OBJECTIVETo compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria.RESEARCH DESIGN AND METHODSSix studies (1999–2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C ≥6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders.RESULTSDiabetes prevalence was lower with the A1C-based diagnostic criteria in four of six studies. The probability of an A1C ≥6.5% among OGTT-diagnosed case subjects ranged widely (17.0–78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons.CONCLUSIONSA shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.

Abdominal visceral and subcutaneous fat thickness was higher with urban residency. A high prevalence of overweight and obesity was found. The Maasai had the highest overall fat accumulation.

BackgroundDiabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent.MethodsA case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants.ResultsAmong 803 cases and 350 controls the mean (SD) age was 34.8 (11.9) and 33.8 (12.0) years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4) and 9.4% (6.6; 13.0), respectively. Diabetes was associated with TB (OR 2.2, 95% CI: 1.5; 3.4, p<0.001). However, the association depended on HIV status (interaction, p = 0.01) due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p = 0.01) compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p = 0.13) after adjusting for age, sex, demographic factors and elevated serum acute phase reactants.ConclusionDiabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control.

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This study investigates the adaptive response of the lower limb muscles and substrate oxidation during submaximal arm or leg exercise after a crossing of the Greenland icecap on cross-country skies. Before and after the 42-day expedition, four male subjects performed cycle ergometer and arm-cranking exercise on two separate days. On each occasion, the subjects exercised at two submaximal loads (arm exercise, 45 W and 100 W; leg exercise, 100 W and 200 W). In addition, peak oxygen uptake (V . O∑max) was determined for both leg and arm exercise. Before and after the crossing, a muscle biopsy was obtained from the vastus lateralis and the triceps brachii muscles prior to exercise (N=3). After the crossing, body mass decreased by 5.7±0.5 kg (in four of four subjects), whereas V . O∑max was unchanged in the arm (3.1±0.2 l min -1 ) and leg (4.0±0.1 l min -1 ). Before the crossing, respiratory exchange ratio (RER) values were 0.84±0.02 and 0.96±0.02 during submaximal arm exercise and 0.82±0.02 and 0.91±0.01 during submaximal leg exercise at the low and high workloads, respectively. After the crossing, RER was lower (in three of four subjects) during arm exercise (0.74±0.02 and 0.81±0.01) but was higher (in three of four subjects) during leg exercise (0.92±0.02 and 0.96±0.01) at the low and high workloads, respectively. Citrate synthase and β-hydroxy-acyl-CoAdehydrogenase activity was decreased by approximately 29% in vastus lateralis muscle and was unchanged in triceps brachii muscle. Fat oxidation during submaximal arm exercise was enhanced without a concomitant increase in the oxidative capacity of the triceps brachii muscle after the crossing. This contrasted with decreased fat oxidation during leg exercise, which occurred parallel to a decreased oxidative capacity in vastus lateralis muscle. Although the number of subjects is limited, these results imply that the adaptation pattern after long-term, prolonged, low-intensity, whole body exercise may vary dramatically among muscles.

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Primary objective To determine the iron, zinc, and calcium content in different insects commonly eaten among the Luo of Kenya. Research design A cross-sectional design was chosen for the study in order to determine the insects eaten and their mineral content during a specific season.Methods and procedures Five different insect species were identified and collected with the help of local informants in the Nyang'oma sublocation of the Bondo district in western Kenya, and were analysed for iron, zinc and calcium contents. Main outcomes and results The iron content ranged from 18 to 1562 mg/100 g dry matter, the zinc content from 8 to 25 mg/100 g, and the calcium content from 33 to 341 mg/100 g in five different insects, onyoso mammon (ant), oyala (termite), ogawo (termite), agaor (termite), onjiri mammon (cricket). Conclusions Insect eating could prove to be a valuable measure to combat, especially, iron and zinc deficiency in developing countries.

The aim of this study was to characterize untrained Nandi boys (mean age 16.6 years) from a town (n = 11) and from a rural area (n = 19) in western Kenya (altitude approximately 2000 m.a.s.l.) in regard to their body dimensions, oxygen uptake and physical activity level. The town boys had a mean maximal oxygen uptake (VO(2 max)) of 50 (range: 45-60) mL kg(-1) min(-1), whereas the village boys reached a value of 55 (37-63) mL kg(-1) min(-1) ( p<0.01) in VO(2 max). The running economy, determined as the oxygen cost at a given running speed, was 221 mL kg(-1) km(-1) (597 mL kg(-0.75) km(-1)) for town as well as for village boys. The body mass index (BMI) was very low for town as well as for village boys (18.6 vs 18.4 kg m(-2)). The daily mean time spent working in the field during secondary school and doing sports were significantly higher in village boys compared to town boys (working in the field: 44.2 (0-128) vs 1.3 (0-11) min, p<0.01; sports: 32.0 (11-72) vs 12.8 (0-35) min, p<0.01, respectively). A positive correlation between the daily time spent doing sports and VO(2 max) was found when pooling the data from the town and the village boys (R = 0.55, p<0.01). It is concluded that the body dimensions of adolescent Nandi town and village boys corresponds well with findings in Kenyan elite runners. They are very slender with relatively long legs. In addition, the VO(2 max) of the village boys was higher than that of the town boys, which is probably due to a higher physical activity level of the village boys during secondary school.