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Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 8531

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Special Issue Editor

Dr. Emmanuel Cohen

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Guest Editor

1. Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7206 « Eco-anthropologie », Muséum National d’Histoire Naturelle, 75116 Paris, France
2. MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
Interests: biocultural studies; holistic anthropology; urbanization; lifestyle transition; migrant populations; public health; wellbeing

Special Issue Information

Dear Colleagues,

In the context of the rapid urbanization process in low and middle-income countries (LMICs) that is generating an epidemiological transition, the existing literature has already identified the main socio-ecological determinants of rising cardiometabolic diseases (CDs) in urban areas. Both physical and sociocultural environments can provide exposure to CDs. A greater access to processed high-calorie food and motorized transports favors obesogenic dietary practices and sedentary behaviors, while the traditional social valorization of stoutness and idleness, as symbols of prosperity and peacefulness, leads to obesogenic fattening practices in urban areas. However, the respective and combined contribution of these socio-ecological determinants remain insufficiently explored because most studies did not integrate these potential drivers together in multivariable analyses. Moreover, the pathways predicting CDs between sociodemographic indirect determinants (age, sex, education, urban lifetime duration, etc.) and socio-ecological direct determinants (dietary intake and physical activity) are also rarely explored to study the etiology of CDs. Yet, both respective and cumulative contributions of these drivers, as well as the multiple driver pathways leading to CDs, must be explored to explain the difference in the prevalence and incidence of CDs between LMICs, and better identify at-risk subgroups toward this rising burden. Therefore, this Special Issue of International Journal of Environmental Research and Public Health (IJERPH) aims to focus on the systemic interactions between drivers of CDs in LMICs, and therefore invites any contribution (all manuscript types: research papers, reviews, case reports, conference papers, commentaries, methodological papers, position papers and brief reports) using holistic and interdisciplinary frameworks to study the determinants of CDs.

Dr. Cohen Emmanuel
Guest Editor

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Keywords

urbanization
epidemiological transition
cardiometabolic diseases
driver pathways
systemic interactions
multivariable analyses
holistic approach
LMICs

Published Papers (5 papers)

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Research

12 pages, 1192 KiB

Open AccessArticle

Consumption of Sugary Drinks among Urban Adults in Colombia: Association with Sociodemographic Factors and Body Adiposity

by Maria A. Santana-Jiménez, Luz D. Nieves-Barreto, Angélica Montaño-Rodríguez, Carolina Betancourt-Villamizar and Carlos O. Mendivil

Int. J. Environ. Res. Public Health 2023, 20(4), 3057; https://doi.org/10.3390/ijerph20043057 - 9 Feb 2023

Viewed by 1663

Abstract

Introduction: Calories from sugar-sweetened beverages (SSBs) contribute to the development of noncommunicable diseases. There is limited knowledge of the intake of SSBs and their correlates in developing countries. Thus, this study aimed to estimate the consumption of multiple SSBs and their sociodemographic correlates in an urban adult population from Colombia, South America. Methods: This was a probabilistic, population-level study of adults aged 18 to 75 from five cities representing different regions of Colombia. Dietary intake was assessed employing a 157-item semiquantitative food frequency questionnaire that inquired about intake over the last year. The consumption of regular soda, low-calorie soda, homemade and industrialized fruit juices, energy drinks, sport drinks, malt drinks and traditional sugar cane infusion (“agua de panela”) was analyzed for the total sample and subgroups defined by sociodemographic and clinical factors of interest. Results: The study included 1491 individuals (female: 54.2%, mean age: 45.3, overweight: 38.0%, obese: 23.3%). Sugary beverages contributed, on average, 287 Cal/d among women and 334 Cal/d among men, representing 8.9% of total daily calories (TDC). Women in the lowest SEL consumed 10.6% of their TDC from sugary drinks, as opposed to 6.6% for those in a high SEL. For men, this difference was not present (p-value for interaction = 0.039). Interestingly, a higher educational level correlated with a lower consumption of calories from sugary drinks only among men. Fruit juices were by far the main source of sugary drinks, and their consumption did not change sizably by sex and socioeconomic or educational level. Among women, there was a negative association between socioeconomic level (SEL) and consumption of regular soda, a 50% difference between extreme levels. The intake of low-calorie soda was much higher among men than women, and it more than tripled in the highest vs. lowest SEL among men. The consumption of energy drinks was heavily concentrated in men of low SEL. Conclusion: Colombian urban adults obtain a considerable proportion of their calories from sugary drinks, especially vulnerable groups such as women with lower education. Given the recent acceleration of the obesity epidemic in Latin America, strategies to limit the intake of such liquid calories may provide important public health benefits. Full article

(This article belongs to the Special Issue Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective)

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13 pages, 506 KiB

Open AccessArticle

Maternal and Dietary Factors Are Associated with Metabolic Syndrome in Women with a Previous History of Gestational Diabetes Mellitus

by Farah Yasmin Hasbullah, Barakatun-Nisak Mohd Yusof, Rohana Abdul Ghani, Zulfitri ‘Azuan Mat Daud, Geeta Appannah, Faridah Abas and Sangeetha Shyam

Int. J. Environ. Res. Public Health 2022, 19(24), 16797; https://doi.org/10.3390/ijerph192416797 - 14 Dec 2022

Cited by 3 | Viewed by 1458

Abstract

While it is known that women with a previous history of gestational diabetes mellitus (post-GDM) have a higher risk of metabolic syndrome (MetS), evidence of lifestyle practices from low- and middle-income countries (LMICs) is still scarce. This study aimed to determine the factors associated with MetS in women post-GDM. This cross-sectional study involved 157 women post-GDM (mean age 34.8 ± 5.6 years) sampled from Selangor, Malaysia. We collected data on sociodemographic characteristics and obstetric history. Food intake was assessed using a food frequency questionnaire, and dietary patterns were derived from principal component analysis. MetS was diagnosed according to the 2009 Harmonized criteria. The prevalence of MetS in this study was 22.3%. Western dietary pattern consumption was correlated with MetS, body mass index (BMI), waist circumference, and triglyceride levels. Independent factors associated with MetS were lower education level (odds ratio, OR 4.017, p = 0.007), pre-pregnancy BMI (OR 1.192, p = 0.002), and Caesarean delivery (OR 3.798, p = 0.009). The study identified the maternal and dietary factors associated with MetS in women post-GDM in Malaysia. Community-based interventions that include dietary modification are warranted to prevent MetS and its complications, thus helping to reduce the overall disease burden. Full article

(This article belongs to the Special Issue Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective)

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10 pages, 653 KiB

Open AccessArticle

Factors Associated with Improved Knowledge of Metabolic Syndrome in Female Market Traders

by Gloria Achempim-Ansong, Amme M. Tshabalala and Philippe J. Gradidge

Int. J. Environ. Res. Public Health 2022, 19(19), 12256; https://doi.org/10.3390/ijerph191912256 - 27 Sep 2022

Viewed by 1336

Abstract

Metabolic syndrome (MetS) is considered to be a clustering of cardiometabolic diseases and is emerging as a public health concern. There is little evidence of this disease in market traders, and so the aim of this study was to determine the prevalence and knowledge of MetS. In this cross-sectional study, anthropometry, blood pressure and bloods were collected using standardized methods to detect the prevalence of MetS using the harmonized method in a cohort of female Ghanaian market traders (n = 338). A questionnaire documented the knowledge of MetS. Linear regression was used to investigate the factors associated with knowledge and was reported as adjusted β values. Forty-two percent (n = 142) had MetS. The overall knowledge of MetS was low, driven by education (β = 0.22, p = 0.0001), low levels of high-density lipoprotein-cholesterol (β = −0.15, p = 0.018) and affiliation with the Ewe cultural group (β = −0.19, p = 0.0004). As females working in a sedentary occupation, market traders are vulnerable to MetS. Our findings indicate the urgent need for culturally sensitive education to promote healthy behaviours. Full article

(This article belongs to the Special Issue Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective)

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9 pages, 336 KiB

Open AccessArticle

The Effect of Obesity on the Waist Circumference Cut-Point Used for the Diagnosis of the Metabolic Syndrome in African Women: Results from the SWEET Study

by Philippe J. Gradidge, Shane A. Norris and Nigel J. Crowther

Int. J. Environ. Res. Public Health 2022, 19(16), 10250; https://doi.org/10.3390/ijerph191610250 - 18 Aug 2022

Cited by 4 | Viewed by 1509

Abstract

Waist circumference (WC) is one of the diagnostic criteria for metabolic syndrome (MetS). However, studies have shown that the waist cut-point may be influenced by BMI. The aim of this study was to, therefore, determine whether the presence of obesity influences the WC cut-point used to diagnose MetS in sub-Saharan African women. The second aim was to determine whether calculated cut-points of other waist-related and dual-energy X-ray absorptiometry (DXA)-determined anthropometric measures used for the diagnosis of MetS were also influenced by BMI. Biochemical, simple anthropometric and dual-energy X-ray absorptiometry-derived anthropometric data were collected in 702 black South African women from the Study of Women Entering and in Endocrine Transition (SWEET). A receiver operating characteristic curve analysis was used to determine waist, waist-to-hip (WHR) and waist-to-height ratios, body shape index (ABSI), total body fat, trunk fat, and peripheral (arm + leg) fat cut-points for MetS (without waist) in subjects with BMI above or below the median value. The estimated WC cut-points (107 cm, 93.5 cm) for women with high BMI and low BMI, respectively, and the cut-points for the other anthropometric variables for the diagnosis of MetS were greater in high BMI women compared to low BMI women. The exceptions were WHR and ABSI, for which the cut-points were very similar in both BMI groups, and peripheral fat, where the cut-point was lower in the high BMI group. Logistic regression analysis demonstrated that WC was associated with a higher risk (odds ratio [95% CIs]: 1.07 [1.04, 1.10]; p < 0.0001), whilst hip was associated with a lower risk (0.97 [0.94, 0.99]; p = 0.02) for MetS. These data suggest that with increasing BMI, the higher levels of protective gluteofemoral fat lead to the requirement for higher WC cut-points for MetS diagnosis. The opposing associations of waist and hip with MetS risk make WHR a more appropriate variable for diagnosing MetS among African women as the WHR cut-point is less influenced by increasing BMI than is WC, which was also observed for ABSI. Full article

(This article belongs to the Special Issue Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective)

17 pages, 3121 KiB

Open AccessArticle

Direct and Indirect Determinants of Body Mass Index in Both Major Ethnic Groups Experiencing the Nutritional Transition in Cameroon

by Emmanuel Cohen, Norbert Amougou, Amandine Ponty, Margaux Guerrien, Wakilongo Wakenge, Glory Chidumwa, Rihlat Said-Mohamed, Léopold K. Fezeu and Patrick Pasquet

Int. J. Environ. Res. Public Health 2022, 19(10), 6108; https://doi.org/10.3390/ijerph19106108 - 17 May 2022

Cited by 1 | Viewed by 1798

Abstract

In the context of rapid nutritional transitions in Africa, few studies have analyzed the etiology of obesity by considering the driver pathways that predict body mass index (BMI). The aim of this study is to innovatively identify these driver pathways, including the main sociodemographic and socioecological drivers of BMI. We conducted a rural–urban quantitative study in Cameroon (n = 1106; balanced sex ratio) to explore this issue. We recruited participants and reported several sociodemographic characteristics (e.g., marital status, socioeconomic status (SES), and ethnicity). We then assessed three main socioecological drivers of BMI (body weight perception, dietary intake, and physical activity) and conducted bioanthropometric measurements. We identified several driver pathways predicting BMI. In Cameroon, Bamiléké ethnicity, higher SES, being married, and older age had positive effects on BMI through overweight valorization and/or dietary intake. Accordingly, we found that being Bamiléké, married, and middle-aged, as well as having a higher SES, were factors that constituted at-risk subgroups overexposed to drivers of obesity. As such, this study highlights the necessity of investigating the complex driver pathways that lead to obesity. Therefore, better identification of the subgroups at risk for obesity will help in developing more targeted population health policies in countries where this burden is a major public health issue. Full article

(This article belongs to the Special Issue Exploring the Determinants of Cardiometabolic Diseases in LMICs through a Holistic Perspective)

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