运动医学与兴奋剂研究杂志

Abstract

Udaipur is one of the Lake city districts Kashmir of Rajasthan having physical area of 1,936 sq km. The region lies between North latitude 30°44’53” to 31°22’01” and East longitude 76°36’10” to 77°15’14” The rural and urban population is 4, 09,362 and 91,195 respectively. The local populations mainly depend on the agriculture for their survival and adopt some traditional practices conducive for farming in sloping lands.

Non-communicable diseases (NCDs) regularly emerge in middle age after long exposure to an unhealthy lifestyle involving cigarette smoking, obesity, and inactive lifestyle, consumption of diets rich in extremely saturated fats, sugars, and salt ect .This is mostly due to changing demographics and lifestyles of the population. Eighty percent of the NCDs can be prevented by the adopting good lifestyle like physical exercise, balance diet, avoiding use of smoking and alcohol.

Overweight and Obesity

Obesity has developed a global public health issue. Overweight and obesity are most important risk factors that underlie the emergence of long-lasting diseases. The other intermediate risk factors of chronic diseases high blood pressure and high blood cholesterol levels are closely linked to and determined by the body weight of an separated. Obesity itself is directly associated with the increased risk of a range of health problems like osteoarthritis, but also increases the risk of NCDs like cardiovascular disease and type 2 diabetes. Overheavy and obesity are defined as abnormal or unnecessary fat accumulation that may impair health.

Obesity and Cardiovascular Disease

Along with high blood pressure, smoking and high blood cholesterol levels, obesity is a middle risk factor for cardiovascular diseases (CVD) like coronary heart disease and strokes. General, obesity contributes up to 40 % of the risk of hypertension and between 20 % and 30 % of the risk of CVD and hit (James and others, 2004). Obesity is also a danger factor for other cardiovascular events such as cardiac failure, arrhythmias, peripheral vascular disease and pulmonary hypertension.

Diabetes Mellitus and Obesity

Overweight and lack of physical action have been consistently associated with increasing the risk of diabetes. Obesity is a major risk factor for non-insulin dependent on the diabetes mellitus (NIDDM), also known as type 2 diabetes, and the risk appears to be related both to the period and degree of obesity. Type 2 diabetes, in turn, is a major risk factor for CVD, as are hypertension and dyslipidemia. The association between obesity and the risk of developing type 2 diabetes has been long-established by several long-term studies. Long term follow up has established that the additional risk of developing diabetes may increase 40 fold in women who are overweight as compared to women within the normal range of weight for height.

Metabolic and other disorders linked to obesity  

Obesity is connected to insulin resistance and dyslipidemia. Dyslipidemia is considered by an increase in levels of plasma triglycerides and an unhealthy pattern of the  plasma cholesterol’s with LDL cholesterol (“bad” cholesterol) levels raised and HDL (“good” cholesterol) levels lowered features that have been shown constantly to be related to an increase in the risk of cardiovascular disease.

Discussion

The occurrence of non-communicable lifestyle diseases and metabolic condition has shown a rapid increase in developing countries over the past few periods. Results of the study discovered distinct risk factor profiles for both male and female persons and identified poorly controlled lifestyle diseases. The high occurrence of obesity in females is symptomatic of long standing problem of diabetes and cardiovascular diseases. Overheavy weight and obesity diet, tobacco use, alcohol consumption,  unhealthy high blood pressure, lack of physical activityanfd  high cholesterol levels have been described as the main risk factors in non-communicable diseases.

The occurrence of prediabetes, diabetes was equivalent in male and females and hypertension was higher in the females than the male individuals owing to stressful living, obesity, lack of physical activity and adoption of significant lifestyle changes different from ancestral indigenous lifestyle. The occurrence of prediabetes, diabetes was equal in male and females and hypertension was the higher in the females than the male individuals owing to stressful obesity, living,  lack of physical activity and acceptance of important lifestyle changes different from inherited indigenous lifestyle. The main risk classical factors for  the NCDs namely alcohol intake, smoking,  unhealthy diet and low physical activity were found to be established in both rural and urban societies. The socio-demographic and economic transition change has a big role in the current rise of non-communicable illnesses in developing countries. Several factors are resulting in the increasing burden of lifestyle disease which includes longer average life span, rising income, increasing tobacco consumption, decreasing physical action and increased consumption of unhealthy food. In Rajasthan, rapid urbanization and globalization mainly donate towards increased number of people suffering from life-style disorders

Conclusion

 The main was the main risk influences for NCDs namely alcohol intake, smoking, unhealthy diet and low physical activity are dominant in both rural and urban societies. There are initiatives to  the control the burden of non  communicable illnesses in the country. Though, there is need to focus more on primary prevention at  the population level targeting interventions to  the reduce exposure to tobacco, reduce alcohol intake,  promote healthy diets, reduce salt intake and physical activity. The practical  the differences in risk factors and prevalence of non-communicable diseases in urban areas could also be clarified by the fact that in urban areas people have more access to advanced processe the  foods which are energy thick and or high fat diets than the traditional foods considered by high roughage content. This could both be due to poverty or lack of information and misconceptions also lack of access to healthy food which was means  to  many are forced to eat what is inexpensively available specially during business hours when outside their homes hence at they  increased risk of NCDs. Further community mobilization is needed to the implement prevention plans and reduce and prevent exposure to the non communicable sicknesses risk factors and subsequently reduce the burden of the diseases.

Note: This work is partly presented at 9th International Congress on Nutrition & Health February 20-21, 2017 Berlin, Germany.

Abstract: The prevalence of low vitamin D ranked to increasing globally and Lebanon is not spared. The objectives of this study are to be determining the prevalence and associates at low vitamin D status, and to assess to the association between percent body fat and vitamin D status independently of obesity.

Methods: A cross sectional study was performed on NDU employees. Data on dietary intake, lifestyle, physical activity, health status, and demographic variables were collected during a face to face interview. Anthropometric measures (weight, height and waist circumference) were measured and body arrangement was assessed using the bioelectrical impedance analysis (BIA) machine In Body 720 (Biospace, Seoul, Korea). The Nutritionist Pro diet analysis software version 31.0 was used to estimate the dietary intake of vitamin D.

Study design and recruitment method

It Startes in October 2016, an e-invite was sent to all staff and faculty members of NDU to invite them to participate in the study. Following the e-invite, 4 nutritionists visited all faculty and staff members in their workplaces to inspire participation. Of the 600 contacted employees in the 3 NDU campuses, 360 accepted to participate and were separated for eligibility. Exclusion criteria included pregnancy, failure to complete the questionnaires, lactation and presence of a pacemaker or metallic pieces in the participant’s body. Those who were found to be the eligible (n = 344) were asked to sign an informed agreement form and then contacted by the study detectives to arrange for a 30-min face of face interview. An ID number was assigned to each participant. All questionnaires were labelled by using codes. These investigators maintained the list associating names with the codes and were in charge of keeping it confidential.

Data collection procedures

During the 30min face to face meeting, trained nutritionists filled out 3 questionnaires (background questionnaire, short-form of the International Physical Activity Questionnaire [IPAQ-short form] and food frequency questionnaire .All questionnaires were pre-tested using a example of 30 NDU employees in the three campuses. For each food item, participants were asked to the mark their incidence of intake of a designated serving/portion size per day/week/month or rarely/never during the past year. The FFQ included full-fat/low-fat dairy products, eggs and egg-based dishes, fish, margarine, cheeses, and ice cream. Nutritional intake of vitamin D was assessed using an adapted version of an existing prototype food frequency questionnaire specific for assessment of vitamin D intake that was developed by the study investigators

The Nutritionist was Pro diet analysis software, version 31.0 was used to generate and estimates of dietary intake of vitamin D. Lebanese dishes and recipes were composed and entered using this software according to the iddle-East Food Composition Tables and the Canadian Nutrient File. At the end of the interview the study participants were invited to the nutrition research laboratory to collect the anthropometric (height, WC, weight and body composition) and biochemical measurements after the overnight fast. Height was measured to the nearest 0.1 cm according to the following protocol: no shoes, heels together and head touching the stadiometer’s ruler associated in horizontally.

Discussion

Low vitamin D status has become a major problem for the worldwide, even in sunny countries like Lebanon. The occurrence of low vitamin D status reported in our study (60%) was in line with the prevalence rates reported in bordering countries ranging from 57.6% in Tehran to up to 91% in Morocco. The range of occurrence rates varied among the studies due to the different study populations, education levels, season, age, BMI, body composition, gender, and cut offs for vitamin D status.

The association between alcohol vitamin D and intake status was observed in women only this has been before reported in the literature. In our sample women who drank alcohol had a higher occurrence of sufficient vitamin D status compared to the non drinkers. The relationship between liquor intake and vitamin D status is not well understood and results are the still inconclusive. It is likely that this relationship is affected by the confounders especially that alcohol intake was not associated with the vitamin D status in multivariable analyses.

The present study has some limits that need to be acknowledged. First the study was design cross sectional, which does not allow drawing causal relationships between vitamin D status and measures of adiposity.

To our knowledge, it is the first study in Lebanon to assess the association between body composition and vitamin D status mean while controlling for BMI and other important confounders.

Conclusion

Our results support our hypothesis confirming that PBF is positively associated with low vitamin D status independent of BMI in our sample of university staffs. Accordingly education about the importance of consuming high bases of vitamin D is primordial, particularly since living in sunlight country might undermine to the need to focus on diet, as Lebanese might believe that sun exposure is sufficient to maintain healthy vitamin D status. further, this study was reinforces to the need for regular screening for low vitamin D status in the Lebanese adults mainly among individuals at risk, including those with high risk WC, high PBF, who work indoors, and have low vitamin D intake and recommending vitamin D supplementation if needed. As low vitamin D status has been recently associated the with many chronic diseases, a nationwide assessment of vitamin D status is required among the different age and gender groups across different seasons to identify the whether the government needs to consider the protection of milk at the national level.

Furthermore cohort studies examining the association between body fat and vitamin D are needed to the address the temporal relationship with the vitamin D status.

Note: 14th International Conference on Clinical Nutrition July 27-29, 2017 Rome, Italy

Abstract

There is a strong association between malnutrition and cardiovascular injury and death. Malnutrition is often associated with sarcopenia and is observed as an independent risk factor of cardiomyopathies (atrophy and hypertrophy). Reduced the cardiac contractility and atherosclerosis has also been reported among malnourished geriatric patients. Its increases the risk of cardiac failure in end-stage renal disease patients and mortality among cardiac failure patients. In addition to sarcopenia, aging is related with fat redistribution with regional or central adiposity and loss of appendicular fat. This is seen as a risk factor for myocardial stroke, infarction, diabetes, hyper lipidemia, heart disease and the hypertension among the elderly. Obesity cardiomyopathy has been reported to the affect cardiac function. BMI is an integral part of anthropometric assessments, a widely used indicator to assess nutritional status 9, 10 stature and body weight are important parameters to assess BMI is a ratio among the weight (in kg) and height (in m2). Inaccurate height measurements lead to BMI misclassification.

Materials and methods

This study includes a heterogeneous sample of men and women from five municipalities of Scania. The Country wide Population Registry was used to randomly invite the participants by letter. Predefined target populations were invited for the age with an over sample of the youngest and the oldest cohorts.

The sample included two groups. The first group (group 1) consisted of 2839 elderly members (aged 60–93 years) 58% of the randomly invited general population in residents. And the second group (group 2) included 2871 members aged 60–99 years, 1573 from baseline and 1298 new participants who took part in the follow up examination of GAS conducted in 2007–2010 (participation rate: 80%) and had a valid demispan dimension.

Data collection

They an informed approval was obtained. The close ended survey investigated socio-demographics, physical, mental health and social factors. These data were obtained from the survey. The marital status denoted whether the members were single, married, divorced or living with a partner. Education was stratified as primary, secondary, or university level. Smoking status specified whether the participants are regular or irregular smokers or had quit smoking.

Height, weight, KH and demispan measured based on validated protocols. The height was measured by using a measuring tape with the individual standing straight with shoulder blades, buttocks and heels against the wall and straight fixed gaze. Arms were along the sides, shoulders relaxed, legs straight, knees touching each other, feet flat and heels together. Readings was made in cm with one the decimal value. Bed ridden patients and those using a wheel chair were excluded from our study.

Statistical analyses

Test for normality was performed for a each flexible and the analysis of the remaining error term raised no concern and simple linear regression analysis was performed by included by men and women age was 60–64 years as a reference population because the minimal age linked height change is expected. KH- and DS-based equations specific for men and women were formulated with measured height as the dependent variable and DS or KH as the independent variable, individually.

Discussion

We investigated the degree of misclassification of obesity and under nutrition owing to the in accurate height approximations are used in BMI calculations among the elderly in Southern Sweden countries. Studies have shown the direct method of underestimates body height measurement among geriatric populations and demispan are used to surrogate measures. The prevalence of the underweight (BMI <20 kg/m2) was significantly lower by 9.4% when the using to measured height to the calculate BMI in those aged 80+ years. The clinical significance of BMI misclassification calls for attention to the use of not only age-, sex- country specific but also ethnicity specific population data for such equations.

We used 60–64 years of age as position to formulate the equations. We found that the direct method of underestimated the height compared with those forecast by KH and demispan.

Under nutrition well defined by BMI ⩽20 kg/m22 is evidently underestimated by BMI demispan among both the youngest (60–64 years) and the oldest (85+ years) age groups. This prediction method better captures under nutrition, especially among the most elderly one,1,42,43 when height changes they are the most severe because of functional impairments.

Obesity (BMI ⩾30 kg/m2)5 is overvalued by standarded measurements. We found that BMI-calculated obesity occurrence in twice as high as KH- and demispan based among men aged 80+ years and women aged 70+ years old , and it doubles with every decade thereafter. As discussed above, this is attributed to the loss of height owing to degenerative conditions. Our demispan observations was concordant with those from the study by Hirani and Aresu19 among thw non institutionalized elderly and with those from the study by Frid et al.9 among hospitalized elderly. However, statistical challenging for agreement was done in these and other similar studies was that comparedto the use of demispan or KH instead of measured height.

Results:

Under nutrition prevalence’s in men and women were 3.9 and 8.6% by KH, associated with 2.4 and 5.4% by standard BMI, and more pronounced for all females aged 85+ years (21% vs 11.3%). The corresponding value in the women aged 85+ years by demispan was 16.5% vs 10% by standard BMI. Obesity occurrence’s in men and women were 17.5 and 14.6% by KH, compared with 19.0 and 20.03% by standarded BMI.

Conclusion

The main strength of our study is the huge population and sample that is country wide representative owing to a random age and the gender-stratified selection and presence of both urban and rural areas. Considerable anthropometric differences between rural and urban populations exist and the former being heavier and having more muscle mass. The equations developed are the major among the Swedish population. A significant limitation is due to the cohort effect, namely the difference in height between the youngest and the oldest age groups owing to an increasing generation height.

There is an age related misclassification of under nutrition and obesity among the old. It is credited to the caveats of inexact height estimation among the elderly. We have to proposed the use of sex specific and age adjusted estimate equations of body height based on the knee height and demispan to the address this issue.

Note: This work is partly presented 9th International Congress on Nutrition & Health February 20-21, 2017 Berlin, Germany.