Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 40
Filtrar
1.
Front Public Health ; 9: 671782, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34490179

RESUMO

Background: Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other. Methods: Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls, M = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls, M = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls, M = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models. Results: Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF. Conclusions: In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age.


Assuntos
Aptidão Cardiorrespiratória , Criança , Costa do Marfim/epidemiologia , Exercício Físico , Feminino , Humanos , Masculino , África do Sul/epidemiologia , Tanzânia/epidemiologia
2.
Nutrients ; 13(8)2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34444895

RESUMO

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children's height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Composição Corporal , Estatura , Transtornos do Crescimento/fisiopatologia , Tecido Adiposo , Criança , Impedância Elétrica , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Modelos Lineares , Masculino , Estado Nutricional , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Sexuais , África do Sul/epidemiologia
3.
J Phys Act Health ; : 1-12, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34172589

RESUMO

BACKGROUND: Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. METHODS: Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. RESULTS: Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA. CONCLUSIONS: A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.

4.
BMC Public Health ; 21(1): 852, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33941121

RESUMO

BACKGROUND: Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children's age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness. METHODS: The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls. RESULTS: Higher socioeconomic status was most closely associated with academic achievement among boys (p < 0.05), whereas higher levels of cardiorespiratory fitness and not being stunted explained most variance in academic achievement in girls (p < 0.05). Higher age turned out to be associated with better performance in the Flanker task (p < 0.01). Additionally, in boys, higher grip strength was associated with better information processing and inhibitory control of attention (p < 0.01), whereas in girls, higher cardiorespiratory fitness levels were positively associated with these cognitive abilities (p < 0.05). CONCLUSIONS: Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children's academic achievement and cognitive performance, and that should be targeted in future school-based interventions.


Assuntos
Sucesso Acadêmico , Helmintos , Adolescente , Animais , Criança , Estudos Transversais , Feminino , Insegurança Alimentar , Transtornos do Crescimento/epidemiologia , Humanos , Masculino , Aptidão Física , Solo , África do Sul/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-33923436

RESUMO

Childhood stunting can have negative long-term consequences on cognitive development, academic achievement, and economic productivity later in life. We determined the prevalence of stunting and examined whether stunting and associated risk factors (low dietary diversity, insufficient hemoglobin, food insecurity, and soil-transmitted helminth (STH) infections) are associated with academic achievement and cognitive function among South African children living in marginalized communities. A cross-sectional sample of 1277 children (aged 5-12 years) was analyzed. Stunting was defined according to 2007 WHO growth references. Cognitive functioning was measured with the computerized Flanker task and academic performance via school grades. Blood and stool samples were collected to obtain hemoglobin level and STH infection. Dietary diversity was assessed by a food frequency questionnaire. Associations were examined via mixed linear regression (with school class as a random intercept). Nine percent of the children were stunted (95% CI: 7.6-10.8%). Low dietary diversity (ß = 0.13, p = 0.004), food insecurity (ß = -0.12, p = 0.034), and stunting (ß = -0.13, p = 0.031) were associated with poorer end of the year results among girls. No such associations were found among boys. No significant associations were found for socioeconomic status and hemoglobin levels. The prevalence of stunting and STH infections were low in the present sample. Risk factors seem differently associated with girls' and boys' academic achievement. Promoting nutrition may help to promote academic achievement among girls living in low- and middle-income countries.


Assuntos
Sucesso Acadêmico , Criança , Pré-Escolar , Cognição , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Masculino , Prevalência , Fatores de Risco , Instituições Acadêmicas
6.
Artigo em Inglês | MEDLINE | ID: mdl-33669905

RESUMO

The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1-4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p < 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p < 0.05) or PA (p < 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Criança , Estudos Transversais , Exercício Físico , Fatores de Risco de Doenças Cardíacas , Humanos , Aptidão Física , Fatores de Risco , Populações Vulneráveis
7.
Public Health Nutr ; 23(13): 2395-2401, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32631457

RESUMO

OBJECTIVE: To estimate the economic burden of overweight in Bangladesh. DESIGN: We used data from Household Income and Expenditure Survey, 2010. A prevalence-based approach was used to calculate the population attributable fraction (PAF) for diseases attributable to overweight. Cost of illness methodology was used to calculate annual out of pocket (OOP) expenditure for each disease using nationally representative survey data. The cost attributable to overweight for each disease was estimated by multiplying the PAF by annual OOP expenditure. The total cost of overweight was estimated by adding PAF-weighted costs of treating the diseases. SETTING: Nationwide, covering the whole of Bangladesh. PARTICIPANTS: Individuals whose BMI ≥ 25 kg/m2. RESULTS: The total cost attributable to overweight in Bangladesh in 2010 was estimated at US$147·38 million. This represented about 0·13 % of Bangladesh's Gross Domestic Product and 3·69 % of total health care expenditure in 2010. The sensitivity analysis revealed that the total cost could be as high as US$334 million or as low as US$71 million. CONCLUSIONS: A substantial amount of health care resource is devoted to the treatment of overweight-related diseases in Bangladesh. Effective national strategies for overweight prevention programme should be established and implemented.

8.
PLoS Negl Trop Dis ; 14(5): e0008328, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32407313

RESUMO

The dual burden of enteric infection and childhood malnutrition continues to be a global health concern and a leading cause of morbidity and death among children. Campylobacter infection, in particular, is highly prevalent in low- and middle-income countries, including Bangladesh. We examined longitudinal data to evaluate the trajectories of change in child growth, and to identify associations with Campylobacter infection and household factors. The study analyzed data from 265 children participating in the MAL-ED Study in Mirpur, Bangladesh. We applied latent growth curve modelling to evaluate the trajectories of change in children's height, as measured by length-for-age z-score (LAZ), from age 0-24 months. Asymptomatic and symptomatic Campylobacter infections were included as 3- and 6-month lagged time-varying covariates, while household risk factors were included as time-invariant covariates. Maternal height and birth order were positively associated with LAZ at birth. An inverse association was found between increasing age and LAZ. Campylobacter infection prevalence increased with age, with over 70% of children 18-24 months of age testing positive for infection. In the final model, Campylobacter infection in the preceding 3-month interval was negatively associated with LAZ at 12, 15, and 18 months of age; similarly, infection in the preceding 6-month interval was negatively associated with LAZ at 15, 18, and 21 months of age. Duration of antibiotic use and access to treated drinking water were negatively associated with Campylobacter infection, with the strength of the latter effect increasing with children's age. Campylobacter infection had a significant negative effect on child's growth and this effect was most powerful between 12 and 21 months. The treatment of drinking water and increased antibiotic use have a positive indirect effect on linear child growth trajectory, acting via their association with Campylobacter infection.


Assuntos
Infecções por Campylobacter/epidemiologia , Deficiências do Desenvolvimento/etiologia , Características da Família , Desnutrição/epidemiologia , Adolescente , Adulto , Antropometria , Bangladesh/epidemiologia , Bioestatística , Infecções por Campylobacter/complicações , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
9.
Food Nutr Bull ; 41(2): 200-210, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32064926

RESUMO

BACKGROUND: Evidence suggests lack of understanding of the association of specific nutrients with different time points of linear growth trajectory. OBJECTIVE: We investigated the role of dietary macro- and micronutrients on length-for-age z (LAZ) score trajectory of children across first 24 months of their life. METHODS: The MAL-ED Bangladesh birth cohort study recruited 265 healthy newborn children after birth. The linear growth trajectory of those children was modeled using latent growth curve modeling (LGCM) technique. RESULTS: Dietary magnesium intake at 9 to 11 months was positively associated (coefficient ß = 0.006, P < .02) with LAZ at 12 months. Animal protein intake at 15 to 17 months, in turn, was positively associated (ß = 0.03, P < .03) with LAZ at 18 months. However, vitamin D intake at 15 to 17 months was negatively associated (ß = -0.06, P < .02) with LAZ at 18 months. Other micro- and macronutrients did not show any statistically significant association with the linear growth trajectory. We also found that birth weight (ß = 0.91, P < .01), treating water (ß = 0.35, P < 0.00), and maternal height (ß = 3.4, P < .00) were positively associated with intercept. Gender had a significant negative association with the intercept, but a positive association with the slope (ß = -0.39, P < .01; ß = 0.08, P < .04), respectively. Conversely, birth weight had negative association with the slope (ß = -0.12, P < .01). CONCLUSIONS: Dietary magnesium and animal protein were positively and vitamin D was negatively associated with the linear growth trajectory. Maternal height, birth weight, gender, and treatment of drinking water also played significant roles in directing the trajectory.


Assuntos
Desenvolvimento Infantil , Proteínas na Dieta/administração & dosagem , Magnésio/administração & dosagem , Desnutrição/epidemiologia , Vitamina D/administração & dosagem , Antropometria , Bangladesh/epidemiologia , Estudos de Coortes , Suplementos Nutricionais , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Desnutrição/prevenção & controle
10.
Trials ; 21(1): 22, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31907019

RESUMO

BACKGROUND: In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. METHODS: Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. DISCUSSION: The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. TRIAL REGISTRATION: The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.


Assuntos
Saúde da Criança , Suplementos Nutricionais , Exercício Físico/fisiologia , Educação em Saúde/organização & administração , Instituições Acadêmicas/organização & administração , Acelerometria , Anti-Helmínticos/uso terapêutico , Criança , Desenvolvimento Infantil/fisiologia , Proteção da Criança , Costa do Marfim , Feminino , Helmintíase/diagnóstico , Helmintíase/tratamento farmacológico , Helmintíase/prevenção & controle , Humanos , Masculino , Micronutrientes/administração & dosagem , Aptidão Física/fisiologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , África do Sul , Tanzânia , Resultado do Tratamento
11.
Asia Pac J Clin Nutr ; 27(2): 366-374, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29384324

RESUMO

BACKGROUND AND OBJECTIVES: Western dietary patterns have been linked with kidney disease. This study investigated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker. METHODS AND STUDY DESIGN: We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three repeated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio >=30 mg/g and kidney dysfunction by estimated glomerular filtration rate <60 mL/min/1.73m2. Generalized estimating equation models were used to estimate ORs (95% CIs) of kidney disease adjusted for covariates. Erythrocyte fatty acids were only measured in blood samples collected in 2008. RESULTS: Three dietary patterns were identified: high fat-meat, traditional Chinese food-snack, and fish-vegetable. In the adjusted model, the high fat-meat and traditional Chinese food-snack diets were not associated with any kidney outcomes. The fishvegetable diet was inversely associated with kidney dysfunction (quartile 4 vs 1, OR: 0.75, 0.58-0.97), but not associated with albuminuria. A higher fish-vegetable diet factor score was associated with higher n-3 fatty acid levels. CONCLUSION: In patients with diabetes, we found greater adherence to a fish-vegetable diet to be associated with better kidney function and greater n-3 fatty acid profiles. The inclusion of repeated dietary assessments and dietary biomarker measurements in future diet-disease research, especially in patient populations, may provide more definitive risk evaluation.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Comportamento Alimentar , Nefropatias/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Taiwan/epidemiologia
12.
Public Health Nutr ; 20(10): 1718-1728, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29125452

RESUMO

OBJECTIVE: We quantified the prevalence of vitamin D status in 6-24-month-old underweight and normal-weight children and identified the socio-economic and dietary predictors for status. DESIGN: Cross-sectional, baseline data from a nutritional intervention study were analysed. Multinomial logistic regression was used to estimate the odds of being vitamin D deficient or insufficient with the reference being vitamin D sufficient. SETTING: Urban slum area of Mirpur field site, Dhaka, Bangladesh. SUBJECTS: Underweight (weight-for-age Z-score <-2·00) and normal-weight (weight-for-age Z-score ≥-1·00) children aged 6-24 months. RESULTS: Among 468 underweight children, 23·1 % were sufficient, 42·3 % insufficient, 31·2 % deficient and 3·4 % severely vitamin D deficient. Among 445 normal-weight children, 14·8 % were sufficient, 39·6 % insufficient and 40·0 % deficient and 5·6 % severely deficient. With adjusted multinominal regression analysis, risk factors (OR (95 % CI)) for vitamin D deficiency in underweight children were: older age group (18-24 months old; 2·9 (1·5-5·7)); measurement of vitamin D status during winter (3·0 (1·4-6·4)) and spring (6·9 (3·0-16·1)); and maternal education (≥6 years of institutional education; 2·2 (1·0-4·9)). In normal-weight children, older age group (3·6 (1·2-10·6)) and living in the richest quintile (3·7 (1·1-12·5)) were found to be significantly associated with vitamin D insufficiency. CONCLUSIONS: The study demonstrates a significant burden of vitamin D insufficiency and deficiency in both underweight and normal-weight children <2 years of age from an urban slum of Bangladesh. Identification of risk factors may help in mitigating the important burden in such children.


Assuntos
Inquéritos Nutricionais/estatística & dados numéricos , Áreas de Pobreza , Magreza/epidemiologia , População Urbana/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Bangladesh/epidemiologia , Peso Corporal , Pré-Escolar , Comorbidade , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos
13.
Public Health Nutr ; 20(12): 2183-2191, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28633684

RESUMO

OBJECTIVE: To estimate the prevalence of underweight and overweight among Bangladeshi adults and to determine if the double burden of underweight and overweight differs by gender and other socio-economic characteristics of individuals. DESIGN: We used data from the Bangladesh Demographic and Health Survey 2011. Multinominal logistic regression was used to examine associations between the different nutritional statuses of individuals and related determinants. Interaction effect was checked between gender and various socio-economic factors. SETTING: Nationwide, covering the whole of Bangladesh. SUBJECTS: Individuals aged >18 years (women, n 16 052; men, n 5090). RESULTS: Underweight was observed among 28·3 % of men and 24·4 % of women, whereas overweight was observed among 8·4 % of men and 16·9 % of women. The odds of being overweight were significantly lower among urban men (OR=0·46; 95 % CI 0·37, 0·57) compared with urban women, whereas the odds of being underweight were significantly higher among urban men (OR=1·33; 95 % CI 1·07, 1·64) compared with urban women. The odds of being overweight were lower among higher educated men (OR=0·48; 95 % CI 0·39, 0·58) and men of rich households (OR=0·45; 95 % CI 0·37, 0·54) compared with higher educated women and women of rich households, respectively. CONCLUSIONS: There are important gender differences in the prevalence of underweight and overweight among the adult population in Bangladesh. Women with higher education, in rich and urban households have higher chances of being overweight and lower chances of being underweight compared with their male counterparts.


Assuntos
Obesidade/epidemiologia , Sobrepeso/epidemiologia , Fatores Sexuais , Magreza/epidemiologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Bangladesh/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Tamanho da Amostra , Fatores Socioeconômicos , População Urbana , Adulto Jovem
14.
J Diabetes ; 9(11): 983-993, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27976508

RESUMO

BACKGROUND: The aim of the present study was to investigate relationships between the risk of chronic kidney disease (CKD) and obesity and weight changes in Asian patients with type 2 diabetes. METHODS: At baseline (2003-05), 1187 diabetic patients aged 30-70 years were recruited to the study, with follow-up surveys completed in 2008, 2009, and 2010. Chronic kidney disease was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m2 ; body mass index (BMI) was categorised as normal (18.5-22.9 kg/m2 ), overweight (23-27.4 kg/m2 ), or obese (≥27.5 kg/m2 ); waist circumference (WC) ≥80 cm for women and ≥90 cm for men was taken to indicate abdominal obesity. Changes in weight and WC were calculated from baseline to each follow-up survey. Relative risk (RR) and 95% confidence intervals (CIs) of CKD were estimated. To estimate the risk for incident CKD, associations were examined in patients without CKD at baseline (n = 881). RESULTS: Over 7 years of follow-up, obesity (RR 1.48; 95% CI 1.08-2.04; P = 0.015) and high WC (RR 1.23; 95% CI 1.00-1.52; P = 0.049) were associated with CKD after adjusting for covariates. Among participants without CKD at baseline, those who gained >10% weight (RR 1.43; 95% CI 1.07-1.90; P = 0.015) and in whom WC increased >15% (RR 1.37; 95% CI 1.01-1.85; P = 0.045) had a higher risk of incident CKD than those who remained stable (±5% changes in weight or WC). CONCLUSIONS: Diabetic patients who are obese and those with excessive central fat were more likely to have CKD. Large weight gain (>10%) and increases in WC (>15%) independently predicted incident CKD.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Obesidade/complicações , Sobrepeso/complicações , Insuficiência Renal Crônica/complicações , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Feminino , Taxa de Filtração Glomerular , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Sobrepeso/etnologia , Insuficiência Renal Crônica/etnologia , Fatores de Risco , Taiwan , Circunferência da Cintura
15.
BMC Public Health ; 16(1): 1014, 2016 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-27669892

RESUMO

BACKGROUND: Effective treatment and prevention of obesity and its co-morbidities requires the recognition and understanding of cultural and social aspects of eating practices. The objective of the present study was to identify social factors and beliefs that may explain undesirable eating practices among women with high body mass index (HBMI) compared with normal-weight (NW) women from rural and urban areas classified as middle-low socioeconomic status (SES) in the State of Querétaro, Mexico. METHODS: A qualitative technique with individual in-depth interviews was used. Fifty-five women with either NW or HBMI from rural and urban areas participated in the study. The responses were analyzed by coding and grouping text fragments into categories in a data matrix, in order to make comparisons between BMI groups and between rural and urban women. RESULTS: The habit of skipping breakfast prevailed among women with HBMI who also reported childhood food deprivation. Feelings related to eating seemed to be more important than losing weight among women with HBMI from urban and rural areas. Thus, overweight might be interpreted as a social symbol of the enjoyment of a good life, primarily in rural areas. Overweight was socially accepted when it occurred in children and in married woman, mainly because it is a symbol of the good life that the head of the household provides, and also because women may feel more relaxed about their weight when they already have a partner. The study also revealed that women with HBMI were not sufficiently motivated to lose weight unless they experience a physical indication of poor health. CONCLUSION: The findings from this study are helpful in the understanding of the reasons why strategies for the prevention and treatment of obesity may not be as effective as expected. The belief system of particular social groups within different SESs should be considered in order to understand the etiology of obesity and develop effective strategies.

16.
Public Health Nutr ; 19(16): 2924-2939, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27198046

RESUMO

OBJECTIVE: To provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels. DESIGN: Five electronic databases were searched for randomized controlled trials of Zn supplementation studies published before 28 February 2015. No statistical pooling of results was carried out due to diversity in study designs. SETTING: Community- or hospital-based, from fourteen developing and developed countries. SUBJECTS: Children and adolescents aged 0 to 10 years. RESULTS: Seven of the fourteen studies reported an overall or subgroup effect of Zn supplementation on at least one parameter of body composition, when determined by anthropometric measurements (increased mid upper-arm circumference, triceps skinfold, subscapular skinfold and mid upper-arm muscle area, and decreased BMI). Three out of the fourteen studies reported increased mean value of total body water estimated by bio-impedance analysis and increased fat-free mass estimated by dual energy X-ray absorptiometry and by total body water. Zn supplementation was associated with increased fat-free mass among stunted children. One study found supplementation decreased leptin and insulin concentrations. CONCLUSIONS: Due to the use of anthropometry when determining body composition, a majority of the studies could not accurately address whether alterations in the fat and/or fat-free mass components of the body were responsible for the observed changes in body composition. The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure.


Assuntos
Adiposidade , Composição Corporal , Suplementos Nutricionais , Hormônios Peptídicos/sangue , Zinco/administração & dosagem , Antropometria , Índice de Massa Corporal , Criança , Pré-Escolar , Humanos , Lactente , Obesidade , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Trop Med Int Health ; 21(4): 458-69, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26892222

RESUMO

OBJECTIVE: To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region. METHOD: Systematic review of articles published until March 2015. RESULTS: Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher. CONCLUSION: Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Gastos em Saúde , Obesidade/economia , Magreza/economia , Adulto , Ásia , Atenção à Saúde , Humanos , Oceania , Sobrepeso/economia
18.
Acta Trop ; 156: 48-56, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26772449

RESUMO

A randomised, double-blind, placebo-controlled trial was carried out among Mexico children aged 6-15 months to determine how household characteristics modify vitamin A and zinc supplementation efficacy on Ascaris lumbricoides, Giardia intestinalis and Entamoeba histolytica/E. dispar infection durations. Children assigned to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A-zinc supplement or a placebo were followed for 1 year. Parametric hazard models were fit to infection durations stratified by personal and household factors. Children supplemented with vitamin A and zinc combined from households lacking piped water and children in all three treatment arms from households with dirt floors had longer G. intestinalis and A. lumbricoides infection durations than their counterparts, respectively. Shorter E. histolytica/E.dispar durations were found among zinc-supplemented children of mothers who had <6 years of education and no indoor bathrooms. Heterogeneity in supplementation efficacy among children may reflect differences in exposure risk and baseline immune responses.


Assuntos
Suplementos Nutricionais , Enteropatias Parasitárias/tratamento farmacológico , Vitamina A/administração & dosagem , Vitaminas/administração & dosagem , Zinco/administração & dosagem , Animais , Ascaríase/tratamento farmacológico , Ascaris lumbricoides/patogenicidade , Método Duplo-Cego , Características da Família , Fezes/parasitologia , Feminino , Giardia lamblia/patogenicidade , Giardíase/tratamento farmacológico , Habitação/normas , Humanos , Lactente , Masculino , México , Contagem de Ovos de Parasitas , Pais/educação , Estudos Prospectivos
19.
Nutr Rev ; 73(7): 438-47, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26081454

RESUMO

CONTEXT: Studies show there is a double burden of underweight and overweight in Bangladesh amidst a global background of increasing rates of overweight in low-income settings. OBJECTIVE: The aim of this review was to determine the rates of change in the prevalence of underweight and of overweight among Bangladeshi women of reproductive age, to investigate whether there has been a shift from underweight to overweight in this population, and, if a shift was documented, to identify potential determinants. DATA SOURCES: Data was obtained via electronic searches of the PubMed, CINAHL, and Embase databases. STUDY SELECTION: Studies and survey reports were eligible for inclusion if they provided data on the prevalence of underweight and of overweight among women of reproductive age as well as sociodemographic information. DATA SYNTHESIS: A meta-analysis was performed by reviewing data extracted from the included studies. Using data from 5 successive national demographic and health surveys, the average annual rates of change in underweight and in overweight were calculated, along with their associations with potential determinants. CONCLUSIONS: In Bangladesh, the prevalence of overweight exceeded that of underweight in 2014. A higher average annual rate of reduction of underweight was found among wealthier, highly educated, urban-living women, while a higher average annual rate of increase of overweight was found among poorer, uneducated, rural-living women. The shift in body mass index from underweight to overweight was most positively associated with urban residence, age, higher socioeconomic status, and higher education attainment.


Assuntos
Sobrepeso/epidemiologia , Magreza/epidemiologia , Bangladesh/epidemiologia , Índice de Massa Corporal , Feminino , Humanos , Metanálise como Assunto , Estudos Observacionais como Assunto , Prevalência , População Rural , Fatores Socioeconômicos , População Urbana
20.
Clin Nutr ; 34(2): 229-34, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24721145

RESUMO

BACKGROUND & AIMS: The n-3 polyunsaturated fatty acids (PUFAs) and the inflammatory indicator, interleukin-6 (IL-6), have been implied in the development of renal dysfunction. This longitudinal study examined the effect of n-3 PUFAs and IL-6 on the risk of renal function decline and explored whether n-3 PUFAs modify the effect of inflammatory indicators on renal dysfunction risk in type 2 diabetes. METHODS: Studying 676 type 2 diabetic patients, we analyzed erythrocyte fatty acids and inflammatory markers in 2008 and estimated glomerular filtration rate (eGFR) in 2008 and 2012. Renal function decline was defined as an eGFR decline of ≥25% over a 4-year period. RESULTS: Multivariable logistic regression revealed erythrocyte total PUFAs, n-3 PUFAs, and n-3/n-6 PUFA ratio correlated negatively with risk of renal function decline (OR = 0.75, 0.78, and 0.61, respectively, all p < 0.01), while n-6 PUFAs did not. IL-6 independently predicted risk of renal dysfunction (OR = 1.18, p = 0.015). Stratifying erythrocyte PUFAs into low (<50(th) percentile) or high group (≥50(th) percentile), we found a positive association between IL-6 and risk of renal dysfunction only in the low n-3 PUFA (OR = 1.27, p = 0.035), low n-3/n-6 PUFA (OR = 1.27, p = 0.034), and low total PUFA groups (OR = 1.36, p = 0.005), but not in the high groups. CONCLUSIONS: High PUFA concentrations, especially n-3 or higher n-3/n-6 PUFA ratio, may exert protective effects against renal function impairment in type 2 diabetic patients. Whether the effect is mediated via modification of inflammatory biomarker such as IL-6 by high n-3 PUFA status warrants further investigation.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Eritrócitos/metabolismo , Ácidos Graxos Insaturados/análise , Interleucina-6/sangue , Rim/fisiologia , Insuficiência Renal/diagnóstico , Adulto , Idoso , Biomarcadores/sangue , Ácidos Graxos Ômega-3/análise , Ácidos Graxos Ômega-6/análise , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Rim/imunologia , Testes de Função Renal/métodos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/etiologia , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...