Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Eur J Epidemiol ; 34(10): 917-926, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31392470

RESUMO

The aim of our study was to assess the association between green tea consumption and all-cause and cause-specific mortality in a pooled analysis of eight Japanese population-based cohort studies. Pooled hazard ratios (HR) and 95% confidence intervals (CI), derived from random effects models, were used to evaluate the associations between green tea consumption, based on self-report at baseline, and risk of all-cause and cause-specific mortality. During a mean follow-up of 17.3 years, among 313,381 persons, 52,943 deaths occurred. Compared with individuals who consumed < 1 cup/day, those in the highest consumption category (≥ 5 cups/day) had a decreased risk of all-cause mortality [the multivariate-adjusted HR was 0.90 (95% CI 0.87-0.94) for men and 0.82 (0.74-0.90) for women]. A similar inverse association was observed for heart disease mortality [HR 0.82 (0.75-0.90) for men, and 0.75 (0.68-0.84) for women], and cerebrovascular disease mortality [HR 0.76 (0.68-0.85) for men, and 0.78 (0.68-0.89) for women]. Among women, green tea consumption was associated with decreased risk of total cancer mortality: 0.89 (0.83-0.96) for the 1-2 cups/day category and 0.91 (0.85-0.98) for the 3-4 cups/day category. Results for respiratory disease mortality were [HR 0.75 (0.61-0.94)] among 3-4 cup daily consumers and [HR 0.66 (0.55-0.79)] for ≥ 5 cups/day. Higher consumption of green tea is associated with lower risk for all-cause mortality in Japanese, especially for heart and cerebrovascular disease. Moderate consumption decreased the risk of total cancer and respiratory disease mortality in women.


Assuntos
Causas de Morte , Mortalidade , Neoplasias/etiologia , Chá , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/mortalidade , Estudos de Coortes , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Neoplasias/epidemiologia , Estudos Prospectivos , Doenças Respiratórias/mortalidade , Fatores de Risco , Fatores Sexuais
2.
Prev Med ; 123: 270-277, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30951734

RESUMO

Coffee consumption is increasing globally. We aimed to assess the effect of coffee consumption on the risk of all-cause and cause-specific mortality in a pooled analysis of eight population-based cohort studies in Japan (Japan Cohort Consortium). Data came from eight Japanese cohort studies (144,750 men and 168,631 women). During a mean follow-up time of 17 years, 52,943 deaths occurred. More specifically, 19,495 cancer deaths, 7321 deaths due to heart disease, 6387 cerebrovascular, 3490 respiratory disease and 3382 injuries and accidents. A random effects model was applied to obtain pooled hazard ratios (HRs) and 95% confidence intervals (95%CIs). In both sexes, coffee consumption up to 5 cups/day was overall protective in relation to all-cause mortality, with the association attenuating in the highest category of coffee consumption (≥5 cups/day). In men, a similar inverse association was observed for major causes of mortality except cancer. In women, coffee consumption decreased the risk for mortality due to heart disease in the 1-2 cups/day category, but increased the risk in the ≥5 cups/day category. Coffee consumption was not associated with cancer in both sexes. Results were similar among male current smokers and female never-smokers. Based on available data, this pooled analysis suggests that coffee consumption under five cups per day may be beneficial for reducing the risk of mortality due to major causes.

4.
Bull World Health Organ ; 96(5): 355-359, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29875520

RESUMO

Problem: If universal health coverage (UHC) is to be achieved globally, it needs sustained promotion and political awareness and support. Approach: During its presidency of the Group of Seven (G7) industrialized nations in 2016, Japan aimed to raise the issue of UHC to the top of the global health agenda. Local setting: Japan has promoted a health agenda at all of the G7 summits since 2000 that it has hosted. Human security has been the core foundation of Japan's foreign diplomacy for several decades and, consequently, there was no apparent opposition within Japan to the inclusion of UHC on the agenda of the summit in 2016. Other G7 governments appeared keen to promote such coverage. Relevant changes: Since the 2016 summit, UHC has remained a central agenda item for the United Nations and World Health Organization, even though the leaders of both these global organizations have changed. In 2017, Japan hosted the UHC Forum in Tokyo. The participants, who were the heads of United Nations agencies, politicians and other decision-makers from all over the world, showed their continued commitment towards UHC. Lessons learnt: In the raising of awareness of an item on the global health agenda, high-level champions are critical. Although they may be very diverse, all relevant stakeholders need to be connected and allowed to discuss policies with each other. Having too many allies can, however, lead to policy fragmentation, especially when there is commitment from the highest echelons within each country.


Assuntos
Saúde Global , Política , Cobertura Universal do Seguro de Saúde , Humanos , Japão , Nações Unidas , Organização Mundial da Saúde
5.
JAMA Intern Med ; 177(9): 1297-1305, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28759681

RESUMO

Importance: Achieving universal health coverage is one of the key targets in the newly adopted Sustainable Development Goals of the United Nations. Objective: To investigate progress toward universal health coverage in 5 South Asian countries and assess inequalities in health services and financial risk protection indicators. Design and Settings: In a population-based study, nationally representative household (335 373 households) survey data from Afghanistan (2014 and 2015), Bangladesh (2010 and 2014), India (2012 and 2014), Nepal (2014 and 2015), and Pakistan (2014) were used to calculate relative indices of health coverage, financial risk protection, and inequality in coverage among wealth quintiles. The study was conducted from June 2012 to February 2016. Main Outcomes and Measures: Three dimensions of universal health coverage were assessed: access to basic services, financial risk protection, and equity. Composite and indicator-specific coverage rates, stratified by wealth quintiles, were then estimated. Slope and relative index of inequality were used to assess inequalities in service and financial indicators. Results: Access to basic care varied substantially across all South Asian countries, with mean rates of overall prevention coverage and treatment coverage of 53.0% (95% CI, 42.2%-63.6%) and 51.2% (95% CI, 45.2%-57.1%) in Afghanistan, 76.5% (95% CI, 61.0%-89.0%) and 44.8% (95% CI, 37.1%-52.5%) in Bangladesh, 74.2% (95% CI, 57.0%-88.1%) and 83.5% (95% CI, 54.4%-99.1%) in India, 76.8% (95% CI, 66.5%-85.7%) and 57.8% (95% CI, 50.1%-65.4%) in Nepal, and 69.8% (95% CI, 58.3%-80.2%) and 50.4% (95% CI, 37.1%-63.6%) in Pakistan. Financial risk protection was generally low, with 15.3% (95% CI, 14.7%-16.0%) of respondents in Afghanistan, 15.8% (95% CI, 14.9%-16.8%) in Bangladesh, 17.9% (95% CI, 17.7%-18.2%) in India, 11.8% (95% CI, 11.8%-11.9%) in Nepal, and 4.4% (95% CI, 4.0%-4.9%) in Pakistan reporting incurred catastrophic payments due to health care costs. Access to at least 4 antenatal care visits, institutional delivery, and presence of skilled attendant during delivery were at least 3 times higher among the wealthiest mothers in Afghanistan, Bangladesh, Nepal, and Pakistan compared with the rates among poor mothers. Access to institutional delivery was 60 to 65 percentage points higher among wealthy than poor mothers in Afghanistan, Bangladesh, Nepal, and Pakistan compared with 21 percentage points higher in India. Coverage was least equitable among the countries for adequate sanitation, institutional delivery, and the presence of skilled birth attendants. Conclusions and Relevance: Health coverage and financial risk protection was low, and inequality in access to health care remains a serious issue for these South Asian countries. Greater progress is needed to improve treatment and preventive services and financial security.


Assuntos
Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Participação no Risco Financeiro , Cobertura Universal do Seguro de Saúde/organização & administração , Ásia Ocidental/epidemiologia , Gastos em Saúde , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Determinação de Necessidades de Cuidados de Saúde , Indicadores de Qualidade em Assistência à Saúde , Participação no Risco Financeiro/métodos , Participação no Risco Financeiro/organização & administração
6.
Health Syst Reform ; 3(4): 268-277, 2017 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-30359179

RESUMO

Abstract-For the past decades Japan has remained number one in a range of population health metrics including the world's longest healthy life expectancy. While this was achieved through various socioeconomic factors besides public health interventions, health promotion policies to prevent and control non-communicable diseases (NCDs) played a major role. Japan introduced its first comprehensive national plan to prevent and control NCDs in 1978 and has revised the plan every decade since. These 10-year policy packages were instrumental in galvanizing stakeholders, while adapting to changing social, behavioral, and epidemiological trends. In this article, we provide an overview of trends in policy on the prevention and control of NCDs in Japan with a focus on successes and challenges especially due to a rapidly aging population. Through this review we aim to share the lessons learned in Japan for other countries tackling or expecting to be challenged by NCDs. These lessons include the role of multisectoral approaches, clear goals and targets with effective monitoring and evaluation mechanisms, addressing social aspects, adjustment to the local context, and foreseeing future demographic transition. Japan is committed to contributing to the world as a forerunner of the health challenges posed by unprecedented demographic change, by sharing its lessons in the global quest to create a world where all people can live longer and healthier lives.

7.
Cancer Causes Control ; 27(4): 583-93, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26960926

RESUMO

PURPOSE: The aim of this study was for the first time to assess the association between glycemic index (GI), glycemic load (GL), and colorectal cancer using a prospective Japanese population-based cohort. METHODS: In our study participants aged 40-69 at baseline of the Japan Public Health Center-based prospective Study (JPHC Study) in 10 prefectural public health centers (PHC) were included. Subjects responding to the five-year follow-up survey (1995-1999) without previous history of cancer and missing data were included in the current analysis n = 73,501 (men n = 34,560 and women n = 38,941). We reported results as hazard ratios (HR) and 95% confidence intervals (CI) by Cox proportional hazards modeling. RESULTS: The average follow-up time was 12.5 years (919,276 person-years). A total of 1,468 colorectal cancer cases were detected. Overall, no significant results were observed; however, GL was inversely nonsignificantly associated with colon cancer in men HR = 0.74 (95% CI 0.51-1.09) and rectal cancer in women 0.52 (95% CI 0.24-1.14). The GL tended to be inversely associated with proximal colon cancer among men 0.62 (95% CI 0.36-1.08), while a positive association with the GI was observed among women 1.37 (95% CI 0.88-2.14). Sensitivity analyses excluding the first three years of observation showed similar results. Results stratified by diabetes status, BMI, smoking and red meat were nonsignificant. CONCLUSIONS: In conclusion, the prospective JPHC Study suggests that the GI and GL do not have a substantial impact on the risk of colorectal cancer in Japanese adults.


Assuntos
Neoplasias Colorretais/epidemiologia , Índice Glicêmico , Carga Glicêmica , Adulto , Idoso , Neoplasias do Colo/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Neoplasias Retais/epidemiologia , Fatores de Risco , Inquéritos e Questionários
8.
Am J Clin Nutr ; 103(2): 495-504, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26739036

RESUMO

BACKGROUND: Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries. OBJECTIVES: We conducted a systematic review and meta-analysis to estimate the pooled prevalence of anemia, the association between maternal anemia and pregnancy outcomes, and the population-attributable fraction (PAF) of these outcomes that are due to anemia in low- and middle-income countries. DESIGN: PubMed, EMBASE, CINAHL, and the British Nursing Index were searched from inception to May 2015 to identify cohort studies of the association between maternal anemia and pregnancy outcomes. The anemic group was defined as having hemoglobin concentrations <10 or <11 g/dL or hematocrit values <33% or <34% depending on the study. A metaregression and stratified analysis were performed to assess the effects of study and participant characteristics on adverse pregnancy risk. The pooled prevalence of anemia in pregnant women by region and country-income category was calculated with the use of a random-effects meta-analysis. RESULTS: Of 8182 articles reviewed, 29 studies were included in the systematic review, and 26 studies were included in the meta-analysis. Overall, 42.7% (95% CI: 37.0%, 48.4%) of women experienced anemia during pregnancy in low- and middle-income countries. There were significantly higher risks of low birth weight (RR: 1.31; 95% CI: 1.13, 1.51), preterm birth (RR: 1.63; 95% CI: 1.33, 2.01), perinatal mortality (RR: 1.51; 95% CI: 1.30, 1.76), and neonatal mortality (RR: 2.72; 95% CI: 1.19, 6.25) in pregnant women with anemia. South Asian, African, and low-income countries had a higher pooled anemia prevalence than did other Asian and upper-middle-income countries. Overall, in low- and middle-income countries, 12% of low birth weight, 19% of preterm births, and 18% of perinatal mortality were attributable to maternal anemia. The proportion of adverse pregnancy outcomes attributable to anemia was higher in low-income countries and in the South Asian region. CONCLUSION: Maternal anemia remains a significant health problem in low- and middle-income countries.


Assuntos
Anemia/fisiopatologia , Retardo do Crescimento Fetal/etiologia , Complicações na Gravidez/fisiopatologia , Nascimento Prematuro/etiologia , Adulto , Anemia/epidemiologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/fisiopatologia , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/fisiopatologia , Países em Desenvolvimento , Feminino , Retardo do Crescimento Fetal/epidemiologia , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/fisiopatologia , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Mortalidade Perinatal , Gravidez , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Prevalência , Fatores de Risco
9.
Cancer Epidemiol ; 39(4): 562-6, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26149122

RESUMO

BACKGROUND: Several studies have assessed the association between hepatitis B virus (HBV) and hepatitis C virus (HCV) and non-Hodgkin's lymphoma. However, few studies are cohort by design, conducted within the Asian context and even fewer studies consider other lymphoid malignancies. The aim of this study was to assess the association between HBV and HCV and the risk of lymphoid malignancies among Japanese adults. MATERIALS AND METHODS: The Japan Public Health Center prospective-based Study Cohort II was initiated in 1993/1994. 20,360 subjects with available data on HBV and HCV infection status from blood samples were followed up until the end of 2010 for an average of 16 years. During 324,139 person-years, 120 newly diagnosed cases of lymphoid malignancies were identified. Cox proportional hazards models were employed to calculate hazard ratios (HRs) and 95% confidence intervals (95%CIs). RESULTS: Of 20,360 subjects, 508 were HBsAg positive, 11,035 were anti-HBc positive, and 1,129 subjects were anti-HCV positive at baseline. The presence of HBsAg was positively associated with malignant lymphoma, especially with non-Hodgkin's lymphoma (HR=3.56, 95%CI=1.37-9.18) and diffuse large B-cell lymphoma (HR=7.22, 95%CI=2.34-22.29). In contrast, no clear association was observed between the presence of anti-HBc and anti-HCV. CONCLUSION: In conclusion, HBsAg but not anti-HBc or anti-HCV was positively associated with malignant lymphoma, particularly non-Hodgkin's lymphoma and diffuse large B-cell lymphoma in Japanese adults.


Assuntos
Hepatite B/complicações , Hepatite C/complicações , Linfoma/etiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Antígenos de Superfície da Hepatite B/análise , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
11.
PLoS One ; 10(2): e0118365, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25692767

RESUMO

OBJECTIVES: To examine awareness, treatment, and control of diabetes mellitus among the adult population in Bangladesh. METHODS: The study used data from the 2011 nationally representative Bangladesh Demographic and Health Survey (BDHS). The BDHS sample is comprised of 7,786 adults aged 35 years or older. The primary outcome variables were fasting blood glucose, diagnosis, treatment, and control of diabetes. Multilevel logistic regression models were used to identify the risk factors for diabetes awareness. RESULTS: Overall, age-standardized prevalence of diabetes was 9.2%. Among subjects with diabetes, 41.2% were aware of their condition, 36.9% were treated, and 14.2% controlled their condition. A significant inequality in diabetes management was found from poor to wealthy households: 18.2% to 63.2% (awareness), 15.8% to 56.6% (treatment), and 8.2% to 18.4% (control). Multilevel models suggested that participants who had a lower education and lower economic condition were less likely to be aware of their diabetes. Poor management was observed among non-educated, low-income groups, and those who lived in the northwestern region. CONCLUSIONS: Diabetes has become a national health concern in Bangladesh; however, treatment and control are quite low. Improving detection, awareness, and treatment strategies is urgently needed to prevent the growing burden associated with diabetes.


Assuntos
Diabetes Mellitus/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Obesidade/epidemiologia , Adulto , Idoso , Bangladesh/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos
12.
Bull World Health Organ ; 92(3): 204-13, 213A, 2014 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-24700980

RESUMO

OBJECTIVE: To estimate the prevalence of diabetes and prediabetes in Bangladesh using national survey data and to identify risk factors. METHODS: Sociodemographic and anthropometric data and data on blood pressure and blood glucose levels were obtained for 7541 adults aged 35 years or more from the biomarker sample of the 2011 Bangladesh Demographic and Health Survey (DHS), which was a nationally representative survey with a stratified, multistage, cluster sampling design. Risk factors for diabetes and prediabetes were identified using multilevel logistic regression models, with adjustment for clustering within households and communities. FINDINGS: The overall age-adjusted prevalence of diabetes and prediabetes was 9.7% and 22.4%, respectively. Among urban residents, the age-adjusted prevalence of diabetes was 15.2% compared with 8.3% among rural residents. In total, 56.0% of diabetics were not aware they had the condition and only 39.5% were receiving treatment regularly. The likelihood of diabetes in individuals aged 55 to 59 years was almost double that in those aged 35 to 39 years. Study participants from the richest households were more likely to have diabetes than those from the poorest. In addition, the likelihood of diabetes was also significantly associated with educational level, body weight and the presence of hypertension. The prevalence of diabetes varied significantly with region of residence. CONCLUSION: Almost one in ten adults in Bangladesh was found to have diabetes, which has recently become a major public health issue. Urgent action is needed to counter the rise in diabetes through better detection, awareness, prevention and treatment.


Assuntos
Diabetes Mellitus/epidemiologia , Estado Pré-Diabético/epidemiologia , Adulto , Distribuição por Idade , Bangladesh/epidemiologia , Glicemia , Diabetes Mellitus/sangue , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Prevalência , Fatores de Risco
14.
Public Health Nutr ; 16(11): 1924-32, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23701712

RESUMO

OBJECTIVE: To assess how the frequency of low fruit and vegetable consumption has changed in countries of the former Soviet Union (FSU) between 2001 and 2010 and to identify factors associated with low consumption. DESIGN: Cross-sectional surveys. A standard questionnaire was administered at both time points to examine fruit and vegetable consumption frequency. Logistic regression analysis was used to examine the relationship between demographic, socio-economic and health behavioural variables and low fruit and vegetable consumption in 2010. SETTING: Nationally representative population samples from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS: Adults aged 18 years and older. RESULTS: Between 2001 and 2010 notable changes occurred in fruit and vegetable consumption in many countries resulting in a slight overall deterioration in diet. By 2010 in six countries about 40% of the population was eating fruit once weekly or less often, while for vegetables the corresponding figure was in excess of 20% in every country except Azerbaijan. A worse socio-economic situation, negative health behaviours (smoking and alcohol consumption) and rural residence were all associated with low levels of fruit and vegetable consumption. CONCLUSIONS: International dietary guidelines emphasise the importance of fruit and vegetable consumption. The scale of inadequate consumption of these food groups among much of the population in many FSU countries and its link to socio-economic disadvantage are deeply worrying. This highlights the urgent need for a greater focus to be placed on population nutrition policies to avoid nutrition-related diseases in the FSU countries.


Assuntos
Dieta/normas , Comportamento Alimentar , Frutas , Comportamentos Relacionados com a Saúde , Verduras , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Estudos Transversais , Dieta/estatística & dados numéricos , Dieta/tendências , Ingestão de Energia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , U.R.S.S. , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA