Prevalence of low physical activity, its predictors and knowledge regarding being overweight/obesity: A community-based study from urban South India

Endoscopic sleeve gastroplasty - minimally invasive treatment for non-alcoholic fatty liver disease and obesity

INTRODUCTION

Adequate weight loss can lead to reduction in steatosis, inflammation, and fibrosis in patients with obesity and non-alcoholic fatty liver disease (NAFLD). We evaluated the role of endoscopic sleeve gastroplasty (ESG) in patients with obesity and NAFLD.

METHODS

In this single-center prospective study, consecutive adult patients with NAFLD who underwent ESG between November 2018 and May 2019 were included. The primary outcome was the impact of ESG on hepatic parameters: change in alanine aminotransferase (ALT), hepatic steatosis index (HSI), NAFLD fibrosis score (NFS), fibrosis-4 index (FIB-4), and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) from baseline to 6 and 12 months. Secondary outcomes included change in glycated hemoglobin (HbA1c), percentage weight loss, and safety. Analysis of variance with repeated measures was used for statistical analysis.

RESULTS

A total of 26 patients (mean age [SD] 41.5 [9.58] years; 16 females) with mean (SD) weight of 99.43 (21.89) kg at baseline were included. There was significant improvement in ALT (mean ± SD) from baseline of 59.54 ± 17.02 IU/L to 49.50 ± 11.72 IU/L and 48.42 ± 13.22 IU/L at 6 and 12 months (p = 0.001). Mean (SD) NFS was significantly improved from 0.228 (1.00) at baseline to -0.202 (1.16) and -0.552 (1.08) at 6 and 12 months (p 0.001). Mean (SD) HSI, FIB-4, and APRI scores significantly reduced from baseline to 6 and 12 months (p = 0.001). There was 18.07% total body weight loss at 12 months, with significant improvement in HbA1c. There were no major adverse events.

CONCLUSION

ESG is a safe and effective treatment option for patients with NAFLD and obesity causing significant weight loss. Rigorous randomized trials are required to incorporate ESG in NAFLD treatment algorithm.

Prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu

BACKGROUND

According to WHO, the deaths due to NCDs in Nepal have soared from 60% of all deaths in 2014 to 66% in 2018. The study assessed the prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu.

MATERIALS AND METHODS

A community based cross-sectional study was conducted from September 2019 to February 2020 among 18-69 years adults residing in municipalities of Kathmandu district. Multi-stage random sampling technique was used to select 245 subjects who were interviewed using WHO NCD STEPS instrument. Chi-square test and logistic regression analysis were done to explore the determinants of NCD risk factors.

RESULTS

The prevalence of current smoking, alcohol consumption, low intake of fruits and vegetables and low physical activity was found to be 22%, 31%, 93.9% and 10.2% respectively. More than half (52.2%) of the participants were overweight or obese and the prevalence of raised blood pressure was 27.8%. Smoking was associated significantly with male gender (AOR = 2.37, CI: 1.20-5.13) and respondents with no formal schooling (AOR: 4.33, CI: 1.50-12.48). Similarly, the odds of alcohol consumption were higher among male gender (AOR: 2.78, CI: 1.47-5.26), people who were employed (AOR: 2.30, CI: 1.13-4.82), and those who belonged to Chhetri (AOR: 2.83, CI: 1.19-6.72), Janajati (AOR: 6.18, CI: 2.74-13.90), Dalit and Madhesi, (AOR: 7.51, CI: 2.13-26.35) ethnic groups. Furthermore, respondents who were aged 30-44 years (AOR: 5.15, CI: 1.91-13.85) and 45-59 years (AOR: 4.54 CI: 1.63-12.66), who were in marital union (AOR: 3.39, CI: 1.25-9.13), and who belonged to Janajati (AOR: 3.37, CI: 1.61-7.04), Dalit and Madhesi (AOR: 4.62, CI: 1.26-16.86) ethnic groups were more likely to be associated with overweight or obesity. Additionally, the odds of raised blood pressure were higher among people who were of older age (AOR: 6.91, CI: 1.67-28.63) and those who belonged to Janajati ethnic group (AOR: 3.60, CI: 1.46-8.87) after multivariate analysis.

CONCLUSION

The findings of the study highlighted high prevalence of behavioral and metabolic risk factors, which varied on different socio-demographic grounds. Thus, population specific health promotion interventions centered on public health interests is recommended to reduce risk factors of NCDs.

Challenges to lifestyle modification of chronic disease patients attending primary health care centers in Riyadh

BACKGROUND

The rate of chronic diseases is increasing due to the global pandemic of inactivity and an unhealthy diet.

OBJECTIVE

We aimed to determine the dietary habits, physical activities of the participants, and challenges facing them to adapt to a healthy lifestyle.

METHODOLOGY

The researchers conducted a cross-sectional study on chronic disease patients attending primary health care centers in Riyadh from January to March 2018. The estimated sample size was 250 patients. The participants completed a self-administered questionnaire.

RESULT

The mean age of the 250 participants was 35.3 years old. The Overweight and obese participants accounted for 67.2% of the sample (mean BMI = 28.0). Two-thirds of the participants depend mainly on rice or pasta for their diet, and 48.4-52.0% eat fruits and vegetables less than three times a week. About 50% of the participants perceived a lack of information, skills, motivation, and family or friends support as a barrier to a healthy diet. Also, (56.4%) of males and (67.8%) of females are physically inactive. Accessibility, cost, and the hot climate were physical activity obstacles in more than 60% of the respondents. Optimal BMI showed a significant association with increased physical activity P = 0.04.

CONCLUSION

Physical inactivity and consuming a non-balanced diet are common. So awareness campaigns of the benefit of a healthy lifestyle besides increasing physical exercise facilities, installing environmental changes, and subsidizing sports gyms would encourage people to be more physically active.

Physical Activity Patterns in India Stratified by Zones, Age, Region, BMI and Implications for COVID-19: A Nationwide Study

Rationale:

India has a high prevalence of noncommunicable diseases (NCDs), which can be lowered by regular physical activity. To understand this association, recent population data is required which is representative of all the states and union territories of the country.

Objective:

We aimed to investigate the patterns of physical activity in India, stratified by zones, body mass index (BMI), urban, rural areas, and gender.

Method:

We present the analysis of physical activity status from the data collected during the phase 1 of a pan-India study. This (Niyantrita Madhumeha Bharata 2017) was a multicenter pan-India cluster sampled trial with dual objectives. A survey to identify all individuals at a high risk for diabetes, using a validated instrument called the Indian Diabetes Risk Score (IDRS), was followed by a two-armed randomized yoga-based lifestyle intervention for the primary prevention of diabetes. The physical activity was scored as per IDRS (vigorous exercise or strenuous at work = 0, moderate exercise at home/work = 10, mild exercise at home/work = 20, no exercise = 30). This was done in a selected cluster using a mobile application. A weighted prevalence was calculated based on the nonresponse rate and design weight.

Results:

We analyzed the data from 2,33,805 individuals; the mean age was 41.4 years (SD 13.4). Of these, 50.6% were females and 49.4% were males; 45.8% were from rural areas and 54% from urban areas. The BMI was 24.7 ± 4.6 kg/m². Briefly, 20% were physically inactive and 57% of the people were either inactive or mildly active. 21.2% of females were found physically inactive, whereas 19.2% of males were inactive. Individuals living in urban localities were proportionately more inactive (21.7% vs. 18.8%) or mildly active (38.9% vs. 34.8%) than the rural people. Individuals from the central (29.6%) and south zones (28.6%) of the country were also relatively inactive, in contrast to those from the northwest zone (14.2%). The known diabetics were found to be physically inactive (28.3% vs. 19.8%) when compared with those unaware of their diabetic status.

Conclusion:

20% and 37% of the population in India are not active or mildly active, respectively, and thus 57% of the surveyed population do not meet the physical activity regimen recommended by the World Health Organization. This puts a large Indian population at risk of developing various NCDs, which are being increasingly reported to be vulnerable to COVID-19 infections. India needs to adopt the four strategic objectives recommended by the World Health Organization for reducing the prevalence of physical inactivity.