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Dec 2025
Background Fast food consumption is the major cause of obesity and overweight in worldwide affecting more than 2 billion people, especially developing countries and low income countries. It can lead to hyperinsulinemia and development of insulin resistance, high energy density, high glycemic index, and fatty acid composition of fast foods may increase the prevalence of obesity and cardiovascular risk factors Objectives The main aim of this study was, to assess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland, 2023. Methods The study was carried out from May 01 to July 20, 2023 at University of Hargeisa using an institutional based cross-sectional study design to among 260 students. The study participants were selected using a simple random sampling technique. A structured questionnaire was prepared based on review literatures and dig out from related studies. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A variable with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of stunting. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable. Results In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants were fast food consumers. The study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. On multi-variable logistic regression model educational level of the students (AOR = 12.45 (95% CI: 1.7, 14.6)) and frequency of fruit (AOR = 0.76, 95% CI (0.7, 0.8)) and vegetable consumptions (AOR = 0.51, 95% CI (0.47, 0.575)) were found to be significantly associated with fast food consumptions (p < 0.05). Conclusion In this study, of the total 90.4% number of fast food consumers. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. Educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions. Effort should be made to increase access to fast food-related information and counseling.
Sep 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5688
Obesity is associated with functional limitations in muscle performance. The true effect of obesity on skeletal muscle mass, including any interactions with aging effects, remains to be elucidated. The present study investigated the impact of obesity on the stimulation of muscle growth, based on a new model of body composition. A dataset of 44 men and 64 women was analysed. Body weight (Wt), body height (Ht), hand circumference (HdC) and waist circumference (WC) were measured. Processed by the Dahlmann-Body-Analysis (DBA) system, a new model of body composition, the increase of skeletal muscle mass (ΔSMM) compared to the individual reference weight was calculated. Muscle mass data derived by the DBA model are compared with DXA-derived predictive equations of studies representing different countries and ethnicities estimating the appendicular skeletal muscle mass. Means of these groups are tested by ANOVA. Age ranged from 18 to 72 years. All subjects had a BMI ≥ 29.7 (kg/m²). The mean values of ΔSMM as an estimate of muscle mass gain calculated by the DBA-system were 11.8 ±3.6 kg for men and 8.9 ±2.6 kg for women, respectively, demonstrating a linear, significantly rising relationship with BMI (ß > 0, p<0.001). The study population did not show a decrease in muscle mass with age in either men or women up to an age of 65 years. The results suggest that the present model has satisfactory prediction qualities to detect an increase in skeletal muscle mass associated with a growing burden of body fat.
Jun 2024 DOI 10.14302/issn.2574-450X.jom-24-5114
Objective We aimed to assess outcomes in patients undergoing sequential intragastric balloon (IGB) treatment for obesity. Methods Consecutive patients who underwent treatment between May 2014 and February 2023 were identified. We recorded outcomes including: weight at 3-monthly intervals, progression to definitive bariatric procedure and morbidity. Results 45 patients were identified. Median weight loss with first IGB was 15.2kg (8.8%). 11 patients (26.7%) had a second IGB, with median weight loss of 3.3kg (1.9%). 21 patients (46.7%) were suitable for definitive surgery after first IGB treatment. One further patient (2.2%) was suitable for surgery after a second IGB. During first IGB, median weight loss was observed during the each of the first three quartiles (months 0-3: 10.1kg; months 3-6: 2.3kg; months 6-9: 4.2kg). There was a median 2kg weight gain during months 9-12. Conclusions Greatest weight loss was achieved during first IGB treatment. Sequential IGB treatment did not lead to beneficial weight loss or progression to surgery. Weight loss with first IGB was not uniform across the 12 month period of treatment, with net weight gain during the last quartile.
Jan 2024 DOI 10.14302/issn.2692-5257.ijgp-23-4772
Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems. Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems.
Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.
Feb 2021 DOI 10.14302/issn.2641-4538.jphi-20-3683
Women in Rwanda are still suffering from overweight and obesity and health-related complications. However, little is known about overweight/obesity prevention knowledge and factors associated with overweight/obesity prevention among women. The aim of this study was to determine knowledge and factors associated with overweight and obesity prevention among women attending Kibagabaga Hospital in Rwanda. A quantitative descriptive cross-sectional design was conducted among women aged 20-45 years that was selected randomly. A structured questionnaire was used to collect data from 384 women seeking health care at the hospital during the study period. SPSS version 21 was used for data analysis; descriptive statistics was used to assess women’s knowledge related to overweight/obesity. Logistic regression was used to determine the factors associated with overweight/obesity prevention, the level of significance was set at 5%. Approval to conduct the study was obtained from the University and Hospital. The majority 35.4% of study participants were aged between 30-34 years. Women who live in urban area dominate the study (76.3%), the majority of study participants were married (60.9%). The study revealed that the 22% and 62% of women had higher level and moderate knowledge respectively. In terms of overweight/obesity prevention practices, we found that 67% mothers had adequate practices towards overweight and obesity prevention. The age of 35-39, and unemployment were found to be significantly associated with overweight/obesity prevention practices. Cost-effective health education focusing on women, physical activity and social support to reduce the socio-cultural constraints that promote overweight/obesity are necessary to combat this epidemic.
Apr 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3269
Abdominal obesitywith a big belly is one of the worse type of morbid obesity that is associated with different health failure outcomes. Central obesity leads to an increased risk of health complications such as metabolic syndrome, hypertension, insulin resistance,type 2 diabetes, heart disease and various cancers. Abdominal obesity also can specifically cause to spinal nerve pain and backache. Depression and disability are other subsequent hazards of central fatness. More importantly ,excessive central body fat ultimately contributes in all-causes of early mortality. In regards to this, individuals with abdominal obesity is urgently needed to reduce central obesity using behavior modifications. Changes in diet and performing some exercise in everyday living are essential steps.
Oct 2019 DOI 10.14302/issn.2574-450X.jom-19-2852
Obesity can be defined as a condition of abnormal or excess fat accumulation in adipose tissue, to the extent that health may be impaired. Fennel is one of the oldest spice plants which widely grows in arid and semi-arid and due to its economic importance and pharmaceutical industry usage. This plant has anti-inflammatory and analgesic effect and is effective in gastrointestinal disorder treatment. The aim of the present study was to evaluate the phytochemical characteristics and therapeutic properties of this medicinal plant. The current study demonstrates that the alteration induced by high fat diet causing changes in blood parameters. These changes are exhibited through a decrease in RBCs, Ht, Hb and platelet and these changes could be due to oxidative stress, which lead to lipid peroxidation in RBCs membranes, auto oxidation of hemoglobin. As regards the total WBCs, lymphocytes and monocytes showed marked decrease. While a distinct increase in the percentage of neutrophils and eosinophil. The present, demonstrates that rats treated with (fennel), (ator) and (fennel with ator) exposure provided significant protection to the altered hematological variables. The effect of the treatment with fennel and ator more effect than fennel only and ator only. The finding of this study indicates that the concentration of Malondialdehyde (MDA) and Myeloperoxidase (MPO) in liver homogenates of the fennel and ator group significant decrease than group (3) and group (4) and the obese group. There is a growing awareness that obesity is a prime risk factor for the development of dyslipidemia profile and that oxidative stress may play a role in various adverse effects of obesity.
Jan 2019 DOI 10.14302/issn.2574-450X.jom-18-2484
Obesity is associated with a number of serious medical complications, which are often referred to as the “insulin resistance syndrome”. The aim of the present study was performed to investigate the possible interaction between a conventional drug used for management of cholesterol and traditional herbal remedies on the obesity. This was carried through out: through estimation of blood test; Estimation of serum tests; Determination of oxidative stress biomarkers and the antioxidant enzymes activities in the liver were assayed; Histopathological examination of the liver and kidney of adult male albino rats were done. In the present study, the serum levels of the total protein and albumin in the obesity group (7.1± 0.2) and (4.78 ± 0.19); respectively were significantly (p ≤ 0.05) more than those of the control group (6.5±0.1) and (3.95± 0.1).The administration of (fennel group) revealed significant (P<0.05) decrease in the serum levels of the albumin and total protein (4.38± 0.1) and (6.65± 0.2); respectively as compared to the obesity group (4.78 ± 0.19) and (7.1± 0.2(. The total cholesterol of the group(5) (fennel and ator) after two weeks from a high fat diet than treatment with fennel and Ator through six weeks equal 142.86±5.9, 100.4±8.68, 93.29±5.99, 87.1±11.28, 80.4±21.55, 78.1±6.7 and 77.1±6.87; respectively. The present study showed a significant (P<0.05) increase in the activities of ALT, AST and ALP in the obesity group which recorded as (60.5±11.45), (57.25±6.3) and (845.0±49.47); respectively as compared to the control group (28.25±1.7), (38.5±3.87) and (537.0±41.5); respectively. The fennel group caused significant decrease in the activities of these enzymes (41.0± 2.9), (42.25+3.2) and (717.75+48.6); respectively compared to the obesity group. Ator group showed a significant decrease in the activities of these enzymes (40.0±2.16), (42.5±3.1) and (679.25±41.16); respectively compared as obesity group. The activity of AlT, AST and ALP in the fennel and ator group (32.75±2.5), (40.5±2.38) and (601.25±17.5); respectively were near to the control group.
Jan 2019 DOI 10.14302/issn.2641-9181.ijnr-18-2530
Nowadays, obesity is seriously threatening healthy life in all societies, especially in developed societies. Obesity is showing its likely effects through biologically active substances called adipokines. The most familiar of these is leptin. Leptin is synthesized in directly proportional to the amount of adipose tissue and reduced appetite by stimulating the satiety center. This status is like a protective mechanism that tries to reverse severe pathological process. Similar to this behavior of leptin, thyroid hormones are increasing in the advanced stages of obesity, increasing the resting energy expenditure (REE). The accelerating oxidative phosphorylation causes the use of energy as heat, the energy that has not transformed into ATP, together with ATP synthesis. This situation, the significant portion of energy provides to consumed instead of storing as fat. In addition, finding that T3 accelerates glucose transport and the TCA cycle without changing the rate of ATP synthesis in skeletal muscles suggests that thyroid hormones may be an effective tool in standing against obesity. In addition of that, the presence of studies indicating that thyroid hormones have an increasing tendency in the advanced stages of obesity is likely thought to be a rescuer mechanism to increase the effectiveness of suppressed thyroid hormones. On the contrary of these ideas, having been reported suppressing 5’-deiodinease enzyme activity in chronic diseases causes anxiety about the effectiveness of thyroid hormones in obesity. Based on available information, we aimed to prepare a review evaluating of this adaptive condition of thyroid hormones.
Dec 2018 DOI 10.14302/issn.2578-8590.ipj-18-2548
Obesity generally accounts for a pathophysiology condition at which excessive body fats get accumulated in body parts. Among different - causes, ambient temperature such as cold environment can dramatically develop obesity in different individual. Cold weather influences the hormones that are related to the hunger and increases appetite toward overeating and subsequently inactivity . Controlling the calorie intakes through informative care are good strategies to prevent or govern obesity at any situation such as cold temperature
May 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2059
Extant epidemiological and social diagnosis information shows an alarming upsurge in the prevalence of overweight and obesity over the last decade in developing countries including Ghana. Despite literature on the dangers and associated risk factors of these two health related constructs is well-written and documented, there seems to be a distinct knowledge gap on cultural influences that may trigger the onset of overweight and obesity, and related comorbidities. This review paper provides a general overview on overweight and obesity, and presents a supportive evidence of their rising prevalence as well as associated overall implications on public health in Ghana. Additionally, the paper explores how indigenous cultural perceptions, beliefs and norms impact on dietary and physical activity behaviours of the people. Based on available evidence, the complementary role of behaviour modification towards the management of overweight and obesity is suggested. The PEN-3 model as an appropriate cultural framework is proposed for future empirical investigations. This would afford programme planners to assess how to design culturally underpinned appropriate intervention programmes that would positively influence long term behavioural practices of the local people.
Jan 2018 DOI 10.14302/issn.2576-6694.jbbs-17-1850
Obesity has become a serious health issue worldwide. There is much evidence that obesity among adolescents contributed to worsening blood biochemical profile that leads to development of many non-communicable diseases. Therefore, the aim of this study was to evaluate the predictive value of some central obesity anthropometric indicators to metabolic risk factors in the Syrian male adolescents. A cross-sectional study of a randomly selected sample of 2064 apparently healthy Syrian males’ adolescents from Damascus city, Syria, aged 18 to 19 years was performed. Waist circumference (WC) and hip circumference (HC) were measured, and waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) were calculated. Blood pressure (BP) was also measured. Serum fasting blood sugar (FBS), triglyceride (TG), low-density lipoprotein cholesterol(LDL-C), total cholesterol (Chol) were determined. The metabolic risk factors components were defined according to the national criterion. A receiver operating characteristics (ROC) curves were drawn to determine appropriate cut-off points of the WC, HC, WHpR and WHtR for defining the performance of these measurements as predictors of metabolic risk factors. The obtained data showed that BP and overall concentrations of TG, Chol and TG/HDL were significantly (p<0.05) increased with increasing WC, HC, WHpR and WHtR values. Based on ROC calculation for the measured anthropometric indicators and some metabolic syndrome (MetS) risk factors, the best WC HC, WHpR, WHtR cut-offs values were ranged between 73.15 - 79.90 cm, 93.75 - 101.10 cm, 0.80 - 0.81, and 0.43 and 0.47, respectively. These cut-off values were lower than the values recommended by the WHO. In conclusion: A significant association between the studied anthropometric indicators and the MetS components has been demonstrated. The best cut-offs of these indicators were defined. These cut-off values were lower than the values recommended by the WHO. Our results indicating that WC, WHpR and WHtR could be better predictors of MetS risk factors in Syrian adolescents.
Sep 2017 DOI 10.14302/issn.2574-4526.jddd-17-1776
Objectives: The rate of morbid obesity among women of reproductive age continues to rise worldwide. Surgical treatment remains the most effective mean to face it. Anatomical, physiological and nutritional modifications lead to several challenges for pregnancy after bariatric procedures. In spite of routine supplementation after bariatric surgery, vitamin and mineral deficiency frequently appear in bariatric pregnancies. The aim of this review is to summarize the existing data on the prevalence and management of nutritional deficiencies in pregnancy after bariatric surgery. Methodology: A comprehensive search of Pubmed Database was conducted for English-language studies using a list of key words. Results: The most common post-operative deficiencies in pregnancy include iron, vitamin B12, folate, vitamin D and magnesium deficiency. Less common are selenium, vitamin A, vitamin B6 and vitamin C deficiency. Finally, copper, vitamin K, vitamin B1, vitamin E and albumin deficiencies are considered to be relatively rare. Conclusions: Pregnancy after bariatric surgery has been proven to be safe for both the mother and the fetus. However, there is still the risk of significant nutritional deficiencies with adverse effects on pregnancy and lactation. As a result, a thorough customized nutritional assessment is mandatory for every woman in reproductive age who has undergone a bariatric operation, with strict regular follow-up during pregnancy and lactation.
Jun 2017 DOI 10.14302/issn.2379-7835.ijn-17-1548
A new approach to weight loss and weight loss maintenance is urgently needed, with the global epidemic of obesity leading to ever higher levels of chronic disease. This new approach should be cheap and simple, it should maintain essential nutrients and not deplete lean mass, should have minimal adverse effects and be carried out safely at home without support from the healthcare profession. This review looked at the forms of caloric restriction (CR) investigated in randomised controlled trials (RCTs) and found that supervised continuous and intermittent CR was more effective than other forms of weight loss over periods from 12 weeks to 2 years and could improve cardiovascular and diabetes risk factors. CR was equally as effective as bariatric surgery, suggesting that it is the post-surgery caloric restriction that has the impact on weight, rather than the surgery itself. Intermittent CR, including alternate day fasting (ADF), was as effective as continuous CR but may show improved compliance and higher lean mass. Unsupervised weight loss maintenance presents a greater problem, since in most weight loss regimens all the weight lost is ultimately regained. Although both continuous and intermittent CR can be effective, it has been found that ADF and a higher protein intake is more likely to maintain the weight loss. These results hold for all age groups and ethnicities and both genders. These findings suggest that intermittent CR, and particularly ADF, may be a viable form of weight loss and maintenance which fulfils all the criteria above. It is therefore recommended that larger RCTs investigate intermittent CR and ADF as a viable and cost effective form of weight loss and weight loss maintenance.
Nov 2016 DOI 10.14302/issn.2574-450X.jom-16-1268
Human obesity is now universal and has drawn serious attention of international academia to unravel its pathophysiology and treatment. In recent years, efforts are being made to understand the complex physiology of both white and brown adipose tissue in detail with relevance to obesity. A large number of secretions from the white fat called the adipokines have been recognized that play a definitive role in obesity and its disorders. Innumerable regulators grouped mainly under the transcriptional, hormonal and signaling factors that govern the thermogenic functions of brown fat have been worked out. Based on these revelations, strong suggestions have been made for treating obesity specially by targeting the brown fat as it plays a key role in energy expenditure as well as through behavioral, pharmacological, physiological and surgical approaches. Such findings have been reported in a nutshell in this communication
Oct 2016 DOI 10.14302/issn.2574-450X.JOM-16-1009
Apart from the physical health implications obesity partakes on an individual; it also takes its toll on mental and psychological wellbeing of a person. A vicious cycle starts with hostility based on ‘obesity stigma’, eventually leading the person being stuck in a positive feedback loop. Every attempt to correct his or her obesity problem results in severe detrimental health effects. It is necessary that appropriate awareness programs and legislations are drafted and implemented to strike out the root causes of obesity stigma.
Jul 2016 DOI 10.14302/issn.2381-862X.jwrh-15-806
Background and Objectives: The prevalence of abnormal cervical cytology in morbidly obese women using ThinPrep® liquid-based Pap Test™ and HPV DNA Test™ is unknown. We aimed to investigate whether women with morbid obesity have a higher frequency of abnormal Pap smears compared with nonobese women, and to explore the rate of Pap smear screening in morbidly obese women. Design and Setting: We conducted a retrospective study over five years in two general government hospitals in Dubai. Patients and Methods: We screened ThinPrep slides and HPV DNA of morbidly obese women and nonobese women. The age, ethnicity, demographic and socioeconomic backgrounds of the two groups were matched. We studied hypertension (HTN), diabetes (DM), infertility, sexually transmitted diseases (STD), connective tissue disease (CTD), immunosuppression and oral contraceptive pills (OCP) as potential risk cofactors. Results: Only 90 (29%) out of 310 morbidly obese women had had Pap tests. They showed more prevalence (P<0.05) of ASC-US, high-risk HPV DNA and LSIL 16 positive (18%) (95% CI: 7.0, and of endometrial AGCs {4 positive (4.5%) (95% CI: 0.3-13.5)} than the nonobese women (n=8175), {279 positive (3%) (95% CI: 3.0-3.8} , and {2 positive (0.024%) (CI:0.01-0.09)}. There were no endocervical AGCs, HSIL or squamous cancer in morbidly obese women. DM, HTN, OCPs, CTD and STD were more common in morbidly obese women having abnormal Pap smears. Conclusions: Low-grade squamous abnormalities, high-risk HPV, and endometrial AGCs are more frequent in morbidly obese women than in nonobese women. Women with morbid obesity have a low rate of cervical screening. This, among other factors, could increase the risk of these women to abnormal cervical cytology. This vulnerable group should benefit from more frequent cervical cytology screening. Appropriate clinical and educational measures should be implemented to encourage compliance to Pap smears. Weight reduction might help.
Jun 2016
Earlier studies reported significant association of obesity, hypertension and Type2 Diabetes Mellitus (T2DM). Genetic and many disease-associated alleles have been identified through GWAS and applied to T2DM and indicated roles of renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been well documented. Angiotensin converting enzyme (ACE) gene catalyzes the conversion of angiotensin I to angiotensin II and also inactive the vasodilatation and hence renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been reported. To best of the knowledge we are reporting for the first time regarding association of ACE gene polymorphism with body composition, physiological and metabolic variables among any endogamous ethnic group (Kurmis) from of West Bengal, Eastern India. To achieve the purpose, total 197 (male 99 and female 98) randomly selected apparently healthy unrelated adult individuals of Kurmi population of Purulia District, West Bengal, India were incorporated in the present study. Anthropometric variables, physiological variables (blood pressure) and metabolic variables (PP blood sugar) have been collected using standard techniques. Extracted genomic DNA was PCR amplified and genotyped to understand ACE gene I/D polymorphism. The result demonstrated significant (p<0.05) sexual dimorphism in PBF. MAP and PP blood sugar found to be in normal range among the Kurmis. ACE gene polymorphism showed no deletion of the Kurmis and hence, only the prevalence of ACE II (insertion-Insertion) genotype has been noticed. The present study vindicated on the basis of body composition in terms of fat patterning, physiological and metabolic variables and ACE gene polymorphism that there is very low or no risk of T2DM among the Kurmis of West Bengal, India.
May 2016 DOI 10.14302/issn.2574-450X.jom-16-1039
Over the last three decades, an epidemic of obesity has markedly affected patients suffering from mental illnesses such as schizophrenia. Antipsychotic medications used to treat schizophrenia are considered as major culprits. The aim of this review is to first consider risk factors, to then outline negative sequelae of obesity for this population, and finally to address timing and content of recommended clinical interventions. Medical databases were searched with the terms “”weight,” “obesity,” and “schizophrenia.” Selection of articles was guided by date of publication; recent papers are preferentially cited. The main findings were that, in addition to antipsychotic medications, socio-economics, lifestyle, immune factors, and circadian rhythms also contribute to obesity risk. A barrier to effective health promotion within psychiatry has been the concern that fears about gaining weight might stop individuals with schizophrenia from taking needed antipsychotic medication. Recommendations, therefore, are to keep the dose of antipsychotic medication as low as possible, avoid polypharmacy, encourage healthy eating and physical activity, address sleep problems and substance use, monitor weight, blood pressure, and metabolic parameters regularly, utilize motivational interviewing techniques and peer support, pay special attention to special needs such as those of women during pregnancy, and include bariatric surgery as a potential intervention. Conclusion: Besides careful attention to medication regimens, the literature supports the active encouragement and support of patient self-management strategies to both prevent and manage obesity in schizophrenia.
Jan 2016 DOI 10.14302/issn.2379-7835.ijn-15-770
The objective of this study was to confirm the nutritional risk factors for asthma and obesity in adolescents using a cross-sectional survey. We included male and female adolescents aged 10 to 19 years of age in this study. The indicators of nutritional status used in this study were body mass index, the height-for-age index, and arm and waist circumferences. We used a food frequency questionnaire to estimate the average consumption of sodium. Physical activity was assessed using the International Physical Activity Questionnaire, and asthma characteristics were evaluated using the International Study of Asthma and Allergies in Childhood (ISAAC). Factors associated with asthma in bivariate and multivariate analyses were assessed using the Poisson regression analysis. The significance level was set at 5%, and the analyses were performed using the SPSS statistical package. We evaluated 1362 students with an average age of 15.65 ± 1.24 years. There was a positive risk for asthma between females (PR = 1.41) and asthma severity in adolescents with a high sodium intake (PR = 2.30). Within overweight adolescents, the prevalence for asthma risk washigher among females (PR = 1.66) and the high sodium intake group (PR = 1.98). An increased risk for asthma severity correlated with high sodium intake (PR = 3.07). There was a higher risk for asthma and its severity in females with high sodium intake. The same pattern was observed for adolescents with excessive weight.
Jun 2015 DOI 10.14302/issn.2572-5424.jgm-14-604
Obesity is a worldwide epidemic that features a multifactorial syndrome characterized by a chronic positive energetic unbalance. Neonatal administration of monosodium L-glutamate (MSG) causes lesion on the arcuate nucleus of hypothalamus that led to development of obesity in the adult life in rodents characterized by a notorious accumulation of catecholamine in the adrenal medulla. The amino acid glycine induces catecholamine secretion of adrenal medulla. Thus, the objective of our work was to evaluate the possible effects of glycine administration in the MSG-obesity model in rats and investigate its impact on adrenal catecholamine medulla homeostasis. Male Wistar rats received MSG solution (4mg/g body weight) subcutaneously in the cervical area for 5 days after delivery, controls received saline solution. Animals were also divided in two groups, in which one received tap water added with glycine (0.1g/Kg) after weaning on 21st day until 90 days of life.Biometrical variables, visceral fat pads weight, total content and basal secretion of adrenal cathecolamine were evaluated. Glycine increased Lee index of all tested groups and had no effect on visceral adiposity. However, glycine treatment completely reestablished catecholamine total content and basal secretion of MSG-obese group. In conclusion, although glycine treatment apparently completely reestablishes catecholamine secretion homeostasis it is not sufficient to significant directly reduce visceral adiposity in MSG obesity model in rats.
Nov 2014 DOI 10.14302/issn.2574-450X.jom-14-564
Objective: Obesity is a major public health problem worldwide. We designed this study to determine the prevalence of obesity among Saudis in the department of primary care at King Fahad Armed Forces Hospital. Methods: Cross section study of Saudis of both sexes, aged more than or equal to 12 years at the department of primary care at King Fahad Armed Forces Hospital between January 2008 and June 2009. Results: A total of 5968 were attending the department of primary care were included in this study. There were 2269 (38.0%) male and 3699 (62.0%) female. With age, a gradual increase was seen in the Body mass index (BMI) in both males and females, up to the age of 59 years, with a decrease occurring thereafter. In the females below 20 years of age, the BMI was lower than in the male group. Above 30 years, the BMI in females was higher than in the males of corresponding ages. The prevalence of BMI≥25 was 70.0%.The prevalence of BMI≥25 was non significantly higher in the male compared to the female,71% and 69.3% respectively, p=0.2.The prevalence of overweight ( BMI=25-29.9) was higher in the males compared to the females, while the reverse was true for obesity(≥30),where 62.0% of the total female population was obese compared to 49.7% of the total male population. The magnitude of the difference in prevalence of obesity in the males and females was significantly high ( p<0.0001). Conclusion: The prevalence of obesity is high among Saudi population at the primary care setting and represents a major clinical and might represent a public health problem. A national prevention program at community level should be implemented.
Apr 2026 DOI 10.14302/issn.2574-450X.jom-26-6138
Indices, based on data such as height and weight in general and in particularly the body mass index (BMI), are often used to assess overweight. However, there is limited capacity to differentiate the amount of fat mass between individuals. This review refers to an anthropometric model called Dahlmann-Body-Analysis (DBA), which uses simple anthropometric parameters to define a Reference Weight (Ref-Wt). It is based on hand circumference as a proxy for the skeletal frame and, in addition, the circumference of the abdomen as a proxy for central obesity. Processed through a network of algorithms, the DBA model enabled to differentiate the Difference Weight – that means the difference between the Actual Weight and the Reference Weight – into fat mass and skeletal muscle mass. The DBA-model resembles the 2-component model of Albert R. Behnke, which he considered as a living functional construct including essential fat. The DBA-model matches with Behnke`s 2-component model insofar, as the essential fat is replaced by a physiological amount of fat tissue. The review summarizes studies to compare DBA-derived data with Metropolitan Life Insurance tables, evaluates DBA-derived fat tissue mass with bioelectrical impedance analysis (BIA) derived results and analyses the meaning of the DBA model in clinical settings to uncover the underlying mechanisms of metabolic syndrome (MetS) pathogenesis with increasing amounts of fat mass. The model offers the opportunity to calculate changes in fat or muscle tissue in an absolute (kg) or relative (%) amount on individuals. The data suggest that the DBA-model has satisfactory prediction qualities for use as a practical tool in public health care.
Dec 2025 DOI 10.14302/issn.2329-9487.jhc-25-5778
Calcium channel blockers (CCBs) are widely used for the treatment of arterial hypertension, but they differ in terms of pharmacology, tolerability, and pleiotropic actions. Lercanidipine, a highly lipophilic third generation dihydropyridine, reduces blood pressure (BP) effectively as monotherapy and in combination without inferiority to other major antihypertensive classes. We systematically searched PubMed and the Cochrane Library (last update: September 1, 2025) and screened reference lists for additional studies. Evidence from dose finding trials, randomized controlled studies, large observational cohorts, and meta analyses shows clinically meaningful reductions in office, home, and ambulatory BP with lercanidipine, including in patients with diabetes, obesity, chronic kidney disease, or high cardiovascular (CV) risk. Fixed- dose combinations with renin angiotensin system blockers (e.g., enalapril) provide greater BP reductions than monotherapy and are associated with favorable neurometabolic profiles. Beyond BP control, lercanidipine improves central hemodynamics and arterial stiffness, favors endothelial biology, and contributes to left ventricular hypertrophy regression. Across comparative trials, lercanidipine is generally better tolerated than older dihydropyridines. Presents lower rates of vasodilatory adverse events, less sympathetic activation, while discontinuations due to adverse events are uncommon. Overall, lercanidipine particularly within single pill combinations offers effective, durable BP lowering across diverse patient profiles with a favorable safety and tolerability profile and pleiotropic benefits that extend beyond BP reduction. Figure 1. Graphical Abstract: Pleiotropic effects of Lercanidipine
Oct 2025 DOI 10.14302/issn.2474-7785.jarh-25-5784
This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.
Feb 2025 DOI 10.14302/issn.2379-7835.ijn-24-5283
This article has been retracted on 30 August 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-7835.ijn-25-5842) Objective The COVID-19 pandemic has led to the global research efforts to identify the risk factors which would lead to severe COVID-19 disease. This study aimed to investigate the relationship between body mass index (BMI) and severity of coronavirus disease 2019 (COVID-19). Methods A total of 2820 patients hospitalized with COVID-19 disease in nine Government Medical Colleges, COVID hospitals or COVID care centers of Maharashtra were included in the study. Interviews were conducted on the telephone and counselling was done. Results Among 2820, 2442 (86.60%) were asymptomatic or had a mild or moderate illness. More than half of the total COVID- 19 positive cases, 1591 (56.41%), were in the normal BMI range, and of these only 183 (11.50%) had severe COVID-19 disease. On the other hand, 647 (22.94%) patients were overweight and 106 (16.38%) had Severe COVID- 19 disease. Similarly, the patients who were obese, 363 (84.03%) were asymptomatic and 69 (15.97%) had severe COVID- 19 disease. Odds ratio for this association was found as 1.5, which indicates that patients who were obese (BMI ≥ 27.5) had one and half times increased odds of progression to severity as compared to patients having normal BMI. This association was found to be statistically significant (p- value < 0.05). Conclusion Our findings highlight the significant role of BMI in clinical progression of COVID-19 disease. Patients with underweight and obesity experienced more severe outcomes than those of normal weight when being hospitalized with COVID-19 disease.
Nov 2024 DOI 10.14302/issn.2574-4518.jsdr-24-5271
Background/Aim Obstructive Sleep Apnea (OSA) is a prevalent disorder characterized by recurrent respiratory disturbances during sleep. Patients with Type 2 Diabetes Mellitus (T2DM) and obesity exhibit a substantial susceptibility to OSA (23%–86%). People with OSA have a high risk of several comorbidities like insulin resistance, cardiovascular disease, depressed mood and hypertension. Thus, the objective was to comprehensively evaluate the risk of OSA among T2DM patients in India. Materials and Methods A cross-sectional survey was conducted across four cities in India involving 2,000 T2DM patients. The survey gathered data on patient demographics, clinical endpoints, and estimated the risk of OSA using an app which included the STOP BANG questionnaire. Multivariate logistic regression analysis was used to evaluate the association between OSA risk and key variables such as age, gender, BMI, and HbA1c. Result Overall, 63.9% of T2DM patients were identified as high risk and 27.3% were at intermediate risk for OSA development. Results of the multivariate logistic regression demonstrated that patients with high BMI ≥35 had significantly greater odds (OR: 5.70; p<0.00) of developing OSA; males had 2.75 times higher odds (p<0.00) and patients with HbA1c value >8% had higher odds (OR: 1.22; p<0.00) of developing OSA. Conclusion OSA risk and prevalence are significantly higher in T2DM patients than in the general population with a notable escalation in patients who are overweight/obese, older, and have prolonged diabetes duration. Early screening using digitalization with a highly sensitive, cost-efficient, and valid tool like STOP-BANG followed by appropriate intervention for OSA can not only reduce the eventual economic burden but can improve patient outcomes.
Aug 2024
Ambulatory blood pressure monitoring is widely used in pediatric patients to identify hypertension and its complications. Previous studies correlating obesity and hypertension using ABPMs showed increasing blood pressure loads with increasing BMI. However, BMI percentiles are more reliable indicators of obesity in children. Our study aimed to describe the association between BMI percentiles and systolic and diastolic blood pressure load using ABPM in children and adolescents. Retrospective analysis of ABPMs (Welch Allyn) was performed on a total of 115 patients between 7 and 18 years of age who were referred for elevated BP without a diagnosis of hypertension at our institution from Jan 2011 to Oct 2013. Patients were divided into 4 groups based on BMI percentile: <94th percentile, 94–98th percentile, 98–99th percentile, and >99th percentile. Analysis between blood pressure loads and BMI percentiles revealed greater mean systolic and diastolic loads with increasing BMI percentiles, but the P value was not statistically significant. Analysis of the systolic loads between children from different racial backgrounds revealed higher values in African American children than in Hispanic and Caucasian children, but the P value was not statistically significant.
Aug 2024 DOI 10.14302/issn.2379-7835.ijn-24-5155
Objective This report aimed to compare the total daily energy expenditure (TDEE) of adolescents measured by doubly labeled water (DLW) with the 2005 and 2023 dietary reference intake (DRI) equations proposed by the Institute of Medicine (IOM) in a sample of Brazilian adolescents. Methodology: This is a cross-sectional and observational study with a convenience sample of 15 obese and eutrophic adolescents, aged between 11 and 14 years, from public schools and the obesity outpatient clinic of the Clinics Hospital of the Ribeirão Preto Medical School – University of São Paulo (HC FMRP-USP) in Brazil. Were obtained stature and weight by conventional methods and used to calculate the body mass index (BMI) to determine the nutritional status. Fat-free mass (FFM) was measured using dual-energy X-ray absorptiometry. Energy expenditure was determined by DLW and estimated by the 2005 and 2023 DRI equations. The level of physical activity was measured with the ActivPAL™ accelerometer to classify adolescents within the equations. Results: Forty-seven percent of the sample were eutrophic and 53% were obese. The adolescents were classified as somewhat active according to the average number of daily steps. The DLW-derived TDEE and the TDEE derived from the 2005 and the 2023 predictive equations are presented as means, standard deviations, and 95% confidence intervals (CI). The 2005 and 2023 DRI equations produced significantly higher values than the DLW-determined TDEE (56.2% and 57.2%, respectively). Conclusion: Additional studies with Brazilian adolescents should be conducted to propose more accurate and specific predictive TDEE equations.
May 2024 DOI 10.14302/issn.2379-7835.ijn-24-5111
The purpose of this work is to emphasize the possible benefits of a microRNA-based diet in reducing the negative effects of a number of diseases, such as cancer, diabetes mellitus, obesity, hypertension, chronic respiratory conditions, and others.
Apr 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5036
According to the Japan’s National Health and Nutrition Survey, trends in the intake of vegetables and fruits (1999-2018), which are considered effective in preventing lifestyle-related diseases, are far below the target value; In the under-50 age group, less than 30% achieved the target vegetable intake of 350g, and less than 15% achieved the target fruit intake of 200g 53. Against such background, it has become a challenge to nurture children's ‘self-management ability’ that leads to spontaneous and healthy dietary habits 16. Until now, almost all research on ‘Dietary education’ has been conducted in the field of nutrition, focusing on accumulating nutritional knowledge by explaining each nutritional component and its function. However, it is difficult to nurture spontaneous and healthy dietary habits simply through repeated nutrition-based education. It can be said that the pedagogical approach of this paper has made it possible to pursue from a broader perspective that influences food choices. Research on ‘nutrition transition’ points out “worldwide obesity dynamics and their determinants” based on “a shift in the broader patterns of dietary habits (Western-style diet) and corresponding nutrition-related diseases” 42. Nutrition transition research 5040 has a broad and holistic perspective on food and health, making it easy to understand nutrition. The purpose of this paper is to pursue how to nurture the ‘self-management ability’ for spontaneous and healthy dietary habits, based on these latest nutritional knowledges. Because nutrition transition is a global phenomenon, the author choses to use broader methods of international comparative research. Comparisons lead to discoveries and value creation. This can be said to have the greatest significance in comparative research.
Feb 2023 DOI 10.14302/issn.2641-5526.jmid-23-4450
Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.
Dec 2022 DOI 10.14302/issn.2574-4526.jddd-22-4151
Steroid cell tumors of the ovary are particularly rare, secreting sex hormones, characterized by steroid cell proliferation and represent only 0.1% of all ovarian tumors. They are classified into three subtypes according to their cell of origin: stromal luteoma, Leydig cell tumors and a third subtype of unknown lineage corresponds to a not specified steroid cell tumor (SCT-NOS). This third subtype accounts for 60% of steroid cell tumors. The clinical manifestations of SCT-NOS can take many forms, including pain, abdominal distension, but perhaps the most visible presentations are those related to hormonal activity and virilization of the tumor. We present a rare case of a 48-year-old woman with vaginal bleeding and a history of trunk obesity, hirsutism for 2 years and hypothyroidism with hormone replacement therapy. Clinical examination revealed a characteristic of obesity, virilization. Serum testosterone was 3.62 µg / L and CA-125 was 40.67. Magnetic resonance imaging identified a left ovarian solid mass and histopathology confirmed a steroid cell tumor not specific. The patient underwent exploratory laparotomy and left salpingoophorectomy. Macroscopically, the mass is well circumscribed, solid, homogeneous and yellowish. Microscopically, the tumor is mainly composed of eosinophilic or vacuolar granular cytoplasm. Immunohistochemistry showed that the tumor cells were strongly positive for inhibin. The postoperative period was uneventful. Through this rare observation, we will discuss the aspects that characterize this type of tumor and present some guidelines to be used in the differential diagnosis, as well as the difficulties encountered in the clinical, radiological and therapeutic fields.
Sep 2022 DOI 10.14302/issn.2329-9487.jhc-22-4252
Background Prevalence of coronary artery disease is between 7-13 percent in urban and 2-7 % in rural India1. The alarm in rise in the prevalence of coronary risk factors like diabetes, hypertension, dyslipidemia, smoking, central obesity and physical inactivity2. The correlation between these risk factors and the severity of coronary atherosclerosis, assessed by angiography which may be either single or multivessel is less consistent with studies reporting conflicting results 3,4. Therefore our study aims to understand the proper correlation between risk factors and severity of coronary artery disease in an Indian population Methods This study was conducted in the department of cardiology, NIMS hospital Hyderabad which receives patients from the urban as well as rural areas of Telangana. the patients admitted in the department of cardiology, NIMS hospital Hyderabad that presented with acute coronary syndromes and diagnosed to have coronary artery disease (single vessel/multivessel disease) on coronary angiography taken for study. Sample Size is 150 Results Among the 150 subjects, males were 111(74%) and females were 39(26%). Mean age of the study population is 55.2 ± 11.4. Among SVD group 73.65% were males &26.3% were females. Among MVD group 76.2% were males & 23.7% were females. Mean age for SVD was 53±14.4 years, while mean age foe MVD was 58.6±14.5 years. For ACS mean age of presentation for females is 60.7±11.4 and for males mean age of presentation is 55.1±12.6. MVD (57.2%) were more common among smokers than SVD. In <45 years age group SVD (69.2%) were more common than MVD (30.8%). In 45- 70 years age group and >70 years age group MVD were more common than SVD with 69.6% and 66.6% respectively, which is statistically significant. MVD (60%) were more common among hypertensives than SVD. Among non-hypertensives MVD (41.8%) was less common than SVD (58.2%) MVD was common among all age groups, which is statistically signicant. Among STEMI group SVD (58.3%) was more common than MVD (41.7%). Among NSTEMI group MVD (62%) was more common than SVD (38%).Correlation between groups was statistically significant. Among SVD study group, LVEF was commonly between 30-45% & very few with LVEF <30% MVD was associated with more severe LV dysfunction as compared to SVD in acute MI. The difference in ejection fraction between the two groups was statistically significant P value=0.0002. In hospital MACE Among SVD there was 1 MI (due to stent thrombosis) who had to TVR (primary PCI) & rest were asymptomatic and discharged in normal state MVD there were in hospital deaths (due to refractory cardiogenic shock) rest were asymptomatic and were discharged in normal state. This difference between the two groups was statistically insignificant. Conclusion Multivessel disease in ACS were seen more commonly among elderly as compared to young subjects where single vessel disease were more common. Females especially elderly more commonly have multivessel disease. Mean age for multivessel disease was higher than single vessel disease. Among <45 years age group, SVD was more prevalent among smokers, obese and physically active. Multi vessel disease is more prevalent among patients with risk factors like diabetes, hypertension, dyslipidemia and physically inactive. Subjects with family history of premature CAD presented early and correlated well with prevalence of SVD.NSTEMI presented more with multi vessel disease. In echocardiographic wall motion analysis, a depressed regional segment of infarcted area with remote hyperkinesis predicted SVD where as remote area hypokinesis predicts more multivessel disease. In hospital outcomes were seen among multi vessel disease as compared to single vessel disease although not statistically significant.
Apr 2021 DOI 10.14302/issn.2689-2855.jan-21-3771
Ascorbic acid is a water-soluble vitamin (Vitamin C) essential for both the plants and animals for the metabolic process. In this study, the liquid chromatography-mass spectrometry (LC-MS) analytical technique was used to characterize the structural properties and isotopic abundance ratio to evaluate the effect of the Trivedi Effect®-Consciousness Energy Healing Treatment on L-ascorbic acid compared to the control sample. The ascorbic acid sample was divided into control and treated parts. Only the treated part received the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a well-known Biofield Energy Healer, Mahendra Kumar Trivedi. The control and treated samples showed a chromatographic peak at retention time (Rt) 1.8 minutes exhibited the deprotonated molecular ion peak at m/z 175 (M-H)- (calculated for C6H7O6-, 175.02) in the mass spectra. The peak area of the treated sample (12817614.01) was significantly increased by 8.81% compared to the control sample (11779918.9). The LC-MS based isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 17O/16O) in the treated ascorbic acid was significantly increased by 23.22% compared with the control sample. Thus,13C, 2H, and17O contributions from (C6H7O6)- to m/z 176 in the treated ascorbic acid were significantly increased compared with the control sample. The increased isotopic composition of the treated ascorbic acid might have altered the neutron to proton ratio in the nucleus. The changes in isotopic abundance could be due to changes in nuclei possibly through the interference of neutrino particles via the Trivedi Effect®-Consciousness Energy Healing Treatment. The increased isotopic abundance ratio and peak area of the treated ascorbic acid may increase the intra-atomic bond strength and its stability. This novel ascorbic acid after the Trivedi Effect®-Consciousness Energy Healing Treatment would be very useful to design more efficacious pharmaceutical formulations against scurvy, obesity, cardiovascular diseases, hypertension, rheumatoid arthritis, Alzheimer's disease, cancer, etc.
Apr 2021 DOI 10.14302/issn.2379-7835.ijn-21-3780
Obesity is a common and preventable Non-Communicable Disease that is of great importance. Population-based interventions are recognised to have a profound effect on improving health outcomes. One of these approaches includes the adoption of the Sugar-Sweetened Beverage (SSB) Tax. Objectives There were three objectives, 1) explore the associations between gender, age, nationality, and change in SSB consumption, 2) explore SSB consumption during Covid-19 lockdown, and 3) inform policy decision making. Methods A cross-sectional survey in the United Arab Emirates. We performed descriptive analysis and chi-square for independence to test the difference between the expected and the observed frequencies in one or more categories. Results Since the introduction of SSB tax, change in SSB consumption by gender, age or nationality was not statistically significant. Further analysis of the proportion of sugar intake per day was statistically significant (P-value <0.001) by nationality. There was no statistically significant change in SSB consumption by age, gender, or nationality during the Covid-19 lockdown. Further analysis within the group that reported change in SSB consumption suggests a majority (80.5%) reported a reduction in SSB consumption. Conclusions Change in SSB consumption by gender, age or nationality was not statistically significant since the introduction of SSB tax, or during Covid-19 lock-down; thus, we accept the Null Hypothesis. Imposing a levy on frequently consumed SSB or revisiting levy by the gram, volume, or type of added sugar (or in combination) may prove to be more effective in reducing SSB consumption. Further research is needed to determine the extent other demographic factors influence SSB consumption as well as the enablers and barriers associated with SSB consumption.
Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3742
Cardiovascular disease is actually a major cause of mortality, illness and hospitalization worldwide. Several risk factors have been identified that are strongly associated with the development of cardiovascular disease. Public prevention strategies have relied predominately on managing environmental factors that contribute to cardiovascular disease, such as obesity, smoking and lack of exercise. The understanding of the role of genetics in cardiovascular disease development has become much more important to link genetics with the onset of disease and response to therapy. This seeks to examine how genes can predispose individuals to cardiovascular disease and how this knowledge might be applied to more comprehensive preventive strategies in the future. In addition, the review explores possibilities for genetics in cardiovascular disease treatment, particularly through the use of identified driver genes and gene therapy. To fully understand the biological implications of these associations, there is a need to relate them to the exquisite, multilayered regulation of protein expression and regulatory elements, mutation, microRNAs and epigenetics. Understanding how the information contained in the DNA relates to the operation of these regulatory layers will allow us not only to better predict the development of cardiovascular disease but also to develop more effective therapies.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3610
Aim To assess the sanitation and hygienic practices of women and its effects on the nutritional status of the mother and preschool children of the Lodha tribal community in two districts of West Bengal. Methods A cross-sectional study was conducted during November, 2014 - December, 2018 of 941 Lodha mothers and 1043 of their preschool children in Paschim Medinipur and Jhargram districts. All information was collected by using KAP questionnaire following interview and group discussion. Mother nutritional status was assessed based on body mass index (BMI) and mid upper arm circumference (MUAC). A child was classified as underweight, stunting and wasting as weight-for-age, height-for-age and weight-of -height Z-score below -2 standard deviation of WHO standard. Results This study found 35% of the households used safe drinking water. Almost 97.2% of the mother had the low hand wash score and about 67.1% of them had an average WaSH score. Overall, 41.6% and 1.6% mothers were suffered from undernutrition (BMI <18.5 kg/m2) and overweight/obesity (BMI≥25kg/m2). Whereas, 48.9% women were undernourished based on MUAC<22.0cm. Moreover, the overall prevalence of wasting, stunting and underweight of preschool children was 31.9%, 62.1% and 61.3%, respectively. The WaSH score of family was significantly associated with child stunted and underweight. Conclusion There is a good association between poor household WaSH practices with child undernutrition and morbidity. Hence, there is an urgent need to develop the comprehensive knowledge, attitude and practice (KAP) guidelines in their language to educate them about appropriate water storage, retrieval methods, sanitation and hand washing practices.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3581
With an increased intake of processed carbohydrates and refined sugars, the obesity rate has shot up in the past decade giving rise to mental and physical health problems. These individuals are also the most vulnerable to a number of other diseases including the current pandemic of Covid-19. This paper aims to address the knowledge gap that is required to promote a healthy lifestyle for mental and physical wellbeing. The paper also analyses a number of different studies conducted and helps in understanding obesity as a strong risk factor to various disorders. Despite constant recommendations from healthcare organisations to address the importance of weight regulation, the process to do so often remains uncertain to the general population. The paper analyses the effects of the ketogenic diet for fat loss as well as treating mental illnesses and aims to address the influence of high carbohydrate diets on mental illnesses.
Oct 2020
Background Osteoarthritis, a serious and increasingly prevalent disabling global health condition found largely among older adults, has been linked to the presence of excess body weight. But what contributes to this growing health epidemic of excess weight, which is increasingly observed in children? Moreover, can a case be made for predicting a possible negative linkage between the pervasive use of social media from the earliest point in time and possible subsequent childhood overweight or obesity and late life osteoarthritis that may be amenable to intervention? Methods To examine the most probable answers to these questions, the EBSCO, Scopus and PUBMED data bases were sourced for relevant data. The extracted data were carefully reviewed, categorized and documented in narrative format. Results While one cannot readily carry out research to answer the above questions, prevailing data imply that there is more risk of being overweight in childhood, as well as acquiring possible later life disabling osteoarthritis, or a more serious manifestation of this disease, through the prolonged, unfettered and frequent use of social media in early and middle childhood. Conclusion Those in the realm of developing preventive strategies against childhood overweight or obesity as well as osteoarthritis are strongly encouraged to examine the role of the media environment and messages children are exposed early on in this regard. Alternately, children who already have disabilities, joint pain due to arthritis or other health conditions, and who may have to rely more on social media than others who are active- may suffer more readily from an energy imbalance and become overweight if due precautions against this are not taken.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463
Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.
Jan 2020 DOI 10.14302/issn.2379-7835.ijn-19-3111
The present paper describes the significance of anthropometric measurements in detecting nutritional status of individuals, specially children. It highlights evolution of anthropometry, discusses importance of various measurements & their role in determining undernutrition & obesity. There is a need to have one measurement to detect obesity & undernutrition both. An ideal such measure is yet to be established.
Sep 2019 DOI 10.14302/issn.2474-3585.jpmc-19-3009
Blount’s disease, also known as tibia vara, is a developmental disorder involving the posteromedial proximal tibial physis resulting in progressive varus, procurvatum and internal torsion of the affected tibia 1. The condition was first published by Blount in 1973 2. The aetiology of this disease is unkown. However, associations exist between blount’s disease and the Afro-Caribbean race, early age of walking and obesity 34. Furthermore, genetic predisposition has been postulated as well as mechanical loading of the physis 456. Affected children are usually overweight and start walking early. It is bilateral in 80% of cases 7.
Sep 2019 DOI 10.14302/issn.2574-450X.jom-19-3000
Background Polycystic ovarian syndrome (PCOS) is increasingly being diagnosed and treated with sometimes variable lifestyle advice and pharmacological interventions. Obesity is considered as the sole culprit and variable definitions in clinics compound the understanding of pathogenic heterogeneity of this syndrome. We evaluated the differences between various simple to calculate anthropometric indices along with some anthropometric-biochemical equations in subjects with or without PCOS. Objective To compare traditional measures like waist to hip and height ratio (WHpR and WHtR), BMI, newer markers depicting central obesity like Abdominal Volume index(AVI), Body roundness index (BRI), A Body Shape index (ABSI), Conicity index (C-index) along with biochemical-anthropometric equations like lipid Accumulation Products (LAP), Visceral Adiposity Index (VAI) and Chinese Visceral Adiposity Index (CVAI) for diagnosing PCOS as per the Rotterdam criteria Design Cross-sectional analysis Place & Study Duration Naval hospital, Islamabad from Jan- 2018 to July- 2019 Subjects and Methods From our finally evaluated 333 female subjects we initially compared the differences for the presence of hirsutism as per modified Ferrimen Gallwey scores and biochemical hyperandrogenism by measuring free androgen index (Total testosterone/SHBG x 1000. We evaluated waist circumference, BMI, WHpR, WHtR,AVI, BRI, ABSI, C-index along with biochemical-anthropometric equations like LAP, VAI and CVAI for differences in subjects diagnosed to have PCOS by Rotterdam criteria or ultrasonography alone. Results Differences in hirsutism as defined by modified FG score between subjects defined to have PCOS or otherwise as per Rotterdam defined criteria were as [(PCOS=169, Mean=17.33 + 9.05) (No PCOS=164, Mean=8.21 + 5.74), p< 0.001] and ultrasound [(PCOS=87, Mean=16.95 + 9.57) (No PCOS=246, Mean=11.38 + 8.51), p< 0.001]. Similarly, the differences in FAI between subjects defined to have PCOS or otherwise as per Rotterdam criteria and ultrasound were as [(PCOS=169, Mean=6.41 + 4.88) (No PCOS=164, Mean=2.77 + 1.79), p< 0.001] and [(PCOS=87, Mean=5.75 + 5.01) (No PCOS=246, Mean=4.22 + 3.68), p= 0.011]. Anthropometric measures and anthropometric-mathematical equations were raised in non-PCOS subjects than PCOS subjects. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS. Conclusion Hirsutism and free androgen indices were raised in PCOS females. Anthropometric based measurements were not different in PCOS cases and non-PCOS females. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2825
Background Concordance or husband wife agreement on various factors like sleep, substance use, dietary supplement use, and diseases like obesity and hypertension has been extensively studied worldwide. But the data regarding concordance of stress among married couples in India is lacking. Objective The prime objective of this study was to find out proportion of concordance of stress among married couples in Nagpur, Central India. Methods This was a community based cross sectional study conducted in an urban area of Nagpur. 260 couples in whom both husband and wife were of the age 30 years or more were included. Stress among couples was assessed by Presumptive stressful life events scale (PSLES). Results 82.3% concordance of stress was observed. Getting married, birth of daughter, death of close family member, illness of family member, gain of new family member and going on pleasure trip or pilgrimage were most common events reported by both spouses. Pregnancy of wife was the most common event reported by husbands. Four husbands reported death of spouse as a life event. None of the spouses reported extra marital relation of spouse and conflict over dowry as life time events. Conclusions Concordance of stress was very high among couples. This suggests role of shared marital environmental factors, which could affect stress concordance among couples.
Mar 2019 DOI 10.14302/issn.2379-7835.ijn-19-2578
We present below a mechanistic cellular and molecular approaches for the development of Anti-Inflammatory biomarkersof Probiotic Bacteria in Fermented Foods. Probiotics are live microorganisms that promote human health by counteracting the noxious toxic gut microflora in human intestine, by modulating of the tight junctions, and by increasing mucin production, enforcing intestinal epithelial cell barrier function, modifying microbial community within the gut intestinal disorders, and improving immune responses associated with chronic inflammation in experimental animal models, collectively enhancing human health. Cytokine secretion by intestinal epithelial cells and macrophages are regulated by probiotics through key signaling pathways such as nuclear factor-κB and mitogen-activated kinases, resulting in alleviation of several disorders such as allergies, diabetes, obesity, heart diseases and cancer. MicroRNAs are small non-coding RNA molecules involved in transcriptional and post-translational regulation of gene expression by inhibiting gene translation. Using in vitro and in vivo approaches in cell lines and mice models to study effects of probiotic conditional media and heat-killed bacterial strains with anti-inflammatory effect to elucidate the mechanisms by which probiotics affect signaling pathways, and by using global cytokine and microRNA gene expression analyses approaches to develop biomarkers for studying different pro- and anti-inflammatory activities, and using statistical approaches to analyse the data, we show that cytokines and miRNAs have an essential role in regulation of cancerous and inflammatory pathways. This mechanistic approach will result in developing specific disease biomarkers for the early diagnosis of certain pathogenic states, as well as evaluating the effect of different dietary components on developed biomarkers in health states that will promote and enhance human health. Comparing the concordance of the in vitro to the in vivo research findings will confirm the correspondence of both approaches to each other. Moreover, this study will have a major public health relevance in elucidating the role of miRNAs and their targets in inflammation, paving the way to diagnosing and treating of pathogenic human disease stages.
Feb 2019 DOI 10.14302/issn.2377-2549.jndc-18-2507
Hydroxypropyl β-Cyclodextrin (HPBCD) used in food, pharmaceutical, chemical industries, as well as environmental, and agriculture engineering. But the major issue related to HPBCD is the low solubility profile. In this study, the influence of the Consciousness Energy Healing Treatment (the Trivedi Effect®) on the physicochemical properties of HPBCD was evaluated using spectroscopic and calorimetric analytical techniques. The test sample (HPBCD) was divided into control sample and treated sample. The control sample did not receive the Biofield Energy Treatment. Whereas, the treated sample received the Biofield Energy Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The particle size values of the treated sample were decreased by 3.28%(d10), 1.36%(d50), 0.45%(d90), and 1.04%{D(4,3)}; therefore, the specific surface area was increased by 1.9% compared with the control sample. The evaporation temperature of the treated HPBCD sample was significantly decreased by 19.89%; however, the latent heat of evaporation and latent heat of fusion were significantly increased by 56.27% and 47.41%, respectively compared with the control sample.The total weight loss in the treated HPBCD was decreased by 5.11%; whereas, the residue amount was significantly 309.67% more compared to the control sample.The results indicated that the Trivedi Effect® might have produced a new form of HPBCD which may show better thermal stability, solubility, dissolution rate, and bioavailability. This new form of HPBCD would be more useful for improvement of solubility of the lipophilic drug, preparation of cholesterol free food products, weight loss supplements, anti-obesity medication, stabilize volatile and unstable compounds, and other manufacturing industry using it as a raw material.
Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456
Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.
Nov 2018 DOI 10.14302/issn.2578-8590.ipj-18-2471
Overusing the computer and internet can yield several health problems. The enhanced use of computer on can impact on both physiological and psychiatric health factors. It is accompanies with bad posture, musculoskeletal pains, obesity, weaker eyesight and mental illness. Health hazard of computer use life demands serious concern. Performing regular exercise largely can prevent or reduce the aforementioned issues that can be expected from computer and internet overuses. Physical activity such as 15 or 30 minutes walking for any break and reducing of the spending time to work with this kind of technology can account for as a helpful strategy toward living in more ideal manners.
Oct 2018 DOI 10.14302/issn.2576-6694.jbbs-18-2408
Improved economic and developed people with their lifestyle have created many challenges of health issues (obesity, osteoporosis, cancer, diabetes, allergies and dental problems), due to selection of different food habits (such as consumption of manifold junk foods). It has created number of health problem (development of many diseases) related to nutritional deficiencies food. Nowadays, people have developed the habit for shifting of synthetic food ingredients to organic foods and ingredients, obtained from natural sources. In this regards, nutraceuticals food or its food products can perform important role in controlling the diseases via fulfilling all the health benefits to many people at worldwide. Incredible dietary supplements as nutraceuticals food (involvement in nutritional, immunologic and physiological functions) can help in prevention or treatment of many diseases (mitigating of gastrointestinal (GI) tract problem), as it is synthesized from raw herbals and lots of rapidly growing industries are reported to synthesize these natural products. And around 100 million people are found to take these products (power of plant based materials) for getting health benefits. It can work as drugs as health benefit of nutraceuticals via regulation/ control for diseases. Global nutraceuticals market had been valued for US$ 165.62 billion in 2014 and it would be grow the value of US$ 278.96 billion by 2021 with compound annual growth rate of 7.3%. This proposed paper will discuss the different types of nutraceuticals food or its functional components involved in prevention or treatment of diseases.
Aug 2018 DOI 10.14302/issn.2575-1212.jvhc-18-2167
A cohort of Pony Club horses was observed for 13 months with data collected from owner-kept diaries and monthly property visits. All horses studied had access to pasture for all or part of the day. Whilst paddock size was seldom limiting, pasture degradation was evident and observed pasture mass and composition varied greatly. Horses’ body weight indices and body condition scores also varied greatly, closely matching seasonal variations in pasture mass. Increments in bodyweight varied in a non-linear fashion with body condition score. Most horses experienced additional year-round hand-fed supplementation and half of the study horses recorded body condition scores greater than 3.5 out of 5. This suggests that the owners of Pony Club horses did not rely on pasture as the sole source of nutrition, even though, based on estimated energy demands, well-managed pasture can meet the energy requirements of Pony Club horses. Furthermore, the fact that owners appeared not to make horse feeding decisions based on body condition score resulting in obesity, raises health and welfare concerns in this cohort of horses. The inappropriate feeding of supplements observed during times of high pasture growth was a concern. Whilst the ideal pasture for Pony Club horses has not been described, it is likely to differ to those considered ideal for broodmares and other livestock because of these unique health risks associated with high levels of non-structural carbohydrate content in improved pasture species. This study highlights the need to educate owners about recognising unhealthy body conditions of horses and better managing pastures and pasture access to reduce the risk of obesity related disorders, whilst at the same time reducing pasture degradation and supplemental feed costs
Mar 2018 DOI 10.14302/issn.2574-4518.jsdr-17-1785
Sleep is vital for the maintenance of physical health and mental wellbeing. Sleep also plays a cardinal role in the process of healing. It is estimated that 50 to 70 million Americans suffer chronically from sleep disturbances and insufficiency, which not only hinders daily functioning but also adversely affects health, quality of life and longevity.1 Deficient sleep is associated with an increased risk of developing chronic diseases such as hypertension, diabetes, obesity, heart disease, stroke, depression, frequent mental distress, as well as increased mortality, and reduced quality of life and productivity.1,2Aging, medical conditions, pain, and mental illness further aggravate sleep disturbances such as insomnia, sleep fragmentation and daytime sleepiness.3, 4, 5, 6, 7, 8 The a common treatment for sleep disturbances and insomnia is pharmacological therapy. Benzodiazepines may have negative long-term side effects including residual daytime sedation and tolerance development. Withdrawal difficulties may increase dependency. In the older patient there are safety issues related to daytime sedation including increase risk of falls. With the importance of sleep in hospital recovery and the side effects of sleep medication becoming more widely recognized, there has been an impetus to s use nonpharmacological alternatives , such as music.. This pilot study builds on the potential impact of music’s effectivity by introducing music therapy as a safe, cost effective and culturally sensitive intervention.
Nov 2017 DOI 10.14302/issn.2641-5518.jcci-17-1806
Background Hypertension is one of the most prevalent risk factors for myocardial infarction, strokes, congestive cardiac failure and chronic kidney disease (CKD)and its prevalence is significantly higher inthe elderly population. Objectives To assess the demography, various presentations and the prevalence of risk factors among elderly hypertensive patients followed up in a tertiary care hospital in Sri Lanka. Materials and Methods This was a cross sectional descriptive study involving 250 patients whoseage was 60 years or above onantihypertensives for at least 6 months. Results Approximately 65.2% of the study population was female. The mean age was 70.17.Dizziness and chest pain were the most prevalent symptoms.The mean age at first detection was 58.17 years.Mean SBP and DBP were 128.5mmHg and 81.14mmHg respectively. The prevalence of alcohol consumption and smoking among men were 70.1% and 72.4% respectively. Approximately 54.7% were either overweight or obese.Approximately 81.6% females and 41.4% males had a waist circumference ofmore than therisk level with p-value<0.05. Approximately 36% had diabetes mellitus and 27.6% of the patients had at least one parent and 36.8% had at least one sibling diagnosed with hypertension. Approximately 61.3% of the patients hadadequate levels of physical activity while 31.8% had IHD,11.5% had stroke and 3.8% had CKD. Conclusion Dizziness and chest pain were the most disturbing symptoms while abdominal obesity among females,and alcohol consumption and smoking among males were the major risk factors in elderly hypertensive patients
Nov 2017 DOI 10.14302/issn.2574-4526.jddd-17-1792
Objectives: Bariatric surgery has been established as the cornerstone of treatment of morbid obesity with good immediate and long-term results. Nutrient deficiencies though, can be an important long-term complication and may lead to hematological, metabolic and especially neurological disorders which are not always reversible. Thiamine (vitamin B1) deficiency has been reported both after restrictive and malabsorptive procedures. The aim of this study is to review all cases that presented with Wernicke Encephalopathy after sleeve gastrectomy. Methods: A review of the literature was conducted to evaluate all sleeve gastrectomies performed till today and caused Wernicke encephalopathy to the patients. Demographic data, operative parameters, postoperative outcomes were collected and assessed. Results: A total of 13 studies, including 13 patients were analyzed. Patients ranged in age from 17 to 55 years. The onset of Wernicke encephalopathy occurred as early as 3 weeks after surgery to as late as 60 weeks after surgery. When symptoms of Wernicke encephalopathy developed, patients had lost from 19 kg up to 60 kg of body weight. Conclusions: Micronutrient deficiencies and particularly B1 deficiency can occur after LSG, although rarely. Preoperative nutritional assessment and postoperative follow-up plan, should signs of Wernicke’s encephalopathy be traced, is recommended in all patients.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1750
Background The prevalence of obesity and type 2 diabetes is escalating at an alarming rate in many developed as well as developing countries. Irisin is a novel muscle and adipose drived chemokine that is, proteolytically processed from the product of the FNDC5 (fibronectin type ш domain containing 5) gene. The purpose of this study is to examine the effect of three kind of training on irisin in sedentary obese women. METHODSː33 obese women (medium age: 37.99 ± 3.7 year, height: 1.55 ± 0.03 meter, BMI: 34.6 ± 5.07 kg/m2) participated in the study, on three groups, including endurance, resistance and concurrent. Results After 8 weeks exercise we did not find significant differences in fasting glucose, insulin, HOMA-IR and irisin between the groups (P>0.05), but glucose and insulin in resistance groups and irisin in all groups had significant changes (P<0.05). Conclusions In summery in this study in contrast to hypothesis there were no difference between groups of training. It can be hypothesise that the increase of irisin in obese people is one of the preventing ways against of obesity's side effects. Exercise could improve the signaling pathways and consume the fat accumulations, therefore at the end of exercise duration, irisin decreased.
Aug 2017 DOI 10.14302/issn.3070-2313.jeh-17-1552
Introduction. Obesity often coexists with insulin resistance, which is related to cardiometabolic risk. However, some obese individuals exhibit comparable insulin sensitivity (IS) to that of normal-weight subjects, a state associated with a reduced cardiometabolic risk. We aimed to determine the efficacy of a panel of surrogate markers of insulin sensitivity (IS) for the identification of insulin sensitive obese (ISO) vs. insulin resistant obese (IRO) with similar total fat mass (FM) and body mass index (BMI). Methods. This is a cross-sectional analysis among 144 overweight and obese post-menopausal women. IS was determined by the hyperinsulinemic-euglycemic clamp (HEC) and by surrogate indices such as Matsuda index, the simple index assessing insulin sensitivity using oral glucose tolerance test (SIisOGTT), Abdul-Ghani liver IS index, HOMA-IR and Abdul-Ghani muscle IR index. Results. When using upper and lower quartiles values or the median as cut-off for IS determined by the reference HEC to define ISO vs. IRO, Matsuda index, SIisOGTT and Abdul-Ghani indices classification identified ISO vs. IRO individuals with similar FM and BMI. With HOMA-IR, the two groups were similar for FM and had borderline significant difference in BMI. Using, receiver operating characteristic curves, Matsuda index AUC was similar to that of SIisOGTT and both indices AUCs were significantly higher than Abdul-Ghani indices AUCs. The best cut-off value for the Matsuda index was 2.5 (83.1% specificity, 54.2% sensitivity) and 0.25 for SIisOGTT (64.8% specificity, 70.8% sensitivity). Conclusion. Whole body IS indices, Matsuda and SIisOGTT indices seem to be reliable indices for the identification of ISO vs. IRO individuals.
Jul 2017 DOI 10.14302/issn.2574-4372.jesr-17-1705
Drug-induced cardiotoxicity is one of the predominant reasons for drug attrition and withdrawals. This is of critical concern when potentially cardiotoxic drugs are administered to individuals with inherited arrhythmogenic cardiac diseases or with metabolic diseases such as obesity and diabetes, which are key risk factors for cardiovascular diseases. Pathophysiological alteration prevalent under such conditions can alter or exacerbate cardiotoxic responses. The growing incidence of obesity, diabetes and metabolic syndrome subject a significant percentage of the population to drug treatments, thereby augmenting their risk for drug-induced cardiovascular toxicity. Hence, screening for drug-induced cardiotoxicity early in the preclinical stages of drug development, by using appropriate human disease models, can be effective in ensuring safety in clinical trials and preventing late stage and post-marketing drug withdrawals owing to cardiotoxicity. The advent of human pluripotent stem cells (hPSC) and induced pluripotent stem cell (iPSC)-derived cardiomyocytes are revolutionizing safety/toxicity screening in human cells by providing relevant human-specific, renewable model systems to explore human drug toxicity. The ability to generate patient-specific iPSCs that can model cardiac diseases, now offers a valuable option that can further improve drug safety assessments and enable a more accurate prediction of toxicity that occurs in the representative population that are prescribed the drugs. Use of appropriate disease models will not only provide cost savings by decreasing potential drug attrition and withdrawals, seen with many drugs, but will also be a promising option to advance precision medicine
Jul 2017 DOI 10.14302/issn.2474-7785.jarh-16-1067
Aim Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in hospital with orthopaedic surgery already an established risk factor. This study aims to establish the length of time that a patient is at risk of sustaining a VTE post orthopaedic surgery. Method A retrospective case series of all patients who underwent orthopaedic surgery between 2010 and 2014 whom re-presented with a VTE within one year of their initial operation. Demographic, operative and clinical information was obtained in order to identify potential risk factors. Results 53 patients were identified as having a VTE within one year of discharge. The majority (63.4%) underwent lower limb arthroplasty. 29% of the cohort had either a family or personal history of VTE, 79% had ischaemic heart disease (IHD), hypertension or both. The average body mass index (BMI) of the cohort was 31.4; above the UK national average. 56.6% of the cohort developed a pulmonary embolism (PE) and 49% developed a deep vein thrombosis (DVT). Co-occurring DVT and PE was diagnosed in 5.6% of patients. The average length of time for readmission for patients to re-present at hospital with a PE was 122 days (range 4-361) and 107 days (range 7 – 360) with a DVT. Conclusion This study confirms the existence of pre-established risk factors for developing VTE including obesity, personal and family history of DVT, cardiovascular disease and lower limb arthroplasty. These risk factors are recognised despite patients receiving post-operative thromboprophylaxis. The findings of this study extend the current research by suggesting that patients presenting with known risk factors of developing VTE may be at risk for longer than the current guidelines cover for the administration of thromboprophylaxis. We propose further studies are needed to identify any potential requirements for more extensive VTE prophylaxis in this population.
Jul 2017 DOI 10.14302/issn.2379-7835.ijn-17-1636
Adipose tissue inflammation is associated with obesity comorbidities. Reducing such inflammation may ameliorate these comorbidities. n-3 fatty acids have been reported to have anti-inflammatory properties in obesity, which may modulate this inflammatory state. In the current study a 1 gram per day oral supplement of the n-3 fatty acid docosahexaenoic acid (DHA) was administered for 12 weeks to 10 grade 12 obese postmenopausal women and markers of adipose tissue and systemic inflammation measured and compared before and after supplementation. DHA administration resulted in approximately a doubling of plasma and red cell phospholipid and adipose tissue DHA content but no change in systemic markers of inflammation, such as circulating C-reactive protein (CRP) or interleukins (IL) 6, 8 and 10 (IL-6, IL-8, IL-10). DHA supplementation did not alter the adipose tissue marker of inflammation crown-like structure density nor did it affect any gene expression pathways, including anti-inflammatory, hypoxic and lipid metabolism pathways. The obese postmenopausal women studied were otherwise healthy, which leads us to suggest that in such women DHA supplementation is not an effective means for reducing adipose tissue or systemic inflammation. Further testing is warranted to determine if n-3 fatty acids may ameliorate inflammation in other, perhaps less healthy, populations of obese individuals.
Feb 2017 DOI 10.14302/issn.2997-2086.jfs-16-1098
We report a twin gestation with one fetus afflicted by a left sided Extra-Lobar Sequestration (ELS) in a morbidly obese mother. The ELS was complicated by a left pleural effusion in the second trimester unresponsive to maternal steroid administration. We discuss the need for repeat shunt placement, in the setting of maternal morbid obesity and twin gestation. Shunt replacement was necessary secondary to dislodgement. Delivery at 34 weeks gestation was followed by successful surgical removal of the ELS. At one year follow up the infant has complete expansion of the left lung with no morbidity.
Dec 2016 DOI 10.14302/issn.2379-7835.ijn-16-1390
Objectives: To evaluate the efficacy of a weight loss programme and the factors that predict successful adherence of the treatment. Methodology: A retrospective chart review of 500 overweight outpatients (427 women, 73 men), mean age 41.7 years (range: 18–81) and mean BMI of 31.44 kg/m2 (range: 25.09–51.33), treated at an obesity specific clinic. A programme involving a hypocaloric Mediterranean diet was prescribed, along with suggestions for leisure exercise and daily activity. The weekly follow-up continued until the weight loss goal was reached (‘completion’ group) or the patient discontinued the programme (‘dropout’ group). Key Results: Those that completed the programme achieved a mean weight loss of 10.6 kg (12.9% percentage loss of initial body weight) and a mean body fat mass loss of 26.8%. Factors predictive of completion were: gender (males higher completion), previous dietary programmes (predictive of dropout), initial percentage of fat mass (higher percentage, lower completion), age (younger age, lower completion) and hypothyroid disease (predictive of dropout). Conclusions: A hypocaloric Mediterranean diet and moderate exercise could help to reduce body weight and body fat in overweight patients. Treatment completion of self-selected and self-paying patients is low, and appear to be more effective for men, persons with a low percentage of fat mass, older age groups and those who have not made other previous diets.
Nov 2016 DOI 10.14302/issn.2324-7339.jcrhap-16-1271
Introduction The cardiovascular complications have became the 3rd cause of death and the 4th reason for hospitalization of the patients infected by the HIV. The objective of this work was to determine the frequency of asymptomatic myocardial ischemia among patients infected by the HIV receiving antiretroviral therapy. Patients and Methods It was a descriptive cross-sectional study which was conducted in November 2015. The patients infected by HIV1 receiving antiretroviral treatment, with asymptomatic myocardial ischemia were included in the study and they were followed up in the HIV clinic of the in Infectious diseases service of the University Hospital Souro Sanou of Bobo-Dioulasso(CHUSS).. The includes patients benefited from a collection of cardiovascular risk factors, and of two measurements of the blood pressure in a sitting position after 10 minutes of rest and an electrocardiogram 12 derivations after rest. Results A total sample of 123 patients infected by HIV1 was selected, with a median age of 42 years (IQR: 36-50). It was composed of 79% of female. The cardiovascular risk factors found were distributed as follows: HTA (31.7%), obesity (33%), dyslipidemia (10.57%), active smoking (0.8%), diabetes (0.8%). All the known hypertensive cases (5.7%) were insufficiently treated. The median duration of exposure to the antiretroviral therapy was 5.3 years (IIQ: 3-7.7). The disorders of the repolarization were observed in 26 cases (21.13%). They were divided into under epicardic ischemia in 20 cases (16.26%), under endocardic lesion in 2 cases (1.63%) and after-effect of necrosis in 4 cases (3.25%). The Left ventricular hypertrophywas observed in 12 cases (9.76%) and all of them were hypertensive patients. QTc was lengthened among 7 patients (5.69%) independently of the class of antiretroviral therapy administrated. Conclusion In this study about patients infected by HIV1, it emerges that asymptomatic myocardial ischemia is frequent. It would be advisable to reinforce its tracking by using more powerful tests of ischemia, in order to better specify its gravity in this population with an increased cardiovascular risk.
Nov 2016
The purpose of this paper is to review the literature linking schizophrenia with chronic inflammation and gluten sensitivity. In addition, the paper discusses the need for dietary interventions that may improve multiple health outcomes for patients. Individuals with schizophrenia are at much greater risk for the development of additional autoimmune disorders. Second generation anti-psychotic medications are the most effective treatment for schizophrenia, but there are numerous potential side effects to the medications. More specifically, individuals with schizophrenia who are treated with SGAs are at increased risk for obesity, diabetes, as well as elevated lipids and blood pressure. An effective evidence-based dietary intervention has the potential to improve numerous outcomes for individuals with schizophrenia.
Sep 2016 DOI 10.14302/issn.2574-450X.jom-16-1062
Background: Obese adults with Type 2 Diabetes (T2D) have shown differences in body composition and response to varying diets when compared to obese adults without T2D. This difference in body composition affects management options for obesity. Such studies have not been done on adolescents thus far. Objectives: To estimate differences in fat mass at baseline as well as following a two-week high protein liquid diet in obese adolescents with and without T2D. Methods: Thiswas a pilot study using a non-randomized, unblinded pre/post intervention design without a control group. We planned to recruit 40 subjects (20 per group, with and without T2D) from ages 10 – 19 years, with Body mass index (BMI) ≥ 95 percentile. Body fat mass was measured via the Bod Pod® at baseline and after two weeks of following the diet with Ensure High Protein shakes. Change in fat mass is presented as mean differences and 95% confidence intervals. Results: We recruited 28 subjects, 19 completed the study and 12 were compliant with the diet. The mean difference in fat mass percent from baseline in subjects who completed the study (n=19) and without T2D was 1.4 (95% confidence interval (CI): -2.1 to -0.8) and in subjects with T2D was 1.2 (95% CI: -3.6 to 1.24). Conclusion: We did not find any meaningful difference in fat mass at baseline or after following a two-week high protein diet between the groups. High dropout rate and noncompliance with the diet were major limitations.
Feb 2016 DOI 10.14302/issn.2471-2175.jdrt-15-718
Pernio is an inflammatory disease that is usually characterized by the development of cold-induced erythrocyanotic skin lesions located in acral regions. Diagnosis is difficult if lesions are present in rare locations. A 21-year-old female suffering from fatigue presented with a 4-day history of painful, purple lesions on both thighs. She worked as a cashier, wore tight clothing, and was otherwise healthy except for mild obesity. Dermatological examination revealed tender and painful edematous papules and plaques on the outer aspects of her thighs. The patient was diagnosed with pernio based on her medical history, and clinical and histological findings. Laboratory tests were normal except for her cold agglutinin titer (1:4). Pernio rarely occurs on the thigh, except in people who ride horses. However, it sometimes occurs in non-riders depending on lifestyle and environmental conditions. Therefore, lesions in this region must be confirmed by a thorough medical history and evaluation of clinical and histopathological findings. Cold agglutinins may be associated with this disease.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-479
Objective: Detailed reports in changes of eating habits especially in elderly subjects with successful weight loss and maintenance are virtually unknown. In this paper we have analyzed the eating habits of 104 obese patients (BMI 37.8±0.3 kg/m2, age range 65 and 84 years) who lost 11.5±0.3kg over an average follow-up period of 37.5±0.5 months. Design: Patients recorded food intake over a period of 12 days before and 12 days after changes of eating habits. Dietary counseling was based on food energy density (ED) with the aim to maintain food quantity as much as possible for adequate satiety in conjunction with a reduction of energy intake. Individual eating habits should be preserved as much as possible. Results: Average daily energy intake of solid food was reduced by 267kcal, food intake by 114g and ED by 0.10 kcal/g, respectively. Liquid calories were reduced by 79 kcal/d. Lower daily energy intake was the result of a reduction of medium and high ED food items compensated for by a greater intake of low ED food items. Changes of macronutrients comprised substantially lower carbohydrate and fat intake with minimal reduction of protein. From 28 different food groups 9 were reduced significantly (bread, butter, marmalade, cheese, meat products, fast food, fruit and chocolate) while 3 were increased (eggs, curds, ham). The relative contributions of the various food groups to daily energy intake remained fairly similar indicating that individual preferences were largely maintained. Conclusion: The data demonstrates that in elderly subjects with severe obesity an individual change of eating habits can lead to successful long-term weight loss with improvement of carbohydrate metabolism. This will contribute to increased mobility and to improved quality of life. This method which is based on the energy density of food items is a simple measure to reduce energy intake while ensuring long-term adherence.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-615
Objective: To prevent childhood obesity, the Chilean government has recently implemented food regulation laws that apply to schools. This paper reviews the literature regarding the challenges in successfully integrating policies to regulate foods offered in schools. In addition, to understand some of the potential implementation barriers, a survey was conducted to evaluate how well food regulation laws were understood and implemented in Chilean schools. Methodology: A narrative literature review was conducted regarding food regulation policies in Chilean schools and potential barriers to implementation. This informed a subsequent descriptive, qualitative survey which was conducted in the Valparaíso region of Chile to examine knowledge, practices, and potential barriers to implementation of the new regulations. Twelve randomly-selected school food kiosk owners completed a survey and structured interview. Visual observations were also performed at each food kiosk. Content analysis identified trends in food items sold and determined the depth of understanding kiosk owners have of a specific new food law, "La Composición Nutricional de los Alimentos y Su Publicidad (20.606)." Key Results: 7 articles in Spanish and 10 in English were reviewed. The literature review revealed that unhealthful food options are readily available to Chilean students in school kiosks. The results of the survey and interview indicated that the school kiosk owners surveyed have a general understanding of the food law. 10 out of 12, however, were unsure of the law's exact contents. Unhealthful food options, inconsistent with regulation 20.606 were observed in all 12 visited kiosks. Conclusion: Evidence from a literature review and the survey findings confirm that unhealthful foods persist in Chilean schools, despite government food regulations. Although the majority of the school kiosk owners acknowledge law 20.606, most lack an understanding of its exact contents and their role in promoting healthier foods in schools. Further education of vendors and school administrators is needed to enhance compliance with the new Chilean food regulations.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-584
During the past three decades the prevalence of childhood obesity has steadily increased in the United States. Causes of childhood obesity are complex and include numerous individual and environmental factors. The purpose of this study was to determine parent perceptions on the social-ecological barriers (community, school, and family) to physical activity and healthy eating, perceived specific to their children. Self-reported data gathered from a 50-item questionnaire and six focus groups were conducted with parents (n=43) enrolled in the Women, Infants, and Children (WIC) Program. Participants (16 to 67 years old) were predominately female (88.4%), Hispanic (67%), low income, and living in or near Lompoc in Santa Barbara County, CA. The social-ecological model (family, school, and community) was utilized to create focus group questions and provide recommendations as part of the Lompoc Community Health Improvement Project (2006-to-the-present). Popular community barriers for physical activity were: disconnected sidewalks, lack of safe bike routes to school, lack of recreational programming at an affordable cost, and language barriers (lack of marketing physical activity programs in Spanish). Two safety barriers involved parks; fear of injury (dilapidated equipment) and fear of gangs (violence). Common school barriers were: teachers do not lead-by-example, lack of healthy food in school cafeteria, and insufficient time for children to purchase food and eat. Family barriers included: grandparents sabotaging healthy eating environments (e.g., spoiling children), insufficient nutrition knowledge (both children and parents), and economics (not being able to afford healthy food and a recreation/gym membership).
Jan 2015 DOI 10.14302/issn.2379-7835.ijn-14-534
Objective: Skipping breakfast has been associated with an increased risk of obesity. This randomized controlled pilot study tested whether emphasizing breakfast consumption, in conjunction with nutrition counseling, would improve weight status and dietary quality in children. Design and Methods: Twenty children were recruited and randomized to a breakfast (BF, n=11) or control (n=9) intervention. Both groups received weekly group nutrition counseling for 12 wk but breakfast consumption was emphasized, and ready-to-eat (RTE) cereal provided, to BF only. Anthropometric measurements were taken weekly. Three-day food records were taken at baseline and endpoint. Results: Weight status did not change significantly, however, children in BF displayed an overall decrease in BMI (-1.0±5.1%) whereas children in the control group had an overall increase (1.1±7.2%) from baseline (P=0.52). Three-day food records (BF, n=6; control, n=5) revealed group x time interactions on total sugars (P=0.007), folate (P=0.05), vitamin B12 (P=0.03), sodium (P=0.05), niacin (P=0.009), and vitamin B6 (P=0.023). Except for sodium, BF had improvements in these nutrients relative to the control group. Conclusions: Preliminary data from this study show that the provision of RTE cereal with weekly nutrition counseling may positively affect intake of essential nutrients. The effects of breakfast consumption on weight status are still uncertain.
Oct 2014 DOI 10.14302/issn.2471-2140.jaa-14-423
There is increasing evidence of the prevalence manifestations of metabolic syndrome worldwide. Metabolic syndrome is a cluster of abnormalities characterized by hypertension, central obesity, insulin resistance, endothelial dysfunction, dyslipidemia and oxidative stress. All these alterations predispose individuals to type 2 diabetes and cardiovascular disease that are major contributing factors to earlier mortality among people. The investigation of food nutrients that could reverse the features of metabolic syndrome is an important aspect for dietary-based therapies that may ameliorate the burden of the disorder. Antioxidant micronutrients are of great interest due to the recent described association between obesity, cardiovascular alterations and oxidative stress. These antioxidant nutrients are also being considered in the management of metabolic syndrome due to their potential benefits on hypertension, insulin resistance and hypertriglyceridemia since growing evidence has emerged that point to a causal link between oxidative stress and metabolic syndrome. Thus, dietary antioxidant supplements could have favourable effect on the attenuation and prevention of the manifestations of metabolic syndrome traits. Therefore, the present review focuses on the importance of antioxidant micronutrients in the treatment and management of metabolic syndrome.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-157
Background: Human Immunodeficiency Virus (HIV) and antiretroviral therapy (ART) are found to be strongly associated with cardiovascular diseases. Data are sparse on the prevalence and distribution of cardiovascular risk factors among people being treated for HIV in South Asia region. Methods: A cross-sectional study of 103 HIV patients (51 women and 52 men) attending routine follow-up consultations at the largest ART centre in Nepal was conducted. Data on several cardiovascular risk factors were collected through interview questionnaires, biophysical measurements and consulting medical records. Results: The most common cardiovascular risk factors observed were central obesity 34.6% 95% Confidence Interval (CI): 25.3% to 43.9%, chronic kidney disease {20.7% (95% CI: 11.6% to 29.7%)} and tachycardia {20.6% (95% CI: 12.7% to 28.5%)}. Females were significantly more likely to have central obesity (male 9.8% vs. female 60%, p=0.016) and chronic kidney disease (male 15.4% vs. female 26.3%, p=0.003) as compared to the males. Participants were fairly active but a large proportion, especially men, had smoked {65% (95% CI: 57%-72.3%)}, used tobacco products {66% (95% CI: 56.4%-74.4%)} or drugs (53.8% of the men) and consumed alcohol {60.2% (95% CI: 50.5%-69.1%)}. Conclusion: A high prevalence of several cardiovascular risk factors was observed among patients being treated for HIV in Nepal. Further larger studies are warranted to better understand the relevance and public health impact of cardiovascular risk factors in this region.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-13-253
Background: Western studies have shown that hypertension increases carotid intima media thickness (cIMT) as early as in childhood and adolescence. However, similar data from India is lacking. Indians have different genetic, racial, geographic, cultural and dietary patterns. Hence a similar trend may not be experienced among young Indian subjects. Methods: 46 young cases (age 16 – 35 years) of hypertension were recruited along with age, sex and BMI matched controls. Patients with body mass index (BMI) >25 kg/m2, diabetes mellitus and secondary causes of hypertension were ruled out. All patients underwent carotid ultrasonography for assessment of cIMT. Results: Mean age and BMI of cases was 25.4 years and 20.89 kg/m2 respectively. 67.4% were male. For all of the subjects combined (n=92), cIMT correlated with BMI (r = 0.244; P=0.019), office systolic blood pressure (SBP) (r = 0.556; p<0.001) and office diastolic blood pressure (DBP) (r =0.426; p<0.001). Among hypertensive subjects (n=46), there was a significant positive correlation between cIMT and SBP (r=0.611, p<0.001). In contrast to SBP, DBP correlated insignificantly with cIMT (r= 0.217; p = 0.14) in the hypertensive subjects. Conclusion: Elevated blood pressure, especially systolic, correlates with increased cIMT among young Indian hypertensives. This provides strong evidence that primary hypertension in early life also is associated with vascular pathology, independent of the effects of obesity and diabetes
Sep 2013 DOI 10.14302/issn.2374-9431.jbd-13-218
The increased association between depression and diabetes mellitus is generally acknowledged. Recent studies suggest that depression leads to diabetes.However, the underlying molecular mechanisms for this association remain unclear.Literature and our data indicate that inflammatory and/or stress factors in depression up-regulate tryptophan (TRP) conversion into kynurenine (KYN), a substrate for nicotinamide adenine dinucleotide (NAD) biosynthesis. Deficiency of vitamin B6, a co-factor of the key enzymes of KYN – NAD pathway, shunts KYN metabolism from formation of NAD towards production of xanthurenic (XA) and kynurenic (KYNA) acids. Human and experimental studies reveal that XA, KYNA and their metabolites interfere with production, release and biological activity of insulin. We propose that inflammation- and/or stress-induced up-regulation of TRP – KYN metabolism in combination with vitamin B6 deficiency is one of the mechanisms mediating increased risk of diabetes in depression. Consequently, monitoring formation of diabetogenic KYN derivatives might help to identify subjects-at-risk for the development of diabetes. Pharmacological down-regulation of the TRP – KYN – NAD pathway and maintenance of adequate vitamin B6 status might help to prevent the development of diabetes in depression and other conditions associated with inflammation/stress–induced excessive production of KYN and vitamin B6 deficiency, e.g., obesity, cardiovascular diseases, aging, menopause, pregnancy, and hepatitis C virus infection.