Thinness, overweight, and obesity among 6- To 17-year-old Malaysians : Secular trends and sociodemographic determinants from 2006-2015

Objective: To examine secular trends and sociodemographic determinants of thinness, overweight, and obesity among Malaysian children and adolescents in 2006-2015. Design: We used cross-sectional data from the National Health and Morbidity Surveys 2006, 2011, and 2015. Individuals were classified into pre- (6-9 years), early (10-13 years) and mid (14-17 years) adolescence. BMI status was determined according to the IOTF and WHO criteria, using measured height and weight. We analysed trends using log-binomial regression, by sex-age groups, stratified by sociodemographic factors (ethnicity, residential area, household size, household income), and accounting for the complex survey design. Associations between sociodemographic factors and prevalence of thinness and overweight (obesity included) in 2015 were assessed using log-Poisson regression. Setting: Nationwide population-based surveys, Malaysia. Participants: Eligible 6-17-year-olds from urban and rural residential areas (N=28,094). Results: The prevalence of thinness decreased from 2006 to 2015 (IOTF: boys from 22% to 18%, girls from 23% to 19%; WHO: boys from 9% to 7%, girls from 8% to 6%), while the prevalence of overweight increased (IOTF: boys from 20% to 26%, girls from 19% to 24%; WHO: boys from 25% to 31%, girls from 22% to 27%). These changes were statistically significant in most sex-age groups. Thinness and overweight co-existed in all sociodemographic subgroups, with variation in the prevalence estimates, but similar secular changes in most subgroups. Conclusions: Malaysia is facing a double burden of malnutrition at population level with a secular increase in overweight and obesity and a gradual decrease in thinness among 6-17-year-olds from varying sociodemographic backgrounds.acceptedVersionPeer reviewe

Children's erythrocyte fatty acids are associated with the risk of islet autoimmunity

Our aim was to investigate the associations between erythrocyte fatty acids and the risk of islet autoimmunity in children. The Environmental Determinants of Diabetes in theYoung Study (TEDDY) is a longitudinal cohort study of children at high genetic risk for type 1 diabetes (n = 8676) born between 2004 and 2010 in the U.S., Finland, Sweden, and Germany. A nested case-control design comprised 398 cases with islet autoimmunity and 1178 sero-negative controls matched for clinical site, family history, and gender. Fatty acids composition was measured in erythrocytes collected at the age of 3, 6, and 12 months and then annually up to 6 years of age. Conditional logistic regression models were adjusted for HLA risk genotype, ancestry, and weight z-score. Higher eicosapentaenoic and docosapentaenoic acid (n - 3 polyunsaturated fatty acids) levels during infancy and conjugated linoleic acid after infancy were associated with a lower risk of islet autoimmunity. Furthermore, higher levels of some even-chain saturated (SFA) and monounsaturated fatty acids (MUFA) were associated with increased risk. Fatty acid status in early life may signal the risk for islet autoimmunity, especially n -3 fatty acids may be protective, while increased levels of some SFAs and MUFAs may precede islet autoimmunity

Troponin T-release associates with cardiac radiation doses during adjuvant left-sided breast cancer radiotherapy

Background Adjuvant radiotherapy (RT) for left-sided breast cancer increases cardiac morbidity and mortality. For the heart, no safe radiation threshold has been established. Troponin T is a sensitive marker of myocardial damage. Our aim was to evaluate the effect of left-sided breast cancer RT on serum high sensitivity troponin T (hscTnT) levels and its association with cardiac radiation doses and echocardiographic parameters. Methods A total of 58 patients with an early stage, left-sided breast cancer or ductal carcinoma in situ (DCIS) who received adjuvant breast RT without prior chemotherapy were included in this prospective, non-randomized study. Serum samples were taken before, during and after RT. An increase of hscTnT >30 % was predefined as significant. A comprehensive 2D echocardiograph and electrocardiogram (ECG) were performed before and after RT. Dose-volume histograms (DVHs) were generated for different cardiac structures. Results The hscTnT increased during RT from baseline in 12/58 patients (21 %). Patients with increased hscTnT values (group A, N = 12) had significantly higher radiation doses for the whole heart (p = 0.02) and left ventricle (p = 0.03) than patients without hscTnT increase (group B, N = 46). For the left anterior descending artery (LAD), differences between groups A and B were found in volumes receiving 15 Gy (p = 0.03) and 20 Gy (p = 0.03) Furthermore, after RT, the interventricular septum thickened (p = 0.01), and the deceleration time was prolonged (p = 0.008) more in group A than in group B. Conclusions The increase in hscTnT level during adjuvant RT was positively associated with the cardiac radiation doses for the whole heart and LV in chemotherapy-naive breast cancer patients. Whether these acute subclinical changes increase the risk of excessive long-term cardiovascular morbidity or mortality, will be addressed in the follow-up of our patients.BioMed Central open acces

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

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

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

Age at menarche and diet among adolescents in slums of Nashik, India

Abstract Background and aim: The role of dietary patterns in determining age at menarche is insufficiently understood in low-income countries. The relationship between dietary patterns, particularly the consumption of oil, and age at menarche in a slum-dwelling adolescent population in India is examined. Methods: Data were derived from a cross-sectional baseline survey and anthropometric measurements among 10- to 19-year-old adolescents (n=545, female respondents 272, of whom 160 were post-menarcheal) and a household survey in two slums in the city of Nashik, Western India. By using mixed effects linear regression models, the association between age at menarche and household-wise use of sources of animal protein and oil and fat is examined. Results: Age at menarche (mean 13.7 years) in the slums studied was relatively high according to Indian standards. Age at menarche and the consumption of dairy products, meat, fish and eggs were not associated. The household per capita consumption of vegetable oil had an inverse association with a girl’s age at menarche, and there was an indication of a positive association between use of ghee (clarified butter) and age at menarche. These associations did not disappear when controlling for anthropometric status and socio-economic characteristics. Conclusion: Intake of fats and foods that are important sources of protein among underprivileged households in India is low and reflected in the relatively late age at menarche. The potential differences in the association between various types of fatty acids, energy intake and age at menarche in conditions of undernutrition requires further prospective study

Dielectric breakdown strength of epoxy bimodal-polymer-brush-grafted core functionalized silica nanocomposites

The central goal of dielectric nanocomposite design is to create a large interfacial area between the matrix polymer and nanofillers and to use it to tailor the properties of the composite. The interface can create sites for trapping electrons leading to increased dielectric breakdown strength (DBS). Nanoparticles with a bimodal population of covalently anchored molecules were created using ligand engineering. Electrically active short molecules (oligothiophene or ferrocene) and matrix compatible long poly(glycidyl methacrylate) (PGMA) chains comprise the bimodal brush. The dielectric breakdown strength was evaluated from recessed samples and dielectric spectroscopy was used to study the dielectric constant and loss as a function of frequency. The dielectric breakdown strength and permittivity increased considerably with only 2 wt% filler loading while the dielectric loss remained comparable to the reference epoxy.peerReviewe