29.E. Workshop: Data analysis, advocacy activities, and actions to counteract the double burden of malnutrition

Abstract The burden of non-communicable chronic diseases (NCDs) represents a public health issue of gigantic proportion at global level. Among others, diet has been demonstrated to be a key element to maintain health and prevent NCDs. Today's world is facing the so-called “double burden of malnutrition”, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NCDs due to a substantial shift toward unhealthy diet high in sugars and ultra-processed foods and concomitant inadequate accessibility of nutritious foods. While interventions to improve diet quality and nutrition knowledge are of paramount importance in order to decrease the burden of NCDs over the next decades, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Food and nutrition section, the EUPHA Chronic diseases section, the EUPHA Health promotion section, in collaboration with the World Health Organization (WHO), aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs, obesity and nutrition-related risk factors as well as ongoing interventions aimed to reduce the double burden of malnutrition. The objectives of the present workshop are the following: To quantify the global burden and temporal trends of NCDs risk factors; To assess the impact of nutrition-related risk factors on NCDs; To provide examples of advocacy activities and actions at global level to improve nutrition education and dietary behaviors; To promote translatable information at global level and drive implementation of knowledge into policy and practice. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. Given the many actors involved, the workshop will provide a unique occasion to discuss about potential policy approaches in the context of the conference. Key messages There is science-based evidence demonstrating that healthy nutrition is a key factor to maintain global health and prevent chronic non-communicable diseases. Governmental and non-governmental efforts are currently working to counteract malnutrition worldwide.

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Workshop: Impact of nutrition on non-communicable chronic diseases: a global perspective

European Journal of Public Health ◽

10.1093/eurpub/ckz185.195 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Risk Factors ◽

Chronic Diseases ◽

Temporal Trends ◽

Global Perspective ◽

Policy Framework ◽

Public Health Issue ◽

Global Health Research ◽

Special Focus ◽

Related Risk ◽

The Impact

Abstract Non-communicable chronic diseases (NCDs) represent a public health issue due to their profound impact on population health. Major NCDs risk factors, including obesity, hypertension and diabetes, represent a threat of gigantic proportion, while intervention to prevent NCDs remains of paramount importance in order to decrease their burden over the next decades. Among others, quality of diets has changed substantially and a global shift to unhealthy diet high in calories and highly processed foods mainly due to the rapid urbanisation, increasing incomes, and inadequate accessibility of nutritious foods has been observed. As the burden of NCDs across the worlds remains unacceptably high, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Sections on Food and Nutrition and on Chronic Diseases aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs and nutrition-related risk factors. The objectives of the present workshop are the following: To quantify the burden and temporal trends of non-communicable chronic diseases risk factors (such as obesity, elevated blood pressure and diabetes) all around the globe, with a focus on European countries; To assess the impact of nutrition-related risk factors on non-communicable chronic diseases; To explore socio-economic and cultural correlates to dietary changes in developed and developing countries; To discuss the usage of instruments aimed to identify best practices in food policies to prevent junk food consumption. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. All publication discussed have been published recently, others are ongoing projects, thus providing a unique opportunity to discuss about potential advocacy activities and policy approaches in the context of a EUPHA conference. Key messages The workshop will provide insights on the current burden of NCDs risk factors. The workshop will focus on dietary risk factors, their socio-economic determinants, and strategies to implement a healthy and sustainable diet globally.

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Creating Healthy Workplaces in Challenging Times

B&G Bewegungstherapie und Gesundheitssport ◽

10.1055/s-0043-113178 ◽

2017 ◽

Vol 33 (04) ◽

pp. 171-173

Author(s):

W. Kirsten ◽

A. Ogata

Keyword(s):

Risk Factors ◽

Chronic Diseases ◽

Well Being ◽

World Health ◽

Behavioral Risk ◽

Disability Adjusted Life ◽

Related Risk ◽

Life Years ◽

Healthy Workplace ◽

Health Organization

SummaryRising exposure to chronic diseases and related risk factors have led to a notable increase in attributable disability-adjusted life years (DALYs) in the last 25 years. This concerning trend has highlighted the need for additional efforts to address behavioral risk factors for chronic diseases. The workplace has proven to be an effective setting to mitigate and improve these risk factors and a growing number of employers worldwide are recognizing their role in advancing employee health and well-being. The question remains what constitutes a healthy workplace and successful programming, which produce positive outcomes for business and employees. The World Health Organization (WHO) Healthy Workplace Model for Action provides globally relevant guidance on how to create a healthy workplace via a continual improvement process.

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The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽

10.3390/cancers13071700 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1700

Author(s):

Melissa Chalada ◽

Charmaine A. Ramlogan-Steel ◽

Bijay P. Dhungel ◽

Christopher J. Layton ◽

Jason C. Steel

Keyword(s):

Risk Factors ◽

Ultraviolet Radiation ◽

Uveal Melanoma ◽

World Health Organisation ◽

World Health ◽

Genetic Mutations ◽

High Incidence ◽

The World ◽

The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

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Impact of disease activity on impaired glucose metabolism in patients with rheumatoid arthritis

Arthritis Research & Therapy ◽

10.1186/s13075-021-02476-0 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Gorica G. Ristić ◽

Vesna Subota ◽

Dejana Stanisavljević ◽

Danilo Vojvodić ◽

Arsen D. Ristić ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Insulin Resistance ◽

Glucose Metabolism ◽

Disease Activity ◽

Impaired Glucose Metabolism ◽

Inflammation Markers ◽

C Peptide ◽

Related Risk ◽

The Impact

Abstract Objective To explore glucose metabolism in rheumatoid arthritis (RA) and its association with insulin resistance (IR) risk factors and disease activity indicators, including matrix metalloproteinase-3 (MMP3). Methods This single-center study included 127 non-diabetic subjects: 90 RA patients and 37 matched controls. IR-related risk factors, disease activity (DAS28-ESR/CRP), concentrations of inflammation markers, MMP3, glucose, specific insulin, and C-peptide (a marker of β-cell secretion) were determined. Homeostasis Model Assessment was used to establish insulin resistance (HOMA2-IR) and sensitivity (HOMA2-%S). Associations of HOMA2 indices with IR-related risk factors, inflammation markers, and RA activity were tested using multiple regression analyses. Results RA patients had significantly increased HOMA2-IR index than controls. In the RA group, multivariate analysis revealed DAS28-ESR, DAS28-CRP, tender joint counts, patient’s global assessment, and MMP3 level as significant positive predictors for HOMA2-IR (β = 0.206, P = 0.014; β = 0.192, P = 0.009; β = 0.121, P = 0.005; β = 0.148, P = 0.007; β = 0.075, P = 0.025, respectively), and reciprocal negative for HOMA2-%S index. According to the value of the coefficient of determination (R2), DAS28-ESR ≥ 5.1 has the largest proportion of variation in both HOMA2-IR indices. DAS28-ESR ≥ 5.1 and ESR were independent predictors for increased C-peptide concentration (β = 0.090, P = 0.022; β = 0.133, P = 0.022). Despite comparability regarding all IR-related risk factors, patients with DAS28-ESR ≥ 5.1 had higher HOMA2-IR than controls [1.7 (1.2–2.5) vs. 1.2 (0.8–1.4), P = 0.000]. There was no difference between patients with DAS28-ESR < 5.1 and controls [1.3 (0.9–1.9) vs. 1.2 (0.8–1.4), P = 0.375]. Conclusions RA activity is an independent risk factor for impaired glucose metabolism. DAS28-ESR ≥ 5.1 was the main contributor to this metabolic disturbance, followed by MMP3 concentration, outweighing the impact of classic IR-related risk factors.

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EXAMINING THE DOUBLE BURDEN OF MALNUTRITION FOR PRESCHOOL CHILDREN AND WOMEN OF REPRODUCTIVE AGE IN LOW- AND MIDDLE-INCOME COUNTRIES: A SCOPING REVIEW PROTOCOL

10.1101/2021.06.17.21259113 ◽

2021 ◽

Author(s):

Jason Mulimba Were ◽

SAVERIO STRANGES ◽

Ishor Sharma ◽

Juan-Camilo Vargas-Gonzalez ◽

M. Karen Campbell

Keyword(s):

Preschool Children ◽

Scoping Review ◽

Reproductive Age ◽

World Health ◽

Women Of Reproductive Age ◽

Double Burden ◽

Middle Income ◽

Middle Income Countries ◽

Double Burden Of Malnutrition ◽

Low And Middle Income

Introduction: The majority of the populations in Low-and Middle-Income Countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its etiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regards to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM. Methods: A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations & Thesis Global. Additionally, searches in other government and institutional sources (World Health Organization website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Ethics and Dissemination: Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

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Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciz188 ◽

2019 ◽

Vol 69 (12) ◽

pp. 2101-2108 ◽

Cited By ~ 6

Author(s):

Lisa A Ronald ◽

Jonathon R Campbell ◽

Caren Rose ◽

Robert Balshaw ◽

Kamila Romanowski ◽

...

Keyword(s):

Risk Factors ◽

World Health Organization ◽

Retrospective Cohort ◽

Latent Tuberculosis ◽

World Health ◽

Administrative Databases ◽

Ltbi Screening ◽

Immunosuppressive Medications ◽

Health Organization ◽

The Impact

Abstract Background Latent tuberculosis infection (LTBI) screening and treatment is a key component of the World Health Organization (WHO) EndTB Strategy, but the impact of LTBI screening and treatment at a population level is unclear. We aimed to estimate the impact of LTBI screening and treatment in a population of migrants to British Columbia (BC), Canada. Methods This retrospective cohort included all individuals (N = 1 080 908) who immigrated to Canada as permanent residents between 1985 and 2012 and were residents in BC at any time up to 2013. Multiple administrative databases were linked to identify people with risk factors who met the WHO strong recommendations for screening: people with tuberculosis (TB) contact, with human immunodeficiency virus, on dialysis, with tumor necrosis factor-alpha inhibitors, who had an organ/haematological transplant, or with silicosis. Additional TB risk factors included immunosuppressive medications, cancer, diabetes, and migration from a country with a high TB burden. We defined active TB as preventable if diagnosed ≥6 months after a risk factor diagnosis. We estimated the number of preventable TB cases, given optimal LTBI screening and treatment, based on these risk factors. Results There were 16 085 people (1.5%) identified with WHO strong risk factors. Of the 2814 people with active TB, 118 (4.2%) were considered preventable through screening with WHO risk factors. Less than half (49.4%) were considered preventable with expanded screening to include people migrating from countries with high TB burdens, people who had been prescribed immunosuppressive medications, or people with diabetes or cancer. Conclusions The application of WHO LTBI strong recommendations for screening would have minimally impacted the TB incidence in this population. Further high-risk groups must be identified to develop an effective LTBI screening and treatment strategy for low-incidence regions.

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Association between leisure-time physical activity and the risk of chronic diseases

European Journal of Public Health ◽

10.1093/eurpub/ckz186.195 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Dedele ◽

A Miskinyte

Keyword(s):

Physical Activity ◽

Chronic Diseases ◽

High Intensity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Adult Population ◽

World Health ◽

Health Study ◽

Moderate Intensity ◽

The Impact

Abstract Background According to the World Health Organization, non-communicable diseases or chronic diseases, account for 71 percent of all deaths globally, affecting individuals of all age groups and countries. Epidemiological studies have shown an association between a lack of physical activity (PA) and the risk of raised blood pressure, increased body mass index and obesity that can lead to chronic diseases. Methods The aim of the study was to assess the relationship between leisure-time PA and the risk of chronic diseases among adult population. We conducted a cross-sectional study of 470 men and 641 women who participated in “The Impact of Sustainable Mobility, Physical Activity and Environmental Factors on Urban Population Health Study (ISMA)” in Lithuania. Leisure-time PA was self-reported and divided into three levels: low, moderate and high. Logistic regression was used to estimate adjusted odds ratios (ORs) of chronic diseases according to leisure-time PA. Results More than half (55%) of the study population engaged in a moderate intensity PA and 12% of participants engaged in a high intensity leisure-time PA. Men 1.6 times more often than women reported engaging in a high intensity PA in leisure time (p = 0.004). Adults who engaged in low intensity leisure-time PA had almost 3 times (OR = 2.91; 95% confidence interval (CI) 1.62-5.24) higher risk of chronic diseases, whereas those adults who reported moderate intensity leisure-time PA had an OR of 1.63 (95% CI 0.92-2.87) compared to individuals who engaged in a high-level PA. Conclusions Our findings suggest that high levels of leisure-time PA could reduce the risk of chronic diseases and this effect was significantly stronger in men. Key messages Global decline in PA is related to inaction during leisure time and sedentary behaviour at work and at home that has a major health impact worldwide. High levels of leisure-time PA are important factor for chronic disease prevention.

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Double Burden of Malnutrition among Chinese Women of Reproductive Age and Their Social Determinants

Nutrients ◽

10.3390/nu12103102 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3102

Author(s):

Jingqi Song ◽

Ji Zhang ◽

Wafaie Fawzi ◽

Yangmu Huang

Keyword(s):

Normal Weight ◽

Overweight And Obesity ◽

Living Environment ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Double Burden ◽

Community Factors ◽

Wide Range ◽

Double Burden Of Malnutrition ◽

The Impact

This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.

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Impact of nutritional risk factors on chronic non-communicable diseases

European Journal of Public Health ◽

10.1093/eurpub/ckz185.197 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Cited By ~ 1

Author(s):

G Grosso

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Communicable Diseases ◽

Nutritional Risk ◽

Special Focus ◽

High Systolic Blood Pressure ◽

Non Communicable Diseases ◽

Dietary Risk Factors ◽

Dietary Risk ◽

The Impact

Abstract Background modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCD). Among various risk factors, poor nutrition quality has been identified as a leading determinant of NCD. Methods The Global Burden of Diseases (GBD) Study provided a comprehensive comparative risk assessment (CRA) of risk factor for NCD, quantifying the impact of behavioural, environmental and occupational, and metabolic risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. Special focus on nutritional risk factors will be dedicated, discussing the proportion of disease-specific burden attributable to each dietary risk factor and the level of intake associated with the lowest risk of mortality. Results In 2017, over 30 million deaths were attributable to risk factors. When ranked, high systolic blood pressure was the leading risk factor, accounting for more than 10 million deaths, followed by, high fasting plasma glucose, and high body-mass index. A total of 11 million deaths were attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits were the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Besides the major aforementioned factors, underrated dietary risk factors, such as low calcium intake, have been found important contributors to cancer burden in certain developed countries. Interpretation The combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in NCD at the global level. These data provide a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations.

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Needs assessment and impact of COVID-19 on pharmacy professionals in 31 commonwealth countries

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-020-00275-7 ◽

2020 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Diane Ashiru-Oredope ◽

◽

Amy Hai Yan Chan ◽

Omotayo Olaoye ◽

Victoria Rutter ◽

...

Keyword(s):

Global Health ◽

Emergency Preparedness ◽

World Health ◽

Global Public Health ◽

Online Questionnaire ◽

Health Crisis ◽

Frequency Distributions ◽

The World ◽

Pandemic Response ◽

The Impact

Abstract Background The declaration of COVID-19 a pandemic by the World Health Organization on 11 March 2020 marked the beginning of a global health crisis of an unprecedented nature and scale. The approach taken by countries across the world varied widely, however, the delivery of frontline healthcare was consistently recognised as being central to the pandemic response. This study aimed to identify and explore the issues currently facing pharmacy teams across Commonwealth countries during the COVID-19 pandemic. The study also evaluates pharmacy professionals’ understanding of key knowledge areas from the COVID-19 webinar hosted by the Commonwealth Pharmacists’ Association (CPA). Method A quantitative survey-based approach was adopted, using a 32-item questionnaire developed from the literature on pharmacy and pandemic response. The survey was hosted on Survey Monkey and pilot tested. The final survey was disseminated by CPA member organisations. A 6-item online questionnaire was sent via email to all attendees of CPA's COVID-19 webinar. Descriptive statistics on frequency distributions and percentages were used to analyse the responses. Data were analysed using Microsoft® Excel (2010). Results There were 545 responses from pharmacy professionals across 31/54 Commonwealth countries in Africa, Asia, the Americas, Europe and the Pacific. Majority of the respondents reported being at least somewhat worried (90%) and more than 65% were very worried or extremely about the impact of COVID-19 on them personally and professionally. Nearly two-thirds of respondents stated finding it somewhat difficult or very difficult to work effectively during the pandemic. Challenges mostly faced by pharmacy professionals working remotely included; general anxiety about the impact of COVID-19 on their lives (12%), and difficulties in communicating with their co-workers (12%). Most pharmacy professionals had not previously been actively involved in a global health emergency (82%) nor obtained training on global/public health emergency preparedness (62%). Between 45 and 97% of the COVID-19 webinar attendees provided the correct answers to post-webinar questions, suggesting some improvement in knowledge. Conclusion Our study confirms pharmacy professionals’ concerns about practice during a pandemic and provides preliminary data on the challenges and learning needs of the profession. The CPA has since acted on these findings, providing ongoing opportunities to develop and refine resources for the profession as the pandemic evolves. Pharmacy professionals have also demonstrated improved knowledge on the management of COVID-19 and resources available for professionals.

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