A Pilot Study on the Quality of Life in Family Caregivers of Cancer Patients at an Urban Tertiary Hospital in Kuala Lumpur

Background: Family plays an important role in caregiving of cancer patients. There are limited published articles on cancer caregiving in the Malaysian population. The aim of the study was to determine the quality of life (QoL) of cancer patient caregivers and its associated factors. Subjects and Method: A cross-sectional study was conducted at an urban tertiary hospital in Kuala Lumpur, Malaysia. A total of 94 family caregivers of all types of cancer patients completed validated questionnaires in the national language. The dependent variable was theQoL in family caregivers, which was measured by the Malay Caregiver Quality of Life–Cancer (MCQOL-C) questionnaire. It consisted of 35 items, and the domains are burden, positive adaptation, disruptiveness, financial concerns and others. The higher the QoL scores, the better the QoL. The independent variables were socio-demographic factors (age, education level, ethnicity, gender, marital status, relationship with patient, any children less than 18 years old, and employment status). The data were analyzed by a linear regression model. Results: The study population (N= 94) comprised of 73.4% females, 38.8% were spouses to cancer patients. The mean age was 45.02+14.65, ranged from 17-78 years old. Half (56.4%) of the study subjects were Malays, 54.3% obtained secondary education, and 50% were not working. The reliability of the questionnaire was good with Cronbach alpha= 0.87. The mean (SD) score of QoL was 80.57 (21.27), ranged from 25-128. The multivariate analysis showed that being non-Malay had lower quality of life than Malay (b= -18.40; 95% CI= 3.10 to 33.70; p= 0.020). Conclusion: Ethnicity affects the QoL of cancer patient caregiving. This provides invaluable insight for developing health care service. Keywords: quality of life, family caregiver, cance

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries

Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.Peer reviewe