Review: Type 2 diabetes in Latin America and the Caribbean: Regional and country comparison on prevalence, trends, costs and expanded prevention.

PURPOSE: To present an overview of type 2 diabetes status in Latin America and the Caribbean region. METHODS: The data were collected from the International Diabetes Federation Atlas and other available published sources where we identified the prevalence in Latin America and the Caribbean, the trends by regions, and sex. Also, we summarized the type 2 diabetes direct and indirect costs, and the current preventative programs and policies available for each region. RESULTS: Latin America and the Caribbean has one of the fastest-growing prevalence of type 2 diabetes, in particular the Caribbean region. Costs are relatively high in Central American countries and the Caribbean Islands. Currently, type 2 diabetes prevention, diagnosis, and management are insufficient in Latin America and the Caribbean and they do not offer a multidisciplinary integrative approach. CONCLUSION: Effective and preventive multidisciplinary policies should be implemented in Latin America and the Caribbean to decrease the high burden of type 2 diabetes.

Perceived weight gain, risk, and nutrition in pregnancy in five racial groups.

OBJECTIVE: Examine perceived pregnancy weight gain needed, perceived risks to mother, and infant of excessive weight and underweight, perceptions of actual, ideal, realistic body size, nutritional intake in five racial/ethnic groups. DESIGN: Cross-sectional Setting: Physicians' offices Participants: A total of 54 women <20 weeks gestation. METHODS: Questionnaires-perceived weight gain needed, risks of weight gain for mother, infant, perceptions of body size, food frequency. RESULTS: A total of 39% of women are overweight or obese (57% Caribbean Black, 50% African American). Perceived pregnancy weight gain needed highest in Central American Hispanic women, lowest Caribbean Black women. African-American women had low perceived risk for mother and infant of gaining too much pregnancy weight, highest perceived risk for both of gaining too little. Caribbean Black women perceived highest risk to mother of gaining too much pregnancy weight, highest risk to infant of gaining too little. White Non-Hispanic women reported smaller prepregnant, ideal, realistic body sizes than other four groups. Daily caloric intake ranged from 599 to 5856 calories. African-American women had significantly more calories; protein, total fats, monounsaturated, polyunsaturated, and saturated fats; carbohydrates, sugar; and iron than White Non-Hispanic women. Women in each racial/ethnic group had less than recommended intake of protein, carbohydrates, calcium, iron, folate, and fiber. CONCLUSIONS: Education is needed to raise awareness of risks of prepregnancy weight and excessive weight gain for mother and infant. The need for prenatal nutritional counseling to reduce the intake of calories, fats, sweets, and snacks; increase intake of vegetables, fruits, foods with iron, folate, and fiber.

Which college students are at higher health risk?

An electronic health risk appraisal was used to determine which demographic factors were associated with higher health risk among college students at an urban state university. Students' real age was assessed as the primary indicator of health risk and it was associated to demographic characteristics. Real age represents the physiological age of the body based on lifestyle choices, and this is often different to chronological age. Approximately 26.0% of 576 students were more than 5 years older than their chronological age, 29.8% were 0 to 5 years older, 29.8% were 0 to 5 years younger, and 14.1% were more than 5 years younger than their chronological age. Students who were male, Black, and nonnutrition majors had significantly higher positive real age differentials: their bodies were more likely to be more than 5 years older than their chronological age. Students with significantly lower negative real age differential--those whose real age was lower than their chronological age--were female and nutrition majors. Students were significantly more likely to report that they were "very motivated" if they were female (88.6%), compared with male (66.7%). These data suggest that when health disparities are assessed at the level of real age differential and motivation to make lifestyle changes, male Black college students are at highest health risk and they are less likely to be "very motivated" to make lifestyle changes than their peers.

Emerging evidence of the effectiveness of nutrition services

Despite lack of uniformity of data, emerging evidence of the effictiveness of nutrition services in outpatient services , prenatal services, among diabetic and hypertensive patients indicate that nutrition services can lead to dietary change and subsequently to improved health outcomes and ultimately to decreased health care costs

Emerging evidence of the effectiveness of nutrition services

Despite lack of uniformity of data, emerging evidence of the effictiveness of nutrition services in outpatient services , prenatal services, among diabetic and hypertensive patients indicate that nutrition services can lead to dietary change and subsequently to improved health outcomes and ultimately to decreased health care costs

Jamaican service club members beliefs about some chronic diseases (Part II) - abstract

This survey sets out to examine Jamaican Service Club members' beliefs about prevention strategies for hypertension, hypercholesterolemia and obesity; the prevalence of modifiable risk factors and to estimate self-reported cardiovascular risk. Kiwanis, Lions and Rotary Club members completed questionnaires which assessed their knowledge of specific strategies to prevent hypertension, hypercholesterolemia and obesity. Service clubs in Kingston, Jamaica were sampled at their regular monthly meetings. Among the 320 members, 253 were males, 67 were females and the majority (61.4 per cent) of respondents had attended university. Respondents demonstrated moderate to high accuracy in their ability to identify prevention strategies for hypertension, hypercholesterolemia and obesity. The majority of respondents (85.9 per cent) reported normal blood pressure levels, and a non-smoking habit (84.8 per cent). However, as many as 31.8 per cent of respondents indicated that their blood cholesterol levels had never been measured. More females (49.3 per cent) than males (27.0 per cent) had never measured their blood cholesterol level. Despite widespread awareness of the importance of exercise for decreasing the risk of hypertension, hypercholesterolemia and obesity, only 36.7 per cent of males and 27.3 per cent of females participated in aerobic activity three times a week. Since exercise appears to be the limiting factor for improving cardiovascular health, programme planners who seek to improve cardiovascular health among service club members need to offer effective strategies for translating individuals' knowledge about the importance of exercise into a personal fitness programme. The highest cardiovascular risk score was derived by those who never participated in aerobic exercise (1.13), compared to those who exercised three times a week (.66). Maximum cardiovascular score was 3.5, minimum 0.0. Those who had attempted to lose weight within six months of the survey (1.00) had a significantly higher risk score than those who had never attempted weight loss (.56) (p<.05), suggesting that chronic dieters were largely unsuccessful at achieving permanent weight loss. Females (.93) had a higher cardiovascular risk compared to males (.77), although the difference was not statistically significant. History of attempted weight loss and aerobic exercise were the only significant predictors of cardiovascular risk (AU)

Jamaican service club members beliefs about some chronic diseases (Part II) - abstract

This survey sets out to examine Jamaican Service Club members' beliefs about prevention strategies for hypertension, hypercholesterolemia and obesity; the prevalence of modifiable risk factors and to estimate self-reported cardiovascular risk. Kiwanis, Lions and Rotary Club members completed questionnaires which assessed their knowledge of specific strategies to prevent hypertension, hypercholesterolemia and obesity. Service clubs in Kingston, Jamaica were sampled at their regular monthly meetings. Among the 320 members, 253 were males, 67 were females and the majority (61.4 per cent) of respondents had attended university. Respondents demonstrated moderate to high accuracy in their ability to identify prevention strategies for hypertension, hypercholesterolemia and obesity. The majority of respondents (85.9 per cent) reported normal blood pressure levels, and a non-smoking habit (84.8 per cent). However, as many as 31.8 per cent of respondents indicated that their blood cholesterol levels had never been measured. More females (49.3 per cent) than males (27.0 per cent) had never measured their blood cholesterol level. Despite widespread awareness of the importance of exercise for decreasing the risk of hypertension, hypercholesterolemia and obesity, only 36.7 per cent of males and 27.3 per cent of females participated in aerobic activity three times a week. Since exercise appears to be the limiting factor for improving cardiovascular health, programme planners who seek to improve cardiovascular health among service club members need to offer effective strategies for translating individuals' knowledge about the importance of exercise into a personal fitness programme. The highest cardiovascular risk score was derived by those who never participated in aerobic exercise (1.13), compared to those who exercised three times a week (.66). Maximum cardiovascular score was 3.5, minimum 0.0. Those who had attempted to lose weight within six months of the survey (1.00) had a significantly higher risk score than those who had never attempted weight loss (.56) (p<.05), suggesting that chronic dieters were largely unsuccessful at achieving permanent weight loss. Females (.93) had a higher cardiovascular risk compared to males (.77), although the difference was not statistically significant. History of attempted weight loss and aerobic exercise were the only significant predictors of cardiovascular risk

Difficulties in assessing drug/food interactions from chart audit in an elderly Barbadian sample group

The aim of this study was to examine the prevalence of potential drug/food interactions among 290 elderly Barbadian outpatients. These findings indicate that chart audit is insensitive to definite interactions but was able to detect the prevalence of potential interactions (1.38 per outpatient). The risk of potential interaction was significantly higher among outpatients who were older, female, and those who used a larger number of prescribed medications. There were no significant differences in the prevalence of potential interactions among diabetics and nondiabetics. The findings indicate that the absence of relevant data on patients'symptoms, and anthropometric and laboratory measures in more than 80 percent of patients' charts makes it impossible to assess the prevalence of definite drug/food interactions from chart audit. Weight changes, nutrient levels, and symptoms were the most frequently missing data. Chart audit is therefore an invalid and unreliavle approach to estimate definite drug/food medications (AU)

Jamaican fast food consumption patterns

Household interviews were conducted with a nationally representative quota sample of 948 rural and urban Jamaicans to examine attitudes to fast food restautants and fast food eating patterns; and how those attitudes and patterns vary by age, location, social class and gender. The most popular fast food restaurant was Kentucky Fried Chicken, which was twice more favoured as its closest rival Mothers', followed by Tastee Patties. Professionals were more likely to patronize Burger King than unskilled persons. Kentucky Fried Chicken was rated as the most expensive fast food restaurant as well as the fast food restaurant offering the fastest service; serving the tastiest, and best quality food. the most popular fast food was fried chicken, twice as popular as traditional Jamaican patties (cresent-shaped pastry shells filled with a green leafy vegetable, vegetables, or ground beef), followed by hamburgers and cheeseburgers. Regarding frequency of visits to fast food restaurants, 20.2 percent of respondents had visited fast food restaurants once in the three-month period prior to the interview. Approximately 29.2 percent had patronized fast food restaurants between two-to-five times, and 19.8 percent had not visited a fast food restaurant within the last three-months. Males were more likely than females to patronize fast food restaurants on a regular basis (AU)

Jamaican fast food consumption patterns

Household interviews were conducted with a nationally representative quota sample of 948 rural and urban Jamaicans to examine attitudes to fast food restautants and fast food eating patterns; and how those attitudes and patterns vary by age, location, social class and gender. The most popular fast food restaurant was Kentucky Fried Chicken, which was twice more favoured as its closest rival Mothers', followed by Tastee Patties. Professionals were more likely to patronize Burger King than unskilled persons. Kentucky Fried Chicken was rated as the most expensive fast food restaurant as well as the fast food restaurant offering the fastest service; serving the tastiest, and best quality food. the most popular fast food was fried chicken, twice as popular as traditional Jamaican patties (cresent-shaped pastry shells filled with a green leafy vegetable, vegetables, or ground beef), followed by hamburgers and cheeseburgers. Regarding frequency of visits to fast food restaurants, 20.2 percent of respondents had visited fast food restaurants once in the three-month period prior to the interview. Approximately 29.2 percent had patronized fast food restaurants between two-to-five times, and 19.8 percent had not visited a fast food restaurant within the last three-months. Males were more likely than females to patronize fast food restaurants on a regular basis

A nutrition education model for chronic conditions in group settings

The ultimate objective of nutrition education for diet-related diseases is lifelong dietary changes and this can be achieved only with the voluntary cooperation of the consumer. It is the responsibility of nutrition professionals to employ strategies that actively involve participants in the educational process and give regular feedback. The Self-Check, Group Check model approach is one such strategy, which is recommended for nutrition professionals who are willing but unable to devote maximal effort and resources to the development of effective nutrition education approaches