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1.
Nutrients ; 12(11)2020 Oct 30.
Article in English | MEDLINE | ID: mdl-33143309

ABSTRACT

Small Island Developing States (SIDS) have high and increasing rates of diet-related diseases. This situation is associated with a loss of food sovereignty and an increasing reliance on nutritionally poor food imports. A policy goal, therefore, is to improve local diets through improved local production of nutritious foods. Our aim in this study was to develop methods and collect preliminary data on the relationships between where people source their food, their socio-demographic characteristics and dietary quality in Fiji and Saint Vincent and the Grenadines (SVG) in order to inform further work towards this policy goal. We developed a toolkit of methods to collect individual-level data, including measures of dietary intake, food sources, socio-demographic and health indicators. Individuals aged ≥15 years were eligible to participate. From purposively sampled urban and rural areas, we recruited 186 individuals from 95 households in Fiji, and 147 individuals from 86 households in SVG. Descriptive statistics and multiple linear regression were used to investigate associations. The mean dietary diversity score, out of 10, was 3.7 (SD1.4) in Fiji and 3.8 (SD1.5) in SVG. In both settings, purchasing was the most common way of sourcing food. However, 68% (Fiji) and 45% (SVG) of participants regularly (>weekly) consumed their own produce, and 5% (Fiji) and 33% (SVG) regularly consumed borrowed/exchanged/bartered food. In regression models, independent positive associations with dietary diversity (DD) were: borrowing/exchanging/bartering food (ß = 0.73 (0.21, 1.25)); age (0.01 (0.00, 0.03)); and greater than primary education (0.44 (0.06, 0.82)). DD was negatively associated with small shop purchasing (-0.52 (95% CIs -0.91, -0.12)) and rural residence (-0.46 (-0.92, 0.00)). The findings highlight associations between dietary diversity and food sources and indicate avenues for further research to inform policy actions aimed at improving local food production and diet.


Subject(s)
Diet Surveys , Diet , Food , Islands , Nutrition Policy , Adolescent , Adult , Female , Fiji/epidemiology , Geography , Health , Humans , Hypertension/epidemiology , Male , Multivariate Analysis , Obesity/epidemiology , Saint Vincent and the Grenadines/epidemiology , Young Adult
2.
J Clin Hypertens (Greenwich) ; 21(6): 710-721, 2019 06.
Article in English | MEDLINE | ID: mdl-31033166

ABSTRACT

The Global Burden of Disease (GBD) 2010 study estimated national salt intake for 187 countries based on data available up to 2010. The purpose of this review was to identify studies that have measured salt intake in a nationally representative population using the 24-hour urine collection method since 2010, with a view to updating evidence on population salt intake globally. Studies published from January 2011 to September 2018 were searched for from MEDLINE, Scopus, and Embase databases using relevant terms. Studies that provided nationally representative estimates of salt intake among the healthy adult population based on the 24-hour urine collection were included. Measured salt intake was extracted and compared with the GBD estimates. Of the 115 identified studies assessed for eligibility, 13 studies were included: Four studies were from Europe, and one each from the United States, Canada, Benin, India, Samoa, Fiji, Barbados, Australia, and New Zealand. Mean daily salt intake ranged from 6.75 g/d in Barbados to 10.66 g/d in Portugal. Measured mean population salt intake in Italy, England, Canada, and Barbados was lower, and in Fiji, Samoa, and Benin was higher, in recent surveys compared to the GBD 2010 estimates. Despite global targets to reduce population salt intake, only 13 countries have published nationally representative salt intake data since the GBD 2010 study. In all countries, salt intake levels remain higher than the World Health Organization's recommendation, highlighting the need for additional global efforts to lower salt intake and monitor salt reduction strategies.


Subject(s)
Feeding Behavior/ethnology , Global Burden of Disease/statistics & numerical data , Hypertension/prevention & control , Sodium Chloride, Dietary/urine , Urine Specimen Collection/methods , Adult , Aged , Aged, 80 and over , Australia/epidemiology , Barbados/epidemiology , Benin/epidemiology , Canada/epidemiology , Europe/epidemiology , Feeding Behavior/psychology , Female , Fiji/epidemiology , Humans , Hypertension/epidemiology , Hypertension/physiopathology , India/epidemiology , Male , Middle Aged , New Zealand/epidemiology , Samoa/epidemiology , Sodium Chloride, Dietary/adverse effects , United States/epidemiology , World Health Organization
3.
Hypertension ; 69(4): 705-711, 2017 04.
Article in English | MEDLINE | ID: mdl-28167685

ABSTRACT

The hypertensive disorders of pregnancy are leading causes of maternal mortality and morbidity, especially in low- and middle-income countries. Early identification of women with preeclampsia and other hypertensive disorders of pregnancy at high risk of complications will aid in reducing this health burden. The fullPIERS model (Preeclampsia Integrated Estimate of Risk) was developed for predicting adverse maternal outcomes from preeclampsia using data from tertiary centers in high-income countries and uses maternal demographics, signs, symptoms, and laboratory tests as predictors. We aimed to assess the validity of the fullPIERS model in women with the hypertensive disorders of pregnancy in low-resourced hospital settings. Using miniPIERS data collected on women admitted with hypertensive disorders of pregnancy between July 2008 and March 2012 in 7 hospitals in 5 low- and middle-income countries, the predicted probability of developing an adverse maternal outcome was calculated for each woman using the fullPIERS equation. Missing predictor values were imputed using multivariate imputation by chained equations. The performance of the model was evaluated for discrimination, calibration, and stratification capacity.Among 757 women with complete predictor data (complete-case analyses), the fullPIERS model had a good area under the receiver-operating characteristic curve of 0.77 (95% confidence interval, 0.72-0.82) with poor calibration (P<0·001 for the Hosmer-Lemeshow goodness-of-fit test). Performance as a rule-in tool was moderate (likelihood ratio: 5.9; 95% confidence interval, 4.23-8.35) for women with ≥30% predicted probability of an adverse outcome. The fullPIERS model may be used in low-resourced setting hospitals to identify women with hypertensive disorders of pregnancy at high risk of adverse maternal outcomes in need of immediate interventions.


Subject(s)
Hypertension, Pregnancy-Induced/epidemiology , Income , Risk Assessment/methods , Adult , Brazil/epidemiology , Female , Fiji/epidemiology , Follow-Up Studies , Humans , Morbidity/trends , Pakistan/epidemiology , Pregnancy , Pregnancy Outcome , Prognosis , ROC Curve , Retrospective Studies , Risk Factors , South Africa/epidemiology , Survival Rate/trends , Uganda/epidemiology , Young Adult
4.
Australas Psychiatry ; 23(6): 667-9, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26139700

ABSTRACT

OBJECTIVE: We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. METHOD: Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. RESULTS: The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. CONCLUSIONS: The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure.


Subject(s)
Anxiety , Depression , Mental Health Services/organization & administration , Adolescent , Adult , Aged , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/therapy , Child , Depression/diagnosis , Depression/epidemiology , Depression/therapy , Female , Fiji/epidemiology , Health Services Accessibility , Humans , Male , Mental Health/ethnology , Mental Health/statistics & numerical data , Middle Aged , Prevalence , Rural Population/statistics & numerical data
5.
Nutr Health ; 7(2): 89-100, 1991.
Article in English | MEDLINE | ID: mdl-1645463

ABSTRACT

It has been suggested that boron deficiency in food may be a cause of some arthritis (Newnham 1979). Epidemiological studies were done to try to ascertain why some countries have more or less arthritis than other countries. Jamaica, Mauritius, Fiji and Israel were visited with a view to ascertaining the boron levels of locally consumed food as it was suspected that excessive use of soluble chemical fertilizers had damaged the soils of the sugar producing lands. Food grown on these soils were found to have low boron levels. By contrast the foods consumed in Israel had high boron concentrations associated with a low incidence of arthritis. South African work has shown that people who eat mostly maize have more arthritis when eating processed maize grown with fertilizer. Brief reference is made to the role of boron in human diets. There are bound to be geographical differences in dietary boron, but even in the USA levels have dropped considerably in 50 years. Arthritis is increasing, especially juvenile arthritis. The increased use of fertilizers and genetic selection of plants has led to a wide range of changes in the quality of foodstuffs and their nutrient content. The identification of the parallel loss of boron may reflect vital changes in trace elements and other nutrients.


Subject(s)
Arthritis/epidemiology , Arthritis/etiology , Boron/deficiency , Fertilizers/adverse effects , Agriculture/methods , Australia/epidemiology , Fiji/epidemiology , Humans , Incidence , Israel/epidemiology , Jamaica/epidemiology , Mauritius/epidemiology , New Zealand/epidemiology , South Africa/epidemiology , United States/epidemiology , Zea mays/analysis
6.
Nutr Health ; 7(2): 89-100, 1991.
Article in English | MedCarib | ID: med-8218

ABSTRACT

It has been suggested that boron deficiency in food may be a cause of some arthritis (Newnham 1979). Epidemiological studies were done to try to ascertain why some countries have more or less arthritis than other countries. Jamaica, Mauritius, Fiji and Israel were visited with a view to ascertaining the boron levels of locally consumed food as it was suspected that excessive use of soluble chemical fertilizers had damaged the soils of the sugar producing lands. Food grown on these soils were found to have low boron level. By contrast the food consumed in Isreal had high boron concentrations associated with a low incidence of arthritis. South African work has shown that people who eat mostly maize have more arthritis when eating processed maize grown with fertilizer. Brief references is made to the role of boron in human diets. There are bound to be geographical differences in dietary boron, but even in the USA levels have dropped considerably in 50 years. Arthritis is increasing, especially juvenile arthritis. The increased use of fertilizers and genetic selection of plants has led to a wide range of changes in the quality of foodstuffs and their nutrient content. The identification of the parallel loss of boron may reflect vital changes in trace elements and other nutrients (AU)


Subject(s)
Arthritis/epidemiology , Arthritis/etiology , Boron/deficiency , Fertilizers/adverse effects , Agriculture/methods , Australia/epidemiology , Zea mays/analysis , Fiji/epidemiology , Incidence , Israel/epidemiology , Jamaica/epidemiology , Mauritius/epidemiology , New Zealand/epidemiology , South Africa/epidemiology , United States/epidemiology
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