Informing diet and physical activity interventions with family involvement in an urban setting: views of children and adults in Lagos, Nigeria

There is limited evidence on diet and physical activity (PA) interventions to prevent childhood over- and under-nutrition in Nigeria, particularly those with parental involvement. The aim of this qualitative cross-sectional study was to explore parents’, children’s, and other stakeholders’ views on what might enable or hinder participation in diet and PA interventions with parental involvement, and potential intervention components likely to be feasible and acceptable. The study took place in Lagos State, Nigeria. Sixteen boys and girls aged 8–11 years in four participating schools were involved in the study. In addition, women (n = 19) and men (n = 13) aged 18–60 years took part. These included parents, teachers, school heads, community leaders, health professionals, and health or education civil servants, recruited via the participating schools, community and professional links. Data were collected in schools, homes, and places of work via one-to-one interviews and focus groups, audio-recorded with participants’ consent. Topics included knowledge about a balanced diet and active living; frequency of exercise and barriers and facilitators of participation; and ideas for fostering good diet and physical activity habits. Socio-demographic data were collected orally at the start of each discussion. Thematic analysis of verbatim transcripts of the recordings was conducted. Three overarching themes were identified: (1) Active community collaboration; (2) strategies for involving families; and (3) schools as key settings for interventions. The main barriers to participation in potential interventions included poor access to clean water, safe outdoor play space, and menstrual hygiene products. Suggested solutions included increased security, infrastructure improvements using recycled materials, school gardening, and health campaigns funded by local dignitaries. Health literacy education for parents, tailored to local dialects, was considered an important potential intervention component that would engage families. The feasibility and acceptability of grassroots suggestions for intervention components and parental involvement could usefully be explored in future pilot studies

Gamma glutamyltransferase, alanine aminotransferase and risk of cancer : systematic review and meta-analysis

The prospective evidence for the associations of gamma glutamyltransferase (GGT) and alanine aminotransferase (ALT) with risk of cancer in the general population is uncertain. We conducted a systematic review and meta-analysis of published prospective observational studies evaluating the associations of baseline levels of GGT and ALT with risk of overall (incidence and/or mortality) and site-specific cancers. Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, reference lists of relevant studies to April 2014 and email contact with investigators. Study specific relative risks (RRs) were meta-analyzed using random effects models. Fourteen cohort studies with data on 1.79 million participants and 57,534 cancer outcomes were included. Comparing top versus bottom thirds of baseline circulating GGT levels, pooled RRs (95% confidence intervals) were 1.32 (1.15-1.52) for overall cancer, 1.09 (0.95-1.24) for cancers of the breast and female genital organs, 1.09 (1.02-1.16) for cancers of male genital organs, 1.94 (1.35-2.79) for cancers of digestive organs and 1.33 (0.94-1.89) for cancers of respiratory and intrathoracic organs. For ALT, corresponding RRs for overall cancer were 0.96 (0.94-0.99) and 1.65 (1.52-1.79) in European and Asian populations, respectively. There was an increased risk of cancers of the digestive organs 2.44 (1.23-4.84). The pooled RR for overall cancer per 5 U/L increment in GGT levels was 1.04 (1.03-1.05). Available observational data indicate a positive log-linear association of GGT levels with overall cancer risk. The positive association was generally evident for site-specific cancers. There are geographical variations in the association of ALT and overall cancer