Suchergebnisse

OBJECTIVES: Though Bangladesh is passing through demographic, epidemiologic and nutritional transitions, national estimates on nutrition and health status of the elderly population are largely unknown. We aimed to determine the status of selected health and nutrition indicators among the elderly population in Bangladesh. METHODS: For the first time in Bangladesh, we included elderly population (≥60 years old females and males) as a separate population group in the national food security and nutrition surveillance round 2018–2019. We collected data on dietary diversity, nutritional status, behavioral risk factors of non-communicable diseases, blood pressure, and self-reported chronic diseases from 4,818 elderly people (48% female) living in 82 clusters (57 rural, 15 non-slums urban, and 10 slums) randomly selected from eight administrative division of Bangladesh. RESULTS: Majority (59% in rural, 53% in non-slum urban, and 69% in slums) of elderly people were consuming an inadequately diverse (4 or less food groups out of 10) diet. Overall, 89% of elderly people were malnourished (20%) or at risk of malnutrition (69%). The highest prevalence of malnutrition was in Mymensingh division (37%) followed by Sylhet division (27%). The prevalence of obesity was 5%, 16%, and 11%, in rural, non-slum urban, and slums, respectively. The national prevalence of smoking, smokeless tobacco consumption, physical inactivity was 18%, 52%, and 38%, respectively. There was a high burden of hypertension (49% in rural, 53% in non-slum urban, and 39% in slums). Overall, 16% of elderly people had heart diseases, 14% had chronic respiratory diseases, 3% had kidney diseases, 9% had diabetes, 8% had stroke, 0.5% had cancer and 1.4% had mental health problems. CONCLUSIONS: The government of Bangladesh should design and implement health and nutrition programs among the elderly population. The regional differences in the prevalence of health and nutrition indicators should be considered while designing such programs. FUNDING SOURCES: Ministry ...

OBJECTIVES: The aim of this study was to examine the prospective association between the consumption of total, unprocessed, and processed red meat and the risk of frailty in older adults. METHODS: We analyzed data from 85,870 women aged ≥60 participating in the Nurses' Health Study. Consumption of red meat was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every four years from 1992 to 2014. RESULTS: During follow-up we identified 13,279 incident cases of frailty. Women with a higher intake of red meat showed an increased risk of frailty after adjustment for lifestyle factors, medication use, and dietary factors. The relative risk (95% confidence interval) for one serving/day increment in consumption was 1.13 (1.08, 1.18) for total red meat, 1.08 (1.02, 1.15) for unprocessed red meat, and 1.26 (1.15, 1.39) for processed red meat. Replacing one serving/day of unprocessed red meat with other protein sources was associated with significantly lower risk of frailty; the risk reduction estimates were 21% for fish and 14% for nuts, while for replacement of processed red meat the percentages were 32% for fish, 26% for nuts, 13% for legumes, and 16% for dairy. CONCLUSIONS: Habitual consumption of red meat was associated with a higher risk of frailty. Replacement of red meat by other protein sources might reduce the risk of frailty. FUNDING SOURCES: This work was supported by grants from the Instituto de Salud Carlos III, State Secretary of R+D+I of Spain and FEDER/FSE (FIS 16/609, 16/1512, 19/319); the European Union (JPI A Healthy Diet for a Healthy Life, SALAMANDER project); and the Nurses´ health study is supported by grant UM1 CA186107 from National Institutes of Health.

OBJECTIVES: The study assessed the blood glucose level of adult women (30–60 Years ), In Njaba Local Government Area of Imo State, Nigeria. In relation to their blood pressure and anthropometric indices. METHODS: A cross sectional survey was conducted. Samples were selected by method of simple random sampling technique of balloting without replacement. Anthropometric indices of weight and height were used to assess the BMI, while waist hip ratio (WHR) was used to check for abdominal obesity. Glucometer and Blood pressure monitor was used to check the random blood sugar (RBS) levels and blood pressure rate respectively. Food frequency table was used to assess food consumption pattern. RESULTS: Result showed the mean standard deviation as follows: Body mass index; 26.29 ± 4.1, Waist hip ratio; 0.86 ± 0.34, Random blood sugar; 112.51 ± 23.0, Systolic blood pressure; 115.4 ± 23.0 and Diastolic blood pressure; 88.45 ± 4.3 (BMI, WHR, RBS, SBP and DBP respectively) Bivariate correlation analysis showed that SBP, DBP, RBS and WHR had positive correlation with BMI while confidence level was at 0.05% (0.206 P = 0.005, 0.16 P = 0.031, 0.081 P = 0.0021 and 0.148 P = 0.000 respectively). WHR also had stronger correlation with RBS (0.90 P = 0.278), systolic (0.272 P = 0.002), diastolic (0.21 P = 0.045). This confirms the assertion that WHR should be used as an indicator of cardiovascular disease not BMI. The study also revealed that 3.6% were underweight. 49.0%, 29.9%, 17.5% accounted for normal, overweight and obesity respectively. Blood pressure levels were marginal as 30.04%, 35.4%, 34.3% were normal, pre hypertensive and hypertensive respectively. Most of the respondents had normal blood sugar (91.2%). CONCLUSIONS: The overweight, obese and those with elevated WHR had higher values of RBS, SBP and DBP. Confirming that, overweight and obesity are consistent parameters associated with cardiovascular risks. There is need for promotion of a healthy life style, regular exercise and proper nutrition. FUNDING SOURCES: Department ...

The current discussion in the EU of the increase in life expectancy as it relates to pension reform misses a big part of the picture. The increase in life expectancy in Europe, as in the US, is accompanied by an increasing risk of disability in the later years. The time between the onset of a chronic disease and death has increased dramatically in the last half century. It has also created a situation where older workers risk being limited in the kind of paid work they can do and the very old risk having two or more chronic diseases. The high prevalence of chronic diseases and disabilities in aging populations has not yet been recognized by the new policy of "Live Longer Work Longer" (Keese, M. et al. 2006). How are workers to work longer if they are limited in the kind and type of work they perform? Official European Union documents stress the demographic changes in Europe primarily the increase in life expectancy but not the increase in disability

OBJECTIVES: Antioxidant intake has been suggested to be associated with the risk of osteoporosis. However, the effect of dietary total antioxidant capacity (TAC) on bone health is not clear. The aim of the present study was to assess the hypothesis that dietary TAC was positively associated with bone mass and negatively with the risk of osteoporosis in Korean women. METHODS: This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, 2008–2011. Dietary TAC was estimated by using task automation technique and algorithm to calculate the theoretical TAC from one day of 24-hour recall data using a TAC database comprising antioxidant capacities of 42 dietary antioxidants, developed for common Korean foods. In total, 8230 women were divided into a postmenopausal and premenopausal group, and each group was subdivided into four groups according to quartiles of dietary TAC. Multiple regression analysis was performed to assess relationships between dietary TAC with bone mass and the risk of osteoporosis risk. RESULTS: Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio: 0.73, 95% confidence interval: 0.54–0.99; p-trend = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women, and BMC of total femur and lumbar spine in premenopausal women. CONCLUSIONS: The present study suggested that dietary TAC was inversely associated with the risk of osteoporosis in postmenopausal women, and positively associated with bone mass in pre- and post-menopausal women. Further long-term cohort or intervention study will be necessary to confirm the effect of a high dietary TAC diet on bone health. FUNDING SOURCES: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Korean government.

OBJECTIVES: Diabetic retinopathy (DR) is a complication of diabetes, caused by high blood glucose levels damaging to blood vessels in the retina. It can leading cause of blindness. Nobiletin is a polymethoxyflavone present in citrus fruit and peels, it has anti-cancer and anti-inflammatory effects. This study investigated the protective effects of nobiletin on retinal blood-retinal barrier (BRB) breakdown in high glucose-exposed human retinal endothelial cells and in db/db mouse eyes. METHODS: Human retinal microvascular endothelial cell (HRMVEC) were incubated in media exposed to 33 mM glucose in the absence and presence of 1–20 μM nobiletin up to 5 d. Antibodies ZO-1, MMP2, Bax and Bcl2 were used for western blot analysis. The in vivo animal model employed db/db mice orally administrated with 10 mg/kg of nobiletin. RESULTS: Non-toxic nobiletin declined the expression of ZO-1 which is retinal tight junction protein and Bcl2 expression in high glucose stimulation. when treated with nobiletin promoted the expression of ZO-1 and Bcl2 in HRMVEC cell. Also, of MMP2 and Bax was up-regulated by high glucose stimulation and nobiletin down-regulated high glucose induced expression of the MMP2 and Bax. In in vivo study, oral administration of 10 mg/kg nobiletin protected the retinal endothelial microvascular through recovering ZO-1 and Bcl2 expression as control. Also, nobiletin reduced tissue expressions of MMP2 and Bax. CONCLUSIONS: These results demonstrated that nobiletin may be a potent retinoprotective agent to prevent diabetes-associated microvascular abnormalities and BRB breakdown in retinal microvascular functions leading to retinal failure. FUNDING SOURCES: This work was supported by the National Research Foundation of Korea (NRF) grants funded by the Korea government (2017R1A6A3A04011473).

OBJECTIVES: To determine the feasibility of a low sodium meal plan intervention aimed at reducing seated blood pressure (BP) in residents of a government-subsidized congregate, senior living facility. METHODS: The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, masked, randomized, controlled pilot study, testing the feasibility of administering a low versus typical sodium meal plan to adult residents of Jack Satter House, a section 202 congregate living facility in Revere, MA, subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years received 3 isocaloric meals with two snacks daily over a 14-day period. Both meal plans were equivalent in potassium and macronutrients, but differed in sodium density ( 2 mg/kcal). The primary outcome was seated systolic BP (SBP) averaged over 2 visits (days 10 and 14) using an Omron HEM-907XL automated cuff. Our objective measure of compliance was morning urine sodium-creatinine ratio. RESULTS: We randomized 20 participants (95% women, 95% white, and mean age 78 +/− 8 years), beginning in October 7, 2019. Baseline characteristics were evenly distributed between groups. Dietary compliance was high (only 2 discontinued meals) and follow-up was 100% with the last participant ending November 4, 2019. Baseline SBP changed from 121 to 116 mm Hg on the typical sodium meal plan (N = 9; mean difference of −5 mm Hg; 95% CI: −18, 8) and 123 to 112 mm Hg on the low sodium meal plan (N = 11; mean difference of −11 mm Hg; 95% CI: −15.2, −7.7). Compared to the typical sodium meal plan, the low sodium meal plan non-significantly reduced SBP by 5 mm Hg (95% CI: −14, 4) and non-significantly reduced urine sodium-creatinine ratio (%-difference −36.0; 95% CI: −60.3, 3.4). Effects on SBP were greater in the subgroup using hypertension medications at baseline (−13 mm Hg; 95% CI: −26, −0) and changes in SBP from baseline were correlated with changes in urine sodium-creatinine ratio (Pearson's r = 0.31). ...

OBJECTIVES: The purpose was to evaluate nutritional status, food security, and related health factors of older adults who were overweight or obese compared to those with a healthy weight. METHODS: Data from 2969 adults aged ≥60 years from NHANES 2011–2014 were analyzed. Participants were categorized by sex and body weight status as healthy weight (body mass index (BMI, kg/m(2)) 18.5–24.9), overweight (BMI 25–29.9), or obese (BMI ≥ 30); underweight individuals were excluded. Healthy Eating Index (HEI)-2015 scores and total usual micronutrient intakes from foods and dietary supplements were estimated using two 24-hour dietary recalls and the National Cancer Institute method. Nutritional biomarkers, including serum vitamin D, vitamin B-12, and methylmalonic acid, and cardiometabolic risk factors were also assessed. RESULTS: A substantial proportion of older adults (>30%) had intakes below Estimated Average Requirements (EAR) for calcium, magnesium, and vitamins C and D even with dietary supplements. Men and women with obesity had a higher prevalence of usual magnesium intakes

Intro -- DISABILITY AND CHRONIC DISEASE -- DISABILITY AND CHRONIC DISEASE -- Library of Congress Cataloging-in-Publication Data -- CONTENTS -- INTRODUCTION -- Chapter 1 DISABILITY AND CHRONIC DISEASE -- ABSTRACT -- INTRODUCTION -- ONCE UPON A TIME -- CHRONIC DISEASE -- REFERENCES -- SECTION ONE: DEVELOPMENTAL ISSUES -- Chapter 2 TEACHING YOUNG MOTHERS TO IDENTIFY DEVELOPMENTAL MILESTONES -- ABSTRACT -- INTRODUCTION -- Identification, intervention and surveillance -- Development and child maltreatment -- Intervention for child maltreatment -- OUR STUDY -- Setting -- Materials -- Observation system -- Reliability -- Experimental procedure -- Intervention -- FINDINGS -- Reliability -- Consumer Satisfaction Results -- DISCUSSION -- ACKNOWLEDGMENTS -- REFERENCES -- Chapter 3 CATEGORIZATION ACTIVITIES PERFORMED BY CHILDREN WITH AN INTELLECTUAL DISABILITY AND TYPICALLY DEVELOPING CHILDREN -- ABSTRACT -- INTRODUCTION -- OUR SAMPLE -- Material -- Procedure -- Coding criteria and data analysis -- FINDINGS -- Type of first choice (taxonomic, thematic or perceptual) -- Type of second choice in relation to the first one -- Nature of the justifications given by children for the three ontological domains -- DISCUSSION -- CONCLUSION -- APPENDIX: LIST OF ITEMS IN THE MATCH-TO-SAMPLE TASK -- REFERENCES -- Chapter 4 DON'T TAG ME MENTALLY RETARDED AS I AM NORMAL -- ABSTRACT -- INTRODUCTION -- CASE STUDY RESEARCH -- A CASE STUDY -- CONCLUSION -- REFERENCES -- Chapter 5 THE THERAPEUTIC INTERVENTIONS IN CEREBRAL PALSY -- ABSTRACT -- INTRODUCTION -- PHYSIOTHERAPY -- OCCUPATIONAL THERAPY -- NEURODEVELOPMENTAL TRAINING (NDT) -- SENSORY INTEGRATION (SI) -- ELECTRICAL STIMULATION -- BODY WEIGHT SUPPORT TREADMILL TRAINING -- CONDUCTIVE EDUCATION -- PATTERNING -- CONSTRAINT-INDUCED THERAPY -- HIPPOTHERAPY -- HYPERBARIC OXYGEN THERAPY -- ACUPUNCTURE.

Tonga is an Archipelago in the south Pacific Ocean, south of Samoa. The public health brief project is on chronic diseases in Tonga. The total population of Tonga was 107,122 in 2010. The Free Wesleyan Church of Tonga is the established religion in Tonga. Tongan's make up the majority of the population but there are other ethnicities such as Euromericans and Europeans too. The major challenges faced by Tonga are decaying infrastructure, low economy, and political corruption. The widespread of non-communicable diseases such as cancer is a major health issue in Tonga. 74% of all adults in Tonga are the victim of these diseases. More than half of the total population is affected by the non-communicable diseases. There is no specific treatment available to cure non-communicable diseases. Vaccines and immunizations are ineffective against these diseases. However, certain measures can be taken to reduce the sufferings of the affected. Primary prevention should be the main aim to prevent chronic diseases. Most of the chronic diseases are incurable. Unhealthy diet, tobacco use, and physical inactivity are the essential causes of chronic diseases.

In his review article in the March 2015 edition ofCME, Prof. A M Meyers refers to chronic kidneydisease as 'an important disease group that threatenshealth'. I fully concur with this observation andwish to go a step further and assert that kidneydisease, together with other related non-communicable diseases(NCDs), poses not only a threat to health but also to theoverall development of South Africa (SA). It is now almost 4 yearssince the adoption of the Political Declaration of the High-levelMeeting of the General Assembly on the Prevention and Controlof Non-communicable Diseases (September 2011), where itwas emphatically stated that member States that have signed theDeclaration (including SA) 'Acknowledge that the global burdenand threat of non-communicable diseases constitutes one of themajor challenges for development in the twenty-first century,which undermines social and economic development throughoutthe world, and threatens the achievement of internationallyagreed development goals'.

The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy.