Diet and Physical Activity for the Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Policy Review

Lachat, Carl; Otchere, S; Roberfroid, Dominique; Abubakari, Abdulai; Seret, Florencia María Aguirre; Milešević, Jelena; Xuereb, Godfrey; Candeias, Vanessa; Kolsteren, Patrick

doi:10.1371/journal.pmed.1001465

Cited by 235 publications

(236 citation statements)

References 27 publications

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“…22 Noncommunicable diseases such as asthma, diabetes, depression, and cancers, are now the greatest contributors to death and disability worldwide and yet have been particularly neglected compared with infectious diseases in lowand middle-income countries. 10,19,23 Our results highlight this disparity, showing much higher correlation between clinical trials and disease burden for infectious diseases than other conditions. Increasing clinical research activity around infectious conditions in less developed nations may not only benefit local populations but also shed light on prevention and treatment strategies in more developed countries where many important infectious diseases are rare.…”

Section: Discussionmentioning

confidence: 74%

Association Between Pediatric Clinical Trials and Global Burden of Disease

Bourgeois¹,

Olson

Ioannidis

et al. 2014

Pediatrics

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BACKGROUND: The allocation of research resources should favor conditions responsible for the greatest disease burden. This is particularly important in pediatric populations, which have been underrepresented in clinical research. Our aim was to measure the association between the focus of pediatric clinical trials and burden of disease and to identify neglected clinical domains. METHODS: We performed a cross-sectional study of clinical trials by using trial records in ClinicalTrials.gov. All trials started in 2006 or after and studying patient-level interventions in pediatric populations were included. Age-specific measures of disease burden were obtained for 21 separate conditions for high-, middle-, and low-income countries. We measured the correlation between number of pediatric clinical trials and disease burden for each condition. RESULTS: Neuropsychiatric conditions and infectious diseases were the most studied conditions globally in terms of number of trials (874 and 847 trials, respectively), while intentional injuries (5 trials) and maternal conditions (4 trials) were the least studied. Clinical trials were only moderately correlated with global disease burden (r = 0.58, P = .006). Correlations were also moderate within each of the country income levels, but lowest in low-income countries (r = .47, P = .03). Globally, the conditions most understudied relative to disease burden were injuries (–260 trials for unintentional injuries and –160 trials for intentional injuries), nutritional deficiencies (–175 trials), and respiratory infections (–171 trials). CONCLUSIONS: Pediatric clinical trial activity is only moderately associated with pediatric burden of disease, and least associated in low-income countries. The mismatch between clinical trials and disease burden identifies key clinical areas for focus and investment.

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Section: Discussionmentioning

confidence: 74%

Association Between Pediatric Clinical Trials and Global Burden of Disease

Bourgeois¹,

Olson

Ioannidis

et al. 2014

Pediatrics

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“…Por outro lado, mesmo considerando a possibilidade de existência de causalidade-reversa neste estudo (devido ao delineamento transversal utilizado), sabe-se que a prática regular de atividades físicas e dieta adequada estão relacionada a menores prevalência e incidência de doenças crônicas na população adulta (LACHAT et al, 2013), resultando em menor utilização de medicamentos entre grupos mais ativos (BERTOLDI; HALLAL; BARROS, 2006;SILVA et al, 2012) e com indicadores de obesidade dentro dos padrões ideais (CODOGNO et al, 2011;CODOGNO;FERNANDES;MONTEIRO, 2012). Destaca-se que nesse estudo, a presença de inatividade física, mesmo sem a presença de obesidade, foi fator significativamente relacionado a compra de medicamentos.…”

Section: Variáveis Independentes Compra De Medicamentos N (%)unclassified

Atividade física, obesidade abdominal e compra de medicamentos em adultos: estudo transversal retrospectivo com usuários da atenção básica de saúde

Turi

Codogno²,

Fernandes³

et al. 2015

R. Educ. Fís. UEM

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RESUMOO objetivo do estudo foi verificar associações entre prática de atividades físicas, obesidade abdominal e compra de medicamentos por usuários do sistema público de saúde da cidade de Bauru/SP. A amostra foi composta por adultos com idade acima de 50 anos e através de entrevista foram coletadas informações sobre compra de medicamentos, prática de atividades físicas, condição econômica e tabagismo. Índice de massa corporal e perímetro abdominal compuseram marcadores de obesidade geral e abdominal. Como principais resultados encontrou-se que a compra de medicamentos foi maior entre mulheres, pessoas com mais de 65 anos, não-fumantes e naqueles com obesidade abdominal. De forma inversa, indivíduos ativos apresentaram menor compra de medicamentos quando comparados aos sedentários. Por fim, quando inatividade física e a obesidade abdominal foram agregadas em uma única variável, pessoas apenas inativas fisicamente e inativas fisicamente com obesidade abdominal apresentaram chances aumentadas de comprar medicamentos no último mês. Palavras

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“…The prevalence of diabetes varies in different age groups with the older population being at a higher risk compared to the young population [5]. The number of older adults with diabetes is increasing in sub-Saharan Africa due to increased lifespan and the increased prevalence of diabetes in the geriatric population [6]. Despite the demographic transition occurring in Africa, few studies have focused on understanding the magnitude of diabetes among older adults in specific countries [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Because elderly patients with diabetes are living longer and are likely to use increasing amounts of scarce health care resources in the next several decades, diabetes in aged adults may ultimately prove to be the most important epidemic of the 21st century [6]. In order to provide more evidence about the magnitude of diabetes among the elderly individuals, the aim of this study was to assess the prevalence, clinical features and complications of type 2 diabetes mellitus among elderly in the Hôpital Provincial du Nord-Kivu in Goma.…”

Section: Introductionmentioning

confidence: 99%

Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

Mbamukonka¹,

Agasa²,

Tonen‐Wolyec³

et al. 2017

ajhissues

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Background and aim: Diabetes is one of the leading non-communicable diseases in the world; diabetes is common in the elderly. The aim of this study is to assess the prevalence, clinical features and complications of type 2 diabetes mellitus among the elderly in the Hôpital Provincial du Nord-Kivu in Goma. Subjects and Methods: A cross sectional study was based on data collected among the elderly from 2013 to 2015 in the Department of Internal Medicine. Overall, 418 elders were included. Results: The prevalence of type 2 diabetes mellitus was 8.6% (95% CI: 6.3 -11.7). Overall, 54% of the elderly were males while 46% were females. Among males, 6.6% were diagnosed with diabetes whereas 11.0% were among females (p < 0.001). All elderly diabetic subjects (n = 36) were taking anti diabetic drugs such as insulin or oral medications (sulfonylurea and/or biguanide). Among those, 15 (41.7%) were on insulin and 21 (58.3%) on oral anti diabetic. Mean fasting glucose was higher among elderly individuals taking oral medications compared with their counterparts on insulin (104.4 versus 157.3 mg/dl, p < 0.001). The asthenia (86.1%), the polyuria (13.9%), the coma (11.1%) and the polydipsia (5.6%) were the principal symptoms on admission. The infectious, metabolic, micro vascular and macrovascular complications were diagnosed in this study. Conclusion: Our study provides evidence on the high prevalence of type 2 diabetes mellitus among elderly individuals. Moreover, the study found many factors associated with type 2 diabetes mellitus among the elderly and the difficulty of diagnosing diabetes in the elderly. Hence, there is need to enhance the existing prevention programmes with emphasis on social determinants of diabetes, which need to be clarified by broad epidemiological studies at the population level.

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Diet and Physical Activity for the Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Policy Review

Abstract: Carl Lachat and colleagues evaluate policies in low- and middle-income countries addressing salt and fat consumption, fruit and vegetable intake, and physical activity, key risk factors for non-communicable diseases. Please see later in the article for the Editors' Summary

Cited by 235 publications

References 27 publications

Association Between Pediatric Clinical Trials and Global Burden of Disease

Association Between Pediatric Clinical Trials and Global Burden of Disease

Atividade física, obesidade abdominal e compra de medicamentos em adultos: estudo transversal retrospectivo com usuários da atenção básica de saúde

Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

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