Joint temporal dietary and physical activity patterns: associations with health status indicators and chronic diseases

Background Diet and physical activity (PA) are independent risk factors for obesity and chronic diseases including type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). The temporal sequence of these exposures may be used to create patterns with relationships to health status indicators. Objectives The objectives were to create clusters of joint temporal dietary and PA patterns (JTDPAPs); determine their association with health status indicators including BMI, waist circumference (WC), fasting plasma glucose, hemoglobin A1c, triglycerides, high-density lipoprotein cholesterol, total cholesterol, blood pressure and disease status including obesity, T2DM, and MetS in United States adults. Design A 24-hour dietary recall and random day of accelerometer data of 1836 participants from the cross-sectional NHANES 2003–2006 data were used to create JTDPAPs clusters by constrained dynamic time warping, coupled with kernel k-means clustering algorithm. Multivariate regression models determined associations between the 4 JTDPAP clusters and health and disease status indicators, controlling for potential confounders and adjusting for multiple comparisons. Result A JTDPAP cluster with proportionally equivalent energy consumed at two main eating occasions reaching up to 1600 and 2200 kcal from 11:00 to 13:00 and 17:00 to 20:00, and the highest PA counts among 4 clusters from 8:00 to 20:00, was associated with significantly lower body mass index (BMI) (P < 0.0001), WC (P = 0.0001), total cholesterol (P = 0.02) and odds of obesity (OR = 0.2, 95% CI: 0.1, 0.5) compared to a JTDPAP cluster with proportionally equivalent energy consumed reaching up to 1600 and 1800 kcal from 11:00 to 14:00 and 17:00 to 21:00, and high PA counts from 9:00 to 12:00. Conclusions The joint temporally patterned sequence of diet and PA can be used to cluster individuals with meaningful associations to BMI, WC, total cholesterol, and obesity. Temporal patterns hold promise for future development of lifestyle patterns that integrate additional temporal and contextual activities.

Rebuilding a US Federal Data Strategy After the End of the “Community Health Status Indicators”

For nearly 2 decades, the Community Health Status Indicators tool reliably supplied communities with standardized, local health data and the capacity for peer-community comparisons. At the same time, it created a large community of users who shared learning in addressing local health needs. The tool survived a transition from the Health Resources and Services Administration to the Centers for Disease Control and Prevention before being shuttered in 2017. While new community data tools have come online, nothing has replaced Community Health Status Indicators, and many stakeholders continue to clamor for something new that will enable local health needs assessments, peer comparisons, and creation of a community of solutions. The National Committee on Vital and Health Statistics heard from many stakeholders that they still need a replacement data source. (Am J Public Health. 2021;111(10):1865–1873. https://doi.org/10.2105/AJPH.2021.306437 )

Epidemiology for Monitoring and Evaluation

Monitoring involves continuous observation to see if plans are on track and evaluation determines the effectiveness of planned health interventions delivered by the health services and programmes. The systems approach uses indicators to measure delivery, access, quality, and coverage of services and programmes and their impact on health status indicators. Efficacy measures the impact of interventions in individual people. Measuring effectiveness in whole communities utilizes quasi-experimental population-based study designs with community controls. The importance of ethical principles and monitoring equity in health planning is presented and emphasised.

Pulse Rate Variability Analysis Using Remote Photoplethysmography Signals

Pulse rate variability (PRV) refers to the change in the interval between pulses in the blood volume pulse (BVP) signal acquired using photoplethysmography (PPG). PRV is an indicator of the health status of an individual’s autonomic nervous system. A representative method for measuring BVP is contact PPG (CPPG). CPPG may cause discomfort to a user, because the sensor is attached to the finger for measurements. In contrast, noncontact remote PPG (RPPG) extracts BVP signals from face data using a camera without the need for a sensor. However, because the existing RPPG is a technology that extracts a single pulse rate rather than a continuous BVP signal, it is difficult to extract additional health status indicators. Therefore, in this study, PRV analysis is performed using lab-based RPPG technology that can yield continuous BVP signals. In addition, we intended to confirm that the analysis of PRV via RPPG can be performed with the same quality as analysis via CPPG. The experimental results confirmed that the temporal and frequency parameters of PRV extracted from RPPG and CPPG were similar. In terms of correlation, the PRVs of RPPG and CPPG yielded correlation coefficients between 0.98 and 1.0.

Experience of rehabilitation in children with chronic pyelonephritis living in industrial city

The consistently high frequency of pathology of urinary system in children dictates the need to find new methods for the treatment and prevention of pyelonephritis.Goal. To study clinical and laboratory indicators of health status in children with chronic pyelonephritis living in the industrial city of Tomsk and evaluate the effectiveness of various rehabilitation treatment regimens.Material and Methods. The kidney and urology examinations were performed in 58 children with a diagnosis of chronic pyelonephritis aged 7 to 12 years. Two treatment schemes including administration of mineral water and physiotherapy were used.Results and Discussion. The following symptoms were detected before treatment: oxaluria in 22.41% of children, microhematuria in 17.24% of children, significant increase in serum and morning urine nitrate/nitrite levels, and microalbuminuria suggesting the instability of cell membranes and inflammatory process in renal tissue.Conclusion. The administration of low-mineralized magnesium-sodium chloride-sulfate water in combination with physical therapy, manual massage, sapropel applications, interference therapy, and enteric oxygen therapy lead to normalization of clinical and laboratory health status indicators in the main group of patients.

Framework for Spatial and Temporal Monitoring of Urban Forest and Vegetation Conditions: Case Study Zagreb, Croatia

Urban forest and vegetation conditions are an important variable in urban ecosystem management decision-making. However, it is difficult to evaluate and monitor solely on the basis of field measurements. Remote sensing technologies can greatly contribute to the faster extraction and mapping of vegetation health status indicators, on the basis of which agronomy and forestry experts can draw conclusions about the condition of urban vegetation in larger areas. A new remote sensing-based urban forest and vegetation cover monitoring framework is presented and applied to a case study of the city of Zagreb, Croatia. In this study, Sentinel-2 multi-temporal imagery was used to derive and analyze the current state of urban forest cover. Vegetation indices (NDVI, RVI, and GRVI) were calculated. K-means unsupervised classification of the vegetation indices was conducted. In this way, the dimensionality of the vegetation indices was reduced, while all the data contained in it were used to represent their graded values. Vegetation that was in a poor condition stood out better that way. Finally, PCA-based change detection was performed on the vegetation indices graded values, and a map of change was produced. These results need to be interpreted and validated by foresters and agronomists in further research.

Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study

Despite expanded antiretroviral therapy (ART) eligibility in South Africa, many people diagnosed with HIV do not initiate ART promptly, yet understanding of the reasons is limited. Using data from an 8-month prospective cohort interview study of women and men newly-diagnosed with HIV in three public-sector primary care clinics in the eThekwini (Durban) region, South Africa, 2010–2014, we examined if theoretically-relevant social-structural, social-cognitive, psychosocial, and health status indicators were associated with time to ART initiation. Of 459 diagnosed, 350 returned to the clinic for their CD4+ test results (linkage); 153 (33.3%) were ART-eligible according to treatment criteria at the time; 115 (75.2% of those eligible) initiated ART (median = 12.86 weeks [95% CI: 9.75, 15.97] after linkage). In adjusted Cox proportional hazard models, internalized stigma was associated with a 65% decrease in the rate of ART initiation (Adjusted hazard ratio [AHR] 0.35, 95% CI: 0.19–0.80) during the period less than four weeks after linkage to care, but not four or more weeks after linkage to care, suggesting that stigma-reduction interventions implemented shortly after diagnosis may accelerate ART uptake. As reported by others, older age was associated with more rapid ART initiation (AHR for 1-year age increase: 1.04, 95% CI: 1.01–1.07) and higher CD4+ cell count (≥300μL vs. <150μL) was associated with a lower rate of initiation (AHR 0.38, 95% CI: 0.19–0.80). Several other factors that were assessed prior to diagnosis, including stronger belief in traditional medicine, higher endorsement of stigma toward people living with HIV, food insecurity, and higher psychological distress, were found to be in the expected direction of association with ART initiation, but confidence intervals were wide and could not exclude a null finding.

Temporal Dietary Patterns Are Associated with Obesity in US Adults

ABSTRACT Background The integration of time with dietary patterns throughout a day, or temporal dietary patterns (TDPs), have been linked with dietary quality but relations to health are unknown. Objective The association between TDPs and selected health status indicators and obesity, type 2 diabetes (T2D), and metabolic syndrome (MetS) was determined. Methods The first-day 24-h dietary recall from 1627 nonpregnant US adult participants aged 20–65 y from the NHANES 2003–2006 was used to determine timing, amount of energy intake, and sequence of eating occasions (EOs). Modified dynamic time warping (MDTW) and kernel k-means algorithm clustered participants into 4 groups representing distinct TDPs. Multivariate regression models determined associations between TDPs and health status, controlling for potential confounders, and adjusting for the survey design and multiple comparisons (P &lt;0.05/6). Results A cluster representing a TDP with evenly spaced, energy balanced EOs reaching ≤1200 kcal between 06:00 to 10:00, 12:00 to 15:00, and 18:00 to 22:00, had statistically significant and clinically meaningful lower mean BMI (P &lt;0.0001), waist circumference (WC) (P &lt;0.0001), and 75% lower odds of obesity compared with 3 other clusters representing patterns with much higher peaks of energy: 1000–2400 kcal between 15:00 and 18:00 (OR: 5.3; 95% CI: 2.8, 10.1), 800–2400 kcal between 11:00 and 15:00 (OR: 4.4; 95% CI: 2.5, 7.9), and 1000–2600 kcal between 18:00 and 23:00 (OR: 6.7; 95% CI: 3.9, 11.6). Conclusions Individuals with a TDP characterized by evenly spaced, energy balanced EOs had significantly lower mean BMI, WC, and odds of obesity compared with the other patterns with higher energy intake peaks at different times throughout the day, providing evidence that incorporating time with other aspects of a dietary pattern may be important to health status.

Eating Alone at Each Meal and Associated Health Status among Community-Dwelling Japanese Elderly Living with Others: A Cross-Sectional Analysis of the KAGUYA Study

This cross-sectional study investigated the association between eating alone at each meal and health status, including functional capacity among community-dwelling Japanese elderly living with others. A self-administered questionnaire was mailed to all 8004 residents aged 65 or older, residing in the same Japanese town in March 2016. Eating alone was assessed by first asking whether participants ate three separate meals each day (i.e., breakfast, lunch, and dinner), and those who answered affirmatively were then asked how many people were usually present at each meal. Health status was assessed in terms of subjective health, medical history, care needs, body mass index, depression, and functional capacity. Data from 2809 respondents were analyzed. Those who reported not being in good subjective health and a history of hypertension were significantly more likely to eat alone at breakfast (odds ratio 1.27; 95% confidence interval 1.01–1.61, and 1.26; 1.06–1.49). Depressive symptoms and many subscales of functional capacity were also significantly associated with eating alone at breakfast, lunch, and dinner (p < 0.05). Many health status indicators were related to eating alone at each meal, especially breakfast.

Temporal Physical Activity Patterns are Associated with Obesity in U.S. Adults

Background: Few attempts have been made to incorporate multiple aspects of physical activity (PA), including timing and volume, to classify patterns that link to health. Temporal PA patterns integrating time and activity counts were created to determine their association with health. Methods: PA accelerometry data obtained from the cross-sectional National Health and Nutrition Examination Survey 2003-2006 was used to pattern PA counts and time of activity from 1,999 non-pregnant adults with one random valid weekday of activity. Constrained dynamic time warping with Sakoe-Chiba band and kernel k-means clustering grouped participants to 4 clusters representing temporal PA patterns. Multivariate regression models controlling for potential confounders and adjusting for multiple comparisons (p<0.05/6) determined associations between clusters and health status indicators and conditions obesity, type 2 diabetes, and metabolic syndrome. Results: Participants in Cluster 2, represented by a temporal PA pattern with activity counts reaching >1.2e5 counts/ h (cph) and tapering off through the day, had lower mean body mass index (BMI) (p<0.001), waist circumference (WC) (p<0.01), and 65% lower odds of obesity relative to normal weight status compared with participants in Cluster 1 with the lowest PA counts reaching 4.8e4 cph from 6:00 to 23:00 (OR: 0.3; 95% CI: 0.2, 0.8). Cluster 3, characterized by a temporal PA pattern with activity counts reaching 9.6e4-1.2e5 cph between 16:00 to 21:00, was associated with lower mean BMI (p<0.001) and WC (p<0.01), and 60% lower odds of obesity relative to normal weight status compared to Cluster 1 (OR: 0.4; 95% CI: 0.2, 0.8). Cluster 4 characterized by activity counts reaching 9.6e4 cph between 8:00 to 11:00 was associated with lower BMI and WC compared to Cluster 1 (both p<0.05). Conclusions: U.S. adults with temporal PA patterns of higher activity counts ranging between 9.6e4->1.2e5 cph performed early (8:00 to 11:00), late (16:00 to 21:00), or throughout the day had significantly lower mean BMI and WC compared with adults with a temporal PA pattern of the lowest PA counts reaching 4.8e4 cph from 6:00 to 23:00. Temporal PA patterns created by integrating time with PA counts throughout a day meaningfully link to health status.