Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Mikrodalga-yardımlı fırınlarda fındığın kavrulma koşullarının optimizasyonu.

The main objective of this study was to optimize the roasting conditions of hazelnuts in microwave-infrared and microwave-convective heating combination ovens by using response surface methodology. It was also aimed to construct regression models for the prediction of quality parameters of hazelnuts as a function of processing conditions. The independent variables were microwave power (10, 30, 50, 70 and 90%), upper-lower infrared power (10, 30, 50, 70 and 90%) and roasting time (2, 3, 4, 5 and 6 min) for microwave-infrared combination roasting. Microwave power (70, 140 and 210W), air temperature (90, 150 and 210°C) and roasting time (5, 15 and 25 min) were the independent variables of microwave-convective heating combination oven. As control, hazelnuts roasted in conventional oven at 150°C for 20 min were used. The quality parameters were L* value, a* value, fracture force and moisture content of the hazelnuts for both microwave assisted ovens. The optimum roasting conditions of microwave-infrared combination oven were determined as 2.5 min of roasting time at 613.8W microwave power, 1800W upper infrared power, and 300W lower infrared power. Hazelnuts roasted at the optimum condition had comparable quality with the conventionally roasted ones. When micro- wave infrared combination oven was used, conventional roasting time of hazelnuts was reduced by 87.5%. Optimum roasting conditions of microwave-convective heating combination oven were 140 W microwave power, 150°C air temperature and 20 min roasting time. High regression coefficients were calculated between the experimental data and predicted values showing that RSM is capable in predicting quality parameters of hazelnuts during microwave assisted roasting.M.S. - Master of Scienc

Optimization of microwave- infrared roasting of hazelnut

In this study, the possibility of using microwave-infrared combination oven for roasting of hazelnut was investigated. in addition, regression models for the responses: L* value, a* value, textural properties and moisture content of hazelnuts were obtained and the optimum roasting conditions were determined by using response surface methodology. Conventionally roasted hazelnut at 150 degrees C for 20 min was considered for comparison. For hazelnuts, 2.5 min roasting time at 90% microwave power, 60% upper halogen lamp power, and 20% lower halogen lamp power were found to be optimum roasting conditions. Hazelnuts roasted at this optimum point had comparable quality with conventionally roasted ones with respect to color, texture, moisture content and fatty acid composition

Optimisation of formulations and infrared-microwave combination baking conditions of chestnut-rice breads

The main objective of this study was to design gluten-free breads containing chestnut and rice flour and xanthan-guar gum blend to be baked in infrared-microwave combination oven. Response surface methodology (RSM) was used to optimise gluten-free bread formulations and processing conditions. Weight loss, firmness, specific volume and colour change of the breads were determined. Rice flour mixed with different proportions of chestnut flour and different emulsifier contents were used to prepare breads. The gluten-free formulations were baked using different upper halogen lamp powers, microwave powers and baking time which were varied from 40% to 80%, 30% to 70% and 9 to 17 min, respectively. Gluten-free breads and wheat breads baked in conventional oven were used for comparison. Breads containing 46.5% chestnut flour and 0.62% emulsifier and baked using 40% infrared and 30% microwave power for 9 min had statistically comparable quality with conventionally baked ones

Effect of vitamin d levels on lipid, glucose, vitamin b12 and c-reactive protein in acute ischemic stroke

Aim: Stroke ranks second among the causes of death world wideand related disability and death rates are high. Recent studies have shown that vitamin D deficiency is higher in patients with ischemic stroke compared to other patients and vitamin D deficiency has emerged as a new risk factor. The aims of the study are to investigate the relation between levels of vitamin D in patients diagnosed with acute ischemic stroke with levels of vitamin B12, glucose, HbA1c, blood urea nitrogen (BUN), creatinine, C-reactive protein (CRP) and lipids, and to determine the effect of vitamin D deficiency on other factors that increase the risk of acute ischemic stroke. Materials and Methods: Two thousand seven hundred thirty-four patients diagnosed with acute ischemic stroke were included in the study. Results of laboratory tests for levels of vitamin D, vitamin B12, HDL cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, glucose, HbA1c, BUN, creatinine and CRP were recorded. Results: As for correlation between vitamin D and other parameters, positive correlations between vitamin D and age, vitamin B12, BUN and creatinine, and negative correlations between vitamin D and triglycerides, LDL cholesterol, VLDL cholesterol, glucose, HbA1c and CRP were identified. Vitamin D and HDL cholesterol showed no correlation in normal HDL values, but there was positive correlation in patients with HDL cholesterol levels 40 mg/dL. Conclusion: Vitamin D levels in patients that suffered ischemic stroke were significantly correlated with lipid metabolism, glucose metabolism, inflammation, kidney function and vitamin B12 levels.No sponso

Baseline characteristics associated with survival in patients with hepatocellular carcinoma

Background and Aim: Hepatocellular carcinoma (HCC) is one of the most common and most lethal cancers worldwide. The objective of this study was to investigate the relationship between basal parameters and survival characteristics in patients with HCC. Materials and Methods: The records of 1447 HCC patients of a tertiary center during the period 2000-2017 were screened retrospectively. The demographic details; basal clinical, laboratory, and radiological characteristics; treatments; and survival time were recorded and prognostic scores were calculated. Results: A total of 788 patients with HCC (male/female: 623/165; mean age: 60.5 +/- 10.9 years) were included in the study. The median length of survival was 26.3 months (95% confidence interval [CI], 22.3-30.4 months). The 5-year survival rate was 28.1%. The number and diameter of the tumors; platelet count; platelet-to-lymphocyte ratio; level of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase; portal and hepatic vein involvement; and an alpha-fetoprotein level of <9.6 ng/mL were found to be independently related to survival. Conclusion: The positive predictive value of the prognostic index derived from independent survival-related parameters for 5- and 10-year survival or overall survival was approximately 86%. Integration of this prognostic index to the criteria used in making treatment decisions for patients with HCC should be considered

Yaşlılarda kandida özofajiti: Tek merkez deneyimi

Giriş ve Amaç: Kandida özofajiti, özofagus mukozasının fungal enfeksiyonudur. Bu çalışmada amaç; insan immün yetmezlik virüsü negatifyaşlılarda kandida özofajiti ile ilişkili olarak predispozan faktörleri belirlemek ve eşlik eden endoskopi bulgularını sunmaktır. Gereç ve Yöntem:Bu çalışma; herhangi bir nedenle endoskopi yapılıp, kandida özofajiti tanısı koyulan, insan immün yetmezlik virüsü (-), ? 65 yaş hastaların retrospektif tek merkezli irdelenmesini içermektedir. Hastaların yaş, cinsiyet,eşlik eden hastalıkları, insan immün yetmezlik virüsü enfeksiyonu varlığı,kullandığı ilaçları, Diabetes Mellitus varlığı, proton pompa inhibitörü kullanımı, örneklemenin nasıl yapıldığı, başvuru semptomları ve endoskopiyapılma nedenleri taranmıştır. Bulgular: Bu çalışmada 65 yaş üstü olupendoskopi yapılan toplam 2462 hastanın 16’sında (%0.65) kandidaözofajiti saptanmıştır. Kandida özofajiti saptanan hastaların yaşları 65ile 88 arasında olup yaş ortalaması 76.75 ± 7.9 yıldır. Hastaların 8’i(%50) kadındır. Hastaların en sık semptom ve endoskopi yapılma nedeni 8 (%50) hastada disfajidir. Hastaların 5’inde (%31.3) Diabetes Mellitus tanısı saptanmıştır. Hastaların ilaç kullanımları incelendiğinde; 6’sının (%37.5) sürekli proton pompa inhibitörü kullandığı, 5’inin (%31.3)son 1 ay içerisinde antibiyotik kullanım öyküsü olduğu anlaşılmıştır. Ondört hastadan (%87.5) biyopsi forsepsi ile, 2 hastadan (%12.5) ise fırçalama tekniği ile örnek alınarak tanıya gidilmiştir. Sonuç: Bu çalışma,bildiğimiz kadarıyla ülkemizde geriatrik popülasyonda kandida özofajitiile ilişkili ilk çalışmadır. Çalışmamızda insan immün yetmezlik virüsü (-),kandida özofajiti olan geriatrik hastaların yaş etkeni yanında kullanılanilaçların ve komorbiditelerin de risk faktörü olduğu, bu hastalarda semptomların değişkenlik gösterebildiği akılda tutulmalıdır