Journal of Health, Population, and Nutrition最新文献

Background: Smoking remains a leading cause of preventable morbidity and mortality globally, with significant public health and economic implications. In Jordan, smoking prevalence among men is alarmingly high, necessitating a deeper understanding of its determinants. This study aims to identify sociodemographic factors influencing smoking behavior among Jordanian men aged 15-59 years using nationally representative data.

Methods: The study utilized data from the 2023 Jordan Population and Family Health Survey (JPFHS) to analyze sociodemographic factors influencing smoking behavior. Descriptive statistics and binary logistic regression analyses were performed. Associations were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs), with statistical significance set at p < 0.05.

Results: Our study included 5,873 Jordanian men, with 3,072 (52.30%) classified as non-smokers, 2,615 (44.52%) as everyday smokers, and 186 (3.17%) as someday smokers. Multivariable analysis revealed several factors significantly associated with higher odds of smoking, including increasing age, working in agriculture, services, and skilled manual occupations, being widowed, residing in Zarqa, being in the poorest or richest wealth categories, and using the internet at least once a week or almost every day (p < 0.05). On the other hand, living in Tafiela and reading newspapers or magazines at least once a week were significantly associated with lower odds of smoking (p < 0.05).

Conclusion: Our study identified several sociodemographic factors significantly associated with smoking among Jordanian men, including older age, working in agriculture or skilled manual labor, widowhood, residence in Zarqa, extreme wealth levels, and frequent internet use. In contrast, newspaper readership and residence in Tafiela were protective. These findings highlight the importance of targeted public health interventions aimed at high-risk groups and strengthening tobacco control efforts across the country.

Background: Mindful eating serves as a therapeutic intervention for recognizing and gradually altering the established daily eating habits and patterns.

Objectives: This study aims to estimate the prevalence of adoption of principles of mindful eating among medical and non-medical university students and to detect the effect of adoption of mindful eating on the Body Mass Index of the studied subjects.

Methods: A cross-sectional study was conducted among 576 undergraduate students using a structured self-administered questionnaire comprising sociodemographic data, perceived weight and height and Mindful Eating Questionnaire.

Results: The majority of the studied students (94.4%) were used to adopt Mindful eating. The percentages of medical and non-medical students were used to adopt Mindful eating were (97.6% and 91.3%, respectively). A statistically significant association was detected between the type of the study (faculty) and adoption of mindful eating (P-value = 0.001). Medical study permits adopting mindful eating by about 73.8% more than non-medical studies. Medical male students showed higher scores for the disinhibition subscale than females (P-value = 0.025) while non-medical female students showed higher scores for the awareness subscale than males (P-value = 0.006). Nearly three fourths of the studied subjects (74.3%) had Body Mass Index ≥ 25. The percentage of medical students (17.4%) having Body Mass Index ≥ 25 was less than the percentage of their non-medical peers (34.0%). The association between the type of the study (faculty) and Body Mass Index categories was statistically significant (P-value = < 0.001). The higher scores on the Mindful Eating Questionnaire overall and on each of the categories except the awareness score had been associated with lower Body Mass Index. Most of the students adopting Mindful eating (75.4%) had Body Mass Index < 25 as compared to their peers who did not adopt Mindful eating where more than one third of them (43.8%) had Body Mass Index ≥ 25. The association between Mindful eating summary score categories and Body Mass Index categories was statistically significant (P-value = 0.016). A significant negative weak correlation was detected between Mindful eating summary score categories and Body Mass Index categories (P-value = 0.044).

Conclusion: Academic background reinforces the potential of mindful eating as a viable strategy for promoting healthier eating habits and effective weight management among university students.

Background: Annually, millions of children under-five die from preventable causes. This study aimed to investigate risk factors associated with the time to death from several causes in children under-five in Bangladesh.

Methodology: The data were extracted from the 2022 Bangladesh Demographic and Health Survey (BDHS). A total of 13,119 under-five children were selected. Eleven causes of child mortality were categorized into disease, non-disease, and other causes. The event was death (in months), and children who were alive at the interview date were censored. This study employed the Cumulative Incidence Function (CIF) to describe cause-specific probabilities over time and the Fine and Gray competing risk model to analyze the risks of death, using sub-distribution hazard ratios (SHR).

Result and discussion: Among 464 (3.5%) under-five deaths, 141 (30.4%), 258 (55.6%), and 65 (14%) died from disease, non-disease, and other causes, respectively. The Sylhet division (SHR: 2.51, Confidence interval (CI): 1.25-5.01, p = 0.009) had a higher risk of child mortality due to disease, and delivery by cesarean section (SHR: 0.544, CI: 0.31-0.96, p = 0.035) had a lower risk of child mortality due to non-disease. Additionally, significant variables included mother's age, birth order number, and place of delivery for disease; mother's age, mother's education, wealth index, birth order number, and place of delivery for non-disease; and division, mother's education level, birth order number, and place of delivery for other causes.

Conclusion: Supporting young mothers, reducing socioeconomic disparities, and tailoring interventions by birth order and specific cause of death can improve child health.

Breastfeeding empowerment among mothers plays a critical role in improving neonatal health outcomes and ensuring sustained breastfeeding practices. Increasing attention has been given to the role of fathers in this process, particularly their attitudes and self-efficacy in supporting breastfeeding. This study aimed to assess paternal attitudes and self-efficacy regarding breastfeeding support and to investigate their associations with maternal breastfeeding empowerment. A cross-sectional study was conducted in 2024 involving 242 couples attending urban health centers in Tabriz, Iran. Data were collected using standardized questionnaires assessing paternal attitudes, paternal self-efficacy in supporting breastfeeding, and maternal breastfeeding empowerment. Descriptive statistics were used to summarize sample characteristics. Pearson correlation was employed to examine bivariate associations, and a general linear model (GLM) was applied to identify predictors of breastfeeding empowerment. The mean (± SD) breastfeeding empowerment score among mothers was 98.42 ± 15.37, while the mean paternal self-efficacy score was 52.64 ± 7.89. Most fathers (64.9%) exhibited neutral attitudes toward breastfeeding. The GLM analysis revealed that paternal self-efficacy was a significant positive predictor of maternal breastfeeding empowerment (B = 0.251, 95% CI: 0.050 to 0.452, p = 0.015). Other significant predictors included attending breastfeeding education classes (B = - 3.956, 95% CI: -7.504 to - 0.409, p = 0.029), maternal education at the elementary level (B = - 7.796, 95% CI: -15.352 to - 0.240, p = 0.043), maternal occupation as a housewife (B = 7.141, 95% CI: 0.670 to 13.612, p = 0.031), and history of abortion (B = 3.340, 95% CI: 0.332 to 6.347, p = 0.030). Paternal attitudes were not significantly associated with maternal breastfeeding empowerment (p = 0.703). Paternal self-efficacy in breastfeeding support is a significant determinant of maternal breastfeeding empowerment. Targeted interventions that enhance paternal self-efficacy during prenatal and postpartum care may contribute to improving breastfeeding outcomes. Involving fathers in breastfeeding promotion programs is essential for fostering supportive family environments.

Background: Obesity among older adults presents a serious public health challenge worldwide. The gut microbiota plays a key role in metabolic health and obesity, however its specific alterations in older adults with obesity remain unclear. This study aimed to assess the differences in the abundance of certain indicator gut bacterial genera between older adults with obesity and those with normal weight.

Methods: We conducted a case-control study in 2025 involving 104 individuals with obesity and 185 with normal weight, selected from the participants in phase III of the Bushehr Elderly Health (BEH) Program. The obesity group included individuals with a body mass index (BMI) ≥ 30 kg/m² along with waist circumference > 88 cm for women or > 102 cm for men, while the normal weight group had BMI between 18.5 and 24.9 kg/m² and waist circumference below these thresholds. Quantitative real-time PCR was used to measure the abundance of six indicator gut bacterial genera. Statistical analyses, including multiple logistic regression, were employed to evaluate associations between bacterial genera abundance and obesity status, with confounders identified by Directed Acyclic Graph.

Results: The participants' mean age was 72.78 ± 3.08 years. In the obesity and normal weight groups, 38.5% and 67.6% of participants were male, respectively. The abundance of Bacteroides (odds ratio [OR]: 0.681, 95% CI: 0.535-0.866), Blautia (OR: 0.450, 95% CI: 0.301-0.673) and Faecalibacterium (OR: 0.750, 95% CI: 0.583-0.965) were negatively associated with obesity in older adults, after adjusting for age, sex, socioeconomic status, physical activity, and nutritional status.

Conclusions: This study highlights the association between specific gut microbiota and obesity in older adults. Understanding this association and interventions targeting the indicator bacteria may contribute to healthy aging by mitigating obesity and its related metabolic disorders.

Background: Epigenetic clocks, biomarkers of aging, show older biological ages among individuals with cardiometabolic disease. Epigenetic age acceleration, often calculated as the residuals from regressing epigenetic age on chronological age, reflects when an individual's biological age is older or younger than expected. Most clocks were developed and validated in Western populations. This study examined associations of epigenetic age acceleration with obesity, hypertension, diabetes, and metabolic syndrome among Guatemalan adults.

Methods: We conducted a cross-sectional analysis of data from participants in the Institute of Nutrition of Central America and Panama (INCAP) Nutritional Supplementation Trial Cohort. DNA methylation (DNAm) was assessed in buffy coat samples using the MethylationEPIC v2 array and standard quality control procedures. Epigenetic age was quantified using DunedinPACE, PhenoAge, and GrimAge. Linear regression models were used to assess associations of obesity, diabetes, hypertension, and metabolic syndrome with epigenetic age acceleration. Dependent variables were DunedinPACE values and PhenoAge and GrimAge residuals. Covariates included sex, birth year, and a clustering variable to account for sibships.

Results: We analyzed data from 1,095 adults (mean age 45 y; 60.3% female; 73.3% overweight or obese; 37.8% with hypertension; 15.4% with diabetes; 66.9% with metabolic syndrome). DunedinPACE (mean 1.2, SD 0.1), PhenoAge (mean 46.7, SD 6.7) and GrimAge (mean 56.3, SD 4.1) all indicate accelerated biological aging. Pearson correlations among the clocks were ≥ 0.5. DunedinPACE and PhenoAge indicated age acceleration among women (DunedinPACE β = 0.04; 95% CI: 0.03, 0.05; PhenoAge β = 0.94; 95% CI: 0.28, 1.60) whereas GrimAge suggested age acceleration among men (β= - 1.02; 95% CI: - 1.31, - 0.72). All three clocks showed accelerated aging among individuals with diabetes (DunedinPACE β = 0.09; 95% CI: 0.07, 0.10; PhenoAge β = 2.69; 95% CI: 1.63, 3.74; GrimAge β = 1.18; 95% CI: 0.71, 1.65). DunedinPACE indicated a faster rate of aging across all cardiometabolic conditions examined, whereas the strength and consistency of associations for PhenoAge and GrimAge varied by condition.

Conclusions: We observed consistent associations of accelerated DunedinPACE with multiple cardiometabolic conditions. All epigenetic clocks showed associations of epigenetic age acceleration with diabetes. These findings emphasize the need for longitudinal analyses to determine the direction and causality of these relationships.

Background: This study aimed to clarify between serum calcium and mortality in osteoarthritis (OA) patients using NHANES data (2003-2018).

Method: A total of 1,249 adults with OA were included. Mortality outcomes were ascertained through linkage to the National Death Index (NDI). Cox proportional hazards models were used to assess the independent association of serum calcium concentration with the risk of death. We used a two-stage Cox proportional hazards model to elucidate the nonlinear relationship between serum calcium concentration and the risk of death in patients with OA. Stratified analyses were performed to identify patients at higher risk.

Results: During follow-up (median: 9.7 years), 220 all-cause deaths occurred (56 CVD-related, 64 cancer-related). After adjusting for relevant variables, serum calcium concentration showed an inverse linear association with all-cause and CVD mortality. Although smoothed curve fitting visually suggested U-shaped and L-shaped patterns for all-cause and CVD mortality, respectively, formal tests for nonlinearity did not reach statistical significance (P for log-likelihood ratio > 0.05). Specifically, the risk was elevated at lower calcium levels and stabilized or showed a non-significant increase at higher levels. In the piecewise linear model, serum calcium below 9.50 mg/dL was inversely associated with all-cause mortality, where each 1 mg/dL increase was associated with a 48% lower risk (HR 0.52, 95% CI: 0.30-0.91). Above 9.50 mg/dL, the association was non-significant (HR 1.09, 95% CI: 0.51-2.35). A similar L-shaped pattern was observed for CVD mortality below the inflection point (HR 0.26, 95% CI: 0.09-0.74). However, formal likelihood ratio tests comparing the threshold model with a linear model did not reach statistical significance (P > 0.05), indicating that the data do not provide strong evidence against a linear association.

Conclusion: Our primary analysis supports an inverse linear association between serum calcium and mortality in OA patients. Although exploratory analyses revealed potential non-linear patterns visually, these were not statistically confirmed. Therefore, the overall relationship is best characterized as linear within the observed range, with lower serum calcium associated with higher mortality risk. Therefore, these findings highlight a potential optimal range for serum calcium but require verification in future studies designed to confirm nonlinearity and assess the clinical utility of calcium management.

Background: Activities of daily living at home (ADL) are a fundamental aspect of adaptive behavior in children, youth, and adults with Down syndrome (DS). However, they have received limited attention in relation to this topic. This highlights the lack of a validated instrument for the DS population in Chile.

Objective: a) Verify validity and reliability of the Scale for Assessing of Daily Living at Home (SAADL) and b) Develop benchmarks for daily activities in children, young people, and adults with DS in central-southern Chile.

Methods: A descriptive cross-sectional study was conducted in children, youth and adults with DS in Chile. A total of 320 young people (168 males and 152 females) with an age range of 6 to 29 years were recruited. Weight and height were assessed and body mass index BMI was calculated. The SAADL was used to measure activities of daily living at home. Reliability was determined by stability measures (test and retest) and validity by confirmatory factor analysis (CFA). Percentiles were constructed using the LMS technique (L(t) Box-Cox power, M(t) median and S(t) coefficient of variation).

Results: In both sexes, the technical error of measurement (TEM) showed very low values, with an absolute error of less than 0.23 and a relative error of 0.85%. The values of the concordance correlation coefficient showed high values of precision and accuracy from 0.94 to 0.98. The Kappa analysis showed substantial agreement values from 0.73 to 0.78. Mean differences in the Bland-Altman plot were minimal (~0.32 to ~0.56 points). The CFA demonstrated the validity of the scale (RMSEA: 0.057). Percentiles were plotted for SAADL (p5, p10, p15, p25, p50, p75, p85, p90 and p95).

Conclusion: The study confirms that the SAADL is highly valid and reliable for assessing activities of daily living in children, youth and adults with DS in the south-central region of Chile. Its use is recommended as an effective tool for clinical assessment, early intervention and personalization of care, based on the proposed reference values.