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

Retrospectiva da produção científica do SIBRACEn: (1988-1994) Retrospectiva de la producción científica del SIBRACEn: (1988-1994) Retrospective analysis of the scientific production presented at the Brazilian Symposium on Nursing Communication - SIBRACEn: (1988-1994)

Buscou-se identificar algumas características da produção científica acerca da Comunicação em Enfermagem tendo-se como amostra os trabalhos de temas livres apresentados nos quatro eventos - Simpósio Brasileiro de Comunicação em Enfermagem (1988, 1990, 1992 e 1994). Verificou-se que a maioria dos autores é composta por docentes, que realizam as investigações preferencialmente em grupos, enfocando principalmente como sujeitos as díades (profissionais e clientela), estabelecendo como objeto de estudo aspectos da interação (qualidade e efetividade), bem como aspectos da produção/utilização do conhecimento em Enfermagem. O contexto interpessoal é o usualmente mais pesquisado. A área mais estudada é a assistencial e o ambiente é o hospitalar. As investigações são na maioria do tipo não experimento. Os resultados arrolados pelos seus autores evidenciam aspectos de inadequação da comunicação nas áreas da assistência (incluindo a administração), da educação (principalmente da clientela) e da pesquisa. Ao mesmo tempo percebe-se a tendência subjacente de busca de soluções inovadoras, bem como avanço no conhecimento do processo de comunicação.<br>En este estudio se buscó identificar algunas características de la producción científica sobre Comunicación en Enfermería tenendo en consideración los trabajos presentados en los cuatro eventos del Simpósio Brasileño de Comunicación en Enfermería (1988, 1990, 1992 y 1994). Se verificó que la mayoría de los autores está compuesta por docentes, que realizan sus investigaciones en grupos, enfocando principalmente como sujetos las diades (profesionales y clientela), estabeleciendo como objeto de estudio aspectos de la interacción (cualidad y efectividad) y aspectos de la producción/utilización del conocimiento en Enfermería. El contexto interpersonal es lo más investigado. El área más estudiada es la asistencial y el ambiente es el hospital. La mayoría de las investigaciones son del tipo no experimento. Los resultados evidenciaron aspectos de inadecuacidad de la comunicación en área de asistencia (incluyendo la administración), educación (principalmente la clientela) e investigación. Al mismo tiempo, percíbese una tendencia de búsqueda por soluciones innovadoras, también por el avance del conocimento sobre el proceso de comunicación.<br>The present study had the purpose of identifying characteristics of the scientific production on Nursing Communication based on a sample of papers presented at four events of the Brazilian Symposium on Nursing Communication (1988, 1990, 1992 and 1994). The majority of authors were faculty, who developed research mainly in groups, focussing as subjects the dyad (professionals and clientele), establishing as objects of their studies aspects of interaction (quality and effectiveness) as well as aspects of the production and utilization of Nursing knowledge. Interpersonal context was the most investigated, care was the area most studied and the usual environment was the hospital. Research were mainly of non-experimental type. Results evidenced aspects of communication inadequateness in areas of care (including administration), education (mainly of clientele) and research. At the same time, authors perceived the trend towards innovative solutions and improvement of knowledge on the communication process

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

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. © Copyright