scholarly journals Characterizing the Urban Diet: Development of an urbanized diet index

2021 ◽  
Author(s):  
Ali Cyr-Scully ◽  
Annie Green Howard ◽  
Erin Sanzone ◽  
Katie A Meyer ◽  
Shufa Du ◽  
...  
Keyword(s):  
Edible Oils ◽  
A Priori ◽  
Nutrition Transition ◽  
Positive Association ◽  
Sociodemographic Factors ◽  
Nutrition Survey ◽  
Rapid Urbanization ◽  
Logistic Regression Models ◽  
Household Level ◽  
Vegetables And Fruits

Abstract BackgroundIn recent decades China has experienced rapid urbanization leading to a major nutrition transition, with increased refined carbohydrates, added sweeteners, edible oils, and animal-source foods, and reduced legumes, vegetables, and fruits. These changes have accompanied increased prevalence of cardiometabolic disease (CMD). There is no single dietary measure that summarizes the distinct food changes across regions and levels of urbanization.ObjectiveWe aimed to develop a diet urbanization index that would represent a dietary pattern for urbanized diet across diverse regions. MethodsUsing a sample of adults (≥18 years) in the 2015 wave of the China Health and Nutrition Survey (CHNS; n = 14,024), we selected literature-based candidate dietary variables and tested their univariate associations with overall and within-region urbanization. Using iterative exclusion of select diet-related variables, we created six potential urbanized diet indices, which we examined relative to overall urbanization to select a final urbanized diet index based on a priori considerations, strength of association with urbanization, and minimal missingness. We tested stability of the final urbanized diet index across sociodemographic factors and used mixed effects logistic regression models to examine associations between the final urbanized diet index and CMD risk factors – hypertension (HTN), overweight, and type 2 diabetes mellitus (T2DM), adjusting for sociodemographics, overall urbanization, physical activity, and including random intercepts to account for correlation at community and household level.ResultsWe identified a final urbanized diet index that captured dietary information unique to consumption of an urbanized diet and performed well across regions. We found a positive association (R2 = 0.17, 0.01 SE) between the final urbanized diet index and overall urbanization in the fully adjusted model. We found no associations between the urbanized diet index with HTN, overweight, and T2DM in fully adjusted models (OR (95% CI) = 0.94 (0.89-1.0), 1.0 (0.95 - 1.05), 1.02 (0.94 - 1.10), respectively).Conclusions We derived an urbanized diet index that captured dietary urbanization that was distinct from overall urbanization and performed well across all regions of China. This urbanized diet index provides an alternative to measures of traditional versus Westernized diet that vary across regions due to different cultural dietary traditions.

scholarly journals Determinants of energy intake in Central African populations experiencing nutrition transition

2021 ◽  
pp. 1-26
Author(s):  
Norbert Amougou ◽  
Patrick Pasquet ◽  
Jonathan Y. Bernard ◽  
Amandine Ponty ◽  
Martin Fotso ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Energy Intake ◽  
Dietary Patterns ◽  
Nutrition Transition ◽  
Central Africa ◽  
Sociodemographic Factors ◽  
Rapid Urbanization ◽  
Dietary Recall ◽  
African Populations ◽  
Living Area

Abstract Central Africa is experiencing rapid urbanization and this situation comes along with changes in food habits and an increased prevalence of obesity and associated health risks. Factors influencing dietary intake among the diverse African populations are not well understood. Our objective was to characterize the dietary intake and their determinants in the two main ethnic groups experiencing nutrition transition in Cameroon, the Bamiléké and the Béti. We sampled Bamiléké (381) and Béti (347) adults living in both rural and urban, collected sociodemographic variables, assessed dietary patterns by using a food portion photographs book to administrate a food frequency questionnaire (FFQ) and a 24–hour dietary recall technique, and derived their Body Mass Index (BMI) from measured weight and height. The dietary patterns of Bamiléké people were comprised of more energy-dense foods than the Béti people, regardless of the living area. The energy intake (13·8 (SD 4·6)–15·4 (SD 4·8) MJ vs 9·7 (SD 3·5)–11·2 (SD 3·9 MJ) and the obesity (15–29 % vs 5–8 %) were therefore higher in Bamiléké than in Béti respectively. Multivariable linear regression analyses showed strong associations of both ethnicities (4·02 MJ; P <0·001), living area (0·21 MJ; P <0·001), and education (0·59 MJ; P <0·048) with energy intake (EI), independently of each other and other sociodemographic factors. The ethnicity factor has been characterized as the more important determinant of diet. Our findings provide new insights and perspectives highlighting the importance of anthropological factors when building prevention campaigns against obesity in Central Africa.

scholarly journals Spatiotemporal Variation of the Association between Urbanicity and Incident Hypertension among Chinese Adults

2020 ◽  
Vol 17 (1) ◽  
pp. 304
Author(s):  
Jinjing Wu ◽  
Jia Chen ◽  
Zhen Li ◽  
Boshen Jiao ◽  
Peter Muennig
Keyword(s):  
Protective Factor ◽  
Cardiovascular Health ◽  
East Coast ◽  
Positive Association ◽  
Social Contexts ◽  
Negative Association ◽  
Nutrition Survey ◽  
Subsequent Increase ◽  
Logistic Regression Models ◽  
Central Regions

Urbanization is believed to result in a transition towards energy-dense diets, sedentary lifestyles, and a subsequent increase in the burden of hypertension (HTN) and other cardiovascular diseases (CVDs) in developing countries. However, the extent to which this occurs is likely dependent on social contexts. We performed multilevel logistic regression models to examine whether the association between incident HTN and the degree to which a community exhibits urban features varied by region (the Northeast, East Coast, Central, and West) within China and period. We used longitudinal data from the China Health and Nutrition Survey (1991–2015) and stratified analyses by sex. Among women, the positive association between medium-to-high urbanicity and HTN onset generally shifted to negative between 1991 and 2015. The high urbanicity was associated with lower odds of developing HTN in the East Coast from the early 1990s. The negative association between high urbanicity and HTN occurrence became statistically significant during 1991–2015 in the Northeastern and Central Regions, while the association remained positive and non-significant in the West. Among men, the relationship between urbanicity and incident HTN was generally non-significant, except for the East Coast in which the negative association between high urbanicity and HTN occurrence became statistically-significant in more recent years. Our findings suggest that, when a subnational region or the society as a whole has become more economically developed, higher urbanicity might turn out to be a protective factor of cardiovascular health. Moreover, improvements made to communities’ urban features might be more effective in preventing HTN for women than for men.

scholarly journals Nutrition transition profiles and obesity burden in Argentina

2019 ◽  
Vol 22 (12) ◽  
pp. 2237-2247 ◽  
Author(s):  
Natalia Tumas ◽  
Constanza Rodríguez Junyent ◽  
Laura Rosana Aballay ◽  
Graciela Fabiana Scruzzi ◽  
Sonia Alejandra Pou
Keyword(s):  
Disease Risk ◽  
Multiple Correspondence Analysis ◽  
Adult Population ◽  
Nutrition Transition ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Double Burden ◽  
Cross Sectional ◽  
Aggregated Data ◽  
Logistic Regression Models

AbstractObjectiveThe present study aimed to identify nutrition transition (NT) profiles in Argentina (2005–2013) and assess their association with obesity in the adult population.DesignA large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence.SettingFirst, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.ParticipantsTwenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people.ResultsThree NT profiles were identified: ‘Socionutritional lag’ (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); ‘Double burden of malnutrition’ (undernutrition and overweight in highly urbanized scenarios; profile 2); and ‘Incipient socionutritional improvement’ (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3.ConclusionsArgentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.

scholarly journals Maternal and familial correlates of anthropometric typologies in the nutrition transition of Colombia, 2000–2010

2018 ◽  
Vol 21 (14) ◽  
pp. 2584-2594 ◽  
Author(s):  
Diana C Parra ◽  
Luis F Gomez ◽  
Lora Iannotti ◽  
Debra Haire-Joshu ◽  
Anne K Sebert Kuhlmann ◽  
...  
Keyword(s):  
Maternal Education ◽  
Nutrition Transition ◽  
Purchase Decisions ◽  
Logistic Regression Models ◽  
Household Level ◽  
Food Purchase ◽  
Dual Burden ◽  
Familial Correlates ◽  
Representative Samples ◽  
Height For Age

AbstractObjectiveWe aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010.DesignWe classified children <5 years old according to height-for-age Z-score (<−2) and BMI-for-age Z-score (>2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight (<18·5 kg/m2) and overweight/obesity (≥25·0 kg/m2). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies.SettingNational and sub-regional (urban and rural) representative samples from Colombia, South America.SubjectsDrawing on data from three waves of Colombia’s Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18–49 years) and their children (birth–5 years).ResultsHigher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children <5 years, being an indigenous household, food purchase decisions by the mother and food security classification were also associated with the four anthropometric typologies.ConclusionsResults suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes.

scholarly journals Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hossein Farhadnejad ◽  
Karim Parastouei ◽  
Hosein Rostami ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Metabolic Syndrome ◽  
Positive Association ◽  
Population Based ◽  
Population Based Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Confounding Variables ◽  
Adjusted Model ◽  
Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

scholarly journals Urban index and lifestyle risk factors for cardiovascular diseases in China: A cross-sectional study

2021 ◽  
Vol 104 (1) ◽  
pp. 003685042110037
Author(s):  
Zhichong Chen ◽  
Menghui Liu ◽  
Shaozhao Zhang ◽  
Zhenyu Xiong ◽  
Xiangbin Zhong ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Fruits And Vegetables ◽  
Cross Sectional Study ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Rapid Urbanization ◽  
Lifestyle Risk Factors

China is at a stage of rapid urbanization over the past decades, and the association of urbanization with cardiovascular disease has been confirmed by previous studies. However, few studies assessed the association of urbanization with cardiovascular risk factors, especially in Chinese population. We conducted a cross-sectional, populational-based study, using data from China Health and Nutrition Survey (CHNS) in 2009. The logistic regression was used to assess the association of urbanization measured by urban index with cardiovascular risk factors (diabetes mellitus, hypertension, dyslipidemia, obesity, smoking, physical activity and fruits and vegetables consumption), varied with sex. The current study included 18,887 participants enrolled (mean age 39.8 ± 19.8 years; 52.2% female) who live in China. In regression model, the urban index was significantly associated with the variations of cardiovascular risk factors for male, including diabetes (OR 1.34, 95% CI: 1.22–1.48), hypercholesterolemia (OR 1.15, 95% CI: 1.09–1.22), never smoking (OR 0.92, 95% CI: 0.89–0.96), higher fruits and vegetables consumptions (OR 0.93, 95% CI: 0.87–0.99), higher body mass index (BMI) (OR 1.16, 95% CI: 1.10–1.22), and higher physical activity (OR 0.69, 95% CI: 0.66–0.73). Compared with the male, the associations of urban index with cardiovascular risk factors for female were similar, but not for BMI (OR 1.00, 95% CI: 0.96–1.05). The present finding emphasizes the changes of cardiovascular risk factors associated with urbanization in China, and indicated that close attention should be paid to the risk of hypercholesterolemia, diabetes and men’s obesity in the process of urbanization.

scholarly journals Crop diversity is associated with higher child diet diversity in Ethiopia, particularly among low-income households, but not in Vietnam

2021 ◽  
pp. 1-12
Author(s):  
Erin E Esaryk ◽  
Sarah Anne Reynolds ◽  
Lia CH Fernald ◽  
Andrew D Jones
Keyword(s):  
Low Income ◽  
Dietary Diversity ◽  
Positive Association ◽  
Household Wealth ◽  
Crop Diversity ◽  
Food Groups ◽  
Crop Species ◽  
Diet Diversity ◽  
Household Level ◽  
Functional Richness

Abstract Objectives: To examine associations of household crop diversity with school-aged child dietary diversity in Vietnam and Ethiopia and mechanisms underlying these associations. Design: We created a child diet diversity score (DDS) using data on seven food groups consumed in the last 24 h. Generalised estimating equations were used to model associations of household-level crop diversity, measured as a count of crop species richness (CSR) and of plant crop nutritional functional richness (CNFR), with DDS. We examined effect modification by household wealth and subsistence orientation, and mediation by the farm’s market orientation. Setting: Two survey years of longitudinal data from the Young Lives cohort. Participants: Children (aged 5 years in 2006 and 8 years in 2009) from rural farming households in Ethiopia (n 1012) and Vietnam (n 1083). Results: There was a small, positive association between household CNFR and DDS in Ethiopia (CNFR–DDS, β = 0·13; (95 % CI 0·07, 0·19)), but not in Vietnam. Associations of crop diversity and child diet diversity were strongest among poor households in Ethiopia and among subsistence-oriented households in Vietnam. Agricultural earnings positively mediated the crop diversity–diet diversity association in Ethiopia. Discussion: Children from households that are poorer and those that rely more on their own agricultural production for food may benefit most from increased crop diversity.

scholarly journals Young Children Feeding Practices: An Update from the Sultanate of Oman

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 818
Author(s):  
Salima Al Maamari ◽  
Saleh Al Shammakhi ◽  
Ibtisam Alghamari ◽  
Jana Jabbour ◽  
Ayoub Al-Jawaldeh
Keyword(s):  
Maternal Education ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Feeding Practices ◽  
Nutrition Survey ◽  
Diet Diversity ◽  
Household Level ◽  
National Nutrition Survey ◽  
Younger Age ◽  
Age Appropriate

Despite proven benefits, most countries fail to meet international targets for appropriate complementary and Breast Feeding (BF) practices. This study assessed feeding practices of children under two years of age and correlated them with family parameters in Oman, a high income country in the Eastern Mediterranean Region. Methods: Data from this study originated from the latest Oman National Nutrition Survey (ONNS). Assessment of children and their mothers’ socioeconomic, anthropometric, and nutritional variables was conducted at the household level. Evaluated feeding practices included age appropriate BF, diet diversity, and minimum acceptable diet (MAD). Results: Pairs of mothers and infants (n = 1344) were assessed. Early BF, exclusive BF at 6 months, infant formula, and iron rich meals were provided to 81, 29, 44, and 84% of children, respectively. Age appropriate BF and MAD were found in 58% and 35% of children, respectively. Low maternal education, younger age, low household income, and governorate negatively affected diet acceptability. Conclusion: Omani children successfully received early BF postpartum and consumed iron rich meals. Yet, rates of exclusive BF rates at six months and MAD for children under two were low. Comprehensive strategies should be placed to assess and influence children feeding practices in the Sultanate.

scholarly journals Gender difference in betel quid consumption levels and tobacco use among adults in Myanmar

2021 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Yin Min Aye ◽  
Seo Ah Hong ◽  
Bang-On Thepthien ◽  
Sariyamon Tiraphat
Keyword(s):  
Tobacco Use ◽  
Multinomial Logistic Regression ◽  
Secondary Data ◽  
Positive Association ◽  
Sociodemographic Factors ◽  
Betel Quid ◽  
P Value ◽  
Cross Sectional ◽  
Betel Quid Chewing ◽  
No Consumption

Several small scaled studies in Myanmar investigated determinants of betel quid chewing status but to better understand more complete profiles of betel quid chewing habits, this study investigated the associations of betel quid consumption levels with tobacco and sociodemographic factors using a nationally representative sample in Myanmar. A cross-sectional, secondary data analysis was conducted by using Myanmar demographic and health survey (MDHS) (2015-2016). Chi-square tests and multinomial logistic regression were performed with p-value&lt;0.05 as significance. Men averagely chewed 5.59 (SD=8.229) pieces per day while women chewed 1.25 (SD=3.584) pieces. The prevalence of chewing daily pieces 1-2, 3-5 and 6+ were 7.9%, 17.1% and 34.2% for men and 6.1%, 8% and 7.1 %, respectively, for women. In multivariate analysis, low education, low family wealth, married, and urban were more likely to chew 6+ pieces per day relevant to no consumption in both genders, while a positive association with age was observed only in women. Tobacco use was associated with low consumption level (1-2 pieces), relative to no consumption in both genders. Therefore, this study underlined the need to improve knowledge on the dangers associated with betel quid chewing and tobacco use among socially disadvantaged populations and urban residents.

scholarly journals Determination of combination therapy prescribing patterns for the treatment of acute agitation in psychiatric patients: A regression model of patient diagnoses and demographics

2019 ◽  
Vol 9 (5) ◽  
pp. 298-303
Author(s):  
Mark S. Maas ◽  
Karen E. Moeller ◽  
Brittany L. Melton
Keyword(s):  
Combination Therapy ◽  
Regression Model ◽  
Psychiatric Patients ◽  
A Priori ◽  
Young Male ◽  
Binary Logistic Regression ◽  
Prescribing Patterns ◽  
Cardiovascular Comorbidity ◽  
Logistic Regression Models ◽  
Acute Agitation

Abstract Introduction Guidelines for the treatment of acute agitation typically recommend monotherapy with an antipsychotic or a benzodiazepine, but combination therapy is frequently used in practice. We created a regression model to identify which factors lead to the prescribing of combination therapy for acute agitation on a psychiatry unit. Methods We collected retrospective data from hospitalized patients in the psychiatry unit. An a priori alpha of 0.05 was used for binary logistic regression models to determine if and how the number of prescribed medications for acute agitation was influenced by: age, sex, race, cardiovascular comorbidities, and psychiatric diagnoses. Results We identified 1998 encounters from 1200 patients. Patients are significantly more likely to be prescribed combination therapy if they are young, male, and of non-white race or have a diagnosis of central nervous system stimulant use, hallucinogen use, depression, bipolar, cluster B personality, or psychosis. Patients are significantly more likely to be prescribed monotherapy if they have cardiovascular comorbidity or have neurocognitive disorder. Discussion Several demographic or diagnostic factors predict combination therapy prescribing. Acute agitation guidelines should be reviewed to include more clear instructions on combination therapy use.

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