Prevention Of Non-communicable Diseases Research Articles

Epidemiological characteristics of fatal drowning and related factors in children in Zhejiang Province, 2022

Objective: To understand the epidemiological characteristics of fatal drowning in children in Zhejiang Province in 2022, analyze factors such as the swimming ability of children, the caregiver behavior at drowning site, types of first aid personnel and methods of first aid of unintentional fatal drowning and provide evidence for targeted intervention. Methods: Using the "Survey Form of Fatal Drowning Case in Children" designed by National Center for Chronic and Non-communicable Disease Control and Prevention of the China CDC, we collected case information of children aged 0-17 years who died due to drowning in Zhejiang in 2022 from medical history/death investigation records, telephone interviews, and home visits. Results: A total of 341 fatal drowning cases in children occurred in Zhejiang in 2022 and 330 cases were investigated (96.77%). The male to female of the cases was 2.33∶1, most cases were aged 15-17 years and 0-4 years, and 54.24% of fatal drowning cases occurred in children from other provinces. In the drowning cases, 83.33% were unintentional ones, and the proportion of intentional fatal drowning cases in children increased with age. Fatal drowning cases mainly occurred in open natural water bodies and public water storage facilities. More fatal drowning cases occurred in open natural water bodies in older children, while more fatal drowning cases occurred in public water storage facilities in younger children. In 275 children who died due to unintentional drowning, 73.09% could not swim, and only 1.09% were fully supervised by adults within an arm's length. First aid personnel, mainly medical staffs, bystanders and adult caregivers, were present for 47.63% fatal drowning cases. The proportion of the cases who had cardiopulmonary resuscitation as the first aid within 5 minutes was 2.18%. Conclusions: Drowning poses a serious threat to children's lives and there are differences in reasons and locations of fatal drowning in children in different age groups in Zhejiang Province in 2022. It is necessary to conduct to interventions to improve children's swimming skills, strengthen effective adult care and conduct health education about field first aid of drowning to reduce the incidence of drowning and related deaths in children.

Implementation of School Nutrition Policies to Address Noncommunicable Diseases in Uzbekistan and Kyrgyzstan.

Noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, and diabetes, account for over 80% of mortality in Uzbekistan and Kyrgyzstan in 2019, and unhealthy dietary behaviors are a major risk factor for NCDs in both countries. In 2021, national stakeholders, in consultation with the World Health Organization, identified school nutrition policies (SNPs) as a major approach to reducing the burden of NCDs in both countries. The SNPs included interventions implemented through a multistakeholder and multisectoral arrangement that aimed to improve the health and nutrition status of children and young people by providing healthy food/beverages and restricting unhealthy foods or beverages in schools. We used a multimethod approach of document review, participatory workshops, and key informant interviews to generate theories of change for the large-scale implementation of SNPs and describe the implementation processes to date, including key implementation and health system challenges, salient implementation strategies, and implementation outcomes in both countries. Multiple pathways for enacting and implementing SNPs successfully were identified. However, significant health system challenges, such as the lack of accountability for contracting and tender processes and coordination among different sectors, continue to hamper the large-scale implementation of these policies in both countries. The pathways, theories, and implementation outcomes identified will facilitate the development of implementation strategies and systematic learning and evaluation around SNPs for NCD prevention and control programs in the Central Asian region and other low- and middle-income countries more broadly.

Primary health care response to noncommunicable diseases: an assessment of Wellness Clinics in Ghana

BackgroundGlobally, there is a significant unmet need for the rapidly growing burden of Non-Communicable Diseases (NCDs). Ghana has adopted and implemented Wellness Clinics (WC) nationwide to respond to the rising burden of NCDs. Regrettably, very little is known about WCs, including their structure and the services they offer. This study explores the concept of WC, their structure, position within the hospital environment, and services from the perspectives of healthcare providers and clients.MethodsAn exploratory qualitative study was conducted with health professionals (n = 12) and clients (n = 26) of Wellness Clinics in two district hospitals and one regional hospital in a deprived region of Ghana where NCDs are rising. Using the WHO-PEN approach, an interview guide was purposely designed for this study. The data were analysed thematically using Atlas.ti.ResultsAll three Wellness Clinics were sub-units under the outpatient department. The WC was created by the facilities to respond to the increase in NCDs and to meet annual performance review requirements. The Wellness Clinics provided NCD diagnosis, counselling, and treatment services to approximately 300 clients per week at the facility level. Only one of the WCs provided NCD prevention services at the community level. Integrated NCD care was also provided at the WC, despite the health system and individual-level challenges reported by the health workers and clients.ConclusionThe implementation of the Wellness Clinic demonstrates the government’s commitment to addressing the increasing burden of NCDs in Ghana through the primary health system. To maximise the impact of the wellness clinics, we recommend developing best practices, providing logistics, and addressing health insurance challenges.

CAN TASTE AND PRESENTATION OF RESTAURANT MENUS CHANGE CUSTOMERS' HEALTH KNOWLEDGE AND PERCEPTIONS? A NATURAL RESTAURANT FIELD EXPERIMENT

This study examines the impact of menu taste and presentation on customers’ health knowledge and perceptions using behavioral economics in a restaurant setting. The increasing prevalence of non-communicable diseases (NCDs) and obesity highlights the importance of dietary choices for health outcomes. Using a natural field experiment involving 349 participants in Chiangmai, Thailand, this study examines how experiments taste and alterations in menu design, specifically through convenience and visibility interventions, can encourage healthier meal selections. The experiment shows that taste significantly influences the perception of meal healthiness, while strategic menu presentation influences customers' meal choices and their ability to accurately estimate caloric content. The findings suggest that making high-calorie options more visible tends to lead participants towards choices with higher caloric content than estimated, indicating the potential of menu design in modifying consumer behavior towards healthier eating habits. Additionally, the study examines demographic factors such as age, gender, and Body Mass Index (BMI), alongside self-reported dietary practices, to understand their influence on meal selection decisions. This study contributes to behavioral economics by providing empirical evidence on how small changes in the food environment can promote healthier diets, addressing the global challenge of tackling non communicable diseases and obesity.

Biodiversity and Diabetes: Is There a link?

Abstract India is rich in agrobiodiversity and is considered to be one of the important countries for production of food, oilseed and horticultural crops, spices, and medicinal plants. However, the prevalence of noncommunicable diseases (NCDs) such as type 2 diabetes (T2D) and obesity has been rapidly increasing in India due to unhealthy food habits, for example, changing from healthy unpolished brown rice to highly polished white rice. Bringing back our traditional foods such as millets and making use of India’s rich biodiversity could help improve the health of its population and help in preventing and control of NCDs such as T2D.

DUKUNGAN LINTAS SEKTOR DALAM MENINGKATKAN GERAKAN MASYARAKAT HIDUP SEHAT

The prevalence of non-communicable diseases in Indonesia showed a significant increasing trend, from 25% at the end of 2013 to 35% at the end of 2018. Prevention efforts in a community had to be conducted through healthy lifestyle implementation characterized by four indicators, namely physical activity, daily fruit and vegetable intake, not smoking, and routine health checks. Public awareness of healthy life is shallow, even though they have a high educational background. The research aimed to know the role of cross-sector support programs as a solution in improving the Healthy Life Behavior of the citizen. This research was conducted in July-August 2018 in 22 working areas of the Bandung City Health Center. The research used a cross-sectional approach design. The respondents were 205 people, using the purposive random sampling technique. The analysis used chi-square test. The results showed that respondents had poor knowledge about GERMAS, 60.4% of whom were also bad at implementing GERMAS. The respondents whose attitude towards GERMAS was poor, 61.0% of them were also poor in implementing GERMAS. Most people had not felt cross-sector support. There was a significant relationship between cross-sector support and the improvement of people's healthy clean living behavior. The research concluded that almost all people have good knowledge and attitudes about GERMAS, but most people were not good at implementing GERMAS, and there were most people who do not feel any cross-sectoral support in implementing GERMAS. There was a meaningful relationship between cross-sectoral support, both government and private, and the implementation of GERMAS.

Clinical and Metabolic Particularities of a Roma Population with Diabetes-Considering Ethnic Disparities in Approaching Healthcare Management.

The Roma population is Europe's largest ethnic minority, yet data on the prevalence of non-communicable diseases remain scarce in medical literature. This study aimed to compare the clinical and metabolic particularities of a Roma population with diabetes with a group of non-Roma. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary diabetes care hospital. The prevalence of metabolic syndrome was high among both groups, 94.3% in the Roma patients and 89.1% in the non-Roma. A slightly higher mean value of the triglyceride-glucose (TyG) index was observed among the Roma group (10.07 ± 0.71 versus 9.71 ± 0.82). Among the non-Roma, variables that were significantly associated with the TyG index were glycated hemoglobin (HbA1c), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-c), and low-density lipoprotein-cholesterol (LDL-c), while among the Roma, HbA1c and HDL-c were correlated with this index. There were no differences concerning myocardial infarction; however, the number of patients with a history of stroke was 2.1 times higher in the Roma group compared to the non-Roma group. The prevalence of cardiovascular risk factors, cardiovascular disease, and microvascular complications among the study's Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies.

Development of “Intelligent particles” for the treatment of dental caries

Dental caries is one of the most prevalent non-communicable diseases worldwide, mediated by a multispecies biofilm that consists of high levels of acidogenic bacteria which ferment sugar to acid and cause teeth demineralization. Current treatment practice remains insufficient in addressing 1) rapid clearance of therapeutic agents from the oral environment 2) destroying bacteria that contribute to the healthy oral microbiome. In addition, increasing concerns over antibiotic resistance calls for innovative alternatives. In this study, we developed a pH responsive nano-carrier for delivery of polycationic silver nanoparticles. Branched-PEI capped silver nanoparticles (BPEI-AgNPs) were encapsulated in a tannic acid − Fe (III) complex-modified poly(D,L-lactic-co-glycolic acid) (PLGA) particle (Fe(III)-TA/PLGA@BPEI-AgNPs) to enhance binding to the plaque biofilm and demonstrate “intelligence” by releasing BPEI-AgNPs under acidic conditions that promote dental caries The constructed Fe(III)-TA/PLGA@BPEI-AgNPs (intelligent particles − IPs) exhibited significant binding to an axenic S. mutans biofilm grown on hydroxyapatite. Ag+ ions were released faster from the IPs at pH 4.0 (cariogenic pH) compared to pH 7.4. The antibiofilm results indicated that IPs can significantly reduce S. mutans biofilm volume and viability under acidic conditions. Cytotoxicity on differentiated Caco-2 cells and human gingival fibroblasts indicated that IPs were not cytotoxic. These findings demonstrate great potential of IPs in the treatment of dental caries.

School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children.

Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income families and rural geographic areas. The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing silver diamine fluoride (SDF) to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of mixed-effects logistic regression for caries prevalence and weighted least squares and mixed-effects negative binomial regression for caries incidence. A non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. A total of 3345 children were enrolled across 35 schools; however there was a large proportion of children who were noncompliant and received external dental care over the course of the trial. In adjusted analyses of compliant participants (n=1083; 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries prevalence was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term. NCT03448107.

Shifting roles of community health workers in the prevention and management of noncommunicable disease during the COVID-19 pandemic: a scoping review.

Community Health Workers (CHWs) play a crucial role in the prevention and management of noncommunicable diseases (NCDs). The COVID-19 pandemic triggered the implementation of crisis-driven responses that involved shifts in the roles of CHWs in terms of delivering services for people with NCDs. Strategically aligning these shifts with health systems is crucial to improve NCD service delivery. The aim of this review was to identify and describe COVID-19-triggered shifting roles of CHWs that are promising in terms of NCD service delivery. We searched Ovid Medline, Embase, CINAHL, Web of Science and CABI for Global Health for relevant articles published between 1 January 2020 and 22 February 2022. Studies that were conducted within a COVID-19 context and focused on the shifted roles of CHWs in NCD service delivery were included. We used Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to report the findings. A total of 25 articles from 14 countries were included in this review. We identified 12 shifted roles of CHWs in NCD service delivery during COVID-19, which can be categorized in three dimensions: 'enhanced' role of CHWs that includes additional tasks such as medication delivery; 'extended' roles such as the delivery of NCD services at household level and in remote communities; and 'enabled' roles through the use of digital health technologies. Health and digital literacy of people with NCDs, access to internet connectivity for people with NCDs, and the social and organizational context where CHWs work influenced the implementation of the shifted roles of CHWs. In conclusion, the roles of CHWs have shifted during the COVID-19 pandemic to include the delivery of additional NCD services at home and community levels, often supported by digital technologies. Given the importance of the shifting roles in the prevention and management of NCDs, adaptation and integration of these shifted roles into the routine activities of CHWs in the post-COVID period is recommended.

Health and Nutrition Promotion Programs in Papua New Guinea: A Scoping Review.

There is a rising prevalence of non-communicable diseases (NCDs) in Papua New Guinea (PNG), adding to the disease burden from communicable infectious diseases and thus increasing the burden on the healthcare system in a low-resource setting. The aim of this review was to identify health and nutrition promotion programs conducted in PNG and the enablers and barriers to these programs. Four electronic databases and grey literature were searched. Two reviewers completed screening and data extraction. This review included 23 papers evaluating 22 health and nutrition promotion programs, which focused on the Ottawa Charter action areas of developing personal skills (12 programs), reorienting health services (12 programs) and strengthening community action (6 programs). Nineteen programs targeted communicable diseases; two addressed NCDs, and one addressed health services. Enablers of health promotion programs in PNG included community involvement, cultural appropriateness, strong leadership, and the use of mobile health technologies for the decentralisation of health services. Barriers included limited resources and funding and a lack of central leadership to drive ongoing implementation. There is an urgent need for health and nutrition promotion programs targeting NCDs and their modifiable risk factors, as well as longitudinal study designs for the evaluation of long-term impact and program sustainability.

Protection of public health at the level of supranational organizations

Emergence of international integration processes raises new issues of the development of the legislative and regulatory framework at the supranational level for public health benefit. The paper explains the need to actively protect the interests of public health at the supranational level based on the analysis of relevant aspects of the policy, structure, functioning and experience of the largest regional integration structures – the Eurasian Economic Union and the European Union. The review of the basic principles, approaches and measures is carried out, using the example of ensuring food safety, which is directly related to solving the problem of prevention and control of infectious and non-communicable diseases. The relevant regulatory framework of the World Trade Organization (WTO), as well as the development of technical regulation, are discussed. The relevance of cooperation between supranational structures and the World Health Organization and other relevant UN organizations in the field of public health is emphasized. Specialists in this field are called upon to participate in the regulation of international integration processes, including the activities of the WTO, trade and investment agreements, and tariff policy.

Intersectoral Collaboration in Healthcare: an Overview of International Practices

Background. Health promotion and universal health coverage are among the functions of any healthcare system which include public, private and voluntary organizations providing health services to the population. However, healthcare actors cannot single-handedly ensure the accessibility of medical care to all individuals. It is intersectoral interactions that could improve the capabilities, performance and efficiency of healthcare system. Objective. To consider the possibilities of intersectoral collaboration in healthcare through the relevant examples of the implementation of intersectorality in healthcare practices. Materials and methods. Common research methods with the content analysis of international scientific articles as the main one were applied. The practices of intersectoral interaction for ensuring public health promotion and access to medical care were identified and collected from all analyzed articles. Results. Intersectoral collaboration might be carried out between various departments and authorities, educational and civil society organizations, commercial companies and other entities. The performance and efficiency of intersectoral collaboration are achieved using the specially developed tools. The international practice of intersectoral collaboration on public health protection issues has many great examples of interactions facilitating the accomplishment of different goals, such as accessibility of medical care, prevention of noncommunicable diseases, and health emergency response.

Accessibility to palliative care services in Colombia: an analysis of geographic disparities

ObjectivesDue to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care.MethodsPopulation-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services’ locations and identify geographic disparities.ResultsA total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards.ConclusionsPalliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs.

Pharmacovigilance in Pregnancy Studies, Exposures and Outcomes Ascertainment, and Findings from Low- and Middle-Income Countries: A Scoping Review.

Pharmacovigilance (PV), or the ongoing safety monitoring after a medication has been licensed, plays a crucial role in pregnancy, as clinical trials often exclude pregnant people. It is important to understand how pregnancy PV projects operate in low- and middle-income countries (LMICs), where there is a disproportionate lack of PV data yet ahigh burden of adverse pregnancy outcomes. We conducted a scoping review to assess how exposures and outcomes were measured in recently published pregnancy PV projects in LMICs. We utilized a search string, secondary review, and team knowledge to review publications focusing on therapeutic or vaccine exposures among pregnant people in LMICs. We screened abstracts for relevance before conducting a full text review, and documented measurements of exposures and outcomes (categorized as maternal, birth, or neonatal/infant) among other factors, including study topic, setting, and design, comparator groups, and funding sources. We identified 31 PV publications spanning at least 24 LMICs, all focusing on therapeutics or vaccines for infectious diseases, including HIV (n = 17), tuberculosis (TB; n = 9), malaria (n = 7), pertussis, tetanus, and diphtheria (n = 1), and influenza (n = 3). As for outcomes, n = 15, n = 31, and n = 20 of the publications covered maternal, birth, and neonatal/infant outcomes, respectively. Among HIV-specific publications, the primary exposure-outcome relationship of focus was exposure to maternal antiretroviral therapy and adverse outcomes. For TB-specific publications, the main exposures of interest were second-line drug-resistant TB and isoniazid-based prevention therapeutics for pregnant people living with HIV. For malaria-specific publications, the primary exposure-outcome relationship of interest was antimalarial medication exposure during pregnancy and adverse outcomes. Among vaccine-focused publications, the exposure was assessed during a specific time during pregnancy, with an overall interest in vaccine safety and/or efficacy. The study settings were frequently from Africa, designs varied from cohort or cross-sectional studies to clinical trials, and funding sources were largely from high-income countries. The published pregnancy PV projects were largely centered in Africa and concerned with infectious diseases. This may reflect the disease burden in LMICs but also funding priorities from high-income countries. As the prevalence of non-communicable diseases increases in LMICs, PV projects will have to broaden their scope. Birth and neonatal/infant outcomes were most reported, with fewer reporting on maternal outcomes and none on longer-term child outcomes; additionally, heterogeneity existed in definitions and ascertainment of specific measures. Notably, almost all projects covered a single therapeutic exposure, missing an opportunity to leverage their projects to cover additional exposures, add scientific rigor, create uniformity across health services, and bolster existing health systems. For many publications, the timing of exposure, specifically by trimester, was crucial to maternal and neonatal safety. While currently published pregnancy PV literature offer insights into the PV landscape in LMICs, further work is needed to standardize definitions and measurements, integrate PV projects across health services, and establish longer-term monitoring.

Relationship between Helicobacter pylori infection, osteoporosis, and fracture.

Osteoporotic fracture is a prevalent noncommunicable disease globally, causing significant mortality, morbidity, and disability. As the population ages, the healthcare and economic burden of osteoporotic fracture is expected to increase further. Due to its multifactorial features, the development of osteoporotic fracture involves a complex interplay of multiple risk factors, including genetic, environmental, and lifestyle factors. Helicobacter pylori, which infects approximately 43% of the world's population, has been associated with increased fracture risk due to hypochlorhydria from atrophic gastritis and systemic inflammation from elevated pro-inflammatory cytokines. However, the potential impact of H. pylori infection and eradication on fracture risk remains contentious among various studies due to the study design and inadequate adjustment of confounding factors including baseline gastritis phenotype. In this review, we provided a comprehensive evaluation of the current evidence focusing on the underlying mechanisms and clinical evidence of the association between H. pylori infection and osteoporotic fracture. We also discussed the potential benefits of H. pylori eradication on fracture risk.

Age Group-Wise Burden of Non-Communicable Diseases Among Shrimp Cultivators in India: A Retrospective Analysis of Disability-Adjusted Life Years Method

ABSTRACT Objective Despite generating huge employment opportunities and profitable business, fishing is considered a dangerous occupation due to challenging weather conditions and exposure to unhealthy occupational factors and lifestyles, which contribute to various health issues. However, few studies have examined the health status of shrimp cultivators. Consequently, this study aims to estimate the age group-wise burden of non-communicable diseases (NCDs) among shrimp cultivators. Methods Simple random sampling was employed for collecting data. The sample size was 357 shrimp cultivators. Disability-adjusted life years (DALY) and relative risk (RR) methods were used to measure the burden of NCDs among shrimp cultivators. This study reported the burden of NCDs per 100,000 shrimp cultivators. Results The top five prevalence of NCDs per 100,000 shrimp cultivators were mental disorders (85,434), musculoskeletal diseases (26,325), digestive diseases (9,803), diabetes (5,882), and cardiovascular diseases (4,481). DALY per 100,000 shrimp cultivators was 33,407.59, while at the national level, it was 24,775.99 per 100,000 people across all age groups. The RR of NCDs among shrimp cultivators in terms of DALY was 1.35, indicating a 0.35 times higher burden of NCDs among shrimp cultivators than at the national level. The largest RR of NCDs was found among shrimp cultivators aged 15–49 years (1.85), followed by 50–69 years (1.09). The highest percentage changes in the burden of NCDs among shrimp cultivators, resulting from changes in the methods of estimating DALY, was observed in the age group of 70 years and above (−48.36%) followed by 15–49 years (−46.08%) and 50–69 years (−40.33%) when compared to the baseline method of estimating DALY without utilizing age weightage and discount rate. Conclusions Focus should be given to improving the lifestyle and occupational factors of shrimp cultivators to mitigate the burden of NCDs.

Impact of distress on the nutritional status of patients with type 2 diabetes mellitus at the National Hospital of Endocrinology in 2022

Diabetes Mellitus (DM), particularly Type 2 Diabetes Mellitus (T2DM), is one of the most prevalent non-communicable chronic diseases and poses significant challenges for the healthcare sector and the community. Distress in patients with T2DM leads to severe physical and mental consequences. This study aims to analyze the relationship between distress and the nutritional status of T2DM patients. A cross-sectional descriptive study was conducted on 203 T2DM patients at the National Hospital of Endocrinology from October to December 2022. Of the participants, 54.2 % were female with an average age of 62.1 (±12.4). The waist circumference (WC) and waist-to-hip ratio (WHR) were significantly different between genders (p < 0.05). The prevalence of overweight/obesity was high at 46.7 %, with females having a 2.3 times higher WC and a 1.5 times higher WHR compared to males. The study identified several factors related to the nutritional status and distress in T2DM patients, including age, gender, residence, family history of T2DM, lifestyle habits, and nutritional status (p < 0.05). Early and comprehensive evaluation of T2DM patients is essential to improve treatment outcomes and quality of life.

Evaluation of the impact of a 20-week exercise referral scheme on Mauritian adults diagnosed with non-communicable diseases

AbstractThe escalating prevalence of non-communicable diseases (NCD) presents a concern in Mauritius. These diseases, caused by many factors, reflect the social, economic and environmental conditions within which people live and work. Type 2 diabetes mellitus, hypertension and obesity are the most prevalent among Mauritian adults. Within the framework of a comprehensive systems approach aiming at addressing the social determinants of health, there is a need for customised strategies for both management and prevention of non-communicable diseases. One such example is exercise referral. Exercise referral schemes (ERS) represent an emerging tool for helping people become more physically active and healthier. Evidence of their effectiveness is equivocal and lacks contextual insight into their value in a Mauritian context. Hence, this study serves to bridge this gap. We report the outcomes of a 20-week ERS. Two hundred sixty consenting adults recruited from Area Health Centres (AHC) and Mediclinic’s around Mauritius were assigned to one of two groups: intervention group (ERS + guidance and support by exercise referral consultant) or control group (exercise ‘advice’ from a general practitioner). Body mass index (BMI), grip strength, waist circumference, fasting blood sugar (FBS), HbA1c, lipid profile and blood pressure were measured at week 0, 10 and 20. This quasi-experimental longitudinal study successfully demonstrated improvements in parameters associated with risk factors for coronary heart disease, particularly among women in the intervention group. Significant reductions in weight, waist circumference, FBS and BMI at week 10 and 20 were noted. A less pronounced decline in parameters was observed in men, except for waist circumference, which reached near significance (p = 0.076). Using female participants as a primary focal point, this study supports the notion of exercise referral as part of a holistic treatment plan to control NCDs. We advocate future ERS initiatives prioritise a patient-centred comprehensive approach in design and implementation to ensure successful outcomes.

Antioxidant and Anti-inflammatory Effects of Marine Phlorotannins and Bromophenols Supportive of Their Anticancer Potential.

Following the goal of optimizing nutrition, the food industry has been continuously working on food reformulation, nutritional patterns, functional foods development, and the general promotion of a healthy lifestyle. To this end, the scientific community has been increasingly investigating natural compounds that could prevent or treat chronic diseases. Phlorotannins and bromophenols are phenolic compounds particularly present in marine organisms. There is extensive evidence that shows their potential in the prevention of noncommunicable diseases, including cancer, the second cause of mortality worldwide. Numerous studies have demonstrated the anticarcinogenic activity of polyphenolic algae compounds both in cell culture and experimental animal models. Although recent reviews are also available, the present update focuses on the most recent findings related to the antioxidant/anti-inflammatory effect of seaweed phenolics, as well as their regulatory capacity for new molecular targets. Additionally, the review addresses and discusses the close link between inflammation and oxidative stress, along with their relationship with tumor onset and progression, including the most recent findings supporting this correlation. Although clinical studies are still needed to support this evidence, phlorotannins and bromophenols constitute an emerging bioactive group with high potential as chemopreventive agents and/or potential adjuvants for existing cancer therapies.