The associations between alcohol intake and cardiometabolic risk in African-origin adults spanning the epidemiologic transition

Background Cardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America. Methods Measurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1–3 drinks daily for men and 1–2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals. Results Neither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites. Conclusion While several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.

Prevalence of Non-Communicable Diseases among Retired Military Personnel

Introduction: Non-communicable diseases (NCDs) have become burning issues worldwide, especially among the elderly individuals. Bangladeshi elderly is also susceptible cohort to NCDs for its recent epidemiologic transition and the NCDs is casting as prominent risk for major mortality and morbidity related issues. Objectives: To find out the prevalence of common NCDs and its risk factors among the Bangladeshi retired military personnel. Methods: This cross-sectional study was conducted among the retired military personnel admitted in Combined Military Hospital (CMH), Savar from January 2019 to July 2019. A face-to-face interview was carried out among the respondents using a semi-structured questionnaire. Results: Among 153 retired military personnel; most common NCDs were hypertension (80.4%), diabetes mellitus 66.7%, ischemic heart disease37.3% and only 3.9 % had low back pain. Most of them accessed their health in CMH (66.7%), where 17.6% reported to Govt. hospital and only a minor portion (15.7%) to private hospital. Moreover, 70.6% of them were not willing to regular health check-up. Conclusions: The most common NCDs were hypertension, diabetes mellitus and ischemic heart disease. This study concluded with a few intervention strategies and community-based health promotion programs to reduce the burden of NCDs among the retired military personnel. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 35-39

Proposal for a Conceptual Framework for the Development of Geriatric Dentistry

Demographic changes with an increasingly higher proportion of older adults worldwide and an epidemiologic transition resulting in more teeth retained and higher demand and expectations set up new scenarios for the oral health of the older population. Thus, geriatric dentistry must be reconfigured, transitioning from the traditional focus on prosthesis to a more holistic discipline, actively incorporating geriatric and gerontologic aspects. We describe some situations that provide the rationale for a new conceptual framework for the advancement of geriatric dentistry as a clinical specialty. On the basis of scientific evidence and our academic experience, we propose 4 concepts that should steer the discipline during the following years and become its structural pillars: minimal intervention dentistry, oral functionality, patient-centered care, and interdisciplinary teamwork. Since data and evidence are limited, a special focus on poor and developing countries is incorporated. Adjusting clinical guidelines and public health policies around these concepts will increase access to oral care for older people, including those with physical or social barriers, and will ensure better oral health–related quality of life and well-being. These concepts have deep consequences in the education and training of new dentists and specialists, at the public and private levels.

Prevalence and socio-demographic factors associated with hypertension among rural and urban population of Kisii County, Kenya

Background: Hypertension (HTN) is a major cause of morbidity and mortality worldwide. 9.4 out of the 20 million cardiovascular deaths are due to HTN. HTN has often been described to be more prevalent in urban areas. However, there has been an epidemiologic transition from urban to rural areas which often go unreported or underreported. This gap therefore called for a study to compare the prevalence of HTN burden and assess how socio-demographic factors contribute to HTN development among the rural and urban population.Methods: This study methodology focused on HTN among residents aged 30-69 years, from urban and rural population of Nyaribari Chache sub county, Kisii County, Kenya using a descriptive cross sectional study in which 490 respondents were interviewed. Sampling involved a random sampling technique which entailed household selection. Data was analysed using statistical package for social scientists (SPSS) version 21.Results: The prevalence of HTN for the sampled population was 44.668%. The prevalence of HTN was 44.134% in rural and 43.598% in urban areas. Rural population were more at risk of developing HTN than urban (OR=1.135 and RR=1.072). On general health, those who had ever been told that they had hypertension (p<0.000), ever been told that they had hypertension for the past 12 months (p=0.000) and those who were currently taking hypertension medication (p=0.026) were statistically significant variables.Conclusions: The study concludes that residents in rural population have higher prevalence of hypertension. Further, female respondents, those who are currently married, completed primary school education and were self-employed reported to have a higher prevalence of hypertension.

Consumption of Monounsaturated Fatty Acids Is Associated with Improved Cardiometabolic Outcomes in Four African-Origin Populations Spanning the Epidemiologic Transition

Long-chain omega-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are of increasing interest because of their favorable effect on cardiometabolic risk. This study explores the association between omega 6 and 3 fatty acids intake and cardiometabolic risk in four African-origin populations spanning the epidemiological transition. Data are obtained from a cohort of 2500 adults aged 25–45 enrolled in the Modeling the Epidemiologic Transition Study (METS), from the US, Ghana, Jamaica, and the Seychelles. Dietary intake was measured using two 24 h recalls from the Nutrient Data System for Research (NDSR). The prevalence of cardiometabolic risk was analyzed by comparing the lowest and highest quartile of omega-3 (EPA+ DHA) consumption and by comparing participants who consumed a ratio of arachidonic acid (AA)/EPA + DHA and >4:1. Data were analyzed using multiple variable logistic regression adjusted for age, gender, activity, calorie intake, alcohol intake, and smoking status. The lowest quartile of EPA + DHA intake is associated with cardiometabolic risk 2.16 (1.45, 3.2), inflammation 1.59 (1.17, 2.16), and obesity 2.06 (1.50, 2.82). Additionally, consuming an AA/EPA + DHA ratio of >4:1 is also associated with cardiometabolic risk 1.80 (1.24, 2.60), inflammation 1.47 (1.06, 2.03), and obesity 1.72 (1.25, 2.39). Our findings corroborate previous research supporting a beneficial role for monounsaturated fatty acids in reducing cardiometabolic risk.

Care of caregivers – who is responsible?

Demographic and epidemiologic transition coupled with increasing life expectancy has resulted in high old age dependency ratios and rising burden of comorbidities; especially non communicable diseases. This demands large pool of caregivers to support the dependents; physically, psychologically and financially. But the problems faced by caregivers – stress, anxiety, monetary, physical exhaustion and sickness, lack of time for personal care and health resulting in caregiver burden – is often neglected. This article summarizes the importance and/or role of caregivers, theirs problems and recommendations to identify, manage and prevent caregiver burden. The involvement of various stakeholders namely medical and para-medical colleges through training and medical education, hospitals, physicians, psychiatrists and/or psychologists, research organizations, governments and their policies is the need of the hour.

A call for better understanding of social media in surveillance and management of noncommunicable diseases

Using social media for health purposes has attracted much attention over the past decade. Given the challenges of population ageing and changes in national health profile and disease patterns following the epidemiologic transition, researchers and policy-makers should pay attention to the potential of social media in chronic disease surveillance, management and support. This commentary overviews the evidence base for this inquiry and outlines the key challenges to research laying ahead. The authors provide concrete suggestions and recommendations for developing a research agenda to guide future investigation and action on this topic.

The Epidemiologic Transition Theory and Evidence for Cancer Transitions in the US, Select European Nations, and Japan

Despite cancer being a leading cause of death worldwide, scant research has been carried out on the existence of “cancer transitions,” the idea that as nations develop, they move from a situation where infectious related cancers are prominent, to one where non-infectious related cancers dominate. We use annual cause-of-death data to produce death rates for common types of cancer in select high-income countries. We find that cancer mortality patterns parallel the epidemiologic transition, which states that as countries advance, they move from a regime where infectious diseases are most common to one where non-infectious disease are most common. An implication is that the epidemiologic transition theory as originally formulated continues to be relevant despite some researchers arguing that we need additional stages beyond the original three.