Sugar-sweetened beverage consumption and risk of hyperuricemia: a longitudinal analysis of the Health Workers Cohort Study participants in Mexico

ABSTRACT Background The elevated consumption of sugar-sweetened beverages (SSBs) in Mexico is an important public health concern. However, the association between SSB consumption and hyperuricemia has been scarcely studied and not well documented. Objectives To prospectively evaluate the association between SSB consumption and risk of hyperuricemia in Mexican adults. Methods A longitudinal analysis was conducted using data from the Health Workers Cohort Study. Participants were followed from 2004 to 2018, with measurements every 6 y. The analysis sample consisted of 1300 adults, aged 18 to 85 y. SSB consumption during the previous year was evaluated through a semiquantitative FFQ. Hyperuricemia was defined as a concentration of uric acid ≥7.0 mg/dL in men and ≥5.7 mg/dL in women. We evaluated the association of interest using 2 methodologies: fixed-effects logistic regression and generalized estimating equations (GEEs). Potential confounders were included in both approaches. Results At baseline, median intake of SSBs was 472.1 mL/wk (IQR: 198.8–1416.4 mL/wk), and 233 participants had hyperuricemia. Uric acid was higher in participants with an SSB intake ≥7 servings/wk, compared with those with an intake <1 serving/wk (P < 0.001). Participants who changed from the lowest to the highest category of servings consumption experienced 2.6 increased odds of hyperuricemia (95% CI: 1.27, 5.26). Results from the GEE model indicated the odds of hyperuricemia increased by 44% (OR=1.44; 95% CI: 1.13, 1.84) in the 2–6 servings/wk group, and by 89% (OR=1.89; 95% CI: 1.39, 2.57) in the ≥7 servings/wk categories, compared with the <1 serving/wk category. Diet soft drinks were not associated with hyperuricemia. Conclusions Our results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSBs. The Health Workers Cohort Study (HWCS) has been approved by the Institutional Review Board of the Mexican Social Security Institute (12CEI 09 006 14), and the National Institute of Public Health of Mexico (13CEI 17 007 36).

Download Full-text

Association between tax on sugar sweetened beverages and soft drink consumption in adults in Mexico: open cohort longitudinal analysis of Health Workers Cohort Study

BMJ ◽

10.1136/bmj.m1311 ◽

2020 ◽

pp. m1311

Author(s):

Luz María Sánchez-Romero ◽

Francisco Canto-Osorio ◽

Romina González-Morales ◽

M Arantxa Colchero ◽

Shu-Wen Ng ◽

...

Keyword(s):

Cohort Study ◽

Longitudinal Analysis ◽

Health Workers ◽

Soft Drink ◽

Soft Drinks ◽

Sugar Sweetened Beverage ◽

Soft Drink Consumption ◽

Sweetened Beverage ◽

Percentage Points ◽

Health Workers Cohort Study

Abstract Objective To examine changes in categories of soft drink consumption in a cohort of Mexican adults, three years after the implementation of the sugar sweetened beverage tax. Design Open cohort longitudinal analysis. Setting Three waves of the Health Workers Cohort Study, Mexico, spanning 2004 to 2018. Participants 1770 people aged 19 years or older with information on drinks consumption available in at least one of the three cohort waves. Main outcome measure Change in probability of belonging to one of four categories of soft drinks consumption (non, low, medium, high) after the tax was implemented. Heterogeneity of associations by income and education was also assessed. Results Before the implementation of the tax, more than 50% of the participants were medium and high consumers of soft drinks and less than 10% were in the non-consumer category. After the tax was implemented, 43% of the population was categorised as medium or high consumers and the prevalence of non-consumers increased to 14%. Three years after implementation of the tax on 1 January 2014, the probability of being a non-consumer of soft drinks increased by 4.7 (95% confidence interval 0.3 to 9.1) percentage points and that of being a low consumer increased by 8.3 (0.6 to 16.0) percentage points compared with the pre-tax period. Conversely, the probability of being in the medium and high levels of soft drinks consumption decreased by 6.8 (0.5 to 13.2) percentage points and 6.1 (0.4 to 11.9) percentage points, respectively. No significant heterogeneity of the tax across income levels was observed, but stronger effects of the tax were seen in participants with secondary school education or higher, compared with those with elementary school or less. Conclusions The Mexican sugar sweetened beverage tax was associated with a reduction in the probability of consuming soft drinks in this cohort of employees from a healthcare provider. The results cannot be extrapolated to the Mexican population, but they suggest that three years after implementation, the tax had helped to increase the proportion of people who do not consume soft drinks while decreasing the proportion of high and medium consumers.

Download Full-text

Estimating the burden of United States workers exposed to infection or disease: a key factor in containing risk of COVID-19 infection

10.1101/2020.03.02.20030288 ◽

2020 ◽

Cited By ~ 4

Author(s):

Marissa G. Baker ◽

Trevor K. Peckham ◽

Noah S. Seixas

Keyword(s):

Public Health ◽

United States ◽

Social Services ◽

Police Officers ◽

Disease Transmission ◽

Health Workers ◽

Septic Tank ◽

Risk Response ◽

Increased Risk ◽

Exposed Workers

AbstractIntroductionWith the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Understanding which occupational groups are exposed to infection and disease in the workplace can help to inform public health risk response and management for COVID-19, and subsequent infectious disease outbreaks.MethodsTo estimate the burden of United States workers exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with BLS O*NET survey data, which ranks occupations with particular physical, ergonomic, and structural exposures. For this analysis, occupations reporting exposure to infection or disease more than once a month was the focus.ResultsBased on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair).ConclusionsThe large number of persons employed in a wide variety of occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. This work also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.

Download Full-text

Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0246085 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0246085

Author(s):

Muhammad Riaz ◽

Ghazala Shah ◽

Muhammad Asif ◽

Asma Shah ◽

Kaustubh Adhikari ◽

...

Keyword(s):

Public Health ◽

Urban Areas ◽

Health Workers ◽

Health Concern ◽

Case Control Studies ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Negatively Associated ◽

Factors Associated ◽

Health Related

Background High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population. Methods We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies. Results We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30–60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension. Conclusion We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

Download Full-text

Serum Uric Acid Levels and Their Changes and Risk of Stroke: A 7-Year Prospective Cohort Study in Northwest China

Cerebrovascular Diseases ◽

10.1159/000519142 ◽

2021 ◽

pp. 1-10

Author(s):

Shan Zheng ◽

Yan Luo ◽

Qian Miao ◽

Zhiyuan Cheng ◽

Yanli Liu ◽

...

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Serum Uric Acid ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Reference Group ◽

Northwest China ◽

Stroke Incidence ◽

Increased Risk ◽

Over Time

Introduction: It is not clear whether serum uric acid (SUA) levels and their changes over time are associated with the risk of stroke. A 7-year prospective cohort study in northwest China was conducted to analyze effects of SUA and their changes on the risk of stroke. Methods: A total of 23,262 individuals without cardiovascular disease in the Jinchang cohort were followed up for an average of 5.26 years. The Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence interval (95% CI) of stroke incidence to SUA and relative changes in SUA. Sensitivity analysis was performed after controlling the effect of renal insufficiency. Results: Baseline SUA and relative changes in SUA were positively correlated with the incidence of stroke in both males and females (p for overall association <0.0001). Stroke risk increased by 4.6% per 10% increase in the relative change of SUA (HR = 1.046, 95% CI, 1.007–1.086). The fully adjusted regression analysis demonstrated that only the large gain (>30%) in SUA was associated with an increased risk of stroke by 36.5% (95% CI, 1.8–83.0%), compared with the reference group (participants within ±10% changes in SUA). The same trend was observed in people with normal baseline SUA. In the unadjusted model, the risk of stroke associated with elevated SUA was significantly higher in the hyperuricemia group than in the normal SUA group. Conclusion: High initial SUA concentration and an increase in SUA concentration over time would increase the risk of stroke, and this means that there is no safe increase in SUA.

Download Full-text

Coronavirus Disease 2019 (COVID-19) Response in Zimbabwe: A Call for Urgent Scale-up of Testing to meet National Capacity

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1301 ◽

2020 ◽

Author(s):

Tafadzwa Dzinamarira ◽

Solomon Mukwenha ◽

Rouzeh Eghtessadi ◽

Diego F Cuadros ◽

Gibson Mhlanga ◽

...

Keyword(s):

Public Health ◽

Working Conditions ◽

Health Workers ◽

Universal Access ◽

Scale Up ◽

Health Concern ◽

Public Health Concern ◽

Frontline Health Workers ◽

National Public Health ◽

National Capacity

Abstract Control of coronavirus disease 2019 (COVID-19) heavily relies on universal access to testing in order to identify who is infected; track them to make sure they do not spread the disease further; and trace those with whom they have been in contact. The recent surge in COVID-19 cases in Zimbabwe is an urgent national public health concern and requires coordinated efforts to scale up testing using the capacity already in existence in the country. There is a need for substantial decentralization of testing, investment in better working conditions for frontline health workers, and the implementation of measures to curb corruption within government structures.

Download Full-text

Soft drink intake is associated with weight gain, regardless of physical activity levels: the health workers cohort study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-00963-2 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Romina González-Morales ◽

Francisco Canto-Osorio ◽

Dalia Stern ◽

Luz María Sánchez-Romero ◽

Leticia Torres-Ibarra ◽

...

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Weight Gain ◽

Health Workers ◽

Soft Drink ◽

Activity Levels ◽

Physical Activity Levels ◽

Health Workers Cohort Study

Download Full-text

Consumption of Raw Herbal Medicines Is Associated with Major Public Health Risks amongst Ugandans

Journal of Environmental and Public Health ◽

10.1155/2020/8516105 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Fred Ssempijja ◽

Keneth Iceland Kasozi ◽

Ejike Daniel Eze ◽

Andrew Tamale ◽

Sylvia Anurika Ewuzie ◽

...

Keyword(s):

Public Health ◽

Heavy Metals ◽

Developing Countries ◽

Health Risks ◽

Daily Intake ◽

Herbal Medicines ◽

World Health ◽

Health Concern ◽

Vernonia Amygdalina ◽

Increased Risk

Background. Community consumption of herbal plants in developing countries is a common practice, however, scarcity of information on their physiochemical composition is a major public health concern. In Uganda, Vernonia amygdalina is of interest in rural communities due to its therapeutical action on both bacterial and protozoal parasites, however no studies have been conducted to assess the heavy metal concentrations in traditional plants used in alternative medicine. The aim of the study was to establish concentrations of heavy metals in Vernonia amygdalina, model the estimated daily intake (EDI), and assess both the non-cancer-related health risk using the target hazard quotient (THQ), and the risk related to cancer through the incremental lifetime cancer risk (ILCR) for the Ugandan population. Methods. Leaves of Vernonia amygdalina were collected from 20 georeferenced villages and processed into powder in the laboratory using standard methods. These were then analyzed in the laboratory using an atomic absorption spectrometer for lead (Pb), chromium (Cr), copper (Cu), zinc (Zn), cobalt (Co), iron (Fe), cadmium (Cd), and nickel (Ni). Concentrations were compared against the World Health Organization (WHO) limits. The EDI, THQ, and ILCR were modelled and significance was measured at 95% confidence. Results. The study showed that mean ± SEM concentrations of heavy metals were highest in the order of Cr, 121.8 ± 4.291 ppm > Ni, 84.09 ± 2.725 ppm > Zn, 53.87 ± 2.277 ppm > Pb, 40.61 ± 3.891 ppm > Cu, 28.75 ± 2.202 ppm > Fe, 14.15 ± 0.7271 ppm > Co, 7.923 ± 0.7674 ppm > Cd, 0.1163 ± 0.005714 ppm. Concentrations of Pb, Cr, Zn, Co, and Ni were significantly higher than the WHO limits. The EDI was significantly higher in children than in adults, demonstrating an increased risk of toxicity in children. The THQ and ILCR were over 1000 times higher in all Ugandans, demonstrating the undesirable health risks following oral consumption of Vernonia amygdalina due to very high Cr and Ni toxicities, respectively. Conclusion. Consumption of raw Vernonia amygdalina was associated with a high carcinogenic risk, demonstrating a need to enact policies to promote physiochemical screening of herbal medicines used in developing countries against toxic compounds.

Download Full-text

Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study

Nutrition Journal ◽

10.1186/s12937-020-00642-9 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Results With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0). Conclusions The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

Download Full-text

Public health impact of PSA doubling time after radical prostatectomy on prostate cancer specific and overall survival

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4568 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4568-4568

Author(s):

S. J. Freedland ◽

E. B. Humphreys ◽

L. A. Mangold ◽

M. Eisenberger ◽

D. J. George ◽

...

Keyword(s):

Public Health ◽

Prostate Cancer ◽

Radical Prostatectomy ◽

Doubling Time ◽

Health Concern ◽

Small Subset ◽

Risk Of Death ◽

Psa Doubling Time ◽

Increased Risk ◽

Psa Recurrence

4568 Background: Among patients treated with radical prostatectomy (RP) with a PSA recurrence, we previously found men with a PSA doubling time (PSADT) <3 months were at increased risk of prostate cancer death, though these men constituted a small subset of patients. We sought to determine the actual and predicted number of prostate cancer deaths stratified by PSADT. Methods: We retrospectively studied 379 men treated with RP between 1982 and 2000 with a PSA recurrence. We calculated the actual and 15-year actuarial number of prostate cancer deaths in each of the following PSADT categories: <3, 3.0–8.9, 9.0–14.9, and ≥15.0 months. Results: Median follow-up after PSA recurrence was 7 years. During this time, there were 76 prostate cancer deaths; the majority (51%) were among men with a PSADT of 3.0–8.9 months. Though men with a PSADT <3 months were at the greatest risk of death, this group accounted for only 20% (n=15) of all prostate cancer deaths. Using actuarial 15-year estimates of prostate cancer specific survival, 50% of all prostate cancer deaths were among men with a PSADT of 3.0–8.9 months while men with a PSADT <3 months accounted for only 13% of prostate cancer deaths. Using actuarial 15-year estimates of all-cause and prostate cancer specific mortality, among men with a PSADT <15 months, prostate cancer was estimated to be the cause of death in 94% (145/155). Only among men with a PSADT >15 months was the risk of competing causes of mortality high enough such that the majority of deaths were not attributed to prostate cancer. Conclusions: Among a select cohort of men treated with RP who experienced a PSA recurrence, prostate cancer was estimated to account for 75% of all deaths. Though men with a PSADT <3 months were at the greatest risk, the majority of deaths occurred among men with a PSADT of 3.0–8.9 months. Efforts to reduce prostate cancer mortality should focus on men with intermediate PSADT times (3.0–15.0 months) as they represent the greatest public health concern among men with PSA recurrence following RP. [Table: see text] No significant financial relationships to disclose.

Download Full-text

Metabolic syndrome, leptin-insulin resistance and uric acid: a trinomial foe for Algerian city-dweller adolescents’ health

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0076 ◽

2018 ◽

Vol 31 (6) ◽

Cited By ~ 2

Author(s):

Hamida Bouhenni ◽

Hadjer Daoudi ◽

Haidar Djemai ◽

Abdelkader Rouabah ◽

Damien Vitiello ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Uric Acid ◽

Serum Levels ◽

Normal Weight ◽

Excess Weight ◽

Health Concern ◽

Critical Periods ◽

Weight Group ◽

Increased Risk

Abstract Background Adolescence is one of the critical periods where increased risk for long-term obesity-related complications is an important health concern. This highlights the need to perform early diagnostics based on precise biomarkers to decrease the risk of complications in adolescents with obesity. Objective To determine the relationships between serum levels of uric acid (UA), leptin and insulin with metabolic syndrome (MS) components in Algerian adolescents. Subjects Nondiabetic adolescents (n = 204). Methods Blood pressure (BP) and anthropometric measurements were performed using standardized techniques. Blood samples were taken for determination of glycemia, triglyceridemia, uricemia, cholesterolemia, leptinemia and insulinemia. Results The rate of MS among an excess weight group was 17.4% [95% confidence interval (CI)]. Serum levels of UA, leptin and insulin were significantly higher in the excess weight group compared to a normal weight group (279.4 ± 86.05 vs. 204.9 ± 50.34 μmol/L and 25.65 ± 14.01 vs. 4.09 ± 2.60 μg/L, p < 0.001; 24.58 ± 13.85 vs. 13.34 ± 6.41 μIU/L, p < 0.05). Serum levels of UA, leptin and insulin were significantly higher in adolescents with MS compared to those without MS (304.86 ± 111.41 vs. 224.72 ± 77.81 μmol/L, 30.26 ± 12.46 vs. 16.93 ± 14.97 μg/L and 30.91 ± 17.30 vs. 18.71 ± 10.14 μIU/L, p < 0.05, respectively). Significant correlations were found between UA and leptin with waist circumference (r = 0.50 and 0.76), diastolic blood pressure (r = 0.58 and 0.43), triglycerides (r = 0.42 and 0.35) and high-density lipoprotein-cholesterol (r = −0.36 and −0.35). Conclusion Serum levels of UA and leptin may be useful biomarkers for early diagnosis of the risk of MS in our Algerian adolescent population.

Download Full-text