Understanding Eating Behaviors of New Dehli\u27s Youth

This qualitative study documents perceived benefits of and barriers to engaging in healthy eating behaviors among adolescents in New Delhi, India. Researchers explored factors that influenced the consumption of breakfast, fruits and vegetables, and soft drinks in this population and adolescents’ ideas about how to intervene to encourage or discourage, respectively, these behaviors. Students (n=151 6th and 8th graders) from five private schools participated in focus group discussions. Findings showed that the majority of youth eat breakfast that may consist of traditional and Western choices. Despite sound knowledge of the benefits of fruits and vegetables consumption, adolescents do not eat the recommended daily servings due to flavor preferences. Soft drink consumption was, reportedly, universal. Several factors influenced these decisions and details are herein provided. The paucity of studies on this subject provides researchers with the opportunity to explore how eating patterns of Indian youth might be shaping the health and disease landscape of India in the upcoming decades. The study adds to the slim body of literature on the subject and could be used to inform future nutrition interventions in India

The influence of “westernization” on nutrition and physical activity behaviors of adolescents in New Delhi, India: Are we exporting an epidemic of obesity?

Purpose. To examine the relationships between “westernization” and nutrition and physical activity behaviors among older adolescents in Delhi, India. These relations have not been explored, despite increasingly strong and pervasive socio-cultural influences from the West. Methods. Students (n=1818) in 8th and 10th grades in 4 Private (higher SES) and 4 Government (lower SES) schools in Delhi, India participated in a cross-sectional study. Height and weight were measured to determine weight status. Information on “westernization” and nutrition, physical activity, sedentary, and dieting behaviors was collected in a survey. The measure of “westernization” assessed 4 domains of culture on a bi-dimensional scale that focused on these young people’s identification with Indian (α=0.86) and Western (α=0.81) ways of living. Mixed-effects regression models were used to investigate the association between “westernization,” weight status, and health behaviors. Gender, school type (SES), and grade were evaluated as effect modifiers. Results. “Westernization” was not directly associated with weight status or BMI (p\u3e0.500). However, adolescents’ identification with Western ways of living was consistently related to both unhealthy (e.g., fast food consumption, pppConclusions. The influence of “westernization” on nutrition and physical activity behaviors of older adolescents in Delhi, India is complex and not wholly negative, as might be hypothesized

Parent dietary, physical activity and sedentary behaviors associated with child behaviors and weight status among private school children in Delhi, India: A cross-sectional study

Background Family can be an important socializing agent that strongly influences child and adolescent behavior. While studies have found associations between parent modeling of healthy behaviors and these behaviors in children in the US and other western countries, there is a dearth of research examining these associations among low and middle-income countries like India. This study examines the association between parent dietary, physical activity, and sedentary behaviors and child behaviors and weight status in Delhi, India. Methods The study was cross-sectional by design. The target population was comprised of a convenience sample of 6th and 8th grade children enrolled at 6 private schools in Delhi, India and their parents. A total of 551 child-parent dyads were used in analysis. Measures included parent and child BMI; physical activity and sedentary behavior; and dietary intake, such as weekly breakfast consumption, daily fruit and vegetable (FV) consumption, daily low-fat dairy consumption, daily energy-dense (ED) food consumption, daily sugar-sweetened beverage (SSB) consumption. Mixed-effects linear regression models were used to test for the association between parent dietary, physical activity, and sedentary behaviors (independent variables) and child dietary, physical activity and sedentary behaviors (dependent variables) while controlling for parent and child demographics. Results Significant, positive associations were observed between all parent and child dietary behaviors (weekly breakfast consumption, daily FV consumption, daily low-fat dairy consumption, daily ED food consumption, daily SSB consumption) after adjusting for child sex and grade, parent sex, and parent weight status (p<0.05, all). Parent moderate/vigorous physical activity was positively associated with child moderate/vigorous physical activity (p=0.000), however there was no significant association between parent and child light physical activity levels (p=0.310). Parent energy-dense food consumption was negatively associated with child overweight/obesity (OR=0.70, p=0.026), while parent sugar-sweetened beverage consumption was positively associated with child overweight obesity (OR=1.63, p=0.018). Conclusions This study provides initial support for an association between parent and child dietary and physical activity behaviors among urban families in India. The findings highlight the need for further longitudinal investigation of this research area to elucidate temporal relationships between these variables

Parent behavioral and psychosocial risk and protective factors associated with child obesity in Delhi, India

This study used data from the Addressing the Emerging Obesity Epidemic in India: A Social Marketing Approach to address three aims: 1) evaluate the association between parent and child weight status in Delhi, India; 2) examine the association between parenting monitoring and encouragement behaviors and child dietary, physical activity, sedentary behaviors and weight status in Delhi, India; and 3) examine the association between parent dietary, physical activity, and sedentary behaviors and child dietary, physical activity, sedentary behaviors, and weight status in Delhi, India. The study was cross-sectional by design and collected anthropometric and behavioral-psychosocial measures from 6th and 8th grade children and parents in six private schools in Delhi, India. Overall, this study found 29.6% of children and 77.7% of parents to be overweight/obese, which are similar to levels found in the US (Flegal, Carroll, Kit, & Ogden, 2012; Ogden et al., 2014). Parent weight status was found to be a strong predictor of child weight status after controlling for child grade and sex. However, while maternal weight status (OR=1.51, 95% CI: 1.04-2.20) was associated with child weight status, paternal weight status was not (OR=1.10, 95% CI: .810-1.48). This association was particularly strong between mothers and sons (OR=2.13, 95% CI: 1.39-3.27). Parents reported high levels of monitoring and encouragement (37%-87%). Several parent monitoring and encouragement behaviors were positively and significantly associated with child overweight/obesity and levels of the behaviors in children: monitoring child sedentary behavior (OR=1.08, p=0.000), encouraging limiting unhealthy food consumption (OR=1.08, p=0.000), and encouraging limiting sedentary behavior (OR=1.18, p=0.050). While only parent energy-dense (ED) food and sugar-sweetened beverage (SSB) consumption were significantly associated with child overweight/obesity (ED was negatively associated: OR=0.70, p=0.26; while SSB was positively associated: OR=1.63, p=0.018), all parent dietary behaviors were significantly and positively associated with those behaviors in children. Parent moderate to vigorous exercise was the only physical activity or sedentary behavior significantly associated with child overweight/obesity and that behavior in children (OR=1.18, p=0.011; Beta=0.30, p=0.000). The results of this study provide initial evidence that parent weight status and dietary behaviors are strong predictors of child weight status and dietary behaviors in Delhi, India. Future research should use more robust methods to continue to explore the relationship between parenting behaviors (monitoring and encouraging) and parent behaviors with child overweight/obesity to better understand the nature of the relationship. Interventions to begin to address child overweight and obesity should include parents as direct targets, particularly for modeling healthy dietary behaviors and achieving healthy weight status

Noncommunicable disease burden among conflict-affected adults in Ukraine: A cross-sectional study of prevalence, risk factors, and effect of conflict on severity of disease and access to care.

BackgroundThere is limited research on noncommunicable diseases (NCDs) in humanitarian settings despite the overall global burden and disproportionate growth in many conflicts and disaster-prone settings. This study aimed to determine the prevalence of NCDs and assess the perceived effect of conflict on NCD severity and access to treatment among conflict-affected adults (≥ 30 years) in Ukraine.Methods and findingsWe conducted two population-representative, stratified, cross-sectional household surveys: one among adult internally displaced people (IDPs) throughout Ukraine and one among adults living in Donbas in eastern Ukraine. One randomly selected adult per household answered questions about their demographics, height and weight, diagnosed NCDs, access to medications and healthcare since the conflict began, as well as questions assessing psychological distress, trauma exposure, and posttraumatic stress disorder. More than half of participants reported having at least one NCD (55.7% Donbas; 59.8% IDPs) A higher proportion of IDPs compared to adults in Donbas experienced serious psychological distress (29.9% vs. 18.7%), interruptions in care (9.7-14.3% vs. 23.1-51.3%), and interruptions in medication than adults in Donbas (14.9-45.6% vs. 30.2-77.5%). Factors associated with perceived worsening of disease included psychological distress (p: 0.002-0.043), displacement status (IDP vs. Donbas) (p: ConclusionsOur study found a high burden of NCDs among two conflict-affected populations in Ukraine and identified obstacles to accessing care and medication. Psychological distress, interruptions to care, and interruptions in medication were all reported by a higher proportion of IDPs than adults in Donbas. There is a need for targeted policies and programs to support the unique needs of displaced conflict-affected individuals in Ukraine that address the economic and perceived barriers to NCD treatment and care

Systematic identification of facility-based stillbirths and neonatal deaths through the piloted use of an adapted RAPID tool in Liberia and Nepal.

Maternal, fetal, and neonatal health outcomes are interdependent. Designing public health strategies that link fetal and neonatal outcomes with maternal outcomes is necessary in order to successfully reduce perinatal and neonatal mortality, particularly in low- and middle- income countries. However, to date, there has been no standardized method for documenting, reporting, and reviewing facility-based stillbirths and neonatal deaths that links to maternal health outcomes would enable a more comprehensive understanding of the burden and determinants of poor fetal and neonatal outcomes. We developed and pilot-tested an adapted RAPID tool, Perinatal-Neonatal Rapid Ascertainment Process for Institutional Deaths (PN RAPID), to systematically identify and quantify facility-based stillbirths and neonatal deaths and link them to maternal health factors in two countries: Liberia and Nepal. This study found an absence of stillbirth timing documented in records, a high proportion of neonatal deaths occurring within the first 24 hours, and an absence of documentation of pregnancy-related and maternal factors that might be associated with fetal and neonatal outcomes. The use of an adapted RAPID methodology and tools was limited by these data gaps, highlighting the need for concurrent strengthening of death documentation through training and standardized record templates

The World Health Organization’s public health intelligence activities during the COVID-19 pandemic response, December 2019 to December 2021

The coronavirus disease (COVID-19) presented a unique opportunity for the World Health Organization (WHO) to utilise public health intelligence (PHI) for pandemic response. WHO systematically captured mainly unstructured information (e.g. media articles, listservs, community-based reporting) for public health intelligence purposes. WHO used the Epidemic Intelligence from Open Sources (EIOS) system as one of the information sources for PHI. The processes and scope for PHI were adapted as the pandemic evolved and tailored to regional response needs. During the early months of the pandemic, media monitoring complemented official case and death reporting through the International Health Regulations mechanism and triggered alerts. As the pandemic evolved, PHI activities prioritised identifying epidemiological trends to supplement the information available through indicator-based surveillance reported to WHO. The PHI scope evolved over time to include vaccine introduction, emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, unusual clinical manifestations and upsurges in cases, hospitalisation and death incidences at subnational levels. Triaging the unprecedented high volume of information challenged surveillance activities but was managed by collaborative information sharing. The evolution of PHI activities using multiple sources in WHO’s response to the COVID-19 pandemic illustrates the future directions in which PHI methodologies could be developed and used.</jats:p

World Health Organization (WHO) criteria for selecting potential signals.

World Health Organization (WHO) criteria for selecting potential signals.</p

World Health Organization (WHO) criteria for initiating a rapid risk assessment.

World Health Organization (WHO) criteria for initiating a rapid risk assessment.</p