Inadequate Vegetable Consumption Research Articles

Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

BackgroundNoncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay).Methods and materialsWe conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension.ResultsOf the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension.ConclusionThe prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.

Co-occurrence of behavioural risk factors fornon-communicable diseases among 40-year and above aged community members in three regions of Myanmar.

Risky behaviours such as smoking, alcohol consumption, physical inactivity and inadequate consumption of fruits and vegetables are known contributing factors for non-communicable diseases (NCDs) which account for 74% of global mortality. Such behavioural risk factors co-occur frequently resulting in synergistic action for developing NCD related morbidity and mortality. This study aims to assess the existence of multiple risk behaviours and determine the socio-economic and demographic factors associated with co-occurrence of behavioural risks among Myanmar adult population. Data were collected, in the context of the SUNI-SEA project (Scaling Up NCD interventions in Southeast Asia), from 660 community members aged 40 years and above of both sexes, residing in selected urban and rural areas from Ayeyawaddy, Yangon and Mandalay regions of Myanmar. The co-occurrence of behavioural risk factors was presented as percentage with 95% CI and its determinants were identified by multinomial logistic regression. The co-occurrence of two risk behaviours and three or four risk behaviours were found in 40% (95% CI: 36.2%, 43.9%) and 10.8% (95% CI: 8.5%, 13.4%) respectively. Urban residents, men, participants without formal schooling and unemployed persons were more likely to exhibit co-occurrence of two risk behaviors and three or four risk behaviours. The current study shows high prevalence of co-occurrence of behavioural risk factors among Myanmar adults in the study area. NCD prevention and control programs emphasizing management of behavioural risks should be intensively promoted, particularly directed towards multiple behavioural risk factors, and not focused on individual factors only.

Association of food consumption and physical activity with metabolic syndrome according to central obesity status in Indonesian adults: A cross-sectional study

Background: Previous studies have reported that the risk of metabolic syndrome differs between obese and non-obese individuals based on food consumption and physical activity.Objective: This study aims to analyze differences in the association of food consumption and physical activity with the incidence of metabolic syndrome in individuals with and without central obesity.Materials and Methods: This cross-sectional study examined individuals aged 19 to 64 years using Riskesdas 2018 data. Sample characteristics, including smoking habits, alcohol consumption, food consumption, physical activity, anthropometric data, clinical data, and biochemical data were collected for univariate, bivariate, and multivariate analyses. Logistic regression was used as a multivariate analysis to investigate the association of food consumption and physical activity with the risk of metabolic syndrome in individuals with and without central obesity. Results: In this study, individuals with and without central obesity significantly increased risk of metabolic syndrome (p<0.05) due to consuming nearly all kinds of unhealthy foods (sweet foods, savory foods, fatty/cholesterol-rich/fried foods, grilled foods, processed meat/chicken/fish, soft drinks/carbonated drinks, energy drinks, and instant noodles/other instant foods). However, only individuals without central obesity who frequently consume seasonings (OR=1.519, 95% CI: 1.241-1.859) have a significant association with an increased risk of metabolic syndrome. Meanwhile, only individuals with central obesity who often consume sugary drinks (OR=1.315, 95% CI: 1.132-1.529) are significantly associated with an increased risk of metabolic syndrome. In addition, inadequate consumption of fruits and vegetables as well as lack of physical activity also significantly increase the risk of metabolic syndrome in individuals with and without central obesity (p<0.05).Conclusion: Only the consumption of seasonings and sugary drinks shows a different relationship to the risk of metabolic syndrome in individuals with and without central obesity.

Prevalence of hypertension and its risk factors among urban school children of Belagavi- a cross sectional study

Background: Primary hypertension is becoming common among apparently healthy children. Measures for early diagnosis of pre hypertension and hypertension along with its risk factors during childhood could benefit from earlier intervention and follow-up. Methods: This cross sectional study was conducted among 270 urban school students of Belagavi of class 10th in 2016 by using a structured questionnaire followed by anthropometry and blood pressure measurement. Results: About 39% of children had family history of hypertension and 27% had family history of chronic diseases. Majority had inadequate consumption of vegetables (84.07%) and fruits (83.70%). The overall physical activity among the students was inadequate (78.15%) and about 46.30% of them got easily angered, stressed or irritated. The waist circumference of 14.07% students was falling in obese category. About 11.48% of them were overweight and 7.04% were obese according to their body mass index. Among the students, 71.85% had normal blood pressure and 18.15% had pre-hypertension. Hypertension was detected among 10.00% of students of which 5.56% belonged to stage I and 4.44% belonged to stage II hypertension. Statistical association between the blood pressures of school children showed significance with family history of chronic diseases (p=0.025), body mass index and waist circumference (p<0.001). Conclusions: One tenth of the children had hypertension and one fifth of the children had pre-hypertension. The children who were obese had increased blood pressure than those with normal weight. Health promotion at early phase of life can help in the prevention of hypertension.

Contribution of dietary patterns and dietary diversity to the nutritional status of children under five years in Nelson Mandela Bay Metro, South Africa

Food insecurity and malnutrition is a major problem in the sub-Saharan African region. The study aimed to determine the contribution of dietary patterns and dietary diversity on child nutritional status of children aged 0 to 60 months. A cross-sectional design was applied using a quantitative approach. A convenience sample (n=184) of children aged 0 to 60 months were included from the Dora Nginza Hospital (situated in Port Elizabeth in South Africa) and data was collected between May and July 2018. Primary caregivers provided informed consent for themselves and their children for participation. The researcher and trained assistants collected data using structured questionnaires which aimed at gathering information on socio-economic factors, health status, dietary patterns, and diversity. Child anthropometric measurements were performed on children following the World Health Organisation (WHO) standardised methods. Slightly more males (52.7%, n = 97) than females were included. The mean age of the children included was 20.21 months (SD = 17.1). Most were of African ethnicity (58.7%, n = 108). A total of 25.6% (n = 47) of the children were stunted, 19.8% (n = 25) were underweight for their age, 6.7% (n = 7) were classified as either moderate acute malnourished (3.9%) or (n =7) or severely acute malnourished (2.8%, n = 5), and 7.2% (n = 13) were overweight or obese. There was low or inadequate consumption of meat, dairy products, fruit and vegetables and the most consumed foods were soft porridge, margarine, potatoes, white bread and chips. About 91% of the children met the minimum dietary diversity score (>4 dietary diversity). The child’s dietary diversity score had a significantly positive relationship with weight for height, weight for age and mid-upper arm circumference, showing improved nutritional status when a more varied diet is eaten. Therefore, these findings confirm the importance of dietary diversity and dietary patterns to nutritional status of children under 60 months of age. Key words: anthropometry, underweight, overweight, malnutrition, caregivers, nutritional status, consumption, stunting, cross-sectional

VEGETABLE CONSUMPTION AND COOKING SKILLS AMONG UNIVERSITY STUDENTS

A high vegetable diet has proved to offer health benefits that can lower blood pressure, reduce the risk of heart disease and stroke, prevent some types of cancer, lower the risk of eye and digestive problems, and have a positive effect on blood sugar, which can help control appetite. However, the prevalence of vegetable consumption below the recommended daily intake is worrying. Nearly 95% of Malaysian adults, including university students, have not met the recommended daily amount of vegetables. Sociodemographic factors and a lack of cooking skills may contribute to inadequate vegetable consumption. A study was carried out to determine the relationship between sociodemographic characteristics and cooking skills with vegetable consumption among Malaysian university students. By utilizing a random sample, a cross-sectional study was conducted to evaluate the frequency of vegetable consumption and cooking skill among university students aged 18 and older. The data was obtained via online survey using the Food Frequency Questionnaire (FFQ) and the Cooking Skills Questionnaire validated and tested by previous researchers. Vegetable consumption was divided into daily and non-daily consumption and a chi-square test was performed to analyze the association followed by the Bonferroni posthoc test. The association between sociodemographic and five dimensions of cooking skills with daily vegetable consumption was subject to logistic regression and an adjusted odds ratio was applied. Results demonstrated that only 24% of students (20% of males and 52% of females) consumed vegetables regularly, while the rest did not. There is a positive association between cooking skills dimensions (availability and accessibility of fruits and vegetables; produce consumption self-efficacy and knowledge of cooking terms and techniques) with daily vegetable consumption. Students who were 25 years old and older, male, lived alone, with friends, or with children, understand how to cook, ordered outside during lunchtime, and dined at the cafeteria for lunch were significantly associated with daily vegetable consumption.

Anemia in female adolescents at Karanganyar regency: A cross-sectional study associated with polymorphism of duodenal cytochrome B gene and daily consumptions of fruits and vegetables.

The prevalence of anemia in female adolescents increases every year. A duodenal Cytochrome B (CYBRD1) enzyme is involved in the regulation of iron metabolism. G797A gene polymorphism of the CYBRD1 reduces nonheme iron transport into the enterocytes, which was mediated by the divalent metal transporter 1 protein. Daily consumption of fruits and vegetables has been recommended for the prevention of non- communicable diseases, including anemia. This study aimed to analyze the association of CYBRD1 polymorphism and daily consumption of fruits and vegetables with anemia in female adolescents in the Karanganyar regency. This cross-sectional study recruited 233 female students in 6 senior and vocational high schools in Karanganyar regency, which were selected using purposive sampling. Data on fruit and vegetable consumption were collected using Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Polymorphism of the G797A CYBRD1 gene was determined using the amplification refractory mutation system polymerase chain reaction. All collected data were analyzed using chi-square and multiple logistic regression tests with p < 0.05. Anemia was found in 13.73% of female students. Inadequate intakes of fruits and vegetables were found in 63.09 and 51.07% of female students, respectively. The AA genotype (OR = 5.779; 95%CI: 0.974-34.289; p = 0.053), inadequate fruit consumption (OR = 1.497; 95%CI: 0.603-3.718; p = 0.133), and inadequate vegetable consumption (OR = 11.99; 95%CI: 3.457-41.586; p < 0.001) increased higher risk of anemia, compared with their counterparts. G797A CYBRD1 gene polymorphism and daily consumption of vegetables increase the risk of anemia but not for daily consumption of fruits in female adolescents in the Karanganyar regency.

Co-occurrence of behavioural risk factors for non-communicable diseases among 40-year and above aged community members in three regions of Myanmar

Background: Risky behaviours such as smoking, alcohol consumption, physical inactivity and inadequate consumption of fruits and vegetables are known contributing factors for non-communicable diseases (NCDs) which account for 74% of global mortality. Such behavioural risk factors co-occur frequently resulting in synergistic action for developing NCD related morbidity and mortality. This study aims to assess the existence of multiple risk behaviours and determine the socio-economic and demographic factors associated with co-occurrence of behavioural risks among Myanmar adult population. Method: Data were collected, in the context of the SUNI-SEA project (Scaling Up NCD interventions in Southeast Asia), from 660 community members aged 40 years and above of both sexes, residing in selected urban and rural areas from Ayeyawaddy, Yangon and Mandalay regions of Myanmar. The co-occurrence of behavioural risk factors was presented as percentage with 95% CI and its determinants were identified by multinomial logistic regression. Results: The co-occurrence of two risk behaviours and three or four risk behaviours were found in 40% (95% CI: 36.2%, 43.9%) and 10.8% (95% CI: 8.5%, 13.4%) respectively. Urban residents, men, participants without formal schooling and unemployed persons were more likely to exhibit co-occurrence of two risk behaviors and three or four risk behaviours. Conclusion: The current study shows high prevalence of co-occurrence of behavioural risk factors among Myanmar adults in the study area. NCD prevention and control programs emphasizing management of behavioural risks should be intensively promoted, particularly directed towards multiple behavioural risk factors, and not focused on individual factors only.

Adherence to the 2021 dietary guidelines of the European Society of Cardiology on cardiovascular disease prevention in residents of the Pomeranian Voivodeship with increased cardiovascular risk.

Good eating habits can reduce cardiovascular risk. The aim of this work was to verify the compliance with the new European Society of Cardiology (ESC) dietary guidelines in people with increased risk of cardiovascular disease. The study included 1244 current or former smokers (636 men and 608 women) at a mean (SD) age of 61.6 (6.4) years who volunteered for the MOLTEST BIS lung cancer prevention program. During the program, 49% of the patients were diagnosed with one of the following: arterial hypertension (AH), diabetes mellitus (DM), or coronary artery disease (CAD). The patients with lung cancer were excluded from the study. The participants completed a Food Frequency Questionnaire (FFQ‑6) and their food intake was assessed with a 24‑hour dietary recall method. Only 2% of the studied individuals declared consuming more than 2 servings of both fruits and vegetables every day, and only 3% of the respondents confirmed daily nut consumption. Most of them weighed too much, consumed too little fiber, and derived too much energy from total and saturated fats. The mean animal to plant protein ratio was higher than recommended, as was the omega‑6 to omega‑3 fatty acid ratio. Only 40% of the participants with AH, DM, or CAD had a daily cholesterol intake below 200 mg, and in only 12% of them less than 7% of total energy came from saturated fats. The smokers with increased cardiovascular risk did not comply with the 2021 ESC dietary recommendations. The most common error was inadequate consumption of vegetables, fruits, and nuts.

Post-migration food habits of New Zealand South Asian migrants: Implications for health promotion practice

IntroductionSouth Asian migrants in western countries have a high risk for diet related diseases post-migration. Hence knowledge on food habits that change post-migration, which are detrimental to health, are critical for health promotion initiatives to reduce this disease burden. Objectiveto describe food consumption changes post-migration according to sex and duration of residence in New Zealand among South Asian migrants. MethodsA cross-sectional mail survey of 150 self-selected people of South Asian ethnicity aged 25–59 years in New Zealand. ResultsThe study achieved responses from 112 participants (75%) with a mean age of 36 (7.5) years. Consumption of green leafy vegetables reduced post-migration for females and in new migrants (P < 0.05). Fruit consumption increased in both genders and across duration of residence (P < 0.05). Only 15% of males and 36% of females met the 3 + a day recommendation for vegetable consumption. Consumption of traditional breads, breakfast items and rice (males) decreased whilst that of breakfast cereals increased (P < 0.05). Consumption of low-fat milk, cheese, ice-cream, butter (females) and margarine increased, whilst ghee decreased (P < 0.05). Consumption of fish, lentils, traditional sweets and savouries decreased, whilst meat, processed meat, chicken, potato chips, cakes and pastries (females) and alcohol (males) increased (P < 0.05), post-migration. Thirty-three percent of males and 24% of females consumed takeaways “weekly or more often”, with the majority (male: 51%; female: 36%) consuming European foods such as pizzas and pastas. Thirteen percent of males and 26% of females consumed festival foods “weekly or more often.” More than half the participants were obese with BMI increasing with duration of residence (P = 0.025). ConclusionsA food-based health promotion initiative focused on inadequate consumption of fruits and vegetables, increased consumption of dairy foods such as cheese and ice cream, and high fat European takeaway foods would be warranted particularly in new South Asian migrants.

Prevalence of nutrition risk and associated risk factors among New Zealand pre-school children.

To determine the prevalence of nutrition risk using the validated, Nutrition Screening Tool for Every Pre-schooler (NutriSTEP) among pre-school children in New Zealand (NZ) and to identify socio-demographic factors associated with nutrition risk. Parents/caregivers of NZ pre-school children (aged 2-5 years) completed an online survey including NutriSTEP, both parent and child height and weight, as well as socio-demographic characteristics. The 17-item NutriSTEP responses were scored between 0 and 4; where item scores ≥2 indicate risk, and the maximum score is 68. Participants were stratified into low-risk (score ≤ 20) and moderate to high-risk (score > 20) groups. Strength of associations between nutrition risk and socio-demographic characteristics were explored using binary regression analysis. Of 505 pre-school children, 96 (19%) were at moderate to high risk (median interquartile range NutriSTEP score 24 [22-26]) and 409 (81%) were at low risk (score 13 [10-16]). Pre-school children at highest risk were non-NZ European (P=0.002), with solo parents (P=0.002), from households with incomes ≤$50 000 (P ≤ 0.021) and with non-university educated parents (P ≤ 0.0001). More than 30% of pre-schoolers were at high risk for inadequate consumption of fruit, vegetables, grains, milk products, meat and meat alternatives, as well as exposure to screens during meals and overuse of supplements. A fifth of NZ pre-school children were at moderate to high nutrition risk and may not have met the nutrition guidelines. Economic and ethnic disparities were apparent. Using NutriSTEP may assist to identify NZ pre-school children at highest nutrition risk who may benefit from appropriate nutrition support.

Factors associated with inadequate consumption of fruit and vegetables among users of Primary Health Care in Brazil

Introdução: O consumo inadequado de frutas e hortaliças (FH) pode derivar de questões individuais, culturais, socioeconômicas e ambientais. Objetivo: Este estudo tem como objetivo identificar os fatores associados ao consumo inadequado de frutas e hortaliças entre homens e mulheres na Atenção Primária à Saúde brasileira. Métodos: Trata-se de um estudo transversal com amostra representativa do Programa Academia da Saúde - PAS. O consumo de FH foi avaliado por um questionário validado, incluindo a frequência e o número de porções consumidas. O consumo inadequado foi classificado como frutas &lt;3 porções/dia; hortaliças&lt;2 porções/dia. Foram investigados o perfil sociodemográfico, de saúde, antropométrico, erelacionado à compra de frutas e hortaliças. Resultados: O consumo inadequado de frutas (mulheres: 61,4%; homens: 68,1%) e hortaliças (mulheres: 40,6%; homens: 51,1%) foi elevado. Entre as mulheres, os fatores associados ao consumo inadequado de FH foram: ser idosa, considerar a sua qualidade de vida como boa e ter conhecimento sobre a safra dos alimentos; e para frutas, ter diabetes. Para os homens, os fatores associados ao consumo inadequado de frutas foram: ser idoso e tentativa atual de emagrecer; e para hortaliças, qualidade de vida boa e risco de complicações metabólicas. Conclusão: Foram identificados fatores iguais e diferentes para mulheres e homens associados ao consumo inadequado de FH. Esses resultados mostram a importância de ações de promoção da alimentação saudável que considerem as diferenças no consumo desses alimentos de acordo com o sexo dos participantes.

Food Consumption Pattern and Dietary Diversity Among Pregnant and Lactating Women, Children, and Adolescent Girls in Devbhumi Dwarka District, Gujarat: A Cross-Sectional Study.

BackgroundFood consumption patterns and dietary diversity are vital sources for the nutrition status of pregnant women (PW) and lactating women (LW), children, and adolescent girls. Undernutrition, food consumption pattern, and poor dietary diversity are interlinked; however, not much is known in the context of rural Gujarat. This study aims to assess the regional pattern of food consumption and dietary diversity among pregnant and lactating women, children, and adolescent girls from Devbhumi Dwarka District in the state of Gujarat.MethodsA cross-sectional study was conducted in four blocks of Devbhumi Dwarka District of Gujarat. A cluster sampling method was used for a better representation. A total of 632 pregnant women, 562 lactating mothers, 855 children aged 7-24 months, and 1,252 adolescent girls were assessed for food consumption patterns.ResultsConsumption of cereals (98%) was found to be highest among pregnant women, whereas consumption of pulses and fruits, which are rich in proteins and vitamins, was inadequate. Overall, the consumption of fruits was inadequate among adolescent girls (56.5%). Moreover, inadequate consumption of green leafy vegetables (36.4%) was noted among children. The dietary diversity score (DDS) for the study population ranges between 4.5 and 4.8, indicating medium diversity in food.ConclusionCereal consumption is higher, which indicates a major part of the energy consumed by vulnerable groups. In contrast, low consumption of pulses, fruits, milk, and green leafy vegetables suggests the possibility of one or more micronutrient deficiencies. There is a need for innovative intervention to change food habits and promote locally available nutrient-rich food and awareness of the importance of various food groups to improve food patterns and the health of vulnerable groups.

Adequate Dietary Intake and Vitamin D Supplementation: A Study of Their Relative Importance in Determining Serum Vitamin D and Ferritin Concentrations during Pregnancy.

Vitamin D is essential for human health. However, it is not clear if vitamin D supplementation is necessary for all pregnant women. This study examines the relative importance of dietary patterns and vitamin D supplementation frequency in determining serum 25-hydroxyvitamin D (25(OH)D) and ferritin concentrations among pregnant women in Hong Kong, China. A total of 572 healthy women were recruited from antenatal clinics at 25–35 weeks pregnant. Participants completed an electronic version of the food frequency questionnaire and a web questionnaire on supplement use. Their blood samples were tested for serum 25(OH)D and ferritin. The associations of dietary patterns and vitamin D supplementation frequency with serum 25(OH)D and ferritin concentrations were analyzed using moderated hierarchical regression. Two dietary patterns were identified. The adequate dietary intake was characterized by the high probability of meeting recommended daily food group servings, whereas the inadequate dietary intake was characterized by inadequate consumption of vegetables, fruits, meat, fish, and eggs, or alternatives. The association between adequate dietary intake and serum ferritin concentrations was independent of vitamin D supplementation frequency (β = 0.05, p = 0.035), but dietary patterns interacted with vitamin D supplementation frequency to determine serum 25(OH)D concentrations (β = −13.22, p = 0.014). The current study presents evidence on the relative importance of dietary patterns and vitamin D supplementation in maintaining sufficient vitamin D and iron in pregnancy. Antenatal nutrition counselling services should be provided to pregnant women who show signs of inadequate dietary intake.

Associations of childhood and adult socioeconomic circumstances with recommended food habits among young and midlife Finnish employees

BackgroundDisadvantaged socioeconomic circumstances are associated with certain unhealthy food habits such as inadequate consumption of fruit and vegetables. This study examined whether multiple socioeconomic measures are consistently associated with a variety of food habits.MethodsWe examined associations of 2 childhood and 6 adult socioeconomic measures with 8 recommended food habits among 19–39-year-old employees of the City of Helsinki, Finland. The data were collected in 2017 via online and mailed surveys. Our sample consisted of 4621 employees (80% women). The analyses included adjusted binary logistic regression models.ResultsMore advantaged socioeconomic circumstances were positively associated with the recommended consumption of vegetables, fruit or berries, dark bread, skimmed milk products, fish, and cooking oil, but not consistently with red or processed meat and fat spread. All socioeconomic measures were positively associated with having several (6–8) recommended food habits after gender and age adjustments. The strongest associations were found for participant’s education, occupational class, and current financial difficulties. These associations remained after adjustments of childhood and adult socioeconomic measures, although especially participant’s education attenuated the associations for occupational class.ConclusionsThe consistent associations between multiple childhood and adult socioeconomic measures and food habits found among employees highlight the need for improving food habits among people with disadvantaged socioeconomic circumstances in particular. Financial barriers together with social aspects of adhering to healthy diets should be considered in future dietary interventions and policy actions.

Dietary Practices among Adolescents in a Rural Area in Kerala

BACKGROUND&#x0D; The rapid physical growth and development in adolescence are associated with increased nutritional needs and this depends on the dietary pattern and eating habits of the adolescents. Adolescence is also a period of increased vulnerability to obesity which is not only linked to food intake but also due to a lack of physical activity in the growing years. Dietary habits that are established during adolescence are often sustained till adulthood. Hence the purpose of the study was to understand the prevalence of unhealthy dietary practices among adolescents that could enable schools to create a health-promoting culture by teaching healthy food choices and creating awareness of the ill effects of unhealthy dietary practices.&#x0D; METHODS&#x0D; A cross-sectional study was conducted using a semi-structured questionnaire among adolescents in the age group 15 to 17 years in a panchayat in Kerala. The socio-demographic characteristics, the family details and dietary practices were recorded, height and weight were measured, and BMI was calculated and ELIZ health pathway for adolescents (EPHA) was used for categorising the study participants. A diet score was also calculated to estimate the prevalence of unhealthy dietary practices among adolescents.&#x0D; RESULTS&#x0D; The prevalence of inadequate consumption of fruits was 60.9 % and inadequate consumption of vegetables was 36.9 %. Based on the dietary score, 36.7 % had poor dietary habits and 36.6 % had good dietary habits. A significant association was found between the type of school, occupation of mother, educational status of parents, type of family and inadequate consumption of fruits and vegetables.&#x0D; CONCLUSIONS&#x0D; An unhealthy lifestyle does not just appear in adulthood, it stems from practices children develop during their childhood and adolescence. Awareness regarding the risk factors of non-communicable diseases should be provided to children to enable primordial and primary prevention as powerful tools to prevent these diseases in future.

Non-communicable disease prevention in Kosovo: quantitative and qualitative assessment of uptake and barriers of an intervention for healthier lifestyles in primary healthcare

BackgroundSmoking, physical inactivity, low fruit and vegetable consumption, and obesity are common in Kosovo. Their prevention is a priority to relieve the health system of from costly non-communicable disease treatments. The Accessible Quality Healthcare project is implementing a primary healthcare intervention that entails nurse-guided motivational counselling to facilitate change in the domains of smoking, diet, alcohol consumption and physical inactivity for at-risk patients. This study quantitatively assesses the uptake of motivational counselling and the distribution of health behaviours and stages of health behaviour change of the participants according to the intervention, as well as qualitatively describes experiences and perceived benefits of motivational counselling.MethodsStudy participants (n = 907) were recruited consecutively in 2019 from patients visiting the Main Family Medical Centres in 12 municipalities participating in the Kosovo Non-Communicable Disease Cohort study as part of the Accessible Quality Healthcare project. For the quantitative study, we used baseline and first follow-up data on smoking status, physical inactivity, obesity, fruit and vegetable as well as alcohol consumption, uptake of counselling, and stages for behavioural change. For the qualitative study, in-depth interviews were conducted with a subset of 26 cohort participants who had undergone motivational counselling.ResultsMotivational counselling was obtained by only 22% of the eligible participants in the intervention municipalities. Unhealthy behaviours are high even in persons who underwent counselling (of whom 13% are smokers; 86% physically inactive; 93% with inadequate fruit and vegetable consumption; and 61% are obese); only the rate of smoking was lower in those who obtained counselling. Among smokers, over 80% were still in the pre-contemplation phase of behaviour change. More advanced stages of behaviour change were observed among the highly prevalent group of inactive persons and participants with poor dietary habits, among the 5 intervention municipalities. According to the qualitative study results, the participants who obtained motivational counselling were very satisfied with the services but requested additional services such as group physical activity sessions and specialized services for smoking cessation.ConclusionsMore tailored and additional primary health care approaches in accordance with patients’ views need to be considered for the motivational counselling intervention to reach patients and efficiently facilitate lifestyle behaviour change.

Modifiable risk factors in adults with and without prior cardiovascular disease: findings from the Indonesian National Basic Health Research

BackgroundsThe majority of risk factors for cardiovascular diseases (CVDs) are modifiable. Continuous monitoring and control of these factors could significantly reduce the risk of CVDs-related morbidity and mortality. This study estimated the prevalence of modifiable risk factors in Indonesia and its co-occurence of multiple risk factors stratified by prior CVDs diagnosis status and sex.MethodsAdult participants (> 15 years, N = 36,329, 57% women) with median age of 40 years were selected from a nationwide Indonesian cross-sectional study called Basic Health Research or Riset Kesehatan Dasar (Riskesdas) conducted in 2018. Thirteen risk factors were identified from the study, including smoking, a high-risk diet, inadequate fruit and vegetable consumption, a low physical activity level, the presence of mental-emotional disorders, obesity, a high waist circumference (WC), a high waist-to-height ratio (WtHR), hypertension, diabetes, a high total cholesterol level, a high low-density lipoprotein (LDL) cholesterol level, and a low high-density lipoprotein (HDL) cholesterol level. Age-adjusted prevalence ratios stratified by CVDs status and sex were calculated using Poisson regression with the robust covariance estimator.ResultsCVDs were found in 3% of the study population. Risk factor prevalence in the overall population ranged from 5.7 to 96.5% for diabetes and inadequate fruit and vegetable consumption respectively. Smoking, a high-risk food diet, and a low HDL cholesterol level were more prevalent in men, whereas a low physical activity level, the presence of mental-emotional disorders, obesity, a high WC, a high WtHR, hypertension, diabetes, a high total cholesterol level, and a high LDL cholesterol level were more prevalent in women. Approximately 22% of men and 18% of women had at least 4 risk factors, and these proportions were higher in participants with prior CVDs diagnosis.ConclusionsThere is a high prevalence of modifiable risk factors in the Indonesian adult population. Sex, age, and the presence of CVD are major determinants of the variations in risk factors. The presence of multiple risk factors, which are often inter-related, requires a comprehensive approach through health promotion, lifestyle modification and patient education.

Cross-sectional and prospective associations of lifestyle risk behaviors clustering with elevated depressive symptoms among middle-aged and older adults

ObjectivesTo investigate the cross-sectional and prospective associations of lifestyle risk behaviors clustering with elevated depressive symptoms and to explore synergic prospective associations of different combinations of lifestyle risk behaviors with subsequent depressive symptoms. Study designProspective cohort study. Data on 31,190 middle-aged and older adults from waves 4 (2011) and 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Main outcome measuresElevated depressive symptoms were estimated using the EURO-D 12-item scale. Lifestyle risk behaviors composing the cluster included physical inactivity, inadequate consumption of fruit and/or vegetables, binge drinking, and tobacco smoking. Gender, age group, education, place of residence, country, number of chronic diseases and body mass index were considered as confounders. ResultsWith the exception of binge drinking, all lifestyle risk behaviors were associated with higher odds of elevated depressive symptoms in cross-sectional and prospective analyses. The clustering of unhealthy lifestyle behaviors was cross-sectionally associated with elevated depressive symptoms and the clustering of two [odds ratio [OR]: 1.39; 95%CI: 1.28–1.51) and three or four (OR: 1.60; 95%CI: 1.38–1.85) were prospectively associated with elevated depressive symptoms. There were no interactions between the pairs of behaviors in the association with later elevated depressive symptoms. ConclusionsOur findings support the need for interventions integrating multiple health behaviors to prevent elevated depressive symptoms among middle-aged and older adults.

Examining prevalence of cancer risk factors across Ontario for the Ontario Cancer Profiles tool

The Ontario Cancer Profiles is an interactive dashboard for the public containing population-level cancerstatistics created by Ontario Health (Cancer Care Ontario). The tool contains data on cancer burden, cancerscreening measures, and cancer risk factors by Local Health Integration Network (LHIN) and Public Health Unit (PHU). It can be used for health system planning, measuring health systems performance, monitoring the impact of interventions, and to help identify new areas of research. There were 9 new modifiable cancer risk factors proposed to be included in future updates of the dashboard. The proposed risk factors include: access to care, active transportation, binge drinking, alcohol abstinence, inadequate fruit consumption, inadequate vegetable consumption, sedentary behaviour, second-hand smoke exposure, and sun safety. My practicum consisted of two main objectives: to conduct a literature review on the association between the proposed risk factors and cancer and to determine the prevalence of exposure of the identified risk factors in Ontario using 2015 to 2017 CCHS data. I performed a literature review to examine current evidence linking each proposed risk factor with cancer risk to determine the inclusion or exclusion of the indicator in the analysis. An analysis was performed with the selected variables in CCHS. Each indicator was age-standardized, and both standardized and crude ratios of individuals engaging in selected indicator activities were calculated. The results were examined for reliability using the produced coefficient of variation values. The estimates for each risk indicators allowed for the identification of target population that may be at higher risk of developing cancer due to greater exposure to the risk factors. They also serve as useful predictors for areas of improvement in regions with a high prevalence, such as healthy living within the community, and a guide to implementing preventative measures, screening, or treatment plans that may have been lacking.