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Lo SF, Lu FT, O. Yang AC, Zeng JL, Yang YY, Lo YT, Chang YH, Pai TH. Metabolic Syndrome-Related Knowledge, Attitudes, and Behavior among Indigenous Communities in Taiwan: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2547. [PMID: 36767919 PMCID: PMC9915030 DOI: 10.3390/ijerph20032547] [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: 12/21/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Metabolic syndrome is characterized by cardiovascular and chronic disease risk factors that cause health problems. Inequalities in medical resources and information present a challenge in this context. Indigenous communities may be unaware of their risk for metabolic syndrome. AIMS This study explored factors associated with metabolic syndrome-related knowledge, attitudes, and behaviors among Taiwanese indigenous communities. METHODS For this descriptive cross-sectional survey, we collected anthropometric data and used a self-administered questionnaire between 1 July 2016, to 31 July 2017, from a convenience sample of an indigenous tribe in eastern Taiwan. The response rate was 92%. RESULTS The prevalence of metabolic syndrome was as high as 71%, and the average correct knowledge rate was 39.1%. The participants' self-management attitudes were mainly negative, and the self-management behaviors were low in this population. Stepwise regression analysis showed that knowledge, attitude, age, perception of physical condition, and body mass index, which accounted for 65% of the total variance, were the most predictive variables for self-management behaviors. CONCLUSIONS This is the first study to report the relationship between metabolic syndrome knowledge, attitudes, and behaviors in an indigenous population. There is an urgent need to develop safety-based MetS health education programs that can provide access to the right information and enhance self-management approaches to lessen the growing burden of MetS in indigenous communities.
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Affiliation(s)
- Shu-Fen Lo
- Department of Nursing, Tzu Chi University, Hualien 970374, Taiwan
| | - Fang-Tsuang Lu
- Charity Development Department, Tzu Chi Charity Foundation, Hualien 971067, Taiwan
| | - An-Chi O. Yang
- Department of Nursing, Tzu Chi University, Hualien 970374, Taiwan
- School and Graduate Institute of Nursing, National Taiwan University, Taipei 100233, Taiwan
| | | | - Ya-Yu Yang
- Department of Nursing, Taipei Guang En Elderly Medicare Center, New Taipei City 231040, Taiwan
| | - Yen-Ting Lo
- Department of Nursing, Tzu Chi University, Hualien 970374, Taiwan
| | - Yu-Hsuan Chang
- Nursing Department, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan
| | - Ting-Hsuan Pai
- Nursing Department, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan
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Kramer CK, Leitão CB, Viana LV. The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry. Lancet 2022; 400:2074-2083. [PMID: 36502845 DOI: 10.1016/s0140-6736(22)00625-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Indigenous Brazilian peoples have faced an unparalleled increase in the rate of cardiovascular diseases following rapid nutritional transition to more urban diets. We aimed to conduct a systematic review and meta-analysis to evaluate the association between urbanisation (including data from Amazon rainforest deforestation) and cardiometabolic risk factors and outcomes. METHODS In this systematic review and meta-analysis, we searched Pubmed, Embase, Web of Science, and Scopus for articles published in any language between the year 1950 and March 10, 2022. Studies conducted in Indigenous Brazilian adults that evaluated metabolic health were included. Data for deforestation was obtained by the Amazon Deforestation Monitoring Project. Cardiovascular mortality was obtained from the Brazilian Health registry. Two independent reviewers evaluated studies for risk of bias, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The main outcomes assessed were the prevalence of obesity and related cardiometabolic risk factors among Indigenous Brazilian peoples and its association with urbanisation. Summary data were extracted from published reports for the meta-analyses. We calculated pooled estimates of the prevalence of each cardiometabolic outcome by using a random-effects model (DerSimonian-Laird method). This study is registered with the International Prospective Register of Systematic Reviews, CRD42021285480. FINDINGS 46 studies were identified, including a total of 20 574 adults from at least 33 Indigenous Brazilian ethnicities. Meta-analyses of the prevalence of obesity showed that there were higher rates of obesity (midwest region: 23% [95% CI 17-29]; and south region 23% [13-34]) and hypertension (south region: 30% [10-50]) in Indigenous peoples living in urban regions of Brazil, while the lowest rates of obesity (11% [95% CI 8-15]) and hypertension (1% [1-2]) were observed in those in the less urbanised (north) regions of Brazil. The prevalence of obesity was 3·5 times higher in participants living in urbanised Indigenous territories (28%) than in those living in lands with >80% native Amazon rainforest (8%). In meta-analyses that evaluated blood pressure level, there was no incremental change in blood pressure with ageing in Indigenous peoples who lived according to traditional lifestyle, in contrast to those living in urbanised regions. For Indigenous men with traditional lifestyles, systolic blood pressure changed from 109·8 mm Hg to 104·4 mm Hg between the youngest (<30 years) and the oldest (>60 years) age groups, and diastolic blood pressure changed from 69·8 mm Hg to 66·1 mm Hg. For Indigenous women with traditional lifestyles, systolic blood pressure was 100·0 mm Hg for the youngest age group with no changes for older age groups, and diastolic blood pressure was 62 mm Hg for the youngest age group with no changes for older age groups. For Indigenous men with urbanised lifestyles, systolic blood pressure changed from 117·3 mm Hg to 124·9 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 72·7 mm Hg to 76·4 mm Hg. For Indigenous women with urbanised lifestyles, systolic blood pressure changed from 110·0 mm Hg to 116·0 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 68·3 mm Hg to 74·0 mm Hg. For the years 1997 and 2019, the cardiovascular mortality rate in individuals living in the southeast region (the most urbanised) was 2·5 times greater than that observed in the north. Conversely, the incremental rise in cardiovascular mortality in the past two decades among Indigenous Brazilians living in the north or northeast (2·7 times increase) stands in stark contrast to the stable rates in those living in already urbanised regions. INTERPRETATION The macrosocial changes of Indigenous peoples' traditional ways of living consequent to urbanisation are associated with an increased prevalence of adverse cardiometabolic outcomes. These data highlight the urgent need for environmental policies to ensure the conservation of the natural ecosystem within Indigenous territories, as well as the development of socio-health policies to improve the cardiovascular health of Indigenous Brazilians peoples living in urban areas. FUNDING None.
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Affiliation(s)
- Caroline K Kramer
- Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
| | - Cristiane B Leitão
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana V Viana
- Serviço de Nutrologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Alves FTA, Prates EJS, Carneiro LHP, Sá ACMGND, Pena ÉD, Malta DC. Mortalidade proporcional nos povos indígenas no Brasil nos anos 2000, 2010 e 2018. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202113010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi analisar a mortalidade indígena no Brasil em 2000, 2010 e 2018. Estudo descritivo com dados do Sistema de Informação sobre Mortalidade. Calculou-se a mortalidade proporcional entre indígenas e restante da população brasileira, segundo idade, sexo, causa e regiões do Brasil. A proporção de óbitos em indígenas menores de 1 ano em 2000, 2010 e 2018 foi de 15,3%, 17,7% e 16,2%; e no restante do Brasil, foi de 7,2%, 3,5% e 2,7% respectivamente. A proporção de óbitos a partir de 50 anos nos indígenas nos mesmos anos foi de 47,0%, 48,1% e 52,0%; e no restante do Brasil, foi de 66,8%, 74,4% e 79,4%. Em 2018, indígenas menores de 1 ano morreram mais de afecções perinatais (39,4%), doenças infecciosas e parasitárias (10,1%) e causas externas (9,8%). Em menores de 1 ano do restante da população brasileira, essas causas corresponderam a 57,8%, 3,8% e 2,8%. Indígenas acima de 50 anos morreram mais por doenças circulatórias (28,6%), respiratórias (15,4%) e neoplasias (14,6%); e no restante da população brasileira, essas causas representaram 31,5%, 13,6% e 19,0%. Evidenciaram-se desigualdades em saúde e piores indicadores nos povos indígenas no Brasil.
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Sanchez-Samaniego G, Tallman PS, Valdes-Velasquez A. Metabolic syndrome risk unexpectedly predicted by traditional food consumption: shifting food systems and health among the Awajún of the Peruvian Amazon. Ann Hum Biol 2021; 48:110-118. [PMID: 33779426 DOI: 10.1080/03014460.2021.1908424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dietary changes, especially declines in traditional food diversity and increases in the consumption of processed foods, have previously been shown to increase the risk of developing cardiovascular diseases. AIM We evaluated the prevalence and risk factors for metabolic syndrome in four Awajún communities in the Peruvian Amazon. SUBJECTS AND METHODS A total of 222 participants answered a socioeconomic questionnaire, a 24-h food recall, and completed a physical examination for metabolic syndrome diagnosis. A Poisson regression with robust variance was used in the statistical analysis of risk factors for metabolic syndrome. RESULTS We found an overall prevalence of 24% for metabolic syndrome. Being female, increased age and body mass index were significant risk factors for metabolic syndrome. Surprisingly, risk more than doubled with the ratio of traditional foods. However, this study revealed that there are fewer traditional foods being consumed in this study compared to prior studies among the Awajún. CONCLUSION We suggest that the unexpected relationship between traditional food consumption and metabolic syndrome may be due to substantial reductions in the diversity of traditional foods. Currently available traditional foods are primarily high in carbohydrates and are supplemented with cheap, non-perishable, and carbohydrate heavy market food items.
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Affiliation(s)
- Giuliana Sanchez-Samaniego
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,School of Science, University of Basel, Basel, Switzerland
| | - Paula S Tallman
- The Field Museum of Natural History, Keller Science Action Center, Chicago, IL, USA
| | - Armando Valdes-Velasquez
- Laboratory for EcoHealth & Urban Ecology, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.,Clima - Latin American Centre for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Barbosa CC, Sacuena ESR, Pinto AM, Cardoso-Costa GL, Guerreiro JF. Anthropometric and metabolic profile of a Brazilian Amerindian group: The Xikrin (Mebengôkre). Am J Hum Biol 2019; 31:e23255. [PMID: 31115128 DOI: 10.1002/ajhb.23255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 03/10/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The purpose of this study was to describe the metabolic and anthropometric profile of the Xikrin (Mebengôkre), an indigenous group. METHODS A total of 363 subjects (55.1% women) aged 18 years or older were evaluated. The variables analyzed were age, body weight and height, waist circumference, blood pressure, fasting blood glucose, triglyceride level, and total cholesterol level. RESULTS A high prevalence of obesity (36.5%) and central obesity (88.1%), mainly among women (46.9% and 96.2%, respectively), was found among the Xikrin (Mebengôkre). Impaired fasting glycemia and diabetes were found in 4.5% and 3.8% of adults, respectively. Twenty-one percent of adults had dyslipidemia and 9.3% had hypertension. CONCLUSIONS The high prevalence of excess weight (overweight and obesity) and central obesity, especially in women, was the most significant finding of this study among the Xikrin (Mebengôkre).
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Affiliation(s)
- Cláudia C Barbosa
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Brazil
| | - Eliene S R Sacuena
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Brazil
| | - André M Pinto
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Brazil
| | | | - João F Guerreiro
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Brazil
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Baldoni NR, Aquino JA, Alves GCS, Sartorelli DS, Franco LJ, Madeira SP, Dal Fabbro AL. Prevalence of overweight and obesity in the adult indigenous population in Brazil: A systematic review with meta-analysis. Diabetes Metab Syndr 2019; 13:1705-1715. [PMID: 31235082 DOI: 10.1016/j.dsx.2019.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/13/2019] [Indexed: 02/03/2023]
Abstract
To carry out a systematic review to identify the prevalence of overweight and obesity in the adult indigenous population in Brazil. The databases used were PubMed, Scopus, Virtual Health Library (VHL), and Science Direct, with the following search strategy: "overweight" OR "obesity" AND "indigenous" OR "tribe" AND "Brazil". For the meta-analysis, RStudio® software was used. Were 22 articles included. The combined effect of the meta-analysis studies showed a global prevalence of overweight and obesity of 45%. Approximately half (45%) of indigenous Brazilian adults have excess weight. These findings highlight the need to implement public policies for the prevention and treatment of these morbidities.
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Affiliation(s)
- Nayara Ragi Baldoni
- Universidade de Itaúna (UIT), Rodovia MG 431 Km 45, S/n, Itaúna, MG, 35680-142, Brazil.
| | - Jéssica Azevedo Aquino
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João Del-Rei, Rua Sebastião Gonçalves Coelho, 400, Bairro Chanadour, CEP 35501-296, Divinópolis, MG, Brazil
| | - Geisa Cristina Silva Alves
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João Del-Rei, Rua Sebastião Gonçalves Coelho, 400, Bairro Chanadour, CEP 35501-296, Divinópolis, MG, Brazil
| | - Daniela Saes Sartorelli
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), 3900, Monte Alegre, CEP 14049-900, Ribeirão Preto, SP, Brazil
| | - Laercio Joel Franco
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), 3900, Monte Alegre, CEP 14049-900, Ribeirão Preto, SP, Brazil
| | - Sofia Pereira Madeira
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), 3900, Monte Alegre, CEP 14049-900, Ribeirão Preto, SP, Brazil
| | - Amaury Lelis Dal Fabbro
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), 3900, Monte Alegre, CEP 14049-900, Ribeirão Preto, SP, Brazil
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de Alencar RRFR, Galvao TF, Antonio BVR, Silva MT. Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region. Ethn Dis 2018; 28:49-54. [PMID: 29467566 DOI: 10.18865/ed.28.1.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess the prevalence of, and associated factors to, self-reported chronic diseases and health care utilization by ethnicity in the Manaus Metropolitan Region. Methods We conducted a cross-sectional, population-based survey from May through August 2015. Using probabilistic sampling in three stages, we recruited adults aged ≥18 years. Ethnicity was self-identified as White, Black, Yellow, Brown (Brazilian mixed-race), and Indigenous. We calculated adjusted prevalence ratios (PR) and 95% CI of chronic diseases and health service utilization for each ethnic minority and compared the data using Poisson regression with data from White respondents. Results In this study, we interviewed 4,001 people. Of these, 15.9% were White, 7.5% Black, 3.4% Yellow, 72.1% Brown, and 1.0% Indigenous. Indigenous respondents had the highest prevalence of self-reported hypertension (29.4%), diabetes (12.3%) and hypercholesterolemia (17.0%) among the ethnic respondent groups. Compared with the White population, Browns had less health insurance coverage (PR=.76; 95% CI: .62-.93) and reported hypertension (PR=.84; 95% CI: .72-0.98) and diabetes (PR=.69; 95% CI: .51-.94) less frequently. Yellows visited the doctor more frequently than Whites (PR=1.13; 95% CI: 1.04-1.22), with no significant difference in prevalence of diseases. Conclusions Indigenous respondents had higher prevalence rates of the investigated diseases. Compared with Whites, Brown respondents had lower rates of self-reported arterial hypertension and diabetes, as well as lower rates of private health insurance coverage.
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Affiliation(s)
| | - Tais Freire Galvao
- University of Campinas, Faculty of Pharmaceutical Science, Campinas, Brazil
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