Fast-food consumption among 17-year-olds in the Birth to Twenty cohort

Objectives: Assessment of fast-food consumption in urban black adolescents.Design: The current research was a descriptive cross-sectional study.Setting: Subjects attending the Birth to Twenty (Bt20) research facility at the Chris Hani Baragwanath Hospital in Soweto, Johannesburg between September 2007 and May 2008 were enrolled.Subjects: 655 black subjects (51.1% females) were consecutively selected to participate from the larger cohort of Bt20.Outcome measures: Fast-food item consumption and frequency of  fast-food outlet visits were assessed by interviewer-administered questionnaire.Results: Over a 7-day assessment period, participants consumed 5 026 fast-food items, with the most popular food item being an item known colloquially as a ‘quarter’. There were no gender differences in terms of preferences. Mean fast-food intake was 8.1 (4.6) items and 7.2 (4.7) items per week for males and females respectively (ρ = 0.01). A typical ‘quarter’ consists of a quarter-loaf of white bread, chips, a slice of cheese and any number of delicatessen meats and sauces. A macronutrient comparison between a ‘quarter’ and three commercially available fast-food meals was undertaken, with the ‘quarter’ providing the most energy (5 970 kJ) and being the least expensive (mean cost = R9.16).Conclusion: The average estimated daily energy requirement for a 17-year-old is approximately 10 000 kJ, thus the ‘quarter’ may make a significant contribution to daily energy intake. Further research assessing the role of fast-foods in the provision of total energy and nutrient intakes in adolescents is require

Occipital alpha activity during stimulus processing gates the information flow to object-selective cortex.

Given the limited processing capabilities of the sensory system, it is essential that attended information is gated to downstream areas, whereas unattended information is blocked. While it has been proposed that alpha band (8–13 Hz) activity serves to route information to downstream regions by inhibiting neuronal processing in task-irrelevant regions, this hypothesis remains untested. Here we investigate how neuronal oscillations detected by electroencephalography in visual areas during working memory encoding serve to gate information reflected in the simultaneously recorded blood-oxygenation-level-dependent (BOLD) signals recorded by functional magnetic resonance imaging in downstream ventral regions. We used a paradigm in which 16 participants were presented with faces and landscapes in the right and left hemifields; one hemifield was attended and the other unattended. We observed that decreased alpha power contralateral to the attended object predicted the BOLD signal representing the attended object in ventral object-selective regions. Furthermore, increased alpha power ipsilateral to the attended object predicted a decrease in the BOLD signal representing the unattended object. We also found that the BOLD signal in the dorsal attention network inversely correlated with visual alpha power. This is the first demonstration, to our knowledge, that oscillations in the alpha band are implicated in the gating of information from the visual cortex to the ventral stream, as reflected in the representationally specific BOLD signal. This link of sensory alpha to downstream activity provides a neurophysiological substrate for the mechanism of selective attention during stimulus processing, which not only boosts the attended information but also suppresses distraction. Although previous studies have shown a relation between the BOLD signal from the dorsal attention network and the alpha band at rest, we demonstrate such a relation during a visuospatial task, indicating that the dorsal attention network exercises top-down control of visual alpha activity

Diagnostic pitfalls of urogenital tuberculosis

Objectives: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low-prevalence country. Methods: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB between 1st January 2014 and 31st October 2019 in an East London hospital. Results: 68% (25/37) of patients were male and the median age was 42 years (IQR 34–55). 89% (33/37) of patients were born outside the United Kingdom with 65% (24/37) born in the South Asian region. Renal (32.4%), epididymal (24.3%) and endometrial TB (21.6%) were the most prevalent forms of UGTB. Only 13.5% of UGTB patients had concurrent pulmonary TB. The median length of time from symptom onset to treatment was 163 days, while endometrial TB had an average delay to diagnosis of 564 days. Approximately half of patients with UGTB were culture positive (51.4%). However, 70% of early morning urines (EMUs) sent in urinary TB were culture positive. 11 patients (30.6%) underwent two or more invasive procedures, such as biopsy to obtain specimen samples. The mean treatment length for all UGTB cases was 7.3 months (SD 3.1). Notably, 25% of patients with endometrial TB required surgery despite antituberculous treatment. Conclusions: UGTB is challenging to diagnose as early disease is often asymptomatic. Clinicians faced with non-specific symptoms, or features suggestive of urogenital malignancy amongst patients from TB-endemic areas, should maintain a high suspicion of UGTB

Under- and overnutrition and evidence of metabolic disease risk in rural black South African children and adolescents

Objectives: The objective was to determine the prevalence of under- and overnutrition, as well as evidence of metabolic disease risk in rural black South African children and adolescents.Design: A cross-sectional study was conducted.Setting: The setting was the Agincourt Health and Socio-demographic Surveillance System site, Mpumalanga province.Subjects: Six hundred children were randomly selected, of whom 588 were included in the analytical sample (mean age of 11.5 years, range of 7-15 years).Outcome measures: Outcome measures were anthropometric and blood pressure assessments, Tanner pubertal staging, as well as the determination of fasting serum lipid and glucose concentrations.Results: Using age and sex-specific World Health Organization 2007  growth references, the prevalence of stunting was determined to be 6.2% in the boys, and 2.7% in the girls, while 4.1% of the boys and 4.4% of the girls were underweight. Combined overweight and obesity prevalence was higher in the girls (13.5%) than in the boys (2.7%). Girls had significantly a higher body mass index and hip circumference than the boys in the early, mid and late pubertal stages. Pre-hypertension prevalence, using either systolic or diastolic blood pressure for sex, age and height, was 15% and 10% in the girls and boys, respectively. Furthermore, impaired fasting glucose (FG) (FG . 5.6 mmol/l) was detected in 5% of the children.  High-density lipoprotein cholesterol concentrations less than 1 mmol/l were observed in 0.7% of the boys and in 12% of the girls, which is indicative of cardiometabolic risk.Conclusion: Stunting levels were higher in the boys than in the girls in mid to late childhood in a rural setting in South Africa, while the girls had a higher prevalence of overweight and obesity than the boys.  Pre-hypertension prevalence in the boys and girls was high. Other  metabolic risk factors, i.e. impaired FG and lipids, were also seen in this population and were associated with adiposity. The study highlights the critical need for targeted health promotion interventions to optimise child health as part of a noncommunicable disease preventative strategy

Paediatric hypertension in South Africa: An underestimated problem calling for action.

Hypertension is a major global health problem and the most prominent risk factor for cardiovascular diseases, which disproportionately affect low- and middle-income countries (LMICs). According to a recent report from the Word Health Organization/Strategic Advisory Group of Experts (WHO-SAGE) group, almost half of the South African (SA) adult population is living with hypertension. Although the condition occurs less frequently in children than in adults, evidence now supports the concept that adult essential hypertension has its roots in childhood. A systematic review reports that the prevalence of hypertension in SA children ranges from 7.5% to 22.3%. One in five children aged 5 years is hypertensive (≥95th percentile for age, height and sex), and 60% of children with elevated blood pressure (BP) (>90th percentile for age, height and sex) maintain that status into early adulthood. In addition, there are distinct BP trajectories set early in childhood that are mainly driven by patterns of early life growth and socioeconomic environment. We seek to raise awareness of paediatric hypertension, its risk factors and its consequences, and highlight the importance of action, which can inform early detection and intervention strategies in the context of an increasing burden of cardiovascular disease in SA

Effects of Photobiomodulation Therapy on Regulation of Myogenic Regulatory Factor mRNA Expression In Vivo: A Systematic Review

Non-invasive promotion of myogenic regulatory factors (MRFs), through photobiomodulation therapy (PBMT), may be a viable method of facilitating skeletal muscle regeneration post-injury, given the importance of MRF in skeletal muscle regeneration. The aim of this systematic review was to collate current evidence, identifying key themes and changes in expression of MRF in in vivo models. Web of Science, PubMed, Scopus and Cochrane databases were systematically searched and identified 1459 studies, of which 10 met the inclusion criteria. Myogenic determination factor was most consistently regulated in response to PBMT treatment, and the expression of remaining MRFs was heterogenous. All studies exhibited a high risk of bias, primarily due to lack of blinding in PBMT application and MRF analysis. Our review suggests that the current evidence base for MRF expression from PBMT is highly variable. Future research should focus on developing a robust methodology for determining the effect of laser therapy on MRF expression, as well as long-term assessment of skeletal muscle regeneration

Socio-economic predictors of stunting in preschool children – a population-based study from Johannesburg and Soweto

Background. Stunting continues to be a child public health concern in many African countries, including South Africa. This study uses data from the Birth to Twenty study, held in Johannesburg, to investigate a range of household-level socioeconomic and social support predictors of stunting in children aged less than 30 months.Design. Logistical regression models were constructed using aconceptual framework to investigate the association between early life measures of socio-economic status and stunting

Obesity in early adulthood and physical functioning in mid-life: Investigating the mediating role of c-reactive protein

INTRODUCTION: Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. METHODS: We used data from 8495 participants in the 1958 British birth cohort study. Body mass index (BMI), CRP and PF were measured at 33, 45 and 50y, respectively. Poor PF was defined as the lowest (sex-specific) 10% on the Short-form 36 Physical Functioning subscale. We accounted for prospectively measured confounders in early-life (e.g., social class at birth) and in mid-adulthood (e.g., 42y comorbidities). We decomposed the total effect of early-adult obesity on mid-life PF into direct and indirect (via CRP) effects, by employing a mediation analysis based on parametric g-computation. RESULTS: The estimated total effect of obesity at 33y on poor PF at 50y, expressed as an odds ratio (OR), was 2.41 (95% CI: 1.89, 3.08). The direct effect of obesity on poor PF (i.e., not operating via CRP), was 1.97 (95% CI: 1.51, 2.56), with an indirect effect of 1.23 (95% CI: 1.10, 1.37). As such, the proportion of the total effect which was mediated by the effect of obesity on CRP at 45y, was 23.27% (95% CI: 8.64%, 37.90%). CONCLUSION: Obesity in early-adulthood was associated with over twice the odds of poor PF in mid-life, with approximately 23% of the obesity effect operating via a downstream effect on CRP. As current younger generations are likely to spend greater proportions of their life course in older age and with obesity, both of which are associated with poor PF, there is an urgent need to identify mechanisms, and thus potential modifiable intermediaries, linking obesity to poor PF