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Arora S, Sahadevan P, Sundarakumar JS. Association of sleep quality with physical and psychological health indicators in overweight and obese rural Indians. Sleep Med X 2024; 7:100112. [PMID: 38800099 PMCID: PMC11127281 DOI: 10.1016/j.sleepx.2024.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To measure the association of sleep quality with physical (i.e., grip strength, functional mobility, balance) and psychological (depression, anxiety) health indicators in an overweight/obese population. Methods Baseline data of 2337 participants (1382 overweight/obese and 955 normal weight) from an aging cohort in rural southern India (CBR-SANSCOG) was analyzed retrospectively. Assessment tools included the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, dynamometry for Hand Grip Strength (HGS), Timed Up-and-Go (TUG) for functional mobility, Chair Stand Test (CST) for lower limb strength, Geriatric Depression scale (GDS-30) for depressive symptoms and Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms. Linear regression models, adjusted for known confounders, were used to examine the association of sleep quality with the health parameters in overweight/obese and normal-weight groups. Results In the fully adjusted model, higher global PSQI score was associated with higher TUG time (β = 0.06, 95 % CI: 0.004,0.12), higher scores on GDS (β = 1.08, 95 % CI: 0.96,1.20) and GAD (β = 0.71, 95 % CI: 0.62,0.79), and lower scores on CST (β = -0.12, 95 % CI: -0.19,-0.06) in overweight/obese individuals. The sleep disturbance sub-component of PSQI was associated with most of the physical (TUG, CST) and psychological (GDS and GAD) health indicators. Sleep duration and use of sleep medication showed no significant association with any of the health indicators. Conclusion The concurrent presence of poor sleep quality and overweight/obesity could worsen physical and psychological health in middle-aged and older adults. We highlight the importance of early detection and timely management of sleep problems in this population to reduce physical and psychological morbidities.
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Affiliation(s)
- Sakshi Arora
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Pravin Sahadevan
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
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srivastav P, K V, Bhat HV, Broadbent S. Effect of a pragmatic lifestyle modification intervention on physical activity levels and body mass index among obese and overweight adolescents in Udupi, India: a cluster randomized trial. F1000Res 2024; 13:859. [PMID: 39113943 PMCID: PMC11303949 DOI: 10.12688/f1000research.153483.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
Background Determine the effects of a multifactorial lifestyle intervention on physical activity (PA), BMI and health-related quality of life (QoL) in obese and overweight adolescents. Methods Nine schools in India were clustered randomly in a 12-month study with students allocated to a multifactorial intervention (MFI), or exercise only (EX) or control (CON) group. Participants were adolescents aged 11-16 years (n=671). In the MFI group, adolescents and their parents received lifestyle education using a validated booklet combined with a PA intervention for school students. The EX group received school-based PA only; the CON group continued regular activities. Primary outcomes were PA levels measured with the PAQ-A, and BMI; the secondary outcome was health-related QoL. A linear regression statistical model was used to analyse time, group effects and interactions, with Bonferroni correction for within-group differences at baseline (T0) and at 12-weeks (T1) (post-intervention), 6-month (T2) and 12-month (T3) follow-ups. Results Significant time and group effects observed for all groups with PA scores (p<0.001), with MFI group having largest increase in PA; with BMI (p<0.001) and MFI showing the least gain in BMI; and HRQOL (p<0.001), with MFI group showing greatest improvement in scores. There were significant increases in PA at T1 and T3 time-points with the EX group, and at T3 time-point only for MFI and CON, with MFI group showing largest increase in HRQOL scores. BMI increased significantly for all groups at T2 (MFI p=0.001, EX p<0.001) and T3 (p<0.001), while HRQOL increased significantly for both MFI and EX at both follow-ups (p<0.001). Conclusions School-based lifestyle MFI was more effective for improving PA, lifestyle behaviours and HRQOL than exercise alone for adolescents, although BMI was not reduced. MFI with PA could be an effective school-based approach for behaviour modification but BMI has limitations for measuring body composition changes. Registration CTRI/2019/04/018834 (30/04/2019).
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Affiliation(s)
- prateek srivastav
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - H Vinod Bhat
- The Apollo University, Chittoor, Andhra Pradesh, 517127, India
| | - Suzanne Broadbent
- School of Health, University of Sunshine Coast, Sippy Downs, Queensland, 4556, Australia
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Yu H, Li M, Qian G, Yue S, Ossowski Z, Szumilewicz A. A Systematic Review and Bayesian Network Meta-Analysis Comparing In-Person, Remote, and Blended Interventions in Physical Activity, Diet, Education, and Behavioral Modification on Gestational Weight Gain among Overweight or Obese Pregnant Individuals. Adv Nutr 2024; 15:100253. [PMID: 38879168 PMCID: PMC11267029 DOI: 10.1016/j.advnut.2024.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor. OBJECTIVES The aim of this study was to ascertain the most effective treatment modalities for gestational weight gain (GWG) in pregnant women classified as overweight or obese. METHODS A systematic search was conducted across 4 electronic databases: Embase, EBSCOhost, PubMed, and Web of Science. To assess the quality of evidence, the Confidence In Network Meta-Analysis (CINeMA) approach, grounded in the Grading of Recommendations Assessment, Development, and Evaluation framework, was employed. A Bayesian network meta-analysis was conducted to synthesize the comparative effectiveness of treatment modalities based on GWG outcomes. RESULTS The analysis incorporated 60 randomized controlled trials, encompassing 16,615 participants. Modes of intervention administration were classified as remote (R: eHealth [e] and mHealth [m]), in-person (I), and a combination of both (I+R). The interventions comprised 5 categories: education (E), physical activity (PA), dietary (D), behavior modification (B), and combinations thereof. The quality of the evidence, as evaluated by CINeMA, ranged from very low to high. Compared to the control group, the I-D intervention (mean difference [MD]: -1.27; 95% confidence interval [CI]: -2.23, -0.32), I-PADB (MD: -0.60, 95% CI: -1.19, -0.00), and I-B (MD: -0.34, 95% CI: -0.57, -0.10) interventions showed significant efficacy in reducing GWG. CONCLUSIONS Preliminary findings suggest that the I-D intervention is the most efficacious in managing GWG among pregnant women who are overweight or obese, followed by I-PADB and I-B+R-B(m) treatments. These conclusions are drawn from evidence of limited quality and directness, including insufficient data on PA components used in the interventions. Owing to the absence of robust, direct evidence delineating significant differences among various GWG management strategies, it is tentatively proposed that the I-D intervention is likely the most effective approach. This study was registered with PROSPERO as CRD42023473627.
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Affiliation(s)
- Hongli Yu
- College of Physical Education, Sichuan University of Science & Engineering, Zigong, Sichuan, China.
| | - Mingmao Li
- Department of Fitness, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Guoping Qian
- Department of Fitness, Gdansk University of Physical Education and Sport, Gdansk, Poland.
| | - Shuqi Yue
- Department of Fitness, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Zbigniew Ossowski
- Department of Fitness, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Anna Szumilewicz
- Department of Fitness, Gdansk University of Physical Education and Sport, Gdansk, Poland
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Takale G, Handore A, Jeyakumar A, Godbharle S. Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:77. [PMID: 38835054 DOI: 10.1186/s41043-024-00560-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 05/03/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Multiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households. METHODS Data used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019-21. Data sets of men (15-54 years) and women (15-49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results. RESULTS A prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33-0.39)), urban areas (AOR 1.11 (1.02-1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81-0.97)), and ST (AOR 1.30 (1.17-1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress. CONCLUSION A 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.
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Affiliation(s)
- Geetanjali Takale
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Avantika Handore
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Angeline Jeyakumar
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Nutrition, University of Nevada, Reno, NV, USA
| | - Swapnil Godbharle
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India.
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa.
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Singh NK, Singh NK, Verma R, Diwan AD. Validation and Estimation of Obesity-Induced Intervertebral Disc Degeneration through Subject-Specific Finite Element Modelling of Functional Spinal Units. Bioengineering (Basel) 2024; 11:344. [PMID: 38671766 PMCID: PMC11048157 DOI: 10.3390/bioengineering11040344] [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: 02/07/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Intervertebral disc degeneration has been linked to obesity; its potential mechanical effects on the intervertebral disc remain unknown. This study aimed to develop and validate a patient-specific model of L3-L4 vertebrae and then use the model to estimate the impact of increasing body weight on disc degeneration. (2) Methods: A three-dimensional model of the functional spinal unit of L3-L4 vertebrae and its components were developed and validated. Validation was achieved by comparing the range of motions (RoM) and intradiscal pressures with the previous literature. Subsequently, the validated model was loaded according to the body mass index and estimated stress, deformation, and RoM to assess disc degeneration. (3) Results: During validation, L3-L4 RoM and intradiscal pressures: flexion 5.17° and 1.04 MPa, extension 1.54° and 0.22 MPa, lateral bending 3.36° and 0.54 MPa, axial rotation 1.14° and 0.52 MPa, respectively. When investigating the impact of weight on disc degeneration, escalating from normal weight to obesity reveals an increased RoM, by 3.44% during flexion, 22.7% during extension, 29.71% during lateral bending, and 33.2% during axial rotation, respectively. Also, stress and disc deformation elevated with increasing weight across all RoM. (4) Conclusions: The predicted mechanical responses of the developed model closely matched the validation dataset. The validated model predicts disc degeneration under increased weight and could lay the foundation for future recommendations aimed at identifying predictors of lower back pain due to disc degeneration.
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Affiliation(s)
- Nitesh Kumar Singh
- Computational Biomechanics Lab, Department of Biomedical Engineering, National Institute of Technology, Raipur 492010, India;
| | - Nishant K. Singh
- Computational Biomechanics Lab, Department of Biomedical Engineering, National Institute of Technology, Raipur 492010, India;
| | - Rati Verma
- Biomechanics Lab, School of Biomedical Engineering, Indian Institute of Technology (BHU), Varanasi 221005, India;
| | - Ashish D. Diwan
- Spine Labs & Spine Service, St George & Sutherland Campus, Clinical School of Faculty of Health & Medicine, University of New South Wales, Sydney, NSW 2502, Australia;
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Listyoko AS, Okazaki R, Harada T, Inui G, Yamasaki A. Impact of obesity on airway remodeling in asthma: pathophysiological insights and clinical implications. FRONTIERS IN ALLERGY 2024; 5:1365801. [PMID: 38562155 PMCID: PMC10982419 DOI: 10.3389/falgy.2024.1365801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
The prevalence of obesity among asthma patients has surged in recent years, posing a significant risk factor for uncontrolled asthma. Beyond its impact on asthma severity and patients' quality of life, obesity is associated with reduced lung function, increased asthma exacerbations, hospitalizations, heightened airway hyperresponsiveness, and elevated asthma-related mortality. Obesity may lead to metabolic dysfunction and immune dysregulation, fostering chronic inflammation characterized by increased pro-inflammatory mediators and adipocytokines, elevated reactive oxygen species, and reduced antioxidant activity. This chronic inflammation holds the potential to induce airway remodeling in individuals with asthma and obesity. Airway remodeling encompasses structural and pathological changes, involving alterations in the airway's epithelial and subepithelial layers, hyperplasia and hypertrophy of airway smooth muscle, and changes in airway vascularity. In individuals with asthma and obesity, airway remodeling may underlie heightened airway hyperresponsiveness and increased asthma severity, ultimately contributing to the development of persistent airflow limitation, declining lung function, and a potential increase in asthma-related mortality. Despite efforts to address the impact of obesity on asthma outcomes, the intricate mechanisms linking obesity to asthma pathophysiology, particularly concerning airway remodeling, remain incompletely understood. This comprehensive review discusses current research investigating the influence of obesity on airway remodeling, to enhance our understanding of obesity's role in the context of asthma airway remodeling.
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Affiliation(s)
- Aditya Sri Listyoko
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
- Pulmonology and Respiratory Medicine Department, Faculty of Medicine, Brawijaya University-Dr. Saiful Anwar General Hospital, Malang, Indonesia
| | - Ryota Okazaki
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tomoya Harada
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Genki Inui
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Akira Yamasaki
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
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Ghosh K, Chakraborty AS, Haloi B, Zakir S. Spatial Clustering of Malnutrition and Anemia Among Reproductive Women and Its Associated Risk Factors in India: Evidence From National Family Health Survey-5. Food Nutr Bull 2024; 45:3-11. [PMID: 38439659 DOI: 10.1177/03795721241234086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND Malnutrition and anemia are 2 severe public health concerns, predominantly in low-and middle-income nations. Malnutrition is defined as poor nutritional condition that encompasses both under nutrition and over nutrition. The prevalence of overweight or obesity and anemia has increased in India from 2016 to 2021. The study aims to investigate the spatial clustering and factors responsible for underweight, overweight/obesity, and anemia among reproductive women (15-49 years) in India using the data from National Family and Health Survey-5 (2019-2021). METHODS We conducted hot-spot analysis using Moran's Index (MI) with the help of spatial analysis software (i.e., GeoDa 1.18 and ArcGIS 10.8). It also demonstrates the autocorrelation. Multivariable logistic regression analysis has been performed to examine different determinants and risk associated with underweight, overweight/obesity, and anemia with various dependent variable by using Stata-14 software. RESULTS Moran's Index for underweight (MI = 0.68), overweight/obesity (MI = 0.72), and anemia (MI = 0.62) indicates a high level of spatial-autocorrelation (P < .001) exists across the districts in India. As a result, a total of 156, 143, and 126 hot-spot districts are detected for underweight, overweight/obesity, and anemia, respectively. The burden of undernutrition and anemia is higher in rural areas. Risk of under nutrition and anemia are both reduced by media exposure and eating habits. Moreover, low income and low education level raises the risk of anemia and undernutrition, while obesity shows an inverse trend with income and education level. CONCLUSION The study recommends targeting hot-spot districts for malnutrition and anemia, and policy level initiatives by addressing the responsible risk factors.
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Affiliation(s)
- Koustav Ghosh
- Department of Population Studies and Health Economic, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India
- Population Research Centre (PRC), Baroda, Vadodara, Gujarat, India
| | - Atreyee Sinha Chakraborty
- Department of Population Studies and Health Economic, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India
| | - Banashri Haloi
- Public Health Department, Central University of Kerala, Kerala, India
| | - Sofia Zakir
- Department of Geography, Gauhati University, Assam, India
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Swärdh E, Thorstensson CA, Khatri S, Kindblom K, Opava CH. Approaches to osteoarthritis: a qualitative study among physical therapists in Maharashtra, India. Physiother Theory Pract 2024; 40:327-337. [PMID: 36047816 DOI: 10.1080/09593985.2022.2118005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 08/21/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Osteoarthritis (OA) is a major and growing problem in India. Better knowledge dissemination and implementation of evidence-based practice in Indian physical therapy require a better understanding of approaches to OA (i.e. perceptions of the condition and its management by Indian physical therapists (PTs)) which was the aim of our study. DESIGN AND METHOD We used qualitative content analysis to analyze semi-structured interviews with 19 PTs from Maharashtra state, purposefully selected to represent both sexes, different ages and different educational and professional backgrounds. FINDINGS We identified a main overarching theme of meaning, OA as a degenerative and irreversible condition with the four descriptive themes Assessment, Standardized treatment protocol, Leadership and Patient compliance as PTs' approaches to OA. The descriptive themes indicate that much focus seems to be on pain, physical impairments and biomechanics, with initial treatments being mainly passive. Communication appears to be mainly unidirectional with the PTs instructing the patients, who are expected to comply with PTs instructions. Clinical practice guidelines (CPGs) were not mentioned. CONCLUSIONS Our findings can inform the design of awareness campaigns on evidence-based OA management and increase the understanding of the educational needs of students and PTs in non-Western countries. It is important to recognize that CPGs are mainly based on studies carried out in Western countries and that there are context-specific barriers to implementation in other parts of the world that have large populations.
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Affiliation(s)
- Emma Swärdh
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Carina A Thorstensson
- Institute of Neuroscience and Physiology, Gothenburg University, Göteborg, Sweden
- Department of Research and Development, Halland County Council, Varberg, Sweden
| | - Subhash Khatri
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Rahata, Ahmednagar, Maharashtra, India
| | - Kristina Kindblom
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Rahata, Ahmednagar, Maharashtra, India
| | - Christina H Opava
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Rahata, Ahmednagar, Maharashtra, India
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Saha MR, Dey P. Pharmacological benefits of Acacia against metabolic diseases: intestinal-level bioactivities and favorable modulation of gut microbiota. Arch Physiol Biochem 2024; 130:70-86. [PMID: 34411504 DOI: 10.1080/13813455.2021.1966475] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT Obesity-associated chronic metabolic disease is a leading contributor to mortality globally. Plants belonging to the genera Acacia are routinely used for the treatment of diverse metabolic diseases under different ethnomedicinal practices around the globe. OBJECTIVE The current review centres around the pharmacological evidence of intestinal-level mechanisms for metabolic health benefits by Acacia spp. RESULTS Acacia spp. increase the proportions of gut commensals (Bifidobacterium and Lactobacillus) and reduces the population of opportunistic pathobionts (Escherichia coli and Clostridium). Acacia gum that is rich in fibre, can also be a source of prebiotics to improve gut health. The intestinal-level anti-inflammatory activities of Acacia are likely to contribute to improvements in gut barrier function that would prevent gut-to-systemic endotoxin translocation and limit "low-grade" inflammation associated with metabolic diseases. CONCLUSION This comprehensive review for the first time has emphasised the intestinal-level benefits of Acacia spp. which could be instrumental in limiting the burden of metabolic disease.
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Affiliation(s)
- Manas Ranjan Saha
- Department of Life Science, Vidyasagar Primary Teachers Training Institute (B.Ed.), Malda, India
| | - Priyankar Dey
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, India
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Behera S, Sharma R, Yadav K, Chhabra P, Das M, Goel S. Prevalence and predictors of risk factors for cardiovascular diseases among women aged 15-49 years across urban and rural India: findings from a nationwide survey. BMC Womens Health 2024; 24:77. [PMID: 38281909 PMCID: PMC10822148 DOI: 10.1186/s12905-023-02869-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/25/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Women's health is usually looked upon in terms of their reproductive health. However, cardio-vascular diseases are one of the leading causes of death and disability among women, globally as well as in India. Risk factors of today can be disease of tomorrow. Gradience in level of epidemiological transition is observed across different states. The study aims to estimate the national and regional prevalence, and sociodemographic determinants of biological and behavioural risk factors for cardiovascular diseases. MATERIALS AND METHODS The present study was conducted among women in the age group of 15 to 49 years using nationally representative sample from fifth round National Family Health Survey in India. The data analysis in the current study included 7,24,115 women in the age group of 15 to 49 years. SPSS version 20 was used for the purpose of analysis. Weighted prevalence was computed for the studied behavioral and biological (dependent variable) risk factors using women specific weights as provided in the dataset. Binary logistic regression model was employed to calculate the adjusted odds ratio (OR) with the corresponding 95% confidence interval (CI) to study the sociodemographic determinants (independent variables) of these risk factors. RESULTS Highest prevalent risk factor for cardiovascular diseases was reported to be central obesity (78.2%), followed by overweight/obesity (23.9%), oral contraceptive use (13.4%), raised blood pressure (11.8%), raised blood sugar (8.6%), tobacco use (4.0%), and alcohol use (0.7%). Higher odds of all the studied risk factors were reported with increasing age. All of the studied risk factors, except for alcohol consumption [OR (95%CI): 0.9 (0.8-0.96)], had higher odds in rural areas compared to urban areas. Compared to other castes, the odds of tobacco [OR (95% CI): 2.01 (1.91-2.08)] and alcohol consumption [OR (95% CI): 5.76 (5.12-6.28)], and raised blood pressure [OR (95% CI): 1.07(1.04-1.11)] was significantly higher among the people belonging to schedule tribe. CONCLUSION AND RECOMMENDATION The present study highlights the state-wise disparities in the burden and predictors of risk factors for cardio-vascular diseases among women of reproductive age. The study provides insights to these disparities, and focuses on the need of tailoring the disease prevention and control measures suiting to the local needs.
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Affiliation(s)
- Shyambhavee Behera
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Rahul Sharma
- Department of Community Medicine, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Kartikey Yadav
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Pragti Chhabra
- Department of Community Medicine, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Milan Das
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Sonu Goel
- School of Medicine, University of Limerick, Limerick, Ireland.
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Ma Y, Sun L, Mu Z. Network meta-analysis of three different forms of intermittent energy restrictions for overweight or obese adults. Int J Obes (Lond) 2024; 48:55-64. [PMID: 37980382 DOI: 10.1038/s41366-023-01416-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
This network meta-analysis aimed to compare the efficacy of three forms of intermittent energy restriction (IER), including alternate-day fasting (ADF), the 5:2 diet, and time-restricted feeding (TRF), in overweight or obese adults. A literature search was conducted in PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) to find relevant randomized controlled trials (RCTs) until August 10, 2022. The modified Cochrane risk of bias assessment tool was applied to assess the methodological quality of eligible studies. Random network meta-analysis was conducted using STATA 14.0. Sixteen RCTs were included, with 1228 patients. Overall, the methodological quality ranged from low to moderate. ADF was superior to CER and 5:2 diet in reducing waist circumference, whereas 5:2 diet was superior to CER in reducing BMI. Regarding fat mass and drop-out, all forms of IER were comparable. Sensitivity analyses indicated that the type of individuals had no influence on the pooled results; nevertheless, ADF significantly reduced weight compared to CER and achieved significant waist circumference reduction compared to CER, 5:2 diet, and TRF. ADF may be preferentially prescribed for overweight or obese adults. More large-scale and high-quality studies are required, however, to investigate the effect of TRF on overweight and obesity.
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Affiliation(s)
- Yahui Ma
- Department of Endocrinology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
| | - Lina Sun
- Department of Endocrinology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Zhijing Mu
- Department of Endocrinology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
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Viniston J SB, Bhushan S, Saha S. Assessment and evaluation of work-related musculoskeletal disorders among nuclear medicine professionals in India: A cross-sectional study. Work 2024; 78:207-215. [PMID: 38701126 DOI: 10.3233/wor-230693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) are a severe occupational health issue among medical radiation practitioners. It is mostly linked to personal protective wear, working posture, tools employed and ergonomics. OBJECTIVE To assess and evaluate the musculoskeletal disorders among nuclear medicine professionals (NMP) in India. METHODS An online survey was distributed to 455 NMP throughout India between November 2021 and March 2022 covering the demographic characteristics and questions for evaluation of musculoskeletal symptoms using the Standardized Nordic Musculoskeletal Questionnaire (NMQ). Participants with any pre-existing musculoskeletal disorder or trauma were excluded. Descriptive statistics summarized the data from the demographics, discomfort, aches and work-related musculoskeletal injuries. Chi-square test was used to examine the association between the obtained values. RESULTS 91 out of 124 respondents were included based on the inclusion and exclusion criteria. Results shows that there is a significant association between the height of the individual and neck pain, body mass index and elbows pain, age and low back pain, experience in the current work and upper back pain, the weight of the individual and knee pain, use of mobile lead screens and shoulder pain, use of gonad shield, trouble in the ankles and use of lead screens, and QC phantoms for gamma camera / PET and wrists/hands pain. CONCLUSION Work-related musculoskeletal disorders among NMP are resulting from factors of individual demographic variables (such as age, height, weight, body mass index), years of experience at the current workplace and of using instruments in their work area.
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Affiliation(s)
- Sam Blessing Viniston J
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shivanand Bhushan
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shovan Saha
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Yadav K, Behera S, Singh M, Parashar M, Goel S, Jaiswal N, Gupta A. Trend of risk factors for cardiovascular diseases among young and middle-aged indians: Insights from a nationally representative survey. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 19:200200. [PMID: 37663033 PMCID: PMC10472237 DOI: 10.1016/j.ijcrp.2023.200200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/08/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023]
Abstract
Background India, as a nation is witnessing epidemiological transition, which is taking place across all the states at different level, over past couple of decades. Owing to the long natural history of non-communicable diseases (NCDs), early identification of these risk factors can aid in understanding the distribution and future development of cardiovascular diseases (CVDs). Also, studying the trend of these risk factors over time can help in prediction of burden of various CVDs in future. Thus, the present study aims at understanding the trend of various risk factors for CVDs across rural and urban India, and states. Methods The present study was conducted using secondary data from the third, fourth and fifth round of the National Family Health Survey (NFHS) conducted in India. The surveys collected data for estimation of burden of the common modifiable risk factors of CVDs including tobacco and alcohol consumption overweight/obesity, raised blood pressure, and raised blood sugar. The analysis for the present study was done among interviewed males and females between 15 and 49 years. The weighted prevalence of these risk factors was computed and binary logistic regression was done to study the predictors for the same. Results A declining trend of tobacco (29.2% in NFHS 3; 8.1%in NFHS 5) and alcohol consumption (14.2% in NFHS 3; 3.2%in NFHS 5) was observed from 2005 -06 to 2019-21. A rising trend of overall raised blood pressure (11.4% in NFHS 4; 12.2%in NFHS 5), raised blood sugar (6.2% in NFHS 4; 8.5%in NFHS 5), and overweight and obesity (11.4% in NFHS 3; 23.6%in NFHS 5) was observed from the three rounds of the survey. The odds of all the studied risk factors were significantly higher among older age across all the rounds of the survey. Except overweight/obesity, the odds of rest all studied risk factors was found to be higher among males compared to females. Also, higher odds of alcohol consumption, overweight/obesity, raised blood pressure, and raised blood sugar were found among the participants living in urban areas compared to rural areas, across all the rounds of the survey. Conclusion The present highlights the rising burden of CVD risk factors, including overweight and obesity, raised blood pressure and raised blood sugar, and a declining trend of tobacco and alcohol consumption across the country. The study also highlights the need for in-depth assessment of predictors of these risk factors using longitudinal study designs.
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Affiliation(s)
- Kartikey Yadav
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Shyambhavee Behera
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Mitasha Singh
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi, India
| | - Mamta Parashar
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Sonu Goel
- Public Health Master's Program, School of Medicine, University of Limerick, Ireland
| | | | - Arpit Gupta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
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14
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Jin Q, Gheeya J, Nepal S, Shi N, Folefac E, Webb MZ, Grainger EM, Wei L, Prosek JM, Focht BC, Gong M, Clinton SK, Tabung FK. Associations of dietary patterns with kidney cancer risk, kidney cancer-specific mortality and all-cause mortality among postmenopausal women. Br J Cancer 2023; 129:1978-1987. [PMID: 37898720 PMCID: PMC10703863 DOI: 10.1038/s41416-023-02469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/19/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND The empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) are novel measures of dietary quality associated with insulin hypersecretion or chronic inflammation, respectively, whereas the Healthy Eating Index (HEI-2015) measures adherence to the Dietary Guidelines for Americans (DGA). We evaluated associations of EDIH, EDIP and HEI-2015 on the risk of both kidney cancer development and mortality. METHODS We calculated the dietary scores from baseline food frequency questionnaires among 115,830 participants aged 50-79 years in the Women's Health Initiative. Multivariable-adjusted Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for kidney cancer risk, kidney cancer-specific mortality and all-cause mortality, per 1-standard deviation increment in dietary pattern scores. RESULTS Higher EDIH was associated with greater risk of kidney cancer development [HR, 1.12; 95%CI, (1.01,1.23)], kidney cancer-specific death [1.22(0.99,1.48)], and all-cause mortality, [1.05(1.02,1.08)]. Higher HEI-2015 was associated with lower risk of kidney cancer development, [0.85(0.77, 0.94)], kidney cancer-specific death, [0.84(0.69,1.03)] and all-cause mortality, [0.97(0.95,1.00)]. However, EDIP was not significantly associated with outcomes. Associations did not differ by BMI categories. CONCLUSIONS Low-insulinemic dietary patterns and higher quality diets, are worthy of testing in dietary pattern intervention trials for kidney cancer prevention and improved survivorship.
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Affiliation(s)
- Qi Jin
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH, USA
- Department of Exercise and Nutrition Sciences, Weber State University, Ogden, UT, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jinesh Gheeya
- Hematology and Medical Oncology Fellowship Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sushma Nepal
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Ni Shi
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Edmund Folefac
- Hematology and Medical Oncology Fellowship Program, The Ohio State University College of Medicine, Columbus, OH, USA
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Maxine Z Webb
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Elizabeth M Grainger
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Lai Wei
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Jason M Prosek
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Brian C Focht
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Michael Gong
- Department of Urology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Steven K Clinton
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Fred K Tabung
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH, USA.
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
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Saha A, Mandal B, Muhammad T, Barman P, Ahmed W. Gender-specific determinants of overweight and obesity among older adults in India: evidence from a cross-sectional survey, 2017-18. BMC Public Health 2023; 23:2313. [PMID: 37993827 PMCID: PMC10664315 DOI: 10.1186/s12889-023-17156-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 11/04/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND A major societal trend of the twenty-first century is the rapidly ageing population as a consequence of the decline in fertility and increase in life expectancy. Along with the rise in ageing population, the burden of obesity and related non-communicable diseases is also equally rising. In this study, we aimed to investigate the potential gender-specific determinants of overweight and obesity among older adults in India. SUBJECTS AND METHODS The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 25,952 older adults (≥ 60 years) was selected for the study. Descriptive statistics, bivariate chi-square test, and logistic regression estimation were applied to accomplish the study objectives. Body mass index (BMI) has been classified in this study according to the WHO criteria. RESULTS The prevalence of overweight was higher among women (18.15% in rural areas and 46.62% in urban areas) compared to men (12.9% in rural areas and 30.61% in urban areas). Similarly, obesity was higher among women than men who were residing in urban areas (17.07% vs. 5.37%), had secondary or above education (32.38% vs. 6.1%) belonged to richest strata (16.37% vs. 4.50%), or had mobility impairment (9.2% vs. 2.8%). Despite adjustment for several confounders, women were more likely to be overweight (OR: 2.18; CI: 1.86, 2.55) and obese (OR: 3.79; CI: 2.86, 5.03) than men. However, among both the elderly men and women, those who were highly educated were 2.29 times (OR: 2.29; CI: 1.80, 4.11) and 2.71 times (OR: 2.71; CI: 1.78, 4.11), respectively more likely to be overweight than their illiterate counterparts. Older adults living in urban areas were more likely to suffer from obesity compared to rural men (OR: 1.47; CI: 1.07, 2.02) and women (OR: 2.58; CI: 1.85, 3.60). Both men and women, who were highly educated were 2.64 times (OR: 2.64; CI: 1.71, 4.09) and 2.94 times (OR: 2.94; CI: 1.40, 6.20), respectively, more likely to be obese than their illiterate counterparts. Older men and women who were richest (OR: 1.60; CI: 1.19, 2.14 & OR: 2.12; CI: 1.63,2.76), or had mobility impairment (OR: 1.33; CI: 1.09,1.61 & OR: 1.72; CI: 1.42,2.08) were more likely to be overweight than their counterparts who were poorest or did not have any mobility limitation, respectively. CONCLUSIONS This study found increased vulnerability of overweight and obesity among older women than men irrespective of their socioeconomic, demographic, and health status. The present study suggests that introducing preventative measures such as campaigns to encourage physical activity, and community awareness may help reduce the high burden of overweight and obesity. Finally, the findings are important for better functioning of any public health programme and suitable intervention techniques to maintain a healthy body in order to lower the prevalence and risk factors of non-communicable diseases in later life.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology, Indore, 453552, India
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India
| | - Papai Barman
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India
| | - Waquar Ahmed
- Tata Institute of Social Sciences, Mumbai, 400088, India
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Gupta RD, Frank HA, Akonde M, Mazumder A, Siddika N, Apu EH, Chakraborty PA. Rural-Urban Differences in Prevalence and Associated Factors of Underweight and Overweight/Obesity among Bangladeshi Adults: Evidence from Bangladesh Demographic and Health Survey 2017-2018. EPIDEMIOLOGIA 2023; 4:505-520. [PMID: 38131674 PMCID: PMC10742748 DOI: 10.3390/epidemiologia4040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to identify the differences in prevalence and associated factors of underweight and overweight/obesity among Bangladeshi adults (≥18 years) by analyzing the cross-sectional Bangladesh Demographic and Health Survey 2017-2018 data. Multilevel multivariable logistic regression was applied to identify the factors associated with underweight and overweight/obesity in urban and rural areas. The prevalence of underweight was 12.24% and 19.34% in urban and rural areas, respectively. The prevalence of overweight/obesity was 50.23% and 35.96%, respectively, in urban and rural areas. In the final multivariable analysis in both urban and rural areas, 30-49 years of age, female sex, being educated up to college or higher level, living in the wealthiest household, and being currently married or being separated/divorced/widowed had higher odds of being overweight/obese compared to other categories. Residence in the Mymensingh and Sylhet region was associated with decreased odds of overweight/obesity in urban and rural areas. On the other hand, being educated up to college or higher level, living in the wealthiest household, and being married were associated with reduced odds of being underweight in both areas. These high-risk groups should be brought under targeted health promotion programs to curb malnutrition.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Hanna A. Frank
- School of Population and Public Health, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Ananna Mazumder
- Jahurul Islam Medical College (JIMC), Bajitpur, Kishoreganj 2336, Bangladesh
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
- Department of Biomedical Engineering, Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 48105, USA
- Department of Biomedical Science, College of Dental Medicine, Lincoln Memorial University, Knoxville, TN 37923, USA
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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Weber MB, Rhodes EC, Ranjani H, Jeemon P, Ali MK, Hennink MM, Anjana RM, Mohan V, Narayan KMV, Prabhakaran D. Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial. Implement Sci Commun 2023; 4:134. [PMID: 37957783 PMCID: PMC10642065 DOI: 10.1186/s43058-023-00516-1] [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: 07/05/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Structured lifestyle change education reduces the burden of cardiometabolic diseases such as diabetes. Delivery of these programs at worksites could overcome barriers to program adoption and improve program sustainability and reach; however, tailoring to the worksite setting is essential. METHODS The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at 11 large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, and peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. RESULTS Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add a wider variety of exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. CONCLUSION This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. TRIAL REGISTRATION Clinicaltrials.gov NCT02813668. Registered June 27, 2016.
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Affiliation(s)
- Mary Beth Weber
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Elizabeth C Rhodes
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Harish Ranjani
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Panniyammakal Jeemon
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Mohammed K Ali
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Monique M Hennink
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ranjit M Anjana
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
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Gupta H, Kumar S. Clinical features of COVID-19 casualties. J Family Med Prim Care 2023; 12:2996-2997. [PMID: 38186805 PMCID: PMC10771196 DOI: 10.4103/jfmpc.jfmpc_2348_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Harish Gupta
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Satish Kumar
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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Masih D, Rakhra G, Vats A, Verma SK, Singh VK, Kirar V, Tripathi JK, Singh SN. Optimal Cut-Off Values for Body Mass Index and Fat Mass Index Based on Age in Physically Active Males Using Receiver Operating Characteristic Curve. Diseases 2023; 11:137. [PMID: 37873781 PMCID: PMC10594458 DOI: 10.3390/diseases11040137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023] Open
Abstract
This study aims to redefine obesity cut-off points for body mass index (BMI) and fat mass index (FMI) according to the different age groups of physically active males. Healthy physically active volunteers (N = 1442) aged 18-57 years (y), with a mean BMI = 22.7 ± 2.8 kg/m2, and mean FMI = 4.3 ± 1.7 kg/m2 were recruited from various fitness centers. BMI was calculated and individuals were categorized according to the Asia-Pacific BMI criterion of ≤22.9 kg/m2 and the previous WHO-guided BMI criterion of ≤24.9 kg/m2. FMI was also calculated for the study participants with a cut-off of 6.6 kg/m2. Redefining of BMI and FMI cut-off values was carried out based on different age groups categorized with a difference of 10 y and 5 y using the receiver operating characteristic (ROC) curve and Youden's index. For the entire study population, BMI redefined cut-off points for overweight and obesity were 23.7 kg/m2 and 24.5 kg/m2, respectively, while FMI redefined cut-off points for overweight and obesity were 4.6 kg/m2 and 5.7 kg/m2, respectively. With 10 y of age group difference, a constant BMI and FMI values were observed, while with 5 y of age group difference, a constant increase in the BMI cut-offs was observed as the age group increased, i.e., from 23.3 kg/m2 in 20-24 y to 26.6 kg/m2 in ≥45 y and a similar trend was seen in FMI cut-offs. To conclude, our study suggests that age-dependent BMI and FMI cut-off points may provide appropriate measurements for physically active males as the age group increases.
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Affiliation(s)
- Daisy Masih
- Nutrition Division, Defence Institute of Physiology and Allied Sciences, (DIPAS), Delhi 110054, India; (G.R.); (A.V.); (S.K.V.); (V.K.S.); (V.K.); (S.N.S.)
| | | | | | | | | | | | - Jitendra Kumar Tripathi
- Correspondence: (D.M.); or (J.K.T.); Tel.: +91-987-349-6113 (D.M.); +1-701-739-9283 (J.K.T.)
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Singh A, Let S, Tiwari S, Chakrabarty M. Spatiotemporal variations and determinants of overweight/obesity among women of reproductive age in urban India during 2005-2021. BMC Public Health 2023; 23:1933. [PMID: 37798718 PMCID: PMC10557305 DOI: 10.1186/s12889-023-16842-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND India has witnessed rapid urbanization in recent decades, leading to a worrisome surge in non-communicable diseases, particularly overweight/obesity, which now present a critical public health concern. Therefore, this study seeks to examine spatiotemporal variations and determinants of overweight/obesity among women of reproductive age (WRA) in urban India and its states during 2005-2021. METHODS The study used 44,882, 171,443, and 135,272 WRA aged 15-49 from National Family Health Survey (NFHS)-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21), respectively. The outcome variable was overweight/obesity, defined as a Body Mass Index (BMI) of ≥ 25 kg/m2. Chi-squared test and multivariable logistic regression were used to identify the determinants of overweight/obesity. RESULTS Overweight/obesity prevalence among WRA in urban India has risen significantly, from 23% in 2005-06 to 33% in 2019-21. This increase is particularly pronounced among SC/ST women and women with lower educational levels. During the study period, overweight/obesity rates in different states exhibited varying increases, ranging from 3 percentage points (pp) in Rajasthan to 22 pp in Odisha. Certain southern (e.g., Tamil Nadu and Andhra Pradesh) and northeastern states saw a significant 15 pp or more increase. In contrast, several northern, central, and eastern states (e.g., Punjab, Haryana, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand, West Bengal) experienced relatively smaller increases ranging from 5 to 8 pp. As of 2019-21, two regions exhibited high prevalence rates of overweight/obesity, exceeding 35%: the southern region (Tamil Nadu, Andhra Pradesh, Kerala, and Karnataka) and the northern region (Punjab, Himachal Pradesh, Uttarakhand, and Haryana). In contrast, the Empowered Action Group states had relatively lower rates (25% or less) of overweight/obesity. Regression results showed that older women [AOR: 5.98, 95% CI: 5.71-6.27], those from the richest quintile [AOR: 4.23, 95% CI: 3.95-4.54], those living in south India [AOR: 1.77, 95% CI: 1.72-1.82], and those having diabetes [AOR: 1.92, 95% CI: 1.83-2.02] were more likely to be overweight/obese. CONCLUSION Considering the significant increase in overweight/obesity among urban WRA in India, along with substantial disparities across states and socioeconomic groups, it is imperative for the government to formulate state-specific strategies and policies based on determinants to effectively combat overweight/obesity.
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Affiliation(s)
- Aditya Singh
- Department of Geography, Banaras Hindu University, Varanasi, Uttar Pradesh, India
- Girl Innovation, Research, and Learning (GIRL) Center, Population Council, New York, USA
| | - Subhojit Let
- Department of Geography, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Seema Tiwari
- Geography Section, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
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Saha A, Muhammad T, Mandal B, Adhikary M, Barman P. Socio-demographic and behavioral correlates of excess weight and its health consequences among older adults in India: Evidence from a cross-sectional study, 2017-18. PLoS One 2023; 18:e0291920. [PMID: 37796783 PMCID: PMC10553247 DOI: 10.1371/journal.pone.0291920] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Rapid population aging is expected to become one of the major demographic transitions in the twenty-first century due to the continued decline in fertility and rise in life expectancy. Such a rise in the aged population is associated with increasing non-communicable diseases. India has suffered from obesity epidemic, with morbid obesity affecting 5% of the population and continuing an upward trend in other developing countries. This study estimates the prevalence of excess weight among older adults in India, and examines the socio-demographic and behavioral factors and its health consequences. METHODS The study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 25,952 older adults (≥ 60 years) was selected for the study. Descriptive statistics, bivariate Chi-Square test, and logistic regression models were applied to accomplish the study objectives. Body mass index (BMI) has been computed for the study according to the classification of the World Health Organization, and "excess weight" refers to a score of BMI ≥ 25.0 kg/m2. RESULTS Overall, 23% of older adults (≥ 60 years) were estimated with excess weight in India, which was higher among women irrespective of socioeconomic and health conditions. The higher levels of excess weight (than the national average of ≥22.7%) were observed among older adults in states like Haryana, Tamil Nadu, Telangana, Maharashtra, Gujarat, Manipur, Goa, Kerala, Karnataka, Himachal Pradesh, Punjab, Sikkim and some other states. After adjusting for selected covariates, the odds of excess weight were higher among females than males [OR: 2.21, 95% CI: 1.89, 2.60]. Similarly, the likelihood of excess weight was 2.18 times higher among older adults who were living in urban areas compared to their rural counterparts [OR: 2.18; 95% CI: 1.90, 2.49]. Higher level of education is significantly positively correlated with excess weight. Similarly, higher household wealth index was significantly positively correlated with excess weight [OR: 1.98, CI: 1.62, 2.41]. Having hypertension, diabetes and heart diseases were associated with excess weight among older adults. Regional variations were also observed in the prevalence of excess weight among older adults. CONCLUSION The findings suggest that introducing measures that help to reduce the risk of non-communicable diseases, and campaigns to encourage physical activity, and community awareness may help reduce the high burden of excess weight and obesity among older Indians. The findings are important for identifying the at-risk sub-populations and for the better functioning of any public health programme and suitable intervention techniques to lower the prevalence and risk factors for excess weight in later life.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Bittu Mandal
- Indian Institute of Technology, School of Humanities and Social Sciences, Indore, India
| | - Mihir Adhikary
- Department of Public health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Papai Barman
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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ZHAO H, JUN P, LEE C, HAN CH. Acupoint catgut embedding for simple obesity in animal studies: a systematic review and Meta-analysis. J TRADIT CHIN MED 2023; 43:860-867. [PMID: 37679973 PMCID: PMC10465837 DOI: 10.19852/j.cnki.jtcm.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/27/2022] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To assess the efficacy of acupoint catgut embedding (ACE) for simple obesity in preclinical animal experiments. METHODS We searched the following 14 electronic databases: PubMed, Cochrane Library, EMBASE, Oriental Medicine Advanced Searching Integrated System, KoreaMed, Korean Studies Information Service System, Science-on, Research Information Sharing Service, Korea Citation Index, Korea Traditional Knowledge Portal, China Network Knowledge Infrastructure Database, Wanfang Database, Chinese Science and Technology Journal Database, and Chinese Biology Medicine Database, from inception to November 2021 without language limitation. The assessment was performed according to the guidelines of Animal Research: Reporting of experiments; and Meta-analysis was performed using Reviewer Manager 5.4.1 software. RESULTS Twenty-four studies involving 813 animals were selected. Meta-analysis showed that ACE was beneficial for weight control [ 40, = -50.63, 95% (-57.59, -43.67), 0.000 01, = 0%] and reduced the Lee index [ 40, = -18.79, 95% (-20.01, -17.57), 0.000 01, = 0%]. However, when efficacy of ACE was compared with that of manual acupuncture, electroacupuncture, or oilistat therapy, statistical difference was not observed between the two groups. CONCLUSIONS This systematic review suggests that ACE may be efficacious in treating obesity. Moreover, the analyses highlighted the necessity to perform well-designed, higher-quality experiments.
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Affiliation(s)
- HuiYan ZHAO
- 1 Korean Convergence Medical Science, University of Science and Technology (UST), School of Korea Institute of Oriental Medicine
- 2 Daejeon 34054, Republic of Korea; KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Purumea JUN
- 3 KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Chaewon LEE
- 4 St. Johnsbury Academy Jeju, 304, Global edu-ro, Daejeong-eup, Seogwipo-si 63644, Republic of Korea
| | - Chang-Hyun HAN
- 5 Korean Convergence Medical Science, University of Science and Technology (UST), School of Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- 6 KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
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Opava CH, Kindblom K, Rao K, Thorstensson CA, Swärdh E. Challenges of transforming evidence-based management of osteoarthritis into clinical practice in rural central Western India. Perceptions of an educational program. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2014. [PMID: 37170720 DOI: 10.1002/pri.2014] [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: 02/22/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Osteoarthritis (OA) is a major threat to public health worldwide and is predicted to increase. Existing interventions to implement clinical practice guidelines (CPGs) seem to be used mainly in the Western world. We conducted a structured educational program on the evidence-based management of OA (BOA) for Indian physical therapists (PT). Our study aimed to describe Indian PTs' knowledge, attitudes and confidence on evidence-based management of OA, and their perceptions of a course on this subject. METHODS The 2-day course included didactic parts and practical skills training. Thirty-five PTs participated and answered a questionnaire. Fourteen of them participated in focus group interviews. Questionnaire data are presented as medians and full ranges. Manifest content analysis was used to analyze interview data that are presented as catagories illustrated by interview quotes. The formal ethics permission was granted. RESULTS 74% of PTs agreed that radiography determines the type of treatment required, and 69% agreed that a prescription for exercise is enough to ensure adherence. PTs agreed (mean 5 on 6-point scale) that exercises increasing pain should be advised against. Confidence in guiding the physical activity was generally high (≥5 on 6-point scales). Five categories reflected participants' perceptions of the course content: Shift in management focus, Need for cultural adaptation, Importance of social support, Development of organization and collaboration, and Feelings of hesitation. DISCUSSION Our results indicate that in order to facilitate the implementation of CPGs, PT curricula may consider the inclusion of knowledge on CPGs, focus more on students' own reflections on transforming theory into practice, and incorporate training of basic skills required for implementation of self-management, body awareness, and neuromuscular fitness. If given access and mandates, PTs may play a major role in the early diagnosis and treatment of OA and thus contribute to the prevention of an epidemic of OA in India.
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Affiliation(s)
- Christina H Opava
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Loni, Maharashtra, India
| | - Kristina Kindblom
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Loni, Maharashtra, India
| | - Keerthi Rao
- Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences - DU, Loni, Maharashtra, India
| | - Carina A Thorstensson
- Institute of Neuroscience and Physiology, Gothenburg University, Goteborg, Sweden
- Department of Research and Development, Halland County Council, Varberg, Sweden
| | - Emma Swärdh
- Division of Physiotherapy, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Rai R, Ghosh T, Jangra S, Sharma S, Panda S, Kochhar KP. Relationship Between Body Mass Index and Body Fat Percentage in a Group of Indian Participants: A Cross-Sectional Study From a Tertiary Care Hospital. Cureus 2023; 15:e47817. [PMID: 38021794 PMCID: PMC10676745 DOI: 10.7759/cureus.47817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Body mass index (BMI) is an important indicator of overweight and obesity. Unlike BMI, body fat percentage (BF%) can be utilized to estimate body composition regardless of weight and height. The association between BMI and BF%, as well as the impact of age and gender, may help estimate the prevalence of obesity more clearly. This study aimed to assess the relationship between BMI and BF%, examine the effect of age and gender on this relationship, and establish the linearity/curvilinearity of this relationship. Methodology The body composition analysis of 1,150 participants in various institutional events (institution foundation day) during 2019 and 2023 was performed using the Accuniq bio-electrical impedance analyzer (BIA) (Accuniq, Netherlands). The participants included undergraduate, postgraduate medical, and PhD students, as well as employees of All India Institute of Medical Sciences, New Delhi. Age groups were categorized as under 17 years, young adults (18-25 years), adults (26-44 years), middle-aged adults (45-59 years), and older adults (≥60 years). Pearson's correlation coefficient (r) was used for analyzing the relationship between BMI and BF%. To assess the effect of age and gender on this relationship, multiple regression analysis was applied, and polynomial regression was applied to test its linearity. The data were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results Males made up a larger proportion of the participants (56.3%; 647). The mean age of the participants was 36.5 ± 13.6 years. The mean BMI and BF% were 24.7 ± 4.0 kg/m2 and 29.1 ± 8.7%, respectively. A significant and moderate positive correlation (r = 0.630, p < 0.01) was observed between BMI and BF%. The mean ± SD of BMI and BF% had a directly proportional relationship with age. Among both genders, females showed a greater correlation (r = 0.852). Both age and gender had a significant effect on this relationship, with gender impacting more than age (β = 0.488, p < 0.000). The curvilinear nature of the relationship between BMI and BF% was demonstrated with the female model showing a more precise fit (R2 = 0.72, standard error of the estimate = 3.3%). Conclusions The relationship between BMI and BF% was significant and positive in this group of Indians. This relationship was significantly impacted by age and gender and was curvilinear in nature. Females had a higher association than males between BMI and BF%. The study suggests that BMI, BF%, and the effects of age and gender should be taken into consideration when predicting obesity.
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Affiliation(s)
- Raiza Rai
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Tamoghna Ghosh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sunil Jangra
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Shweta Sharma
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sujata Panda
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Kanwal P Kochhar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
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25
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Das S, Goswami V, Chandel S. Normal weight central obesity and hypertension in India: Cross-sectional finding from LASI, 2017-19. Nutr Metab Cardiovasc Dis 2023; 33:1888-1898. [PMID: 37544873 DOI: 10.1016/j.numecd.2023.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIM The current public health guidelines for preventing and managing obesity still emphasize the importance of maintaining a normal Body Mass Index, while paying little attention to central obesity, which is common among the general population. Normal Weight Central Obesity (NWCO) is a less explored risk factor for hypertension in India. Therefore, this study aims to investigate the prevalence of NWCO and its association with hypertension in India. METHODS AND RESULTS The cross-sectional study used data from the Longitudinal Aging Study in India (LASI), 2017-19, which included 54,016 participants (22,438 men and 31,578 women). Hypertension was evaluated following the JNC-VIII guidelines for the detection, evaluation, and treatment of hypertension. Anthropometric measurements were taken to identify NWCO. The study found that NWCO was more prevalent among women (33.9%) than men (17.8%), while men had a higher prevalence of hypertension (47.6%) than women (43.8%). In India, the state of Haryana had the highest proportion of NWCO among men (26.4%), while Kerala had the highest proportion among women (39.1%). Binary logistic regression analysis showed that NWCO was significantly associated with an increased risk of hypertension. The odds ratio (aOR) was 1.57 (95% CI 1.45-1.67, p < 0.001) in men and 1.53 (95% CI 1.43-1.63, p < 0.001) in women, compared to normal-weight study participants. CONCLUSIONS The study emphasizes the importance of considering central obesity in individuals with a normal BMI when assessing cardiovascular risk, particularly for hypertension. State-specific data can help identify high-risk areas and facilitate targeted prevention and treatment strategies.
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Affiliation(s)
- Sayani Das
- Department of Health Research, International Institute of Health Management Research, New Delhi 110075, India.
| | - Vaidehi Goswami
- Department of Anthropology, University of Delhi, Delhi 110007, India
| | - Shivani Chandel
- Department of Anthropology, University of Delhi, Delhi 110007, India
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26
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Gupta A, Garg R, Chawla SPS, Kaur S, Goyal S. Assessment of Cardiovascular Parameters on Submaximal Treadmill Exercise in Obese versus Nonobese Adults. Int J Appl Basic Med Res 2023; 13:212-217. [PMID: 38229726 PMCID: PMC10789467 DOI: 10.4103/ijabmr.ijabmr_290_23] [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: 06/26/2023] [Revised: 09/17/2023] [Accepted: 10/18/2023] [Indexed: 01/18/2024] Open
Abstract
Background Obesity and overweight, irrespective of metabolic status, confer an increased risk of adverse consequences including cardiovascular diseases (CVDs). The mechanisms underlying altered cardiovascular responses in obese individuals during and after submaximal treadmill exercise are the subjects of great interest to public health. After graded exercise, delayed heart rate recovery (HRR), exaggerated blood pressure (BP) response, and prolongation of QT interval are the powerful predictors of cardiovascular morbidity and mortality that may facilitate timely identification of individuals at risk of CVD and help to evaluate the effectiveness of treatment interventions. Aim To compare the cardiovascular parameters on submaximal treadmill exercise in obese and nonobese adults. Materials and Methods This study was conducted on 80 subjects, 40 obese (cases) and 40 normal-weight individuals (controls), belonging to the age group of 18-60 years. Each participant was subjected to submaximal treadmill exercise according to the Bruce protocol. Heart rate (HR), systolic BP and diastolic BP (SBP and DBP), mean arterial pressure (MAP), QT and corrected QT (QTc) intervals, and rate pressure product (RPP) were measured preexercise, immediately after exercise, and during passive recovery at 1 min and 5 min after exercise. The Chi-square test and Mann-Whitney U-test, whichever is appropriate, were employed for the comparison of variables between the two study groups. P < 0.05 was considered statistically significant. Results Mean HR immediately after exercise, at 1 min and 5 min postexercise was significantly higher in obese when compared to nonobese participants (P = 0.006, P = 0.001, P = 0.001) despite similar resting HR in both the groups (P = 0.874). Mean SBP, DBP, MAP, and RPP were significantly higher in obese in comparison to nonobese subjects in all stages, i.e. before exercise, immediately after exercise, at 1 min and 5 min after exercise. QT and QTc intervals were also found to be significantly greater in obese than nonobese subjects in all stages (P = 0.001 each). Conclusion Obese subjects had higher resting BP (SBP, DBP, and MAP), QT/QTc interval, RPP, and increased response to submaximal treadmill exercise activity. Delayed HRR after exercise was also noted in obese subjects which indicates that obese populations are at risk of developing CVDs due to alteration in autonomic functions with sympathetic hyperactivity.
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Affiliation(s)
- Aditya Gupta
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Ravinder Garg
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Sumit Pal Singh Chawla
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Sarabjot Kaur
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Shiwali Goyal
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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Choudhari S, Patil SK, Rathod S. Identification of hits as anti-obesity agents against human pancreatic lipase via docking, drug-likeness, in-silico ADME(T), pharmacophore, DFT, molecular dynamics, and MM/PB(GB)SA analysis. J Biomol Struct Dyn 2023:1-23. [PMID: 37735906 DOI: 10.1080/07391102.2023.2258407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
Obesity, characterized by excessive fat accumulation, is a major health concern. Inhibition of human pancreatic lipase, an enzyme involved in fat digestion, offers a potential strategy for weight loss and obesity treatment. This study aimed to identify polyphenols capable of forming stable complexes with human pancreatic lipase to block its activity. Molecular docking, density functional theory (DFT), molecular dynamics (MD) simulations, and MMPBGBSA calculations were employed to evaluate ligand binding, stability, and energy profiles. Pharmacophore modeling was also performed to identify key structural features for effective inhibition. Virtual screening identified ZINC000015120539, ZINC000000899200, ZINC000001531702, and ZINC000013340267 as potential candidates, exhibiting favorable binding and stable interactions over 100 ns MD simulations. These findings provide insights into the inhibitory potential of selected polyphenols on human pancreatic lipase and support further experimental investigations for obesity treatment.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sujata Choudhari
- Department of Pharmaceutical Chemistry, Sarojini College of Pharmacy, Kolhapur, MS, India
- Department of Pharmaceutics, Ashokrao Mane College of Pharmacy, Peth Vadgaon, MS, India
| | - Sachin Kumar Patil
- Department of Pharmaceutics, Ashokrao Mane College of Pharmacy, Peth Vadgaon, MS, India
| | - Sanket Rathod
- Department of Pharmaceutical Chemistry, Bharati Vidyapeeth College of Pharmacy, Kolhapur, MS, India
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Simmons SS. Strikes and Gutters: Biomarkers and anthropometric measures for predicting diagnosed diabetes mellitus in adults in low- and middle-income countries. Heliyon 2023; 9:e19494. [PMID: 37810094 PMCID: PMC10558610 DOI: 10.1016/j.heliyon.2023.e19494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
The management of diabetes necessitates the requirement of reliable health indices, specifically biomarkers and anthropometric measures, to detect the presence or absence of the disease. Nevertheless, limited robust empirical evidence exists regarding the optimal metrics for predicting diabetes in adults, particularly within low- and middle-income countries. This study investigates objective and subjective indices for screening diabetes in these countries. METHODS Data for this study was sourced from surveys conducted among adults (aged 18 years and above) in seventeen (17) countries. Self-reported diabetes status, fifty-four biomarkers, and twenty-six core and twenty-eight estimated anthropometric indices, including weight, waist circumference, body mass index, glycaemic triglycerides, and fasting blood glucose, were utilised to construct lasso regression models. RESULTS The study revealed variances in diabetes prediction outcomes across different countries. Central adiposity measures, fasting plasma glucose and glycaemic triglycerides demonstrated superior predictive capabilities for diabetes when compared to body mass index. Furthermore, fasting plasma or blood glucose, serving as a biomarker, emerged as the most accurate predictor of diabetes. CONCLUSIONS These findings offer critical insights into both general and context-specific tools for diabetes screening. The study proposes that fasting plasma glucose and central adiposity indices should be considered as routine screening tools for diabetes, both in policy interventions and clinical practice. By identifying adults with or at higher risk of developing diabetes and implementing appropriate interventions, these screening tools possess the potential to mitigate diabetes-related complications in low- and middle-income countries.
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Affiliation(s)
- Sally Sonia Simmons
- Department of Social Policy, London School of Economics and Political Science, London, WC2A 2AE, United Kingdom
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Dwivedi LK, Puri P, Pant A, Chauhan A, Scott S, Singh S, Pedgaonker S, Nguyen PH. Concurrent Undernutrition and Overnutrition within Indian Families between 2006 and 2021. Curr Dev Nutr 2023; 7:101987. [PMID: 37720241 PMCID: PMC10502368 DOI: 10.1016/j.cdnut.2023.101987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background The double burden of malnutrition (DBM), characterized by concurrent undernutrition and overnutrition, is a growing global concern. Families share resources and eating behaviors and programs often target households, yet evidence of the DBM at the family level is scarce. Objectives This study examined trends and inequality in the intrahousehold DBM in India between 2006 and 2021. Methods Data were from 3 waves of India's National Family Health Survey (NFHS 2006, 2016, and 2021). We examined 3 types of household member (with children aged <5 y) combinations: mother-child (N = 328,039 across 3 waves), father-child, and parent (mother and father)-child (N = 47,139 for each pair). The DBM was defined as one or more individuals with undernutrition (either wasting or stunting in children or underweight in adults) and one or more overweight individuals within the same household. DBM was examined over time, at national and subnational levels, and by residence and wealth. Results Nearly all DBM was in the form of an overweight parent and an undernourished weight or stunted child. The prevalence of parent-child DBM increased from 15% in 2006 to 26% in 2021. Father-child pairs experienced the most rapid DBM increase, from 12% in 2006 to 22% in 2021, an 83% increase, driven by increasing overweight among men. In 2021, the DBM was highest in North-Eastern and Southern states, and among relatively rich households from urban areas. The increase in the DBM was faster in rural areas and among poor households compared with that in urban areas and rich households. Urban-rural and rich-poor inequalities in the DBM have decreased over time. Conclusions The intrahousehold DBM has increased over time, affecting 1 in 4 households in India in 2021. Family-based interventions that can simultaneously address child underweight and parent overweight are required to address India's increasing intrahousehold DBM.
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Affiliation(s)
| | - Parul Puri
- International Institute of Population Sciences, Mumbai, India
| | - Anjali Pant
- International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Alka Chauhan
- International Institute of Population Sciences, Mumbai, India
| | - Samuel Scott
- International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Shrikant Singh
- International Institute of Population Sciences, Mumbai, India
| | | | - Phuong H. Nguyen
- International Food Policy Research Institute, South Asia Office, New Delhi, India
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Kundu S, Sharma P, Singh S, Kumar P. District-level heterogeneity in overweight or obesity among women of reproductive age: A geo-spatial analysis in India. PLoS One 2023; 18:e0290020. [PMID: 37590188 PMCID: PMC10434895 DOI: 10.1371/journal.pone.0290020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/01/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Globally by 2030, 38% of the world's population would be overweight, and another 20% would be obese. This has led to rising concerns regarding how swiftly and substantially the world is moving towards this epidemic of "globesity". India too is facing an increased burden of overweight and obese population. The changing dietary patterns are significantly associated with the increasing prevalence of overweight/obesity and related complications, especially among women. Hence, the present study aims to observe the spatial patterns of overweight or obesity among women in reproductive age group in India and factors associated with it. METHODS The study analyzed data from a cross-sectional nationwide household survey, i.e. National Family Health Survey (NFHS-4), 2015-16. The primary outcome variable of this study was overweight/obesity among reproductive-age women, which was measured through the body mass index (BMI) of the women. Bivariate and multivariate logistic regression analysis was used to analyze the data. Additionally, for spatial analysis in terms of overweight/obesity among women in India, univariate and bivariate Moran's I index measurements were used along with the usage of spatial regression models. RESULTS The value of spatial-autocorrelation for overweight or obese was 0.64, which depicts the moderately high prevalence of the overweight/obesity coverage over districts of India. The overall prevalence overweight/obesity among women in India is around 25% and higher proportion of women from urban areas (37.8%), and non-poor (33.4%) economic group reported to be overweight or obese. From spatial lag model, the lag coefficient was found to be 0.28, implying that a change in the prevalence of overweight/obesity among women in a certain district may statistically lag the prevalence of overweight/obesity by 28% in the neighbouring districts. There were significantly high clustering of overweight/obese women and non-poor wealth quintiles in 132 districts, mainly from states of Punjab, Haryana, Gujarat, Maharashtra, Kerala, Tamil Nadu, Karnataka and Andhra Pradesh. Additionally, there was high-high clustering of overweight/obese women and those who ever had caesarean in 82 districts, mostly from Kerala, Tamil Nadu, Andhra Pradesh and Karnataka. CONCLUSION The spatial patterns on the prevalence of overweight and obesity in India show that the women belonging to the southern states' districts are more overweight or obese in comparison to other states. The determinants like older age, higher education, urban residence, higher economic status are the key factors contributing to the prevalence of overweight or obesity among women in the reproductive age group. The study concludes and recommends an urgent need of interventions catering to urban women belonging to higher socio-economic status, to reduce the risks of health consequences due to overweight and obesity.
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Affiliation(s)
- Sampurna Kundu
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, Delhi, India
| | - Pratima Sharma
- School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Shivani Singh
- Specialist- Monitoring and Evaluation, India Health Action Trust (IHAT), Lucknow, India
| | - Pradeep Kumar
- Specialist- Monitoring and Evaluation, India Health Action Trust (IHAT), Lucknow, India
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Das U, Kar N. Prevalence and risk factor of diabetes among the elderly people in West Bengal: evidence-based LASI 1st wave. BMC Endocr Disord 2023; 23:170. [PMID: 37568234 PMCID: PMC10416355 DOI: 10.1186/s12902-023-01421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The complication of Diabetes is one of the important health issues among the older adult population in any region. The higher risks of diabetes prevalence among older adult people in the countries was due to social-cultural changes such as increasing urbanization, dietary changes, without physical activity, and unhealthy lifestyle behavior. The present study examines the prevalence and associated risk factors of diabetes among older adults in the state of West Bengal. METHODS The first wave of the Longitudinal Ageing Study in India 2017-18 was used to achieve the study objectives. Descriptive statistics with multinomial logistic regression models were used to carry out crude and adjusted odds ratios with 95% confidence intervals and examine the associated risk factors of diabetes prevalence among older adults. RESULTS The findings of the study indicate that the overall prevalence of diabetes among the study participants was found to be 12.4% which was significantly higher in urban areas (19%) compare to rural areas (6%). The socio-economic and bio-demographic factors like educational status, richest background family, marital status, obesity, and family history of diabetes were significantly associated with higher risks of diabetes prevalence among the older adult population in West Bengal. The risks of diabetes in the richest adult people were significantly higher than in the poorest adult people (OR = 2.78; 95% CI: 1.974-3.917). The higher risks of diabetes mellitus among the richest wealthy people are because of lifestyle behavior, smoking, and tobacco consumption respectively. CONCLUSION The study needs to policy and awareness program to reduce economic inequality and prevention of diabetes care and treatment-seeking behavior, especially for the older adult population in West Bengal.
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Affiliation(s)
- Ujjwal Das
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
- Dept. of Geography, Fakir Mohan University, Balasore, Odisha India
| | - Nishamani Kar
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
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Weber MB, Rhodes EC, Ranjani H, Jeemon P, Ali MK, Hennink MM, Anjana RM, Mohan V, Narayan KV, Prabhakaran D. Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial. RESEARCH SQUARE 2023:rs.3.rs-3143470. [PMID: 37577514 PMCID: PMC10418536 DOI: 10.21203/rs.3.rs-3143470/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Delivery of proven structured lifestyle change education for reducing the burden of cardiometabolic diseases such as diabetes at worksites could overcome barriers to program adoption and improve sustainability and reach of these programs; however, tailoring to the worksite setting is essential. Methods The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at eleven large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. Results Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. Conclusion This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. Trial Registration Clinicaltrial.gov NCT02813668, registered June 27, 2016.
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Jabbar PK, Nair A, Chellamma J, Jayakumar RV, Ramesh J, Gomez R, Vishnu G. G, Voise S, Soumya S, Vijayakumar K. Type 2 Diabetes and Precursors in Community Dwelling Asian Indian Adult Youth. Indian J Endocrinol Metab 2023; 27:307-314. [PMID: 37867989 PMCID: PMC10586547 DOI: 10.4103/ijem.ijem_331_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/23/2022] [Accepted: 01/06/2023] [Indexed: 10/24/2023] Open
Abstract
Background Recent studies have shown a high prevalence of Type-2-diabetes (T2DM) (24%) and prediabetes (18.1%) in Kerala. There is no community based study from South Asia regarding the prevalence of type 2 diabetes and its precursors in the young adult population. This community based study was done to find the prevalence of type 2 diabetes and its precursors in South Indian adult youth (18-30 years age) of Thiruvananthapuram district. Research Design and Methods Cross sectional design was used for this study. Multistage cluster sampling was used to enrol community dwelling youth of 18 to 30 years, residing in Thiruvananthapuram district. Six panchayath wards from rural and urban regions and 4 from coastal area were randomly selected as the primary sampling units. Trained staff nurses conducted the survey with the help of accredited-social-health-activists (ASHA). Socio-demographic data, anthropometry, clinical features of insulin resistance, and random capillary glucose (CG) and blood pressure were assessed and recorded. Oral Glucose tolerance test or HbA1c was done for participants with a CG ≥130 mg/dl for diagnosis of diabetes and prediabetes. Results A total of 1031 participants were included from the rural (n = 394), coastal (n = 269) and urban (n = 368) areas. Prevalence of hyperglycaemia i.e., T2DM and pre-diabetes was 0.48% (n = 5) and 2.4% (n = 25) respectively. Family-history of T2DM was present in 35.1% subjects. Prevalence of overweight, obesity and abdominal-obesity was 28.2%, 16.1% and 28.4% respectively. Clinical-features of insulin resistance (CFIR) were present in 27.1% subjects (acanthosis [17.7%], skin tags [1.7%] and PCOS phenotype [10.7%]). Among various anthropometric measurements and their derivatives, CFIR correlated best (r = 0.24, P < 0.01) with the product of BMI and the sum of abdominal circumference and hip circumference (Trivandrum Medical College [TMC] -adiposity-index), which is a newly proposed parameter. Hyperglycaemia was more common in males, did not correlate with waist hip ratio, and correlated best again with TMC-adiposity-index ((r = 0.13, P < 0.01). Conclusions The burden of insulin resistance in the young South Indian population, hitherto unknown in any community based study, has been studied for the first time. The prevalence of precursors of T2DM is high in this population. Early identification of 'at risk' individuals could provide a window of opportunity for preventing or delaying future diabetes and its long term complications. TMC adiposity index could become a valuable tool in the anthropometric assessment for predicting future T2DM.
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Affiliation(s)
- P. K. Jabbar
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
- Indian Institute of Diabetes, Thiruvananthapuram, Kerala, India
| | - Abilash Nair
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Jayakumari Chellamma
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
| | - R. V. Jayakumar
- Indian Institute of Diabetes, Thiruvananthapuram, Kerala, India
| | - Jeena Ramesh
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Ramesh Gomez
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Giri Vishnu G.
- Department of Health Services, Government of Kerala, Kerala, India
| | - Syamji Voise
- Department of Health Services, Government of Kerala, Kerala, India
| | - S. Soumya
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Karthik Vijayakumar
- Department of Endocrinology and Metabolism, Government Medical College, Thiruvananthapuram, Kerala, India
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Chaudhary M, Sharma P. Abdominal obesity in India: analysis of the National Family Health Survey-5 (2019-2021) data. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100208. [PMID: 37492420 PMCID: PMC10363491 DOI: 10.1016/j.lansea.2023.100208] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/15/2022] [Accepted: 04/24/2023] [Indexed: 07/27/2023]
Abstract
Background The ever-growing trend of abdominal obesity worldwide has garnered global attention over the past three decades. In India, BMI has conventionally been used to measure obesity. National Family Health Survey (NFHS) is the largest demographic and health survey (DHS) in India. For the first time, the NFHS conducted the fifth round in 2019-21 which assessed abdominal obesity through waist circumference. The objective of the current study was to determine the prevalence of abdominal obesity and explore the associated socioeconomic factors. Methods The prevalence of abdominal obesity in India was determined using the NFHS-5 dataset, where waist circumference was used as a measure. Multivariable binary logistic regression was then employed to examine the association of different socioeconomic factors with abdominal obesity. Findings The prevalence of abdominal obesity in the country was found to be 40% in women and 12% in men. The findings show that 5-6 out of 10 women between the ages of 30-49 are abdominally obese. The association of abdominal obesity in women is stronger with older age groups, urban residents, wealthier sections, and non-vegetarians. For those practising the Sikh religion, the prevalence is higher in both men and women. Abdominal obesity is also on the rise in rural areas and is penetrating lower and middle socioeconomic sections of society. Interpretation The findings of the current study highlight the need for the government and other stakeholders to proactively design targeted interventions for abdominal obesity, especially for women in their thirties and forties in India. Further research is recommended to understand the driving factors of abdominal obesity, their inter-operability, and the disease risk associated with this type of obesity. Funding None.
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Affiliation(s)
- Monika Chaudhary
- IIHMR University, Jaipur, India
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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Pradeepa R, Shreya L, Anjana RM, Jebarani S, Venkatesan U, Kamal Raj N, Swami OC, Mohan V. Sex-Based Differences in Clinical Profile and Complications among Individuals with Type 2 Diabetes Seen at a Private Tertiary Diabetes Care Centre in India. Healthcare (Basel) 2023; 11:healthcare11111634. [PMID: 37297774 DOI: 10.3390/healthcare11111634] [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: 03/16/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January 2017 and 31 December 2019, and included 72,980 individuals with T2DM, aged ≥ 18 years (age and sex-matched-males-36,490; females-36,490). Anthropometric measurements, blood pressure, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), glycated haemoglobin (HbA1c), lipids, urea, and creatinine were measured. Retinopathy was screened using retinal photography, neuropathy using biothesiometry, nephropathy measuring urinary albumin excretion, peripheral vascular disease (PVD) using Doppler, and coronary artery disease (CAD) based on the history of myocardial infarction and/or drug treatment for CAD and/or electrocardiographic changes. Obesity (73.6% vs. 59.0%) rates were significantly higher in females compared to males. FPG, PPPG, and HbA1c were higher among younger age groups among both sexes, with males having higher values compared to females. However, after the age of 44 years, control of diabetes was worse among females. In addition, only 18.8% of the females achieved glycemic control (HbA1c < 7%) compared to 19.9% in males (p < 0.001). Males had higher prevalence of neuropathy (42.9% vs. 36.9%), retinopathy (36.0% vs. 26.3%), and nephropathy (25.0% vs. 23.3%) compared to females. Males had 1.8- and 1.6-times higher risk of developing CAD and retinopathy compared to females. Hypothyroidism (12.5% vs. 3.5%) and cancers (1.3% vs. 0.6%) were significantly higher in females compared to males. In this large sample of T2DM seen at a chain of private tertiary diabetes centres, females had higher prevalence of metabolic risk factors and poorer diabetes control compared to males, emphasizing the need for better control of diabetes in females. However, males had higher prevalence of neuropathy, retinopathy, nephropathy, and CAD compared to females.
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Affiliation(s)
- Rajendra Pradeepa
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Lal Shreya
- Emcure Pharmaceuticals Ltd., Pune 411057, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Saravanan Jebarani
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Nithyanantham Kamal Raj
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
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Joseph S, Rajan RP, Sundar B, Venkatachalam S, Kempen JH, Kim R. Validation of diagnostic accuracy of retinal image grading by trained non-ophthalmologist grader for detecting diabetic retinopathy and diabetic macular edema. Eye (Lond) 2023; 37:1577-1582. [PMID: 35906419 PMCID: PMC10220051 DOI: 10.1038/s41433-022-02190-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/22/2022] [Accepted: 07/15/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To validate the fundus image grading results by a trained grader (Non-ophthalmologist) and an ophthalmologist grader for detecting diabetic retinopathy (DR) and diabetic macular oedema (DMO) against fundus examination by a retina specialist (gold standard). METHODS A prospective diagnostic accuracy study was conducted using 2002 non-mydriatic colour fundus images from 1001 patients aged ≥40 years. Using the Aravind Diabetic Retinopathy Evaluation Software (ADRES) images were graded by both a trained non-ophthalmologist grader (grader-1) and an ophthalmologist (grader-2). Sensitivity, specificity, positive predictive value and negative predictive value were calculated for grader-1 and grader-2 against the grading results by an independent retina specialist who performed dilated fundus examination for every study participant. RESULTS Out of 1001 patients included, 42% were women and the mean ± (SD) age was 55.8 (8.39) years. For moderate or worse DR, the sensitivity and specificity for grading by grader-1 with respect to the gold standard was 66.9% and 91.0% respectively and the same for the ophthalmologist was 83.6% and 80.3% respectively. For referable DMO, grader-1 and grader-2 had a sensitivity of 74.6% and 85.6% respectively and a specificity of 83.7% and 79.8% respectively. CONCLUSIONS Our results demonstrate good level of accuracy for the fundus image grading performed by a trained non-ophthalmologist which was comparable with the grading by an ophthalmologist. Engaging trained non-ophthalmologists potentially can enhance the efficiency of DR diagnosis using fundus images. Further study with multiple non-ophthalmologist graders is needed to verify the results and strategies to improve agreement for DMO diagnosis are needed.
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Affiliation(s)
- Sanil Joseph
- Lions Aravind Institute of Community Ophthalmology, Aravind Eye Care System, Madurai, India
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Vic, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Vic, Australia
| | - Renu P Rajan
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India
| | - Balagiri Sundar
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India
| | | | - John H Kempen
- Department of Ophthalmology, , Massachusetts Eye and Ear and Harvard Medical School; Schepens Eye Research Institute, Boston, MA, USA
- MCM Eye Unit, MyungSung Christian Medical Center (MCM) Multispecialty Hospital and MyungSung Medical School, Addis Ababa, Ethiopia
- Department of Ophthalmology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ramasamy Kim
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India.
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Tabassum H, Chakraborty R, Chatterjee NS. A review of venous thromboembolism in India. Indian J Med Res 2023; 157:281-292. [PMID: 37282391 PMCID: PMC10438400 DOI: 10.4103/ijmr.ijmr_1538_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Indexed: 06/08/2023] Open
Abstract
Venous thromboembolism (VTE), which entails the formation of a thrombus (blood clot) in a vein, has a significant disease burden worldwide. While VTE has traditionally been considered to predominantly affect Caucasian populations, recent studies have indicated a gradual shift in the disease burden towards Asian populations, with added significance of it being a key driver of post-operative mortality. It is imperative to develop a sound understanding of the various factors that affect VTE in stratified local populations. However, there is a glaring paucity of quality data on VTE and its ramifications among Indians - both in terms of quality of life and cost of healthcare. This review aims to throw light on the disease burden, epidemiology, risk factors, environmental factors, food and nutrition that plays a key role in VTE. We also explored the association of VTE with coronavirus disease 2019 to grasp the interplay between the two most significant public health crises of our time. It is vital to place a special emphasis on future research on VTE in India to plug the gaps, which exist in our current knowledge of the disease, particularly with respect to Indian population.
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Affiliation(s)
- Heena Tabassum
- Division of Biomedical Sciences, Indian Council of Medical Research, Jamia Hamdard, New Delhi, India
| | - Rohan Chakraborty
- Department of Toxicology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Nabendu Sekhar Chatterjee
- Division of Biomedical Sciences, Indian Council of Medical Research, Jamia Hamdard, New Delhi, India
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Shri N, Singh S, Singh A. Prevalence and Predictors of Combined Body Mass Index and Waist Circumference Among Indian Adults. Int J Public Health 2023; 68:1605595. [PMID: 37065643 PMCID: PMC10090356 DOI: 10.3389/ijph.2023.1605595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
Objective: To determine the prevalence and predictors of combined BMI-WC disease risk categories among Indian adults.Methods: The study utilizes data from Longitudinal Ageing Study in India (LASI Wave 1) with an eligible sample of 66, 859 individuals. Bivariate analysis was done to get the proportion of individuals in different BMI-WC risk categories. Multinomial logistic regression was used to identify the predictors of BMI-WC risk categories.Results: Poor self-rated health, female sex, urban place of residence, higher educational status, increasing MPCE quintile, and cardio-vascular disease increased with increasing BMI-WC disease risk level while increasing age, tobacco consumption, and engagement in physical activities was negatively associated with BMI-WC disease risk.Conclusion: Elderly persons in India have a considerable higher prevalence of BMI-WC disease risk categories which make them vulnerable to developing several disease. Findings emphasize the need of using combined BMI categories and waist circumference to assess the prevalence of obesity and associated disease risk. Finally, we recommend that intervention programs with an emphasis on urbanites wealthy women and those with a higher BMI-WC risk categories be implemented.
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Affiliation(s)
- Neha Shri
- Department of Survey Research and Data analytics, International Institute for Population Sciences(IIPS), Mumbai, India
- *Correspondence: Neha Shri,
| | - Saurabh Singh
- Department of Survey Research and Data analytics, International Institute for Population Sciences(IIPS), Mumbai, India
| | - Akancha Singh
- Department of Population and Development, International Institute for Population Sciences(IIPS), Mumbai, India
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Raju A, Santhanakrishnan N, Sathiyaseelan M. Neck Circumference is Associated with General and Central Obesity in Young Indian Adults. Indian J Community Med 2023; 48:264-268. [PMID: 37323729 PMCID: PMC10263036 DOI: 10.4103/ijcm.ijcm_209_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 01/31/2023] [Indexed: 06/17/2023] Open
Abstract
Background Obesity has been a major concern due to its increasing prevalence and associated metabolic complications. Body mass index (BMI) assesses general obesity, but it does not distinguish between muscle and fat accumulations, so using only BMI can lead to an erroneous result. Waist circumference (WC), a marker of central obesity, predicted mortality risk better than BMI. However, WC can be affected by abdominal distension, is time-consuming, and may not be culture-sensitive. Neck circumference (NC) is devoid of these disadvantages and is believed to be an index of upper body fat distribution. This study aimed to assess the association of neck circumference with general and central obesity and to identify the cut-off points for evaluating obesity in young adults using NC. Material and Methods Height, weight, waist, and hip circumference were measured to determine BMI and waist-hip ratio. NC was measured at the level of the mid-cervical spine and mid-anterior neck in a standing position with the arms hanging freely. For males with a laryngeal prominence, NC was measured just below the prominence. Results In total, 357 (170 male and 187 female) young, healthy Indian adults aged 18-25 participated. Neck circumference (NC) is significantly associated with BMI and WC in both genders. We found the best cut-off for male and female participants to be ≥34 cm and ≥30.5 cm, with a sensitivity of 88.3% and 84.4% for assessing obesity. Conclusion NC may be a better alternative to BMI and WC as a marker to assess obesity since it is more practical, simple, inexpensive, time-saving, and less invasive.
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Affiliation(s)
- Aruna Raju
- Department of Physiology, All India Institute of Medical Science, Kalyani, West Bengal, India
| | - Niveatha Santhanakrishnan
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidhyapeeth, (Deemed to be University), Puducherry, India
| | - Manikandan Sathiyaseelan
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidhyapeeth, (Deemed to be University), Puducherry, India
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Gayathri R, Abirami K, Kalpana N, Manasa VS, Sudha V, Shobana S, Jeevan RG, Kavitha V, Parkavi K, Anjana RM, Unnikrishnan R, Gokulakrishnan K, Beatrice DA, Krishnaswamy K, Pradeepa R, Mattes RD, Salas-Salvadó J, Willett W, Mohan V. Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial. Front Nutr 2023; 9:1055923. [PMID: 36704786 PMCID: PMC9873375 DOI: 10.3389/fnut.2022.1055923] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/07/2022] [Indexed: 01/12/2023] Open
Abstract
Background Asian Indians have an increased susceptibility to type 2 diabetes and premature coronary artery disease. Nuts, like almonds, are rich in unsaturated fat and micronutrients with known health benefits. Objectives This study aimed to assess the efficacy of almonds for reduction of insulin resistance and improving lipid profile in overweight Asian Indian adults. Methods This parallel-arm, randomized, controlled trial was conducted in Chennai, India on 400 participants aged 25-65 years with a body mass index ≥ 23 kg/m2. The intervention group received 43 g of almonds/day for 12 weeks, while the control group was advised to consume a customary diet but to avoid nuts. Anthropometric, clinical, and dietary data were assessed at periodic intervals. Glucose tolerance, serum insulin, glycated hemoglobin, C-peptide and lipid profile were assessed at baseline and end of the study. Insulin resistance (homeostasis assessment model-HOMA IR) and oral insulin disposition index (DIo) were calculated. Results A total of 352 participants completed the study. Significant improvement was seen in DIo [mean (95% CI) = + 0.7 mmol/L (0.1, 1.3); p = 0.03], HOMA IR (-0.4 (-0.7, -0.04; p = 0.03) and total cholesterol (-5.4 mg/dl (-10.2, -0.6); p = 0.03) in the intervention group compared to the control group. Incremental area under the curve (IAUC) and mean amplitude of glycemic excursion (MAGE) assessed using continuous glucose monitoring systems were also significantly lower in the intervention group. Dietary 24-h recalls showed a higher significant reduction in carbohydrate and increase in mono unsaturated fatty acid (MUFA) and polyunsaturated fatty acids (PUFA) intake in the intervention group compared to the control group. Conclusion Daily consumption of almonds increased the intake of MUFA with decrease in carbohydrate calories and decreases insulin resistance, improves insulin sensitivity and lowers serum cholesterol in Asian Indians with overweight/obesity. These effects in the long run could aid in reducing the risk of diabetes and other cardiometabolic disease.
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Affiliation(s)
- Rajagopal Gayathri
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,Department of Biochemistry, University of Madras, Chennai, Tamil Nadu, India
| | - Kuzhandhaivelu Abirami
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Natarajan Kalpana
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Valangaiman Sriram Manasa
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Sudha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Raman Ganesh Jeevan
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Kavitha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Karthikeyan Parkavi
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kuppan Gokulakrishnan
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - D. Annette Beatrice
- Department of Home Science, Women’s Christian College, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Pradeepa
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Richard D. Mattes
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Walter Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States,Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,*Correspondence: Viswanathan Mohan, , www.drmohansdiabetes.com
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Verma A, Singh G, Agrawal R, Tripathi N. Overweight and obesity, the clock ticking in India? A secondary analysis of trends of prevalence, patterns, and predictors from 2005 to 2020 using the National Family Health Survey. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2023. [DOI: 10.4103/jncd.jncd_58_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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42
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Are C. Reflections on Cancer/Healthcare Landscape in India on the Occasion of 75 Years of Independence: Glorious Past and a Future Filled with Pride and Optimism. Indian J Surg Oncol 2022; 13:96-100. [PMID: 36212625 PMCID: PMC9532231 DOI: 10.1007/s13193-022-01662-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Chandrakanth Are
- Fred and Pamela Buffett Cancer Center, Division of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198 USA
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43
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Rani K, Ali SA, Kaul G, Behare PV. Protective effect of probiotic and prebiotic fermented milk containing Lactobacillus fermentum against obesity-induced hepatic steatosis and inflammation. J Food Biochem 2022; 46:e14509. [PMID: 36334279 DOI: 10.1111/jfbc.14509] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/08/2022]
Abstract
Obesity has reached epidemic proportions, with major economic and health implications. The complex pathophysiology of obesity explains the difficulty provided to health policy for its clinical management. Increasing data show that obesity and metabolic abnormalities are intimately connected to differences in consumption of probiotics, its relevance to gut microbiota activity and composition. The goal of this investigation was to assess the effect of oral delivery of indigenous probiotic Lactobacillus fermentum NCDC 400 and prebiotic fructo-oligosaccharide (FOS) on obesity-associated hepatic steatosis and inflammation produced by a high-fat diet (HFD). C57BL/6 mice treated with L. fermentum NCDC 400 either independently or in conjunction with FOS demonstrated reduced body weight and abdominal obesity after 24 weeks of treatment. Also, the anti-oxidative enzyme activity went down, and the inflammatory profile got better, with less fat getting into the hepatocytes. The lipid profile changed, with HDL cholesterol going up and LDL cholesterol and triglyceride levels going down. Further, L. fermentum NCDC 400 and FOS combinations decreased fasting glucose, gHbA1c, gastric inhibitory peptide, and insulin levels in mice fed with HFD, thus improving glucose homeostasis. Overall, consumption of L. fermentum NCDC 400 alone or its combinational effects had a protective role on obesity-associated hepatic steatosis. PRACTICAL APPLICATIONS: The potential indigenous probiotic Lactobacillus fermentum NCDC 400 and prebiotic FOS had a preventive role in obesity-induced hepatic steatosis and improves anti-oxidant and anti-inflammatory properties in HFD-fed obese mice. Our finding would be helpful to prevent obesity-associated hepatic steatosis and inflammation upon supplementation of pre- and pro-biotics (synbiotics).
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Affiliation(s)
- Kavita Rani
- Semen Biology Lab, Animal Biochemistry Division, ICAR-National Dairy Research Institute, Haryana, India
| | - Syed Azmal Ali
- German Cancer Research Center, Division Proteomics of Stem Cells and Cancer, Heidelberg, Germany.,Cell Biology and Proteomics Lab, Animal Biotechnology Center, ICAR-National Dairy Research Institute, Karnal, India
| | - Gautam Kaul
- Semen Biology Lab, Animal Biochemistry Division, ICAR-National Dairy Research Institute, Haryana, India
| | - Pradip V Behare
- National Collection of Dairy Cultures (NCDC) Lab, Dairy Microbiology Division, ICAR-National Dairy Research Institute, Karnal, India
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44
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Yadav N, Chaudhary V, Saraswathy KN, Devi NK. Vitamin intake in obesity and hypertension: A population-based study from Haryana, North India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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45
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Muhammad T, Balachandran A, Kumar P, Srivastava S. Obesity-related measures and successful ageing among community-dwelling older adults in India: a cross-sectional study. Sci Rep 2022; 12:17186. [PMID: 36229480 PMCID: PMC9561529 DOI: 10.1038/s41598-022-21523-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 09/28/2022] [Indexed: 01/04/2023] Open
Abstract
Obesity is a chief lifestyle disease globally and causes a significant increase in morbidities. Overweight/ obesity prevalence has been rising faster in India compared to the world average. Therefore, the study examined the association between overweight/ obesity and successful ageing among older population in India. We also explored the gender difference in risks posed by obesity on successful ageing and the different socio-economic correlates associated with successful ageing. This study utilized data from India's first nationally representative longitudinal ageing survey (LASI-2017-18). The effective sample size for the present study was 31,464 older adults with a mean age of 69.2 years (SD: 7.53). Overweight/ obesity was defined as having a body mass index of 25 or above. The study carried out a bivariate analysis to observe the association between dependent and independent variables. Further, multivariable analysis was conducted to examine the associations after controlling for individual socio-demographic, lifestyle and household/community-related factors. The study included 47.5% men and 52.5% women. It was found that the prevalence of obesity/overweight was higher among older women compared to older men (23.2% vs 15.5%). Similarly, high-risk waist circumference (32.7% vs 7.9%) and high-risk waist-hip ratio (69.2% vs 66.5%) were more prevalent among older women than older men. The study found significant gender differences (men-women: 8.7%) in the prevalence rate of successful ageing (p < 0.001). The chances of successful ageing were significantly higher among older adults who were not obese/overweight [AOR: 1.31; CI 1.31-1.55], had no high-risk waist circumference [AOR: 1.41; CI 1.29-1.54], and those who had no high-risk waist-hip ratio [AOR: 1.16; CI 1.09-1.24] compared to their respective counterparts. Interaction results revealed that older women who were not obese/overweight had a lower likelihood of successful ageing compared to the older men who was not obese/overweight [AOR: 0.86; CI 0.80-0.93]. Similarly, older womens who had no high-risk waist circumference [AOR: 0.86; CI 0.80-0.96] and no high risk-hip ratio [AOR: 0.81; CI 0.73-0.89] were less likely to have successful ageing compared to their counterparts, respectively. Being overweight/ obese and having high-risk waist circumference and waist-hip ratio were found to be significant factors associated with less successful ageing among older adults, especially women in this study. The current findings highlight the importance of understanding the modifiable factors, including nutritional awareness and developing targeted strategies for promoting successful ageing.
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Affiliation(s)
- T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 Maharashtra India
| | - Arun Balachandran
- grid.164295.d0000 0001 0941 7177University of Maryland, College Park, MD 20742 USA
| | - Pradeep Kumar
- grid.482915.30000 0000 9090 0571Population Council, New Delhi, India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 Maharashtra India
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46
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Nadiger N, Anantharamu S, Priyanka CN, Vidal-Puig A, Mukhopadhyay A. Unique attributes of obesity in India: A narrative review. OBESITY MEDICINE 2022; 35:100454. [PMID: 38572212 PMCID: PMC7615800 DOI: 10.1016/j.obmed.2022.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Obesity has become a burgeoning epidemic in India, even though the country is still dealing with undernutrition. As a significant determinant of the Metabolic Syndrome (MetS) and non-communicable diseases (NCDs) such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), understanding the Indian context of the problem and learning how to deal with the obesity epidemic in this country has gained paramount importance. This narrative review points to the unique features of the obesity epidemic in India and its associated contributing factors, including the evolving nature of the Indian diet, the peculiarity of the increased adiposity at lower BMIs, unique obesity-associated genetic variants in Indians, the contribution of the gut microbiome, the impact of chronic inflammation and the role of ambient air pollution, and the contribution of decreased physical activity levels concerning the rapid urbanisation and the built environment. We believe that disseminating our insights into these unique features influencing the development of obesity in India will help increase global awareness and pave the way for better control and management of this obesity epidemic.
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Affiliation(s)
- Nikhil Nadiger
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - Sahana Anantharamu
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - CN Priyanka
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - Antonio Vidal-Puig
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, MDU MRC, Addenbrooke's Hospital, Cambridge, UK
| | - Arpita Mukhopadhyay
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
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47
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Saha J, Chouhan P, Ahmed F, Ghosh T, Mondal S, Shahid M, Fatima S, Tang K. Overweight/Obesity Prevalence among Under-Five Children and Risk Factors in India: A Cross-Sectional Study Using the National Family Health Survey (2015-2016). Nutrients 2022; 14:3621. [PMID: 36079879 PMCID: PMC9460849 DOI: 10.3390/nu14173621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
The occurrence of overweight and obesity has increased in recent years in India. In this study, we investigate the prevalence and associated risk factors of overweight/obesity among children aged 0-59 months in India. Using data from the 2015-2016 National Family Health Survey-4 (NFHS-4), the research sample included 176,255 children aged 0 to 59 months. Bivariate and multivariate techniques were used to analyze children's risk factors for overweight/obesity. We identified that the prevalence of overweight/obesity among children aged 0-59 was 2.6% in India. The study findings reveal that factors such as child sex, age, birth weight, birth rank, maternal education, number of children, age at marriage, mother's BMI, media exposure, social group, and dietary diversity score were most significantly correlated with childhood overweight and obesity in India. Furthermore, we found that male children (ARR: 1.08) aged between 0 and 11 months (ARR: 3.77) with low birth rank (ARR: 1.24), obese (ARR: 1.81) children whose mothers married after the age of 18 (ARR: 1.15), children who belong to a scheduled tribe family (ARR: 1.46), and children who consumed 7-9 food items (ARR: 1.22) were at highest risk of being overweight and obese. However, breastfeeding (ARR: 0.85) and Muslim families (ARR: 0.87) appeared to be protective factors with respect to childhood overweight and obesity in India. Pertinent public health programs, clinical follow-up, and awareness about sedentary lifestyles can help to reduce overweight/obesity risks in children.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Farooq Ahmed
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- Department of Anthropology, Quaid-i-Azam University Islamabad 44000, Pakistan
| | - Tanmoy Ghosh
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Muhammad Shahid
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China
| | - Saireen Fatima
- Fazaia Medical College, Air University, Islamabad 44000, Pakistan
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
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48
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Practice and short-term outcomes in ventral hernia repair: a prospective multicenter data audit of Indian Association of Gastrointestinal Endo Surgeons Research Collaborative. Hernia 2022; 26:1573-1581. [PMID: 36036303 DOI: 10.1007/s10029-022-02666-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/12/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There is considerable variation in the practice of ventral hernia repair (VHR). Consequently, both short- and long-term outcomes are different. We report the first multicenter data from India on the variations in procedures and short-term outcomes after ventral hernia repair. METHODS A prospective study was planned under the aegis of the Indian Association of Gastrointestinal Endo Surgeons (IAGES). Participating surgeons prospectively recorded the data of patients who underwent VHR from January 21, 2021, to April 20, 2021. Patients were followed for 3-6 months. RESULTS Data from 648 patients were analyzed for demographics, hernia characteristics, technical variations, and outcomes. 375 (57.8%) were primary hernias (PH) and 273 (42.15%) were incisional hernias (IH), of which 63 (9.7%) were recurrent hernias. In the PH group, there were 171 minimal access (MAS) and 170 open repair. In descending order of frequency, there were 111 (32.6%) open onlay, 83 (24.3%) intraperitoneal onlay meshplasty (IPOM) Plus, 36 (10.6%) IPOM, 35 (10.3%) suture repair, 22 (6.5%) endoscopic Rives Stoppa (eRS), 11 (3.2%) open RS, 11 (3.2%) TAPP, 7 (2%) hybrid, 6 (1.8%) open preperitoneal, 19 (5.6%) others. There were 3.73% seroma, 3.2% SSI, 0% 90-day readmission, 0% recurrence, and 0.3% mortality. In the IH group, 164 patients underwent open repair and 104 MAS repair. In descending order of frequency, there were 90 (33.6%) open onlay, 47 (17.5%) IPOM Plus, 38 (14.1%) open sublay, 28 (10.4%) IPOM, 12 (4.5%) Transversus Abdominis Release (TAR), 11 (4.1%) suture repair, 9 (3.4%) open preperitoneal, 7 (2.6%) hybrid, 6 (2.2%) TAPP, 5 (1.9%) eRS, 4 (1.5%) TARM, 3 (1.1%) endoscopic TAR (eTAR), and 8 (3%) others. There were 13.92% seroma, 4.4% hematoma, 9.5% SSI, 1.1% mesh explantation, 0.4% wound sinus, 2.2% 90-day readmission, 0% recurrence, and 1.1% mortality. CONCLUSION Onlay meshplasty is the commonest procedure in India both in PH and IH. IPOM/IPOM plus is the second commonest procedure. TAR is the preferred component separation technique. Complication rates were comparable to published literature. TRIAL REGISTRATION The study was registered with Clinical Trial Registry of India. CTRI number-CTRI/2021/01/030435.
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Gupta RD, Haider SS, Eusufzai SZ, Hoque Apu E, Siddika N. Differences in Prevalence and Associated Factors of Underweight and Overweight/Obesity among Bangladeshi Adults by Gender: Analysis of a Nationally Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710698. [PMID: 36078414 PMCID: PMC9517755 DOI: 10.3390/ijerph191710698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 05/23/2023]
Abstract
The objective of this study was to find the differences in prevalence and associated factors of underweight and overweight/obesity among Bangladeshi adults by gender, using the nationally representative Bangladesh Demographic and Health Survey 2017-2018 data. To identify the factors associated with underweight and overweight/obesity in both genders, multilevel multivariable logistic regression was conducted. The prevalence of underweight was 19.79% and 15.49% among males and females, respectively. The prevalence of overweight/obesity was 32.67% and 45.60% among males and females, respectively. Among both genders, participants with the highest likelihood of overweight/obesity were aged 30-49 years and 50-69 years, had the highest educational attainment up to primary and secondary level, resided in a household that belonged to the middle, richer, or richest wealth quintiles, and were currently married. On the other hand, among both genders, increased educational attainment and wealth index were inversely associated with being underweight. Health promotion programs in Bangladesh should focus on these high-risk groups to address the burden of underweight and overweight/obesity.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, University Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Ehsanul Hoque Apu
- Department of Biomedical Engineering, Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
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Ross S, Chadha K, Mishra S, Lewington S, Shepperd S, Gathani T. The burden of risk factors for non-communicable disease in rural Bihar, India: a comparative study with national health surveys. BMC Public Health 2022; 22:1538. [PMID: 35962330 PMCID: PMC9375264 DOI: 10.1186/s12889-022-13818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of non-communicable diseases (NCDs) is increasing in rural India. The National Family Health Survey-5 (NFHS-5) provides estimates of the burden of NCDs and their risk factors in women aged 15-49 and men aged 15-54 years. The aim of this study is to estimate the prevalence of hypertension and body-mass index (BMI) in adults aged 35-70 years in rural India and to compare these estimates, where age ranges overlap, to routinely available data. METHODS The Non-Communicable Disease in Rural India (NCDRI) Study was a cross-sectional household survey of 1005 women and 1025 men aged 35-70 conducted in Bihar in July 2019. Information was collected on personal characteristics, self-reported medical history and physical measurements (blood pressure, height and weight). Prevalence estimates for hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, or diagnosed and treated for hypertension), and for underweight (body-mass index < 18.5 kg/m2), normal weight (18.5-25.0 kg/m2) and overweight (≥ 25.0 kg/m2) were calculated. Where age ranges overlapped, estimates from the NCDRI Study were compared to the NFHS-5 Survey. RESULTS In the NCDRI Study, the estimated prevalence of hypertension was 27.3% (N = 274) in women and 27.6% (N = 283) in men aged 35-70, which was three-times higher in women and over two-times higher in men than in the NFHS-5 Survey. One-quarter (23.5%; N = 236) of women and one-fifth (20.2%; N = 207) of men in the NCDRI Study were overweight, which was approximately 1.5 times higher than in the NFHS-5 Survey. However, where age groups overlapped, similar age-standardized estimates were obtained for hypertension and weight in both the NCDRI Study and the NFHS-5 Survey. CONCLUSION The prevalence of NCDs in rural India is higher than previously reported due to the older demographic in our survey. Future routine national health surveys must widen the age range of participants to reflect the changing disease profile of rural India, and inform the planning of health services.
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Affiliation(s)
- Stephanie Ross
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | | | | | - Sarah Lewington
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Sasha Shepperd
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Toral Gathani
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK.
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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