Opportunistic Screening for CVD Risk Factors The Dubai Shopping for Cardiovascular Risk Study (DISCOVERY)

BackgroundComprehensive cardiovascular disease risk factor (CVDRF) screening programs are limited in the developing world. Simplifying screening can increase its utility.ObjectivesThe present study aims to estimate the burden of CVDRF in volunteers and the yield of newly discovered CVDRF comparing different sites and nationalities using this screening method.MethodsVoluntary point-of-care CVDRF screening was conducted in 4 shopping malls, 9 health care facilities, and 3 labor camps in 5 cities in the United Arab Emirates. Follow-up for newly diagnosed diabetes mellitus, hypertension, and dyslipidemia was made 1 month after screening to inquire about physician consultation, confirmation of diagnosis, and lifestyle changes.ResultsA total of 4,128 subjects were screened (43% at malls, 36% at health care facilities, and 22% at labor camps). Subjects were relatively young (38 ± 11 years), predominantly male (75%), and of diverse nationalities (United Arab Emirates: 7%, other Arabs: 10%, South Asians: 74%, other Asians: 5%, and other nationalities: 5%). CVDRF were frequent (diabetes mellitus: 32%, hypertension: 31%, dyslipidemia: 69%, current smokers: 21%, obesity: 20%, and central obesity: 24%). Most subjects (85%) had ≥1 CVDRF, and many (17%) had ≥3 CVDRF. A new diagnosis of diabetes mellitus, hypertension, or dyslipidemia was uncovered in 61.5%, with the highest yield (74.0%) in labor camps. At follow-up of those with new CVDRF, positive lifestyle changes were reported in 60%, but only 33% had consulted a doctor; of these, diagnosis was confirmed in 63% for diabetes mellitus, 93% for hypertension, and 87% for dyslipidemia.ConclusionsIn this relatively young and ethnically diverse cohort, CVDRF burden and yield of screening was high. Screening in these settings is pertinent and can be simplified

Analysis of common methodological flaws in the highest cited e-cigarette epidemiology research

The prevalence of vaping, also known as using e-cigarettes, vapes and vape pens, has prompted a demand for reliable, evidence-based research. However, published literature on the topic of vaping often raises concerns, characterized by serious flaws and a failure to adhere to accepted scientific methodologies. In this narrative review, we analyze popular vaping studies published in medical journals that purport to evaluate the association of vaping and smoking cessation, smoking initiation or health outcomes. We analyzed 24 included studies to identify the questions they claimed to address, stated methods, manner of implementation, discussions, and stated conclusions. After critical appraisal, we noted a multiplicity of flaws in these studies, and identified patterns as to the nature of such flaws. Many studies lacked a clear hypothesis statement: to the extent that a hypothesis could be inferred, the methods were not tailored to address the question of interest. Moreover, main outcome measures were poorly identified, and data analysis was further complicated by failure to control for confounding factors. The body of literature on “gateway” theory for the initiation of smoking was particularly unreliable. Overall, the results and discussion contained numerous unreliable assertions due to poor methods, including data collection that lacked relevance, and assertions that were unfounded. Many researchers claimed to find a causal association while not supporting such findings with meaningful data: the discussions and conclusions of such studies were, therefore, misleading. Herein, we identify the common flaws in the study design, methodology, and implementation found in published vaping studies. We present our summary recommendations for future vaping research. Our aim is to prompt future researchers to adhere to scientific methods to produce more reliable findings and conclusions in the field of vaping research

The Future of Food to Tackle Climate and Health – Reflections from COP26

A shift in how we obtain protein from our diets, away from intensive farming and fishing, towards cleaner sources, be they animal or plant-based, will form an essential part of the solution to achieving the pledges formalised following COP26. This can be achieved through many different approaches including reduction, substitution, reducing the frequency of consumption, blending into hybrid products, and without the necessity of a complete eschewal of animal-based products. The new paradigm of ‘planetary health’, which focuses on the interdependence of human health, animal health and environmental health, will greatly facilitate meeting the ambitious and near-term targets set. This commentary discusses these issues in depth, with a focus on solutions to promote both planetary and human health in unison

How will the COVID-19 pandemic shape the future of meat consumption?

AbstractSince its recent onset, the COVID-19 pandemic has altered the daily lives of millions around the world. One area particularly affected is our diets, with food supply chain disruptions, media coverage of food safety issues and restaurant closures all influencing consumer dietary behaviour. Given this situation, we pose a timely question – what is the impact of the current pandemic on longer-term meat consumption patterns? This issue is pertinent given accumulating evidence that overconsumption of meat, particularly red meat, is associated with negative environmental and health outcomes. Here, we discuss how the current pandemic has already begun to shift public awareness of illnesses linked to animals and has resulted in short-term changes in patterns of meat consumption. Past zoonotic outbreaks, such as SARS and swine flu, are also referred to, and we find that these led to similar short-term reductions in meat intake, a shift in the type of meat chosen and longer-lasting impacts on consumer perceptions of the health risks associated with meat. We conclude that, if immediate changes in eating patterns as a result of COVID-19 are retained in the longer term, one possible opportunity to emerge from the current pandemic may be a shift away from overconsumption of meat, leading to potential health and environmental benefits in the longer term.</jats:p

Communication of Risk in Covid-19: An Urgent Need for Clarity

The Covid-19 pandemic has resulted in an unprecedented spotlight on health risks. This article discusses how such risks have been communicated to the public, arguing the approaches used may have inflated perceptions of risk amongst younger and disease-free individuals. This has led to undue anxiety and had a deleterious effect on other health behaviours, including sleep and exercise. We advise that more conventional public health messaging approaches would have been useful - deploying clear, non-jargon language, keeping advice consistent and presenting a combination of absolute health risks and comparisons with other everyday risks. This may have facilitated more accurate understanding of risk levels in different population segments. The evidence-base on effective ways to communicate to encourage health-seeking behaviour change – such as emphasizing the benefits of compliance to recommendations rather than the risks of non-compliance and highlighting the social impacts of Covid-19 preventative measures – must be more effectively leveraged in future to support risk mitigation efforts and implementation of vaccines during their forthcoming rollout.</p