Physical Activity Tracking Among Sri Lankan Adults: Findings From a 7-Year Follow-up of the Ragama Health Study.

Limited data are available on physical activity tracking among adults in low- and middle-income countries. Using a longitudinal design, we assessed trends and correlates of physical activity among Sri Lankan adults. Individuals selected through age-stratified random sampling, were screened initially in 2007 (n = 2986) and reevaluated in 2014 (n = 2148). On both occasions, structured interviews and clinical measurements were completed. Approximately 40% of the participants engaged in recommended levels of physical activity both at baseline and follow-up. One-fifth reported increased physical activity at follow-up, a similar proportion reported being persistently inactive or a reduction in physical activity. In the adjusted analysis, being persistently active was associated with male sex, a lower educational level and income, being free of any chronic disease conditions, better self-rated health, and sitting time <8 hours. Our findings support public health interventions to help maintain recommended physical activity levels over time, particularly for subgroups at high-risk of physical inactivity.

Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study.

OBJECTIVE: To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. DESIGN: A prospective population-based cohort study. SETTING: Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. PARTICIPANTS: Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. MEASURES: At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. RESULTS: There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. CONCLUSIONS: Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.

Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka.

OBJECTIVE: To assess the micronutrient status and its relationship with nutritional status in preschool children. METHODS: In a cross sectional study, anthropometric data and fasting blood samples were obtained from 340 children attending preschool in urban Sri Lanka. Serum concentrations of vitamin D, parathyroid hormone, vitamin A, zinc and haemoglobin were measured. Z-scores of anthropometric indices of height-for-age, weight-for-age and weight-for-height were computed to evaluate the nutritional status. RESULTS: Prevalence of stunting, underweight, wasting and anaemia among children were 7.1%, 16.9%, 21.2% and 7.4%, respectively. Deficiencies of zinc and vitamin A occurred among 67% and 38% of children, respectively. Vitamin D deficiency (<10 ng/mL) and insufficiency (10-20 ng/mL) occurred in 5.0% and 29.1% of children, respectively, and12% had parathyroid hormone levels indicative of hypocalcaemia. Nutritional status was significantly correlated (p<0.05) with vitamin D status [height-for-age (r=0.10), weight-for-age (r=-0.18), weight-for-height (r=-0.12)], and with haemoglobin status [weight-for-age (r=0.11)]. Zinc and vitamin A levels were lower in severe stunting compared with normal height (p<0.05). Significant correlations (p<0.05) were observed between vitamin D and parathyroid hormone (r=-0.12) and between haemoglobin and vitamin A (r=0.01), zinc (r=0.02) and vitamin D (r=0.02) levels. CONCLUSIONS: In the surveyed population, zinc deficiency was high and to a lesser degree vitamin A deficiency and vitamin D insufficiency prevailed. The nutritional status of the children was related to vitamin D status and with haemoglobin status. Zinc and vitamin A levels were low in children with severe stunting. Vitamins A, D and zinc levels were associated with haemoglobin status.

Erythrocyte antioxidant enzymes in patients with cataract.

The pathogenesis of cataract has been found to be influenced by a number of factors including oxidative stress. Catalase, glutathione peroxidase (GPX), and superoxide dismutase (SOD) are some of the antioxidant enzymes that protect the body from oxidative damage. The present study investigates the activities of erythrocyte catalase, GPX, and SOD with respect to senile cataract (non-diabetic cataract) and osmotic cataract (diabetic cataract) in a Sri Lankan population. One hundred and two non-diabetic subjects (50 with cataract and 52 non-cataract) and 106 diabetic subjects (56 with cataract and 50 non-cataract) were recruited into the study. Erythrocyte catalase, GPX, and SOD activities were assayed and the data were analysed by t-test (p <0.05 for significance). In the non-diabetic group, significantly low levels of catalase, GPX, and SOD activities were associated with cataract when compared with non-cataract. No significant changes in catalase, GPX, and SOD activities were observed in the diabetic group between cataract and non-cataract. Senile cataract (non-diabetic cataract) was associated with significantly low levels of erythrocyte catalase, GPX, and SOD when compared with osmotic cataract (diabetic cataract). Positive correlations were observed between catalase and SOD (r = 0.75), catalase and GPX (r = 0.63), and SOD and GPX (r = 0.59) in subjects with senile cataracts. Our results indicate that erythrocyte antioxidant enzyme levels are decreased in senile cataract as opposed to osmotic cataract. Assays of these erythrocyte enzyme activities could provide a marker to identify individuals predisposed to senile cataract.