Risk Factors For Non-communicable Diseases Research Articles

The Association of Physical Activity With Overweight/Obesity and Type 2 Diabetes in Nepalese Adults: Evidence From a Nationwide Non-Communicable Disease Risk Factor Survey.

The rising prevalence of obesity and type 2 diabetes (T2DM) is a significant public health concern, particularly in low- and middle-income countries. This study aimed to explore the association between physical activity levels, overweight/obesity, and T2DM in a nationwide survey of Nepalese adults. This was a secondary analysis of the 2019 non-communicable diseases (NCD) risk factors STEPS survey conducted in Nepal. Demographic and anthropometric data, body mass index (BMI) and T2DM status were collected along with assessment of physical activity using Global Physical Activity Questionnaire (GPAQ). A two-stage data analysis was conducted, first using descriptive statistics to summarize participant characteristics and differences across BMI and T2DM status, and then applying multivariate analyses to assess associations between physical activity levels, BMI and T2DM. Of the 5284 participants included, 28.0% had overweight/obesity, 5.8% had obesity, and 6.5% had T2DM. The mean age of the participants was 40.1years (95% CI: 39.8-40.6), and 63.9% were female. The overall physical activity energy expenditure was higher in the lean group (BMI<25kg/m2) compared to the those with overweight/obesity, and among participants without T2DM compared to those with T2DM. Sedentary behavior was more common among individuals with overweight/obesity and T2DM. A higher proportion of participants with low physical activity was observed in the overweight/obesity group compared to the lean group (8.9% vs. 6.3%) and the T2DM group compared to the non-T2DM group (11.7% vs. 6.7%). Low physical activity was associated with overweight/obesity (OR:1.4; 95% CI:1.1-1.8), obesity (OR:2.1; 95% CI:1.5-2.3), T2DM (OR:1.6; 95% CI:1.1-2.3) and T2DM in the presence of obesity (OR:3.6; 95% CI:1.7-7.8). This study highlights the low rates of physical activity and higher rates of sedentary behavior among adults with overweight/obesity and T2DM in Nepal. Public health interventions promoting physical activity and reducing sedentary behavior may help reduce the burden of these NCDs.

Burden and attributable risk factors of non-communicable diseases and subtypes in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021.

Understanding based on up-to-date data on the burden of non-communicable diseases (NCDs) is limited, especially regarding how subtypes contribute to the overall NCD burden and the attributable risk factors across locations and subtypes. We aimed to report the global, regional, and national burden of NCDs, subtypes, and attributable risk factors in 2021, and trends from 1990 to 2021 by age, sex, and socio-demographic index (SDI). We used data from the Global Burden of Disease Study 2021 to estimate the prevalence, deaths, and disability-adjusted life years (DALYs) for NCDs and subtypes, along with attributable risk factors. Estimates were presented with 95% uncertainty intervals (UI). Relationships between NCD DALYs and SDI across regions and countries were estimated using smoothing splines models. In 2021, NCDs accounted for 7.3 trillion global cases, 43.8 million deaths, and 1.73 billion DALYs. Global age-standardized rates showed NCD prevalence at 91034.0, deaths at 529.7, and DALYs at 20783.0 per 100000 population, with changes of -0.1%,-27.9%, and -19.4% from 1990, respectively. Subtypes with the highest age-standardized DALYs were cardiovascular disease (5056), neoplasms (2954), and other NCDs (1913 per 100000 population), with diabetes and kidney diseases increasing by 25.6% since 1990. Regionally, Oceania had the highest age-standardized DALYs (28782.0) in 2021, while Southern Sub-Saharan Africa saw the largest increase (+8.0%) since 1990. Nationally, Nauru reported the highest age-standardized DALYs (42754.3), with Lesotho experiencing the largest increase since 1990 (+38.4%). Cardiovascular diseases had the highest age-standardized DALYs among subtypes across 16 of 21 regions and 159 of 204 countries. Key risk factors globally were high systolic blood pressure (contributing to 12.8% of age-standardized DALYs), dietary risks (10.0%), and tobacco usage (9.9%), with the most significant increase in high body-mass index (+57.8%). High systolic blood pressure was the biggest attributable risk factor for NCDs in 9 regions and 101 countries. Age-standardized data reveal higher NCD prevalence in women and greater mortality and DALYs in men, with DALYs spiking post-45 for both sexes. Men have higher DALYs attributed to most risk factors, excluding those from unsafe sex, intimate partner violence, low physical activity, and high body-mass index. Age-standardized DALYs of NCDs generally decline with the SDI spectrum. Dominant NCD risk factors follow gender-age and SDI-based trajectories. Despite declining age-standardized prevalence, death rates, and DALYs for NCDs, they remain a major health issue. Emphasis on managing cardiovascular diseases, cancers, diabetes, kidney diseases, and mental disorders is essential. The burden of NCDs is more severe in low-SDI countries and among males. Prevention efforts should prioritize blood pressure control, dietary improvements, and tobacco reduction, tailoring interventions according to gender-age-based and SDI-development-based trajectories of dominant risk factors.

Socioeconomic inequality in hypertension and its determinants in people over 60 years in Fasa, southern Iran: a Blinder-Oaxaca decomposition

BackgroundHypertension (HTN) is well-known as a major risk factor for various noncommunicable diseases. Evidence indicates a link between socioeconomic status and the likelihood of developing HTN. A thorough comprehension of the inequalities in HTN is crucial for implementing evidence-based interventions. This study aimed to assess the socioeconomic disparities in HTN among people aged 60 and older in Fasa County, located in southern Iran.MethodsA total of 1,632 seniors, aged 60 and above, were included in the analysis, with data obtained from the Fasa Adults Cohort Study (FACS). Initially, we utilized both simple and multiple logistic regression models to investigate the associations between HTN and the determinant variables. The Blinder‒Oaxaca decomposition method was used to decompose the disparity between the impoverished and the wealthy.ResultsThe research indicated that elderly individuals with a higher risk of developing HTN were notably linked to factors such as socioeconomic status, education level, a history of coronary artery disease, employment status, smoking habits, body mass index (BMI), waist‒hip ratio (WHR), and physical activity (p < 0.05). The decomposition model revealed a significant gap in HTN rate between rich and poor individuals, with those in the lower income bracket having a 7.59% higher rate of HTN (p = 0.001). Additionally, the leading factors contributing to the greatest disparities in HTN among older adults from different socioeconomic backgrounds include education level (33.07%), employment status (12.78%), BMI (12.25%), physical activity (-15.02%), and WHR (-9.22%).ConclusionsThe decomposition model illustrated a significant disparity in HTN rates among various socioeconomic groups, with a higher rate observed in the lower-income demographic. The analysis revealed that a substantial part of the explained gap can be attributed to factors including education level, employment status, WHR, BMI, and level of physical activity. Nonetheless, a considerable portion of HTN inequality among older adults remains unexplained by the model, highlighting the necessity for additional research that includes a wider variety of factors and variables to gain a deeper insight into the root causes of these disparities.

Assessing Metabolic Ageing via DNA Methylation Surrogate Markers: A Multicohort Study in Britain, Ireland and the USA.

Metabolomics and epigenomics have been used to develop 'ageing clocks' that assess biological age and identify 'accelerated ageing'. While metabolites are subject to short-term variation, DNA methylation (DNAm) may capture longer-term metabolic changes. We aimed to develop a hybrid DNAm-metabolic clock using DNAm as metabolite surrogates ('DNAm-metabolites') for age prediction. Within the UK Airwave cohort (n = 820), we developed DNAm metabolites by regressing 594 metabolites on DNAm and selected 177 DNAm metabolites and 193 metabolites to construct 'DNAm-metabolic' and 'metabolic' clocks. We evaluated clocks in their age prediction and association with noncommunicable disease risk factors. We additionally validated the DNAm-metabolic clock for the prediction of age and health outcomes in The Irish Longitudinal Study of Ageing (TILDA, n = 488) and the Health and Retirement Study (HRS, n = 4018). Around 70% of DNAm metabolites showed significant metabolite correlations (Pearson's r: > 0.30, p < 10-4) in the Airwave test set and overall stronger age associations than metabolites. The DNAm-metabolic clock was enriched for metabolic traits and was associated (p < 0.05) with male sex, heavy drinking, anxiety, depression and trauma. In TILDA and HRS, the DNAm-metabolic clock predicted age (r = 0.73 and 0.69), disability and gait speed (p < 0.05). In HRS, it additionally predicted time to death, diabetes, cardiovascular disease, frailty and grip strength. DNAm metabolite surrogates may facilitate metabolic studies using only DNAm data. Clocks built from DNAm metabolites provided a novel approach to assess metabolic ageing, potentially enabling early detection of metabolic-related diseases for personalised medicine.

Clustering of obesogenic behaviours amongst 140052 South American adolescents: a harmonized meta-analysis of national health surveys.

Physical activity, sedentary behaviour, and diet synergically coexist (in different ways) within adolescents' lifestyles. Thus, understanding obesogenic behaviour patterns within populations is critical to promoting adolescents' health. This study investigates clustering patterns of adolescents' obesogenic behaviours across South American countries. The present work is a harmonized analysis of 10 national representative cross-sectional health surveys investigating adolescents' risk and protective factors for non-communicable diseases. The surveys used questionnaires, and three obesogenic behaviours were analyzed for cluster formation (physical activity, sitting time, and diet). Sociodemographic variables were sex, age, and food insecurity. The Two-step cluster, the Rao-Scott chi-square test, and a meta-analysis were performed for data analysis. Three to four cluster solutions were identified in each country, and most clusters are unhealthy. The All-day sitters-very poor diet cluster was observed in Paraguay, Peru, Suriname, Chile, Guyana, Argentina, Brazil, Colombia, and Ecuador, with a pooled prevalence of 17.8% (95% CI:15.0; 20.7) amongst South American countries, with the highest prevalence observed in Argentina [26.8% (95% CI: 26.7; 26.9)]. Girls were more likely to belong to the unhealthiest clusters. The lifestyle behaviours of South American adolescents coexist negatively, and there is a severe obesogenic risk for this population. The synergy between physical inactivity and poor/very poor diet was clustered together in all countries, and our analysis did not reveal any natural healthy clusters. Furthermore, girls are at a disadvantage, given that they are the majority in clusters with unhealthy profiles in South America.

Longitudinal Analysis of Cardiovascular Risk Factors Among Older Adults Participating in a Park-Based Fitness Program.

Background: Physical inactivity is a major risk factor for noncommunicable diseases, particularly among older adults. We examined changes in cardiovascular risk factors among older adults in a community-based fitness program in Miami-Dade County, FL. Methods: We used repeated measures linear mixed models to examine participants' cardiovascular risk factor changes over 28 months. Outcomes (body mass index, blood pressure, pulse, arm/leg strength, and mobility) were modeled accounting for park, individual, time, and sociodemographic factors (2017-2019). Results: The study included 210 participants (mean age 71 years; 86% female; 52% Hispanic, 38% non-Hispanic Black). Participation was positively associated with reductions in cardiovascular risk, including improvements in systolic and diastolic blood pressure (-0.83 and -0.39 mmHg, respectively), mobility (-0.07 s) and arm strength (0.5 arm curls). Differences were observed in arm curls across sex and pulse across poverty areas. Conclusion: Participating in a park-based fitness program was associated with improved older adults' cardiovascular health.

Burden of disease attributable to high body mass index in Belgium: a comparative risk assessment analysis

Background and methodsHigh body mass index (BMI) is a major risk factor for several non-communicable diseases. The increasing concern about the health and economic burden of BMI makes it essential...

Socioeconomic and behavioural factors that contribute to the co-occurrence of risk factors for noncommunicable diseases

It is observed that the global burden of diseases had shifted from infectious diseases to Non-Communicable Diseases (NCDs), with an accumulative trend in developing countries. NCDs share key modifiable behavioral risk factors like unhealthy diet and lack of physical activity that are typically established during adolescence or young adulthood and will set the stage for NCDs development later in life. Therefore, this paper aimed to explore factors contributing to the co-occurrence of risk factors for NCDs among persons aged 30 years and above in selected urban areas of Namibia. Specifically, the paper focused on examining the social, economic and behavior characteristics of people living with NCDs and how they contribute to the relative risk of the co-occurrence of NCDs. The study is based on secondary data and analysis is based on a total sample of 1527 which was successfully interviewed. The dependent variable was co-occurrence of NCD risk factors per respondent with the following groups: No co-occurrence, at most two risk factors, 3–4 risk factors, and 5–6 risk factors. The risk factors included excessive alcohol consumption, smoking of tobacco, insufficient physical activeness, insufficient intake of fruits, and insufficient intake of vegetable and unhealthy dietary pattern. Descriptive statistics were obtained using frequencies and averages. Pearson Chi-square was used to assess the association between co-occurrence of risk factors and socio-economic and behavioural variables using cross-tabulation. A multinomial regression model was also used to predict the effects of factors contributing to the co-occurrence of risk factors. The significance of variables was tested using 5% level. The results showed that overall, co-occurrence of risks was more prevalent among respondents with HBP than those with diabetes or HRD. Notably, age and education level positively contribute to co-occurrence of risk factors of NCDs. Increased co-occurrence of risks was also relatively high among respondents with NCD who did not take medication and those who did not go for follow up. The paper concluded that taking medication, regular check-up and following healthy diet significantly reduce the risk of co-occurrence of NCD risk factors. The study recommends for infrastructural developments in urban areas that promotes health lifestyles including provision for cycling, walking paths and participation in urban agriculture.

Risk factor clusters for non-communicable diseases in adolescents in Eastern Cape, South Africa

Background: The increasing prevalence of non-communicable diseases (NCDs) among adolescents in South Africa is a growing public health concern.Aim: To examine the clustering of NCD risk factors, with a focus on gender, socio-economic status (SES) and perceived stress among adolescents.Setting: The study involved adolescents from eight schools in Buffalo City Metropolitan Municipality and Amatole district, Eastern Cape.Methods: A stratified random sample of 266 adolescents (aged 12 years–18 years) was assessed for anthropometric, physiological, and perceived stress measures. Data included body mass index (BMI), blood pressure (BP), cholesterol, glucose levels, and perceived stress (via the Perceived Stress Scale). Analysis involved descriptive statistics, Chi-square tests, t-tests, and k-means clustering.Results: Females (n = 155) showed a higher prevalence of NCD risk factors, with 80.2% classified as overweight or obese compared to 19.8% of males, and 77.2% had elevated cholesterol versus 22.8% of males. Perceived stress was higher in affluent schools (59.8%) despite fewer metabolic risks. K-means analysis identified four health profiles with significant SES and health differences (p 0.001). Cluster 1 (high SES) showed elevated BP, BMI, and stress, while Clusters 2–4 (low SES) varied in risks, with Cluster 4 showing the highest BP and metabolic risks despite low stress.Conclusion: These results highlight unique health profiles and risk factors across socio- economic contexts, with female adolescents from lower socio-economic backgrounds facing greater metabolic risks.Contribution: This Study provides original insights into the interplay between gender, SES and perceived stress in shaping NCD risk among South African adolescents.

Comprehensive assessment of the impact of blood pressure, body mass index, smoking, and diabetes on healthy life expectancy in Japan: NIPPON DATA90.

Healthy life expectancy (HLE) is a population health indicator that is widely used in developed countries, but little is known about its relationships with combinations of non-communicable disease risk factors. This study was conducted to examine HLE at age 65 according to combinations of blood pressure levels, body mass index, smoking status, and diabetes mellitus (DM) in a Japanese population. In a nationwide cohort study (NIPPON DATA90), data on these risk factors were obtained from participants in 1990 through physical examinations, blood tests, interviews, and questionnaires. Subsequently, participants aged ≥65 years underwent surveys on activities of daily living in 1995 and 2000, and multistate life tables were used to calculate combination-specific HLEs and their 95% confidence intervals (CIs). The study population comprised 6,569 participants (men: 2,797; women: 3,772) who were followed-up until 2010. HLE at age 65 in men with grade II/III hypertension, obesity, current smoker status, and DM (HLE: 12.9 years, 95% CIs: 12.9-13.0 years) was 9.7 years shorter than men without these risk factors (HLE: 22.6 years, 95% CIs: 22.4-22.8 years). Similarly, HLE at age 65 in women with grade II/III hypertension, obesity, current smoker status, and DM (HLE: 16.2 years, 95% CIs: 15.9-16.5 years) was 10.1 years shorter than women without these risk factors (HLE: 26.3 years, 95% CIs: 26.3-26.3 years). The large discrepancies in HLEs underscore the impact of non-communicable disease risk factors, which should be considered when formulating health interventions to improve HLE in Japanese older adults.

Scoping Review of Knowledge, Attitude and Practices Related to NCD Risk Factors Among Medical Undergraduates, India

India is witnessing an epidemiologic transition from infectious diseases to non-communicable diseases (NCDs). Prevention of the NCD risk factors is an effective way, and future doctors play a vital role in preventing the disease epidemics. Undergraduate medical education forms the basis of knowledge development, including NCD risk factors. With this backdrop, the scoping review aimed to map available evidence on the knowledge, attitude, perception and practices related to NCD risk factors amongst medical undergraduates in India. A systematic search was conducted using key terms from five electronic databases of peer-reviewed articles. Two reviewers independently screened all articles for eligibility and assessed the quality of included studies. Studies were included if they reported on the medical students’ knowledge, attitude, perception and practice related to NCD risk factors. Thirteen studies on undergraduate medical students in India were included in the systematic review. Twelve of these reported on students’ knowledge about NCD risk factors, nine explored their attitude towards NCD risk factor prevention, and eleven studies were on the practice of NCD prevention. The studies revealed a high level of knowledge about NCD risk factors. Still, their attitude and practices about NCD reduction were deficient. An overall rise in health-risking behaviour and a fall in health-promoting behaviour was observed by various studies. The level of physical activity among girls was significantly lower compared to the boys. Studies show many few students take patient history or counsel their patients to quit unhealthy lifestyle habits. Various studies found a rise in health-risking behaviour and a fall in health-promoting behaviour among medical students, which suggest creating an enabling environment and conducive climate for promoting healthy behaviour that can then be taught to their patients.

Co-occurrence of behavioural risk factors for non-communicable diseases and mortality risk in Spain: a population-based cohort study

ObjectivesThis study aims to estimate the impact of the co-occurrence of behavioural risk factors on mortality in the Spanish adult population.DesignPopulation-based cohort study based on data from the 2011–2012 Spanish...

Integrating post-validation surveillance of lymphatic filariasis with the WHO STEPwise approach to non-communicable disease risk factor surveillance in Niue, a study protocol.

Lymphatic filariasis (LF), a mosquito-borne parasitic disease caused by three species of filarial worms, was first detected in Niue, a small Pacific Island nation of approximately 1,600 people, in 1954. After extensive efforts involving multiple rounds of Mass Drug Administration, Niue was validated by the World Health Organization (WHO) as having e4liminated LF as a public health problem in 2016. However, no surveillance has been conducted since validation to confirm infection rates have remained below WHO's elimination threshold. WHO has encouraged an integrated approach to disease surveillance and integrating LF post-validation surveillance (PVS) with existing surveys is an anticipated recommendation of the upcoming WHO LF-PVS guidelines. This paper describes a protocol for the implementation of an integrated approach to LF-PVS in Niue as cost-efficient and operationally feasible means of monitoring the disease in the population. The LF-PVS will be implemented as part of a planned national population-based WHO STEPwise approach to non-communicable disease (NCD) risk factor surveillance (STEPS) in Niue. Integration between the LF-PVS and STEPS will occur at multiple points, including during pre-survey community awareness raising and engagement, when obtaining informed consent, during the collection of demographics, risk factor, and location data, and when collecting finger-prick blood samples (for glucose as part of the STEPS survey and LF as part of the LF-PVS). The primary outcome measure for LF transmission will be antigen positivity. Microfilaria slides will be prepared for any antigen-positive cases. Dried blood spots will be prepared for all participants for Multiplex Bead Assays-based analysis to detect anti-filarial antibodies. We estimate a total sample size of 1,062 participants aged 15-69, representing approximately 66% of the population. The results of this study will provide insight into the status of LF in Niue and evaluate the advantages, challenges, and opportunities offered by integrated approaches to disease surveillance.

Classifying the WHO European countries by noncommunicable diseases and risk factors.

In the twenty-first century, noncommunicable diseases (NCDs) are a major obstacle to global development and the accomplishment of the Sustainable Development Goals set forth by the United Nations. The WHO (World Health Organization) European Region lacks comprehensive understanding of NCD risk factors, the NCDs they trigger, and the more disadvantaged countries. This study aims to classify the countries in the European Region at the country level based on NCDs and their key risk factors. The Ward method, a hierarchical clustering technique based on Manhattan and Euclidean distance measures, was used. The study's dataset comes from the WHO's publicly available NCDs and key risk factors dataset. The European region's countries have been categorized into two clusters based on key NCD risk factors. The second cluster consists of countries with high income levels. On the other hand, in the European Region, countries fall into three clusters based on NCDs. Countries in the third cluster, which consists of low- and upper-middle-income countries, have lower average values in four variables compared to other countries, resulting in lower overall disease prevalence. The prevalence of NCDs varies among clusters, with high-income countries having lower disease prevalence, particularly in diabetes and hypertension. Addressing risk factors and improving healthcare access and infrastructure are crucial in reducing the burden of NCDs in the European region.

Multiple behavioral risk factors for chronic noncommunicable diseases: the concept of concatenated influence

Multiple behavioral risk factors for chronic noncommunicable diseases: the concept of concatenated influence

A post-pandemic snapshot of the magnitude of COVID-19 in Brazil: A countrywide study.

To outline the features of COVID-19 in Brazil through a countrywide telephone survey. Data from the Telephone Survey of Risk Factors for Chronic Noncommunicable Diseases During the Pandemic (Covitel), a telephone survey of individuals aged 18 years or older from all macro-regions of Brazil, were used. The questionnaire included sociodemographic characteristics and outcomes related to COVID-19 infection, severity, vaccination, and use of masks. Data revealed that 34.7 % (95 %CI 32.4 - 37.1) of the population had been diagnosed with COVID-19, and 10.1 % (95 %CI 7.9 - 12.7) of those required hospital admission. The prevalence of COVID-19 diagnosis increased with education level: <8 years (26.6 % [95 %CI 23.1 - 30.7]), 9-11 years (33.4 % [95 %CI 29.4 - 37.7]), and >11 years (53.2 % [95 % CI 49.7 - 56.8]). Nevertheless, the hospitalization rate of Brazilians with more than eleven years of education was lower (5.8 % [95 %CI 4.3 - 7.6]). In 2023, 92.9 % (95 %CI 90.9 - 94.4) of the Brazilian population was fully vaccinated against COVID-19, but only 37.2 % (95 %CI 33.5 - 40.9) have received the updated vaccinal scheme (two doses and two boosters). During the pandemic outbreak, 81.9 % (95 %CI 79.4 - 84.2) reported always using face masks. However, only 16.1 % (95 %CI 13.5 - 19.0) maintained this practice in 2023. There were inequalities in COVID-19 testing in Brazil. Testing and vaccination policies implemented in the COVID-19 pandemic must be reevaluated by the Brazilian government.

Risk of Dementia and Its Associated Factors Among the Patients With Coronary Artery Disease Attending a Tertiary Cardiac Hospital of Dhaka City: A Cross-Sectional Study.

In Bangladesh, data related to the future risk of dementia and its associated factors are scarce. Furthermore, no dementia risk prediction tool has yet been applied to estimate the risk in any population in Bangladesh. Therefore, our objective was to assess the risk of dementia and its associated factors among patients with coronary artery disease (CAD). This cross-sectional study conveniently recruited 280 stable patients with CAD who were admitted for coronary revascularization at a tertiary cardiac hospital situated in Dhaka, Bangladesh. Data were collected face-to-face using a pretested questionnaire adapted from the WHO STEP-wise Approach to Surveillance (STEPS) of Noncommunicable Diseases Risk Factors questionnaire (Version 3.2). The questionnaire included background information (sociodemographic, comorbidity), behavioral and metabolic risk factors, physical and biochemical measurements. The next 20 years' risk of dementia was estimated using the "Cardiovascular Risk Factors, Aging, and Incidence of Dementia" score. The risk score, risk levels, and risk factors were presented descriptively. The associated factors of dementia risk were elucidated using hierarchical multiple regression analysis. The mean ( ± standard deviation) risk score for dementia was 6.26 ± 2.28. The predicted "at-risk" population was 63.6%. The prevalent risk factors were unhealthy diets (84.3%) presented by inadequate fruit/vegetable consumption (70%) and added salt intake (46.4%). In the final model of hierarchical multiple regression, the risk score showed a significant association with several risk factors: family history of diabetes (p = 0.03), alcohol intake (p = 0.03), current smoking (p = 0.03), estimated glomerular filtration rate (p = 0.001), and diastolic blood pressure (p = 0.02). A substantial proportion of patients with CAD had a future risk of dementia which demands an urgent risk reduction strategy in Bangladesh. Future longitudinal studies may more precisely justify the current findings.

Clustering of non-communicable disease risk factors among school teachers: A cross-sectional study in Kerala, India

Clustering of non-communicable disease risk factors among school teachers: A cross-sectional study in Kerala, India

Association of Cardiovascular Disease Risk Factors With Estimated Dietary Salt Consumption in Bangladeshi Adults: A Nationally Representative Cross-Sectional Study.

This population-based, nationally representative cross-sectional study assessed the daily salt consumption status and its associated cardiovascular disease (CVD) risk factors using weighted data from the STEPwise approach to noncommunicable disease risk factor surveillance conducted in 2018 in Bangladesh. It included a non-institutionalized adults' population of 6189 men and women aged 18-69years. Their daily salt consumption was estimated using the spot urine sodium concentration following the Tanaka equation and reported according to the standard nomenclature proposed by the World Hypertension League and partner organizations involved in dietary salt reduction. Out of a total of 6189 participants, 2.4% consumed the recommended amount of salt (<5g/day), 67.8% consumed a high amount of salt (≥5-10g/day), 27.2% consumed a very high amount of salt (>10-15g/day), and 2.6% consumed an extremely high amount of salt (>15g/day). In univariate analysis, a higher than recommended level of salt intake (≥5g/day) was significantly prevalent among rural residents (high=78.4%, very-high=81.6%, extremely-high=84.9%, p=0.01), literates (high=51.6%, very-high=57.9%, extremely-high=59.1%, p=0.02), newly diagnosed hypertension (high=20.6%, very-high=23.6%, extremely-high=24.1%, p=0.008), and overweight/obese (high=25.9%, very-high=33.3%, extremely-high=29.8%, p=0.000). Similarly, in ordinal logistic regression analysis, the categories of daily salt consumption showed a significant association with rural residence (OR: 1.300, CI: 1.109-1.524, p=0.001), literates (OR: 0.777, CI: 0.671-0.900, p=0.001), newly diagnosed hypertension (OR: 1.204, CI: 1.022-1.419, p=0.026), and overweight/obesity (OR: 1.353, CI: 1.145-1.598, p=0.000). The current national pattern of salt consumption in Bangladesh may help reconstruct the salt reduction strategy considering the associated risk factors.

Knowledge, Attitude, and Practice Regarding High Salt Intake and Association With Hypertension Among Rural Women in Chandpur District of Bangladesh.

The human body requires a relatively little quantity of sodium to transmit nerve impulses, contract and relax muscles, and maintain appropriate water and mineral balance and which is typically added from diets. The study aimed to assess the level of knowledge, attitude, and practice regarding high salt intake and their association with hypertension among rural women of a selected community in Chandpur. A cross-sectional study was adopted to collect data from 250 households of Chandpur district. The study was conducted during May 2022 to July 2022. The semi-structured pretested WHO-modified step-wise approach to the non-communicable disease risk factor surveillance (STEPS). Instrument version 3.1 module was used to administer the knowledge, attitude and practice questionnaire to assess the knowledge, attitude and practice of the participants. Binary logistic regression was performed to examine the factor related with knowledge, attitude, and practices. The result gives evidence that participant who added always salt to their meals were three times more likely to be hypotensive (AOR: 2.99; CI: 1.40, 6.42). Besides, participants who avoid eating outside are significantly less likely (AOR: 0.19; C.I: 0.05 to 0.70) to be hypertensive. Findings showed that daily salt consumption and "avoid eating out" were significantly associated with hypertension status. These findings imply that further educational intervention is needed to increase understanding of healthy dietary salt intake among rural women.