Prevalence and sociodemographic correlates of stunting, underweight, and overweight among Palestinian school adolescents (13-15 years) in two major governorates in the West Bank

<p>Abstract</p> <p>Background</p> <p>There is little information about height and weight status of Palestinian adolescents. The objective of this paper was to assess the prevalence of stunting, underweight, and overweight/obesity among Palestinian school adolescents (13-15 years) and associated sociodemographic factors in 2 major governorates in the West Bank.</p> <p>Methods</p> <p>A Cross-sectional survey was conducted in 2005 comprising 1942 students in 65 schools in Ramallah and Hebron governorates. Data was collected through self-administered questionnaires from students and parents. Weights and heights were measured. Overweight and obesity were assessed using the 2000 Centers for Disease Control and Prevention (CDC) reference and the International Obesity Task Force (IOTF) criteria. Stunting and underweight were assessed using the 2000 CDC reference.</p> <p>Results</p> <p>Overweight/obesity was more prevalent in Ramallah than in Hebron and affected more girls than boys. Using the 2000 CDC reference, the prevalence of overweight and obesity in Ramallah among boys was 9.6% and 8.2%, respectively versus 15.6% and 6.0% among girls (P < 0.01). In Hebron, the corresponding figures were 8.5% and 4.9% for boys and 13.5% and 3.4% for girls (P < 0.01). Using the IOTF criteria, the prevalence of overweight and obesity among boys in Ramallah was 13.3% and 5.2%, respectively versus 18.9% and 3.3% for girls. The prevalence of overweight and obesity among boys in Hebron was 10.9% and 2.2%, respectively versus 14.9% and 2.0% for girls. Overweight/obesity was associated with high standard of living (STL) among boys and with the onset of puberty among girls. More boys were underweight than girls, and the prevalence was higher in Hebron (12.9% and 6.0% in boys and girls, respectively (P < 0.01)) than in Ramallah (9.7% and 3.1% in boys and girls, respectively (p < 0.01)). The prevalence of stunting was similar in both governorates, and was higher among boys (9.2% and 9.4% in Ramallah and Hebron, respectively) than among girls (5.9% and 4.2% in Ramallah and Hebron, respectively). Stunting was negatively associated with father's education among boys and with urban residence, medium STL and onset of puberty among girls.</p> <p>Conclusion</p> <p>Under- and overnutrition co-exist among Palestinian adolescents, with differences between sexes. Region, residence, STL, and onset of puberty were associated factors.</p

Lifestyle physical activity among urban Palestinians and Israelis: a cross-sectional comparison in the Palestinian-Israeli Jerusalem risk factor study

<p>Abstract</p> <p>Background</p> <p>Urban Palestinians have a high incidence of coronary heart disease, and alarming prevalences of obesity (particularly among women) and diabetes. An active lifestyle can help prevent these conditions. Little is known about the physical activity (PA) behavior of Palestinians. This study aimed to determine the prevalence of insufficient PA and its socio-demographic correlates among urban Palestinians in comparison with Israelis.</p> <p>Methods</p> <p>An age-sex stratified random sample of Palestinians and Israelis aged 25-74 years living in east and west Jerusalem was drawn from the Israel National Population Registry: 970 Palestinians and 712 Israelis participated. PA in a typical week was assessed by the Multi-Ethnic Study of Atherosclerosis (MESA) questionnaire. Energy expenditure (EE), calculated in metabolic equivalents (METs), was compared between groups for moderate to vigorous-intensity physical activity (MVPA), using the Wilcoxon rank-sum test, and for domain-specific prevalence rates of meeting public health guidelines and all-domain insufficient PA. Correlates of insufficient PA were assessed by multivariable logistic modeling.</p> <p>Results</p> <p>Palestinian men had the highest median of MVPA (4740 METs-min_*wk^-1) compared to Israeli men (2,205 METs-min_*wk^-1<it>p </it>< 0.0001), or to Palestinian and Israeli women, who had similar medians (2776 METs-min_*wk^-1). Two thirds (65%) of the total MVPA reported by Palestinian women were derived from domestic chores compared to 36% in Israeli women and 25% among Palestinian and Israeli men. A high proportion (63%) of Palestinian men met the PA recommendations by occupation/domestic activity, compared to 39% of Palestinian women and 37% of the Israelis. No leisure time PA was reported by 42% and 39% of Palestinian and Israeli men (<it>p </it>= 0.337) and 53% and 28% of Palestinian and Israeli women (<it>p </it>< 0.0001). Palestinian women reported the lowest level of walking. Considering all domains, 26% of Palestinian women were classified as insufficiently active versus 13% of Palestinian men (<it>p </it>< 0.0001) who did not differ from the Israeli sample (14%). Middle-aged and elderly and less educated Palestinian women, and unemployed and pensioned Palestinian men were at particularly high risk of inactivity. Socio-economic indicators only partially explained the ethnic disparity.</p> <p>Conclusions</p> <p>Substantial proportions of Palestinian women, and subgroups of Palestinian men, are insufficiently active. Culturally appropriate intervention strategies are warranted, particularly for this vulnerable population.</p

Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study

BACKGROUND: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. METHODS: We studied a sample of 197 diabetic patients who were recruited from three refugee camps in the Gaza strip and 197 age- and sex-matched controls living in the same camps. To assess HRQOL, we used the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) including four domains (physical health, psychological, social relations and environment). Domain scores were compared for cases (diabetic patients) and controls (persons without diabetes) and the impact of socio-economic factors was evaluated in both groups. RESULTS: All domains were strongly reduced in diabetic patients as compared to controls, with stronger effects in physical health (36.7 vs. 75.9 points of the 0–100 score) and psychological domains (34.8 vs. 70.0) and weaker effects in social relationships (52.4 vs. 71.4) and environment domains (23.4 vs. 36.2). The impact of diabetes on HRQOL was especially severe among females and older subjects (above 50 years). Low socioeconomic status had a strong negative impact on HRQOL in the younger age group (<50 years). CONCLUSION: HRQOL is strongly reduced in diabetic patients living in refugee camps in the Gaza strip. Women and older patients are especially affected

Metabolic syndrome in a Taiwanese metropolitan adult population

<p>Abstract</p> <p>Background</p> <p>Metabolic syndrome (MS) is a combination of medical disorders that increase one's risk for cardiovascular disease and diabetes. Little information exists on the prevalence of MS in a general adult population in Taiwan.</p> <p>Methods</p> <p>We did a cross-sectional survey in a representative sample of 2,359 Chinese adults aged 40 years and over who lived in a metropolitan city, Taiwan in 2004–05. MS was defined by Adult Treatment Panel III criteria modified for Asians.</p> <p>Results</p> <p>The prevalence of MetS was 35.32% and 43.23% in men aged 40–64 years and 65 years and over, respectively, and 24.19% and 51.82% in women aged 40–64 years and 65 years and over. Older age, postmenopausal status, higher body mass index, current smoking, low education attainment, low household income, no alcohol consumption, lower level of occupation physical activity, and a family history of diabetes were associated with increased odds of MetS.</p> <p>Conclusion</p> <p>MetS was present in more than 30% of the Taiwan adult population aged 40 years and over in a metropolitan area; there were substantial variations by age and body mass index groups.</p

Trends of obesity and abdominal obesity in Tehranian adults: a cohort study

<p>Abstract</p> <p>Background</p> <p>Considering the increasing trend of obesity reported in current data, this study was conducted to examine trends of obesity and abdominal obesity among Tehranian adults during a median follow-up of 6.6 years.</p> <p>Methods</p> <p>Height and weight of 4402 adults, aged 20 years and over, participants of the Tehran Lipid and Glucose Study (TLGS), were measured in 1999-2001(phase I) and again in 2002-2005(phase II) and 2006-2008 (phase III). Criteria used for obesity and abdominal obesity defined body mass index (BMI) ≥ 30 and waist circumference ≥ 94/80 cm for men/women respectively. Subjects were divided into10-year groups and the prevalence of obesity was compared across sex and age groups.</p> <p>Results</p> <p>The prevalence of obesity was 15.8, 18.6 and 21% in men and 31.5, 37.7 and 38.6% in women in phases I, II and III respectively (p < 0.001). The prevalence of abdominal obesity in men was 36.5, 57.2 and 63.3% and in women was 76.7, 83.8 and 83.6% in the three periods mentioned (p < 0.001). Men aged between 20-29 years had highest increase rates of obesity and abdominal obesity in phase III in comparison with phase I (with a respective rates of 2.2- and 3.3-fold). In both sexes, an increased trend was observed between phases I and II, whereas between phases II and III, this trend was observed in men, but not in women.</p> <p>Conclusion</p> <p>This study demonstrates alarming rises in the prevalences of both obesity and abdominal obesity in both sexes especially in young men, calling for urgent action to educate people in lifestyle modifications.</p

Pharmaceutical cost and multimorbidity with type 2 diabetes mellitus using electronic health record data

© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.[EN] Background: The objective of the study is to estimate the frequency of multimorbidity in type 2 diabetes patients classified by health statuses in a European region and to determine the impact on pharmaceutical expenditure. Methods: Cross-sectional study of the inhabitants of a southeastern European region with a population of 5,150,054, using data extracted from Electronic Health Records for 2012. 491,854 diabetic individuals were identified and selected through clinical codes, Clinical Risk Groups and diabetes treatment and/or blood glucose reagent strips. Patients with type 1 diabetes and gestational diabetes were excluded. All measurements were obtained at individual level. The prevalence of common chronic diseases and co-occurrence of diseases was established using factorial analysis. Results: The estimated prevalence of diabetes was 9.6 %, with nearly 70 % of diabetic patients suffering from more than two comorbidities. The most frequent of these was hypertension, which for the groups of patients in Clinical Risk Groups (CRG) 6 and 7 was 84.3 % and 97.1 % respectively. Regarding age, elderly patients have more probability of suffering complications than younger people. Moreover, women suffer complications more frequently than men, except for retinopathy, which is more common in males. The highest use of insulins, oral antidiabetics (OAD) and combinations was found in diabetic patients who also suffered cardiovascular disease and neoplasms. The average cost for insulin was 153€ and that of OADs 306€. Regarding total pharmaceutical cost, the greatest consumers were patients with comorbidities of respiratory illness and neoplasms, with respective average costs of 2,034.2€ and 1,886.9€. Conclusions: Diabetes is characterized by the co-occurrence of other diseases, which has implications for disease management and leads to a considerable increase in consumption of medicines for this pathology and, as such, pharmaceutical expenditure.This study was financed by a grant from the Fondo de Investigaciones de la Seguridad Social Instituto de Salud Carlos III, the Spanish Ministry of Health (FIS PI12/0037).Sancho Mestre, C.; Vivas Consuelo, DJJ.; Alvis, L.; Romero, M.; Usó Talamantes, R.; Caballer Tarazona, V. (2016). Pharmaceutical cost and multimorbidity with type 2 diabetes mellitus using electronic health record data. BMC Health Services Research. 16(394):1-8. https://doi.org/10.1186/s12913-016-1649-2S1816394Whiting DR, Guariguata L, Weil C, Shaw J. 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Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified