Both dietary diversity and physical activity during pregnancy are very important since they are known to affect pregnancy and birth outcomes. However, little is documented on dietary diversity and physical activity among pregnant women in Bangladesh. Accordingly, this study was designed to assess the dietary diversity and physical activity level, as well as their associated factors, among pregnant women at an antenatal care setting in Bangladesh.
An institution-based cross-sectional study was conducted with 96 randomly selected pregnant women who sought antenatal care at a hospital in Khulna City, Bangladesh in July 2020. Dietary diversity and physical activity were assessed using the 24-h dietary recall method of consuming seven food groups, and standardized Pregnancy Physical Activity Questionnaire (PPAQ), respectively. Simple and multivariable logistic regressions were conducted to determine the factors associated with dietary diversity and physical activity among pregnant women.
Around 70% of participants had high dietary diversity and 58.3% were physically active. Being job holders, getting counseling on diet, and being from higher income and food-secured families were identified as potential determinants of the high dietary diversity of participants. Having higher secondary education, being job holders, and being from families with a size of below five were more likely to be physically active compared to others.
In light of these findings, there is a need to support existing policies and devise new policies targeting these variables. Improving awareness on the importance of dietary diversity during pregnancy, incorporating counseling services, ensuring household food security especially during this pandemic situation, and providing women with diet counseling are recommended to increase pregnant women's dietary diversity and physical activity level.
Status disclosure remains a major challenge for most caregivers of children living with HIV/AIDS, and it remains suboptimal, resulting in reduced adherence and negative psychological and physical outcomes in these children. This study explored caregivers’ experiences of disclosure of the HIV status of their affected children within the Greater Accra Region of Ghana.
Using the interpretive phenomenological qualitative approach, in-depth interviews were conducted among 15 caregivers (aged 27–55 years) who were either the biological parents or guardians of children living with HIV (aged 6–15 years) from three main hospitals giving antiretroviral care in the Greater Accra Region. Interviews focused on the reasons for disclosure, the process of disclosure, and the aftermaths of disclosure. The interviews were recorded, transcribed, and subsequently analyzed thematically.
Three main themes emerged from the analysis: “The Despair of HIV Diagnosis,” “The Dilemma and Nuances of Disclosure,” and “Aftermaths of Disclosure” Generally, the diagnosis of HIV in the children came as a shock to most caregivers which led to subsequent testing and diagnosis of caregivers. Two forms of disclosure were observed from the narratives: partial and full disclosure. Reasons for full disclosure were the child's curiosity, non-adherence to antiretroviral therapy, and transition to high school. Non-disclosure was as a result of stigma, the child been too young, and a lack of skill to disclose. Overall, caregivers reported that disclosure improved adherence and well-being in their children; and helped reduce tension and anxiety among caregivers.
These findings suggest disclosure of HIV status to children living with HIV/AIDS has the potential to positively influence health outcomes in these children. However, caregivers need to be educated to initiate disclosure with the needed assistance from health care providers.
Acid suppression is the accepted treatment for gastroesophageal reflux disease, despite being ineffective in one third of patients. Certain conditions presenting as reflux may later be attributed to food allergy (infant cow's milk allergy; eosinophilic esophagitis), but the role of food allergy in adult reflux disease has rarely been investigated. The mechanisms of gastroesophageal reflux disease are examined to explore potential subgroups within the population, such as undisclosed food allergy, which may determine the responsiveness to treatment. The relevant literature was searched systematically using ProQuest Dialog, yielding 113 papers that were evaluated for quality. The extracted evidence was formed into a mechanistic diagram representing the processes of disease. As yet, insufficient research exists to evaluate the relationship between food allergies and reflux in adults. Of significance, however, is the potential for multiple variables to affect the integrity of the esophageal mucosa, thereby allowing symptoms to emerge which are independent of acid exposure. Where nonacidic drivers of inflammation exist, acid suppression is unlikely to offer adequate symptom resolution and may serve to explain the high proportion of nonresponders in this group. The review concludes that symptoms of gastroesophageal reflux may emerge in response to the coexistence of physiological reflux and esophageal mucosal inflammation. The latter may arise due to reflux-induced acid erosion, or due to alternative endogenous sources of inflammation. When a patient presents with refractory reflux and a history of allergic disease, the role of antigen-induced inflammation should be considered for further investigation. Nonallergic individuals presenting with refractory reflux symptoms may benefit from further analysis of relevant co-morbidities that have the capacity to compromise mucosal integrity, including obesity or psychological stress. The identification of specific mediators of inflammation in refractory reflux disease may enable the development of personalized treatment regimes which improve outcomes and reduce the reliance on acid suppressants.
Risk of cardiovascular disease (CVD) among postmenopausal Bangladeshi women has not yet been evaluated using a country-specific tool. Hence, we prompted to estimate the risk and identify the predictors that were not typically included in any CVD risk assessment tool.
This cross-sectional study used a web version of country-specific lab-based Globorisk calculator to estimate the risk of CVD among 265 postmenopausal women who visited a primary healthcare centre in a rural area of Bangladesh. The centre was selected purposively and the participants were recruited using a convenient sampling technique. Data were collected using a modified STEP-wise approach to surveillance of non-communicable disease risk factors questionnaire of the World Health Organization. The risk levels were presented using descriptive statistics and the associated predictors were identified using adjusted multiple linear regression analysis.
Overall, 56.7% of the subjects were identified as ‘at risk’ of future CVD events. After adjusting the confounders, CVD risk factors including age of onset of menopause (β = 0.441, p < 0.001), duration of menopause (β = 0.603, p < 0.001), smokeless tobacco use (β = –1.047, p = 0.003), added salt intake (β = 1.081, p = 0.002), waist–hip ratio (β = 0.094, p = 0.03) and diastolic blood pressure (β = 0.145, p = 0.001) were identified as significant predictors of CVD risk.
This finding suggests screening program among postmenopausal women for early detection of CVD risk and efforts to control the associated predictors.
Cardiometabolic diseases (CMDs) are the most common, noncommunicable diseases that claim many lives every year. CMDs have great impact on public health, often driving the attention of healthcare resources to prevent and treat them. CMDs include cardiovascular diseases, type 2 diabetes mellitus, metabolic syndrome, and obesity. Deep understanding of the root causes and pathogenic factors of CMDs would help in their effective prevention and treatment. Metabolomic profiling of biosamples usually sheds light on the metabolic biomarkers and the involved pathways. Metabolomic analysis to identify CMDs metabotypes revealed that they share similar metabolic signatures and metabolic pathways. These metabolic pathways may indicate the presence of insulin resistance, mitochondrial dysfunction, low-grade inflammation, and dysbiotic gut microbiota. This study is aimed to review the literature on the common metabolic biomarkers of CMDs as well as the shared pathways that can be targeted by dietary interventions and pharmacologic treatment.
Re: Redsell S, Bains KK, Le Broq S, Bucks RS, Byrne-Davis L, Gray L, Hotham S, Hennessy M, Kyle TK, McPherson A, Quigley F, Vicari M, Zinn SR. Concerns regarding “Association between intelligence quotient and obesity in England” and unjustifiable harm to people in bigger bodies. Lifestyle Medicine 2021.
We thank Redsell and colleagues for preparing a comment on our important work surrounding the cross-sectional association between intelligence quotient (IQ) and obesity, while adjusting for sex, age, ethnicity, marital status, qualification, employment, income, chronic physical conditions, loneliness, social support, stressful life events, smoking status, alcohol dependence, drug use, and common mental disorders.
Our analysis was conducted and reported in accordance with STROBE guidance. The analyses showed that after adjustment for the aforementioned confounders, compared to IQ scores of 120–129, IQ scores of 110–119 (odds ratio [OR] = 1.16), 100–109 (OR = 1.35), 90–99 (OR = 1.26), 80–89 (OR = 1.68), and 70–79 (OR = 1.72) were associated with increased odds for obesity. Furthermore, a 10-point decrease in IQ was associated with a 1.10-fold increase in the odds for obesity. We went on to discuss the findings (i.e., the potential mechanisms that could explain the IQ–obesity relationship) in the context of the limitations of the study and concluded that there was a negative association between IQ and obesity in the UK population.
Correlates of health outcomes and behaviors can either be modifiable (e.g., physical activity level) or nonmodifiable (e.g., IQ). Modifiable correlates inform targets for change in interventions (such as increasing levels of physical activity) and nonmodifiable correlates inform populations who should be targeted for intervention (such as those with a low IQ in obesity prevention).1 These people with characteristics which may not be modifiable can also benefit from lifestyle interventions as they may be more likely to engage in lifestyle factors, which can lead to adverse health outcomes. In our study, which found that low IQ is associated with obesity, we discuss the potential contribution of lifestyle factors in this association. Identifying both types of correlates in terms of health behavior is essential for successful and targeted intervention. In this context, the present paper perfectly fits into the scope of “Lifestyle Medicine.”
It is not, nor ever has been our intention to fuel inappropriate perceptions of anyone in society. Indeed, we partake in a lot of co-created research with vulnerable groups and their voice is very important to us. We would like it acknowledged though that we do not have control over how research is used. The authors of this letter seem to infer that open access to scientific articles is not appropriate as it may be misinterpreted by parties with a vested interest. We would strongly refute this and choose to publish in open access jou
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