170 research outputs found

    Prevalence, Trends and Associated Socio-Economic Factors of Obesity in South Asia

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    Aim: Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. Methods: A review of articles using Medline with combinations of the MeSH terms: 'Obesity', ‘Overweight’ and ‘Abdominal Obesity’ limiting to epidemiology and South Asian countries. Results: Despite methodological heterogeneity and variation according to country, area of residence and gender, the most recent nationally representative and large regional data demonstrates that without any doubt there is an epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ≥ 23 kg/m[superscript]2, obesity ≥ 25 kg/m[superscript]2) ranged from 3.5% in rural Bangladesh to over 65% in the Maldives. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. Conclusion: South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions

    Study protocol: a randomised controlled trial of supervised resistance training versus aerobic training in Sri Lankan adults with type 2 diabetes mellitus: SL-DART study

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    Background: The prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) is rising globally. T2DM is particularly problematic in South Asia with an estimated 10–15% of Sri Lankans diagnosed with the disease. Exercise is known to improve blood glucose, lipid profiles, blood pressure and adiposity, key goals in the management of T2DM. However, much of the evidence to date has been gained from white Caucasians who have a different body composition and disease profile compared to South Asians. Similarly, the recreational exercise culture is new to Sri Lankans and the effects of exercise on T2DM has not been studied in this population. Methods: The Sri Lanka Diabetes Aerobic and Resistance Training (SL-DART) Study will be comprised of 2 components. Component 1 is a 12-week randomized controlled trial (RCT) to compare the effects of a supervised progressive resistance exercise program (RT) and aerobic exercise program (AT) with standard treatment/control (CN). Sedentary Sri Lankan adults with T2DM (aged 35–65 years) and with no contraindications to exercise will be randomized into one of 3 groups (AT, RT, CN). Exercise sessions will be conducted 2 days/week for 3 months. Baseline and post-intervention biochemical (glycemic control, lipid and liver profiles, inflammatory markers), anthropometric (height, weight, body circumferences), body composition, physical fitness, food preference (liking and wanting food) and quality of life parameters will be measured and compared between groups. Component 2 will be a qualitative study conducted immediately post-intervention via in-depth interviews to assess the barriers and facilitators for adherence to each exercise program. Discussion: SL-DART Study represents one of the first adequately powered methodologically sound RCTs conducted in South Asia to assess the effects of resistance and aerobic exercise in participants with T2DM. Triangulation of quantitative and qualitative outcomes will enable the design of a culturally appropriate therapeutic physical activity intervention for Sri Lankans with T2DM, and the initiation of a professionally driven and specialized clinical exercise prescription service

    Energy and nutrient intakes among Sri Lankan adults

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    Introduction: The epidemic of nutrition related non-communicable diseases such as type 2 diabetes mellitus and obesity has reached to epidemic portion in the Sri Lanka. However, to date, detailed data on food consumption in the Sri Lankan population is limited. The aim of this study is to identify energy and major nutrient intake among Sri Lankan adults. Methods: A nationally-representative sample of adults was selected using a multi-stage random cluster sampling technique. Results: Data from 463 participants (166 Males, 297 Females) were analyzed. Total energy intake was significantly higher in males (1913 ± 567 kcal/d) than females (1514 ± 458 kcal/d). However, there was no significant gender differences in the percentage of energy from carbohydrate (Male: 72.8 ± 6.4%, Female: 73.9 ± 6.7%), fat (Male: 19.9 ± 6.1%, Female: 18.5 ± 5.7%) and proteins (Male: 10.6 ± 2.1%, Female: 10.9 ± 5.6%). Conclusion: The present study provides the first national estimates of energy and nutrient intake of the Sri Lankan adult population

    High dietary diversity is associated with obesity in Sri Lankan adults: An evaluation of three dietary scores.

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    Background: Dietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults. Methods: Six hundred adults aged > 18 years were randomly selected by using multi-stage stratified sample. Dietary intake assessment was undertaken by a 24 hour dietary recall. Three dietary scores, Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) were calculated. Body mass index (BMI) ≥ 25 kg.m−2 is defined as obese and Asian waist circumference cut-offs were used diagnosed abdominal obesity. Results: Mean of DDS for men and women were 6.23 and 6.50 (p=0.06), while DDSP was 3.26 and 3.17 respectively (p=0.24). FVS values were significantly different between men and women 9.55 and 10.24 (p=0.002). Dietary diversity among Sri Lankan adults was significantly associated with gender, residency, ethnicity, education level but not with diabetes status. As dietary scores increased, the percentage consumption was increased in most of food groups except starches. Obese and abdominal obese adults had the highest DDS compared to non-obese groups (p<0.05). With increased dietary diversity the level of BMI, waist circumference and energy consumption was significantly increased in this population. Conclusion: Our data suggests that dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Although high dietary diversity is widely recommended, public health messages should emphasize to improve dietary diversity in selective food items

    Validity of a food frequency questionnaire to assess nutritional intake among Sri Lankan adults

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    Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no validated food frequency questionnaire (FFQ) exists to measure habitual dietary intake of Sri Lankan adults. The purpose of the study is to assess the validity of a semi-quantitative FFQ and 7-day weighed-intake dietary records (7DWR), designed to assess dietary intake among Sri Lankan adults. Dietary intake was measured using both a FFQ and 7DWR. The FFQ consisted of 8 food groups containing the main foods comprising the diet of Sri Lankan adults, a total of 85 items and 12 color photographs to identify serving size. One hundred healthy adults were randomly recruited from a community sample and administrated the FFQ followed by completion of the 7DWR. Paired sample t tests, Pearson’s correlation coefficients, kappa test and Bland–Altman analysis were conducted to determine correlation and the level of agreement for energy and micronutrients. Seventy-seven participants completed both the FFQ and 7DWR. Estimated mean energy intake (SD) from FFQ (1794 ± 398 kcal) and 7DWR (1698 ± 333 kcal, p < 0.001) were significantly different due to a significant overestimation of carbohydrate (11.5 g/day, p < 0.001) and to some extent fat (5.7 g/day, ns). Significant positive correlations (p < 0.05) were found between the FFQ and 7DWR for energy (r = 0.39), carbohydrate (r = 0.47), protein (r = 0.26), fat (r = 0.17) and dietary fiber (r = 0.32). Bland–Altman graphs indicated fairly good agreement between methods with no relationship between bias and average intake of each nutrient examined. Based on these findings, the FFQ appears to be an acceptable tool for assessing the nutrient intake of Sri Lankans and will assist proper categorization of individuals by dietary intake

    Food consumption of Sri Lankan adults: an appraisal of serving characteristics

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    Objective: The main aim of the present study was to identify food consumption in Sri Lankan adults based on serving characteristics. Design: Cross-sectional study. Fruits, vegetables, starch, meat, pulses, dairy products and added sugars in the diet were assessed with portion sizes estimated using standard methods. Setting: Twelve randomly selected clusters from the Sri Lanka Diabetes and Cardiovascular Study. Subjects: Six hundred non-institutionalized adults. Results: The daily intake of fruit (0.43), vegetable (1.73) and dairy (0.39) portions were well below national recommendations. Only 3.5 % of adults consumed the recommended 5 portions of fruits and vegetables/d; over a third of the population consumed no dairy products and fewer than 1 % of adults consumed 2 portions/d. In contrast, Sri Lankan adults consumed over 14 portions of starch and 3.5 portions of added sugars daily. Almost 70 % of those studied exceeded the upper limit of the recommendations for starch intake. The total daily number of meat and pulse portions was 2.78. Conclusions: Dietary guidelines emphasize the importance of a balanced and varied diet; however, a substantial proportion of the Sri Lankan population studied failed to achieve such a recommendation. Nutrition-related diseases in the country may be closely correlated with unhealthy eating habits
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