Obesity and its Effects on Health in Middle-Aged Women from Slums of Pune

"Cancer Education on Wheels," a Novel Cost-Effective Method in Creating Awareness in the Community: a Pilot Study

Cancer education raises disease awareness, the value of early identification and importantly the need for prompt screening and treatment when diagnosed. In this study, an effort was made to understand how well a unique cancer education program, "Cancer Education on Wheels," transfers knowledge in general public in society. The community was shown prerecorded cancer awareness videos using a TV monitor, CD player, and speaker system mounted on an eight-seat Toyota Innova. Before and after seeing the video presentation, consenting volunteers filled out questionnaires asking about demographics and understanding of cancer. Frequency and percentage calculations were done on the demographic information and a Wilcoxon signed-rank test was run on the overall subject score. Data was stratified based on demographic information and compared by applying Kruskal-Wallis test and Mann-Whitney test. p values under 0.05 were regarded as significant. A total of 584 people completed the pre-test and post-test questionnaires. The Wilcoxon signed-rank test revealed a difference between the pre-test and post-test (3.29 ± 2.48 vs. 6.78 ± 3.52; P = 0.0001). The pre-test results showed that volunteers between the ages of 18 and 30; men; students; urban residents; single volunteers; graduates; people who had known a person/or family member with cancer; and people who were aware of the suffering cancer causes had a high baseline knowledge of cancer (p = 0.015 to 0.001). The post-test results show that participants who had less baseline scores like housewives and unemployed people performed better (p = 0.006 to 0.0001). The findings unambiguously demonstrated that "Cancer Education on Wheels" was successful in raising participants' awareness of cancer signs and screening. Additionally, the findings showed that volunteers who were aged, married, housewives, and unemployed had higher scores. Most importantly, this approach to cancer education is simple to organize and carry out in a local setting. It is also affordable and simple to execute using readily available technological equipment and manageable logistics. According to the authors' knowledge, this is the first study to use "Cancer Education on Wheels" to spread awareness of cancer throughout the neighborhood especially in budget constrained areas.

Validation of New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH) FFQ with multiple 24-h dietary recalls among pregnant women in Pune, India

Adequate dietary intake is critical to prevent adverse pregnancy outcomes. India has a high burden of maternal and child morbidity and mortality, but there is a lack of adequate tools to assess dietary intake. We validate an FFQ, New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH), among pregnant women living with and without HIV in Pune, India. Women were selected from a cohort study investigating immune responses to HIV and latent tuberculosis during pregnancy. The FFQ was administered during the third trimester and validated against multiple 24-h dietary recalls (24-HDR) collected in second and third trimesters. Data for analysis were available from fifty-eight women out of seventy enrolled into this sub-study, after excluding those with incomplete data or implausible energy intake. The median (Q1, Q3) age of study participants was 23 (20, 25) years. Median (Q1, Q3) daily energy intakes were 10 552 (8000, 11 958) and 10 673 (8510, 13 962) kJ by 24-HDR and FFQ, respectively, with FFQ overestimating nutrient intake. Pearson correlations between log-transformed estimates from FFQ and 24-HDR for energy, protein, carbohydrate, fat, Fe and Zn were 0·47, 0·48, 0·45, 0·33, 0·4 and 0·54, respectively. Energy-adjusted and de-attenuated correlations ranged from 0·41 (saturated fat) to 0·73 (Na). The highest misclassification into extreme tertiles was observed for fat (22 %), saturated fat (21 %) and Na (21 %). Bias existed at higher intake levels as observed by Bland-Altman plots. In conclusion, NINA-DISH is a valid and feasible tool for estimating dietary intakes among urban pregnant women in Western India.

Prevalence and factors associated with triple burden of malnutrition among mother-child pairs in India: a study based on National Family Health Survey 2015-16

BACKGROUND

Malnutrition in mothers as well as in children is a significant public health challenge in most of the developing countries. The triple burden of malnutrition is a relatively new issue on the horizon of health debate and is less explored among scholars widely. The present study examines the prevalence of the triple burden of malnutrition (TBM) and explored various factors associated with the TBM among mother-child pairs in India.

METHODS

Data used in this study were drawn from the fourth round of the National Family Health Survey (NFHS-IV) conducted in 2015-16 (N = 168,784). Bivariate and binary logistic regression analysis was used to quantify the results. About 5.7% of mother-child pairs were suffering from TBM.

RESULTS

Age of mother, educational status of the mother, cesarean section delivery, birth size of baby, wealth status of a household, and place of residence were the most important correlates for the triple burden of malnutrition among mother-child pairs in India. Further, it was noted that mothers with secondary education level (AOR: 1.15, CI 1.08-1.23) were having a higher probability of suffering from TBM, and interestingly the probability shattered down for mothers having a higher educational level (AOR: 0.90, CI 0.84-0.95). Additionally, mother-child pairs from rich wealth status (AOR: 1.93, CI 1.8-2.07) had a higher probability of suffering from TBM.

CONCLUSION

From the policy perspective, it is important to promote public health programs to create awareness about the harmful effects of sedentary lifestyles. At the same time, this study recommends an effective implementation of nutrition programs targeting undernutrition and anemia among children and obesity among women.

Effect of age and weight on physical activity

Background: Individuals tend to develop metabolic disorders and other chronic diseases, due to the poor conduction of physical activities. Meanwhile, a high level of physical activity positively affects the quality of life. However, irrespective of the numerous studies reported on the correlation between age, weight, and physical activity, there is limited study on the differences of physical activities in the geriatric and adult groups of obese and non-obese people. This study, therefore, aims to investigate the effect of age and weight on physical activity in geriatric and adult groups.

Design and methods: The purposive sampling technique was used to obtain data from 154 respondents from community-integrated health care in Surabaya, East Java, Indonesia. These respondents were equally divided into two groups of adult (21-60 years) and geriatric (>60 years) groups.

Results: The Chi-Square test showed that there were no significant differences between physical activity in the obese and nonobese people of the geriatric groups (P>0.05). Conversely, in the adult group, there were significant differences between physical activities and the age of obese and non-obese groups (P<0.05).

Conclusions: In conclusion, age affects physical activity in adult and geriatric groups.

Health-Promoting Behaviors and Menopausal Symptoms: An Interventional Study in Rural India

Background:

Menopausal transition initiates with menstrual cycle length variety and finishes when last menstrual period happens. As life expectancy has increased, a menopausal woman has to spend one-third of her life span with estrogen deprivation stage that leads to major long-term symptomatic and metabolic complications.

Methods:

This was a quasi-experimental study conducted on 103 menopausal women between 40 and 60 years of age residing in Ambala district, Haryana. In the experimental group, women received lifestyle modification program that includes six domains, i.e., health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. Intervention was divided into two sessions of total 2-h duration on 2 consecutive days. Sociodemographic pro forma, Menopausal Rating Scale, and Health Promoting Lifestyle Profile II were used to collect data from women through face-to-face interview.

Results:

There was a significant difference (P < 0.05) in mean menopausal symptom score and mean health-promoting behavior score in the experimental group after the intervention, but there was no significant difference in the comparison group (P > 0.05). It was revealed that there was no significant difference between the groups with regard to mean menopausal symptom score and mean health-promoting behavior score before intervention (P < 0.05). The mean posttest menopausal symptom score (t = −8.99, P = 0.01**) was significantly low and the mean health-promoting behavior score (t = 8.7, P = 0.01**) was significantly high in the experimental group.

Conclusion:

Based on the finding of the study, it can be concluded that Lifestyle modification program was significantly effective in reducing menopausal symptoms and improving health-promoting behaviors among women.

Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists

Menopause has been identified as a high-risk stage for weight gain in a woman's lifecycle. Menopause-related weight gain is a consequence of low circulating estrogen levels due to progressive loss of ovarian function. Moreover, the changes in the hormonal milieu, chronological aging, decline in physical activity coupled with westernized dietary pattern, and recurrent emotional eating episodes associated with psychological distress also contribute to the increase in total body fat and waist circumference. Higher waist circumference is an independent risk factor for cardiovascular and metabolic disease in menopausal women. These obesity-related cardiometabolic risk factors and menopausal symptoms can be effectively managed by achieving clinically significant weight loss through lifestyle modification. Behavioral lifestyle intervention uses behavioral techniques for counseling corrective dietary and physical activity practices in achieving sustainable weight loss outcomes. Majority of menopausal women seek this counseling from gynecologist, especially in primary care settings due to nonavailability of multidisciplinary teams. Thus, the aim of the review is to understand the menopause-obesity link, associated risk factors, and its health-related burden in perimenopausal women to devise a practical women-centric weight management module based on lifestyle modification techniques to address the burden of menopausal obesity in regular gynecological practice.