Sociodemographic differences in dietary trends among Iranian adults: findings from the 2005-2016 Iran-WHO STEPS survey.

OBJECTIVE: To examine trends in the intake of key food groups among Iranian adults between 2005 and 2016, overall, and according to sociodemographic characteristics. DESIGN: Repeat cross-sectional data from the Iran-STEPwise approach to risk factor surveillance (Iran-WHO STEPS) 2005-2016 were analysed. Regression analyses were used to evaluate trends in the frequency of fruits, vegetables and fish intake and type of oil used over time. Interactions by sex, age and area of residence were examined. SETTING: Iran. PARTICIPANTS: 225 221 Iranian adults. RESULTS: The frequency of vegetables (ß: -0·03; 95 % CI (-0·06, -0·00); P-trend = 0·030) and fish (ß: -0·09; 95 % CI (-0·10, -0·08); P-trend < 0·001) intake and use of solid fat (OR: 0·70; 95 % CI (0·70, 0·72); P-trend < 0·001) declined, whilst the frequency of fruit intake (ß-Coeff: 0·03, 95 % CI (0·01, 0·05); P-trend = 0·014) and liquid oil use (OR: 1·40; 95 % CI (1·3, 1·4); P-trend<0·001) rose. Rising trends in fruit intake were larger in mid-aged (40-60 years) and older (>60 years) adults (P-interaction < 0·001), whilst declines in vegetable (P-interaction < 0·001) and fish intake (P-interaction = 0·001) were larger in older adults. The declining use of solid fat was strongest in middle-aged and older adults (P-interaction = 0·035), while the increasing use of liquid oil was strongest in rural areas (P-interaction = 0·011). CONCLUSIONS: During the nutrition transition, liquid oil use and the frequency of fruit intake rose, while the frequency of vegetables and fish intake declined. Nonetheless, the fatty acid composition and cooking methods are important considerations. The changes observed are concerning from a public health perspective and demonstrate the need for interventions and possible targets for tailored strategies.

Exploring educational inequalities in hypertension control, salt knowledge and awareness, and patient advice: insights from the WHO STEPS surveys of adults from nine Eastern European and Central Asian countries.

OBJECTIVE: To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. DESIGN: Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. SETTINGS: Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). PARTICIPANTS: Nationally representative samples of 30 455 adults aged 25-65 years. RESULTS: HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction. CONCLUSIONS: There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.

Low attendance in cervical cancer screening, geographical disparities and sociodemographic determinants of screening uptake among adult women in Burkina Faso : results from the first nationwide population-based survey.

OBJECTIVE: To explore the level, geographical disparities and sociodemographic determinants of cervical cancer screening uptake among adult women in Burkina Faso by using data from the first national population-based survey. METHODS: This was a cross-sectional secondary analysis of primary data obtained by the 2013 World Health Organization (WHO) Stepwise Approach to Surveillance survey conducted in Burkina Faso. All 13 Burkinabè regions, with their different rates of urbanization, were surveyed. Lifetime cervical cancer screening uptake was explored. We included 2293 adult women for analyses and performed Student's t, chi-square and Fisher's exact tests, and logistic regression. RESULTS: Only 6.2% (95% CI: 5.3-7.3) of women had ever been screened for cervical cancer. For two regions ("Centre" and "Hauts-Bassins"), the pooled frequency was 16.6% (95% CI: 13.5-20.1) while in the other eleven regions it was significantly lower, 3.3% (95% CI: 2.5-4.2). In urban and rural areas, the respective frequencies for the screening uptake were 18.5% and 2.8% (p < 0.001), and in educated and un-educated women, frequencies were 27.7% and 3.3% (p < 0.001) respectively. The sociodemographic factors associated with screening uptake were being educated (adjusted odd-ratio [aOR] = 4.3; 95% CI: 2.8-6.7), urban residence (aOR = 3.8, 95% CI: 2.5-5.8) and having an occupation providing income (aOR = 3.1, 95% CI: 1.8-5.4). CONCLUSION: There was a significantly wide range in screening uptake between Burkina Faso regions, and the overall national as well as the region-specific levels were far below the WHO's target for cervical cancer elimination. Cervical cancer interventions should be tailored specifically for Burkinabè women with different educational levels, and prevention strategies based on community engagement integrating psychosocial considerations could be helpful.

A comparison of unhealthy lifestyle practices among adults with hypertension aware and unaware of their hypertensive status: results from the 2013 WHO STEPS survey in Burkina Faso.

BACKGROUND: We compared the prevalence of unhealthy lifestyle factors between the hypertensive adults who were aware and unaware of their hypertensive status and assessed the factors associated with being aware of one's hypertension among adults in Burkina Faso. METHODS: We conducted a secondary analysis of data from the World Health Organization Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso. Lifestyle factors analysed were fruits and vegetables (FV) consumption, tooth cleaning, alcohol and tobacco use, body mass index and physical activity. RESULTS: Among 774 adults living with hypertension, 84.9% (95% CI: 82.2-87.3) were unaware of their hypertensive status. The frequencies of unhealthy lifestyle practices in those aware vs. unaware were respectively: 92.3% vs. 96.3%, p = 0.07 for not eating, at least, five FV servings daily; 63.2% vs. 70.5%, p = 0.12 for not cleaning the teeth at least twice a day; 35.9% vs. 42.3%, p = 0.19 for tobacco and/or alcohol use; 53.9% vs. 25.4%, p = 0.0001 for overweight/obesity and 17.1% vs, 10.3%, p = 0.04 for physical inactivity. In logistic regression analysis, older age, primary or higher education, being overweight/obese [adjusted odds ratio (aOR) = 3.2; p < 0.0001], intake of adequate FV servings daily (aOR = 2.9; p = 0.023) and non-use of alcohol and tobacco (aOR = 0.6; p = 0.028) were associated with being aware of one's hypertensive status. CONCLUSION: Undiagnosed hypertension was very high among Burkinabè adults living with hypertension. Those aware of their hypertension diagnosis did not necessarily practise healthier lifestyles than those not previously aware of their hypertension. Current control programmes should aim to improve hypertension awareness and promote risk reduction behaviour.

Is the rural population of Puducherry district healthy in terms of the burden of non-communicable diseases? Findings from a cross-sectional analytical survey.

INTRODUCTION: Epidemiological transition remains a key contributor to the rising prevalence of non-communicable diseases (NCDs) across developing nations. Population-specific NCD risk factors estimates derived using World Health Organization (WHO) 'STEP-wise approach' are crucial for devising evidence-based public health interventions to combat NCDs. OBJECTIVE: To estimate the prevalence of behavioral and biological risk factors for NCDs among the rural adult population of Puducherry district in India. METHODOLOGY: STEPS survey was conducted by following all three steps (behavioral, physical measurements and biochemical risk factors) of NCD risk factor assessment. A total of 790 participants were selected from 50 villages through multistage cluster sampling method. STEPS instrument was used to assess behavioral risk factors, physical measurements and biochemical (fasting blood glucose and total cholesterol) risk factors. RESULTS: Tobacco use and alcohol consumption were present among 11.3% (95% Confidence Interval (CI): 9-13.6%) and 19.2% (95% CI: 16.5-22.4%) of the population, respectively. Low physical activity, inadequate intake of fruits and vegetables, overweight and obesity were observed among 29.3% (95% CI: 26.2-32.7%), 89.8% (95% CI: 87.6-92%), 15.6% (95% CI: 13.1-18.3%) and 38.9% (95% CI: 35.4-42.2%), respectively. About 28.2% (95% CI: 25.2-31.6%) had hypertension and 24.4% (95% CI: 20-29%) had diabetes mellitus. Abdominal obesity was twice highly prevalent among women. Tobacco and alcohol use were more common among men, whereas low physical activity, obesity and hypercholesterolemia were higher among women. CONCLUSION: Public health interventions to promote healthy lifestyle need to be initiated especially to increase physical activity, intake for fruits and vegetables, and quitting of tobacco and alcohol consumption in the rural population of Puducherry.

Oral hygiene practices and their sociodemographic correlates among adults in Burkina Faso: results from the First National Survey.

BACKGROUND: Sociodemographic parameters are the driving determinants of oral hygiene practices. This study aims to describe oral hygiene practices and associated sociodemographic factors in the Burkinabè population using the first nationally representative data. METHODS: This descriptive, cross-sectional study included 4677 adults through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, fluoridated toothpaste use and dentist visits within the last six months. Sociodemographic variables and oral hygiene practices were described, and the first variables were used as the explanatory variables for the seconds in the multivariable analyses. RESULTS: Individuals who cleaned teeth at least once a day represented 82.8% and at least twice a day represented 31.4%; 25.6% used fluoridated toothpaste and 2.1% visited a dentist. With the highest odds ratio, only being educated was a favourable factor for each oral hygiene practice. Living in an urban area or being a younger adult were favourable factors for cleaning teeth at least twice a day or the use of a fluoridated paste. Female gender applied more to regular tooth cleaning, as well as to dentist visits. CONCLUSION: Cleaning teeth at least once a day was common among Burkinabè, while cleaning at least twice a day, the use of fluoridated paste or dentist visits were infrequent. Education was the key favourable determinant for healthy oral hygiene practices, and improving oral health literacy interventions through basic health education should be promoted.

Prevalence and determinants of cardiovascular disease risk factors using the WHO STEPS approach in Cochabamba, Bolivia.

BACKGROUND: Cardiovascular diseases (CVDs) are considered the number one cause of death worldwide, especially in low- and middle-income countries, Bolivia included. Lack of reliable estimates of risk factor distribution can lead to delay in implementation of evidence-based interventions. However, little is known about the prevalence of risk factors in the country. The aim of this study was to assess the prevalence of preventable risk factors associated with CVDs and to identify the demographic and socioeconomic factors associated with them in Cochabamba, Bolivia. METHODS: A cross-sectional community-based study was conducted among youth and adults (N = 10,704) with permanent residence in Cochabamba, selected through a multistage sampling technique, from July 2015 to November 2016. An adapted version of the WHO STEPS survey was used to collect information. The prevalence of relevant behavioural risk factors and anthropometric measures were obtained. The socio-demographic variables included were age, ethnicity, level of education, occupation, place of residence, and marital status. Proportions with 95% confidence intervals were first calculated, and prevalence ratios were estimated for each CVD risk factor, both with crude and adjusted models. RESULTS: More than half (57.38%) were women, and the mean age was 37.89 ± 18 years. The prevalence of behavioural risk factors were: current smoking, 11.6%; current alcohol consumption, 42.76%; low consumption of fruits and vegetables, 76.73%; and low level of physical activity, 64.77%. The prevalence of overweight was 35.84%; obesity, 20.49%; waist risk or abdominal obesity, 54.13%; and raised blood pressure, 17.5%. Indigenous populations and those living in the Andean region showed in general a lower prevalence of most of the risk factors evaluated. CONCLUSION: We provide the first CVD risk factor profile of people living in Cochabamba, Bolivia, using a standardized methodology. Overall, findings suggest that the prevalence of CVD risk factors in Cochabamba is high. This result highlights the need for interventions to improve early diagnosis, monitoring, management, and especially prevention of these risk factors.

Alarming prevalence and clustering of modifiable noncommunicable disease risk factors among adults in Bhutan: a nationwide cross-sectional community survey.

BACKGROUND: Bhutan is currently facing a double burden of non-communicable (NCDs) and communicable diseases, with rising trends of NCDs. The 2014 STEPS survey identified high prevalence of several NCD risk factors; however, associations with socio-demographic characteristics as well as clustering of risk factors were not assessed. This study aimed to determine the distribution and clustering of modifiable NCD risk factors among adults in Bhutan and their demographic and social determinants. METHODS: This was secondary analysis of data from NCD Risk Factors WHO STEPS Survey 2014 in Bhutan. A weighted analysis was conducted to calculate the prevalence of NCD risk factors, and associations were explored using weighted log-binomial regression models. RESULTS: This study included 2822 Bhutanese aged 18-69 years; 52% were 18-39 years, 62% were female, and 69% were rural resident. Prevalence of high salt intake, unhealthy diet and tobacco use were 99, 67 and 25% respectively. Raised blood pressure was the commonest (36%) modifiable biological risk factor followed by overweight (33%). The median NCD risk factors per person was 3 (Inter Quartile Range: 2-4); 52.5%% had > = 3 risk factors. A statistically significant difference was found between male vs. female in alcohol consumption(aPR 0.71, 95% CI: 0.53-0.97), low physical activity(aPR 2.06, 95% CI: 1.54-2.75), impaired fasting glycaemia(aPR 1.24, 95% CI: 1.01-1.52), and being overweight(aPR 1.46, 95% CI: 1.31-1.63). Low physical activity was more common among those with secondary and above education level vs. those without any formal education(aPR 1.71, 95% CI: 1.24-2.35), and among those residing in urban areas vs. those in rural(aPR 3.43, 95% CI: 2.27-5.18). Older participants and urban residents were more likely to have > = 3 NCD risk factors compared to younger(aPR 1.46, 95% CI: 1.35-1.58) and rural residents(aPR 1.21, 95% CI: 1.10-1.32). CONCLUSION: Lifestyle modifications at the population level are urgently required in Bhutan as several NCD risk factors such as high salt intake, unhealthy diet, overweight, and high blood pressure were alarmingly high and frequently clustered. Moreover there is a need to consider policy and socio-political and economic factors that have undermined global and national progress to address the rise of NCDs and their risk factors in Bhutan as elsewhere.

Disparity in metabolic risk factors of non-communicable diseases between Palauans and Filipinos living in Palau.

Non-communicable diseases have been recognized as a serious threat to public health in Palau. To tackle the problem, different strategies might be necessary for populations with different ethnic backgrounds. This study aims to find the differences in the prevalence of metabolic risk factors of non-communicable diseases between Palauans and Filipinos living in Palau, and examine possible determinants of the differences. We selected data of 2,032 participants, including native Palauans and Filipinos, from the Palau STEPS Survey 2011-2013 for this study. Logistic regression models were used to inspect the association of each metabolic risk factor with ethnicity by calculating odds ratios adjusted for potential confounding factors. Palauans had higher age-standardized prevalence of overweight or obesity (84% vs. 45%), hypertension (50% vs. 38%) and diabetes (19% vs. 13%) than Filipinos. However, after adjusting for BMI and various lifestyle related factors, there are no statistical significant differences in the prevalence of hypertension and diabetes between these two ethnic groups. Palauan men were less likely to have elevated total cholesterol, especially after adjusting for BMI (odds ratio=0.55, 95% confidence interval: 0.33-0.91), while Palauan women were more likely to have elevated triglycerides than their Filipino counterparts (odds ratio=1.45, 95% confidence interval: 1.02-2.06). Our findings suggested that Palauans' higher BMI distribution might be able to explain their higher prevalence of hypertension and partially explain their higher diabetes prevalence. Palauans were not consistently more likely to have all metabolic risk factors, namely dyslipidemia were less likely to be observed in Palauan men.

Profile of non-communicable disease risk factors among adults in the Republic of Palau: findings of a national STEPS survey.

Palau, similar to other Pacific island countries, is currently highly burdened with non-communicable diseases (NCDs). The WHO STEPS was launched in 2011 to comprehensively survey indicators for NCDs in the country. This paper aims to describe the prevalence of key NCD risk factors assessed by the survey. The WHO instrument, including behavioral, physical and biochemical measurements, was adopted to the nationwide survey for all residents aged 25 to 64 years. A cluster-based sampling method was performed to obtain a national representative data. Valid data from 2,184 individuals were selected for the analyses, of which 75% were Palauans and 19% were Filipinos. Prevalence of current cigarette smoking was 25% in men and 10% in women. Betel nut chewing with tobacco was prevalent particularly among Palauans (58% in men, 69% in women) compared to the other ethnic groups. In terms of all types of tobacco use, 60% of men and 58% of women were current users. Overweight or obesity was very common among Palauans (84% in men, 86% in women) as well as Filipinos (52% in men, 40% in women). Hypertension was found in 55% of men and 49% of women, with the stage 2 hypertension being 21% and 19%, respectively. The prevalence of diabetic level hyperglycemia was more than 20%. Raised total cholesterol was detected in 16% of men and 20% of women. This survey revealed an alarmingly high prevalence of NCD risk factors, especially tobacco use, obesity, hypertension and raised blood glucose. The data would be useful baseline information to develop effective NCD strategies in Palau.

Risk factors for non-communicable diseases in Afghanistan: insights of the nationwide population-based survey in 2018.

BACKGROUND: Noncommunicable diseases (NCDs) account for a substantial number of deaths in Afghanistan. Understanding the prevalence and correlates of major NCD risk factors could provide a benchmark for future public health policies and programs to prevent and control NCDs. Therefore, this study aimed to examine the prevalence and correlates of NCD risk factors among adults aged 18-69 years in Afghanistan. METHODS: We used data from the Afghanistan STEPS Survey 2018. The study population were 3650 (1896 males and 1754 females) adults aged 18-69 years sampled from all 34 provinces through a multistage cluster sampling process. Information on behavioural and biological risk factors was collected. We used STATA (version 18.0) for data analysis. RESULTS: Of the total participants, 42.8% were overweight or obese, 8.6% were current smokers, 26.9% had insufficient physical activities, 82.6% had low consumption of fruits and vegetables, and only 0.5% had ever consumed alcohol. Approximately 15% of participants had a high salt intake, while 25% and 8% had elevated blood pressure and blood glucose levels, respectively. Similarly, around 18% had elevated total cholesterol. The study revealed a lower prevalence of current smoking among females [AOR = 0.17, 95%CI (0.09-0.30)] compared with males, but a higher prevalence in those who had higher education levels [1.95 (1.13-3.36)] compared with those with no formal education. Insufficient physical activity was higher in participants aged 45-69 years [1.96 (1.39-2.76)], females [4.21 (1.98-8.84)], and urban residents [2.38 (1.46-3.88)] but lower in those with higher education levels [0.60 (0.37-0.95)]. Participants in the 25th to 75th wealth percentiles had higher odds of low fruit and vegetable consumption [2.11 (1.39-3.21)], while those in the > 75th wealth percentile had lower odds of high salt intake [0.63 (0.41-0.98)]. Being overweight/obese was more prevalent in participants aged 45-69 years [1.47 (1.03-2.11)], females [1.42 (0.99-2.01)], currently married [3.56 (2.42-5.21)] or ever married [5.28 (2.76-10.11)], and urban residents [1.39 (1.04-1.86)]. Similarly, high waist circumference was more prevalent in participants aged 45-69 years [1.86 (1.21-2.86)], females [5.91 (4.36-8.00)], those being currently married [4.82 (3.12-7.46)], and those being in 25th to 75th wealth percentile [1.76 (1.27-2.43)]. A high prevalence of elevated blood pressure was observed in participants aged 45-69 years [3.60 (2.44-5.31)] and currently married [2.31 (1.24-4.31)] or ever married [6.13 (2.71-13.8)] participants. Elevated blood glucose was more prevalent in older adults ([1.92 (1.09-3.39)] for 45-69 and [3.45 (2.44-5.31)] for 30-44 years), urban residents [2.01 (1.33-3.03)], and ever-married participants [4.89 (1.48-16.2)]. A higher prevalence of elevated cholesterol was observed in females [2.68 (1.49-4.82)] and those currently married [2.57 (1.17-5.63)] or ever married [4.24 (1.31-13.73)]. CONCLUSION: This study used up-to-date available data from a nationally representative sample and identified the prevalence of NCDs and associated risk factors in Afghanistan. Our findings have the potential to inform and influence health policies by identifying people at high risk of developing NCDs and can assist policymakers, health managers, and clinicians to design and implement targeted health interventions.

A Comparative Study on the Prevalence of Lifestyle Risk Factors Among Users and Non-users of Any Health-Based Mobile App Among University Students in Chennai.

Introduction Adolescents and young adults are often neglected in terms of healthcare, despite forming a significant demographic and economic force. This study aims to compare the prevalence of lifestyle risk factors among users and non-users of health-based mobile apps among university students in Chennai. Methods This cross-sectional study was conducted from January 2019 to June 2019, with a sample size of 680 undergraduate college students. A standardized WHO STEPwise approach to noncommunicable disease (NCD) risk factor surveillance (WHO STEPS) questionnaire was used to collect data on sociodemographic features, behavioral risk factors, and mobile app usage, along with physical measurements like height, weight, waist circumference, and blood pressure. Results About 238 (35%) study participants were regularly using health-based mobile apps, and 442 (65%) were not using any health-based mobile apps, of which 540 (79.41%) were between 22 and 24 years old, with the majority being female (362, 53.2%). The prevalence of various risk factors was higher among non-users of mobile health apps, except for physical activity, which was similar in both groups. On adjusted multivariable analysis, age category, place of current stay, and unhealthy diet were found to be significant. Conclusion This study helps assess the efficacy of health-based mobile apps in promoting healthy lifestyles among university students. Health-based mobile apps for delivering effective healthcare services are to be promoted among college students for a healthy lifestyle and well-being.

Effectiveness of nurse-led intervention on weight reduction among adults in urban Puducherry - A randomized controlled pilot trial.

BACKGROUND: The recent spike in the incidence of type 2 diabetes is most likely caused by the obvious rise in the prevalence of overweight and obesity. The risk of developing noncommunicable illnesses can be prevented and reduced with even modest weight loss. This study was conducted with the aim of evaluating the effectiveness of a nurse-led intervention (NLI) strategy on weight reduction among adults in urban Puducherry. MATERIALS AND METHODS: A two-arm, parallel-group, randomized controlled study with an open label was conducted with obese adults in urban areas of Puducherry, namely Nesavalar colony and Govindanpet, from November 2022 to February 2023. Totally, 88 obese adults were randomized using a simple random sampling method to either the NLI arm or the general care (GC) arm. WHO STEPS (version 3.2) questionnaire was adopted to gather baseline and end line data. NLI arm participants received NLI and GC arm participants received GC from urban primary health center. In statistical analysis, the proportion was used to summarize categorical variables. The parametric and nonparametric tests were applied based on the variable type and normality of the data. Multiple linear regressions were used with outcome changes in weight in the NLI arm. RESULTS: At 16 weeks, the NLI arm lost a mean weight of - 2.58 kg and the GC arm gained 0.38 kg with a mean difference in weight of 2.96 between arms. A significant reduction was found (P < 0.001) in weight, waist circumference, body mass index, and also found significant improvement in cholesterol profile and thyroid stimulating hormone. CONCLUSION: This community-based NLI study is effective for weight reduction in urban Puducherry and it lowers the risk of developing noncommunicable diseases among adults. Due to the larger size of the geographical area and the more number of clusters, a stringent follow-up plan and extra manpower must be created for the main study.

Prevalence of clustering of non-communicable disease risk factors in a highly urbanized district of India: findings of a cross-sectional survey in Puducherry.

Background: In an individual, the development and severity of Non-Communicable Diseases (NCDs) are determined by the presence or absence of clustering of NCD risk factors in them. We aimed to determine the prevalence and the factors associated with clustering of risk factors of NCDs in the district of Puducherry in India. Methodology: We conducted a community-based cross-sectional survey among the adult population (18-69 years) of Puducherry district (N = 1114) between February 2019 and February 2020. Ten risk factors of NCDs (behavioral, physical measurements and biochemical) were assessed. Individuals having ≥ 3 risk factors were regarded as having clustering of risk factors. Categorical variables are summarized using proportions (95% CI). Adjusted prevalence ratio was estimated using weighted forward stepwise generalized linear modelling. Results: Clustering of NCD risk factors was present in majority (95.2%, 95% CI: 93.8-96.3) of the population. The presence of clustering was significantly higher among women (97.1%, 95% CI: 95.9-98.3) and the urban population (97.2%, 95% CI: 96.1-98.3). The risk factors that primarily drove the high prevalence of clustering were raised salt intake and inadequate intake for fruits and vegetables in nine out of 10 people in the district. Nearly 1 in 10 (13.3%, 95% CI: 11.3-15.3), 1 in 5 (21.5%, 95% CI: 19.1-23.8) and 1 in 4 (26.8%, 95% CI: 24.1-29.4) participants had three, four and five risk factors, respectively. Conclusion: We highlight the urgent need for population-based health promotion interventions in the district of Puducherry targeting the highly prevalent NCD risk factors, especially among the women and urban populations.

Effectiveness of multi-component modular intervention among adults with prehypertension in a village of Dakshina Kannada district - a community-based interventional study - protocol.

INTRODUCTION: The Joint National Committee (JNC 7) report on Prevention, Detection, Evaluation, and Treatment of Hypertension, defined "prehypertension," as individuals with a Systolic Blood Pressure (SBP) in the range of 120-139 mmHg and a (diastolic blood pressure) DBP of 80-89 mmHg. Prehypertension is directly linked with hypertension which is a precursor of CVDs. Owing to its high conversion rate to hypertension, it is important to identify individuals with blood pressures in this category and bring about lifestyle modifications in them that can prevent them from being hypertensive and from developing cardiovascular diseases later in life. METHODS: This randomized controlled trial will be done among the selected pre-hypertensive adults of all genders residing in Kateel Gram panchayat, Dakshina Kannada district, Karnataka. A baseline survey will be done initially to assess the level of prehypertension among the study population. To study the effectiveness of the intervention, 142 individuals will be randomly allocated using block randomization technique to intervention and control groups. A multi-component module (educational intervention) will be developed, validated, and administered to participants in the intervention group, while the control group receives standard care. Each participant will then be followed up once in four months till the end of the study period of one year to assess for changes in SBP, DBP, WHR, BMI, stress levels, and usage of tobacco and alcohol. ETHICS AND DISSEMINATION: Institutional Ethics Committee approval was obtained from Kasturba Medical College in Mangalore, India. The plans for dissemination of findings include presenting at scientific conferences and publishing in scholarly journals.

Diabetes Susceptibility Assessment Using the Indian Diabetes Risk Score: A Cross-Sectional Analytical Study on Young Medical Students in Chennai, South India.

Background Youth must identify their diabetes risk factors because the disease is currently affecting young people at an epidemic rate. The Indian Diabetes Risk Score (IDRS) is a reliable and affordable method for determining a person's risk of developing diabetes. This study aims to evaluate the ability of the IDRS to predict type 2 diabetes mellitus (T2DM) and investigate the relationship between diabetes risk and other variables in young medical students. Methodology In this cross-sectional analytical survey of a cohort of 670 undergraduate medical scholars over six months, a meticulously designed semi-structured questionnaire was administered. The questionnaire captured sociodemographic specifics, substance use habits (tobacco and alcohol), dietary patterns, and physical activity patterns in line with the WHO STEPwise approach to non-communicable disease risk factor surveillance and the IDRS tool. Results There was an equal proportion of males and females. The majority were in their second year of study. Overall, 5.2% of students reported tobacco use, while alcohol consumption was reported by 25.6% of the cohort. Furthermore, IDRS score insights revealed that 80.2% of the participants exhibited low diabetes risk, 18.9% were categorized as moderate risk, and 0.9% demonstrated high risk. Gender (adjusted prevalence ratio (PR) = 1.8, 95% confidence interval (CI) 1.3-2.7) and tobacco usage (adjusted PR = 1.6 (1.1 to 2.2)) were found to be significantly associated with higher IDRS scores on multivariable analysis. Conclusions Illuminating the landscape of risk determinants among medical students in Chennai, this study accentuates the pressing need for bespoke interventions, underpinned by behavioral change theories. Such strategies can potentially catalyze healthier lifestyle shifts, shaping favorable public health trajectories in the foreseeable future.

Prevalence and Predictors of Risk Factors for Noncommunicable Diseases among women in an Urbanized Village of India.

Background: The burden of noncommunicable diseases (NCDs) and their risk factors among the underprivileged women of the urban areas are expected to increase. The objective of the study was to estimate the prevalence and sociodemographic predictors of these risk factors. Materials and Methods: A cross-sectional study was conducted among 370 women between 25 and 64 years in an urbanized village of India. Risk factors for NCDs were assessed using the WHO STEPS instrument. To determine the sociodemographic predictors of these risk factors binary logistic regression was used. Results: The prevalence of tobacco consumption, physical inactivity, and insufficient fruit and vegetable intake, overweight, and obesity was found to be 18.3%, 61.6%, 96.5%, 27.6%, and 5.9%, respectively. Raised blood pressure, blood glucose, and cholesterol were found to be present in 23%, 22%, and 42%, respectively. Older age was found to be a significant predictor of tobacco consumption, physical inactivity, raised blood pressure, and raised blood glucose. Conclusion: The current study reported a high prevalence of physical inactivity and insufficient fruit and vegetable intake, with age being a significant predictor of the majority of risk factors. Thus, arises the need for programs and policies tailored toward addressing the local needs, targeted toward older women.

Profile of Non-communicable disease risk factors among nurses in a tertiary care hospital in South India.

PURPOSE: The work nature of nurses and the associated lifestyle changes put them at high risk of developing non-communicable diseases (NCDs). This study was conducted to estimate the prevalence of NCD risk factors among nurses working in a tertiary care hospital in Puducherry and to determine the associated factors among nurses. METHODS: We conducted a cross-sectional study among all nurses (N=1217) in the tertiary care hospital aged between 21 and 60 from May 2019 to April 2020. We assessed NCDs behavioral, physical and biochemical risk factors using a self-administered questionnaire. The adjusted prevalence ratio was calculated using a generalized linear regression model to determine factors associated with NCD risk factors. RESULTS: The response rate was 99% (1217/1229), and 77.5 % of the participants were women. Current tobacco use, and alcohol consumption were 1.5% (95% CI: 0.8-2.2) and 2.9% (95% CI: 2-3.9) respectively with significantly higher prevalence among men. Overweight or Obesity (BMI >23 kg/m2) was 77.7%, with a significantly higher prevalence among those aged ≥30 and married. Prevalence of hypertension was 14.4 % (95% CI: 12.5-16.4), and diabetes mellitus was 11.5 % (95% CI: 9.7-13.6) were significantly higher among those aged ≥50 years. One-third of nurses, 34.3% (95% CI: 31.6-37.1), had hypercholesterolemia, significantly higher among men. CONCLUSION: We found a high prevalence of various NCD risk factors among the nurses. We highlight the urgent need for initiating health promotion interventions, especially to improve intake of healthy diet and physical activity among nurses aged ≥30 years.

Prevalence and correlates of prehypertension and hypertension among adults in Delta State, Nigeria: a cross-sectional community-based study.

BACKGROUND: There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk. OBJECTIVE: To determine the prevalence, awareness and correlates of prehypertension and hypertension among adults in Delta State, Nigeria. METHODS: This was a cross-sectional study. We recruited adults aged ≥18 years from two communities in Delta State, Nigeria, using the multi-stage sampling technique. The study instrument was a modified WHO-STEPS questionnaire. Prehypertension and hypertension were defined using the JNC-7 criteria. Ethical approval was obtained before the recruitment of participants. RESULTS: Of the 852 adults studied, the mean (±SD) age was 42.64 (±16.07) years, females (55.9%) and urban dwellers (55.8%). The prevalence of prehypertension and hypertension were 42.5% and 29.3%, respectively; both were higher among urban dwellers. The peak age-group for prehypertension and hypertension were 25-34 and 35-44 years, respectively. Awareness of hypertension was low; 12.0% (102/852). Blood pressure category significantly correlated with age, body mass index, place of residence, level of education, employment status and fruit intake. CONCLUSION: The prevalence of prehypertension and hypertension in this study were high. Based on the premise that prehypertension is a precursor of hypertension and occurred more among youths, the higher prevalence of prehypertension gives an inkling to rising prevalence of hypertension. FUNDING: Nil.

An epidemiological evaluation of predictors of overweight and obesity in Garhwal region of Uttarakhand.

INTRODUCTION: Now a day, obesity has become a chronic disorder affecting the larger population than any other disease in the world, which made its presence felt first in the Northern Hemisphere, and has now taken a pandemic look affecting practically almost all the countries of the globe. METHOD: A cross sectional study with a sample size of 632 was carried out. Multistage stratified random sampling and "Kish" method was applied for selection of study area and selection of study subjects (21-60 years). WHO STEPS for NCD Risk Factor Surveillance, was used to gather the necessary data. Percentage, Chi square, & logistic regression analysis was done and significant level was taken at p < 0.05. RESULTS: As per Asia Pacific classification 16.0% & 33.4% of subjects while as per WHO classification 24.5% & 8.9% of subjects were found to be overweight and obese respectively. It was nearly 2 times higher in urban males. Central obesity was more commonly observed in urban subjects as compared to rural. At risk Waist hip ratio was recorded in 55.9% and high Weight height ratio was recorded in 66.8% of total subjects. All the predictors showed higher percentages in females of urban area and increased with the rise in age. CONCLUSION: The present study reveals that, there is high prevalence of overweight and obesity in the study population. Certainly, there has been a considerable shift in their dietary and lifestyle profile. there appears to be an urgent need to develop suitable health strategies as well as intervention programmes for combating the prevalence of overweight and obesity.