Risk Factors For Non-communicable Diseases Research Articles

Burden of non-communicable diseases among women of reproductive age in Kenya: a cross-sectional study

ObjectiveTo examine the burden of non-communicable diseases (NCDs) among women of reproductive age in Kenya, highlighting the prevalence and risk factors.DesignCross-sectional design based on the 2022 Kenya Demographic and Health...

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.

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Association between the nutritional quality of food purchases and household food at home expenditures in Mexico.

Poor-quality diets are a major risk factor for non-communicable diseases. Few studies in Mexico have tested whether higher expenditures are needed to purchase high quality food. The objective of the study was to assess how dietary quality for food purchases was associated with household food at home expenditures. This study is a secondary analysis of cross-sectional data from the National Household Income and Expenditure Survey (ENIGH 2018). The study includes 74,469 households with information on food and beverages purchases in Mexico in 2018. Quarterly household food expenditures by adult equivalent (AE) for all food groups that were scored in the Global Dietary Quality Score (GDQS) for food purchases expressed in dollars/quarterly/AE. Adjusted generalized linear models were used to evaluate the association between GDQS for food purchases (expressed in tertiles: low-, mid-, and high-), and quarterly food expenditures. The analyses were performed at the national level, by place of residence and income quintile. At the national level, the difference in food expenditures between the high- and the low-GDQS group was +$13.85 dollars/AE. By place of residence, the difference between the high- and the low-GDQS group was +$17.31 dollars/AE in urban and +$5.12 dollars/AE in rural areas. For income quintile 1 (lowest) there was statistical difference of -$4.79 dollars/AE and for quintile 5 (highest) +$43.25. Quality of food purchases can be associated with higher or lower expenditures depending on the specific food purchased. High GDQS is associated with lower expenditures among the lowest-income households as they purchase less expensive options compared to high-income households.

Analysis of the structure of the information field of perception of risk factors for non-communicable diseases

When studying the attitude of the population to saving their own health, the question of the connection between abstract knowledge about the harm caused to health by risk factors and a real understanding of the harm caused by these factors to their own health remains poorly understood.The purpose of this work is to analyze the structure of the information field of the population’s attitude to the impact of FR on health.Materials and methods. The material for the analysis was the results of a sociological survey in three pilot regions of the Russian Federation – Tula Region, Stavropol Territory and the Republic of Crimea. The questionnaire consisted of 33 questions concerning risk factors and their impact on the human body and a block of questions concerning sources of medical information and trust in them. The sample size was 1,718 respondents. The following methods were used: descriptive statistics and the sociological method of questioning. Statistical data processing and reweighing were carried out in the statistical data processing package SPSS22.0. In general, the sampling error in the study does not exceed 1.99% for a confidence level of p<0.1.Results. The study showed that abstract knowledge about the harm of a particular FR in almost all FR is quite high, since it is precisely on them that the efforts of the medical community have been directed in recent decades. Moreover, the highest values are expected to have such factors as tobacco use, alcohol consumption, elevated blood sugar (glucose) and high blood pressure. The level of knowledge of the harm of FR, to which the medical community paid less attention, was expected to be lower. The lowest value is such a FR as a low iodine content in salt, which is consumed in food. An assessment of the relationship of variables such as abstract knowledge of harm about FR and understanding of their harm to one’s body using a two-way T-criterion showed that these variables are completely independent of each other at the significance level p<0.001. This result made us look more closely at the factor structure of the studied field of reality and put forward the assumption of independence of knowledge about the harm caused to the human body by FR and behavioral patterns in relation to FR. As a result of factor analysis of 73 variables, 9 factors were identified: the first and most powerful factor (10.33%) – knowledge of the effect of FR on one’s own health; the second most powerful factor (8.71%) – knowledge of the harm of FR; the third highlighted factor (5.46%) – trust in information sources, which included both trust in the media and trust in TV presenters, popular personalities and trust in the leaders of the region and the city; the fourth highlighted factor (4.67%) is the gender characteristics of the control of the FR by the population; the fifth highlighted factor (4.59%) is the sources of information about the FR; the sixth highlighted factor (4.30%) – age–related features of FR control; the seventh highlighted factor (3.32%) – the use of gadgets to control FR and exercise; the eighth highlighted factor (3.00%) – trust in health workers as a source of information; the ninth highlighted factor (2.59%) – smoking and alcohol consumption.Conclusion. The assessment of the effect of FR on the respondents’ own health in the framework of the conducted study turned out to be significantly lower than abstract knowledge about the harmful effects of these FR. The analysis of the factor structure of the studied field confirmed the validity of such a division of knowledge based on ideas about its various forms – «knowledge in itself» and «knowledge for oneself». The analysis made it possible to formulate a number of conditions for improving the effectiveness of preventive work with the population, including to increase the impact of population prevention: it is necessary to more actively involve the most important sources for the population – medical workers, scientific medical workers and health managers; more fully take into account the gender and age characteristics of audiences in preventive measures; the use of mass media should be preceded by an analysis of the level of trust in them from the target audience; the information messages themselves must first be checked for memorability. Preventive measures should change the personal meanings of specific people in relation to FR and HLS, and not be limited to stating general knowledge about them. The study also allows us to determine the directions for further research of the population’s attitude to the FR and their own health as an interdisciplinary task with the necessary involvement of specialists in medical and general psychology, personality psychology and motivation psychology, as well as sociologists.

Smoking and the Risk of Type 2 Diabetes: A Cross-sectional Analytical Study

Background: India is undergoing epidemiological transitions with the increase in noncommunicable disease (NCD) burden. Targeting the modifiable risk factors through lifestyle changes in the early years of life remains the most effective strategy for decreasing the prevalence of type 2 diabetes mellitus (T2DM). To determine the association between cigarette smoking and T2DM. Materials and Methods: An analytical cross-sectional study was conducted among the patients attending the outpatient department of a tertiary care teaching hospital in Kolkata, West Bengal, India. Patients aged more than 35 years were enrolled, and details regarding sociodemography, clinical status, and NCD risk factors were collected using pretested semistructured questionnaires after obtaining IEC approval. Data collected were entered in MS Excel and analyzed using SPSS software. Simple logistic regression and multivariable logistic regression analysis were used to calculate the crude and adjusted odds ratio with 95% confidence interval. Results: Out of 434 participants, 37.3% had diabetes mellitus, 51.6% were males, and 28.6% had alcohol consumption. Univariate logistic regression analysis revealed age, BMI, systolic BP, diastolic BP, and cigarette smoking were significantly associated with increased risk of T2DM. Multivariable logistic regression analysis revealed cigarette smoking, systolic BP, age, and female gender were significant risk factors for T2DM. Conclusions: Our study reported cigarette smoking and systolic BP are modifiable risk factors associated with T2DM. Early identification of smoking through screening and appropriate control of hypertension in T2DM patients will decrease the morbidities and mortalities in T2DM cases.

Hypertension, diabetes, and hypercholesterolemia in Bangladesh: Evaluating role of physical activity from cross-sectional STEPS 2018 survey.

The objective of this study was to assess current condition of three noncommunicable diseases (NCDs)-diabetes, hypertension, and hypercholesterolemia and vulnerable cohorts among adults in Bangladesh. The STEPwise Approach to the NCD Risk Factor Surveillance survey of 2018 was analyzed to evaluate the association between NCDs and sociodemographic factors, levels of physical activity, and behavioral measurements. Complex survey weight-adjusted logistic models were fitted. From 6875 samples, prevalence of diabetes, hypertension and hypercholesterolemia were 27.3%, 9.8%, and 30.2%, respectively. The prevalence of the three NCDs were higher among older respondents. Low occupational activity with obese-BMI status people was more prone to NCDs. Lower prevalence of hypercholesterolemia was observed in Rangpur, Rajshahi, and Mymensingh, whereas lesser diabetes in Khulna region. Likelihood of NCDs were higher among highly educated, urban residents with low physical activity. Lesser physical activity, and lack of weight maintenance were found to be key factors in higher rates of NCDs in Bangladesh. Greater education and less strenuous profession led to a higher chance of NCDs. Overall, physical activity and maintenance of weight seem to be factors driving higher rates of NCDs in Bangladesh. As a preventive measure against NCDs, an active lifestyle is to be encouraged, particularly to the most vulnerable cohort.

The Role of Antioxidants in the Treatment of Metabolic Dysfunction-Associated Fatty Liver Disease: A Systematic Review

Non-alcoholic fatty liver disease (NAFLD) is a global public health problem that causes liver-related morbidity and mortality. It is also an independent risk factor for non-communicable diseases. In 2020, a proposal was made to refer to it as “metabolic dysfunction-associated fatty liver disease (MAFLD)”, with concise diagnostic criteria. Given its widespread occurrence, its treatment is crucial. Increased levels of oxidative stress cause this disease. This review aims to evaluate various studies on antioxidant therapies for patients with MAFLD. A comprehensive search for relevant research was conducted on the PubMed, SCOPUS, and ScienceDirect databases, resulting in the identification of 87 studies that met the inclusion criteria. In total, 31.1% of human studies used natural antioxidants, 53.3% used synthetic antioxidants, and 15.5% used both natural and synthetic antioxidants. In human-based studies, natural antioxidants showed 100% efficacy in the treatment of MAFLD, while synthetic antioxidants showed effective results in only 91% of the investigations. In animal-based research, natural antioxidants were fully effective in the treatment of MAFLD, while synthetic antioxidants demonstrated effectiveness in only 87.8% of the evaluations. In conclusion, antioxidants in their natural form are more helpful for patients with MAFLD, and preserving the correct balance of pro-oxidants and antioxidants is a useful way to monitor antioxidant treatment.

Trends in weight gain recorded in English primary care before and during the Coronavirus-19 pandemic: An observational cohort study using the OpenSAFELY platform.

Obesity and rapid weight gain are established risk factors for noncommunicable diseases and have emerged as independent risk factors for severe disease following Coronavirus Disease 2019 (COVID-19) infection. Restrictions imposed to reduce COVID-19 transmission resulted in profound societal changes that impacted many health behaviours, including physical activity and nutrition, associated with rate of weight gain. We investigated which clinical and sociodemographic characteristics were associated with rapid weight gain and the greatest acceleration in rate of weight gain during the pandemic among adults registered with an English National Health Service (NHS) general practitioner (GP) during the COVID-19 pandemic. With the approval of NHS England, we used the OpenSAFELY platform inside TPP to conduct an observational cohort study of routinely collected electronic healthcare records. We investigated changes in body mass index (BMI) values recorded in English primary care between March 2015 and March 2022. We extracted data on 17,742,365 adults aged 18 to 90 years old (50.1% female, 76.1% white British) registered with an English primary care practice. We estimated individual rates of weight gain before (δ-prepandemic) and during (δ-pandemic) the pandemic and identified individuals with rapid weight gain (>0.5 kg/m2/year) in each period. We also estimated the change in rate of weight gain between the prepandemic and pandemic period (δ-change = δ-pandemic-δ-prepandemic) and defined extreme accelerators as the 10% of individuals with the greatest increase in their rate of weight gain (δ-change ≥1.84 kg/m2/year) between these periods. We estimated associations with these outcomes using multivariable logistic regression adjusted for age, sex, index of multiple deprivation (IMD), and ethnicity. P-values were generated in regression models. The median BMI of our study population was 27.8 kg/m2, interquartile range (IQR) [24.3, 32.1] in 2019 (March 2019 to February 2020) and 28.0 kg/m2, IQR [24.4, 32.6] in 2021. Rapid pandemic weight gain was associated with sex, age, and IMD. Male sex (male versus female: adjusted odds ratio (aOR) 0.76, 95% confidence interval (95% CI) [0.76, 0.76], p < 0.001), older age (e.g., 50 to 59 years versus 18 to 29 years: aOR 0.60, 95% CI [0.60, 0.61], p < 0.001]); and living in less deprived areas (least-deprived-IMD-quintile versus most-deprived: aOR 0.77, 95% CI [0.77, 0.78] p < 0.001) reduced the odds of rapid weight gain. Compared to white British individuals, all other ethnicities had lower odds of rapid pandemic weight gain (e.g., Indian versus white British: aOR 0.69, 95% CI [0.68, 0.70], p < 0.001). Long-term conditions (LTCs) increased the odds, with mental health conditions having the greatest effect (e.g., depression (aOR 1.18, 95% CI [1.17, 1.18], p < 0.001)). Similar characteristics increased odds of extreme acceleration in the rate of weight gain between the prepandemic and pandemic periods. However, changes in healthcare activity during the pandemic may have introduced new bias to the data. We found female sex, younger age, deprivation, white British ethnicity, and mental health conditions were associated with rapid pandemic weight gain and extreme acceleration in rate of weight gain between the prepandemic and pandemic periods. Our findings highlight the need to incorporate sociodemographic, physical, and mental health characteristics when formulating research, policies, and interventions targeting BMI in the period of post pandemic service restoration and in future pandemic planning.

The epidemiology of behavioral risk factors for noncommunicable disease and hypertension: A cross-sectional study from Eastern Uganda.

In light of the suboptimal noncommunicable disease (NCD) risk factor surveillance efforts, the study's main objectives were to: (i) characterize the epidemiological profile of NCD risk factors; (ii) estimate the prevalence of hypertension; and (iii) identify factors associated with hypertension in a peri-urban and rural Ugandan population. A population-based cross-sectional survey of adults was conducted at the Iganga-Mayuge Health and Demographic Surveillance System site in eastern Uganda. After describing sociodemographic characteristics, the prevalence of NCD risk factors and hypertension was reported. Prevalence ratios for NCD risk factors were calculated using weighted Poisson regression to identify factors associated with hypertension. Among 3220 surveyed respondents (mean age: 35.3 years (standard error: 0.1), 49.4% males), 4.4% were current tobacco users, 7.7% were current drinkers, 98.5% had low fruit and vegetable consumption, 26.9% were overweight, and 9.3% were obese. There was a high prevalence of hypertension and prehypertension, at 17.1% and 48.8%, respectively. Among hypertensive people, most had uncontrolled hypertension, at 97.4%. When we examined associated factors, older age (adjusted prevalence ratio (APR): 3.1, 95% CI: 2.2-4.4, APR: 5.2, 95% CI: 3.7-7.3, APR: 8.9, 95% CI: 6.4-12.5 among 30-44, 45-59, and 60+-year-old people than 18-29-year-olds), alcohol drinking (APR: 1.6, 95% CI: 1.3-2.0, ref: no), always adding salt during eating (APR: 1.6, 95% CI: 1.1-2.2, ref: no), poor physical activity (APR: 1.3, 95% CI: 1.1-1.6, ref: no), overweight (APR: 1.3, 95% CI: 1.1-1.5, ref: normal weight), and obesity (APR: 2.0, 95% CI: 1.6-2.4, ref: normal weight) had higher prevalence of hypertension than their counterparts. The high prevalence of NCD risk factors highlights the immediate need to implement and scale-up population-level strategies to increase awareness about leading NCD risk factors in Uganda. These strategies should be accompanied by concomitant investment in building health systems capacity to manage and control NCDs.

Air quality and attributable mortality among city dwellers in Kampala, Uganda: results from 4 years of continuous PM2.5 concentration monitoring using BAM 1022 reference instrument.

Air pollution is a known risk factor for non-communicable diseases that causes substantial premature death globally. Rapid urban growth, burning of biomass and solid waste, unpaved sections of the road network, rising numbers of vehicles, some with highly polluting engines, contribute to the poor air quality in Kampala. To provide evidence-based estimates of air pollution attributable mortality in Kampala city, with focus on ambient fine particulate matter (PM2.5). We utilized a time series design and prospectively collected data on daily ambient PM2.5 concentration levels in micrograms per cubic meter (μg/m3) using a Beta Attenuation Monitor (BAM-1022) in Kampala city, Uganda. We combined the PM2.5 data with all-cause mortality data obtained from the Uganda Bureau of Statistics and the Ministry of Health in Kampala. We calculated attributable risk estimates for mortality using the WHO AirQ+ tools. Overall, the annual average concentration for PM2.5 for the period of 4 years, 2018-2021, was 39 μg/m3. There was seasonal variation, with the rainy season months (March-June and October-December) having lower values. PM2.5 concentrations tend to be highest in the morning (09.00 h) and in the evening (21.00 h.) likely due to increased vehicular emissions as well as the influence of weather patterns (atmospheric temperature, relative humidity and wind). Saturday has the most pollution (daily average over 4 years of 41.2 μg/m3). Regarding attributable risk, we found that of all the deaths in Kampala, 2777 (19.3%), 2136 (17.9%), 1281 (17.9%) and 1063 (19.8%) were attributable to long-term exposure to air pollution (i.e., exposure to PM2.5 concentrations above the WHO annual guideline of 5 μg/m3) from 2018 to 2021, respectively. For the 4 years and considering the WHO annual guideline as the reference, there were 7257 air pollution-related deaths in Kampala city. Our study is the first to estimate air pollution attributable deaths in Kampala city considering the target as the WHO annual guideline value for PM2.5 of 5 μg/m3. Our monitoring data show that fine particulate matter air pollution in Kampala is above the WHO Air Quality Guideline value, likely resulting in substantial adverse health effects and premature death. While further monitoring is necessary, there is a clear need for control measures to improve air quality in Kampala city.

Prevalence of multiple non-communicable diseases risk factors among self-reported healthy older adults living in community dwelling in India: Evidence from the Longitudinal Ageing Study in India

IntroductionNoncommunicable disease (NCDs) risk factor clustering multiplies the risk especially in aging populations. The study objective was to estimate the prevalence and determinants of multiple NCD risk factors amongst older adults in India using the Community-Based Assessment Checklist (CBAC). MethodsA secondary analysis was undertaken using the Longitudinal Ageing Study in India (LASI) data wave-I having 40,510 participants aged ≥ 45 years without a history of diabetes or hypertension. The CBAC recommended by the national program consists of assesses six NCD risk factors: age, tobacco use, alcohol use, waist circumference, physical activity, and family history. ResultsThe prevalence of individuals at high-risk for NCDs defined as a CBAC score ≥ 4 was 55.2 % (95 % CI: 54.1, 56.29). Male gender, widowhood, obesity, and unemployment were independently associated with higher odds of having a high NCD risk factor status. Geographically, Northeastern and Southern states had higher burden of individuals at high-risk for NCDs. Furthermore, 28.44 % of patients at high-risk for NCDs were also having undiagnosed hypertension detected on screening. ConclusionMore than one in two older adults aged ≥ 45 years in India without an established history of diabetes or hypertension have four or more NCD related risk factors that accentuate their NCD risk.

Empowering pharmacy professionals to enhance public health nutrition: a mixed methods study

Unhealthy dietary patterns stand as the foremost risk factor for noncommunicable disease- associated morbidity and mortality(1). As widely accessible healthcare providers, pharmacy professionals’ potential to catalyze improvements in public health nutrition is substantial, offering a means to combat the escalating epidemic of obesity and NCDs through tailored interventions, services, and education(2,3).Our study employed a mixed-methods approach to assess the role of pharmacy professionals in promoting nutrition advice and healthy dietary practices.An online questionnaire (N=200) was designed and conducted to evaluate pharmacy professionals’ nutrition knowledge, the advice given in various diet-related conditions (e.g. obesity, type 2 diabetes, cardiovascular disease risk factors, malnutrition, sustainable diets), practices in delivering diet- related guidance within their routine practice and perceived roles and future ambitions of pharmacy professionals towards nutrition counselling, yielding both quantitative and qualitative insights.Subsequently, qualitative interviews and focus group discussions (N=19) were conducted, engaging pharmacists, nutritionists and dietitians to gather insights essential for the development of a comprehensive nutrition toolkit tailored for pharmacy practice.These interviews delved deeper into the subject, with the goal of designing a nutrition toolkit that empowers pharmacists with the knowledge, tools, and resources needed to play a more active and impactful role in promoting nutrition and healthy lifestyle practices among their patients. Thematic analysis was conducted, and emerging themes and subthemes were identified.Our findings indicate that a significant portion of participants in our study are involved in providing nutrition and diet advice for various health conditions. The majority of pharmacists considered diabetes programmes having a high level of importance (84%), followed by weight management services (78%), hypertension management (86%), and healthy diet campaigns (63.5%). However, our knowledge and confidence rating questions revealed a significant gap in training and a clear need for educational materials tailored for pharmacists to enhance their ability to provide nutrition advice effectively. Key themes identified in open-text questions were referrals and collaboration, training and education needs, wider needs (changes in the public health system, materials/resources, integration and implementation of nutrition in pharmacy practice) and perceived roles as pharmacists in providing nutrition advice (patient support, feeling responsible, specialised focus areas).Qualitative findings underscore the pressing demand for nutrition training and education to deliver comprehensive services, as well as the necessity for collaborative efforts with dietitians and nutritionists to ensure effective care and the improvement of referral pathways in pharmacy practice.This research contributes to the advancement of public health nutrition by recognizing the potential role of pharmacy professionals as key players in the dissemination of nutrition knowledge and fostering healthy behaviours within the community. The results will guide us in the collaborative development of a nutrition toolkit tailored for pharmacy practice, employing a co-design approach.

A systematic scoping review characterising studies investigating workplace nutritional interventions in male employees

Non-communicable diseases (NCDs) are the predominant cause of death in the UK(1) and place an economic burden on societies(2). An unhealthy diet is one of the four main behavioural risk factors for NCDs(3) and thus, interventions targeting dietary behaviour are of particular interest in the prevention of NCDs. The workplace may be a valuable setting for these interventions as employees represent a large proportion of the population in the UK(4). In the male population, NCDs and several risk factors typically manifest at a younger age(5) and, additionally, males participate less in health-promoting activities(6).The aim of this scoping review was to identify and characterise the evidence base to determine if a future full systematic review on nutrition interventions in the workplace to improve health and well- being in males is feasible.The review was conducted adhering to the PRISMA guideline for Scoping Reviews(7). Three electronic databases (Ovid, PubMed, and The Cochrane Library) were systematically searched for relevant publications responding to the research question from inception. No restrictions were made in the search and all study types were eligible. Articles that were not available in English were excluded from the review. Eligible studies were reviewed using a pre-defined data extraction form and references hand-searched for relevant publications. Data synthesis was focused on describing application-oriented aspects and outcome analyses were reduced to anthropometric outcomes.Of the 1,224 publications from the initial database search, 46 were included in the review, with an additional 15 studies identified from hand-searching, resulting in 61 included reports on 57 interventions. Four main approaches to nutrition interventions at the workplace were identified; educational, environmental, individual counselling, and meal provision/replacement. Most interventions used multicomponent approaches. One of the 61 included reports followed a qualitative design. Anthropometric outcomes were reported in the majority (83.6%) of studies, followed by bioclinical outcomes (45.9%), other outcomes were food (34.4%) and nutrient intake (22.9%), smoking habits (14.8%) and, one study reported on Quality of Life. Of the studies reporting anthropometric outcomes 69% reported to be effective in improving body weight, 47.8% BMI and 54.5% waist circumference. No determinants of successful interventions such as type, duration, workplace participation were identified.This review suggests that nutrition interventions at the workplace are effective in improving several anthropometric outcomes. A future full systematic review is feasible but should consider narrowing the research question to account for limitations in the current evidence base as differences in reporting of design, population, intervention, and outcomes severely limited data analyses. Furthermore, to enable high-quality research, the development of a reporting tool, such as the TIDieR checklist (8) is recommended.

Disparities and determinants of testing for early detection of cervical cancer among Nepalese women: evidence from a population-based survey.

Cervical cancer (CC) 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 CC screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of CC among Nepalese women. Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (WHO-STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30-69 years, were used. Respondents were asked if they had undergone CC testing through VIA, Pap smear, or HPV test ever or in the past five years. The slope index of inequality (SII) and relative concentration index (RCI) were used to measure socioeconomic and education-based disparities in CC test uptake. Only 7.1% (95% CI: 5.1-9.9) Nepalese women had ever undergone CC testing, while 5.1% (95% CI: 3.4-7.5) tested within the last five years. The ever uptake of CC testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from richest compared to 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 to 21.9). Less than one in ten women in Nepal had a CC testing, primarily favoring higher educated and wealthier individuals. Targeted early detection and CC screening interventions are necessary to address these disparities and improve access and uptake.

Prevalence of behavioral risk factors of non-communicable diseases in Mumbai: a descriptive cross-sectional study

Prevalence of behavioral risk factors of non-communicable diseases in Mumbai: a descriptive cross-sectional study

Engagement of private healthcare sector in addressing noncommunicable diseases at primary care level in the Eastern Mediterranean Region.

The private healthcare sector is a critical stakeholder in the provision of health care services, including noncommunicable diseases (NCDs), and engagement with the sector is increasingly being advocated in efforts to achieve Universal Health Coverage. This study was conducted to explore the role of the private health sector in delivering NCD-related primary care services in selected countries of the WHO Eastern Mediterranean Region (EMR): Jordan, Oman, Pakistan, Sudan, and the Syrian Arab Republic. We adapted the analytical framework for this study from the "Framework for action to implement the United Nations political declaration on noncommunicable diseases". We conducted a desk review to gather evidence, identify gaps and provide direction for the subsequent stakeholder interviews. Key informant interview respondents were selected using the snowball sampling method. Data from the interviews were analysed using MAXQDA, version 2020. We reviewed 26 documents and interviewed 19 stakeholders in Jordan, Oman, Pakistan, Sudan and the Syrian Arab Republic. Our results indicated increasing advocacy at the regional and national levels to align the private and public health sectors, just as there were efforts to reduce the risk factors for NCDs by implementing tobacco laws, introducing food labelling guidelines, increasing taxes on soft drinks, and promoting the healthy cities approach. NCDs health information systems varied widely among the countries, from being organized and developed to having poor recordkeeping. The private health sector is the predominant provider of care at primary level in most of the EMR countries. Increased collaboration between the public and private sectors is essential for better management of NCDs in the EMR. Governments need to strengthen regulation and defragment the private health sector and harness the sector's strengths as part of efforts to achieve national health targets, NCD goals and Universal Health Coverage.

Host obesity impacts genetic variation in influenza A viral populations.

Obesity is well established as a risk factor for many noncommunicable diseases; however, its consequences for infectious disease are poorly understood. Here, we investigated the impact of host obesity on influenza A virus (IAV) genetic variation using a diet-induced obesity ferret model and the A/Hong Kong/1073/1999 (H9N2) strain. Using a co-caging study design, we investigated the maintenance, generation, and transmission of intrahost IAV genetic variation by sequencing viral genomic RNA obtained from nasal wash samples over multiple days of infection. We found evidence for an enhanced role of positive selection acting on de novo mutations in obese hosts that led to nonsynonymous changes that rose to high frequency. In addition, we identified numerous cases of mutations throughout the genome that were specific to obese hosts and that were preserved during transmission between hosts. Despite detection of obese-specific variants, the overall viral genetic diversity did not differ significantly between obese and lean hosts. This is likely due to the high supply rate of de novo variation and common evolutionary adaptations to the ferret host regardless of obesity status, which we show are mediated by variation in the hemagglutinin and polymerase genes (PB2 and PB1). We also identified defective viral genomes (DVGs) that were found uniquely in either obese or lean hosts, but the overall DVG diversity and dynamics did not differ between the two groups. Our study suggests that obesity may result in a unique selective environment impacting intrahost IAV evolution, highlighting the need for additional genetic and functional studies to confirm these effects.IMPORTANCEObesity is a chronic health condition characterized by excess adiposity leading to a systemic increase in inflammation and dysregulation of metabolic hormones and immune cell populations. Influenza A virus (IAV) is a highly infectious pathogen responsible for seasonal and pandemic influenza. Host risk factors, including compromised immunity and pre-existing health conditions, can contribute to increased infection susceptibility and disease severity. During viral replication in a host, the negative-sense single-stranded RNA genome of IAV accumulates genetic diversity that may have important consequences for viral evolution and transmission. Our study provides the first insight into the consequences of host obesity on viral genetic diversity and adaptation, suggesting that host factors associated with obesity alter the selective environment experienced by a viral population, thereby impacting the spectrum of genetic variation.

Association of risk factors for high blood pressure across 46 low- and middle-income countries: A multi-country cross-sectional analysis.

Despite acknowledging the influence of various lifestyle and metabolic risk factors on hypertension, it remains uncertain to identify the primary contributors and differentiate which modifiable risk factors mediate the causal effects of hypertension. We aimed to examine the hierarchical association of eight prominent lifestyle and metabolic risk factors, along with demographic variables, with hypertension in adults and to explore the mediating effects of modifiable metabolic risk factors on hypertension. A cross-sectional study was conducted in 46 low- and middle-income countries using the World Health Organization (WHO) STEPwise approach to noncommunicable disease risk factor surveillance from 2002 to 2020. In a sample of 179 535 non-pregnant adults, we assessed the weighted population-attributable risk percentages (PAR%) for hypertension associated with eight risk factors. Additionally, we investigated the mediating role of metabolic risk factors on the effects of lifestyle risk factors on hypertension. After adjusting for the sample weight in each country, 26.7% of participants had hypertension. The prevalence of hypertension was highest in those aged ≥65 years, with obesity-associated hypertension (45.7%) exceeding the rates for overweight (32.2%) and non-overweight individuals (18.2%). These eight risk factors collectively explain 83.7% of the PAR% associated with hypertension adjusted for the communal variance. Among the modifiable factors, obesity contributed to a weighted PAR% of 38.2%, while sedentary behaviour and low physical activity combined accounted for a weighted PAR% of 3.1%. Overweight/obesity played a predominant mediating role in the correlation between lifestyle risk factors and systolic and diastolic blood pressure, with the indirect effect accounting for approximately 25-64% and 13-80% of the total effect, respectively. These findings offer new insights into the modified risk factors associated with hypertension in adults in low- and middle-income countries, highlighting the crucial role of maintaining a normal body weight for the effective prevention and management of hypertension.