Implication of Diet and Nutrition for Growth and Prevalence of Anemia in Rural Preschool-Aged Children in Shandong Province, China

A nutrition surveillance and nutritional improvement programme through nutrition field worker training, nutrition education and encouraging the utilization of home gardens was undertaken among rural preschool-aged children in the four counties of Linshu, Caoxin, Zoucheng and Yucheng in Shandong Province in China from 1990 to 1995. A baseline survey was conducted in 1990. This included physical and biochemical measurements being taken on 3474 children aged 0–5 years and dietary household surveys being taken on a random subsample of 312 children. The baseline survey showed that the average height and weight of the subjects was lower than the World Health Organization (WHO) standard with the prevalence of stunting, underweight and wasting being 24.2, 12.5 and 2.1%, respectively (using the Z score

The CKD.QLD data linkage framework: chronic kidney disease and health services utilisation in Queensland, Australia

Chronic kidney disease (CKD) is one of the most common chronic diseases in the western world. In Australia, around 1.7 million Australians aged 18 years and over (about one in ten) have indicators of CKD, and 1.8 million hospitalisations were associated with CKD in 2017–18. There is currently very little understanding of the impact of CKD on health service utilisation and costs. Understanding the disease pathways of CKD and its effects on service utilisation and patient outcomes is essential to predicting the course of the disease in the future, its effects on health services utilisation and capacity to better manage the burden of premature deaths or the need for dialysis that results from CKD. We describe the establishment of a data linkage framework to study hospital admissions of CKD patients in the public renal services in the Australian state of Queensland, and its potential to advance understanding of their course and outcomes. Seven years of retrospective data (2011–2018) on hospital-based health services utilisation were provided by Queensland Health for all 7,341 patients who enrolled in the CKD.QLD Registry up to Jan 2019. The data were supplied from three datasets: the Queensland Hospital Admitted Patient Data Collection, the Queensland Registrar General deaths, and the Activity Based Funding Model Output data. In addition, data were supplied from two cohorts of de-identified patients admitted to hospital in the same interval (22,023 patients each), who were not in the CKD.QLD Registry, the first with CKD and the second without CKD as indicated by International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification. The comprehensive and multifaceted data via the data linkage will enable us to identify opportunities for efficiencies in management of patients with CKD and for interventions that improve their outcomes

Mind-body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis

Objectives: Mind-body exercise has been generally recognized as beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind-body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind-body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: mind-body exercise (taichi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD=-0.76, 95%CI=-0.91, -0.60, p=0.04, I2=47.4%) and depression (SMD=-0.86, 95%CI=-1.14, -0.58, p=0.000, I2=71.4%). Sub-group analysis indicated that for anxiety, 30-60 minutes exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than10-year disease course. For depression, 2-3 times a week, 30-60 minutes each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years and have less than10-year disease course. Conclusions: Mind-body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic

The prevalence of Fabry disease in a statewide chronic kidney disease cohort – Outcomes of the aCQuiRE (Ckd.Qld fabRy Epidemiology) study

Background: Prevalence of Fabry disease amongst Chronic Kidney Disease (CKD) patients on haemodialysis has been shown to be approximately 0.2%. Methods: We undertook a cross-sectional study employing a cascade screening strategy for Fabry Disease amongst 3000 adult, male and female patients affected by CKD stage 1-5D/T at public, specialty renal practices within participating Queensland Hospital and Health Services from October 2017 to August 2019. A multi-tiered FD screening strategy, utilising a combination of dried blood spot (DBS) enzymatic testing, and if low, then lyso-GB3 testing and DNA sequencing, was used. Results: Mean (SD) age was 64.0 (15.8) years (n = 2992), and 57.9% were male. Eight participants withrew out of the 3000 who consented. Of 2992 screened, 6 (0.20%) received a diagnosis of FD, 2902 (96.99%) did not have FD, and 84 (2.81%) received inconclusive results. Of the patients diagnosed with FD, mean age was 48.5 years; 5 were male (0.29%) and 1 was female (0.08%); 4 were on kidney replacement therapy (2 dialysis and 2 transplant); 3 were new diagnoses. Conclusions: Estimated overall FD prevalence was 0.20%. Screening of the broader CKD population may be beneficial in identifying cases of FD. Trial registration: The aCQuiRE Study has been prospectively registered with the Queensland Health Database of Research Activity (DORA, https://dora.health.qld.gov.au) as pj09946 (Registered 3rd July 2017)

Association Between Overweight or Obesity and Household Income and Parental Body Mass Index in Australian Youth: Analysis of the Australian National Nutrition Survey, 1995

This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS). A random subsample of 1581 school children aged 7 15 years old from the NNS was studied. The results show the prevalence of overweight, obesity and combined overweight and obesity was 10.6 20.9%, 3.7 7.2% and 15.6 25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was significantly smaller than those with the lowest household income. The proportion of combined overweight and obesity in children whose parents were overweight or obese was significantly greater compared with those whose parents were not. The trend of increasing prevalence of overweight or obesity among children with increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father's BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian school children using new international absolute BMI cut-off points. It indicated that young school girls (7 9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight or obesity in older boys (13 15 year) was significantly greater than in other age groups while in girls it was the opposite. The boys with lowest household income ($0 17 500) were more likely to be overweight or obese compared with those with the highest household income (greater than$67 500). Having parents especially mothers who were overweight or obese may increase the risk of children being overweight or obese

The correlates of urinary albumin to creatinine ratio (ACR) in a high risk Australian Aboriginal community

Background: Albuminuria marks renal disease and cardiovascular risk. It was estimated to contribute 75% of the risk of all-cause natural death in one Aboriginal group. The urine albumin/creatinine ratio (ACR) is commonly used as an index of albuminuria. This study aims to examine the associations between demographic factors, anthropometric index, blood pressure, lipid-protein measurements and other biomarkers and albuminuria in a cross-sectional study in a high-risk Australian Aboriginal population. The models will be evaluated for albuminuria at or above the microalbuminuria threshold, and at or above the "overt albuminuria" threshold with the potential to distinguish associations they have in common and those that differ

Chronic kidney disease in public renal practices in Queensland, Australia, 2011–2018

Aim: To describe adults with (non-dialysis) chronic kidney disease (CKD) in nine public renal practice sites in the Australian state of Queensland. Methods: 7,060 persons were recruited to a CKD Registry in May 2011 and until start of kidney replacement therapy (KRT), death without KRT or June 2018, for a median period of 3.4 years. Results: The cohort comprised 7,060 persons, 52% males, with a median age of 68 yr; 85% had CKD stages 3A to 5, 45.4% were diabetic, 24.6% had diabetic nephropathy, and 51.7% were obese. Younger persons mostly had glomerulonephritis or genetic renal disease, while older persons mostly had diabetic nephropathy, renovascular disease and multiple diagnoses. Proportions of specific renal diagnoses varied >2-fold across sites. Over the first year, eGFR fell in 24% but was stable or improved in 76%. Over follow up, 10% started KRT, at a median age of 62 yr, most with CKD stages 4 and 5 at consent, while 18.8% died without KRT, at a median age of 80 yr. Indigenous people were younger at consent and more often had diabetes and diabetic kidney disease and had higher incidence rates of KRT. Conclusion: The spectrum of characteristics in CKD patients in renal practices is much broader than represented by the minority who ultimately start KRT. Variation in CKD by causes, age, site and Indigenous status, the prevalence of obesity, relative stability of kidney function in many persons over the short term, and differences between those who KRT and die without KRT are all important to explore

Influences Of Socioeconomic Status, Dietary Factors And Physical Activity On Overweight And Obesity Of Australian Children And Adolescents

The increasing prevalence of overweight and obesity in young people is a major global public health concern, especially in developed countries. In Australia, studies in 2001 have suggested that 20% of boys and 21.5% of girls aged 7-15 years were overweight or obese, while in 1985 the figures were 10.7% and 11.8%, respectively. In the short-term, overweight and obese children and adolescents suffer from both adverse physical and psychological consequences. The most significant long-term consequence of childhood obesity is its persistence into adulthood, along with numerous associated health risks. A number of studies have shown that there is an association between being an overweight child and subsequent adulthood obesity. In general, childhood overweight and obesity is a multifactorial disease and its development is due to multiple interactions between genes and environment. A number of risk factors such as socioeconomic status, dietary patterns, and physical activity have been frequently identified as contributors to its development. However, the results of recent studies provide conflicting evidence. The statistical limitations also make it difficult to compare the studies on childhood obesity between countries. In addition, existing research in Australia that examines the contribution of different risk factors to childhood obesity is limited. There are no published data on the relationship between overweight/obesity, dietary patterns, and physical activity/inactivity in Australian children and adolescents. This study examined the influences of household income, dietary factors, physical activity/inactivity and ethnicity on overweight and obesity among Australian children and adolescents. It also explored the relationship between self-reported weight and height to actual weight and height in older Australian adolescents in order to clarify the accuracy of self-reported data among Australian youth. Data from the two national cross-sectional surveys, the 1995 Australian National Health Survey (NHS) and the 1995 National Nutrition Survey (NNS) were analysed to explore the influences of household income, intake of energy and fat and percentage of energy from fat on childhood obesity. The study focused on 1585 children and adolescents aged 7-15 years. These data were also used to examine the relationship of self-reported weight and height to measured weight and height in older adolescents. Additionally, another cross-sectional survey among a group of Australian primary school children from a multi-cultural school in southern Brisbane was undertaken as well as providing indicative data on the relationship of overweight/obesity to physical activity levels and ethnicity, and to provide a protocol on the methodology and practicality of measuring physical activity level in such a school setting. The results suggested that boys from households with low incomes were more likely to be overweight or obese compared with those from households with higher incomes. Having parents, especially mothers, who were overweight or obese increased the risk of children being overweight or obese. The results do not provide evidence that there are statistically significantly differences in the average intake of energy and fat and percentage of energy from fat between non-overweight and overweight or obese boys and girls. The correct classification of weight or obesity from self-reported height and weight by Australian older adolescents was about 70%, bias in reporting weight and height is higher among overweight or obese older adolescents than non-overweight counterparts. In addition, preliminary, indicative data from the pilot study on the relationship between body mass index (BMI) and physical activity in 10-12 year old Australian school children from a multi-cultural school revealed that the average daily physical activity level (PAL) was 2.3 Metabolic Equivalents (METs) when the PAL was measured using self-reported activity diary. The proportion of light, moderate and heavy PAL was 2.9%, 20.4% and 76.7% in children, respectively. Additionally no ethnic differences in the prevalence of overweight /obesity was found. There was no statistically significant difference in average daily TV view times between non-overweight and overweight or obese boys and girls. The average daily number of steps measured using pedometer in the weekdays was 16,505 in boys and 12766 in girls. Most of boys (94.0%) have a medium and over level of steps taken daily while nearly one-third of the girls had not reached the minimum level in the number of steps for optimal health. However it must be noted this school-based study was a small cross-sectional survey in a single school. The results should be viewed as indicative, not generalisable. The study does not provide any longitudinal data on physical activity patterns and the trends in relationship to body mass index. In spite of the limitations of this study, it did provide some preliminary data on PAL and its relationship to overweight/ obesity among young Australian schoolchildren from diverse cultural backgrounds. Most importantly, this pilot study has provided a protocol on the methodology and practicality of measuring physical activity levels of children using self-reported activity diaries and pedometers in a multicultural school setting. A number of strategies for the prevention and treatment of childhood overweight and obesity are discussed. In future studies, a population-based and randomly selected sample would ensure findings that are more representative of general Australian children, and the longitudinal studies would help to define the association between the risk factors and childhood obesity, as well as enabling conclusions on causality to be drawn

Alcohol use in the Northern Territory

This fact sheet provides an overview of the level, pattern and prevalence of alcohol consumption among the NT population