Recently Published Documents
The association of mycoprotein-based foods consumption with diet quality, energy intake and non-communicable diseases’ risk in the UK adult population using the National Diet and Nutrition Survey (NDNS) years 2008/09-2016/17: A cross-sectional study
Abstract Mycoprotein is a fungal-based ingredient rich in fibre and protein used in meat-replacement foods sold under the name of Quorn in 17 countries. Fibre and protein positively regulate glycaemia, lipidaemia, energy intake which are non-communicable diseases’ (NCDs) markers. We performed a cross-sectional study to investigate the association of mycoprotein intake with diet quality, nutrient, energy intake and NCDs risk within UK free-living adults from the National Diet and Nutrition Survey (NDNS) from years 2008/09-2016/17. Dietary approaches to stop hypertension (DASH) and healthy diet index (HDI) were calculated to estimate diet quality. Comparison between mycoprotein consumers (>1% kcal) and non-consumers, and associations between consumers and nutrient intakes, NCDs’ risk markers and diet quality were investigated using a survey-adjusted general linear model adjusted for sex, age, body mass index (BMI), ethnicity, socio-economic, smoking status, region of residency, total energy, energy density, HDI and non-mycoprotein fibre intake. 5507 adults were included, of which 3.44% were mycoprotein consumers and had a higher intake of dietary fibre (+22.18%,p<0.001), DASH score (+23.33%) and HDI (+8.89%) (p<0.001, both) and lower BMI (−4.77%,p=0.00) vs. non-consumers. There was an association (p=0.00) between mycoprotein consumers and diet quality scores (+0.19 and +0.26), high fibre (+3.17g), total and food energy (+3.09 and +0.22 kcal), but low energy density intakes (−0.08 kcal/g,p=0.04). Consumers were negatively associated with fasting blood glucose (−0.31 mmol/L,p=0.00), and glycated haemoglobin A1c (HbA1c) (−0.15%,p=0.01). In conclusion, mycoprotein intake is associated with lower glycaemic markers and energy density intake, and high fibre, energy intake and diet quality scores.
Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates
Abstract Objectives The study assessed the prevalence and associated factors of behavioural risk factors of non-communicable diseases (NCDs) among adolescents in four Caribbean countries. Content In all 9,143 adolescents (15 years = median age) participated in the cross-sectional “2016 Dominican Republic, 2016 Suriname, 2017 Jamaica, and 2017 Trinidad and Tobago Global School-Based Student Health Survey (GSHS)”. Eight behavioural risk factors of NCDs were assessed by a self-administered questionnaire. Summary Prevalence of each behavioural NCD risk factor was physical inactivity (84.2%), inadequate fruit and vegetable intake (82.2%), leisure-time sedentary behaviour (49.6%), daily ≥2 soft drinks intake (46.8%), ever drunk (28.6%), twice or more days a week fast food consumption (27.6%), having overweight/obesity (27.4%), and current tobacco use (13.8%). Students had on average 3.6 (SD=1.4), and 79.0% had 3–8 behavioural NCD risk factors. In multivariable linear regression, psychological distress and older age increased the odds, and attending school and parental support decreased the odds of multiple behavioural NCD risk factors. Outlook A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered and several factors independently contributing to multiple behavioural NCD risk factors were identified.
Endogenous Fructose Metabolism Could Explain the Warburg Effect and the Protection of SGLT2 Inhibitors in Chronic Kidney Disease
Chronic low-grade inflammation underlies the pathogenesis of non-communicable diseases, including chronic kidney diseases (CKD). Inflammation is a biologically active process accompanied with biochemical changes involving energy, amino acid, lipid and nucleotides. Recently, glycolysis has been observed to be increased in several inflammatory disorders, including several types of kidney disease. However, the factors initiating glycolysis remains unclear. Added sugars containing fructose are present in nearly 70 percent of processed foods and have been implicated in the etiology of many non-communicable diseases. In the kidney, fructose is transported into the proximal tubules via several transporters to mediate pathophysiological processes. Fructose can be generated in the kidney during glucose reabsorption (such as in diabetes) as well as from intra-renal hypoxia that occurs in CKD. Fructose metabolism also provides biosynthetic precursors for inflammation by switching the intracellular metabolic profile from mitochondrial oxidative phosphorylation to glycolysis despite the availability of oxygen, which is similar to the Warburg effect in cancer. Importantly, uric acid, a byproduct of fructose metabolism, likely plays a key role in favoring glycolysis by stimulating inflammation and suppressing aconitase in the tricarboxylic acid cycle. A consequent accumulation of glycolytic intermediates connects to the production of biosynthetic precursors, proteins, lipids, and nucleic acids, to meet the increased energy demand for the local inflammation. Here, we discuss the possibility of fructose and uric acid may mediate a metabolic switch toward glycolysis in CKD. We also suggest that sodium-glucose cotransporter 2 (SGLT2) inhibitors may slow the progression of CKD by reducing intrarenal glucose, and subsequently fructose levels.
Take the Initiative, Stop Being Passive to NCDs: A PCA-Weighted Composite Indicator towards Prevalence of NCDs in Malaysia
In today’s highly dynamic socio-economic environment, the high degree of non-communicable diseases (NCDs) poses both direct and indirect health problems for nations. This study constructed a composite Non-Communicable Diseases Risk Indicator (NCDRI) that comprises leading characteristics to predict the movement of NCDs’ prevalence, which serves as an early signaling tool for policymakers and public health sectors. A weighting scheme for both non-weighted and principal component analysis (PCA)-weighted was applied from the PCA loading factor. The findings verified that the constructed PCA-weighted approach had a remarkable lead time, which also produced better lead times and was consistent in predicting the direction of change in the fluctuations caused by NCDs’ prevalence. An appropriate regime for policymaking and implementation is required, followed by periodic monitoring and rapid action, to reduce the deadly diseases. The findings of this study demonstrate that the cost indicator marked the most significant risk factor to indicate the prevalence of NCDs; therefore, policymakers should converge on this indicator so that cost-effective interventions can result in more valuable outcomes.
Background: Patients with non-communicable diseases are vulnerable to disasters. This is a systematic review describing the impact of disasters on non-communicable diseases. Methods: A systematic review was conducted using PRISMA standards. Relevant articles published from 1997 to 2019 collected by searching the Scopus, PubMed, Science Direct, databases. We specifically examined reports describing NCDs and including the key words “non-communicable disease and Disasters”. NCDs included cardiovascular, respiratory, diabetes, cancer and mental health diseases. Results: Of the 663 studies identified, only 48 articles met all the eligibility criteria. Most studies have shown the impact of all natural disasters on non-communicable diseases (39.8% n=19). The largest study was the effect of earthquakes on non-communicable diseases (29.2% n=14). For the NCDs targeted by this research, most of the included studies were a combination of four diseases: cardiovascular disease, respiratory disease, diabetes and cancer (44% n=21). Followed by cardiovascular disease (14.6% n=7), chronic respiratory disease (12.5% n=6), diabetes and cancer (6.2% n=3) and mental health (12.5% n=6). Conclusion: The incidence of disasters affects the management of treatment and care for patients with NCDs. Specific measures include a multi-part approach to ensuring that patients with non-communicable diseases have access to life-saving services during and after disasters. The approach of the health system should be expanded from traditional approaches to disasters and requires comprehensive planning of health care by policy makers and health professionals to develop effective strategies to enable patients to access medical, therapeutic and diagnostic services in natural disasters.
The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Diseases among Elderly People in Rural Areas: A Systematic Review
Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs. Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.
The average life expectancy of the world population has increased remarkably in the past 150 years and it is still increasing. A long life is a dream of humans since the beginning of time but also a dream is to live it in good physical and mental condition. Nutrition research has focused on recent decades more on food combination patterns than on individual foods/nutrients due to the possible synergistic/antagonistic effects of the components in a dietary model. Various dietary patterns have been associated with health benefits, but the largest body of evidence in the literature is attributable to the traditional dietary habits and lifestyle followed by populations from the Mediterranean region. After the Seven Countries Study, many prospective observational studies and trials in diverse populations reinforced the beneficial effects associated with a higher adherence to the Mediterranean diet in reference to the prevention/management of age-associated non-communicable diseases, such as cardiovascular and metabolic diseases, neurodegenerative diseases, cancer, depression, respiratory diseases, and fragility fractures. In addition, the Mediterranean diet is ecologically sustainable. Therefore, this immaterial world heritage constitutes a healthy way of eating and living respecting the environment.
Facilitators, barriers and potential solutions to the integration of depression and non-communicable diseases (NCDs) care in Malawi: a qualitative study with service providers
Abstract Background Integration of depression services into infectious disease care is feasible, acceptable, and effective in sub-Saharan African settings. However, while the region shifts focus to include chronic diseases, additional information is required to integrate depression services into chronic disease settings. We assessed service providers’ views on the concept of integrating depression care into non-communicable diseases’ (NCD) clinics in Malawi. The aim of this analysis was to better understand barriers, facilitators, and solutions to integrating depression into NCD services. Methods Between June and August 2018, we conducted nineteen in-depth interviews with providers. Providers were recruited from 10 public hospitals located within the central region of Malawi (i.e., 2 per clinic, with the exception of one clinic where only one provider was interviewed because of scheduling challenges). Using a semi structured interview guide, we asked participants questions related to their understanding of depression and its management at their clinic. We used thematic analysis allowing for both inductive and deductive approach. Themes that emerged related to facilitators, barriers and suggested solutions to integrate depression assessment and care into NCD clinics. We used CFIR constructs to categorize the facilitators and barriers. Results Almost all providers knew what depression is and its associated signs and symptoms. Almost all facilities had an NCD-dedicated room and reported that integrating depression into NCD care was feasible. Facilitators of service integration included readiness to integrate services by the NCD providers, availability of antidepressants at the clinic. Barriers to service integration included limited knowledge and lack of training regarding depression care, inadequacy of both human and material resources, high workload experienced by the providers and lack of physical space for some depression services especially counseling. Suggested solutions were training of NCD staff on depression assessment and care, engaging hospital leaders to create an NCD and depression care integration policy, integrating depression information into existing documents, increasing staff, and reorganizing clinic flow. Conclusion Findings of this study suggest a need for innovative implementation science solutions such as reorganizing clinic flow to increase the quality and duration of the patient-provider interaction, as well as ongoing trainings and supervisions to increase clinical knowledge. Trial registration This study reports finding of part of the formative phase of “The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building—A Clinic-Randomized Trial of Strategies to Integrate Depression Care in Malawi” registered as NCT03711786
Abstract Background One of the effective strategies to prevent and control Non- communicable diseases risk factors is to identify priorities and problems of Non-communicable programs. this study was conducted to identify the challenges of non-communicable diseases programs in order to improve programs development. Methods This study was a qualitative study which was carried out in 5 universities of medical sciences and the Ministry of Health in 2019 year. The sampling method was purposive and the participants include specialists in the field of NCD who have executive and research experience in this field. Data were collected through 40 individual interviews with health professionals and care providers. Data were analyzed by content analysis using CIPP model. Results In the present study, problems of non-communicable disease programs were identified in 4 main categories, 12 sub-categories including inadequate participation of all levels of service delivery in program development, needs assessment, budget allocation, data and program evaluation system. Conclusions Some problems of non-communicable diseases programs included inadequacy of needs assessment, lack of prioritization based on local and regional conditions, program evaluation system. Paying attention to the mentioned points will help to solve underlying problems and improve the processes of developing, implementing and evaluating programs.