total del grupo, así como en el grupo de mujeres, las variables tabaco y ejercicio influyeron en el IMC de los participantes, ya que tuvieron efecto en el modelo de regresión. Dichas variables se correlacionaron significativa e inversamente con el IMC, lo que particularmente llamó la atención en el caso del tabaco. Discusión: el estudio muestra que el estilo de vida influye de manera importante en el IMC de esta población de adultos.
Estilo de vida, índice de masa corporal, obesidad. (Fuente: DeCs, BIREME)
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Hebert JR, Pednekar MS, Gupta PC. Forced expiratory volume predicts all-cause and cancer mortality in Mumbai, India: results from a population-based cohort study. Int J Epidemiol 2010; 39:1619-27. [PMID: 20846948 DOI: 10.1093/ije/dyq157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Reduction in pulmonary function, as estimated by forced expiratory volume in 1 s (FEV(1)), has been found to predict all-cause mortality in developed-country populations. This study was designed to examine the association between FEV(1) and mortality in an urban developing-country population. METHODS Data from the large, well-characterized Mumbai Cohort Study (Maharashtra, India) were used to compute hazard ratios (HRs; deaths/100-ml FEV(1)) and 95% confidence intervals (CIs) from Cox proportional hazards regression models in which age, tobacco use, education, height and relative body weight were controlled. RESULTS A total of 13,261 deaths occurred in this cohort of 148,173 individuals. After controlling for important covariates, there was a 1.7% reduction in risk of overall death in women for each 100-ml increment in FEV(1) (HR = 0.983; 95% CI = 0.980-0.986) and a 1.5% reduction in men (HR = 0.985; 95% CI = 0.984-0.986). There was a 1.6% reduction in cancer deaths in women (HR = 0.984; 95% CI = 0.973-0.996) and a 0.8% reduction in men (HR = 0.992; 95% CI = 0.987-0.997). The largest reductions in women were observed in tuberculosis deaths (3.7%/100-ml increment in FEV(1)), and in men in respiratory system deaths (3.2%). CONCLUSIONS In a densely populated urban Indian population, FEV(1) predicted overall and cancer mortality. Effects were larger in women and were not attenuated by exclusion of smokers or restricting analyses to subjects dying >2 years from recruitment. Because FEV(1) may be affected by air pollution, which is worsening in urban areas of most developing countries, further research is recommended to deepen understanding of these factors in relation to mortality.
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Affiliation(s)
- James R Hebert
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India.
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Slama K. Le contrôle du tabac et l’équité en santé. Glob Health Promot 2010. [DOI: 10.1177/1757975909358367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Karen Slama
- Consultante dans le domaine du contrôle du tabac, France,
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Srivastava M, Parakh P, Srivastava M. Predictors and prevalence of nicotine use in females: A village-based community study. Ind Psychiatry J 2010; 19:125-9. [PMID: 22174536 PMCID: PMC3237129 DOI: 10.4103/0972-6748.90344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Nicotine use and abuse is gaining increasing attention due to its negative and serious medical consequences. Multiple morbidities occur due to the intake of nicotine in various forms. AIMS To find the prevalence and type of nicotine use/abuse in females. SETTINGS AND DESIGN House to house survey in a village in Purvanchal, i.e. eastern part of Uttar Pradesh and bordering Bihar. MATERIALS AND METHODS Semi-structured performa was used to collect data; a house to house visit was made to collect data. STATISTICAL ANALYSIS Simple percentages were calculated. RESULTS Tooth powder form of nicotine use is common and the need to address this problem is urgent. CONCLUSIONS Widespread dissemination of knowledge and legislative measures have to be undertaken to stop the problem.
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Affiliation(s)
- Mona Srivastava
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Slama K. Control del tabaco e igualdad en materia de salud. Glob Health Promot 2010. [DOI: 10.1177/1757975909358371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Karen Slama
- Consultante dans le domaine du contrôle du tabac, France,
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Affiliation(s)
- Karen Slama
- Consultante dans le domaine du contrôle du tabac, France,
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Kwon JD, Kim BT, Kim KM, Park SB, Kim E, Chang CS, Kim BY, Joo NS. The Relationship between Cigarette Smoking and Obesity in the Adolescents. Korean J Fam Med 2010. [DOI: 10.4082/kjfm.2010.31.5.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Jong-Dae Kwon
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Bom-Taeck Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kwang-Min Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Sat-Byul Park
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eugene Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Chung-Soo Chang
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Bo-Young Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
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Pednekar MS, Hébert JR, Gupta PC. Tobacco use, body mass and cancer mortality in Mumbai Cohort Study. Cancer Epidemiol 2009; 33:424-30. [DOI: 10.1016/j.canep.2009.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 09/23/2009] [Accepted: 09/24/2009] [Indexed: 12/30/2022]
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Association of blood pressure and cardiovascular mortality in India: Mumbai cohort study. Am J Hypertens 2009; 22:1076-84. [PMID: 19629050 DOI: 10.1038/ajh.2009.131] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To determine all-cause and circulatory system (cardiovascular)-related mortality in subjects with different grades of hypertension, we performed a prospective study. METHODS A total of 148,173 individuals aged > or =35 years were recruited in Mumbai, India in years 1991-1997. Clinical history and anthropometric data were obtained and hypertension-categorized using US 7th Joint National Committee guidelines into normal, prehypertension, stage-I, and stage-II. These subjects were followed to ascertain vital status from 1997 to 2003. Multivariate analysis was performed using Cox proportional analyses and adjusted hazard ratios (HRs), 95% confidence intervals (CIs) determined for mortality in various hypertension grades. RESULTS At baseline, hypertension was in 47.3% men and 45.7% women, while prehypertension in 40.8% men and 35.9% women. In total, 13,261 persons died during average 5.5 years follow-up of whom 9,259 deaths were matched and coded using International Classification of Diseases-10. Compared to those with normal blood pressure (BP), all cause mortality (HR, 95% CI) was significantly greater in stage-II (men 1.41, 1.31-1.52; women 1.46, 1.30-1.64). Circulatory system deaths were significantly more in stage-II (men 2.05, 1.77-2.39; women 2.06, 1.62-2.61) as well as stage-I (men 1.31, 1.14-1.52; women 1.39, 1.10-1.77). Subjects with stage-II hypertension had greater risk of death from hypertensive heart disease (men 2.77, 1.75-4.40; women 3.04, 1.73-5.35), ischemic heart disease (men 1.87, 1.54-2.28; women 1.85, 1.29-2.65), and cerebrovascular diseases (men 3.50, 2.42-5.05; women 3.09, 1.77-5.39). CONCLUSIONS In urban Indian subjects, compared to normal BP stage-II hypertension is associated with increased risk of all-cause mortality, while both stage-II and stage-I hypertension with circulatory system-related mortality.
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Khan MMH, Khan A, Kraemer A, Mori M. Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparison. BMC Public Health 2009; 9:149. [PMID: 19463157 PMCID: PMC2705350 DOI: 10.1186/1471-2458-9-149] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 05/22/2009] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Smoking is one of the leading causes of premature death particularly in developing countries. The prevalence of smoking is high among the general male population in Bangladesh. Unfortunately smoking information including correlates of smoking in the cities especially in the urban slums is very scarce, although urbanization is rapid in Bangladesh and slums are growing quickly in its major cities. Therefore this study reported prevalences of cigarette and bidi smoking and their correlates separately by urban slums and non-slums in Bangladesh. METHODS We used secondary data which was collected by the 2006 Urban Health Survey. The data were representative for the urban areas in Bangladesh. Both slums and non-slums located in the six City Corporations were considered. Slums in the cities were identified by two steps, first by using the satellite images and secondly by ground truthing. At the next stage, several clusters of households were selected by using proportional sampling. Then from each of the selected clusters, about 25 households were randomly selected. Information of a total of 12,155 adult men, aged 15-59 years, was analyzed by stratifying them into slum (= 6,488) and non-slum (= 5,667) groups. Simple frequency, bivariable and multivariable logistic regression analyses were performed using SPSS. RESULTS Overall smoking prevalence for the total sample was 53.6% with significantly higher prevalences among men in slums (59.8%) than non-slums (46.4%). Respondents living in slums reported a significantly (P < 0.001) higher prevalence of smoking cigarettes (53.3%) as compared to those living in non-slums (44.6%). A similar pattern was found for bidis (slums = 11.4% and non-slums = 3.2%, P < 0.001). Multivariable logistic regression revealed significantly higher odds ratio (OR) of smoking cigarettes (OR = 1.12, 95% CI = 1.03-1.22), bidis (OR = 1.90, 95% CI = 1.58-2.29) and any of the two (OR = 1.23, 95% CI = 1.13-1.34) among men living in slums as compared to those living in non-slums when controlled for age, division, education, marital status, religion, birth place and types of work. Division, education and types of work were the common significant correlates for both cigarette and bidi smoking in slums and non-slums by multivariable logistic regressions. Other significant correlates of smoking cigarettes were marital status (both areas), birth place (slums), and religion (non-slums). Similarly significant factors for smoking bidis were age (both areas), marital status (slums), religion (non-slums), and birth place (both areas). CONCLUSION The men living in the urban slums reported higher rates of smoking cigarettes and bidis as compared to men living in the urban non-slums. Some of the significant correlates of smoking e.g. education and division should be considered for prevention activities. Our findings clearly underscore the necessity of interventions and preventions by policy makers, public health experts and other stakeholders in slums because smoking was more prevalent in the slum communities with detrimental health sequelae.
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Affiliation(s)
- Md Mobarak Hossain Khan
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Germany
| | - Aklimunnessa Khan
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Germany
| | - Mitsuru Mori
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
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Sundbeck M, Grahn M, Lönngren V, Månsson NO, Råstam L, Lindblad U. Snuff use associated with abdominal obesity in former smokers. Scand J Public Health 2009; 37:487-93. [DOI: 10.1177/1403494809105546] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Aim: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and Methods: Tobacco use was explored in 834 men aged 30—75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. Results: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08—3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08—2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05—2.36) (p = 0.041) waist circumference and 0.01 (0.00—0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. Conclusions: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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Affiliation(s)
| | - Mathias Grahn
- Department of Social and Preventive Medicine, Malmö University Hospital, Malmö, Sweden
| | | | | | - Lennart Råstam
- Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Ulf Lindblad
- Department of Clinical Sciences, Malmö, Lund University, Sweden, , Skaraborg Institute, Skövde, Sweden, Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at Göteborg University, Sweden
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Alcácera MA, Marques-Lopes I, Fajó-Pascual M, Puzo J, Blas Pérez J, Bes-Rastrollo M, Martínez-González MÁ. Lifestyle factors associated with BMI in a Spanish graduate population: the SUN Study. Obes Facts 2008; 1:80-7. [PMID: 20054166 PMCID: PMC6452167 DOI: 10.1159/000124237] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To study the association between BMI and lifestyle factors such as alcohol consumption, smoking habits, education level and marital status in a Spanish graduate population. METHOD Cross-sectional analysis of 8,706 participants (3,643 men and 5,063 women) from the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Data on body weight, height and sociodemographic characteristics, and lifestyle habits were collected with self-administered validated questionnaires. RESULTS Among older participants (above sex-specific median age), educational level was a factor independently associated with BMI. University graduates with a lower educational level (3-year college degree or 5-year university degree) had a significantly higher BMI than those with doctorate which requires, at least, 8 years of university studies in Spain. Mean BMI was significantly higher among past smokers than among never smokers. Alcohol consumption, marital and smoking status were associated with BMI only among men. CONCLUSION In a study whose members were all university graduates, several factors were independently associated with a higher BMI, such as less years of higher education, past smoking, marital status and higher alcohol consumption.
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Affiliation(s)
| | - Iva Marques-Lopes
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Marta Fajó-Pascual
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - José Puzo
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Juan Blas Pérez
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, Clinica Universitaria-Medical School, University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard School of Public Health, Boston, MS, USA
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Clinica Universitaria-Medical School, University of Navarra, Pamplona, Spain
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Ackerson LK, Kawachi I, Barbeau EM, Subramanian SV. Exposure to domestic violence associated with adult smoking in India: a population based study. Tob Control 2008; 16:378-83. [PMID: 18048613 DOI: 10.1136/tc.2007.020651] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the relation between domestic violence and tobacco use among adults in India. DESIGN Multilevel cross sectional analyses of a nationally representative population based sample from the 1998-9 Indian national family health survey. PARTICIPANTS 278,977 individuals aged 15 or older; and 89,092 ever married women aged 15-49. MAIN OUTCOME Dichotomous variables for smoking and chewing tobacco. RESULTS Women who reported being abused more than one year ago and those who reported being abused in the past year were more likely to smoke and chew tobacco than women who have never experienced domestic violence. Compared to individuals who lived in homes where no abuse was reported, those who lived in homes where a woman reported experiencing domestic violence were more likely to smoke and chew tobacco. CONCLUSION Domestic violence is associated with higher odds of smoking and chewing tobacco in India. Efforts to control tobacco use need to consider the larger psychosocial circumstances within which individuals who practise such harmful health behaviours reside.
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Affiliation(s)
- Leland K Ackerson
- Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, KRESGE 7th floor, Boston, MA 02115-6096, USA
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Chiriboga DE, Ma Y, Li W, Olendzki BC, Pagoto SL, Merriam PA, Matthews CE, Hebert JR, Ockene IS. Gender differences in predictors of body weight and body weight change in healthy adults. Obesity (Silver Spring) 2008; 16:137-45. [PMID: 18223626 PMCID: PMC4355617 DOI: 10.1038/oby.2007.38] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Overweight and obesity are important predictors of a wide variety of health problems. Analysis of naturally occurring changes in body weight can provide valuable insights in improving our understanding of the influence of demographic, lifestyle, and psychosocial factors on weight gain in middle-age adults. OBJECTIVE To identify gender-specific predictors of body weight using cross-sectional and longitudinal analyses. METHODS AND PROCEDURES Anthropometric, lifestyle and psychosocial factors were measured at baseline and then quarterly for 1 year in 572 healthy adult volunteers from Central Massachusetts who were recruited between 1994 and 1998. Linear mixed models were used to analyze the relationship between body weight and potential predictors, including demographic (e.g., age, educational level), lifestyle (e.g., diet, physical activity, smoking), and psychosocial (e.g., anxiety, depression) factors. RESULTS Over the 1-year study period, on average, men gained 0.3 kg and women lost 0.2 kg. Predictors of lower body weight at baseline in both men and women included current cigarette smoking, greater leisure-time physical activity, and lower depression and anxiety scores. Lower body weights were associated with a lower percentage of caloric intake from protein and greater occupational physical activity levels only among men; and with higher education level only among women. Longitudinal predictors of 1-year weight gain among women included increased total caloric intake and decreased leisure-time physical activity, and among men, greater anxiety scores. DISCUSSION Demographic, lifestyle and psychosocial factors are independently related to naturally occurring changes in body weight and have marked differential gender effects. These effects should be taken into consideration when designing interventions for weight-loss and maintenance at the individual and population levels.
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Affiliation(s)
- David E Chiriboga
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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Pednekar MS, Gupta PC. Prospective study of smoking and tuberculosis in India. Prev Med 2007; 44:496-8. [PMID: 17391745 DOI: 10.1016/j.ypmed.2007.02.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 02/12/2007] [Accepted: 02/16/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Although tuberculosis has already become uncommon in industrialised countries, is a major burden in many developing countries, including India. This paper examines the association between smoking (mainly bidi smoking) and tuberculosis in Mumbai, India. METHOD To study the possible association between smoking and tuberculosis, recruitment of a cohort of 81,443 men > or =35 years began in 1991 and was followed up to the end of 2003 in Mumbai. RESULTS The adjusted risk of tuberculosis deaths among bidi smokers was 2.60 (95% confidence interval (CI): 2.02, 3.33) times higher than never-smokers, with a significant trend for daily frequency of bidi smoking. Also the risk of prevalence of self reported tuberculosis among bidi smokers was 5.23 (95% CI: 4.01, 6.82) times higher than never-smokers. CONCLUSION In India around 32% of tuberculosis deaths can be attributable to bidi smoking. Thus, bidi smoking seems to be an important cause of manifestation and death from tuberculosis.
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