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Proaño GV, Rodriguez Moreno LM, Arciniegas MJ, Sifre-Acosta N, Espinal C, Chowdhury R, Hernández Flórez LJ, Palacios C. Effectiveness, barriers, and facilitators of overweight and obesity prevention strategies in Latin America; a scoping review and qualitative study in Colombia. LANCET REGIONAL HEALTH. AMERICAS 2024; 29:100656. [PMID: 38250673 PMCID: PMC10797189 DOI: 10.1016/j.lana.2023.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024]
Abstract
Background This project aimed to synthesize the quantitative/qualitative evidence on the effectiveness of overweight/obesity prevention strategies implemented in Colombia and their barriers and facilitators. Methods A scoping review was conducted by searching PubMed, SciELO, Scopus, and the grey literature (2012–2023). In-depth interviews were also conducted among key stakeholders on their perception of these strategies’ effectiveness, barriers, and facilitators. Findings 26 records were included; four studies found positive changes in weight/body mass index, five found positive changes in physical activity, two found positive changes in food intake, and four found positive changes in healthy lifestyle knowledge, perception, attitudes, and habits. The main barrier reported was the obesogenic environment, and the facilitators were program flexibility and community engagement. Eighteen interviews were conducted (one interview per strategy); the main barriers reported were political, lack of evaluation access, economic situation, and lack of articulation; the main facilitators were incorporating the strategy into policies, articulation with stakeholders, and strong oversight. Interpretation Moderate evidence indicates that these strategies positively impact outcomes related to overweight/obesity in Colombia, but more long-term studies are needed for overweight/obesity reduction. Lack of (1) evaluation and resources (barriers), (2) incorporation into policies (facilitators), and (3) strong stakeholder coordination (facilitators) was identified. Funding Global Health Consortium , Department of Global Health , 10.13039/100007681 FIU .
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Affiliation(s)
- Gabriela V. Proaño
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | | | - Niliarys Sifre-Acosta
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Carlos Espinal
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Rajiv Chowdhury
- Department of Global Health, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
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Del Rio AI, Moreno Velásquez I, Roa R, Montenegro Mendoza R, Motta J, Quintana HK. Prevalence of hypertension and possible risk factors of hypertension unawareness among individuals aged 30-75 years from two Panamanian provinces: Results from population-based cross-sectional studies, 2010 and 2019. PLoS One 2022; 17:e0276222. [PMID: 36441768 PMCID: PMC9704556 DOI: 10.1371/journal.pone.0276222] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 10/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Recent estimates of hypertension in Panama remain unknown. We aim to describe the variation in prevalence and unawareness of hypertension in two Panamanian provinces using two different cross-sectional population-based studies and to investigate risk factors associated with hypertension unawareness. METHODS Data were derived from a sub-national study conducted in the provinces of Panama and Colon (PREFREC-2010 [2,733 participants]) and from a nationally representative study (ENSPA-2019), in which we restricted our analyses to the same provinces (4,653 participants). Individuals aged 30-75 years who had (a) self-reported history of hypertension or (b) blood pressure (BP) ≥140/90mmHg or (c) a combination or both were classified as hypertensive. Participants with BP≥140/90mmHg who denied a history of hypertension were considered unaware of the condition. Multivariable logistic regression models were used to estimate the association between risk factors and unawareness, expressed as odds ratios (OR) and 95% confidence interval (CI). FINDINGS In 2010, the prevalence and unawareness of hypertension in men were 51.6% (95% CI: 45.7-57.5) and 32.3% (25.4-40.1), respectively, and in women 46.0% (42.1-49.9) and 16.1% (12.6-20.4), respectively. In 2019, the prevalence and unawareness of hypertension in men were 46.5% (42.1-51.0) and 52.3% (45.9-58.6), and in women 42.1% (39.6-44.7) and 33.3% (29.8-37.0). Men (2010 and 2019), age <50 years (2010 and 2019), having no/primary education (2010), and living in a non-urban region (2019) were positively associated with hypertension unawareness, whereas obesity (2010), physical inactivity (2010), family history of hypertension (2019), and BP assessment in the year before study enrollment (2010 and 2019) were inversely associated with hypertension unawareness. INTERPRETATION Benefits of a decrease in the prevalence of hypertension are being undermined by an increase in hypertension unawareness. Actions should be encouraged to strengthen the implementation of the existing healthcare program for cardiovascular risk factor control.
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Affiliation(s)
- Angela Isabel Del Rio
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
- Ministry of Health, Panama City, Panama
- * E-mail:
| | - Ilais Moreno Velásquez
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
| | - Reina Roa
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
- Ministry of Health, Panama City, Panama
| | | | - Jorge Motta
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
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Sharma N, Behl T, Singh S, Kaur P, Zahoor I, Mohan S, Rachamalla M, Dailah HG, Almoshari Y, Salawi A, Alshamrani M, Aleya L. Targeting Nanotechnology and Nutraceuticals in Obesity: An Updated Approach. Curr Pharm Des 2022; 28:3269-3288. [PMID: 36200206 DOI: 10.2174/1381612828666221003105619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/22/2022] [Indexed: 01/28/2023]
Abstract
HYPOTHESIS This review article represents a brief layout of the risk factors and pathophysiology responsible for obesity, customary treatment strategies, and nanotechnology-based nutraceutical for the therapeutics of obesity. EXPERIMENTS An exhaustive search of the literature was done for this purpose, using Google Scholar, PubMed, and ScienceDirect databases. A literature study was conducted using publications published in peer-reviewed journals between 2000 and 2022. FINDINGS This was revealed that risk factors responsible for obesity were genetic abnormalities and environmental and socio-economic factors. Several research articles published between 2000 and 2022 were based on phytoconstituents-based nanoformulation for obesity therapeutics and, therefore, have been systematically compiled in this review. Various nutraceuticals like Garcinia cambogia, quercetin, resveratrol, capsaicin, Capsicum, Curcuma longa, Camella Sinensis, Zingiber officinalis, Citrus aurantium, Aegle marmelos, Coffea canephora, Asparagus officinalis, Gardenia jasminoides, Catha edulis, Clusia nemroisa, Rosmarinus officinalis, Cirsium setidens, Betula platyphylla, Tripterygium wilfordi possessing anti-obesity actions are discussed in this review along with their patents, clinical trials as well as their nanoformulation available. CONCLUSION This review illustrates that nanotechnology has a great propensity to impart a promising role in delivering phytochemicals and nutraceuticals in managing obesity conditions and other related disorders.
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Affiliation(s)
- Neelam Sharma
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana- Ambala, Haryana 133207, India
| | - Tapan Behl
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
| | - Sukhbir Singh
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana- Ambala, Haryana 133207, India
| | - Parneet Kaur
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Ishrat Zahoor
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Syam Mohan
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India.,Substance Abuse and Toxicology Research Center, Jazan University, Jazan, Saudi Arabia
| | - Mahesh Rachamalla
- Department of Biology, University of Saskatchewan, 112 Science Place, Saskatoon, SK S7N 5E2, Canada
| | - Hamed Ghaleb Dailah
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Yosif Almoshari
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Salawi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Lotfi Aleya
- Chrono-environment Laboratory, Bourgogne Franche-Comté University, Besançon, France
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Prevalence of central obesity according to different definitions in normal weight adults of two cross-sectional studies in Panama. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100215. [PMID: 36777687 PMCID: PMC9904116 DOI: 10.1016/j.lana.2022.100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Methods Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Findings Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. Interpretation NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Funding Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.
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Ayza A, Tadesse E, Halala Handiso Y. Prevalence of overweight/obesity and associated factors among adults in Wolaita Sodo Town, Southern Ethiopia. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1965709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Azalech Ayza
- Research And Community Service Vice President Office, Kotebe Metropolitan University, Addis Ababa, Ethiopia. P.O. Box: 31248
| | - Elazar Tadesse
- Research And Community Service Vice President Office, Kotebe Metropolitan University, Addis Ababa, Ethiopia. P.O. Box: 31248
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Tramontin NDS, Luciano TF, Marques SDO, de Souza CT, Muller AP. Ginger and avocado as nutraceuticals for obesity and its comorbidities. Phytother Res 2020; 34:1282-1290. [PMID: 31989713 DOI: 10.1002/ptr.6619] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/19/2019] [Accepted: 01/13/2020] [Indexed: 12/17/2023]
Abstract
Obesity is a worldwide epidemic and is one of the factors involved in the etiology of type 2 diabetes mellitus. Obesity induces low-grade inflammation and oxidative stress. The treatment for obesity involves changes in diet, physical activity, and even medication and surgery. Currently, the use of nutraceutical compounds is associated with health benefits. Ginger and avocado are used for many people all around the world; however, its effect as a nutraceutical compound is less known by the general population. For this reason, we searched information of the literature to point its effects on distinct mechanisms of defense against the obesity its comorbidities. The present review aimed showing that these nutraceuticals may be useful in obesity treatment. Reports have shown that ginger and avocado induce antioxidant and anti-inflammatory effects by improving enzymatic activity and modulating obesity-related impairments in the anti-inflammatory system in different tissues, without side effects. Furthermore, ginger and avocado were found to be effective in reversing the harmful effects of obesity on blood lipids. In conclusion, on the basis of the positive effects of ginger and avocado in in vitro, animal, and human studies, these nutraceuticals may be useful in obesity treatment.
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Affiliation(s)
| | - Thais F Luciano
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | | | - Claudio T de Souza
- Department of Internal Medicine, Medicine School, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Alexandre P Muller
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Prevalence of Diabetes, Prediabetes, and Obesity in the Indigenous Kuna Population of Panamá. J Racial Ethn Health Disparities 2019; 6:743-751. [PMID: 30805801 DOI: 10.1007/s40615-019-00573-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/06/2019] [Accepted: 02/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diabetes is a burgeoning disease affecting more than 8% of the world population. Indigenous communities are disproportionately impacted by diabetes; however, limited data is available on prevalence and correlates of diabetes. METHODS Data was collected from 211 Indigenous Kuna adults off the coast of Panamá in the San Blas region of the Caribbean. Diabetes and prediabetes were measured by HbA1c. Obesity was defined using the US BMI categories as well as categories defined by the WHO to assess obesity among Asian populations. Univariate analyses (chi2 tests) were used to investigate diabetes status and obesity by demographic factors. Logistic regression was used to examine the correlates of diabetes and obesity. RESULTS Of the 211 adults, 13% had diabetes, 35% had prediabetes, and approximately 39% were obese. Using the Asian cut point for obesity, this number increased to 61%. Income was statistically significantly related to an HbA1c cut point of 6.5 (p = 0.005). Individuals who reported a monthly income of greater than $250 had increased odds of prediabetes and diabetes nearly sixfold for HbA1c of > 6.5 (OR 6.3; CI 1.43-28.45) and HbA1c of > 5.7 (OR 5.1; CI 1.03-26.14). CONCLUSIONS These findings represent one of the first studies examining diabetes and prediabetes in indigenous Kuna of the San Blas region. Our findings suggest Kuna Indians may be at an increased risk for diabetes and prediabetes. Current national estimates for diabetes is considered low in this population. Greater understanding of determinants of diabetes and obesity are needed in order to address diabetes in this indigenous community.
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Herrera-Ballesteros VH, Castro F, Gómez B. Análisis de los Determinantes Socioeconómicos del Gasto de Bolsillo en Medicamentos en Seis Zonas Geográficas de Panamá. Value Health Reg Issues 2018; 17:64-70. [PMID: 29709795 DOI: 10.1016/j.vhri.2017.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 10/24/2017] [Accepted: 12/17/2017] [Indexed: 11/30/2022]
Abstract
OBJETIVO Caracterizar el gasto de bolsillo privado en medicamentos en función de los determinantes sociodemográficos y socioeconómicos. MATERIALES Y MéTODOS: La fuente de datos es la Encuesta de Gasto de Bolsillo en Medicamentos de 2014. Se caracterizó el gasto de bolsillo privado mediante variables explicativas sociodemográficas (SOD) y socioeconómicas (SES). Se hizo análisis factorial por componentes principales, regresión logística y lineal simple. RESULTADOS Los Odds Ratio demuestran que la educación y la zona geográfica son determinantes fundamentales que inciden en el gasto de bolsillo. Los medicamentos son productos necesarios, en adición a que el gasto de bolsillo aumenta a un promedio del 2% por cada año de vida cronológica adicional. CONCLUSIONES Existe mayor vulnerabilidad en las zonas más pauperizadas respecto del acceso a medicamentos, en especial en las indígenas e implica un mayor riesgo de gasto catastrófico a menor ingreso ante la mayor prevalencia de enfermedades crónicas.
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Affiliation(s)
| | - Franz Castro
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá
| | - Beatriz Gómez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá
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Mc Donald Posso AJ, Bradshaw Meza RA, Mendoza Morales EA, Jaen Y, Cumbrera Ortega A, Mendoza Posada EJ. Diabetes in Panama: Epidemiology, Risk Factors, and Clinical Management. Ann Glob Health 2018; 81:754-64. [PMID: 27108143 DOI: 10.1016/j.aogh.2015.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To draw evidence-based conclusions about the epidemiology, drivers, and management of diabetes in Panama based on a literature review and original analyses of large databases. METHODS A search about diabetes in Panama was conducted through PubMed. We used the final reports of 2 studies: the first Survey of Health and Life Quality, 2007, and the first Survey of Risk Factors Associated to Cardiovasular Diseases, 2010-2011, conducted in Panama and analyzed the databases. We reviewed the approach adopted by the Panamanian Social Security institution and the diabetes national guidelines published by the Panamanian Ministry of Health. FINDINGS The prevalence of diabetes, as estimated in 1 database (ENSCAVI), was 5.4% (4.3% men; 6.0% women; OR = 1.41 [confidence interval 1.26-1.59]; P < 0.0001), with the highest prevalence in urbanized regions. In another database (PREFREC), prevalence was 9.5% (10.3% men and 9.1% women), again higher in urbanized regions, but also in males, older adults, and Afro-Panamanians. Obesity, abdominal obesity, physical inactivity, family history of diabetes, high blood pressure, and triglycerides ≥ 150 mg/dL were associated as risk factors for diabetes in both genders (P < 0.0001). Total cholesterol ≥ 200 mg/dL and high-density lipoprotein cholesterol < 40 mg/dL were risk factors in men (P < 0.0001). In the last 5 years, diabetes was ranked between the sixth and fifth cause of death in Panama. In response, the Panamanian Social Security created the "Program for Prevention and Control of Diabetes" to strengthen primary health care. CONCLUSIONS Diabetes is a serious national public health threat in Panama. To address this problem in a public health modality, information from large databases was analyzed and presented to the Panamanian Ministry of Health to prompt constructive policy change to enhance diabetes prevention.
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Affiliation(s)
| | | | | | - Ycly Jaen
- Panamanian Social Security, Panama City, Panama
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Carrión Donderis M, Moreno Velásquez I, Castro F, Zúñiga J, Gómez B, Motta J. Analysis of mortality trends due to cardiovascular diseases in Panama, 2001-2014. Open Heart 2016; 3:e000510. [PMID: 28123756 PMCID: PMC5237747 DOI: 10.1136/openhrt-2016-000510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/20/2016] [Accepted: 11/08/2016] [Indexed: 11/17/2022] Open
Abstract
Objective Cardiovascular diseases (CVDs) are still the leading cause of death worldwide despite the recent decline in mortality rates attributable to CVD in Western Europe and the Americas. The aim of this study is to investigate mortality trends due to ischaemic heart disease (IHD) and stroke in Panama from 2001 to 2014, as well as the mortality differences by sex and age groups. Methods Data were obtained from the National Mortality Register. The International Classification of Diseases 10th revision codes (ICD-10) I20–I25 and I60–I69 were used for IHD and stroke, respectively. Age-adjusted mortality rates were calculated using the world population of the WHO as standard. Trends were analysed using Joinpoint Regression Program and annual percentage changes (APC) were estimated. Results From 2010, the IHD mortality trend began to decline in the whole population of Panama (APC −4.7%, p<0.05). From 2001 to 2014, a decline in the trend for IHD mortality was observed (APC −1.7%, p<0.05) in women, but not in men. Stroke mortality showed a significant annual decline during the study period (APC −3.8%, p<0.05) and it was more pronounced in women (APC −4.5%, p<0.05) than in men (APC −3.3%, p<0.05). Conclusions In Panama, the mortality rates from IHD and stroke have declined in recent years. Better access to healthcare, improved treatment of acute IHD and stroke, low tobacco consumption and better control of hypertension probably account for a significant part of this mortality reduction.
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Affiliation(s)
| | | | - Franz Castro
- Gorgas Memorial Institute for Health Studies , Panama City , Panama
| | - Julio Zúñiga
- Gorgas Memorial Institute for Health Studies , Panama City , Panama
| | - Beatriz Gómez
- Gorgas Memorial Institute for Health Studies , Panama City , Panama
| | - Jorge Motta
- Gorgas Memorial Institute for Health Studies, Panama City, Panama; National Secretariat for Science and Technology, Panama City, Panama
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Mc Donald A, Bradshaw RA, Fontes F, Mendoza EA, Motta JA, Cumbrera A, Cruz C. Prevalence of obesity in panama: some risk factors and associated diseases. BMC Public Health 2015; 15:1075. [PMID: 26489845 PMCID: PMC4618152 DOI: 10.1186/s12889-015-2397-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 10/07/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To estimate the prevalence of obesity in Panama and determine some risk factors and associated diseases in adults aged 18 years and older. METHODS A cross-sectional descriptive study was conducted in the provinces of Panama and Colon where 60.4 % of all Panamanians 18 years or older reside, by administering a survey regarding the consumption of protective and predisposing foods and assessing the development of obesity by measuring the weight, height, and waist circumference of 3590 people. A single-stage, probabilistic, and randomized sampling strategy employing multivariate stratification was used. Individuals with a body mass index ≥ 30 kg/m(2) (men and women) were considered obese. Prevalence and descriptive analysis were conducted according to sex using Odds Ratio, with statistical significance set at a p value ≤ 0.05. RESULTS The general prevalence of obesity was 27.1 % (30.9 % women and 18.3 % men). In women, obesity was associated with living in urban areas, being 40-59 years of age, being Afro-Panamanian, consuming beverages / foods rich in sugar, being physically inactive and having a family history of obesity. In men, obesity was associated with living in urban areas, consuming beverages/foods rich in sugar, and having a family history of obesity. Almost the totality of obese women (97.9 %), and 80.0 % of men with obesity had abdominal obesity according to the WHO classification. In both sexes, obesity was a risk factor associated to type 2 Diabetes Mellitus, hypertension, LDL values ≥ 100 mg/dL, and low HDL values (<50 mg/dL for women and < 40 mg/dL for men), Odds Ratio > 1.0; P < 0.05. CONCLUSIONS Obesity represents a very serious threat to Panamanian public health. Our study confirms a direct association in Panama between excess weight, hypertension, type 2 Diabetes Mellitus, LDL values ≥ 100 mg/dL and low HDL values for women and men (<50 mg/dL and < 40 mg/dL, respectively). Intervention / treatment programs should be targeted, specially, to Afro-Panamanian women, whom are 40-59 years old, living in urban areas, and those having a family history of obesity.
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Affiliation(s)
- Anselmo Mc Donald
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Ryan A Bradshaw
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Flavia Fontes
- Department of Nutrition, Ministry of Health of Panama, Gorgas Avenue, Ancon, Panama.
| | - Enrique A Mendoza
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Jorge A Motta
- Gorgas Memorial Institute for Health Studies, Panama, Panama.
| | - Alberto Cumbrera
- Department of Research in Health Systems, Environment and Society, Gorgas Memorial Institute for Health Studies, Justo Arosemena Avenue and 35th Street, Panama, Panama.
| | - Clara Cruz
- School of Statistics, Faculty of Sciences, University of Panama, Avenida Transístmica, Panama, Panama.
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Politis M, Higuera G, Chang LR, Gomez B, Bares J, Motta J. Trend Analysis of Cancer Mortality and Incidence in Panama, Using Joinpoint Regression Analysis. Medicine (Baltimore) 2015; 94:e970. [PMID: 26091467 PMCID: PMC4616533 DOI: 10.1097/md.0000000000000970] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cancer is one of the leading causes of death worldwide and its incidence is expected to increase in the future. In Panama, cancer is also one of the leading causes of death. In 1964, a nationwide cancer registry was started and it was restructured and improved in 2012. The aim of this study is to utilize Joinpoint regression analysis to study the trends of the incidence and mortality of cancer in Panama in the last decade. Cancer mortality was estimated from the Panamanian National Institute of Census and Statistics Registry for the period 2001 to 2011. Cancer incidence was estimated from the Panamanian National Cancer Registry for the period 2000 to 2009. The Joinpoint Regression Analysis program, version 4.0.4, was used to calculate trends by age-adjusted incidence and mortality rates for selected cancers. Overall, the trend of age-adjusted cancer mortality in Panama has declined over the last 10 years (-1.12% per year). The cancers for which there was a significant increase in the trend of mortality were female breast cancer and ovarian cancer; while the highest increases in incidence were shown for breast cancer, liver cancer, and prostate cancer. Significant decrease in the trend of mortality was evidenced for the following: prostate cancer, lung and bronchus cancer, and cervical cancer; with respect to incidence, only oral and pharynx cancer in both sexes had a significant decrease. Some cancers showed no significant trends in incidence or mortality. This study reveals contrasting trends in cancer incidence and mortality in Panama in the last decade. Although Panama is considered an upper middle income nation, this study demonstrates that some cancer mortality trends, like the ones seen in cervical and lung cancer, behave similarly to the ones seen in high income countries. In contrast, other types, like breast cancer, follow a pattern seen in countries undergoing a transition to a developed economy with its associated lifestyle, nutrition, and body weight changes.
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Affiliation(s)
- Michael Politis
- From the The Gorgas Memorial Institute for Health Studies (MP, BG, JM); Santo Tomas Hospital (GH); MINSA (Ministry of Health, Panama) (LRC); and FUNDACANCER, Panama City, Panama (JB)
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Mc Donald Posso AJ, Motta Borrel JA, Fontes F, Cruz Gonzalez CE, Pachón Burgos AA, Cumbrera Ortega A. High blood pressure in Panama: prevalence, sociodemographic and biologic profile, treatment, and control (STROBE). Medicine (Baltimore) 2014; 93:e101. [PMID: 25396327 PMCID: PMC4616318 DOI: 10.1097/md.0000000000000101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/05/2014] [Accepted: 08/09/2014] [Indexed: 01/13/2023] Open
Abstract
The objective of this study is to estimate the prevalence, treatment, and control of high blood pressure, hypertension (HBP) in Panama and assess its associations with sociodemographic and biologic factors.A cross-sectional, descriptive study was conducted in Panama by administering a survey on cardiovascular risk factors to 3590 adults and measuring their blood pressure 3 times. A single-stage, probabilistic, and randomized sampling strategy with a multivariate stratification was used. The average blood pressure, confidence intervals (CIs), odds ratio (OR), and a value of P ≤ 0.05 were used for the analysis.The estimated prevalence of HBP was 29.6% (95% CI, 28.0-31.1); it was more prevalent in men than in women, OR = 1.37 (95% CI, 1.17-1.61); it increased with age and was more frequent among Afro-Panamanians (33.8%). HBP was associated with a family history of HBP with being physically inactive and a body mass index ≥25.0 kg/m or a waist circumference >90 cm in men and >88 cm in women (P < 0.001). Of those found to have HBP, 65.6% were aware of having HBP and taking medications, and of these, 47.2% had achieved control (<140/90 mm Hg).HBP is the most common cardiovascular risk factor among Panamanians and consequently an important public health problem in Panama. The health care system needs to give a high priority to HBP prevention programs and integrated care programs aimed at treating HBP, taking into consideration the changes in behavior that have been brought about by alterations in nutrition and sedentary lifestyles.
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Affiliation(s)
- Anselmo J Mc Donald Posso
- Department of Endocrinology and Metabolism (AAPB), Hospital Rafael Hernández, David, Chiriquí; Gorgas Memorial Institute of Health Studies (AJMDP, JAMB, ACO); Ministry of Health of Panama (FF); and School of Statistics (CECG), Faculty of Sciences, University of Panama, Panama
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