Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol�which is a marker of cardiovascular risk�changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95 credible interval 3.7 million�4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. © 2020, The Author(s), under exclusive licence to Springer Nature Limited

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Relevance of Ground-based Electron-Induced Electrostatic Discharge Measurements to Space Plasma Environments

Electron-induced electrostatic discharge (ESD) can lead to severe spacecraft anomalies. It is crucial to the success of space missions that the likelihood of ESD occurrence is understood and mitigated. To aid in predicting ESD occurrence, a model for electric fields above and below the charge layer inside an electronirradiated dielectric material was developed. An instrumentation system was also designed to induce and detect ESD events. Because ESD events with a wide range of maximum current values can occur over a range of time intervals, multiple simultaneous detection methods were employed as charge was accumulated on a sample surface; these included monitoring of sample current and optical emissions from the sample surface. Data from ESD experimentation for James Webb Space Telescope (JWST) materials was used to verify that the instrumentation system was effective in inducing and observing ESD. Two types of discharge events were observed during JWST testing: a sudden-onset, decaying current accompanied by luminescence in the optical data, and an arc or flash in optical data. JWST test results were applied to the electric field models developed to determine the threshold electric field for luminescence onset. The models were also applied to the JWST materials in five different space plasma environments to determine the accumulated electric field as a function of time, and to thereby predict the likelihood of sample luminescence in each location

MON-P095: The Effect of Fish Oil-Supplemented Gemcitabine Treatment on Leukotriene B4 Levels in Pancreatic Cancer

Pancreatic cancer (PC) is an aggressive cancer and is the 5th leading cause of cancer death in Western Europe and unfavourable prognosis is attributed to advanced disease at diagnosis and lack of effective therapy. The tumour microenvironment is an inflammatory one, and immune-mediators, such as Leukotriene B4 (LTB4), might contribute to the growth and spread of PC. The aim of this study is to determine the potential anti-inflammatory effects of omega-3 fatty acids in patients being treated for PC. Blood samples were taken from PC patients undergoing Gemcitabine treatment (n=8, CON) and from patients undergoing Gemcitabine treatment supplemented (n=17, O-3) with omega-3 fatty acids (Lipidem, BBraun, Germany), for up to a maximum of 6 months where possible. Plasma was isolated from blood and stored at -80⁰C until analysis for baseline LTB4 levels (baseline). A further aliquot of blood was incubated with 1mg/ml Zymosan for 30 min at RT then 30 min at 37⁰C, samples were centrifuged and plasma was collected and stored until analysis (stimulated). All samples were analysed using human LTB4 commercial ELISA kits according to the manufacturers’ instructions (Invitrogen, USA and R&D Systems, UK). There was an overall reduction in plasma LTB4 levels in O-3 patients (CON 3.5±0.3 (mean±SEM) ng/ml vs O-3 2.8±0.1 ng/ml, p=0.02). The stimulated levels of LTB4 in O-3 patients was also significantly reduced (p<0.05). There were no differences in baseline of CON or O-3 patients or stimulated CON patient LTB4 levels of low or high Progression Free Survival (PFS) patients. However, there was a significant reduction in LTB4 levels of stimulated high PFS O-3 patients (O-3 low PFS 4.5±0.3 ng/ml vs O-3 high PFS 3.6±1.1 ng/ml, p=0.01) and in patients at later TNM stage (O-3 stage 3 4.8±0.2 ng/ml vs stage 4 2.9±0.2 ng/ml, p<0.0001). Our results show that although the baseline inflammatory profile of PC patients is unaffected by omega-3 supplementation, the stimulated leukocyte response is reduced and is associated with increased patient PFS and later disease stage. These data indicate that omega-3 supplementation affects an anti-inflammatory profile in these patients, being more effective at later disease stages and may improve survival. Further work is required to assess the effects of omega-3 on the inflammatory profiles in PC