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1. Peripheral Arterial Disease Prevalence in a Population-Based Sample of People with Diabetes on the Caribbean Island of Barbados

Author

Adams OP, Herbert JR, Unwin N, and Howitt C

Subjects
diabetes, peripheral arterial disease, peripheral artery disease, claudication, waveform, doppler ultrasound, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

O Peter Adams,1 Joseph R Herbert,1 Nigel Unwin,2– 4 Christina Howitt2 1Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St Michael, Barbados; 2George Alleyne Chronic Disease Research Centre, University of the West Indies, St. Michael, Barbados; 3MRC Epidemiology Unit, University of Cambridge, Cambridge, UK; 4European Centre for Environment and Human Health, University of Exeter, Truro, UKCorrespondence: O Peter Adams, Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St. Michael, Barbados, Tel +1 246 417 4260, Fax +1 246 438 9170, Email peter.adams@cavehill.uwi.eduBackground: Peripheral arterial disease (PAD) is a risk factor for amputation and systemic atherosclerotic disease. Barbados has a high diabetes prevalence, and 89% of diabetes-related hospital admissions are for foot problems. Foot examination is infrequent in Barbados primary care. The prevalence and potential risk factors for PAD in people with diabetes in Barbados were studied.Methods: Multistage probability sampling was used to select a representative population sample of people ≥ 25 years of age with known diabetes or fasting blood glucose ≥ 7 mmol/L or HbA1c ≥ 6.5%. We administered the Edinburgh claudication questionnaire and assessed the ankle brachial pressure index (ABI) and Doppler waveform in both dorsalis pedis and posterior tibial arteries. Participants were classified into categories based on ABI as follows: PAD ≤ 0.90 in any leg; borderline 0.91 to 0.99 in one leg and the other not ≤ 0.90 or > 0.4; normal 1.00 to 1.40 in both legs; and non-compressible > 1.40 in one leg and the other not ≤ 0.9. Waveforms crossing the zero-flow baseline were categorised as normal. Multivariable logistic regression assessed the associations of potential risk factors with PAD.Results: Of 236 participants (74% response rate, 33% male, median age 58.6 years), 51% had previously diagnosed diabetes. Of nine people with symptoms of definite or atypical claudication, four had PAD and one had non-compressible arteries. ABI prevalence (95% CI) was PAD 18.6% (13.8, 24.6), borderline 21.9% (16.6, 28.4), normal 55.5% (49.4, 61.5) and non-compressible 3.9% (1.6, 9.3). Increasing age and female gender were independently associated with PAD. Over 80% of normal legs (ABI 1.00 to 1.40) had normal posterior tibial and dorsalis pedis waveforms, while only 23% legs with PAD (ABI ≤ 0.90) had normal waveforms in both arteries (Kappa = 0.43).Conclusion: Asymptomatic PAD is common in people with diabetes and requires ABI screening to detect it. Female gender is associated with PAD.Keywords: diabetes, peripheral arterial disease, peripheral artery disease, claudication, waveform, Doppler ultrasound

Published
2022

2. Karia and Krete : a study in social and cultural interaction

Author

Carless Unwin, N. H.

Subjects
900
Abstract

My thesis focuses on social and cultural interaction between Karia (in south western Anatolia) and Krete, over a long time span; from the Bronze Age to the Roman period. A persistent tradition existed in antiquity linking the Karians with Krete; this was mirrored in civic mythologies in Karia, as well as in cults and toponyms. My research aims to construct a new framework in which to read these traditions. The way in which a community ‘remembered’ its past was not an objective view of history; traditions were transmitted because they were considered to reflect something about a society. The persistence of a Kretan link within Karian mythologies and cults indicates that Krete was ‘good to think with’ even (or especially) during a period when Karia itself was undergoing changes (becoming, in a sense, both ‘de-Karianized’ and ‘Hellenized’). I focus on the late Classical and Hellenistic periods, from which most of our source material derives. The relevance of a shared past is considered in light of actual contacts between the two regions: diplomatic, economic, cultural and military. Against the prevailing orthodoxy, which maintains that traditions of earlier contacts, affinities and kinship between peoples from different parts of the Mediterranean were largely constructs of later periods, I take seriously the origins of such traditions and explore how the networks that linked Minoan Krete with Anatolia could have left a residuum in later conceptualisations of regional history. That I am able to do so is mainly thanks to developments in recent archaeological and linguistic research into Bronze Age western Anatolia. Such a diachronic approach throws up obvious questions of methodology: one cannot draw straight lines between the late Bronze age and the second century BC, and so must develop a way of analysing how, and in which contexts, traditions survived.

Published
2013

3. Properties, Concepts and Empirical Identity

Author

Unwin, N. and Unwin, N.

Abstract

Properties and concepts are similar kinds of thing in so far as they are both typically understood to be whatever it is that predicates stand for. However, they are generally supposed to have different identity criteria: for example, heat is the same property as molecular kinetic energy, whereas the concept of heat is different from the concept of molecular kinetic energy. This paper examines whether this discrepancy is really defensible, and concludes that matters are more complex than is generally thought. The distinction between canonical and non-canonical designators, as applied to such entities as propositions, properties and concepts, is examined, as are causal realist accounts of the semantics of such terms as ‘electricity’ and ‘mass’.

Published
2022

4. A Combined Theory of Change-Group Model Building Approach to Evaluating 'Farm to Fork' Models for School Feeding in the Caribbean

Author

Saint Ville, Arlette, Hickey, Gordon M., Rouwette, E.A.J.A., Samuels, A., Guariguata, Leonor, Unwin, N., Phillip, Leroy E., Saint Ville, Arlette, Hickey, Gordon M., Rouwette, E.A.J.A., Samuels, A., Guariguata, Leonor, Unwin, N., and Phillip, Leroy E.

Abstract

05 april 2022, Contains fulltext : 284689.pdf (Publisher’s version ) (Open Access)

Published
2022

5. The Impact of Nutrition-Based Interventions on Nutritional Status and Metabolic Health in Small Island Developing States: A Systematic Review and Narrative Synthesis

Author

Augustus, E, Haynes, E, Guell, C, Morrissey, K, Murphy, MM, Halliday, C, Jia, L, Iese, V, Anderson, SG, Unwin, N, Augustus, E, Haynes, E, Guell, C, Morrissey, K, Murphy, MM, Halliday, C, Jia, L, Iese, V, Anderson, SG, and Unwin, N

Abstract

Small island developing states (SIDS) have a high burden of nutrition-related disease associated with nutrient-poor, energy-dense diets. In response to these issues, we assessed the effectiveness of nutrition-based interventions on nutritional status (under-nutrition) and metabolic health (over-nutrition) among persons in SIDS. We included SIDS-based nutrition studies with change in nutrition status (e.g., markers of anaemia) or metabolic status (e.g., markers of glycaemia) as outcomes. The PRISMA framework was applied and MEDLINE, Embase, CINAHL, OARE library, Web of Science, Scopus, ASSIA, EconLit, AGORA, AGRICOLA, AGRIS, WHO-EMRO, and LILACS were searched (2000−2020). Cochrane risk of bias (ROB) and Cochrane ROBINS-I tools assessed ROB for randomised and non-randomised studies, respectively. PROSPERO registration (CRD42021236396) was undertaken. We included 50 eligible interventions, involving 37,591 participants: 14 trials reported on nutritional status, 36 on metabolic health. Effective interventions, evaluated at the individual level, took a multifaceted approach for metabolic outcomes; while nutrition outcomes utilised supplements. Most intervention types were suitable for issues related to ‘over’ nutrition versus ‘under’ nutrition. Twenty-six studies (nutrition status (six); metabolic health (twenty)) were effective (p < 0.05). With the current rise of nutrition-related public health challenges, there is a need for further development and evaluation of these and related interventions at the population level.

Published
2022

6. Dietary Patterns, Food Insecurity, and Their Relationships with Food Sources and Social Determinants in Two Small Island Developing States

Author

Bhagtani, D, Augustus, E, Haynes, E, Iese, V, Brown, CR, Fesaitu, J, Hambleton, I, Badrie, N, Kroll, F, Saint-Ville, A, Samuels, TA, Forouhi, NG, Benjamin-Neelon, SE, Unwin, N, Bhagtani, D, Augustus, E, Haynes, E, Iese, V, Brown, CR, Fesaitu, J, Hambleton, I, Badrie, N, Kroll, F, Saint-Ville, A, Samuels, TA, Forouhi, NG, Benjamin-Neelon, SE, and Unwin, N

Abstract

Small Island Developing States (SIDS) have high burdens of nutrition-related chronic diseases. This has been associated with lack of access to adequate and affordable nutritious foods and increasing reliance on imported foods. Our aim in this study was to investigate dietary patterns and food insecurity and assess their associations with socio-demographic characteristics and food sources. We recruited individuals aged 15 years and above from rural and urban areas in Fiji (n = 186) and St. Vincent and the Grenadines (SVG) (n = 147). Data collection included a 24 h diet recall, food source questionnaire and the Food Insecurity Experience Scale. We conducted latent class analysis to identify dietary patterns, and multivariable regression to investigate independent associations with dietary patterns. Three dietary patterns were identified: (1) low pulses, and milk and milk products, (2) intermediate pulses, and milk and milk products and (3) most diverse. In both SIDS, dietary pattern 3 was associated with older age, regularly sourcing food from supermarkets and borrowing, exchanging, bartering or gifting (BEB). Prevalence of food insecurity was not statistically different across dietary patterns. In both SIDS, food insecurity was higher in those regularly sourcing food from small shops, and in SVG, lower in those regularly using BEB. These results complement previous findings and provide a basis for further investigation into the determinants of dietary patterns, dietary diversity and food insecurity in these settings.

Published
2022

7. Interventions in Small Island Developing States to improve diet, with a focus on the consumption of local, nutritious foods: a systematic review.

Author

Haynes, E, Augustus, E, Brown, CR, Guell, C, Iese, V, Jia, L, Morrissey, K, Unwin, N, Haynes, E, Augustus, E, Brown, CR, Guell, C, Iese, V, Jia, L, Morrissey, K, and Unwin, N

Abstract

INTRODUCTION: Food security in Small Island Developing States (SIDS) is an international policy priority. SIDS have high rates of nutrition-related non-communicable diseases, including obesity and type 2 diabetes, micronutrient deficiencies and, in many, persistent childhood stunting. This is associated with an increasing reliance on imported processed food of poor nutritional quality. Calls have been made for strengthening local food systems, resilient to climate change, to increase the consumption of nutritious locally produced food. We aimed to systematically review interventions intended to improve diet in SIDS, and specifically explore whether these interventions applied a local food approach. METHODS: The search strategy was applied to 11 databases, including in health, social science and agriculture. Screening of titles, abstracts and data extraction was undertaken in duplicate. Risk of bias was assessed using Cochrane tools. Narrative synthesis of the results was undertaken. The study protocol was registered (PROSPERO registration number: 2020CRD42020201274). RESULTS: From 26 062 records, 154 full texts were reviewed and 24 were eligible. Included studies were from the Caribbean, Pacific, Mauritius and Singapore. Five were a randomised study design, one an interrupted time series analysis, eight controlled and ten uncontrolled pre-test and post-test. Nine studies included some aspect of a local food approach. Most interventions (n=15) included nutrition education, with evidence of effectiveness largely limited to those that also included practical skills training, such as vegetable gardening or food preparation. Three studies were considered low risk of bias, with the majority (n=13) of moderate risk. CONCLUSION: There is a lack of robust evidence on interventions to improve diet in SIDS. The evidence suggests that multifaceted approaches are likely to be the most effective, and local food approaches may promote effectiveness, through mechanisms of cultural

Published
2022

8. Perspectives on strengthening local food systems in Small Island Developing States

Author

Guell, C, Brown, CR, Navunicagi, OW, Iese, V, Badrie, N, Wairiu, M, Saint Ville, A, Unwin, N, Guell, C, Brown, CR, Navunicagi, OW, Iese, V, Badrie, N, Wairiu, M, Saint Ville, A, and Unwin, N

Abstract

UNLABELLED: Small Island Developing States (SIDS) share high burdens of nutrition-related conditions, including non-communicable diseases, associated with an increasing reliance on imported, processed foods. Improving health through increasing the production and consumption of local, nutritious foods is a policy objective of many SIDS governments. This study aimed to understand contemporary challenges and opportunities to strengthening local food systems in two case study settings, Fiji and St. Vincent and the Grenadines. Fifty-two in-depth, semi-structured interviews were conducted with key stakeholders involved in local food production. Interviews were analysed by both country teams using thematic analysis. Local food production networks in both settings included formal governance bodies as well as more informal connections through civil society and communities. Their main function was the sharing of resources and knowledge, but levels of trust and cooperation between the stakeholders varied in a market open to intense competition from imports. Local food production was hindered by few and slow investments by local governments, dated technology, and lack of knowledge. Stakeholders believed this marginalisation was occurring against a background of rising preferences for imported foods in the population, and increasing disinterest in employment in the sector. Despite the challenges, strong narratives of resilience and opportunity were highlighted such as national pride in local produce for commercialisation and local diets. Efforts to support local food production in SIDS should focus on strengthening governance structures to prioritise local produce over corporate and import markets, assist collaboration and co-learning, and support alternative agro-food practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12571-022-01281-0.

Published
2022

12. Newcastle Heart Project

Author

Fischbacher, C. M., White, M., Bhopal, R., Unwin, N., and Alberti, K. G. M. M.

Published
2002

17. Impacts of COVID-19 on agriculture and food systems in Pacific Island countries (PICs): Evidence from communities in Fiji and Solomon Islands

Author

Iese, V, Wairiu, M, Hickey, GM, Ugalde, D, Salili, DH, Walenenea, J, Tabe, T, Keremama, M, Teva, C, Navunicagi, O, Fesaitu, J, Tigona, R, Krishna, D, Sachan, H, Unwin, N, Guell, C, Haynes, E, Veisa, F, Vaike, L, Bird, Z, Ha'apio, M, Roko, N, Patolo, S, Dean, AR, Kiran, S, Tikai, P, Tuiloma, J, Halavatau, S, Francis, J, Ward, AC, Iese, V, Wairiu, M, Hickey, GM, Ugalde, D, Salili, DH, Walenenea, J, Tabe, T, Keremama, M, Teva, C, Navunicagi, O, Fesaitu, J, Tigona, R, Krishna, D, Sachan, H, Unwin, N, Guell, C, Haynes, E, Veisa, F, Vaike, L, Bird, Z, Ha'apio, M, Roko, N, Patolo, S, Dean, AR, Kiran, S, Tikai, P, Tuiloma, J, Halavatau, S, Francis, J, and Ward, AC

Abstract

CONTEXT: COVID-19 mitigation measures including border lockdowns, social distancing, de-urbanization and restricted movements have been enforced to reduce the risks of COVID-19 arriving and spreading across PICs. To reduce the negative impacts of COVID-19 mitigation measures, governments have put in place a number of interventions to sustain food and income security. Both mitigation measures and interventions have had a number of impacts on agricultural production, food systems and dietary diversity at the national and household levels. OBJECTIVE: Our paper conducted an exploratory analysis of immediate impacts of both COVID-19 mitigation measures and interventions on households and communities in PICs. Our aim is to better understand the implications of COVID-19 for PICs and identify knowledge gaps requiring further research and policy attention. METHODS: To understand the impacts of COVID-19 mitigation measures and interventions on food systems and diets in PICs, 13 communities were studied in Fiji and Solomon Islands in July-August 2020. In these communities, 46 focus group discussions were carried out and 425 households were interviewed. Insights were also derived from a series of online discussion sessions with local experts of Pacific Island food and agricultural systems in August and September 2020. To complement these discussions, an online search was conducted for available literature. RESULTS AND CONCLUSIONS: Identified impacts include: 1) Reduced agricultural production, food availability and incomes due to a decline in local markets and loss of access to international markets; 2) Increased social conflict such as land disputes, theft of high-value crops and livestock, and environmental degradation resulting from urban-rural migration; 3) Reduced availability of seedlings, planting materials, equipment and labour in urban areas; 4) Reinvigoration of traditional food systems and local food production; and 5) Re-emergence of cultural safety networks and val

Published
2021

20. Using Group Model Building to Describe the System Driving Unhealthy Eating and Identify Intervention Points: A Participatory, Stakeholder Engagement Approach in the Caribbean

Author

Guariguata, Leonor, Rouwette, Etienne A.J.A., Murphy, Madhuvanti M., Saint Ville, Arlette, Dunn, Leith L., Hickey, Gordon M., Alafia Samuels, T., Unwin, N., Guariguata, Leonor, Rouwette, Etienne A.J.A., Murphy, Madhuvanti M., Saint Ville, Arlette, Dunn, Leith L., Hickey, Gordon M., Alafia Samuels, T., and Unwin, N.

Abstract

31 januari 2020, Contains fulltext : 218618.pdf (publisher's version ) (Open Access)

Published
2020

32. Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa

Author

Ekoru, K., Murphy, G. A.V., Young, E. H., Delisle, H., Jerome, C. S., Assah, F., Longo-Mbenza, B., Nzambi, J. P.D., On'Kin, J. B.K., Buntix, F., Muyer, M. C., Christensen, D. L., Wesseh, C. S., Sabir, A., Okafor, C., Gezawa, I. D., Puepet, F., Enang, O., Raimi, T., Ohwovoriole, E., Oladapo, O. O., Bovet, P., Mollentze, W., Unwin, N., Gray, W. K., Walker, R., Agoudavi, K., Siziya, S., Chifamba, J., Njelekela, M., Fourie, C. M., Kruger, S., Schutte, A. E., Walsh, C., Gareta, D., Kamali, A., Seeley, J., Norris, S. A., Crowther, N. J., Pillay, D., Kaleebu, P., Motala, A. A., Sandhu, M. S., Ekoru, K., Murphy, G. A.V., Young, E. H., Delisle, H., Jerome, C. S., Assah, F., Longo-Mbenza, B., Nzambi, J. P.D., On'Kin, J. B.K., Buntix, F., Muyer, M. C., Christensen, D. L., Wesseh, C. S., Sabir, A., Okafor, C., Gezawa, I. D., Puepet, F., Enang, O., Raimi, T., Ohwovoriole, E., Oladapo, O. O., Bovet, P., Mollentze, W., Unwin, N., Gray, W. K., Walker, R., Agoudavi, K., Siziya, S., Chifamba, J., Njelekela, M., Fourie, C. M., Kruger, S., Schutte, A. E., Walsh, C., Gareta, D., Kamali, A., Seeley, J., Norris, S. A., Crowther, N. J., Pillay, D., Kaleebu, P., Motala, A. A., and Sandhu, M. S.

Abstract

Background:Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk.Methods:We used individual level cross-sectional data on 24 181 participants aged

Published
2018

33. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, Gm, Carnahan, E, Stevens, Ga, Cowan, Mj, Farzadfar, F, Lin, Jk, Finucane, Mm, Rao, M, Khang, Yh, Riley, Lm, Mozaffarian, D, Lim, Ss, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, Na, Rahim, Hf, Addo, J, Aekplakorn, W, Afifi, Mm, Agabiti Rosei, E, Salinas, Ca, Agyemang, C, Ali, Mk, Ali, Mm, Al Nsour, M, Al Nuaim AR, Ambady, R, Di Angelantonio, E, Aro, P, Azizi, F, Babu, Bv, Bahalim, An, Barbagallo, Cm, Barbieri, Ma, Barceló, A, Barreto, Sm, Barros, H, Bautista, Le, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, Enzo, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León AC, Campos, H, Cappuccio, Fp, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, Cj, Chaouki, N, Chatterji, S, Chen, Cj, Chen, Z, Choi, Js, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Corsi, Am, Costanza, Mc, Craig, Cl, Dankner, Rs, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, Gh, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, Ch, Fan, Jg, Ferreccio, C, Fezeu, L, Firmo, Jo, Florez, Hj, Fornés, Ns, Fowkes, Fg, Franceschini, G, Frisk, F, Fuchs, Fd, Fuller, El, Getz, L, Giampaoli, S, Gómez, Lf, Gomez Zumaquero JM, Graff Iversen, S, Grant, Jf, Carvajal, Rg, Gulliford, Mc, Gupta, R, Gupta, Pc, Gureje, O, Gutierrez, Hr, Hansen, Tw, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, Wh, Herrera, Vm, Ho, S, Holdsworth, M, Frisman, Gh, Hopman, Wm, Hussain, A, Husseini, A, Ibrahim, Mm, Ikeda, N, Jacobsen, Bk, Jaddou, Hy, Jafar, Th, Janghorbani, M, Jasienska, G, Joffres, Mr, Jonas, Jb, Kadiki, Oa, Kalter Leibovici, O, Kamadjeu, Rm, Kaptoge, S, Karalis, I, Kastarinen, Mj, Katz, J, Keinan Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, Kw, Kiyohara, Y, Kobayashi, J, Krause, Mp, Kubínová, R, Kurjata, P, Kusuma, Ys, Lam, Th, Langhammer, A, Lawes, Cm, Le, C, Lee, J, Lévy Marchal, C, Lewington, S, Li, Y, Lim, To, Lin, X, Lin, Cc, Lin, Hh, Lind, L, Lissner, L, Liu, X, Lopez Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, Dr, Maggi, S, Magliano, Dj, Makdisse, M, Mancia, G, Mannami, T, Marques Vidal, P, Mbanya, Jc, McFarlane Anderson, N, Miccoli, R, Miettola, J, Minh, Hv, Miquel, Jf, Miranda, Jj, Mohamed, Mk, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, Wf, Morales, Dd, Morgan, K, Muiesan, Lm, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, Ka, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, Sw, Ohkubo, T, Olivieri, Oliviero, Önal, Ae, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, Wh, Panagiotakos, Db, Panza, F, Park, Y, Passos, Vm, Pednekar, Ms, Pelizzari, Pm, Peres, Ma, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, Ot, Ramos, Lr, Rampal, S, Rampal, L, Rasmussen, F, Reddy, Kk, Redon, J, Revilla, L, Reyes García, V, Roaeid, Rb, Robinson, Ca, Rodriguez Artalejo, F, Rojas Martinez, R, Ronkainen, K, Rosero Bixby, L, Roth, Ga, Sachdev, Hs, Sánchez, Jr, Sanisoglu, Sy, Sans, S, Sarraf Zadegan, N, Scazufca, M, Schaan, Bd, Schapochnik, N, Schelleman, H, Schneider, Ij, Schooling, Cm, Schwarz, B, Sekuri, C, Sereday, Ms, Serra Majem, L, Shaw, J, Shera, As, Shi, Z, Shiri, R, Shu, Xo, Silva, Da, Silva, E, Simons, La, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, Ad, Stergiou, Gs, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, Ab, Tai, Es, Tambs, K, Tesfaye, F, Thomas, Gn, Thorogood, M, Tilvis, Rs, Tobias, M, Torheim, Le, Trenkwalder, P, Tuomilehto, Jo, Tur, Ja, Tzourio, C, Uhernik, Ai, Ukoli, Fa, Unwin, N, Hoorn, Sv, Vanderpump, Mp, Varo, Jj, Veierød, Mb, Velásquez Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Yx, Ward, M, Waspadji, S, Welin, Lx, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, Xavier, Aj, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, Lc, Yoon, Js, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Ward, M., Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration, Danaei, G., Lu, Y., Singh, G.M., Carnahan, E., Stevens, G.A., Cowan, M.J., Farzadfar, F., Lin, J.K., Finucane, M.M., Rao, M., Khang, Y.H., Riley, L.M., Mozaffarian, D., Lim, S.S., Ezzati, M., Aamodt, G., Abdeen, Z., Abdella, N.A., Rahim, H.F., Addo, J., Aekplakorn, W., Afifi, M.M., Agabiti-Rosei, E., Salinas, C.A., Agyemang, C., Ali, M.K., Ali, M.M., Al-Nsour, M., Al-Nuaim, A.R., Ambady, R., Di Angelantonio, E., Aro, P., Azizi, F., Babu, B.V., Bahalim, A.N., Barbagallo, C.M., Barbieri, M.A., Barceló, A., Barreto, S.M., Barros, H., Bautista, L.E., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Botana, M.A., Bovet, P., Breckenkamp, J., Breteler, M.M., Broda, G., Brown, I.J., Bursztyn, M., de León, A.C., Campos, H., Cappuccio, F.P., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C.J., Chaouki, N., Chatterji, S., Chen, C.J., Chen, Z., Choi, J.S., Chua, L., Cífková, R., Cobiac, L.J., Cooper, R.S., Corsi, A.M., Costanza, M.C., Craig, C.L., Dankner, R.S., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G.H., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, R., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C.H., Fan, J.G., Ferreccio, C., Fezeu, L., Firmo, J.O., Florez, H.J., Fornés, N.S., Fowkes, F.G., Franceschini, G., Frisk, F., Fuchs, F.D., Fuller, E.L., Getz, L., Giampaoli, S., Gómez, L.F., Gomez-Zumaquero, J.M., Graff-Iversen, S., Grant, J.F., Carvajal, R.G., Gulliford, M.C., Gupta, R., Gupta, P.C., Gureje, O., Gutierrez, H.R., Hansen, T.W., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W.H., Herrera, V.M., Ho, S., Holdsworth, M., Frisman, G.H., Hopman, W.M., Hussain, A., Husseini, A., Ibrahim, M.M., Ikeda, N., Jacobsen, B.K., Jaddou, H.Y., 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MM, Rao M, Khang Y-H, Riley LM, Mozaffarian D, Lim SS, Ezzati M, Aamodt G, Abdeen Z, Abdella NA, Abdul Rahim HF, Addo J, Aekplakorn W, Afi fi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MK, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Di Angelantonio E, Aro P, Azizi F, Babu BV, Bahalim AN, Barbagallo CM, Barbieri MA, Barcelo A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Bjorkelund C, Bo S, Bobak M, Bonora E, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de Leon A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang C-J, Chaouki N, Chatterji S, Chen C-J, Chen Z, Choi J-S, Chua L, Cifkova R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong G-H, Dorsi E, Dragano N, Drewnowski A, Eggertsen R, Elliott P, Anders Engeland, Erem C, Esteghamati A, Fall CHD, Fan J-G, Ferreccio C, Fezeu L, Firmo JO, Florez HF, Fornes NF, Fowkes FGR, 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Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Santos Silva DA, Silva E, Simons LA, Smith M, Soderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, StattinP, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundstrom J, Swai AB, Tai ES, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik A, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierod MB, Velasquez-Melendez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Whitlock G, Wilhelmsen L, Willeit J, Woodward M, Wormser D, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh L-C, Yoon J-S, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, 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Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, and Zhou, M

Subjects
Male, Settore MED/09 - Medicina Interna, kidney disease, Endocrinology, Diabetes and Metabolism, humanos, coste de las enfermedades, Disease, Global Health, Cohort Studies, Endocrinology, Cost of Illness, cardiovascular disease, Health Transition, Risk Factors, transición sanitaria, estudios prospectivos, Renal Insufficiency, Chronic -- complications -- epidemiology -- mortality, evaluación de riesgos, Renal Insufficiency, Prospective Studies, Chronic, estudios de cohortes, Metabolic Syndrome, education.field_of_study, diabetes, Mortality rate, Age Factors, Cardiovascular Diseases, Diabetes Complications, Female, Health Surveys, Humans, Metabolic Syndrome X, Renal Insufficiency, Chronic, Risk Assessment, Sex Factors, Spatio-Temporal Analysis, Internal Medicine, Cardiovascular Diseases -- complications -- epidemiology -- mortality, Cardiovascular disease,Diabetes Mellitus, chronic kidney disease, Diabetes Complications -- epidemiology -- mortality, Sciences bio-médicales et agricoles, Diabetes and Metabolism, encuestas de salud, análisis temporoespacial, Risk assessment, complicaciones de la diabetes, insuficiencia renal, medicine.medical_specialty, Cardiovascular disease, diabetes mortality, Population, enfermedades cardiovasculares, Metabolic Syndrome X -- complications -- epidemiology -- mortality, Article, chronic kidney disease, mortality, Internal medicine, Environmental health, Diabetes mellitus, medicine, factores de riesgo, Risk factor, education, business.industry, medicine.disease, Relative risk, Cardiovascular Diseases/complications, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Diabetes Complications/epidemiology, Diabetes Complications/mortality, Metabolic Syndrome X/complications, Metabolic Syndrome X/epidemiology, Metabolic Syndrome X/mortality, Renal Insufficiency, Chronic/complications, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/mortality, business, Kidney disease
Abstract

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010., 0, info:eu-repo/semantics/published

Published
2014

35. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008

Author

Danaei, G., Singh, G., Paciorek, C., Lin, J., Cowan, M., Finucane, M., Farzadfar, F., Stevens, G., Riley, L., Lu, Y., Rao, M., Ezzati, M., Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt, G., Abdeen, Z., Abdella, N., Rahim, H., Addo, J., Aekplakorn, W., Afifi, M., Agabiti Rosei, E., Aguilar Salinas CA, Agyemang, C., Ali, M., Al Nsour, M., Al Nuaim AR, Ambady, R., Aro, P., Azizi, F., Barbagallo, C., Barbieri, M., Barceló, A., Barreto, S., Barros, H., Bautista, L., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Bontha, B., Botana, M., Bovet, P., Breckenkamp, J., Breteler, M., Broda, G., Brown, I., Bursztyn, M., Cabrera de León, A., Campos, H., Cappuccio, F., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C., Chaouki, N., Chatterji, S., Chen, Z., Chen, C., Choi, J., Chua, L., Cífková, R., Cobiac, L., Cooper, R., Corsi, A., Costanza, M., Craig, C., Dankner, R., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, W., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C., Fan, J., Ferreccio, C., Fezeu, L., Firmo, J., Florez, H., Fornés, N., Fowkes, F., Franceschini, G., Frisk, F., Fuchs, F., Fuller, E., Getz, L., Giampaoli, S., Gómez, L., Gomez Zumaquero JM, Graff Iversen, S., Grant, J., Guerrero Carvajal, R., Gulliford, M., Gupta, R., Gupta, P., Gureje, O., Hansen, T., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W., Herrera, V., Ho, S., Holdsworth, M., Hollman Frisman, G., Hopman, W., Hussain, A., Husseini, A., Ibrahim, M., Ikeda, N., Jacobsen, B., Jaddou, H., Jafar, T., Janghorbani, M., Jasienska, G., Joffres, M., Jonas, J., Kadiki, O., Kalter Leibovici, O., Kamadjeu, R., Karalis, I., Kastarinen, M., Katz, J., Keinan Boker, L., Kelly, P., Khalilzadeh, O., Khang, Y., Kiechl, S., Kim, K., Kiyohara, Y., Kobayashi, J., Krause, M., Kubínová, R., Kurjata, P., Kusuma, Y., Lam, T., Langhammer, A., Lawes, C., Le, C., Lee, J., Lévy Marchal, C., Li, Y., Lim, S., Lim, T., Lin, X., Lin, C., Lin, H., Lind, L., Lissner, L., Liu, X., Lopez Jaramillo, P., Lorbeer, R., Ma, G., Ma, S., Macià, F., Maclean, D., Maggi, S., Magliano, D., Makdisse, M., Mancia, G., Mannami, T., Marques Vidal, P., Mbanya, J., McFarlane Anderson, N., Miccoli, R., Miettola, J., Minh, H., Miquel, J., Miranda, J., Mohamed, M., Mohan, V., Mohanna, S., Mokdad, A., Mollentze, W., Morales, D., Morgan, K., Muiesan, L., Muntoni, S., Nabipour, I., Nakagami, T., Nangia, V., Nemesure, B., Neovius, M., Nerhus, K., Nervi, F., Neuhauser, H., Nguyen, M., Ninomiya, T., Noale, M., Oh, S., Ohkubo, T., Olivieri, O., Önal, A., Onat, A., Oróstegui, M., Ouedraogo, H., Pan, W., Panagiotakos, D., Panza, F., Park, Y., Passos, V., Pednekar, M., Peres, M., Pérez, C., Pérez Fernández, R., Pichardo, R., Phua, H., Pistelli, F., Plans, P., Polakowska, M., Poulter, N., Prabhakaran, D., Qiao, Q., Rafiei, M., Raitakari, O., Ramos, L., Rampal, S., Rampal, L., Rasmussen, F., Reddy, K., Redon, J., Revilla, L., Reyes García, V., Roaeid, R., Rodriguez Artalejo, F., Rojas Martinez, R., Ronkainen, K., Rosero Bixby, L., Roth, G., Sachdev, H., Sánchez, J., Sanisoglu, S., Sans, S., Sarraf Zadegan, N., Scazufca, M., Schaan, B., Schapochnik, N., Schelleman, H., Schneider, I., Schooling, C., Schwarz, B., Sekuri, C., Sereday, M., Serra Majem, L., Shaw, J., Shera, A., Shi, Z., Shiri, R., Shu, X., Silva, D., Silva, E., Simons, L., Smith, M., Söderberg, S., Soebardi, S., Solfrizzi, V., Sonestedt, E., Soysal, A., Stattin, P., Stein, A., Stergiou, G., Stessman, J., Sudo, A., Suka, M., Sundh, V., Sundquist, K., Sundström, J., Swai, A., Tai, E., Tambs, K., Tesfaye, F., Thomas, G., Thorogood, M., Tilvis, R., Tobias, M., Torheim, L., Trenkwalder, P., Tuomilehto, J., Tur, J., Tzourio, C., Uhernik, A., Ukoli, F., Unwin, N., Vander Hoorn, S., Vanderpump, M., Varo, J., Veierød, B., Velásquez Meléndez, G., Verschuren, M., Viet, L., Villalpando, S., Vioque, J., Vollenweider, P., Volpato, S., Wang, N., Wang, Y., Ward, M., Waspadji, S., Welin, L., Wilhelmsen, L., Willeit, J., Woodward, M., Xavier, A., Xu, F., Xu, L., Yamamoto, A., Yang, G., Yang, X., Yeh, L., Yoon, J., You, Q., Yu, Z., Zhang, J., Zhang, L., Zheng, W., Zhou, M., Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, Farzadfar F, Stevens GA, Riley LM, Lu Y, Rao M, Ezzati M and Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt G, Abdeen Z, Abdella NA, Rahim HF, Addo J, Aekplakorn W, Afifi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Aro P, Azizi F, Barbagallo CM, Barbieri MA, Barceló A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Björkelund C, Bo S, Bobak M, Bonora E, Bontha BV, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de León A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang CJ, Chaouki N, Chatterji S, Chen Z, Chen CJ, Choi JS, Chua L, Cífková R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong GH, Dorsi E, Dragano N, Drewnowski A, Eggertsen W, Elliott P, Engeland A, Erem C, Esteghamati A, Fall CH, Fan JG, Ferreccio C, Fezeu L, Firmo JO, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff-Iversen S, Grant JF, Guerrero Carvajal R, Gulliford MC, Gupta R, Gupta PC, Gureje O, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Hollman Frisman G, Hopman WM, Hussain A, Husseini A, Ibrahim M, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Khang YH, Kiechl S, Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubínová R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CM, Le C, Lee J, Lévy-Marchal C, Li Y, Lim S, Lim TO, Lin X, Lin CC, Lin HH, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Ma G, Ma S, Macià F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JC, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, Miranda J, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Önal AE, Onat A, Oróstegui M, Ouedraogo H, Pan WH, Panagiotakos DB, Panza F, Park Y, Passos VM, Pednekar MS, Peres MA, Pérez C, Pérez-Fernández R, Pichardo R, Phua HP, Pistelli F, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KK, Redon J, Revilla L, Reyes-García V, Roaeid RB, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sánchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJ, Schooling C, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Silva DA, Silva E, Simons LA, Smith M, Söderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, Stattin P, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundström J, Swai AB, Tai E, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik AI, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierød B, Velásquez-Meléndez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Wilhelmsen L, Willeit J, Woodward M, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh LC, Yoon JS, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, ACS - Amsterdam Cardiovascular Sciences, APH - Amsterdam Public Health, and Public and occupational health

Subjects
Gerontology, Adult, Male, Risk, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Measures of national income and output, Population, Hypercholesterolemia, OBESIDADE, Blood Pressure, Global Health, Body Mass Index, Age Distribution, Risk Factors, cardiovascular disease, Physiology (medical), Diabetes mellitus, risk factors, Epidemiology, medicine, Diabetes Mellitus, Humans, Obesity, Risk factor, Sex Distribution, education, Developing Countries, Cholesterolo, education.field_of_study, business.industry, Urbanization, Feeding Behavior, Middle Aged, medicine.disease, Blood pressure, Cholesterol, Socioeconomic Factors, Cardiovascular Diseases, Hypertension, Western World, Female, Cardiology and Cardiovascular Medicine, business, Body mass index, Demography
Abstract

Background— It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Methods and Results— Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. Conclusions— The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented.

Published
2013

36. Systems Science for Caribbean Health: the development and piloting of a model for guiding policy on diabetes in the Caribbean

Author

Guariguata, L., Guell, C., Samuels, T.A., Rouwette, E.A.J.A., Woodcock, J., Hambleton, I.R., Unwin, N., Guariguata, L., Guell, C., Samuels, T.A., Rouwette, E.A.J.A., Woodcock, J., Hambleton, I.R., and Unwin, N.

Abstract

Contains fulltext : 162273pub.pdf (publisher's version ) (Open Access), BACKGROUND : Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries. METHODS : Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions. DISCUSSION : SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.

Published
2016

37. A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries

Author

Mason, Helen, Shoaibi, Azza, Ghandour, Rula, O'Flaherty, Martin, Capewell, Simon, Khatib, Rana, Jabr, Samer, Unal, Belgin, Sozmen, Kaan, Arfa, Chokri, Aissi, Wafa, Ben Romdhane, Habiba, Fouad, Fouad, Al-Ali, Radwan, Husseini, Abdullatif, Critchley, J., Ahmad, B., Phillimore, P., Zaman, S., Dherani, M., Vartjes, I., Bennett, K., Altun, D., Arik, H., Aslan, O., Demiral, Y., Doganay, S., Ergor, G., Gerceklioglu, G., Kilic, B., Saatli, G., Simsek, H., Satman, I., Gogen, S., Kalaca, S., Elias, M., Rastam, S., Soulaiman, N., Moukeh, G., Maziak, W., Abou Mayaleh, M., Abu-Rmeileh, N., Jaber, S., Khatib, R., Mikki, N., Abu-Kteish, H., Allani, R., Beltaifa, L., Ben Mansour, N., Lassoued, O., Saidi, O., Tlili, F., Achour, N., Ben Salah, N., Collins, M., Roglic, G., Fadhil, I., and Unwin, N.

Subjects
Palestine, Policy Models, economic evaluation, food industry, Turkey, Non-Clinical Medicine, health promotion, Epidemiology, Economics, Cost-Benefit Analysis, Economic Models, Coronary Disease, Coronary Artery Disease, Political Aspects of Health, Cardiovascular, Global Health, Social and Behavioral Sciences, Turkey (republic), Cost Effectiveness, Environmental protection, Health care, Medicine, Socioeconomics, health care economics and organizations, 2. Zero hunger, Multidisciplinary, Cost–benefit analysis, 1. No poverty, blood pressure regulation, health care cost, Cost-effectiveness analysis, salt intake, 3. Good health, Health Education and Awareness, health care policy, Quality-Adjusted Life Years, Public Health, Research Article, Operations Research, Tunisia, Clinical Research Design, Science, Political Science, Cost-Effectiveness Analysis, Public policy, Public Policy, Health Promotion, Syrian Arab Republic, Middle East, Health Economics, food composition, food processing, health education, Humans, Salt intake, Sodium Chloride, Dietary, sodium restriction, Cardiovascular Disease Epidemiology, cost control, Nutrition, Health economics, Health Care Policy, Syria, business.industry, cost effectiveness analysis, Modeling, Health Risk Analysis, ischemic heart disease, Quality-adjusted life year, Economic evaluation, Preventive Medicine, business, food packaging
Abstract

Background: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and Findings: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives. European Community' Seventh Framework Programme (FP7/2007-2013) under grant agreement n223075 the MedCHAMPS project. Scopus

Published
2014

42. Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa

Author

Ekoru, K, Murphy, G A V, Young, E H, Delisle, H, Jerome, C S, Assah, F, Longo–Mbenza, B, Nzambi, J P D, On'Kin, J B K, Buntix, F, Muyer, M C, Christensen, D L, Wesseh, C S, Sabir, A, Okafor, C, Gezawa, I D, Puepet, F, Enang, O, Raimi, T, Ohwovoriole, E, Oladapo, O O, Bovet, P, Mollentze, W, Unwin, N, Gray, W K, Walker, R, Agoudavi, K, Siziya, S, Chifamba, J, Njelekela, M, Fourie, C M, Kruger, S, Schutte, A E, Walsh, C, Gareta, D, Kamali, A, Seeley, J, Norris, S A, Crowther, N J, Pillay, D, Kaleebu, P, Motala, A A, and Sandhu, M S

Abstract

Background:Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk.Methods:We used individual level cross-sectional data on 24?181 participants aged ?15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC.Results:The optimal WC cut-point was 81.2?cm (95% CI 78.5–83.8?cm) and 81.0?cm (95% CI 79.2–82.8?cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63–65) than in men (53%, 95% CI 51–55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4–2.9, for men and 2.2, 95% CI 2.0–2.3, for women).Conclusion:The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (?81.2?cm) than current guidelines (?94.0?cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.

Published
2018
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43. The Croonian Lecture 2000. Nicotinic acetylcholine receptor and the structural basis of fast synaptic transmission

Author

Unwin, N

Subjects
Research Article
Abstract

Communication in the nervous system takes place at chemical and electrical synapses, where neurotransmitter-gated ion channels, such as the nicotinic acetylcholine (ACh) receptor, and gap junction channels control propagation of electrical signals from one cell to the next. Newly developed electron crystallographic methods have revealed the structures of these channels trapped in open as well as closed states, suggesting how they work. The ACh receptor has large vestibules extending from the membrane which shape the ACh-binding pockets and facilitate selective transport of cations across a narrow membrane-spanning pore. When ACh enters the pockets it triggers a concerted conformational change that opens the pore by destabilizing a gate in the middle of the membrane made by a ring of pore-lining alpha-helical segmets. The alternative 'open' configuration of pore-lining segments reshapes the lumen and creates new surfaces, allowing the ions to pass through. The gap junction channel uses a similar structural mechanism, involving coordinated rearrangements of alpha-helical segments in the plane of the membrane, to open its pore.

Published
2000

47. Outlook for Survivors of Childhood in Sub-Saharan Africa: Adult Mortality in Tanzania. Adult Morbidity and Mortality Project

Author

Kitange, H M, Machibya, H, Black, J, Mtasiwa, D M, Masuki, G, Whiting, D, Unwin, N, Moshiro, C, Klima, P M, Lewanga, M, Alberti, K G, and McLarty, D G

Subjects
parasitic diseases, Mortality studies
Abstract

To measure age and sex specific mortality in adults (15-59 years) in one urban and two rural areas of Tanzania. Reporting of all deaths occurring between 1 June 1992 and 31 May 1995. Eight branches in Dar es Salaam (Tanzania's largest city), 59 villages in Morogoro rural district (a poor rural area), and 47 villages in Hai district (a more prosperous rural area). 40,304 adults in Dar es Salaam, 69,964 in Hai, 50,465 in Morogoro rural. Mortality and probability of death between 15 and 59 years of age (45Q15). During the three year observation period a total of 4929 deaths were recorded in adults aged 15-59 years in all areas. Crude mortalities ranged from 6.1/1000/year for women in Hai to 15.9/1000/year for men in Morogoro rural. Age specific mortalities were up to 43 times higher than rates in England and Wales. Rates were higher in men at all ages in the two rural areas except in the age group 25 to 29 years in Hai and 20 to 34 years in Morogoro rural. In Dar es Salaam rates in men were higher only in the 40 to 59 year age group. The probability of death before age 60 of a 15 year old man (45Q15) was 47% in Dar es Salaam, 37% in Hai, and 58% in Morogoro; for women these figures were 45%, 26%, and 48%, respectively. (The average 45Q15s for men and women in established market economies are 15% and 7%, respectively.) Survivors of childhood in Tanzania continue to show high rates of mortality throughout adult life. As the health of adults is essential for the wellbeing of young and old there is an urgent need to develop policies that deal with the causes of adult mortality.

Published
1996

50. Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies

Author

Nissinen, A., Pekkanen, J., Tuomilehto, J., Jousilahti, P., Lindstrom, J., Pyorala, M., Pyorala, K., Gallus, G., Garancini, M.P., Bouter, L.M., Dekker, J.M., Heine, R.J., Nijpels, G., Stehouwer, C.D.A., Feskens, E.J.M., Kromhout, D., Pajak, A., Eliasson, M., Stegmayr, B., Lundberg, V., Wareham, N.J., Unwin, N., Ahmad, N., Alberti, K.G.M.M., Hayes, L., Yudkin, J.S., Gould, M., Haines, A., Morris, R.W., Borch-Johnsen, K., Eriksson, J., Qiao, Q., Hu, G., Nissinen, A., Pekkanen, J., Tuomilehto, J., Jousilahti, P., Lindstrom, J., Pyorala, M., Pyorala, K., Gallus, G., Garancini, M.P., Bouter, L.M., Dekker, J.M., Heine, R.J., Nijpels, G., Stehouwer, C.D.A., Feskens, E.J.M., Kromhout, D., Pajak, A., Eliasson, M., Stegmayr, B., Lundberg, V., Wareham, N.J., Unwin, N., Ahmad, N., Alberti, K.G.M.M., Hayes, L., Yudkin, J.S., Gould, M., Haines, A., Morris, R.W., Borch-Johnsen, K., Eriksson, J., Qiao, Q., and Hu, G.

Published
2004
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