Gender-Related Differences in the Prevalence of Cardiovascular Disease Risk Factors and their Correlates in Urban Tanzania.

\ud Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. However in East Africa, there is limited literature in this research area. The objective of this study was to examine the prevalence of cardiovascular disease risk factors and their correlates among adults in Temeke, Dar es Salaam, Tanzania. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases. The study design was a cross sectional epidemiological study. A total of 209 participants aged between 44 and 66 years were included in the study. A structured questionnaire was used to evaluate socioeconomic and lifestyle characteristics. Blood samples were collected and analyzed to measure lipid profile and fasting glucose levels. Cardiovascular risk factors were defined using World Health Organization criteria. The age-adjusted prevalence of obesity (BMI > or = 30) was 13% and 35%, among men and women (p = 0.0003), respectively. The prevalence of abdominal obesity was 11% and 58% (p < 0.0001), and high WHR (men: >0.9, women: >0.85) was 51% and 73% (p = 0.002) for men and women respectively. Women had 4.3 times greater odds of obesity (95% CI: 1.9-10.1), 14.2-fold increased odds for abdominal adiposity (95% CI: 5.8-34.6), and 2.8 times greater odds of high waist-hip-ratio (95% CI: 1.4-5.7), compared to men. Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001) compared to male counterparts, including abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components. In contrast, female participants had 50% lower odds of having hypertension, compared to men (95%CI: 0.3-1.0). Among men, BMI and waist circumference were significantly correlated with blood pressure, triglycerides, total, LDL-, and HDL-cholesterol (BMI only), and fasting glucose; in contrast, only blood pressure was positively associated with BMI and waist circumference in women. The prevalence of CVD risk factors was high in this population, particularly among women. Health promotion, primary prevention, and health screening strategies are needed to reduce the burden of cardiovascular disease in Tanzania.\u

Nutritional management of children with cerebral palsy: a practical guide

Peer reviewedFinal Published versio

Validity of Stature-predicted Equations using Knee Height for Elderly and Mobility Impaired Persons in Koreans

OBJECTIVES: This study aimed to establish a stature-predicted equation using knee height, and perform a clinical validation on a Korean population. METHODS: Using nationwide data obtained from 'Size Korea 2004', a stature-predicted equation was drawn and cross validation was performed using knee height in 5,063 subjects (2,532 males, 1,785 premenopausal females, and 746 postmenopausal females) who were aged between 20 and 69 yr. The formula was then applied to an elderly group (7 males and 26 females) and a mobility-impaired group (25 males and 14 females) in a real clinical setting. A stature-predicted equation was estimated using knee height and age based on multiple linear regression analysis. Cross validation was performed using paired t-test, and validation using clinical data was performed using Wilcoxon signed rank test. RESULTS: In three groups (males, premenopausal females, and postmenopausal females), a cross validation was performed for a stature-predicted equation which was drawn using knee height and age. There were no significant differences between recorded height and estimated height in the elderly group (mean difference±interquartile range (IQR): male 0.65±4.65 cm, female -0.10±3.65 cm) and the mobility-impaired group (mean difference±IQR: male -0.23±5.45 cm, female 1.64±5.36 cm). CONCLUSION: If several limitations could be overcome, the Korean-specific equations using knee height drawn from this study could be applied to actual clinical settings with Korean elderly or mobility-impaired people.ope

Fat and bone in children - where are we now?

The risk of fracture secondary to low-impact trauma is greater in obese children, suggesting obese children are at risk of skeletal fragility. However, despite this finding, there is a lack of agreement about the impact of excessive adiposity on skeletal development. The combination of poor diet, sedentary lifestyle, greater force generated on impact through falls, and greater propensity to falls may in part explain the increased risk of fracture in obese children. To date, evidence suggests that in early childhood years, obesity confers a structural advantage to the developing skeleton. However, in time, this relationship attenuates and then reverses, such that there is a critical period during skeletal development when obesity has a detrimental effect on skeletal structure and strength. Fat mass may be important to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Evidence from studies examining bone microstructure suggests skeletal adaption to excessive load fails, and bone strength is relatively diminished in relation to body size in obese children. Mechanisms that may explain these changes include changes in the hormonal environment, particularly in relation to alterations in adipokines and fat distribution. Given the concomitant rise in the prevalence of childhood obesity and fractures, as well as adult osteoporosis, further work is required to understand the relationship between obesity and skeletal development

Body composition and morphological assessment of nutritional status in adults : a review of anthropometric variables

This document is the Accepted Manuscript version of the following article: A. M. Madden, and S. Smith, ‘Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables’, Journal of Human Nutrition and Dietetics, vol. 29 (1): 7-25, February 2016, DOI: https://doi.org/10.1111/jhn.12278 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Evaluation of body composition is an important part of assessing nutritional status and provides prognostically useful data and opportunity to monitor the effects of nutrition-related disease progression and nutritional intervention. The aim of this narrative review is to critically evaluate body composition methodology in adults, focusing on anthropometric variables. The variables considered include height, weight, body mass index and alternative indices, trunk measurements (waist and hip circumferences and sagittal abdominal diameter) and limb measurements (mid-upper arm and calf circumferences) and skinfold thickness. The importance of adhering to a defined measurement protocol, checking measurement error and the need to interpret measurements using appropriate population-specific cut-off values to identify health risks were identified. Selecting the optimum method of assessing body composition using anthropometry depends on the purpose, i.e. evaluating obesity or undernutrition, and requires practitioners to have a good understanding of both practical and theoretical limitations and to wisely interpret the results.Peer reviewe

Assessing the Body Composition of 6-17 Year-old Black and White Girls in Field Studies

The purpose of the study was to develop ethnic-specific equations for fat-free mass (FFM) from selected anthropometric dimensions and bioelectrical impedance measures of resistance (R) and reactance (Xc) for use in the NHLBI Growth and Heath Study. Using dual-energy X-ray absorptiometry measures of body composition as the dependent variable and field measures of body composition by anthropometry and bioelectrical impedance as the explanatory variables, ethnic-specific prediction equations were developed on a sample of girls representing a wide range of ages and BMI. The equations were cross-validated using (1) the Prediction of Sum of Squares (PRESS) statistic and (2) an independent sample of 20 girls of each race from a study conducted at the National Institute of Child Health and Human Development (NICHD). Subjects were 65 White and 61 Black girls 6-17 years of age. The best race-specific equations for FFM each explained 99% and 97% of the variance in the White and Black girls, respectively. Root mean square errors (RMSE) ranged from 1.14 to 1.95 kg. The equation for Black girls used Stature2/Resistance (R), weight, and reactance (Xc) as predictor variables; the equation for White girls used Stature2/R, weight, and triceps skinfold thickness. The results indicate that (1) equations to predict FFM in girls should be ethnic-specific and that (2) accurate values for TBF and %BF can be calculated from the predicted FFM

Population-specific Mini Nutritional Assessment can improve mortality-risk-predicting ability in institutionalised older Taiwanese

The study determined whether a new version of the Mini Nutritional Assessment that adopted population-specific anthropometric cut-points would improve the mortality-predicting ability in institutionalised Taiwanese older people.Routine screening is the key for detecting emerging malnutrition, but the tool must be simple, reliable and easy-to-use to be well accepted. The Mini Nutritional Assessment can meet these requirements, but for non-Western populations, modifications based on anthropometric considerations are needed.The study purposively sampled 208 residents, aged >65 years, of a long-term care institution in Central Taiwan. Subjects were free of acute infection/disease and able to communicate. A university human-subject-study ethics committee approved the protocol.The study included biochemical measurements and a structured questionnaire for eliciting personal data and answers to questions in the Mini Nutritional Assessment. Follow-up survival/mortality was tracked for two consecutive six-month periods and analysed according to nutritional statuses graded with the original or a modified Mini Nutritional Assessment. The modified version adopted population-specific anthropometric cut-points and was without body mass index.The modification improved the mortality-predictive ability. Mortality rates for the first six months were 8·7, 3·9 and 0% according to the original Mini Nutritional Assessment and 10·6, 3·4 and 0% according to the modified version for subjects rated malnourished, at risk of malnutrition and normal, respectively. The mortality-predictive ability of both versions weakened after six months.Both versions can predict follow-up mortality, but the modified version has improved ability. For best results, the tool should be applied every six months or less (shorter for more frail older people) to screen for new cases of at-risk individuals.The Mini Nutritional Assessment that adopts population-specific anthropometric cut-points may have improved nutritional-risk and mortality-risk predictive abilities. The tool can help care-workers detect emerging nutritional problems and enable timely intervention. Routine use of the tool may help improve the quality of care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79325/1/j.1365-2702.2010.03299.x.pd