Food Safety for the 21st Century

Background: The burden of cardiovascular diseases in India has increased. The data regarding socio-demographic patterning of cardiovascular disease risk factors is scarce. Objectives: The socio-demographic patterning of cardiovascular disease risk factors in rural Lucknow was assessed. Methods: The cross-sectional survey was conducted among adults aged 18 years and above using a predesigned performa. Stratified random sampling and Probability Proportionate to Size technique was used. Three hundred and seventy three individuals gave consent and participated in the study. Prevalence rates of tobacco use, alcohol consumption, physical inactivity, low vegetable and fruit consumption, increased body mass index and raised blood pressure were determined. Data analysis was performed using SPSS windows version 14.0 software. Results: Only 14.7% of respondents admitted to alcohol consumption. The prevalence of smoking and smokeless tobacco use was 27.9% and 24.1% respectively. Sedentary physical activity was observed in 37.0% of respondents. Majority of respondents had low fruit intake (88.2%) and low vegetable intake (99.1%). Also 15.3% of respondents had an increased body mass index while 20.9% respondents had a raised blood pressure. Alcohol consumption, tobacco use, body mass index and waist circumference was higher among males. CVD risk factors studied were highly prevalent among those aged between 18-40 years of age. Hypertension increased with the increase in age. Alcohol and tobacco use and low fruit and vegetable intake were more common in the lower socioeconomic groups. Conclusions: High burden of cardiovascular disease risk factors was observed in the study population. Such information is useful for designing community based interventions to reduce risk factors in the population.

Smoking has been positively and fruit and vegetable intake has been negatively associated with cervical cancer, the second most common cancer among women worldwide. However, a lower consumption of fruits and reduced serum carotenoids have been observed among smokers. It is not known whether the smoking effect on the risk of cervical neoplasia is modified by a low intake of fruits and vegetables. The present study examined the combined effects of tobacco smoking and diet using a validated FFQ and serum carotenoid and tocopherol levels on cervical intraepithelial neoplasia grade 3 (CIN3) risk in a hospital-based case-control study conducted in São Paulo, Brazil, between 2003 and 2005. The sample comprised 231 incident, histologically confirmed cases of CIN3 and 453 controls. A low intake ( ≤ 39 g) of dark-green and deep-yellow vegetables and fruits without tobacco smoking had a lesser effect on CIN3 (OR 1·14; 95 % CI 0·49, 2·65) than among smokers with higher intake ( ≥ 40 g; OR 1·83; 95 % CI 0·73, 4·62) after adjusting for confounders. The OR for the joint exposure of tobacco smoking and low intake of vegetables and fruits was greater (3·86; 95 % CI 1·74, 8·57; P for trend < 0·001) compared with non-smokers with higher intake after adjusting for confounding variables and human papillomavirus status. Similar results were observed for total fruit, serum total carotene (including β-, α- and γ-carotene) and tocopherols. These findings suggest that the effect of nutritional factors on CIN3 is modified by smoking.

AimBad eating habits and an insufficient amount of body activity can contribute to obesity and overweight. This study looked at the prevalence, related risk factors, awareness of predisposing factors and also the avoidance and management of overweight and obesity in North Wollo, Northeast Ethiopia.MethodsFrom January 2022 to January 2023, A cross-sectional community survey was carried out with 1084 respondents aged 18 and above in North Wollo, Northeast Ethiopia. A multi-stage sampling technique was employed to recruit participants for the quantitative study, while a convenience sampling technique was employed for the qualitative study. A structured questionnaire that had been pre-tested was utilized to gather quantitative data, while qualitative data was collected using an interview. Body mass index was used to determine overweight and obesity. We employed ordinal logistic regression to examine the relationship between predictors and dependent variables. A p-value of 0.05 was statistically significant at 95% confidence.ResultsOverweight/obesity affected 21.3% of the population. Some risk factors were known to the majority of participants, such as excessive saturated fat consumption (52.4%) and a lack of regular physical activity (82.9%). However, a large proportion of respondents were not aware about family history (84.0%), age (57.9%), low intake of vegetables (63.0%), low intake of fruit (77.0%), low socioeconomic status (72.0%), smoking (82.5%), medication (58.0%), stress (82.9%), and lack of sufficient sleep (57.9%) were risk factors for overweight and obesity. The mass of respondents was aware of several methods for preventing overweight and obesity, such as limiting saturated fat consumption (52.4%) and engaging in regular physical activity (82.9%). However, a large percentage of respondents were unaware about getting enough sleep (57.9%), reducing stress (82.9%), managing medications (58.0%), quitting smoking (82.5%), having a good socioeconomic status (72.0%), high intake of fruit (77.0%), and high intake of vegetables (63.0%) could help prevent overweight and obesity. The majority of responders were aware that regular exercise helps with treatment strategies for fatness. However, the vast majority of responders were unaware that well-informed nutrition, weight loss medicine, and weight loss surgery were therapeutic options for overweight and obesity. High levels of stress (p = 0.000), female gender (p = 0.000), increasing age (0.000), physical inactivity (p = 0.000), low intake of fruit and vegetables (p = 0.000 and p = 0.012), smoking (p = 0.000), excessive use of saturated fat (0.043), and alcohol consumption (p = 0.000) all significantly increased the risk of over fatness.ConclusionAccording to the findings of this study, one-fifth of adults are overweight or obese. The majority of participants were unaware of typical risk factors for overweight/obesity, as well as prevention and treatment approaches for unhealthy habits and lack of physical activity.

Introduction: While cardio-protective effects of fruits and vegetables are well-established, the impact of their suboptimal intake on the CVD burden across nations and levels of development has not been evaluated. Objective: To systematically quantify the burden of CVD attributable to low intake of fruits and low intake of vegetables in 195 countries by age, sex, country, and development status in 2015. Methods: We obtained data on consumption of fruits and vegetables from nationally or subnationally representative nutrition surveys and data on their national availability from the UN FAO. Etiologic effect sizes of fruits and vegetables on CVD endpoints were obtained from meta- analyses of prospective cohort studies. The optimal level of intakes for each was determined based on the levels associated with lowest risk of mortality in prospective observational studies. A comparative risk assessment analysis was conducted to quantify the proportion of disability- adjusted life years (DALYs) attributable to low intake of each. The variation of this burden was further evaluated across different levels of our newly developed socio-demographic index (SDI). Results: In 2015, low intake of fruits accounted for 57.3 (95% UI: 37.1- 78.4) million DALYs due to CVD globally (41.5% from IHD and 58.5% from stroke). Low intake of vegetable caused 44.6 (23.6- 68.8) million CVD DALYs (67.3% IHD and 32.7% stroke). The highest burden of CVD attributable to low intake of fruits and vegetables was seen in the middle and low-middle SDI quintiles (17.2 and 14.3% of total DALYs), while the lowest burden for each was seen in high and high-middle SDI quintiles (12.7 and 11.2%). At the country level, the attributable CVD burden ranged from 5.1% of total DALYs (Rwanda) to 23.2% (Bangladesh) for low intake of fruit and from 5.9% (North Korea) to 19.4% (Mongolia) for low intake of vegetable. Conclusion: Our findings suggest that population inventions to increase consumption of fruits and vegetables at population level could save millions of life years globally. Figure. Age-standardized proportion of disability-adjusted life years attributable to low intake of fruits (A) and vegetables (B) from cardiovascular disease among adults (&gt; 25y) in 2015.

BackgroundColorectal cancer is the 4th common cancer in China. Most colorectal cancers are due to modifiable lifestyle factors, but few studies have provided a systematic evidence-based assessment of the burden of colorectal cancer incidence and mortality attributable to the known risk factors in China.MethodsWe estimated the population attributable faction (PAF) for each selected risk factor in China, based on the prevalence of exposure around 2000 and relative risks from cohort studies and meta-analyses.ResultsAmong 245,000 new cases and 139,000 deaths of colorectal cancer in China in 2012, we found that 115,578 incident cases and 63,102 deaths of colorectal cancer were attributable to smoking, alcohol drinking, overweight and obesity, physical inactivity and dietary factors. Low vegetable intake was the main risk factor for colorectal cancer with a PAF of 17.9%. Physical inactivity was responsible for 8.9% of colorectal cancer incidence and mortality. The remaining factors, including high red and processed meat intake, low fruit intake, alcohol drinking, overweight/obesity and smoking, accounted for 8.6%, 6.4%, 5.4%, 5.3% and 4.9% of colorectal cancer, respectively. Overall, 45.5% of colorectal cancer incidence and mortality were attributable to the joint effects of these seven risk factors.ConclusionsTobacco smoking, alcohol drinking, overweight or obesity, physical inactivity, low vegetable intake, low fruit intake, and high red and processed meat intake were responsible for nearly 46% of colorectal cancer incidence and mortality in China in 2012. Our findings could provide a basis for developing guidelines of colorectal cancer prevention and control in China.

BackgroundModifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. Using five MHRFs (smoking, high-risk alcohol consumption, physical inactivity, low intake of fruits and vegetables, and obesity) this study investigates the extent to which risk clusters are observed in a representative sample of women aged 65 and older in Germany. Additionally, the structural composition of the clusters is systematically compared with data and findings from other countries.MethodsA pooled data set of Germany’s representative cross-sectional surveys GEDA09 and GEDA10 was used. The cohort comprised 4,617 women aged 65 and older. Specific risk clusters based on five MHRFs are identified, using hierarchical cluster analysis. The MHRFs were defined as current smoking (daily or occasionally), risk alcohol consumption (according to the Alcohol Use Disorders Identification Test, a sum score of 4 or more points), physical inactivity (less active than 5 days per week for at least 30 min and lack of sports-related activity in the last three months), low intake of fruits and vegetables (less than one serving of fruits and one of vegetables per day), and obesity (a body mass index equal to or greater than 30). A total of 4,292 cases with full information on these factors are included in the cluster analysis. Extended analyses were also performed to include the number of chronic diseases by age and socioeconomic status of group members.ResultsA total of seven risk clusters were identified. In a comparison with data from international studies, the seven risk clusters were found to be stable with a high degree of structural equivalency.ConclusionEvidence of the stability of risk clusters across various study populations provides a useful starting point for long-term targeted health interventions. The structural clusters provide information through which various MHRFs can be evaluated simultaneously.

Introduction: Hypertension is an important health issue among Military personnel because of their unique nature of duties and services. Unhealthy diet, low intake of fruits and vegetables, physical inactivity, harmful use of alcohol and tobacco, overweight or obesity, family history of hypertension are the risk factors for hypertension. This study aims to identify the prevalence and risk factors of hypertension among Military personnel of Nepal Army. Methods: Cross-sectional study was conducted among 416 serving army personnel posted at four selected military barracks; Dhading, Birgunj, Lamjung and Tanahun with the data collection period from January to June 2020. The civilian population working in Army units, retired army personnel and dependents were excluded from the study. Systematic random sampling was used for the selection of participants. Pre-tested questionnaires, weighing machine, stadiometer, measuring tape, stethoscope and BP set were used as a tool for data collection. Data was entered and analyzed using SPSS 20.0. Results: Participants had a mean age of 34.46 ± 5.25 years. Prevalence of hypertension and pre-hypertension was 13.4% and 37.3% respectively. Among the risk factors studied for hypertension; spouse’s education, tobacco chewing, history of hypertension in father and being overweight, were found to be statistically significant with p value of 0.047, 0.000, 0.021, and 0.002 respectively. Conclusions: Prevalence of hypertension was less in military personnel compared to other occupational groups. Avoidance of tobacco consumption, awareness on risk factors of non-communicable disease and maintenance of body weight by regular physical exercise could help reduce prevalence of hypertension in military personnel.

Bangladesh is facing a large burden of non-communicable diseases. As a possible remedy, the WHO/FAO recommends consuming 400 g or five servings of fruits and vegetables every day; however, only a small proportion of the population practices this. The present study sets out to determine the sociodemographic factors that affect this low intake of fruits and vegetables, and the roles that beliefs and behavioural practices play in influencing food consumption. Logistic and ordered logistic regressions were used to identify what sociodemographic factors are significantly influencing fruit and vegetable intake, and to explain the role of social food beliefs. It was found that in Bangladesh 75% of urban and 92% of rural populations consume less than five servings a day. While gender was not found to be a significant factor, housewives appeared to be more at risk of a lower intake of fruits and vegetables. People with higher income, higher education, and who are older were all less likely to have problems with a low intake of fruits and vegetables. Higher education assisted in attaining positive beliefs and behavioural practices regarding food, while residing in a rural community was found to be a significant constraint.

Background: Estimates indicate that 35% of cancer deaths worldwide are attributed to behavioral and environmental risk factors, including tobacco use, excess body weight, low intake of fruits and vegetables, physical inactivity, smoking, alcohol use and infection with HPV. For unknown reasons, the incidence of cancer in females residing in Puerto Rico significantly (p&amp;lt;0.05) increased from 203.9 per 100,000 in 1987 to 248.5 per 100,000 in 2009, an annual average increase of 0.9% during this period. Objective: This study assessed the prevalence of modifiable cancer-related risk factors among a population-based sample of women living in the San Juan Metropolitan Area of Puerto Rico. Methods: We used data from a population-based survey of 496 women, aged 16-64 years, living in the San Juan Metropolitan Area to assess the prevalence of cancer-related risk factors and preventive practices, including selected demographic characteristics and cancer-related risk behaviors: tobacco use, alcohol consumption, BMI, physical activity (participation in moderate-intensity activities for a minimum of 30 minutes on five days per week or vigorous-intensity activity for a minimum of 20 minutes on three days per week), daily intake of at least five portions of fruits and vegetables, and cervical HPV-DNA infection in cervix. Logistic regression was used to assess the association between individual cancer-related risk factors and socio-demographic characteristics. Results: The prevalence of cancer-related risk factors was high: obesity (BMI≥30 kg/m2), 41.9%; current smoking, 18.6%; binge drinking, 38.7%; low physical activity, 68.2%; low intake of fruit and vegetables, 95.0%; HPV-DNA infection for any type, 27.8%; and high-risk HPV infection, 8.6%. Only 0.8% of women had none of these cancer-related risk factors, 42.9% had 1-2 risk factors, and 56.2% had at least 3. Multivariable analyses showed that less educated women were significantly more likely to smoke and to meet physical activity recommendations. Older women were significantly more likely to be obese and significantly less likely to report binge drinking or to have HPV-DNA infection (any type or high-risk) in the cervix. Conclusion: The elevated prevalence of major cancer-related risk factors among women in PR underscores the need for interventions aimed at lifestyle modification in this population. Additional research on the extent to which behavioral and environmental exposures are responsible for the increase in cancer incidence in Puerto Rico is highly warranted. Citation Format: Cynthia M. Perez, Daisy González-Barrios, Vivian Colón, Katherine L. Tucker, Ana P. Ortiz. Cancer-related risk factors in Hispanic women in the San Juan metropolitan area of Puerto Rico. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 147. doi:10.1158/1538-7445.AM2013-147

Self-reported intake of fruit and vegetables and risk of chronic obstructive pulmonary disease: A nation-wide twin study.

OBJECTIVE: To investigate the cluster of physical inactivity and low fruit and vegetable intake and the associated factors in university students. METHODS: This cross-sectional study included a representative sample (n=717) of Universidade Federal Rural de Pernambuco students. Low fruit and vegetable intake was defined as an intake of less than five servings a day and physical inactivity was defined as exercising less than 150 minutes a week. The independent variables were gender, age, socioeconomic status, school year, shift, and study time. Clustering was determined by comparing the observed prevalence with the expected prevalence for all possible risk-factor combinations. Logistic regression analysis, performed by the software Statistical Package for the Social Sciences 17.0 with a significance level of 5% (p&lt;0.05), considered the presence of both risk behaviors adjusted to the independent variables. RESULTS: The prevalence of low fruit and vegetable intake was 81.7% (CI95%=78.1-84.3) and of physical inactivity was 65.8% (CI95%=62.2-69.4). Most students (58.6%, CI95%=55.3-62.2) were exposed to both risk factors simultaneously, while 11.0% (CI95%=8.9-13.5) were exposed to neither. Full-time students have a risk 1.45 times greater of simultaneous exposure. Juniors and seniors are, respectively, 1.88 and 2.80 times more likely to present both risk behaviors. CONCLUSION: Although complex, the behaviors are modifiable, and both the healthy and the unhealthy behaviors tend to cluster. The implementation of an intervention that targets both risk behaviors is needed. Different strategies can be used, such as providing areas for physical activity and for learning about healthy and risk behaviors.

BackgroundThere are very few studies on the frequency of breakfast and snack consumption and its relation to fruit and vegetable intake. This study aims to fill that gap by exploring the relation between irregular breakfast habits and snack consumption and fruit and vegetable intake in Tuscan adolescents. Separate analyses were conducted with an emphasis on the potentially modifying factors of sex and age.MethodsData was obtained from the 2010 Tuscan sample of the Health Behaviour in School-aged Children (HBSC) study. The HBSC study is a cross-sectional survey of 11-, 13- and 15-year-old students (n = 3291), selected from a random sample of schools. Multivariate logistic regression was used for analyzing the food-frequency questionnaire.ResultsA significant relation was found between low fruit and vegetable intake and irregular breakfast habits. Similarly, low fruit intake was associated with irregular snack consumption, whereas vegetable intake did not prove to be directly related to irregular snack consumption. Different patterns emerged when gender and age were considered as modifying factors in the analyses. A statistically significant relation emerged only among female students for irregular breakfast habits and fruit and vegetable intake. Generally, older female participants with irregular breakfast habits demonstrated a higher risk of low fruit and vegetable intake. Age pattern varied between genders, and between fruit and vegetable consumption.ConclusionsResults suggest that for those adolescents who have an irregular consumption of breakfast and snacks, fruit intake occurs with a lower frequency. Lower vegetable consumption was associated with irregular breakfast consumption. Gender and age were shown to be moderators and this indicated the importance of analyzing fruit and vegetable intake and meal types separately.This study also confirmed that health-promotion campaigns that aim to promote regular meal consumption and consumption of fruits and vegetables need to take into account gender and age differences in designing promotional strategies. Future research should identify evidence-based interventions to facilitate the achievement of the Italian guidelines for a healthy diet for fruit, vegetables and meals intake.

Background:Myocardial infarction (MI) is a multifactorial noncommunicable disease. The study was conducted with an objective to assess the role of various sociodemographic and clinicoepidemiological determinants of MI.Materials and Methods:The cases and controls were selected in the ratio of 1:1 and were group matched for age, sex, and type of residence. Cases of MI were selected from the intensive coronary care unit of the medicine department at a tertiary care hospital, Rajkot, for 1 year. Controls were selected from the general population of Rajkot district. Information was collected in pretested pro forma using the interview technique.Results:A total of 406 cases and equal number of controls were enrolled in the study. Several risk factors identified for MI included illiteracy, upper socioeconomic class, family history of MI, Type A personality, hypertension, diabetes mellitus, obese or overweight, high waist–hip ratio, low intake of leafy vegetables, low intake of fruits, and history of acute life event for the past 1 year. On applying logistic regression model, these factors were also identified as independent determinants for MI.Conclusion:The findings confirm the role of conventional risk factors for MI and also highlight the role of sociodemographic factors such as illiteracy, higher social class, low intake of leafy vegetables and fruits, and history of acute life event.

Low Intake of Fruits and Vegetables and High Intake of Processed Meats and Juices Are Associated with Risk of MGUS in the National Health and Nutrition Examination Survey (NHANES) Database

Associations between parenting and substance use, meal pattern and food choices: A cross-sectional survey of 13,269 Norwegian adolescents.