Risk Factors For Non-communicable Diseases Research Articles

Brazilians living with diabetes do not meet basic physical activity guidelines for health – a cross-sectional study

Introduction and aim. The purpose of this study was to describe the profile of physical activity (PA) of Brazilian adults living with diabetes mellitus living in large Brazilian urban centers, as well as to determine whether the practice aligns with the physical activity guidelines recommended for people with diabetes. Material and methods. Cross-sectional data were acquired from the 2020 Surveillance System for Risk and Protective Factors for Chronic Non-communicable Diseases, in which about 54,000 persons aged 18 and older in all Brazilian state capitals were contacted in a telephone survey. Participants reported on their engagement in recreational physical activity and active commuting to school and/or work in the three months preceding the interview, as well as the weekly frequency and duration of these activities. They also stated whether they were living with diabetes. A descriptive analysis was performed, and statistical significance was determined using Pearson’s chi-squared test. Results. In 2020, 7.9% of the population identified themselves living with diabetes. There was a greater frequency among older women and those with less education. Walking, water aerobics, and general gymnastics were the most common kinds of physical activity reported by people with diabetes. Moreover, over half of them (54.5%) were inactive, and 15% matched the physical activity criteria. The majority (90%) practiced PA for 30 minutes or more per day, while 87% of those who were active and exercised 1 to 2 times per week did not meet the requirements of the Ministry of Health. Conclusion. In 2020, 7.9% of the population identified themselves as having diabetes. There was a higher frequency among older women and those with less schooling. In the sample as a whole, approximately 70% of people living with diabetes were inactive (54.5%) or did not meet the minimum BP recommendations for people with diabetes. The duration of each session seemed to be in line with the recommendations, however, the lack of regularity caused by the low weekly frequency meant that the minimum recommended target could not be achieved. Efforts involving the continued monitoring of people living with diabetes and counseling in Primary Health Care to opt for a more physically active life, seem to be promising acts for a healthier life, pending a definitive resolution to the disease.

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.

Prevalence of insufficient physical activity among adult residents of Tehran: a cross-sectional report from Tehran Cohort Study (TeCS)

BackgroundInsufficient physical activity (PA) is a major risk factor for non-communicable diseases (NCDs) and one of the leading causes of premature mortality worldwide. This study examined the prevalence and independent determinants of insufficient PA among adults resident of Tehran utilizing Tehran Cohort Study Data (TeCS).MethodWe used the recruitment phase data from the TeCS with complete data on PA. PA was assessed through a Likert-scaled question and categorized into three groups. Utilizing data from the 2016 national census, the age- and sex-weighted prevalence of insufficient PA in Tehran was determined. The adjusted logistic regression model is used to neutralize influencing factors and determine the factors associated with insufficient PA.ResultThe weighted prevalence of insufficient PA was 16.9% among the 8213 adult citizens of Tehran, with a greater prevalence among females (19.0% vs. 14.8% among males). Additionally, older age groups, unemployed, housewives, and illiterate educated participants displayed a much higher prevalence of insufficient PA (p < 0.001). Moreover, Tehran’s central and southern districts had higher rates of insufficient PA. Concerning the adjusted regression model, older age (Odds ratio [OR]: 4.26, 95% confidence interval [95% CI]: 3.24–5.60, p < 0.001), a lower education level (p < 0.001), unemployment (OR: 1.80, 95% CI: 1.28–2.55, p = 0.001), being a housewife (OR: 1.44, 95% CI: 1.15–1.80, p = 0.002), higher body mass index (BMI) (OR for BMI > 30: 1.85, 95% CI: 1.56–2.18, p < 0.001), opium consumption (OR: 1.92, 95% CI: 1.46–2.52, p < 0.001), diabetes mellitus (OR: 1.25, 95% CI: 1.06–1.48, p = 0.008), hypertension (OR: 1.29, 95% CI: 1.11–1.50, p = 0.001), and coronary artery diseases (OR: 1.30, 95% CI: 1.05–1.61, p = 0.018), were significantly associated with insufficient PA.ConclusionsThe identified associated factors serve as a valuable guide for policymakers in developing tailored intervention strategies to address the needs of high-risk populations, particularly among older adults and females.

Supervised Machine Learning-Based Models for Predicting Raised Blood Sugar.

Raised blood sugar (hyperglycemia) is considered a strong indicator of prediabetes or diabetes mellitus. Diabetes mellitus is one of the most common non-communicable diseases (NCDs) affecting the adult population. Recently, the prevalence of diabetes has been increasing at a faster rate, especially in developing countries. The primary concern associated with diabetes is the potential for serious health complications to occur if it is not diagnosed early. Therefore, timely detection and screening of diabetes is considered a crucial factor in treating and controlling the disease. Population screening for raised blood sugar aims to identify individuals at risk before symptoms appear, enabling timely intervention and potentially improved health outcomes. However, implementing large-scale screening programs can be expensive, requiring testing, follow-up, and management resources, potentially straining healthcare systems. Given the above facts, this paper presents supervised machine-learning models to detect and predict raised blood sugar. The proposed raised blood sugar models utilize diabetes-related risk factors including age, body mass index (BMI), eating habits, physical activity, prevalence of other diseases, and fasting blood sugar obtained from the dataset of the STEPwise approach to NCD risk factor study collected from adults in the Palestinian community. The diabetes risk factor obtained from the STEPS dataset was used as input for building the prediction model that was trained using various types of supervised learning classification algorithms including random forest, decision tree, Adaboost, XGBoost, bagging decision trees, and multi-layer perceptron (MLP). Based on the experimental results, the raised blood sugar models demonstrated optimal performance when implemented with a random forest classifier, yielding an accuracy of 98.4%. Followed by the bagging decision trees, XGBoost, MLP, AdaBoost, and decision tree with an accuracy of 97.4%, 96.4%, 96.3%, 95.2%, and 94.8%, respectively.

Behavioral and biological risk factors of non-communicable diseases: Results of a nationally representative cross-sectional survey in Algeria

Behavioral and biological risk factors of non-communicable diseases: Results of a nationally representative cross-sectional survey in Algeria

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.

Poor Health Behaviour in Medical Students at a South African University: A Cross-Sectional Survey Study.

Personal health behaviours and lifestyle habits of health professionals influence their counselling practices related to non-communicable diseases (NCDs). There are limited data on the prevalence of unhealthy lifestyle habits among medical students and the impact of acquired health knowledge throughout the curriculum. The aim of this study was to determine and compare the prevalence of modifiable behavioural NCD risk factors of medical students in different academic years at a South African tertiary institution. A cross-sectional observational study of 532 consenting medical students was conducted. Participants completed five online questionnaires regarding lifestyle behaviours (physical activity, dietary habits, smoking, alcohol consumption and sleep). Lifestyle-related risk factors with the highest prevalence were poor sleep quality (66.0%), low levels of habitual physical activity (55.8%) and low-to-moderate diet quality (54.5%). There were no differences between academic years for all risk factors measured. Over 60% of the cohort had two or more NCD risk factors and this prevalence did not differ across the degree program with the acquisition of more health knowledge. Medical students have a high prevalence of poor sleep quality, low levels of physical activity and low-to-moderate diet quality, which does not appear to change over the course of their academic career. Sleep hygiene, regular physical activity and healthy nutrition should be targeted in intervention programmes and be more prevalent in the medical curriculum.

Lower habitual Intake of grains and protein groups associated with increasing the disease risk among Jordanians: A cross-sectional population-based study

BackgroundDietary habits have drastically and quickly altered worldwide, and this is a crucial modifiable factor affecting obesity prevalence, a risk factor for several non-communicable diseases. AimsThis study aims to illuminate Jordanians' dietary habits and their potential association with non-communicable diseases. MethodsThis is a population-based cross-sectional study. A randomly selected sample of children, adolescents, adults, and older adults was invited to participate. Participants were categorized into two groups: those with diseases (diabetes, cardiovascular diseases, and their comorbidities) and those who had no diseases. A valid food frequency questionnaire was used to recall each food group's average daily number of portions. ResultsThe intake and percentage of recommendations from the groups that included fruits, cereals, and proteins were highest in the obese group. Disease-free individuals had the highest daily intake of proteins and grains, and a higher percentage of grains consumed. Compared to individuals without a condition (83.6 % and 57.6 %, respectively), participants with a disease were more likely to consume less protein (68.8 %) and grains (87.6 %) than the recommended amount. Less than the required amount of grain consumption raises the risk of disease by OR = 1.57 (95%CI: 1.05–2.34). The chance of contracting diseases is reduced when more grains are consumed than recommended (p-trend = 0.001). A lower-than-recommended protein intake doubled the risk of disease (OR = 2.08, 95%CI: 1.13–3.84). ConclusionObesity shifts habitual food toward more fruits, grains, and protein consumption. Grains and protein consumption less than recommendations were associated with increasing the risk of having disease.

Factors influencing smoking cessation attempts and success in Iranian male adults: national survey data

BackgroundSmoking cessation is a dynamic process that often involves a series of unsuccessful quit attempts before long-term abstinence is achieved. To implement interventions that lead to long-term abstinence, it will be necessary to understand the determinants of smoking cessation. Therefore, the main objective of the present study was to determine the effect of factors influencing both smoking cessation attempts and successful smoking cessation in the general population of Iran.MethodsThe data of 1293 participants whose information was obtained through a national cross-sectional study entitled “Survey of Risk Factors of Noncommunicable Diseases in 2016” were analyzed. There were three response levels: “quit attempt and successful quit”, “quit attempt and unsuccessful quit”, and “no quit attempt and unsuccessful quit”. A multinomial logistic regression model was used to assess the effect of covariates on response.ResultsThe mean (sd) age of all participants was 47.21 (13.65) years. According to the results, 883 people (68.29%) did not attempt to quit smoking, and of those who attempted to quit smoking, only 64 (15.61%) men were successful. The factors of living in an urban area (OR = 1.71) and past smoking intensity (OR = 1.967) were associated with no quit attempt and unsuccessful quitting. In addition, physician recommendation to quit smoking was a protective factor for no quit attempt and unsuccessful quit (OR = 0.599). Alcohol consumption was also a protective factor against successful quitting for both attempters (OR = 0.351) and nonattempters (OR = 0.359).ConclusionsTobacco control programs should be implemented with a greater focus on heavy smokers and alcohol users. In addition, the role of health professionals in encouraging smokers to quit smoking should not be ignored.

Development of a health promotion intervention in managing behavioral risk factors for Non-Communicable Diseases in adolescents: An Intervention Mapping Approach

Development of a health promotion intervention in managing behavioral risk factors for Non-Communicable Diseases in adolescents: An Intervention Mapping Approach

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.

Work environment adversity and non-communicable Disease risk among drivers working for application-based-cab-aggregators in an Indian metropolis

BackgroundBengaluru, a metropolis in Southern India, is one of the largest markets for cab aggregator companies. Drivers working for these companies play a vital role in urban transportation but unlike other drivers, their work pattern is stressful, which could increase their proneness to NCD risk factors. Understanding associations between work environment adversity and NCD risk factors among these drivers will help to plan specific health promotion and NCD prevention programs including provision of basic occupational health services.ObjectivesThe study aims to test for an association between work environment adversity and selected Non-communicable Disease (NCD) risk factors among Application Cab Aggregator drivers in Bengaluru city and to estimate the prevalence of selected NCD risk factors among the ABCA drivers.MethodologyThis cross-sectional study was conducted in Bengaluru city among 340 eligible and consenting ABCA drivers with at least one-year experience. Drivers were recruited through a multi-stage sampling procedure and time-period sampling, from transportation and leisure zones in the city. Data was collected through interviews using specifically developed semi-structured tools to assess work environment adversity and NCD risk factors. Prevalence of NCD risk factors is presented per 100 drivers with 95% confidence intervals. Multivariate Logistic regression analysis was conducted to quantify the strength of the association between work environment adversity categories and NCD risk factors. Ethical clearance was obtained from the NIMHANS Ethics Committee.ResultsNearly 97% of the 340 drivers reported having one or more NCD risk factors. Working more than 5 days a week, more than 7 + hours a day, staying away from family, and working night shifts were closely associated with higher risk for NCD risk factors among ABCA drivers. Drivers with work environment adversity scores between 5 and 10 were associated with higher odds of Physical Inactivity (OR = 3.1), Unhealthy diets (OR = 1.62), and Tobacco Use (OR = 3.06).ConclusionThe study highlights the association between work environment adversity and NCD risk factors and indicates a dire need for NCD prevention programs, basic occupational health services, and social security provisions for ABCA cab drivers.

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.

Assessment of non-communicable disease risk factors, functional performance, and health-related quality of life in adults: a comparative analysis in low-resourced urban and rural areas of South Africa

BackgroundGlobally, disparities between non-communicable disease (NCD) risk factors, functional performance, and health-related quality of life (HRQoL) exist in people living in rural and low-resourced urban settings. Evidence of these health differences determined with objective NCD risk factors and functional performance measurements in South Africa, is scarce. Therefore, the study aimed to determine the differences in NCD risk factors, functional performance and HRQoL between rural and low-resourced urban areas.MethodsThe study recruited 311 adults (35–80 years) presenting with at least one NCD risk factor from low-resourced urban- (n = 183) and rural (n = 128) communities. Objective measurements of physical activity (PA) by means of combined heart rate and accelerometery, body composition employing skinfolds, peripheral lipid and glucose concentrations, blood pressure, functional performance indicators (handgrip, single leg stand, sit-to-stand, timed-up-and-go speed, predicted peak VO2 max); and HRQoL were measured according to standard procedures. Independent t-tests, Mann-Whitney U, and chi-square tests were performed to determine differences between the variables of low-resourced urban and rural settings.ResultsThe participants from the low-resourced urban setting were significantly older than the rural residents (59.1 ± 10.7 years vs. 52.8 ± 11.3 years; p = 0.001). NCD risk factors were significantly more prevalent in the low-resourced urban participants compared to rural participants, in particular for elevated systolic (85.8% vs. 62.5%; p = 0.001), and diastolic blood pressure (88.5% vs. 65.6%; p = 0.001), physical inactivity (95.9% vs. 87.7%; p = 0.026), increased cholesterol concentrations (22.1% vs. 8.7%; p = 0.002), and increased waist circumference (61.9% vs. 49.2%; p = 0.027). Low-resourced urban residents presented with a higher average body fat percentage (27.69% ± 7.65% vs. 12.23% ± 4.67%; p < 0.001), and lower moderate to vigorous PA levels (37.19 ± 49.55 [95% CI = 29.12–45.27] vs. 62.92 ± 60.43 min/week [95% CI = 47.95–77.90]; p = 0.003) compared to rural residents. Rural residents showed significantly better functional performance, including peak VO2 (23.99 ± 9.89 vs. 16.95 ± 7.64 ml/min/kg; p = 0.001) and single leg stand (right leg: 44.96 ± 18.47 vs. 20.87 ± 19.18 s; p = 0.001) as well as higher HRQoL for the physical (51.06 ± 8.14% vs. 45.62 ± 11.13%; p < 0.001) and mental (54.75 ± 8.24% vs. 48.91 ± 12.27%; p < 0.001) component scores compared to participants from the low-resourced urban areas.ConclusionNCD risk factors, functional performance, and HRQoL significantly differ in rural communities compared to low-resourced urban communities in South Africa. Urban areas’ most prevalent risk factors were elevated blood pressure, physical inactivity, and increased waist circumference. Participants from rural areas demonstrated significantly better functional performance, such as fitness and balance. HRQoL was better in rural settings than in urban settings. Future intervention programmes should be tailored for specific settings.

Noncommunicable disease risk behaviors and protective factors among children in Samoa: Retrospective trend analysis of global school-based health surveys in 2011 and 2017.

Pacific Island countries experience a high prevalence of noncommunicable diseases (NCDs), which may be prevented by reducing risk behaviors and strengthening protective factors in childhood and adolescence. To better inform preventative interventions, our objective was to use publicly available data from the Global School-based Student Health Survey (GSHS), to provide cross-sectional and trend estimates for the prevalence of NCD risk and protective factors among school-aged children in 2011 and 2017 in Samoa. Two waves of cross-sectional data included 4,373 children (51.98% female), with a median age of 15 years, who were mainly in school years 9-10 in Samoa. Retrospective analyses were adjusted for the GSHS multistage stratified cluster sample design. Weighted prevalences of overweight/obesity, dietary behaviors, physical activity, and sedentary behavior, oral and hand hygiene, emotional and mental health, and community protective factors were reported by study year. Logistic regressions were fitted to assess differences in the prevalence of risk and protective factors, adjusted for age group, sex, and school year. In 2011 and 2017, the prevalence of overweight/obesity remained consistently high in females (59.12% and 64.29%, p = 0.428) and increased from 44.21% to 53.65% in males (p = 0.039). Time spent sitting for long periods, smoking cigarettes, using other tobacco products, and drinking alcohol were lower in 2017 compared to 2011 (all p<0.05). Many children reported experiencing bullying (33.27% for females and 59.30% for males in 2017), while physical fighting was common among males (73.72% in 2011 and 57.28% in 2017). The high prevalence of obesity and related NCD risk factors require urgent public health action in Samoa. Alongside the continued reduction of tobacco and alcohol use, emotional and mental wellness should be prioritized in interventions and programs to promote healthy behaviors and lifestyle changes starting in childhood.

A qualitative assessment of multi-sectoral action for non-communicable diseases (NCDs) in Uttar Pradesh, India

IntroductionNon-communicable diseases (NCDs) on the rise globally, especially affecting vulnerable populations in low- and middle-income countries. To tackle this, urgent and comprehensive actions are needed. The main preventable risk factors for NCDs are tobacco and alcohol use, unhealthy diet, physical inactivity, and air pollution, rooted in social determinants of health (SDOH). In India, some states are adopting a multi-sectoral approach (MSA) to manage NCDs. A qualitative assessment was conducted to evaluate MSA implementation in Uttar Pradesh, India.MethodsInductive approach i.e., grounded theory was used to understand the perceptions regarding MSA. Key-Informant Interviews (KIIs) of senior level officers from both non-health and health sectors were conducted using an interview guide. We targeted all 17 priority sectors as identified in National Multi-sectoral Action plan (NMAP) for prevention and control of NCDs in India. Data could be collected from officials of 14 sectors. Data thus collected was transcribed, translated and coded for identifying themes.ResultsThe non-health sectors expressed readiness to act but don’t have guidelines. They explained the risk factors such as behaviours; nutrition and physical inactivity associated with NCDs and also appreciated the role of MSA in prevention and control of NCD. The attitude and perception of health sector towards implementation of MSA was less promising. Their perspective was based upon the existing vertical structures, response and support they have experienced before from other sectors and from the administration. Non-health sectors uniformly emphasised that health should lead MSA as health sector has scientific knowledge and experience in operationalizing health programs.ConclusionThere is a need to have a common action platform for NCD prevention and control to bridge the gap between health and non-health sectors. A dedicated, parallel structure is essential to translate policy into practice effectively.

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.

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia.

The aim of this study was to investigate the relationship between the number of patient comorbidities and the delays in seeking treatment for coronary heart disease (CHD). This longitudinal study utilized secondary data from the Non-Communicable Disease Risk Factor (NCDRF) cohort study conducted in Bogor City. Individuals who participated in the NCDRF cohort study and were diagnosed with CHD within the 6-year study period met the inclusion criteria. Respondents who were not continuously monitored up to the 6th year were excluded. The final sample included data from respondents with CHD who participated in the NCDRF cohort study and were monitored for the full 6-year duration. The final logistic regression analysis was conducted on data collected from 812 participants. Among the participants with CHD, 702 out of 812 exhibited a delay in seeking treatment. The risk of a delay in seeking treatment was significantly higher among individuals without comorbidities, with an odds ratio (OR) of 3.5 (95% confidence interval [CI], 1.735-7.036; p<0.001). Among those with a single comorbidity, the risk of delay in seeking treatment was still notable (OR, 2.6; 95% CI, 1.259-5.418; p=0.010) when compared to those with 2 or more comorbidities. These odds were adjusted for age, sex, education level, and health insurance status. The proportion of patients with CHD who delayed seeking treatment was high, particularly among individuals with no comorbidities. Low levels of comorbidity also appeared to correlate with a greater tendency to delay in seeking treatment.

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.