Risk Of Non-communicable Diseases Research Articles

Changes in nutritional status, risk factors and food intake in stroke subjects: cohort study analysis of non-communicable disease risk factors

Background: Stroke is a major cause of death and disability worldwide, affecting 15 million people annually. In Indonesia, the prevalence is 10.9%. Major risk factors include high blood pressure, obesity, inactivity, poor diet, and smoking. Objective: This study aims to analyze long-term trends in risk factors, nutritional status, and food intake among stroke patients from 2011-2021, assessing their impact on stroke incidence. Methods: Data from a longitudinal cohort study of 5,329 subjects, including 215 stroke patients, were analyzed using Microsoft Excel 2019 and SAS software. ANOVA was used to assess annual changes in risk factors, nutritional status, and food intake. Survival analysis was conducted with SAS PROC LIFETEST and PROC LIFEREG. Results: The cohort was primarily female (62.8%), aged 60 or older (57.2%), senior high school education (25.6%), civil servants (30.7%), and low income (57.2%). Significant changes were noted in BMI (p=0.037), fasting blood glucose (FBG) (p=0.001), HDL (p=0.049), abdominal circumference, smoking habits, physical activity (p<0.001), protein intake (p=0.026), and intake of energy, fat, carbohydrates, and sodium (p<0.001). Factors significantly associated with stroke included age, FBG, postprandial glucose, smoking (p<0.0001), LDL (p=0.0380), HDL (p=0.0126), physical activity (p=0.0455), energy intake (p=0.0002), fat intake (p=0.0007), and sodium intake (p=0.0012). Conclusions: The study highlights significant changes in nutritional status, glucose levels, HDL cholesterol, physical activity, and smoking habits. These factors, along with age, cholesterol levels, and dietary intake, impact stroke incidence, underscoring the need for comprehensive stroke prevention strategies.

Lifestyle Differences in the Metabolic Comorbidity Score of Adult Population From South Asian Countries: A Cross-Sectional Study

BackgroundMetabolic comorbidities are involved in the development and progression of non-communicable diseases (NCDs). There is convincing evidence that lifestyles are important contributors to metabolic comorbidities. This study measured the metabolic comorbidity score of South Asian adults, and identified its relationship with lifestyles. MethodsWe studied five South Asian countries including Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka, using WHO's Stepwise approach to NCD risk factor surveillance data between 2014 and 2019. This was a nationally representative and cross-sectional survey on participants aged 15-69 years old. The sample size was 27,616. The outcome was metabolic comorbidity score, calculated based on total cholesterol, fasting plasma glucose, blood pressure, and abdominal obesity. Total metabolic comorbidity score of each participant varied between 0-8. It was then divided into three ranges – the lowest range (total metabolic comorbidity score <3), medium range (total metabolic comorbidity score ≥3 & ≤5), and the highest range (total metabolic comorbidity score ≥6). Based on the outcome of non-parametric receiver operating characteristics analysis, the medium and the highest range together was considered as higher metabolic comorbidity score. The lowest range was considered as lower metabolic comorbidity score. The higher metabolic comorbidity score was coded as “1”and the lower metabolic comorbidity score was coded as “0”. Thus, the outcome variable, metabolic comorbidity score, became a binary variable. Exposures included physical inactivity (<150 minutes of MVPS /week), high daily sedentary time (≥ 9 hours/day), use of tobacco (present or past smoking or daily use of smokeless tobacco products), and consumption of alcohol (at least once/month in the last one year). Binomial logistic regression model produced the odds ratios (OR) with corresponding 95% confidence intervals (CI). ResultsThe prevalence of higher metabolic comorbidity score was 34% among South Asian adults, 25% among the male respondents and 41% among the female respondents. Participants who were physically inactive (OR, 1.26; 95% CI, 1.17-1.36), had high sedentary time (OR, 1.24; 95% CI, 1.11-1.33), and consumed alcohol (OR, 1.40; 95% CI, 1.23-1.53) showed higher metabolic comorbidity score compared with the participants who were physically active, had low sedentary time and did not consume alcohol respectively. However, we found an inverse association (OR, 0.75; 95% CI, 0.71-0.81) between the use of tobacco and metabolic comorbidity score. ConclusionsOne third of South Asian adults had higher metabolic comorbidity score. Physical inactivity, daily sedentary hours and minimal alcohol consumption was associated with higher metabolic comorbidity score.

Predicting high blood pressure using machine learning models in low- and middle-income countries

Responding to the rising global prevalence of noncommunicable diseases (NCDs) requires improvements in the management of high blood pressure. Therefore, this study aims to develop an explainable machine learning model for predicting high blood pressure, a key NCD risk factor, using data from the STEPwise approach to NCD risk factor surveillance (STEPS) surveys. Nationally representative samples of adults aged 18-69 years were acquired from 57 countries spanning six World Health Organization (WHO) regions. Data harmonization and processing were performed to standardize the selected predictors and synchronize features across countries, yielding 41 variables, including demographic, behavioural, physical, and biochemical factors. Five machine learning models - logistic regression, k-nearest neighbours, random forest, XGBoost, and a fully connected neural network - were trained and evaluated at global, regional, and country-specific levels using an 80/20 train-test split. The models’ performance was assessed using accuracy, precision, recall, and F1 score. Feature importance analysis identified age, weight, heart rate, waist circumference, and height as key predictors of blood pressure. Across the 57 countries studied, model performances varied considerably, with accuracy ranging from as low as 58.96% in some models for specific countries to as high as 81.41% in others, underscoring the need for region and country-specific adaptations in modelling approaches. The explainable model offers an opportunity for population-level screening and continuous risk assessment in resource-limited settings.

Disease-associated microbiome signature species in the gut.

There is an accumulation of evidence that the human gut microbiota plays a role in maintaining health, and that an altered gut microbiota (sometimes called dysbiosis) associates with risk for many noncommunicable diseases. However, the dynamics of disease-linked bacteria in the gut and other body sites remain unclear. If microbiome alterations prove causative in particular diseases, therapeutic intervention may be possible. Furthermore, microbial signature taxa have been established for the diagnosis of some diseases like colon cancer. We identified 163 disease-enriched and 98 disease-depleted gut microbiome signature taxa at species-level resolution (signature species) from 10 meta-analyses of multiple diseases such as colorectal cancer, ulcerative colitis, Crohn's disease, irritable bowel syndrome, pancreatic cancer, and COVID-19 infection. Eight signature species were enriched and nine were depleted across at least half of the diseases studied. Compared with signature species depleted in diseases, a significantly higher proportion of disease-enriched signature species were identified as extra-intestinal (primarily oral) inhabitants, had been reported in bacteremia cases from the literature, and were aerotolerant anaerobes. These findings highlight the potential involvement of oral microbes, bacteremia isolates, and aerotolerant anaerobes in disease-associated gut microbiome alterations, and they have implications for patient care and disease management.

Non-pharmaceutical interventions and epigenetic aging in adults: Protocol for a scoping review.

Aging is the strongest risk factor for most chronic diseases. The rising burden of an aging population and non-communicable diseases (NCDs), contributes to escalating costs for society. Several non-pharmaceutical interventions can lower the risk of NCDs, including common mental disorders (CMDs), and may slow down biological aging, as evidenced by outcome markers such as epigenetic clocks. However, a comprehensive overview of whether and which non-pharmaceutical interventions may impact human epigenetic aging is missing. Synthesizing evidence of interventions on epigenetic aging that can be adopted by a wider population is key to guide healthy aging initiatives and to reduce the burden of NCDs and CMDs. This scoping review will identify and assess non-pharmaceutical interventions aimed to slow down epigenetic aging, including their intervention components, and the mode used for intervention delivery. This protocol will include single- and multicomponent intervention studies that target individuals ≥ 18 years of age and use epigenetic clocks as primary or secondary outcomes. Five electronic databases will be searched for studies between July 2011 until December 2023. The final search will include the search terms adults, non-pharmaceutical interventions, epigenetic aging and their respective synonyms. We will include randomized controlled trials, non-randomized controlled studies, cohort studies, and case-control studies. Additionally, the reference list of other reviews will be screened for relevant articles. Study selection is carried out based on the defined eligibility criteria by two authors. Quality and risk of bias for the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklist. Data extraction will include generic key information such as the research question and results, the intervention components, and specific epigenetic outcome measures used. Further data regarding the delivery mode of the treatment protocol will be collected. This scoping review will summarize the characteristics of non-pharmaceutical intervention studies on epigenetic aging. This review will be the first step to formally identify key intervention components and delivery modes to guide future research on healthy aging interventions. The results will be disseminated through a peer-reviewed publication and presented at relevant conferences. This review will synthesize information from available publications and does not require further ethical approval. Open Science Framework https://doi.org/10.17605/OSF.IO/FEHNB.

Waist-based anthropometric measures and central adiposity-related comorbidities in children.

Waist-related measures are commonly used to classify central adiposity and related comorbidities. This classification may be essential among children, as it may identify the risk of future non-communicable diseases. A cross-sectional study was conducted in the Eastern Cape province, South Africa, among 459 primary school learners aged 9-14 years. Height, weight and waist circumference (WC) were measured using standardised techniques recommended by World Health Organization (WHO). The anthropometric measurements, including body mass index (BMI), WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were computed and evaluated. Most participants were girls (57.70%) with an average age of 11.20 ± 1.60 years. The average weight was 38.81 kg ± 10.49 kg with an average height of 144.16 (standard deviation [s.d.] = 10.37) cm. The sample had a BMI of 18.41 kg/m2(s.d. = 3.19). The results showed, on average, WC of 62.10 cm ± 8.12 cm, WHR of 0.82 ± 0.15 and WHtR of 0.44 ± 0.05. Girls reported significantly higher BMI, WC and WHtR. Based on WHtR, the results showed the acceptable ability to classify children according to abdominal obesity, thus identifying their risk for comorbidities. Overall body fat indicated by BMI and central obesity shown by waist-related anthropometric measures can play a significant role in classifying children in terms of their risk of comorbidities.Contribution:To prevent the risks of metabolic diseases in childhood, it is necessary to detect abdominal obesity early using WC-based anthropometric measurements, especially WHtR, to identify those at risk.

ANALYSIS OF FAMILY NURSING CARE WITH FOOD DIARY INTERVENTIONS ON WEIGHT LOSS IN ADOLESCENTS IN RW 06 GROGOL VILLAGE LIMO DEPOK

Introduction: Obesity is the accumulation of excessive fat that can lead to health risks. In adolescence, obesity is at high risk and the incidence of obesity in adolescents is an indicator of a health problem and an increased risk of non-communicable diseases that occur in society. The purpose of this paper is to analyze nursing care with food diary interventions for weight loss in adolescents, where interventions are carried out by adolescents for 30 days by recording the types of food, drinks, and snacks consumed every day and monitoring weight every week. Method: . The implementation method of the intervention in the form of using a food diary for adolescents was carried out first by distributing media in the form of a diary to adolescents, then introducing the media and explaining the contents and also how to use the food diary. Results: The results showed a significant effect on weight loss in obese adolescents by providing interventions in the form of a food diary, where there was a decrease in body weight in managed and resume patients by 1.4 kg and 1.1 kg. Conclusion: Parenting in accordance with the development of adolescence must also be considered for parents in an effort to overcome the risk of obesity.

Dairy Product Consumption among Adults and Determining the Population-Attributable Risk of Common Non-Communicable Diseases: A Population-Based Cross-Sectional Study

Background: Over the past decade, Iranian households have experienced a decline in dairy product consumption. This study aimed to evaluate the population-attributable risk of prevalent non-communicable diseases related to dairy product consumption. Methods: This cross-sectional analytical study involved 628 adults over 18 years old in Hamadan City in 2021. Clusters were selected based on comprehensive urban health centers. The standardized Iranian version of the food frequency questionnaire was used. Participants were categorized into 3 levels of dairy product consumption: &gt;1 serving per day, 1–2 servings per day, and ≥3 servings per day. Results: The mean age of the 628 participants was 38.05 (SD: 12.5), with 42.36% being male. Cheese (54.5%), yogurt (39.7%), and milk (30.4%) were consumed most frequently. The prevalence of insufficient dairy product consumption was 48.6%, higher than that reported in previous studies. Insufficient dairy product consumption was associated with hypertension (9.3%), cardiovascular disease (5.6%), and osteoporosis (5.1%). Conclusion: Individuals with lower education levels, female gender, lowest quartile of socioeconomic status, and those diagnosed with cardiovascular disease were more likely to have insufficient dairy product consumption. Insufficient dairy product consumption was associated with hypertension, cardiovascular disease, and osteoporosis.

Classroom intervention to improve behavioral intention toward regular physical activity among adolescents.

During adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents' behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines 'Attitude,' 'Subjective norm,' and 'Perceived behavioral control.' Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India. A school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention's impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster. Following the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04-1.48) when compared to the control group. Health Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.

Training cadres and establishment of an integrated development post for non-communicable diseases based on a mosque

Introduction: Non-communicable diseases (NCDs) are the highest cause of death due to non-communicable diseases in Indonesia. This condition is certainly very worrying, because the trend of NCDs is increasing followed by a shift in disease patterns, where previously NCDs were experienced by the elderly group, are now starting to threaten younger age groups. Public awareness of NCD risk factors needs to be increased. This requires community participation in PTM (penyakit tidak menular) integrated development activities (Posbindu). Posbindu PTM is an activity for early detection and monitoring of the main risk factors for PTM through community participation. The aim of this activity is cadre training and the establishment of a mesque-based Posbindu PTM. Methods: The method used is Asset Based Community Development (ABCD). The ABCD method is a service method that focuses on the strengths and capacities of local communities. The establishment of the PTM Posbindu was carried out at the Aisyah Abdul Latif Farah Mosque, Namorambe District, Deli Serdang Regency. There were 10 cadres recruited at Posbindu PTM Mosque. Results: The results of the establishment of the mask-based PTM Posbindu are expected to be able to detect PTM risk factors as early as possible and reduce the number of PTM congregants at mosques in particular and society in general. Conclusion: The socialization and formation of the mosque-based Posbindu PTM received positive support from the Deli Serdang Health Service and the Aisyah Abdul Latif Farah Mosque.

Distribution and disparities of healthy lifestyles and noncommunicable diseases risk factors between men and women aged 20-59 years in Bangladesh: Evidence from a nationwide survey.

Noncommunicable diseases (NCDs) are public health threats globally and recognized impediments to socioeconomic development. This study aimed to identify the prevalence and clustering of NCDs risk factors among Bangladeshi men and women aged 20-59 years using nationally representative data. This study was conducted in 82 rural, nonslum urban, and slum clusters across all eight administrative divisions of Bangladesh using multistage cluster sampling. A total of 4917 men and 4905 women aged 20-59 years were included in the study. Descriptive analyses were performed to report the prevalence and distribution of behavioral and clinical risk factors. Multivariable binary logistic regression was performed to identify factors associated with the coexistence of three or more NCD risk factors. The prevalence of tobacco use (any form), insufficient physical activity, inadequate fruit and vegetable consumption, overweight and obesity, and central obesity were 38.3%, 13.6%, 87.1%, 42.3%, and 36.0%, respectively. Furthermore, 21.9% and 4.9% participants had hypertension and self-reported diabetes, respectively. Regarding the clustering of risk factors, 37.1% men and 50.8% women had at least three NCD risk factors. Only 3.0% men and 1.8% women reported no NCD risk factors. Age, place of residence, education, and wealth status were associated with the presence of at least three risk factors for both sexes. Since a large proportion of Bangladeshi 20-59 years old population had multiple risk factors, population-based programs with multisectoral approaches are essential to reduce NCDs among Bangladeshi women and men.

The psychological burden associated with metabolic syndrome: Evidence from UK and US older adults.

We examined the psychological burden associated with metabolic syndrome (MetSyn). We used comparable longitudinal data of older adults (≥50years) from the UK (English Longitudinal Study of Aging) and the US (Health and Retirement Study). We defined MetSyn based on biomarker assessments (e.g., blood pressure, impaired glycemic control). Using regression models, we tested a range of individual psychological outcomes (e.g., depressive symptoms) associated with MetSyn. We also examined whether these psychological outcomes may explain or moderate the link between MetSyn and non-communicable diseases (NCDs). MetSyn was associated cross-sectionally with a range of psychological outcomes, including depression, anxiety, loneliness, hopelessness, cynical hostility, social strain, negative affect and decreased positive affect, social support and purpose in life. There was no convincing evidence that psychological factors interacted with or explained (mediated) the relationship between MetSyn and increased risk of developing NCD over 10-year follow-ups. MetSyn and the psychological burden outcomes examined may have independent effects on NCD risk.

Exploring the Relationship Between Lifestyle Factors, Cholesterol Levels, and Non-Communicable Diseases Risk: A Cross-sectional Survey of Middle-aged Adults in Edo State, Nigeria

NCDs are a global health issue, especially in low-income and lower-middle-income countries. LLMICs lack a clear grasp of the link between socioeconomic position and behavioural risk factors for NCDs, unlike high-income nations. A cross-sectional survey of middle-aged adults in Edo State, Nigeria, examined how lifestyle factors like alcohol and tobacco use, poor diets, and physical inactivity affect socioeconomic position. A comprehensive search of 13 electronic databases, including Embase and MEDLINE, grey literature, and reference lists found primary research published between January 1, 1990, and June 30, 2015. Numerous socioeconomic and lifestyle studies from LLMICs were included. Data extraction focused on household and individual-level data, study types, methodology, outcomes, and results utilising the Cochrane Effective Practice and Organisation of Care Group data collecting checklist. Due to study design and outcome measure diversity, narrative synthesis was used. Of 4,242 records reviewed, 75 studies satisfied inclusion criteria, including 2,135,314 people aged 10 and older from 39 LLMICs. The results showed that lower socioeconomic groups used smoke and alcohol more, while higher socioeconomic groups ate more fats, salt, and processed foods. Contrary to predictions, higher socioeconomic groups reported less physical activity. To accomplish Sustainable Development Goal 3.4, which aims to reduce early NCD mortality by one-third by 2030, socioeconomic inequities must be targeted. These policymakers and health practitioners must prioritise poverty-health nexus solutions to reduce NCD burdens.

Health determinants among participants in targeted health dialogues offered to all 40-year-old individuals in a metropolitan region of 1.4 million people

Objective To examine cardiovascular risk factors in 40-year-old participants in the health screening program targeted health dialogues (THDs). Design Cross-sectional study. Setting 99 Swedish healthcare centers. Intervention Metabolic risk factors and health behaviors were assessed. THDs were provided. Subjects 1831 (62.3%) THD participants that consented to take part in the research project. Main outcome measures (1) Prevalence of metabolic risk factors (blood pressure, LDL cholesterol, fasting plasma glucose, BMI, waist-hip ratio) and unhealthy behaviors (tobacco, alcohol, diet, physical activity) by sex, education, and place of birth. (2) Associations between different health behaviors and between the number of unhealthy behaviors and prevalence of metabolic risk factors. (3) THD participation by sociodemographics compared to age-matched controls. Results Men had a higher prevalence of all metabolic risk factors, excessive alcohol use and tobacco use than women. Lower educated individuals had a higher prevalence of metabolic risk factors (except for LDL cholesterol) and tobacco use than highly educated. Participants born outside Sweden had a higher prevalence of obesity, high waist-hip ratio, and tobacco use. Participants with 3–4 unhealthy behaviors had significantly higher prevalence of each of the metabolic risk factors except BMI. Women, highly educated and Swedish-born participants were slightly over-represented in the THDs. Conclusion Considering the associations between unhealthy behaviors and metabolic risk factors, the THD method, covering lifestyle as well as objective health measures, may be an appropriate method for early identification of individuals at risk for future non-communicable diseases in the whole population with a specific focus on certain groups. ClinicalTrials.gov NCT04912739

Measuring Dietary Quality Among Toddlers in the Feeding Infants and Toddlers Study, 2016, Using the New Healthy Eating Index-Toddlers-2020

BackgroundChild diet can influence risk for obesity and other related noncommunicable diseases. Few studies have used the Healthy Eating Index (HEI)-Toddlers-2020 to assess diet quality among toddlers (children aged 12 to 23.9 months). ObjectiveThe aim of this study was to examine diet quality among toddlers participating in the Feeding Infants and Toddlers Study, 2016, and determine differences by sociodemographic characteristics. Caregiver perception of how their toddler’s diet aligns with HEI-Toddlers-2020 diet quality scores was also assessed. DesignThis cross-sectional study used 24-hour dietary records collected in 2016. Participants and settingData were collected on toddlers ages 12 to 23.9 months (N = 1133) participating in the Feeding Infants and Toddlers Study, 2016. Main outcome measuresDiet quality was assessed using the HEI-Toddlers-2020. Statistical analyses performedThe population ratio method was used for all analyses using weighted data to estimate HEI-Toddlers-2020 scores overall and within subgroups. To determine significant differences of the HEI-Toddlers-2020 score between subgroups, pairwise t tests were used. Statistical significance at P < .05 was used as a cutoff for all 2-sided P values. ResultsAverage HEI-Toddlers-2020 score among toddlers ages 12 to 23.9 months participating in the Feeding Infants and Toddlers Study, 2016, was 71.2 out of a possible 100. Total scores (mean, standard error) varied by race and ethnicity with Hispanic toddlers having higher scores compared with non-Hispanic White toddlers (76.4 ± 2.5 vs 69.0 ± 1.2; P = .03) and by federal poverty level with those >200% of the poverty level having higher scores compared with those <100% of the poverty level (74.7 ± 1.5 vs 67.0 ± 2.6; P = .01). ConclusionsOpportunities for improvement in dietary intake were identified using the new HEI-Toddlers-2020 to assess diet quality among children ages 12 to 23.9 months. Scores were indicative of toddlers consuming excess added sugars and lower-than-recommended amounts of seafood and plant proteins, greens and beans, whole grains, and vegetables. Interventions to improve diet quality in toddlers may benefit from focusing on foods children should eat more of along with foods to consume in moderation.

Prevalence of Non-communicable Disease Risk Factors Among Adults in a Rural Field Practice Area of a Tertiary Care Medical Center in Karnataka.

Background Non-communicable diseases (NCDs), also referred to as chronic diseases, typically have a long duration and arise from a combination of genetic, physiological, environmental, and behavioral factors. Each year, 17 million people under the age of 70 die from non-communicable diseases (NCDs), with 86% of these premature deaths occurring in low- and middle-income countries. Objectives To estimate the prevalence of NCD risk factors among adults (18-65 years) in a rural population. Methods A cross-sectional study was conducted by selecting 200 participants from 200 households using convenience sampling. Participants aged 18-65 years were included, and locked households were excluded. Sociodemographic profiles were assessed using semi-structured questionnaires, and NCD risk factors were assessed using a Community-Based Assessment Checklist (CBAC). Descriptive statistics and associations were analyzed. Results The majority of participants were men (53.5%), married (89.5%), and belonged to the class 2 socioeconomic classification. The prevalence of NCD risk factors was 17%, with smoking (12.5%), alcohol consumption (6%), and waist circumference (1.8% for men and 27.9% for women) being the most common risk factors. Older age, lower educational attainment, unemployment, and lower-incomeclasses were associated with a higher risk of NCDs. Conclusion The study identifies key risk factors for non-communicable diseases (NCDs) as family history, waist circumference over 90 cm, daily alcohol consumption, and tobacco use, all significantly increasing the risk. Physical activity under 150 minutes per week and occupational exposure to crop residue showed no significant effect.

Epidemiology of non-communicable diseases among professional drivers in LMICs: a systematic review and meta-analysis.

This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). We conducted a thorough search on PubMed/MEDLINE, EMBASE, Scopus, Global Health, Web of Science and Africa-wide information databases on 11 May 2023. We adapted the Joanna Briggs Institute (JBI) tool to assess the quality of the studies. We estimated the prevalence of hypertension, prediabetes, diabetes mellitus (DM), overweight and obesity among professional drivers using a random effect model to compute pooled and subgroup analyses. In addition, we conducted a narrative synthesis of the risk factors and recommendations presented in the included studies. Forty-one studies, including 48 414 study participants, met the criteria for inclusion. The pooled prevalence of hypertension, DM and obesity among professional drivers was 36.7% [95% confidence interval (CI): 31.8-41.6%], 15.2% (95% CI: 7.0-23.4%) and 27.2% (95% CI: 18.7-35.8%), respectively. Unsupportive environment, work stress, sedentary lifestyle, consumption of unhealthy foods and shift work were the most common modifiable risk factors reported. Our findings also show a significant burden of hypertension, DM and obesity among professional drivers in LMICs. The prevalence of DM and obesity was two- and three-fold higher than findings in general populations, respectively. Our findings indicate an urgent need for tailored interventions for different occupation-related risk factors for NCDs among professional drivers in LMICs.

Disparities and Determinants of Testing for Early Detection of Cervical Cancer among Nepalese Women: Evidence from a Population-Based Survey.

Cervical cancer presents a considerable challenge in South Asia, notably in Nepal, where screening remains limited. Past research in Nepal lacked national representation and a thorough exploration of factors influencing cervical cancer screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of cervical cancer among Nepalese women. Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (World Health Organization STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30 to 69 years, were used. Respondents were asked if they had undergone cervical cancer testing through visual inspection with acetic acid, Pap smear, or human papillomavirus test ever or in the past 5 years. The slope index of inequality (SII) and relative concentration index were used to measure socioeconomic and education-based disparities in cervical cancer test uptake. Only 7.1% [95% confidence interval (CI): 5.1-9.9] Nepalese women had ever undergone cervical cancer testing, whereas 5.1% (95% CI: 3.4-7.5) tested within the last 5 years. The ever uptake of cervical cancer testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from the richest compared with the poorest households. Education-based disparities were particularly pronounced, with a 13.9 percentage point difference between highly educated urban residents and their uneducated counterparts (SII: 13.9, 95% CI: 5.8-21.9). Less than one in ten women in Nepal had a cervical cancer testing, primarily favoring higher educated and wealthier individuals. Targeted early detection and cervical cancer screening interventions are necessary to address these disparities and improve access and uptake.

Health-Promoting Potential of Mandarin Pomace Extracts Enriched with Phenolic Compounds.

The aim of this work was to assess the effect of in vitro human digestion on the chemical composition (carbohydrates and phenolic compounds) and bioactivity of hydro-alcoholic-acid pomace extracts from two mandarin varieties (Clemenule and Ortanique) by measuring their antioxidant, antidiabetic, anti-glycative, hypolipidemic, and anti-inflammatory properties. The phenolic compound profile showed that nobiletin was the main flavonoid found in the extracts and digests of Clemenule pomace and extract, while isosinensetin/sinensetin/tangeretin were the ones in the Ortanique samples. The digests of Clemenule and Ortanique extracts showed Folin reaction values of 9.74 and 9.20 mg gallic acid equivalents (GAE)/g of sample, ABTS values of 83.2 and 91.7 µmol Trolox equivalents (TE)/g of sample, and ORAC-FL values of 142.8 and 891.6 µmol TE/g of sample, respectively. Extracts (50-500 µg/mL) inhibited intracellular reactive oxygen species (ROS) formation in CCD-18Co cells under physiological and oxidative-induced conditions. Clemenule and Ortanique extract digests showed IC50 values of 13.50 and 11.07 mg/mL for α-glucosidase, 28.79 and 69.64 mg/mL for α-amylase, and 16.50 and 12.77 mg/mL for AGEs, and 2.259 ± 0.267 and 0.713 ± 0.065 mg/mL for pancreatic lipase inhibition, respectively. Ortanique extract (250-1000 µg/mL) inhibited the production of nitric oxide in RAW264.7 macrophages under inflammation-induced conditions, and intracellular ROS formation. In conclusion, altogether, the results supported the potential of mandarin extracts to be used as health promoters by reducing the risk of non-communicable chronic diseases.

A gut microbial metabolite cocktail fights against obesity through modulating the gut microbiota and hepatic leptin signaling.

Excessive body weight and obesity elevate the risk of chronic non-communicable diseases. The judicious application of the gut microbiome, encompassing both microorganisms and their derived compounds, holds considerable promise in the treatment of obesity. In this study, we showed that a cocktail of gut microbiota-derived metabolites, comprising indole 3-propionic acid (IPA), sodium butyrate (SB) and valeric acid (VA), alleviated various symptoms of obesity in both male and female mice subjected to a high-fat diet (HFD). The 16S ribosomal RNA (rRNA) sequencing revealed that administering the cocktail via oral gavage retained the gut microbiota composition in obese mice. Fecal microbiota transplantation using cocktail-treated mice as donors mitigated the obesity phenotype of HFD-fed mice. Transcriptomic sequencing analysis showed that the cocktail preserved the gene expression profile of hepatic tissues in obese mice, especially up-regulated the expression level of leptin receptor. Gene delivery via in vivo fluid dynamics further validated that the anti-obesity efficacy of the cocktail was dependent on leptin signaling at least partly. The cocktail also inhibited the expression of appetite stimulators in hypothalamus. Together, the metabolite cocktail combated adiposity by retaining the gut microbiota configuration and activating the hepatic leptin signaling pathway. Our findings provide a sophisticated regulatory network between the gut microbiome and host, and highlight a cocktail of gut microbiota-derived metabolites, including IPA, SB, and VA, might be a prospective intervention for anti-obesity in a preclinical setting. © 2024 Society of Chemical Industry.