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BACKGROUND: Cardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America. METHODS: Measurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1-3 drinks daily for men and 1-2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals. RESULTS: Neither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites. CONCLUSION: While several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.
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Hipertensão , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , HDL-Colesterol , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Obesidade/epidemiologia , Fatores de Risco , Estados UnidosRESUMO
BACKGROUND: Associations between socioeconomic status (SES) and risk factors for noncommunicable diseases (NCD-RFs) may differ in populations at different stages of the epidemiological transition. We assessed the social patterning of NCD-RFs in a study including populations with different levels of socioeconomic development. METHODS: Data on SES, smoking, physical activity, body mass index, blood pressure, cholesterol and glucose were available from the Modeling the Epidemiologic Transition Study (METS), with about 500 participants aged 25-45 in each of five sites (Ghana, South Africa, Jamaica, Seychelles, United States). RESULTS: The prevalence of NCD-RFs differed between these populations from five countries (e.g., lower prevalence of smoking, obesity and hypertension in rural Ghana) and by sex (e.g., higher prevalence of smoking and physical activity in men and of obesity in women in most populations). Smoking and physical activity were associated with low SES in most populations. The associations of SES with obesity, hypertension, cholesterol and elevated blood glucose differed by population, sex, and SES indicator. For example, the prevalence of elevated blood glucose tended to be associated with low education, but not with wealth, in Seychelles and USA. The association of SES with obesity and cholesterol was direct in some populations but inverse in others. CONCLUSIONS: In conclusion, the distribution of NCD-RFs was socially patterned in these populations at different stages of the epidemiological transition, but associations between SES and NCD-RFs differed substantially according to risk factor, population, sex, and SES indicator. These findings emphasize the need to assess and integrate the social patterning of NCD-RFs in NCD prevention and control programs in LMICs.
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Doença Crônica/epidemiologia , Adulto , Pressão Sanguínea , Colesterol/sangue , Países em Desenvolvimento/estatística & dados numéricos , Estudos Epidemiológicos , Exercício Físico , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fatores de Risco , População Rural , Fumar/epidemiologia , Classe Social , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual's body image can inform obesity prevention and management. This study's objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension. SETTING: Research visits were completed in local research clinics in respective countries. PARTICIPANTS: Seven hundred and fifty-one African-origin participants from the USA and the Republic of Seychelles (both high-income countries), and Ghana (low/middle-income country). PRIMARY AND SECONDARY OUTCOME MEASURES: Silhouette showcards were used to measure perceived body size and body size dissatisfaction. Objectively measured body size was measured using a scale and stadiometer. Diabetes was defined as fasting blood glucose ≥126 mg/dL and hypertension was defined as ≥130 mm Hg/80 mm Hg. RESULTS: Most women and men from the USA and Seychelles had 'Perceived minus Actual weight status Discrepancy' scores less than 0, meaning they underestimated their actual body size. Similarly, most overweight or obese men and women also underestimated their body size, while normal weight men and women were accurately able to estimate their body size. Finally, participants with diabetes were able to accurately estimate their body size and similarly desired a smaller body size. CONCLUSIONS: This study highlights that overweight and obese women and men from countries spanning the epidemiological transition were unable to accurately perceive their actual body size. Understanding people's perception of their body size is critical to implementing successful obesity prevention programmes across the epidemiological transition.
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Diabetes Mellitus , Hipertensão , Masculino , Humanos , Feminino , Sobrepeso/epidemiologia , Sobrepeso/complicações , Imagem Corporal , Estudos de Coortes , Obesidade/complicações , Índice de Massa Corporal , Hipertensão/epidemiologia , Hipertensão/complicações , Peso CorporalRESUMO
The relationship between microbiota, short chain fatty acids (SCFAs), and obesity remains enigmatic. We employ amplicon sequencing and targeted metabolomics in a large (n = 1904) African origin cohort from Ghana, South Africa, Jamaica, Seychelles, and the US. Microbiota diversity and fecal SCFAs are greatest in Ghanaians, and lowest in Americans, representing each end of the urbanization spectrum. Obesity is significantly associated with a reduction in SCFA concentration, microbial diversity, and SCFA synthesizing bacteria, with country of origin being the strongest explanatory factor. Diabetes, glucose state, hypertension, obesity, and sex can be accurately predicted from the global microbiota, but when analyzed at the level of country, predictive accuracy is only universally maintained for sex. Diabetes, glucose, and hypertension are only predictive in certain low-income countries. Our findings suggest that adiposity-related microbiota differences differ between low-to-middle-income compared to high-income countries. Further investigation is needed to determine the factors driving this association.
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Microbioma Gastrointestinal , Hipertensão , Microbiota , Humanos , Microbioma Gastrointestinal/genética , Adiposidade , Gana/epidemiologia , Obesidade/epidemiologia , Ácidos Graxos Voláteis , GlucoseRESUMO
BACKGROUND: The ability of different obesity indices to predict cardiovascular risk is still debated in youth and few data are available in sub Saharan Africa. We compared the associations between several indices of obesity and cardiovascular risk factors (CVRFs) in late adolescence in the Seychelles. METHODS: We measured body mass index (BMI), waist circumference, waist/hip ratio (WHiR), waist/height ratio (WHtR) and percent fat mass (by bioimpedance) and 6 CVRFs (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting blood glucose and uric acid) in 423 youths aged 19-20 years from the general population. RESULTS: The prevalence of overweight/obesity and several CVRFs was high, with substantial sex differences. Except for glucose in males and LDL-cholesterol in females, all obesity indices were associated with CVRFs. BMI consistently predicted CVRFs at least as well as the other indices. Linear regression on BMI had standardized regression coefficients of 0.25-0.36 for most CVRFs (p<0.01) and ROC analysis had an AUC between 60%-75% for most CVRFs. BMI also predicted well various combinations of CVRFs: 36% of male and 16% of female lean subjects (BMI
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Doenças Cardiovasculares/epidemiologia , Obesidade/epidemiologia , Adolescente , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Seicheles/epidemiologia , Adulto JovemRESUMO
The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m2), obesity alone (BMI ≥ 30 kg/m2), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20-68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34-3.97] BMI units/silhouette unit in the US, 3.23 [2.93-3.74] in Seychelles, and 1.99 [1.72-2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m2 in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers' silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries.
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Macrophages and polymorphonuclear cells (PMNs) rapidly respond to microbial and immune inflammatory stimuli and die during these responses. We have shown earlier that many macrophage and PMN functions are compromised in x-linked immunodeficient (Xid) mice with functional deficiency in Bruton's tyrosine kinase (Btk). We now report that Btk-deficient macrophages show enhanced susceptibility to apoptotic death on exposure to the microbial and immune inflammatory signals bacterial lipopolysaccharide (LPS) and interferon-gamma (IFNγ) in vitro. In vivo in mixed bone marrow (BM) chimeras Btk deficiency leads primarily to loss of peripheral macrophage numbers without affecting BM development, suggesting a role of inflammation-induced apoptosis in regulating macrophage life span. Surprisingly, Btk deficiency does not affect macrophage apoptosis induced by DNA damage or CD95 engagement. Reactive nitrogen and oxygen species also do not contribute to inflammation-induced apoptosis, but apoptotic process involves loss of mitochondrial potential, shows increased activation of caspase 9 and enhanced loss of Bcl-xL. The lack of pro-survival signaling through the Btk-phosphotidylinositol 3-kinase-Akt pathway, and persistent MEK signaling, lead to enhanced death in Btk-deficient macrophages only downstream of inflammatory triggers. These data underline the complex role of Btk in the regulation of macrophage survival and function.
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Apoptose , Macrófagos Peritoneais/citologia , Macrófagos Peritoneais/enzimologia , Proteínas Tirosina Quinases/metabolismo , Tirosina Quinase da Agamaglobulinemia , Animais , Apoptose/efeitos dos fármacos , Células da Medula Óssea/citologia , Células da Medula Óssea/efeitos dos fármacos , Contagem de Células , Sobrevivência Celular/efeitos dos fármacos , Dano ao DNA , Proteína Ligante Fas/metabolismo , Interferon gama/farmacologia , Lipopolissacarídeos/farmacologia , Macrófagos Peritoneais/efeitos dos fármacos , Camundongos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo , Monócitos/citologia , Monócitos/efeitos dos fármacos , Proteínas Tirosina Quinases/deficiência , Espécies Reativas de Nitrogênio/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteína bcl-X/metabolismo , Receptor fas/metabolismoRESUMO
BACKGROUND: We assessed the impact of a smoking ban in hospitality venues in the Seychelles 9 months after legislation was implemented. METHODS: Survey officers observed compliance with the smoking ban in 38 most popular hospitality venues and administered a structured questionnaire to two customers, two workers and one manager in each venue. RESULTS: Virtually no customers or workers were seen smoking in the indoor premises. Patrons, workers and managers largely supported the ban. The personnel of the hospitality venues reported that most smokers had no difficulty refraining from smoking. However, a third of workers did not systematically request customers to stop smoking and half of them did not report adequate training. Workers reported improved health. No substantial change in the number of customers was noted. CONCLUSION: A ban on public smoking was generally well implemented in hospitality venues but some less than optimal findings suggest the need for adequate training of workers and strengthened enforcement measures. The simple and inexpensive methodology used in this rapid survey may be a useful approach to evaluate the implementation and impact of clean air policy in low and middle-income countries.
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Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Logradouros Públicos/legislação & jurisprudência , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Adolescente , Adulto , Poluição do Ar em Ambientes Fechados/prevenção & controle , Comércio/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos/métodos , Humanos , Aplicação da Lei , Masculino , Pessoa de Meia-Idade , Restaurantes/legislação & jurisprudência , Seicheles , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto JovemRESUMO
BACKGROUND: The relationship between body mass index (BMI) and socioeconomic status (SES) tends to change over time and across populations. In this study, we examined, separately in men and women, whether the association between BMI and SES changed over successive birth cohorts in the Seychelles (Indian Ocean, African region). METHODS: We used data from all participants in three surveys conducted in 1989, 1994 and 2004 in independent random samples of the population aged 25-64 years in the Seychelles (N = 3'403). We used linear regression to model mean BMI according to age, cohort, SES and smoking status, allowing for a quadratic term for age to account for a curvilinear relation between BMI and age and interactions between SES and age and between SES and cohorts to test whether the relation between SES and BMI changed across subsequent cohorts. All analyses were performed separately in men and women. RESULTS: BMI increased with age in all birth cohorts. BMI was lower in men of low SES than high SES but was higher in women of low SES than high SES. In all SES categories, BMI increased over successive cohorts (1.24 kg/m2 in men and 1.51 kg/m2 for a 10-year increase in birth cohorts, p < 0.001). The difference in BMI between men or women of high vs. low SES did not change significantly across successive cohorts (the interaction between SES and year of birth of cohort was statistically not significant). Smoking was associated with lower BMI in men and women (respectively -1.55 kg/m2 and 2.46 kg/m2, p < 0.001). CONCLUSIONS: Although large differences exist between men and women, social patterning of BMI did not change significantly over successive cohorts in this population of a middle-income country in the African region.
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Índice de Massa Corporal , Disparidades nos Níveis de Saúde , Classe Social , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores Sexuais , SeichelesRESUMO
BACKGROUND: We examined the associations between substance use (cigarette smoking, alcohol drinking, and cannabis use) and psychosocial characteristics at the individual and family levels among adolescents of the Seychelles, a rapidly developing small island state in the African region. METHODS: A school survey was conducted in a representative sample of 1432 students aged 11-17 years from all secondary schools. Data came from a self-administered anonymous questionnaire conducted along a standard methodology (Global School-based Health Survey, GSHS). Risk behaviors and psychosocial characteristics were dichotomized. Association analyses were adjusted for a possible classroom effect. RESULTS: The prevalence of cigarette smoking, alcohol drinking and cannabis use was higher in boys than in girls and increased with age. Age-adjusted and multivariate analyses showed that several individual level characteristics (e.g. suicidal ideation and truancy) and family level characteristics (e.g. poor parental monitoring) were associated with substance use among students. CONCLUSIONS: Our results suggest that health promotion programs should simultaneously address multiple risk behaviors and take into account a wide range of psychosocial characteristics of the students at the individual and family levels.
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Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Maconha/epidemiologia , Fumar/epidemiologia , Absenteísmo , Adolescente , Comportamento do Adolescente , Distribuição por Idade , Criança , Comportamento Infantil , Depressão/epidemiologia , Feminino , Amigos , Humanos , Solidão , Masculino , Análise Multivariada , Pais , Distribuição por Sexo , Seicheles/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously. METHODS: Based on a population-based survey (n = 1255) in the Seychelles, weight and height were measured and self-perception of one's own body weight, education, occupation, and income were assessed by a questionnaire. Individuals were considered to have appropriate weight perception when their self-perceived weight matched their actual body weight. RESULTS: The prevalence of overweight and obesity was 35% and 28%, respectively. Multivariate analysis among overweight/obese persons showed that appropriate weight perception was directly associated with actual weight, education, occupation and income, and that it was more frequent among women than among men. In a model using all three SES indicators together, only education (OR = 2.5; 95% CI: 1.3-4.8) and occupation (OR = 2.3; 95% CI: 1.2-4.5) were independently associated with appropriate perception of being overweight. The OR reached 6.9 [95% CI: 3.4-14.1] when comparing the highest vs. lowest categories of SES based on a score including all SES indicators and 6.1 [95% CI: 3.0-12.1] for a score based on education and occupation. CONCLUSIONS: Appropriately perceiving one's weight as too high was associated with different SES indicators, female sex and being actually overweight. These findings suggest means and targets for clinical and population-based interventions for weight control. Further studies should examine whether these differences in weight perception underlie differences in cognitive skills, healthy weight norms, or body size ideals.
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Imagem Corporal , Autoimagem , Classe Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seicheles , Inquéritos e QuestionáriosRESUMO
We assessed the difference in the prevalence of hypertension in community surveys when blood pressure (BP) was measured on two vs. one visits and its impact on hypertension awareness, treatment and control proportions. A community-based BP screening programme was conducted in public places in the Seychelles (619 adults) and BP was rechecked a few days later among untreated participants with high BP (≥140/90 mmHg). A narrative review of the literature on this question was also conducted. Only 64% of untreated participants with high BP still had high BP at the second visit. The prevalence of hypertension in the whole sample decreased by 13% (from 33.8% to 29.5%) when BP was measured on two vs. one visits. These results concurred with our findings in our narrative review based on 10 surveys. In conclusion, the prevalence of hypertension can be markedly overestimated in community surveys when BP is measured on two vs. one visits. The overestimation could be addressed by measuring BP on a second visit among untreated individuals with high BP or, possibly, by taking more readings at the first visit. These findings have relevance for clinical practice, policy and surveillance.
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Determinação da Pressão Arterial , Hipertensão , Pressão Sanguínea , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Prevalência , SeichelesRESUMO
Tobacco control has been recognized as a main public health concern in Seychelles for the past two decades. Tobacco advertising, sponsoring and promotion has been banned for years, tobacco products are submitted to high taxes, high-profile awareness programs are organized regularly, and several other control measures have been implemented. The Republic of Seychelles was the first country to ratify the WHO Framework Convention on Tobacco Control (FCTC) in the African region. Three population-based surveys have been conducted in adults in Seychelles and results showed a substantial decrease in the prevalence of smoking among adults between 1989 and 2004. A first survey in adolescents was conducted in Seychelles in 2002 (the Global Youth Tobacco Survey, GYTS) in a representative sample of 1321 girls and boys aged 13-15 years. The results show that approximately half of students had tried smoking and a quarter of both boys and girls had smoked at least one cigarette during the past 30 days. Although "current smoking" is defined differently in adolescents (>or=1 cigarette during the past 30 days) and in adults (>or=1 cigarette per day), which precludes direct comparison, the high smoking prevalence in youth in Seychelles likely predicts an increasing prevalence of tobacco use in the next adult generation, particularly in women. GYTS 2002 also provides important data on a wide range of specific individual and societal factors influencing tobacco use. Hence, GYTS can be a powerful tool for monitoring the situation of tobacco use in adolescents, for highlighting the need for new policy and programs, and for evaluating the impact of current and future programs.
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Comportamento do Adolescente , Abandono do Hábito de Fumar/estatística & dados numéricos , Prevenção do Hábito de Fumar , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Publicidade , Estudos Transversais , Feminino , Humanos , Masculino , Vigilância da População , Prevalência , Seicheles/epidemiologia , EstudantesRESUMO
OBJECTIVE: The assessment of blood pressure (BP) in individuals is traditionally based on a few BP readings obtained at intervals of just a few minutes. We examined if increasing intervals between BP readings on one visit would have an impact on the BP estimates. METHODS: We conducted an examination survey of cardiovascular risk factors in the general population aged 25-64 years in Seychelles (Indian Ocean), attended by 1255 of 1565 eligible participants. BP was measured once shortly after participants' arrival to the study centers (BP1) and twice before discharge, 15-351 min later (BP2, BP3; separated by 2 min). RESULTS: Mean (standard error) BP1 was 135.1 (0.7)/87.9 (0.4) mmHg, BP2: 130.7 (0.6)/85.1 (0.4) mmHg and BP3: 128.4 (0.6)/83.9 (0.3) mmHg. The difference in BP between the first and the last measurements (DeltaBP1-BP3) was, respectively, 5.8 (1.3)/2.6 (0.9) mmHg for a time interval between BP1 and BP3 of 15-60 min, 6.3 (0.5)/3.9 (0.3) mmHg for 61-120 min, 6.9 (0.6)/4.1 (0.4) mmHg for 121-240 min and 7.4 (0.7)/4.3 (0.5) mmHg for 241-351 min (P-trend for systolic/diastolic BP: 0.15/0.49). In multivariate analysis, both systolic and diastolic DeltaBP were associated with the initial BP level and the female sex but not with time (in minutes) between BP readings (for systolic/diastolic BP, P=0.12/0.34). CONCLUSION: The decrease in subsequent BP readings obtained did not differ whether the time interval between BP measurements was larger or smaller than 1 h. This indirectly suggests that extending the time interval between repeated BP readings on one single visit is unlikely to be a valid, alternative strategy to the recommendation of gathering BP readings on several, separate visits to define hypertension.
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Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
The direction and magnitude of the associations between cardiovascular risk factors (CVRFs) and psychological stress continue to be debated, and no data are available from surveys in the African region. In this study, we examine the associations between CVRFs and psychological stress in the Seychelles, a rapidly developing small island state in the African region. A survey was conducted in 1,240 adults aged 25-64 years representative of the Seychelles. Participants were asked to rank psychological stress that they had experienced during the past 12 months in four domains: work, social life, financial situation, and environment around home. CVRFs (high blood pressure, tobacco use, alcohol drinking, and obesity) were assessed using standard procedures. Psychological stress was associated with age, sex, and socioeconomic status. Overall, there were only few consistent associations between psychological stress and CVRFs, adjusting for age, sex, and socioeconomic status. Social stress was associated with smoking, drinking, and obesity, and there were marginal associations between stress at work and drinking, and between financial stress, and smoking and drinking. Psychological stress was not associated with high blood pressure. These findings suggest that psychological stress should be considered in cardiovascular disease prevention and control strategies.
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Consumo de Bebidas Alcoólicas/psicologia , Hipertensão/complicações , Obesidade/complicações , Fumar/psicologia , Estresse Psicológico/complicações , Adulto , Feminino , Humanos , Hipertensão/psicologia , Renda , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Fatores de Risco , Seicheles , Classe Social , Estresse Psicológico/psicologiaRESUMO
OBJECTIVE: This study assessed trends in the prevalence of children and adolescents with obesity, overweight, and thinness in the Seychelles, a rapidly developing nation in the Indian Ocean, and changes in the distribution of BMI over time. METHODS: Between 1998 and 2016, examination surveys were conducted every year in all students of four selected school grades (kindergarten, primary 4, secondary 1, and secondary 4) in all schools. We categorized BMI by using the International Obesity Task Force criteria. RESULTS: Based on 70,187 observations, the prevalence of combined overweight or obesity increased largely and monotonically between 1998 and 2016, from 8.9% to 20.0% in boys and from 12.3% to 23.6% in girls, but the prevalence of underweight did not decrease. BMI increased mostly in the upper range of the BMI population distribution: percentile 5 (P5), -1.7%; P10, -0.8%; P25, 0.3%; P50, 2.5%; P75, 7.4%; P90, 12.7%; and P95, 13.3%. CONCLUSIONS: The distribution of BMI was increasingly skewed, with a rising prevalence of obesity, a modest or null increase in BMI in a substantial proportion of the population, and a continued burden of underweight. Further studies should assess child growth trajectories and their underlying determinants, which may bear significance for weight control strategies.
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Índice de Massa Corporal , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Adolescente , Criança , Feminino , História do Século XX , História do Século XXI , Humanos , Masculino , Seicheles , Inquéritos e QuestionáriosRESUMO
High salt intake is a major risk factor of hypertension and cardiovascular disease. Improving knowledge, attitudes, and practices (KAP) related to salt intake in the general population is a key component of salt reduction strategies. The objective of this study was to describe and compare the KAP of adults related to salt in urban areas of five countries in sub-Saharan Africa. The survey included 588 participants aged 25 to 65 years who were selected using convenience samples in the urban areas of Benin, Guinea, Kenya, Mozambique, and Seychelles. Socio-demographic and food consumption were assessed using a structured closed-ended questionnaire administered by survey officers. Height, weight, and blood pressure were measured. Food consumption varied largely between countries. Processed foods high in salt, such as processed meat, cheese, pizzas, and savory snacks were consumed rather infrequently in all the countries, but salt-rich foods, such as soups or bread and salty condiments, were consumed frequently in all countries. The majority of the participants knew that high salt intake can cause health problems (85%) and thought that it is important to limit salt intake (91%). However, slightly over half (56%) of the respondents regularly tried to limit their salt intake while only 8% of the respondents thought that they consumed too much salt. Salt and salty condiments were added most of the time during cooking (92% and 64%, respectively) but rarely at the table (11%). These findings support the need for education campaigns to reduce salt added during cooking and for strategies to reduce salt content in selected manufactured foods in the region.
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População Negra , Ingestão de Alimentos/etnologia , Fast Foods , Comportamento Alimentar/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hipertensão/etnologia , Cloreto de Sódio na Dieta/administração & dosagem , População Urbana , Adulto , África Subsaariana/epidemiologia , Idoso , População Negra/psicologia , Culinária , Estudos Transversais , Inquéritos sobre Dietas , Ingestão de Alimentos/psicologia , Fast Foods/efeitos adversos , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/prevenção & controle , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Fatores de Proteção , Recomendações Nutricionais , Fatores de Risco , Comportamento de Redução do Risco , Cloreto de Sódio na Dieta/efeitos adversosRESUMO
BACKGROUND: n-3 polyunsaturated fatty acids (n-3 PUFA) convey several health benefits, including a reduction of serum concentration of triglycerides (TG). AIM: To examine the effect on blood lipids, particularly TG, of a diet with n-3 PUFA enriched eggs in healthy volunteers in the Seychelles (Indian Ocean). METHODS: Double-blind crossover trial with one group of volunteers fed with 5 normal eggs per week during 3 weeks followed by 5 enriched eggs per week during the next 3 weeks while the other group received eggs in the inverse sequence. Hen feed was supplemented at 5% with tuna oil. Enriched eggs contained nine times more n-3 PUFA than usual eggs (mainly docosahexaenoic acid). RESULTS: Twenty-five healthy volunteers participated in the study. Based on pooled results observed during the two 3-week periods, consumption of enriched eggs was associated with a significant 16-18% decrease in serum triglycerides (P<0.01) but with no significant difference in serum LDL-cholesterol and HDL-cholesterol. Serum LDL-cholesterol increased during the first 3-week period and decreased during the second 3-week period with both normal and enriched eggs. Participants did not report a systematic preference for either type of eggs. CONCLUSIONS: Reasonable consumption of n-3 PUFA enriched eggs was associated with a significant decrease in serum triglycerides. These eggs could be a palatably acceptable source of n-3 PUFA.
Assuntos
Ração Animal , Ovos/análise , Ácidos Graxos Ômega-3/administração & dosagem , Triglicerídeos/sangue , Adulto , Animais , Galinhas , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Ácidos Graxos/análise , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Limited data are available in the African region on trends in blood pressure (BP) and awareness, treatment and control rates. OBJECTIVE: We examined trends in these indicators for a 25-year period in the Seychelles, a rapidly developing small island state in the African region. METHODS: Population-based surveys of adults aged 25-64 years were performed in 1989, 1994, 2004 and 2013 using nearly identical methods for all surveys. BP was based on the average of the second and third readings. Data were age-standardized. RESULTS: Between 1989 and 2013, mean SBP decreased in older adults (but increased in younger adults) and mean DBP decreased in all age categories, despite a marked secular increase in mean BMI. At age 25-64 years, the proportions with BP at least 140/90 mmHg decreased from 44%/33% (men/women) in 1989 to 37%/22% in 2013. The proportions of persons aware of having high BP (among those with BP ≥ 140/90 or treatment) increased from 40%/63% (men/women) in 1989 to 65%/80% in 2013; the proportions under treatment (among aware) increased from 37%/49% to 64%/78%; and the proportions with controlled BP (among treated) increased from 10%/16% to 34%/61%. Awareness was associated with female sex, age, obesity and diabetes; treatment with age, obesity, low alcohol consumption and diabetes; and control with female sex, age and high socio-economic status. In 2013, the main classes of antihypertensive medications were used in similar proportions, and 64.5% received at least two medications. CONCLUSION: The prevalence of high BP (≥140/90 mmHg) decreased over time, which paralleled improved detection and control of hypertension. The identified associated factors should be considered when strengthening BP control programs.
Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Anti-Hipertensivos/farmacologia , Pressão Sanguínea/fisiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Seicheles/epidemiologiaRESUMO
BACKGROUND: Smoking, alcohol drinking and cannabis use ("risk behaviors") are often initiated at a young age but few epidemiological studies have assessed their joined prevalence in children in developing countries. This study aims at examining the joint prevalence of these behaviors in adolescents in the Seychelles, a rapidly developing country in the Indian Ocean. METHODS: Cross-sectional survey in a representative sample of secondary school students using an anonymous self-administered questionnaire (Global Youth Tobacco Survey). The questionnaire was completed by 1,321 (92%) of 1,442 eligible students aged 11 to 17 years. Main variables of interest included smoking cigarettes on > or =1 day in the past 30 days; drinking any alcohol beverage on > or =1 day in the past 30 days and using cannabis at least once in the past 12 months. RESULTS: In boys and girls, respectively, prevalence (95% CI) was 30% (26-34)/21% (18-25) for smoking, 49% (45-54)/48% (43-52) for drinking, and 17% (15-20)/8% (6-10) for cannabis use. The prevalence of all these behaviors increased with age. Smokers were two times more likely than non-smokers to drink and nine times more likely to use cannabis. Drinkers were three times more likely than non-drinkers to smoke or to use cannabis. Comparison of observed versus expected frequencies of combination categories demonstrated clustering of these risk behaviors in students (P < 0.001). CONCLUSION: Smoking, drinking and cannabis use were common and clustered among adolescents of a rapidly developing country. These findings stress the need for early and integrated prevention programs.