LIFESTYLE DISORDERS IN CHILDREN: AN AYURVEDIC OVERVIEW

Lifestyle Disorders (LSD) are common problems among upper-middle and higher society children. Lifestyle has long been associated with the development of many chronic diseases. It affects both genders. WHO has recognized Noncommunicable diseases (NCDs), especially diabetes, obesity, cardiovascular disease, cancer, and chronic lung disease, have everyday lifestyle linked risk factors like lack of physical activity, unhealthy diet and feeding habits and harmful use of alcohol. Worldwide, the current scenario of NCDs is the primary cause of morbidity and mortality, even in young children. According to WHO Report 2004, these account for nearly 60% of deaths and 47% of the global burden of illness. The rise in NCDs is substantially accelerating in most developing countries like India. In India, 53% of the deaths in 2008 were due to NCDs, and cardiovascular disease (CVDs) alone accounted for 24% of deaths (WHO). In 2005 India experienced the highest loss in potentially productive years of life globally, and the leading cause of death was cardiovascular disease. The cumulative loss of national income for India due to NCDs mortality for 2006-2015 was around USD237 billion. By 2030, this productivity loss is estimated to double to 17.9 million years lost. These major NCDs are preventable through effective Ayurvedic interventions by judiciously treating lifestyle-related modifiable risk factors. This review confers the current scenario of NCDs in children and their Ayurvedic Management.

Adherence to Mediterranean-DASH Intervention for Neurodegenerative Delay Diet Can Decreased Risk of Age Associated Poor Muscle Strength; A Cross- Sectional from Kurdish Cohort Study

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet aims to reduce dementia and the decline in brain health that often occurs as people get older. Loss of muscle strength (sarcopenia) is a geriatric syndrome that has associated with the loss of skeletal muscle mass and strength. The current study aimed to investigate the association between adherence to MIND diet and decrease the risk of age-associated poor muscle strength. This cross-sectional study was performed using data from Ravansar's non-communicable diseases (RaNCD) cohort study on 3181 adults (48.5% men) aged 35–65 years. The dietary intake of the studied participants was assessed by the use of a 114-item food frequency questionnaire (FFQ) developed by RaNCD cohort study. The MIND diet and the major dietary patterns were computed based on their dietary intake and three dietary patterns were identified including plant-based diet, high protein diet, and unhealthy diet. Hand grip strength (HGS) was measured using a hand-held hydraulic handgrip dynamometer and poor HGS was defined as HGS less than 32.8 and 20.5 kg in men and women, respectively. We found that greater adherence to MIND diet was associated with lower risk of poor HGS (OR: 0.65; CI 95%: 0.51-0.83). Furthermore, participants who were in third tertiles of plant- based and high protein diet were more likely 37% and 33% lower risk of poor HGS (OR: 0.63; CI 95%: 0.5-0.79), (OR: 0.67; CI 95%: 0.54-0.84), respectively. On the other hand, greater following to unhealthy diet was related to higher risk of poor HGS (OR: 1.39; CI 95%: 1.11-1.74). Overall, our findings provide that adhere to plant- based and high protein diet, as well as MIND diet had protective effects on age related poor HGS, while adherence to unhealthy diet can developed age related poor HGS.

High-Fat High-Sugar Diet-Induced Changes in the Lipid Metabolism Are Associated with Mildly Increased COVID-19 Severity and Delayed Recovery in the Syrian Hamster

Pre-existing comorbidities such as obesity or metabolic diseases can adversely affect the clinical outcome of COVID-19. Chronic metabolic disorders are globally on the rise and often a consequence of an unhealthy diet, referred to as a Western Diet. For the first time in the Syrian hamster model, we demonstrate the detrimental impact of a continuous high-fat high-sugar diet on COVID-19 outcome. We observed increased weight loss and lung pathology, such as exudate, vasculitis, hemorrhage, fibrin, and edema, delayed viral clearance and functional lung recovery, and prolonged viral shedding. This was accompanied by an altered, but not significantly different, systemic IL-10 and IL-6 profile, as well as a dysregulated serum lipid response dominated by polyunsaturated fatty acid-containing phosphatidylethanolamine, partially recapitulating cytokine and lipid responses associated with severe human COVID-19. Our data support the hamster model for testing restrictive or targeted diets and immunomodulatory therapies to mediate the adverse effects of metabolic disease on COVID-19.

Population-level interventions targeting risk factors of diabetes and hypertension in South Africa: a document review

Background South Africa bears an increasing burden of non-communicable diseases (NCDs), particularly diabetes, cardiovascular diseases, and cancer. The objective of this study was to identify which population-level interventions, implemented at the level of governmental or political jurisdictions only, targeting risk factors of diabetes and hypertension were included in policies in South Africa. We also looked at whether these have been implemented or not. Methods A review of relevant reports, journal articles, and policy documents was conducted. Documentation from government reports that contains information regarding the planning, implementation and evaluation of population-level interventions targeting diabetes and hypertension were considered, and various databases were searched. The identified population-level interventions were categorized as supportive policies, supportive programs and enabling environments according to the major risk factors of NCDs i.e., tobacco use, harmful consumption of alcohol, unhealthy diet/nutrition and physical inactivity, in accordance with the WHO ‘Best buys’. A content document analysis was conducted. Results The source documents reviewed included Acts and laws, regulations, policy documents, strategic plans, case studies, government reports and editorials. South Africa has a plethora of policies and regulations targeting major risk factors for diabetes and hypertension implemented in line with WHO ‘Best buys’ since 1990. A total of 28 policies, legislations, strategic plans, and regulations were identified - 8 on tobacco use; 7 on harmful consumption of alcohol; 8 on unhealthy diet and 5 on physical inactivity - as well as 12 case studies, government reports and editorials. There is good progress in policy formulation in line with the ‘Best buys’. However, there are some gaps in the implementation of these policies and programs. Conclusion Curbing the rising burden of NCDs requires comprehensive strategies which include population-level interventions targeting risk factors for diabetes and hypertension and effective implementation with robust evaluation to identify successes and ways to overcome challenges.

Physical comorbidity and use of healthcare services in people with schizophrenia: protocol for a systematic review

IntroductionPeople with schizophrenia die about 15–20 years earlier than the general population. A constellation of factors contributes to this gap in life expectancy: side effects of psychotropic drugs, unhealthy lifestyles (inactivity, unhealthy diet) and inequality in the provision of healthcare services. This is a topic of main importance, which requires constant update and synthesis of the literature. The aim of this review is to explore the evidence of physical comorbidity and use of healthcare services in people with schizophrenia.Methods and analysisWe will conduct a systematic literature search in the databases PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and Cochrane Library, Proquest Health Research Premium Collection, in order to identify studies that answer to our research question: Are patients with schizophrenia different from the non-psychiatric population in terms of physical comorbidity and use of healthcare services? Two authors will independently review the studies and extract the data.Ethics and disseminationThis study does not include human or animal subjects. Thus, ethics considerations are not applicable. Dissemination plans include publications in peer-reviewed journals and discussion of results in psychiatric congresses.PROSPERO registration numberCRD42020139972.

Impact of Working from Home on Cardiovascular Health: An Emerging Issue with the COVID-19 Pandemic

Mandatory working from home is one of the consequences of the COVID-19 pandemic for a large number of workers. Transition to working from home may significantly impact lifestyle, psychosocial status, and the overall health of workers. This review summarizes available data about the effects of lockdown measures, particularly working from home, on cardiovascular risk factors including sedentary lifestyle, unhealthy diet pattern, psychological distress, smoking, alcohol misuse, and cardiometabolic parameters. Finally, we suggest countermeasures that can attenuate the negative health impact of working from home. Indeed, timely and tailored interventions implemented by companies in cooperation with the health care system could allow workers to benefit more from some of the advantages associated with working from home.

JUSTIFYING THE NEED FOR IMPROVED HEALTH EDUCATION OF OBESE ADULT PATIENTS IN BULGARIA

Bulgaria is the second-fastest aging nation in Eastern Europe and fifth in the world. Older people are the largest and ever-growing group of people in health care. The most common diseases in this age group are circulatory, endocrine, digestive, musculature, neoplasms, and respiratory systems. Some of the main reasons for these diseases include an unhealthy diet, a sedentary lifestyle, and obesity. One hundred twelve adult patients with chronic diseases were interviewed. The aim of the study is to establish the awareness of older people about overweight-related problems. In order to increase their knowledge and improve their quality of life and independence, we prepared a training program (Table4).

Project PaThWay: protocol for a school-based health promotion intervention for prevention of non-communicable diseases (NCDs) behavioral risk factors

Background: Prevention of non-communicable diseases (NCDs) and their behavioral risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol) among children and adolescents have garnered paramount importance under the Sustainable Development Goals. Methods: Project PaThWay is a school-based, two years, multi-component intervention to prevent key behavioral NCD risk factors among school-going children (classes 6-8th; 10-14 years) from private and public schools across two Indian cities (Pune and Bengaluru). We assessed the baseline knowledge, attitude, and behavior related to NCD risk factors (unhealthy diet, physical inactivity, and tobacco use) of the participating students through a survey. The intervention was developed and designed for implementation by the trained teachers and similar-age peers, as facilitators. The teachers and peer leaders were trained through organising school-level orientation workshops for implementation of intervention activities, after baseline assessment. Year 1 of the intervention focuses on the knowledge and learnings and year 2 on enhancing the life-skills (leadership, communication, refusal, health advocacy, etc.). Regular monitoring visits by the project team to ensure intervention activities are being carried out as planned and providing continuous support. The end line evaluation will be done after the completion of two years’ intervention to evaluate the effectiveness of the Project PaThWay intervention. Outcome measures will include improved knowledge, positive attitude, improve behaviors related to diet, physical activity, and tobacco use, and enhanced skills in handling NCD risk factors. A process evaluation will explore several aspects of Project PaTHWay intervention (fidelity, dosage, reach, adaptations), social validity (acceptability, feasibility, utility). Conclusion: Project PaTHWay, having a multiple-component intervention, may offer the best chance for success, as it addresses multiple risk factors using multi-pronged strategies. The agents of intervention implementation are trained teachers and similar-age student peer leaders (as facilitators), one of the successful and effective approaches in school-based interventions globally and in India.

Clustering of Physical Activity, Diet and Sedentary Behavior among Youth from Low-, Middle-, and High-Income Countries: A Scoping Review

Background: The interaction between physical activity (PA), diet, and sedentary behavior (SB) plays an important role on health-related outcomes. This scoping review (Prospero CRD42018094826) aims to identify and appraise clusters of PA, diet, and SB among youth (0–19 years) according to country income. Methods: Five databases were searched. Fifty-seven articles met the inclusion criteria. Results: Fifty-five cluster types were identified, with greater variety in high-income than lower income countries. The most prevalent profiles were “High SB and consumption of sugar, salt, and beverages (SSB)” (n = 17) and “High PA” (n = 13–5), both of which presented in all income countries. The healthiest profile, “High PA and fruit and vegetables (F&V); Low SB and SSB” (n = 12), was present in upper-middle and high-income countries, while the unhealthiest “Low PA and F&V; High SB and SSB” (n = 6) was present only in high-income countries. Conclusions: High SB and unhealthy diet (SSB) were more prevalent in clusters, mainly in high-income countries. The results support the need for multi-component actions targeting more than one behavior at the same time.

Impact of COVID-19 pandemic on diet behaviour among UK adults: a longitudinal analysis of the HEBECO study

COVID-19 pandemic restrictions impacted dietary habits during the initial months of the pandemic, but long-term effects are unclear. In this longitudinal study, self-selected UK adults (n=1,733) completed three online surveys (May-June, August-September and November-December 2020, with a retrospective pre-pandemic component in the baseline survey), self-reporting sociodemographics, lifestyle and behaviours, including high fat, salt and sugar (HFSS) snacks, HFSS meals and fruit and vegetable (FV) intake. Data were analysed using generalised estimating equations. Monthly HFSS snacks portion intake increased from pre-pandemic levels (48.3) in May-June (57.6, p<0.001), decreased in August-September (43.7, p<0.001), before increasing back to pre-pandemic levels in November-December (49.2, p<0.001). 48.5% self-reported increased (25.9 [95% confidence interval: 24.1, 27.8]) and 47.7% self-reported decreased (24.1 [22.4,26.0]) monthly HFSS snacks portion intakes in November-December compared with pre-pandemic levels. Monthly HFSS meals portion intake decreased from pre-pandemic levels (7.1) in May-June (5.9, p<0.001), being maintained in August-September (5.9, p=0.897), and then increasing again in November-December (6.6, p<0.001), to intakes that remained lower than pre-pandemic levels (p=0.007). 35.2% self-reported increased (4.8 [4.3, 5.3]) and 44.5% self-reported decreased (5.1 [4.6,5.6]) monthly HFSS meals portion intakes in November-December compared with pre-pandemic levels. The proportion meeting FV intake recommendations was stable from pre-pandemic through to August-September (70%), but decreased in November-December 2020 (67%, p=0.034). Increased monthly HFSS snacks intake was associated with female gender, lower quality of life, and - in a time-varying manner - older age and higher HFSS meals intake. Increased monthly HFSS meals intake was associated with female gender, living with adults only and higher HFSS snacks intake. Reduced FV intake was associated with higher body mass index (BMI) and lower physical activity. These results suggest large interindividual variability in dietary change during the first year of the pandemic, with important public health implications in individuals experiencing persistent increases in unhealthy diet choices, associated with BMI, gender, quality of life, living conditions, physical activity and other dietary behaviours.