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Shridhar SV, Beghini F, Alexander M, Singh A, Juárez RM, Brito IL, Christakis NA. Environmental, socioeconomic, and health factors associated with gut microbiome species and strains in isolated Honduras villages. Cell Rep 2024; 43:114442. [PMID: 38968070 DOI: 10.1016/j.celrep.2024.114442] [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: 01/09/2024] [Revised: 04/27/2024] [Accepted: 06/19/2024] [Indexed: 07/07/2024] Open
Abstract
Despite a growing interest in the gut microbiome of non-industrialized countries, data linking deeply sequenced microbiomes from such settings to diverse host phenotypes and situational factors remain uncommon. Using metagenomic data from a community-based cohort of 1,871 people from 19 isolated villages in the Mesoamerican highlands of western Honduras, we report associations between bacterial species and human phenotypes and factors. Among them, socioeconomic factors account for 51.44% of the total associations. Meta-analysis of species-level profiles across several datasets identified several species associated with body mass index, consistent with previous findings. Furthermore, the inclusion of strain-phylogenetic information modifies the overall relationship between the gut microbiome and the phenotypes, especially for some factors like household wealth (e.g., wealthier individuals harbor different strains of Eubacterium rectale). Our analysis suggests a role that gut microbiome surveillance can play in understanding broad features of individual and public health.
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Affiliation(s)
- Shivkumar Vishnempet Shridhar
- Yale Institute for Network Science, Yale University, New Haven, CT, USA; Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Francesco Beghini
- Yale Institute for Network Science, Yale University, New Haven, CT, USA
| | - Marcus Alexander
- Yale Institute for Network Science, Yale University, New Haven, CT, USA
| | - Adarsh Singh
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | | | - Ilana L Brito
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
| | - Nicholas A Christakis
- Yale Institute for Network Science, Yale University, New Haven, CT, USA; Department of Biomedical Engineering, Yale University, New Haven, CT, USA; Department of Statistics and Data Science, Yale University, New Haven, CT, USA; Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
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Benka-Coker ML, Clark ML, Rajkumar S, Young BN, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, Wilson A, L'Orange C, Good N, Quinn C, Koehler K, Africano S, Osorto Pinel AB, Diaz-Sanchez D, Neas L, Peel JL. Household air pollution from wood-burning cookstoves and C-reactive protein among women in rural Honduras. Int J Hyg Environ Health 2022; 241:113949. [PMID: 35259686 PMCID: PMC8934269 DOI: 10.1016/j.ijheh.2022.113949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/15/2022]
Abstract
Household air pollution from solid fuel combustion was estimated to cause 2.31 million deaths worldwide in 2019; cardiovascular disease is a substantial contributor to the global burden. We evaluated the cross-sectional association between household air pollution (24-h gravimetric kitchen and personal particulate matter (PM2.5) and black carbon (BC)) and C-reactive protein (CRP) measured in dried blood spots among 107 women in rural Honduras using wood-burning traditional or Justa (an engineered combustion chamber) stoves. A suite of 6 additional markers of systemic injury and inflammation were considered in secondary analyses. We adjusted for potential confounders and assessed effect modification of several cardiovascular-disease risk factors. The median (25th, 75th percentiles) 24-h-average personal PM2.5 concentration was 115 μg/m3 (65,154 μg/m3) for traditional stove users and 52 μg/m3 (39, 81 μg/m3) for Justa stove users; kitchen PM2.5 and BC had similar patterns. Higher concentrations of PM2.5 and BC were associated with higher levels of CRP (e.g., a 25% increase in personal PM2.5 was associated with a 10.5% increase in CRP [95% CI: 1.2-20.6]). In secondary analyses, results were generally consistent with a null association. Evidence for effect modification between pollutant measures and four different cardiovascular risk factors (e.g., high blood pressure) was inconsistent. These results support the growing evidence linking household air pollution and cardiovascular disease.
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Affiliation(s)
- Megan L Benka-Coker
- Department of Health Sciences, Gettysburg College, Gettysburg, PA, USA; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bonnie N Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Annette M Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Robert D Brook
- Division of Cardiovascular Diseases, Wayne State University, Detroit, MI, USA
| | - Tracy L Nelson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Stephen J Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Christian L'Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Nicholas Good
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Casey Quinn
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Anibal B Osorto Pinel
- Trees, Water & People, Fort Collins, CO, USA; Asociación Hondureña para el Desarrollo, Tegucigalpa, Honduras
| | - David Diaz-Sanchez
- U.S. Environmental Protectection Agency, ORD, NHEERL, Environmental Public Health Divsion, USA
| | - Lucas Neas
- U.S. Environmental Protectection Agency, ORD, NHEERL, Environmental Public Health Divsion, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
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Walker ES, Clark ML, Young BN, Rajkumar S, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L’Orange C, Africano S, Pinel ABO, Good N, Koehler K, Peel JL. Exposure to household air pollution from biomass cookstoves and self-reported symptoms among women in rural Honduras. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:160-173. [PMID: 30760020 PMCID: PMC6692243 DOI: 10.1080/09603123.2019.1579304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/31/2018] [Indexed: 06/09/2023]
Abstract
Household air pollution from combustion of solid fuels is an important risk factor for morbidity and mortality, causing an estimated 2.6 million premature deaths globally in 2016. Self-reported health symptoms are a meaningful measure of quality of life, however, few studies have evaluated symptoms and quantitative measures of exposure to household air pollution. We assessed the cross-sectional association of self-reported symptoms and exposures to household air pollution among women in rural Honduras using stove type (traditional [n = 76]; cleaner-burning Justa [n = 74]) and 24-hour average personal and kitchen fine particulate matter (PM2.5) concentrations. The odds of prevalent symptoms were higher among women using traditional stoves vs Justa stoves (e.g. headache: odds ratio = 2.23; 95% confidence interval = 1.13-4.39). Associations between symptoms and measured PM2.5 were generally consistent with the null. These results add to the evidence suggesting reduced exposures and better health-related quality of life among women using cleaner-burning biomass stoves.
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Affiliation(s)
- Ethan S. Walker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Annette M. Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science and Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Stephen J. Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Mountain and Plains ERC, Denver, CO, USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | | | | | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Young BN, Peel JL, Benka-Coker ML, Rajkumar S, Walker ES, Brook RD, Nelson TL, Volckens J, L’Orange C, Good N, Quinn C, Keller JP, Weller ZD, Africano S, Osorto Pinel AB, Clark ML. Study protocol for a stepped-wedge randomized cookstove intervention in rural Honduras: household air pollution and cardiometabolic health. BMC Public Health 2019; 19:903. [PMID: 31286921 PMCID: PMC6615088 DOI: 10.1186/s12889-019-7214-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/20/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Growing evidence links household air pollution exposure from biomass-burning cookstoves to cardiometabolic disease risk. Few randomized controlled interventions of cookstoves (biomass or otherwise) have quantitatively characterized changes in exposure and indicators of cardiometabolic health, a growing and understudied burden in low- and middle-income countries (LMICs). Ideally, the solution is to transition households to clean cooking, such as with electric or liquefied petroleum gas stoves; however, those unable to afford or to access these options will continue to burn biomass for the foreseeable future. Wood-burning cookstove designs such as the Justa (incorporating an engineered combustion zone and chimney) have the potential to substantially reduce air pollution exposures. Previous cookstove intervention studies have been limited by stove types that did not substantially reduce exposures and/or by low cookstove adoption and sustained use, and few studies have incorporated community-engaged approaches to enhance the intervention. METHODS/DESIGN We conducted an individual-level, stepped-wedge randomized controlled trial with the Justa cookstove intervention in rural Honduras. We enrolled 230 female primary cooks who were not pregnant, non-smoking, aged 24-59 years old, and used traditional wood-burning cookstoves at baseline. A community advisory board guided survey development and communication with participants, including recruitment and retention strategies. Over a 3-year study period, participants completed 6 study visits approximately 6 months apart. Half of the women received the Justa after visit 2 and half after visit 4. At each visit, we measured 24-h gravimetric personal and kitchen fine particulate matter (PM2.5) concentrations, qualitative and quantitative cookstove use and adoption metrics, and indicators of cardiometabolic health. The primary health endpoints were blood pressure, C-reactive protein, and glycated hemoglobin. Overall study goals are to explore barriers and enablers of new cookstove adoption and sustained use, compare health endpoints by assigned cookstove type, and explore the exposure-response associations between PM2.5 and indicators of cardiometabolic health. DISCUSSION This trial, utilizing an economically feasible, community-vetted cookstove and evaluating endpoints relevant for the major causes of morbidity and mortality in LMICs, will provide critical information for household air pollution stakeholders globally. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02658383 , posted January 18, 2016, field work completed May 2018. Official title, "Community-Based Participatory Research: A Tool to Advance Cookstove Interventions." Principal Investigator Maggie L. Clark, Ph.D. Last update posted July 12, 2018.
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Affiliation(s)
- Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
- Department of Health Sciences, Gettysburg College, Gettysburg, PA USA
| | - Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Ethan S. Walker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
| | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Casey Quinn
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
| | - Joshua P. Keller
- Department of Statistics, Colorado State University, Fort Collins, CO USA
| | - Zachary D. Weller
- Department of Statistics, Colorado State University, Fort Collins, CO USA
| | | | - Anibal B. Osorto Pinel
- Trees, Water & People, Fort Collins, CO USA
- Asociación Hondureña para el Desarrollo, Tegucigalpa, Honduras
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681 USA
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Variation in dietary intake and body fatness by socioeconomic status among women in the context of Costa Rican nutrition transitions. J Biosoc Sci 2019; 52:230-247. [PMID: 31218982 DOI: 10.1017/s0021932019000403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The Nutrition Transition model posits that vegetable oils, animal source foods (ASFs) and caloric sweeteners contribute to increases in adiposity and hence body mass index. Body mass index (BMI) is increasing more rapidly among Latin American populations of low versus high socioeconomic status (SES). The objectives of this study among Costa Rican women were to: (1) compare indicators of adiposity and dietary intake by SES and (2) evaluate the relationship between intake of foods high in vegetable oils, ASFs or caloric sweeteners and body fatness. This cross-sectional study, conducted in 2014-2015, included 128 low-, middle- and high-SES non-pregnant, non-lactating women aged between 25 and 45 years with 1-4 live births. Anthropometry was used to assess BMI, body composition and body fat distribution. Dietary recalls (n = 379) were used to assess dietary intake. Percentage body fat was greater in low- versus high-SES women (31.5 ± 3.9 vs 28.2 ± 4.7%). Skinfold measurements at four sites on the upper and lower body were greater in low- versus high-SES women. Body mass index did not vary in low- versus high-SES women. Intake frequency of foods high in vegetable oils was greater in low- and middle- (1.8 and 1.8 times/day, respectively) versus high- (1.1 times/day) SES women. For individual foods, intake frequency varied significantly by SES for high-fat condiments, fried vegetables, dairy, sweetened coffee/tea and pastries and desserts. Intake frequency of Nutrition Transition food categories was not associated with percentage body fat after adjustment for energy intake. Indicators of body composition provide additional information beyond BMI that are useful in understanding SES-adiposity associations in Latin America. Approaches to understanding diet and adiposity in Latin America that focus on vegetable oils, ASFs and caloric sweeteners should consider within-country variation in the pace of the Nutrition Transition, especially when explaining variation in adiposity by SES.
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Rajkumar S, Young BN, Clark ML, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L'Orange C, Good N, Koehler K, Africano S, Osorto Pinel AB, Peel JL. Household air pollution from biomass-burning cookstoves and metabolic syndrome, blood lipid concentrations, and waist circumference in Honduran women: A cross-sectional study. ENVIRONMENTAL RESEARCH 2019; 170:46-55. [PMID: 30557691 PMCID: PMC6360106 DOI: 10.1016/j.envres.2018.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 05/30/2023]
Abstract
BACKGROUND Household air pollution from cooking with solid fuels affects nearly 3 billion people worldwide and is responsible for an estimated 2.5 million premature deaths and 77 million disability-adjusted life years annually. Investigating the effect of household air pollution on indicators of cardiometabolic disease, such as metabolic syndrome, can help clarify the pathways between this widespread exposure and cardiovascular diseases, which are increasing in low- and middle-income countries. METHODS Our cross-sectional study of 150 women in rural Honduras (76 with traditional stoves and 74 with cleaner-burning Justa stoves) explored the effect of household air pollution exposure on cardiovascular disease risk factors. Household air pollution was measured by stove type and 24-h average kitchen and personal fine particulate matter [PM2.5] mass and black carbon concentrations. Health endpoints included non-fasting total cholesterol, high-density lipoprotein, calculated low-density lipoprotein, triglycerides, waist circumference to indicate abdominal obesity, and presence of metabolic syndrome (defined by current modified international guidelines: waist circumference ≥ 80 cm plus any two of the following: triglycerides > 200 mg/dL, HDL < 50 mg/dL, systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 85 mmHg, or glycated hemoglobin > 5.6%). RESULTS Forty percent of women met the criteria for metabolic syndrome. The prevalence ratio [PR] for metabolic syndrome (versus normal) per interquartile range increase in kitchen PM2.5 and kitchen black carbon was 1.16 (95% confidence interval [CI]: 1.01-1.34) per 312 μg/m3 increase in PM2.5, and 1.07 (95% CI: 1.03-1.12) per 73 μg/m3 increase in black carbon. There is suggestive evidence of a stronger effect in women ≥ 40 years of age compared to women < 40 (p-value for interaction = 0.12 for personal PM2.5). There was no evidence of associations between all other exposure metrics and health endpoints. CONCLUSIONS The prevalence of metabolic syndrome among our study population was high compared to global estimates. We observed a suggestive effect between metabolic syndrome and exposure to household air pollution. These results for metabolic syndrome may be driven by specific syndrome components, such as blood pressure. Longitudinal research with repeated health and exposure measures is needed to better understand the link between household air pollution and indicators of cardiometabolic disease risk.
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Affiliation(s)
- Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bonnie N Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Megan L Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Health Sciences Program, Gettysburg College, Gettysburg, PA, USA.
| | - Annette M Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Tracy L Nelson
- Department of Health and Exercise Science, Colorado State University; Fort Collins, CO, USA.
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
| | - Stephen J Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Christian L'Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
| | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Anibal B Osorto Pinel
- Trees, Water & People, Fort Collins, CO, USA; Asociación Hondureña para el Desarrollo, Tegucigalpa, Honduras
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
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Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112544. [PMID: 30428575 PMCID: PMC6267103 DOI: 10.3390/ijerph15112544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/26/2018] [Accepted: 11/07/2018] [Indexed: 12/14/2022]
Abstract
Household air pollution is estimated to be responsible for nearly three million premature deaths annually. Measuring fractional exhaled nitric oxide (FeNO) may improve the limited understanding of the association of household air pollution and airway inflammation. We evaluated the cross-sectional association of FeNO with exposure to household air pollution (24-h average kitchen and personal fine particulate matter and black carbon; stove type) among 139 women in rural Honduras using traditional stoves or cleaner-burning Justa stoves. We additionally evaluated interaction by age. Results were generally consistent with a null association; we did not observe a consistent pattern for interaction by age. Evidence from ambient and household air pollution regarding FeNO is inconsistent, and may be attributable to differing study populations, exposures, and FeNO measurement procedures (e.g., the flow rate used to measure FeNO).
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Rajkumar S, Clark ML, Young BN, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L’Orange C, Good N, Koehler K, Africano S, Osorto Pinel AB, Peel JL. Exposure to household air pollution from biomass-burning cookstoves and HbA1c and diabetic status among Honduran women. INDOOR AIR 2018; 28:10.1111/ina.12484. [PMID: 29896912 PMCID: PMC6292747 DOI: 10.1111/ina.12484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/08/2018] [Indexed: 05/05/2023]
Abstract
Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle-income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross-sectional study of 142 women (72 with traditional stoves and 70 with cleaner-burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24-hour average kitchen and personal fine particulate matter [PM2.5 ] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 μg/m3 increase in personal PM2.5 , 1.49; 95% confidence interval [CI], 1.11-2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.
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Affiliation(s)
- Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Annette M. Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Domino’s Farms, 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105, USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science, Colorado State University, 215D Moby Complex B Wing, Fort Collins, CO 80523, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
- Department of Mechanical Engineering, Colorado State University, 306 Scott Bioengineering Building, Fort Collins, CO 80523, USA
| | - Stephen J. Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
- Mountain and Plains ERC, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop B119, Aurora, CO 80045, USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, 306 Scott Bioengineering Building, Fort Collins, CO 80523, USA
| | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205, USA
| | - Sebastian Africano
- Trees, Water & People, 633 Remington Street, Fort Collins, CO 80524, USA
| | - Anibal B. Osorto Pinel
- Trees, Water & People, 633 Remington Street, Fort Collins, CO 80524, USA
- Asociación Hondureña para el desarrollo, Calle Principal, Casa No. 2245, Tegucigalpa, Honduras
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
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Cooper CG, Burns JL, Koster JM, Perri AR, Richards MP. Economic and demographic predictors of dietary variation and nutritional indicators in Nicaragua. Am J Hum Biol 2018; 30:e23125. [PMID: 29637643 DOI: 10.1002/ajhb.23125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/11/2017] [Accepted: 03/12/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES We measured carbon and nitrogen isotopic ratios in a contemporary population, and tested how the isotopic variability relates to measures of socioeconomic status (e.g., household wealth) and anthropometric measures (e.g., standardized height-for-age and weight-for-age z-scores). METHODS Hair samples from individuals living in the Bosawas Biosphere Reserve in Nicaragua were analyzed for δ13 C and δ15 N, and these data were examined in relation to individual (e.g., age, sex, anthropometrics) and household (e.g., household size, wealth) variables. RESULTS We found through mixed-effects modeling that δ13 C and δ15 N varied predictably with individual age and household wealth. δ13 C and δ15 N did not, however, improve models predicting variation in individual anthropometric measures. CONCLUSION These results indicate that, although there is a relationship between diet (δ13 C and δ15 N) and socioeconomic variables, these dietary differences are not the main cause of health differences in this population.
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Affiliation(s)
| | - Jessica L Burns
- The University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
| | - Jeremy M Koster
- The University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
| | - Angela R Perri
- The University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
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Mayén AL, Marques-Vidal P, Paccaud F, Bovet P, Stringhini S. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review. Am J Clin Nutr 2014; 100:1520-31. [PMID: 25411287 DOI: 10.3945/ajcn.114.089029] [Citation(s) in RCA: 228] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. OBJECTIVE We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. DESIGN We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. RESULTS A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. CONCLUSIONS In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs.
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Affiliation(s)
- Ana-Lucia Mayén
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Fred Paccaud
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2012; 19:429-34. [PMID: 22931856 DOI: 10.1097/med.0b013e328358c698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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