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1. Social support and ideal cardiovascular health in urban Jamaica: A cross-sectional study

Author: Alphanso L. Blake, Nadia R. Bennett, Joette A. McKenzie, Marshall K. Tulloch-Reid, Ishtar Govia, Shelly R. McFarlane, Renee Walters, Damian K. Francis, Rainford J. Wilks, David R. Williams, Novie O. Younger-Coleman, and Trevor S. Ferguson
Subjects: Public aspects of medicine, RA1-1270
Published: 2024

2. Community stressors (violence, victimization, and neighborhood disorder) with cardiometabolic outcomes in urban Jamaica

Author: Tiffany L. Gary-Webb, Harika Dyer, Joette Mckenzie, Novie Younger-Coleman, Marshall Tulloch-Reid, Alphanso Blake, Ishtar Govia, Nadia Bennett, Shelly McFarlane, Rainford J. Wilks, David R. Williams, and Trevor S. Ferguson
Subjects: cardiometabolic risk, Black, community, stressors, Caribbean (Jamaica), Public aspects of medicine, RA1-1270
Abstract: BackgroundDespite limited data on neighborhood factors and health risk in Caribbean populations, previous analyses from Jamaica have shown that neighborhood and home disorder were associated with lower physical activity and higher cumulative biological risk among women, while poorer neighborhood infrastructure was associated with higher overweight/obesity among men.DesignCross-sectional survey design.ObjectivesIn this study, we explored whether community stressors, as measured by community violence, victimization and neighborhood disorder scores, were associated with cardiometabolic outcomes (obesity, diabetes, hypertension and high cholesterol) in urban Jamaican communities. Sex-specific Poisson regression models were used to estimate prevalence ratios (PR) for these associations, adjusting for age, education, diet, physical activity and smoking.ParticipantsOf the 849 participants (M = 282; F = 567), mean age was 48 ± 18.5 years and most had at least a high school education. Men were more likely to be current smokers (29.4 vs. 10.6%) and adequately physically active (53.2 vs. 42.0%); more women were obese (46.0 vs. 19.0%), more likely to have hypertension (52.9 vs. 45.4%) and had high cholesterol (34.2 vs. 21.6%) (all p
Published: 2023
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3. Association study in African-admixed populations across the Americas recapitulates asthma risk loci in non-African populations

Author: Michelle Daya, Nicholas Rafaels, Tonya M. Brunetti, Sameer Chavan, Albert M. Levin, Aniket Shetty, Christopher R. Gignoux, Meher Preethi Boorgula, Genevieve Wojcik, Monica Campbell, Candelaria Vergara, Dara G. Torgerson, Victor E. Ortega, Ayo Doumatey, Henry Richard Johnston, Nathalie Acevedo, Maria Ilma Araujo, Pedro C. Avila, Gillian Belbin, Eugene Bleecker, Carlos Bustamante, Luis Caraballo, Alvaro Cruz, Georgia M. Dunston, Celeste Eng, Mezbah U. Faruque, Trevor S. Ferguson, Camila Figueiredo, Jean G. Ford, Weiniu Gan, Pierre-Antoine Gourraud, Nadia N. Hansel, Ryan D. Hernandez, Edwin Francisco Herrera-Paz, Silvia Jiménez, Eimear E. Kenny, Jennifer Knight-Madden, Rajesh Kumar, Leslie A. Lange, Ethan M. Lange, Antoine Lizee, Pissamai Maul, Trevor Maul, Alvaro Mayorga, Deborah Meyers, Dan L. Nicolae, Timothy D. O’Connor, Ricardo Riccio Oliveira, Christopher O. Olopade, Olufunmilayo Olopade, Zhaohui S. Qin, Charles Rotimi, Nicolas Vince, Harold Watson, Rainford J. Wilks, James G. Wilson, Steven Salzberg, Carole Ober, Esteban G. Burchard, L. Keoki Williams, Terri H. Beaty, Margaret A. Taub, Ingo Ruczinski, Rasika A. Mathias, Kathleen C. Barnes, and CAAPA
Subjects: Science
Abstract: The burden of asthma varies between ancestries, but GWAS have so far focused on mainly European ancestry populations. Here, Daya et al. perform GWAS for asthma in 14,654 individuals of African ancestry and, besides confirming previously known loci, identify two potentially African ancestry-specific loci.
Published: 2019
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4. Cost of care of chronic non-communicable diseases in Jamaican patients: the role of obesity

Author: Christine M. Fray-Aiken, Rainford J. Wilks, Abdullahi O. Abdulkadri, and Affette M. McCaw-Binns
Subjects: chronic non-communicable diseases, obesity, cost-of-illness, Medicine (General), R5-920
Abstract: OBJECTIVE: To estimate the economic cost of Chronic Non-Communicable Diseases (CNCDs) and the portion attributable to obesity among patients in Jamaica. METHODS: The cost-of-illness approach was used to estimate the cost of care in a hospital setting in Jamaica for type 2 diabetes mellitus, hypertension, coronary heart disease, stroke, gallbladder disease, breast cancer, colon cancer, osteoarthritis, and high cholesterol. Cost and service utilization data were collected from the hospital records of all patients with these diseases who visited the University Hospital of the West Indies (UHWI) during 2006. Patients were included in the study if they were between15 and 74 years of age and if female, were not pregnant during that year. Costs were categorized as direct or indirect. Direct costs included costs for prescription drugs, consultation visits (emergency and clinic visits), hospitalizations, allied health services, diagnostic and treatment procedures. Indirect costs included costs attributed to premature mortality, disability (permanent and temporary), and absenteeism. Indirect costs were discounted at 3% rate. RESULTS: The sample consisted of 554 patients (40%) males (60%) females. The economic burden of the nine diseases was estimated at US$ 5,672,618 (males 37%; females 63%) and the portion attributable to obesity amounted to US$ 1,157,173 (males 23%; females 77%). Total direct cost was estimated at US$ 3,740,377 with female patients accounting for 69.9% of this cost. Total indirect cost was estimated at US$ 1,932,241 with female patients accounting for 50.6% of this cost. The greater cost among women was not found to be statistically significant. Overall, on a per capita basis, males and females accrued similar costs-of-illness (US$ 9,451.75 vs. US$ 10,758.18). CONCLUSIONS: In a country with per capita GDP of less than US$ 5,300, a per capita annual cost of illness of US$ 10,239 for CNCDs is excessive and has detrimental implications for the health and development of Jamaica.
Published: 2016
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5. Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study

Author: Trevor S. Ferguson, Novie O.M. Younger-Coleman, Marshall K. Tulloch-Reid, Nadia R. Bennett, Amanda E. Rousseau, Jennifer M. Knight-Madden, Maureen E. Samms-Vaughan, Deanna E. Ashley, and Rainford J. Wilks
Subjects: Elevated blood pressure, Hypertension, Cardiovascular disease risk factors, Young adults, Caribbean, Blacks, Medicine, Biology (General), QH301-705.5
Abstract: Background Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. Methods Data from 898 young adults, 18–20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. Results Prevalence of EBP/HTN was 30% among males and 13% among females (p
Published: 2018
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6. Author Correction: Association study in African-admixed populations across the Americas recapitulates asthma risk loci in non-African populations

Author: Michelle Daya, Nicholas Rafaels, Tonya M. Brunetti, Sameer Chavan, Albert M. Levin, Aniket Shetty, Christopher R. Gignoux, Meher Preethi Boorgula, Genevieve Wojcik, Monica Campbell, Candelaria Vergara, Dara G. Torgerson, Victor E. Ortega, Ayo Doumatey, Henry Richard Johnston, Nathalie Acevedo, Maria Ilma Araujo, Pedro C. Avila, Gillian Belbin, Eugene Bleecker, Carlos Bustamante, Luis Caraballo, Alvaro Cruz, Georgia M. Dunston, Celeste Eng, Mezbah U. Faruque, Trevor S. Ferguson, Camila Figueiredo, Jean G. Ford, Weiniu Gan, Pierre-Antoine Gourraud, Nadia N. Hansel, Ryan D. Hernandez, Edwin Francisco Herrera-Paz, Silvia Jiménez, Eimear E. Kenny, Jennifer Knight-Madden, Rajesh Kumar, Leslie A. Lange, Ethan M. Lange, Antoine Lizee, Pissamai Maul, Trevor Maul, Alvaro Mayorga, Deborah Meyers, Dan L. Nicolae, Timothy D. O’Connor, Ricardo Riccio Oliveira, Christopher O. Olopade, Olufunmilayo Olopade, Zhaohui S. Qin, Charles Rotimi, Nicolas Vince, Harold Watson, Rainford J. Wilks, James G. Wilson, Steven Salzberg, Carole Ober, Esteban G. Burchard, L. Keoki Williams, Terri H. Beaty, Margaret A. Taub, Ingo Ruczinski, Rasika A. Mathias, Kathleen C. Barnes, and CAAPA
Subjects: Science
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Published: 2019
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7. P130 TEST-RETEST RELIABILITY FOR PULSE WAVE VELOCITY AND CARDIO-ANKLE VASCULAR INDEX AMONG AFRO-CARIBBEAN YOUNG ADULTS

Author: Janeil M. Williams, Trevor S. Ferguson, Nadia R. Bennett, Amanda Rousseau, Renee Walters, Novie O. Younger-Coleman, Marshall K. Tulloch-Reid, Seeromanie Harding, J. Kennedy Cruickshank, and Rainford J. Wilks
Subjects: Specialties of internal medicine, RC581-951, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background: This study evaluated the test-retest reliability of carotid-femoral pulse wave velocity (PWV) and cardio-ankle vascular index (CAVI) among young adults in Jamaica. Methods: We recruited participants from the Jamaica 1986 Birth Cohort Study. PWV was measured using the Arteriograph device™ (TensioMed, Budapest) and CAVI with the VaSera™ device (Fukuda Denshi, Tokyo). Both measurements were done twice on the same day with a 1-hour interval between measurements. Test-retest reliability was estimated using the intra-class correlation coefficient (ICC) and Bland-Altman plots. Kappa statistic was used to assess agreement between repeated tests in classifying participants as high PWV or CAVI, defined as being in the upper tertile of measurements. Results: Analyses included 89 participants (43 males; 46 females; mean age 28.4±0.50 years). Mean PWV for first and second readings were 6.56 cm/s and 6.64 cm/s, respectively (mean difference −0.08 [95%CI −0.18, 0.03, p = 0.142]). Mean values for first and second CAVI were 6.53 and 6.20, respectively, (mean difference 0.34 [95%CI 0.18, 0.50, p < 0.001]). ICC for PWV was 0.88 (95%CI 0.83, 0.92) and for CAVI 0.57 (95%CI 0.41, 0.69). Bland-Altman plots indicated that measurements taken from both devices were highly reproducible, with most points (85/89 for PWV; 86/89 for CAVI) falling within 2 SD of the mean difference. Kappa statistic was 0.76 for PWV and 0.56 for CAVI. Conclusion: PWV (Arteriograph™) and CAVI (VaSera™) have good test-retest reliability among Jamaican youth adults; however repeated CAVI values were marginally lower than the first measurement and the ICC and kappa estimates were lower.
Published: 2017
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8. Educational Health Disparities in Cardiovascular Disease Risk Factors: Findings from Jamaica Health and Lifestyle Survey 2007–2008

Author: Trevor S. Ferguson, Novie O. M. Younger-Coleman, Marshall K. Tulloch-Reid, Ian R. Hambleton, Damian K. Francis, Nadia R. Bennett, Shelly R. McFarlane, Aurelian Bidulescu, Marlene Y. MacLeish, Anselm J. M. Hennis, Rainford J. Wilks, E. Nigel Harris, and Louis W. Sullivan
Subjects: health disparity, cardiovascular disease, education, socioeconomic status, hypertension, diabetes, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: ObjectivesSocioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD) risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity), among Jamaican adults.MethodsWe analyzed data from the Jamaica Health and Lifestyle Survey 2007–2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates.ResultsThe sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p
Published: 2017
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9. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica

Author: Krystal A.T. Gayle, Marshall K. Tulloch-Reid, Novie O. Younger, Damian K. Francis, Shelly R. McFarlane, Rosemarie A. Wright-Pascoe, Michael S. Boyne, Rainford J. Wilks, and Trevor S. Ferguson
Subjects: foot wear, foot care, diabetes, diabetic foot, Jamaica, Caribbean., Medicine (General), R5-920
Abstract: This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90%) reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. In conclusion, approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82%) or leather shoes (64%), fairly high proportions reported wearing pointed toe shoes (39%), and 43% of women wore high heel shoes. Approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided.
Published: 2012
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10. The slipping slipper sign: a simple test with high specificity and positive predictive value for peripheral neuropathy among diabetic patients

Author: Krystal A.T. Gayle, Marshall K. Tulloch-Reid, Rainford J. Wilks, and Trevor S. Ferguson
Subjects: slipping slipper sign, diabetic neuropathy, diabetic foot, Jamaica., Medicine (General), R5-920
Abstract: This study evaluated the ability of the slipping slipper sign (defined as unknowingly losing a slipper while walking) to identify diabetic neuropathy in Jamaican patients. A single question was used to ascertain the presence of the slipping slipper sign (SSS) among 69 patients attending a diabetes clinic. Nurses assessed pain, vibration and pressure perception among the same patients in order to detect diabetic neuropathy. The sensitivity, specificity and positive predictive value for the SSS were calculated. Eight participants (men=5, women=3) reported positive SSS. The SSS had a sensitivity of 28.6%, specificity of 100% and positive predictive value (PPV) 100% for neuropathy on at least one of the three tests. These findings indicate that the SSS has high specificity and PPV for diabetic neuropathy but the sensitivity is low. The sign may be a useful adjuvant to conventional methods of screening for severe neuropathy
Published: 2012
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11. Reported Hours of Sleep, Diabetes Prevalence and Glucose Control in Jamaican Adults: Analysis from the Jamaica Lifestyle Survey 2007-2008

Author: Chisa G. Cumberbatch, Novie O. Younger, Trevor S. Ferguson, Shelly R. McFarlane, Damian K. Francis, Rainford J. Wilks, and Marshall K. Tulloch-Reid
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Background. There are limited data on sleep duration and diabetes from developing countries. We therefore examined the relationship between reported hours of sleep, diabetes prevalence and glucose control in Jamaican adults. Methods. Data on reported hours of sleep and diabetes (based on glucose measurement and medication use) from a national survey of 15–74-year-old Jamaicans were analyzed. Results. The 2,432 participants (31% M, Age 42±16 years, BMI 27.6±6.6 kg/m2, diabetes prevalence 12%) reported sleeping 8.2±1.8 hours. In men, sleeping less than 6 hours (OR (95% CI) = 2.65 (1.09–6.48)) or more than 10 hours (OR (95% CI) = 4.36 (1.56–12.19)) was associated with diabetes when adjusted for age, BMI, and family history of diabetes. In women sleeping less than 6 hours was associated with a reduced likelihood of diabetes after adjusting for the same confounders ((OR (95% CI) = 0.43 (0.23–0.78)). There was no significant association between sleep and glucose control. Conclusion. Insufficient and excessive sleep was associated with increased diabetes prevalence in Jamaican men but not women.
Published: 2011
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12. May Measurement Month 2019: an analysis of blood pressure screening results from Jamaica

Author: Magdalene Nwokocha, Chukwuemeka R. Nwokocha, Rainford J. Wilks, Adedamola Soyibo, Trevor S. Ferguson, Joan Leitch, Thomas Beaney, Daniel C. Oshi, Vincent Riley, Natalie Whylie, Karen Thaxter Nesbeth, Tomlin J. Paul, Paul D. Brown, Neil R Poulter, Mark Hosang, and Cheryl Holder
Subjects: Jamaica, medicine.medical_specialty, Diastole, 030204 cardiovascular system & hematology, Asymptomatic, African origin, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Control, Medicine, AcademicSubjects/MED00200, 030212 general & internal medicine, 1102 Cardiorespiratory Medicine and Haematology, Antihypertensive medication, Health professionals, business.industry, Previous pregnancy, Articles, Treatment, Blood pressure, Cardiovascular System & Hematology, Hypertension, Screening, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract: There is evidence of an elevated risk of hypertension in populations that are primarily of African origin. Hypertension is predominantly asymptomatic, necessitating increased awareness. May Measurement Month was a descriptive, population-based, cross-sectional study of blood pressure (BP) screening and awareness campaign conducted in 2019 in a sample of 2550 participants (≥18 years) in Jamaica. In total, 1791 (70.2%) of the participants were female, 756 (29.6%) were male, with an average age of 49.3 years, and a body mass index (kg/m2) of 28.5 (6.2). Of all participants, 2289 (89.8%) were black and 154 (6.0%) were of mixed races. Twenty-two (0.9%) had never had their BP measured, whereas 354 (13.9%) had their measurements more than a year ago, and 2129 (83.5%) had measured within the year. Of all 2550 participants, 1055 (41.4%) had hypertension, 69.9% of our subjects with hypertension were aware, whereas only 62.5% were on antihypertensive medication and 27.8% had controlled BP (systolic
Published: 2021

13. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. 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Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. 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Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. Santos, Marjeta Majer, Herman Schargrodsky, Bruna Gonçalves Cordeiro da Silva, Ebrahim Eftekhar, Jesús Vioque, Marisa K. Sophiea, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Stefan Söderberg, Isabel O. Oliveira, Joanne Katz, Xingwang Ye, Christophe Tzourio, Marie Zins, Aneta Weres, Ulrich Keil, Haiquan Xu, Akihiro Yoshihara, Rachel Dankner, Gabriella Gruden, Maroje Sorić, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Christa L. Lilly, Veikko Salomaa, Gilad Twig, Senthil K Vasan, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Wilma M. Hopman, Karl-Heinz Jöckel, Ari Voutilainen, Peter Schnohr, Jerzy Chudek, Katia Vergetti Bloch, Vincenzo Capuano, Jyh Eiin Wong, Torben Jørgensen, Anja Schienkiewitz, Nader Saki, Carolina Tarqui-Mamani, Maria Cecília Formoso Assunção, Kazi M. Jamil, Juraci Almeida Cesar, Pedro J Ortiz, Delphine De Smedt, Luciana Zaccagni, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Wellcome TrustEuropean Commission, Clinical Developmental Psychology, APH - Mental Health, Sociology, The Social Context of Aging (SoCA), Nutrition and Health, Iurilli, Maria LC [0000-0003-0409-1635], Zhou, Bin [0000-0002-1741-8628], Ezzati, Majid [0000-0002-2109-8081], Apollo - University of Cambridge Repository, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH 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Ltd, Orebro University, University of London, Universitas Indonesia, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Children’s Hospital of Fudan University, University of Cyprus, Niigata University, International Medical University, Iran University of Medical Sciences, Center for Diabetes and Endocrine Care, Peking University First Hospital, Jiangsu Provincial Center for Disease Control and Prevention, Sun Yat-sen University, West Kazakhstan Medical University, Inner Mongolia Medical University, University of Ghana, Maria Lc Iurilli , Bin Zhou , James E Bennett , Rodrigo M Carrillo-Larco , Marisa K Sophiea , Andrea Rodriguez-Martinez , Honor Bixby , Bethlehem D Solomon , Cristina Taddei , Goodarz Danaei , Mariachiara Di Cesare , Gretchen A Stevens , Leanne M Riley , Stefan Savin , Melanie J Cowan , Pascal Bovet , Albertino Damasceno , Adela Chirita-Emandi , Alison J Hayes , Nayu Ikeda , Rod T Jackson , Young-Ho Khang , Avula Laxmaiah , Jing 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Chiara Donfrancesco , Silvana P Donoso , Angela Döring , Maria Dorobantu , Ahmad Reza Dorosty , Kouamelan Doua , Nico Dragano , Wojciech Drygas , Jia Li Duan , Charmaine A Duante , Priscilla Duboz , Rosemary B Duda , Vesselka Duleva , Virginija Dulskiene , Samuel C Dumith , Anar Dushpanova , Vilnis Dzerve , Elzbieta Dziankowska-Zaborszczyk , Ricky Eddie , Ebrahim Eftekhar , Eruke E Egbagbe , Robert Eggertsen , Sareh Eghtesad , Gabriele Eiben , Ulf Ekelund , Mohammad El-Khateeb , Jalila El Ati , Denise Eldemire-Shearer , Marie Eliasen , Paul Elliott , Reina Engle-Stone , Macia Enguerran , Rajiv T Erasmus , Raimund Erbel , Cihangir Erem , Louise Eriksen , Johan G Eriksson , Jorge Escobedo-de la Peña , Saeid Eslami , Ali Esmaeili , Alun Evans , David Faeh , Albina A Fakhretdinova , Caroline H Fall , Elnaz Faramarzi , Mojtaba Farjam , Victoria Farrugia Sant'Angelo , Farshad Farzadfar , Mohammad Reza Fattahi , Asher Fawwad , Francisco J Felix-Redondo , Trevor S Ferguson , Romulo A Fernandes , Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen 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, Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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, Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021

14. EFFECT OF LINEAR GROWTH RATE AND CHANGE IN BODY MASS INDEX IN CHILDHOOD AND ADOLESCENCE ON BLOOD PRESSURE IN AFRO-CARIBBEAN YOUTH: THE VULNERABLE WINDOWS COHORT STUDY

Author: Clive Osmond, Terrence Forrester, Rainford J. Wilks, Chin-Harty L, Trevor S. Ferguson, Tamika Y. Royal-Thomas, Minerva Thame, and Michael S. Boyne
Subjects: Blood pressure, business.industry, Medicine, Gestational age, Early childhood, Afro-Caribbean, Anthropometry, business, Linear growth, Body mass index, Cohort study, Demography
Abstract: BackgroundFaster growth velocity during childhood may increase blood pressure (BP) in adults, but there are little data from African-origin populations. We evaluated the effect of postnatal linear growth (increase in height) and change in body mass index (BMI) from birth to adolescence on systolic and diastolic blood pressure (SBP and DBP) in Afro-Caribbean youth.MethodsWe used data from the Vulnerable Windows Birth Cohort Study in Jamaica. Children were followed from birth, with periodic anthropometric measurements. BP measurements started at age 1-year and every six months thereafter. Analyses used BP measurements (mmHg) from age 15-21 years. Linear growth and change in BMI measurements were calculated for: early infancy (0-6 months), late infancy (6 months - 2 years), early childhood (2-8 years), and later childhood (8-15 years). Conditional analyses were used to compute growth rates (as z-scores). Linear mixed models were used to estimate the effect of growth rates on BP.ResultsAnalyses included 365 individuals (162 males, 203 females) with mean age 16.7 years. In multivariable models, after adjustment for age, sex, birth length, gestational age and BMI at age 15 years, faster linear growth for early infancy (β=1.06, p=0.010) was significantly associated with higher SBP. For change in BMI, after adjustment for age, sex, gestational age, height and SES at birth, significant associations of higher SBP were seen for greater increase in BMI in late infancy (β=1.41, p=0.001), early childhood (β=1.22, p=0.001) and later childhood (β=0.74, p=0.035). Faster post-natal linear growth had no significant associations with DBP, but greater increase in BMI for each of the late infancy to late childhood periods was significantly associated with higher DBP. When both growth rates were modeled together, rate of change of BMI and faster linear growth in early infancy retained significance for SBP, but only change in BMI retained significance for DBP.ConclusionFaster linear growth and greater rate of increase in BMI were associated with higher SBP and DBP in Afro-Caribbean youth, but the BMI effect was stronger.
Published: 2021

15. Socioeconomic and gender disparities in tobacco smoking among Jamaican adults from a national health survey

Author: E. Nigel Harris, Novie O. Younger-Coleman, Rainford J. Wilks, Nadia R. Bennett, Damian Francis, Simon G. Anderson, Trevor S. Ferguson, and Marlene Y. MacLeish
Subjects: National health, Post stratification, Tobacco use, business.industry, Usual occupation, Psychological intervention, Smoking prevalence, symbols.namesake, symbols, Medicine, Poisson regression, business, Socioeconomic status, Demography
Abstract: ObjectivesLittle is known of socioeconomic and gender disparities in tobacco use in the Caribbean. We evaluated education and occupation disparities in tobacco smoking prevalence in Jamaica.MethodsData on tobacco smoking, education attainment and usual occupation in adults 25-74 years in a national survey collected between 2007 and 2008 was analyzed. Using post stratification survey weights, Poisson regression models estimated sex-specific, age-adjusted prevalence estimates, prevalence differences and prevalence ratios.ResultsAnalyses included 2299 participants (696 men, 1603 women), mean age 43 years. Current smoking prevalence was 26% in men and 8% in women (pConclusionIn Jamaica, there are socioeconomic disparities in current tobacco smoking among men, where it is inversely associated with education attainment and occupation but in women is less clear. These findings suggest interventions to reduce smoking should consider these disparities.
Published: 2021

16. Associations of neighborhood physical and crime environments with obesity-related outcomes in Jamaica

Author: Novie O. Younger-Coleman, Parris Lyew-Ayee, Rainford J. Wilks, Katherine P. Theall, Colette Cunningham-Myrie, and Lisa-Gaye Greene
Subjects: Male, Intraclass correlation, Physiology, Social Sciences, Criminology, Social Geography, Geographical locations, Body Mass Index, Urban Environments, 0302 clinical medicine, Sociology, Residence Characteristics, Risk Factors, Medicine and Health Sciences, Public and Occupational Health, 030212 general & internal medicine, Multidisciplinary, Geography, Middle Aged, Terrestrial Environments, Socioeconomic Aspects of Health, Physiological Parameters, Neighborhoods, Medicine, Female, Crime, Research Article, Public park, Adult, Jamaica, Waist, Adolescent, Science, 030209 endocrinology & metabolism, Human Geography, 03 medical and health sciences, Young Adult, medicine, Area of residence, Humans, Obesity, Socioeconomic status, Life Style, Aged, Caribbean, Body Weight, Ecology and Environmental Sciences, Biology and Life Sciences, Small island, Physical Activity, medicine.disease, Health Care, Cross-Sectional Studies, Social Class, North America, Earth Sciences, People and places, Body mass index, Demography
Abstract: Objective To examine whether proximity and density of public open spaces, public parks, street connectivity, and serious and violent crimes were associated with Body Mass Index (BMI) and Waist Circumference (WC) within and across levels of urbanicity, sex and socioeconomic status (SES) in Jamaica, a small island developing state (SIDS). Methods Secondary analysis was conducted using data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II). All respondents were geocoded to area of residence in Enumeration Districts (EDs). Intraclass correlation coefficients (ICCs) were derived and multilevel mixed effects regression models applied to 2529 participants nested within 101 EDs from all 14 parishes in Jamaica. Results There was significant clustering across neighborhoods for mean BMI (ICC = 4.16%) and mean WC (ICC = 4.42%). In fully adjusted models statistically significant associations included: increased mean BMI among men, with increased intersection density/ km2 (β = 0.02; 95% CI = 1.96 x10-3, 0.04, p = 0.032); increased mean WC among urban residents with increased crimes/km2/yr (β = 0.09; 95% CI = 0.03, 0.16, pp Conclusions Neighborhood physical and crime environments were associated with obesity-related outcomes in Jamaica. Policymakers in SIDS such as Jamaica should also note the important differences by urbanicity, sex and SES in prevention efforts designed to stem the growing obesity epidemic.
Published: 2021

17. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. Murtagh, Kamel Ajlouni, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Xiangjun Wang, Lars Lind, Macia Enguerran, Marjeta Mišigoj-Duraković, Bo Werner, Jean-Michel Gaspoz, Kyungwon Oh, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Felix Kaducu, Ramon O. Jimenez, Jonathan E. Shaw, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Parvina Mukhtorova, Eha Nurk, Bhawesh Koirala, Óscar Lopes, Ana Jelakovic, Karolina Milkowska, Magda Gasull, Regina Heidinger-Felso, Marcela González-Gross, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Tran Quoc Bao, José Boggia, Daniela Galeone, Josep Redon, Matthias Bopp, Abbas Rezaianzadeh, Dusko Bjelica, Amir Houshang Mehrparvar, Felipe F. Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. 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González-Rivas, Rob M. van Dam, Daniel Bia, Oonagh Markey, Ryutaro Ohtsuka, Kumiko Ohara, Ričardas Radišauskas, Jurate Medzioniene, Tiina Vlasoff, Tania Tello, Suzanne C. Ho, Kodavanti Mallikharjuna Rao, May Soe Aung, Vesselka Duleva, Michael Hobbs, Lutgarde Thijs, Marjolein Visser, Parasmani Dasgupta, Inge Huybrechts, Raimund Erbel, Alice Bonilla-Vargas, Hermann Brenner, Mohammad Reza Fattahi, Jolanda Hyska, Roman Topor-Madry, Ranjit Mohan Anjana, Merike Liivak, Eruke E. Egbagbe, Mathilde Savy, Herculina S. Kruger, Neil Murphy, Vinay Nangia, Cesar G. Victora, Mostafa K. Mohamed, H. Bas Bueno-de-Mesquita, Gabriella Gruden, Marcos André Moura-dos-Santos, Mohammed Rasoul Tarawneh, Maria Teresa Menzano, Francesco Branca, Abdonas Tamosiunas, Elena Bogova, Niveen M E Abu-Rmeileh, Maroje Sorić, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Tatjana Hejgaard, Yves Kameli, Margarita Samoutian, Andreia N. Pizarro, Jin Soo Moon, Frank Claessens, Zulfiqar A Bhutta, Frank Tanser, Nor Azwany Yaacob, Vanina Bongard, Gregor Jurak, Johan G. Eriksson, Christina-Paulina Lambrinou, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Thomas Meinertz Dantoft, Wichai Aekplakorn, Anwar Batieha, Eduardo Capuano, Teresa Haugsgjerd, Jeremy M. Jacobs, Paola Russo, Nguyen D Nguyen, Luis Revilla, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Wan Mohamad Wan Bebakar, Paul Elliott, Denise Eldemire-Shearer, Angela Döring, Giovanni Viegi, Xiaoguang Yang, María-Elena González-Villalpando, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Tomasz Zdrojewski, Carlos P. Boissonnet, Mohamad Hasnan Ahmad, Mahmudur Rahman, Günther Fink, Marcia Makdisse, Dragana P Jovic, Aline Wagner, Coimbatore Subramaniam Shanthirani, Pascal Bovet, Dong Wook Kim, Tom Wilsgaard, Anders Grøntved, Thirunavukkarasu Sathish, Antonia Trichopoulou, Noushin Mohammadifard, Igor Spiroski, Natasja M. van Schoor, Cláudia S. Minderico, Betina H. Thuesen, Queenie Chan, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Line Lund Kårhus, Cihangir Erem, Amina Barkat, Maria Paula Santos, Fernanda Cunha Soares, Constanta Huidumac Petrescu, Allan G. Hill, Honor Bixby, Benoît Salanave, Joana Carvalho, Maigeng Zhou, Ofra Kalter-Leibovici, Roy A Wong-McClure, Kim F. Michaelsen, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, José R. Banegas, Quang Ngoc La, Uruwan Yamborisut, Parinaz Mehdipour, Farhad Pourfarzi, Sudha Ramachandra Rao, Katsuyasu Kouda, Chien-Jen Chen, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Ronald D. Gregor, Rudolf Kaaks, Maria do Carmo Franco, Marta García-Solano, Beata Gurzkowska, Bahman Cheraghian, Stefaan De Henauw, Daniel Ferrante, Johanna A. Otero, Jamila Abubakar Garba, Antonio Pedro Graça, Sumit Bharadwaj, Shiqi Zhen, Xiu-Hua Guo, Prashant Mathur, Raphael Mendes Ritti-Dias, Kouamelan Doua, Esteban Carmuega, Majid Shirani, Przemyslaw Slusarczyk, Petra Rust, Visnja Djordjic, Farahnaz Joukar, Johanna Gunnlaugsdottir, Leila Houti, Nayu Ikeda, Imperia Brajkovich, Amirabbas Momenan, Erik J. Timmermans, Marcin Rutkowski, Biruta Velika, Joana Araújo, Jostein Steene-Johannessen, Christa L. Lilly, Per Tynelius, Michael Tornaritis, Anne Juolevi, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Espen Bjertness, Ana P. Ortiz, Joel G. R. Roy, Himanshu K. Chaturvedi, Michelle Holdsworth, Niels Wedderkopp, Johan Van der Heyden, Mukharram M. 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Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020

18. Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study

Author: Colette Cunningham-Myrie, Novie Younger, Lisa-Gaye Greene, Katherine P. Theall, Rainford J. Wilks, and Parris Lyew-Ayee
Subjects: Adult, Jamaica, Adolescent, Cross-sectional study, Epidemiology, Population, diabetes & endocrinology, Social class, Body Mass Index, Food Supply, Young Adult, Residence Characteristics, Medicine, Humans, education, Neighbourhood (mathematics), Life Style, nutrition & dietetics, Aged, education.field_of_study, business.industry, Multilevel model, public health, General Medicine, Anthropometry, Middle Aged, medicine.disease, Obesity, Cross-Sectional Studies, Caribbean Region, Multilevel Analysis, Female, business, Body mass index, Demography
Abstract: ObjectiveTo derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.DesignCross-sectional study.SettingData from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.ParticipantsA subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.Primary outcome measureMean BMI, calculated as weight divided by height squared (kg/m2).ResultsThere was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.ConclusionsHigher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.
Published: 2020

19. Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries

Author: Alexis Karamanos, Christelle Elia, Rainford J. Wilks, Ingrid Wolfe, Jane Sandall, J. Kennedy Cruickshank, Alexandru Dregan, Reeta Gobin, Craig Morgan, Seeromanie Harding, and Majella O'Keeffe
Subjects: Male, Pediatric Obesity, Cross-sectional study, Physiology, Economics, Epidemiology, Child Behavior, Social Sciences, Overweight, Adolescents, Families, 0302 clinical medicine, Risk Factors, Medicine and Health Sciences, Public and Occupational Health, 030212 general & internal medicine, Child, Suicidal ideation, Children, 11 Medical and Health Sciences, education.field_of_study, Age Factors, General Medicine, Socioeconomic Aspects of Health, Suicide, Mental Health, Caribbean Region, Physiological Parameters, Life course approach, Medicine, Female, medicine.symptom, Research Article, Adolescent, Population, 030209 endocrinology & metabolism, Risk Assessment, Suicidal Ideation, 03 medical and health sciences, Young Adult, Sex Factors, General & Internal Medicine, Mental Health and Psychiatry, medicine, Humans, Obesity, education, Socioeconomic status, Nutrition, business.industry, Body Weight, Biology and Life Sciences, Odds ratio, medicine.disease, Health Surveys, Economic Analysis, Diet, Health Care, Cross-Sectional Studies, Latin America, Adolescent Behavior, Age Groups, Food, Medical Risk Factors, People and Places, Population Groupings, business, Demography
Abstract: Background Adolescents and young people (10–24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region’s population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated. Methods and findings The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10–19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health–related issues. Conclusions This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health., Author summary Why was this study done? Adolescents and young people (10–24 years old) in the Latin America and the Caribbean (LAC) region represent over 1 quarter of the region’s population. Adolescent nutrition and mental health are key policy priorities in the region. Despite the considerable diversity across the LAC region in economic development, welfare and health systems, little is known about the influence of level of national development or country-level income inequality on adolescent with overweight and obesity or suicidal ideation and planning. What did the researchers do and find? Using data from 21 LAC countries between 2009 and 2013, we found that adolescents living in more economically developed LAC countries were at higher risk of overweight and obesity. Suicidal ideation and planning was not associated with the level of development, but it was associated with overweight and obesity. What do these findings mean? This study shows that the risk of overweight and obesity is not only limited to individual or household level influences, but also to wider societal influences. Countries in the LAC region need to monitor and prevent adolescent overweight/obesity as they transition from lower to middle- and higher-income status.
Published: 2020

20. Ideal Cardiovascular Health in Urban Jamaica: Prevalence Estimates and Relationship to Community Property Value, Household Assets and Educational Attainment

Author: Ishtar Govia, Trevor S. Ferguson, Renee Walters, David R. Williams, Karen Webster-Kerr, Rainford J. Wilks, Andriene Grant, Shelly R. McFarlane, Damian Francis, Marshall K. Tulloch-Reid, Joette A. McKenzie, Nadia R. Bennett, Tamu Davidson, and Novie O. Younger-Coleman
Subjects: business.industry, Cardiovascular health, Survey research, Land value, Healthy diet, Logistic regression, Educational attainment, nervous system diseases, Odds, Medicine, cardiovascular diseases, business, Socioeconomic status, Demography
Abstract: BACKGROUNDIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We estimated the prevalence of ICH in urban Jamaica and evaluated associations between ICH and community, household and individual socioeconomic status (SES).METHODSCross-sectional study using data from 360 men and 665 women, age ≥20 years in urban Jamaica. ICH was defined as having seven characteristics: current non-smoking, healthy diet, moderate physical activity, and normal body mass index, blood pressure, glucose, and cholesterol. Logistic regression, weighted for survey design, quantified association between the outcome (≥5 ICH characteristics [ICH-5]), and exposure variables (tertiles of community median land value [MLV], tertiles of household assets and educational attainment).RESULTSPrevalence of ICH (7 characteristics) was 0.51%, while prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared to men in the upper tertile (lowest tertile: OR 0.33, 95%CI 0.12-0.91, p=0.032; middle tertile: OR 0.46 (0.20-1.04) p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. No significant association was seen for household assets.CONCLUSIONPrevalence of ICH is low in urban Jamaica. Living in poorer communities was associated with lower odds of ICH-5 among men. Higher education was associated with higher odds of ICH-5 among women but lowers odds among men.
Published: 2020

21. Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: A pooled analysis of population-based surveys

Author: J Jaime Miranda, Rodrigo M Carrillo-Larco, Catterina Ferreccio, Ian R Hambleton, Paulo A Lotufo, Ramfis Nieto-MartSínez, Bin Zhou, James Bentham, Honor Bixby, Kaveh Hajifathalian, Yuan Lu, Cristina Taddei, Leandra Abarca-Gómez, Benjamin Acosta-Cazares, Carlos A Aguilar-Salinas, Dolores S Andrade, Maria Cecília F Assunção, Alberto Barceló, Aluisio JD Barros, Mauro VG Barros, Joao Luiz D Bastos, Iqbal Bata, Rosangela L Batista, Mikhail Benet, Antonio Bernabe-Ortiz, Heloísa Bettiol, Daniel Bia, Katia V Bloch, Jose G Boggia, Carlos P Boissonnet, Imperia Brajkovich, Lizzy M Brewster, Christine Cameron, Ana Paula C Cândido, Felicia Cañete, Viviane C Cardoso, Esteban Carmuega, Juraci A Cesar, Queenie Chan, Diego G Christofaro, Janine Clarke, Susana C Confortin, Cora L Craig, Felipe V Cureau, Juvenal Soares Dias-da-Costa, Alejandro Diaz, Silvana C Donoso, Eleonora d'Orsi, Paula Duarte de Oliveira, Samuel C Dumith, Denise Eldemire-Shearer, Paul Elliott, Jorge Escobedo-de la Peña, Trevor S Ferguson, Romulo A Fernandes, Daniel Ferrante, Damian K Francis, Flavio D Fuchs, Sandra C Fuchs, Andrea Gazzinelli, David Goltzman, Helen Gonçalves, Bruna Goncalves Cordeiro da Silva, Angel R Gonzalez, David A Gonzalez-Chica, Margot González-Leon, Juan P González-Rivas, Clicerio González-Villalpando, María-Elena González-Villalpando, Mariano Gorbea Bonet, Ronald D Gregor, Ramiro Guerrero, Andre L Guimaraes, Martin C Gulliford, Laura Gutierrez, Leticia Hernandez Cadena, Victor M Herrera, Wilma M Hopman, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Christina Howitt, Vilma E Irazola, Kenneth James, Ramon O Jimenez, Santa Magaly Jiménez-Acosta, Michel Joffres, Patrick Kolsteren, Orlando Landrove, Maria Lazo-Porras, Christa L Lilly, M Fernanada Lima-Costa, Tania Lopez, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Marcia Makdisse, Paula Margozzini, Larissa Pruner Marques, Reynaldo Martorell, Luis Mascarenhas, Alicia Matijasevich, Anselmo J Mc Donald Posso, Shelly R McFarlane, Scott B McLean, Ana Maria B Menezes, Juan Francisco Miquel, Michele Monroy-Valle, Eric A Monterrubio, Eric Monterubio Flores, Leila B Moreira, Alain Morejon, Suzanne N Morin, Jorge Motta, William A Neal, Flavio Nervi, Ramfis E Nieto-Martínez, Oscar A Noboa, Angélica M Ochoa-Avilés, Maria Teresa Olinto Anselmo, Isabel O Oliveira, Lariane M Ono, Pedro Ordunez, Ana Paula C Ortiz, Pedro J Ortiz, Johanna A Otero, Alberto Palloni, Sergio Viana Peixoto, Alexandre C Pereira, Marco A Peres, Cynthia M Pérez, Rafael N Pichardo, Daniel A Rangel Reina, Ramon A Rascon-Pacheco, Luis Revilla, Robespierre Ribeiro, Raphael M Ritti-Dias, Juan A Rivera, Cynthia Robitaille, Laura A Rodríguez-Villamizar, Rosalba Rojas-Martinez, Joel GR Roy, Adolfo Rubinstein, Blanca Sandra Ruiz-Betancourt, Eduardo Salazar Martinez, Jose Sánchez-Abanto, Ina S Santos, Diego Augusto Santos Silva, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Herman Schargrodsky, Victor Sequera, Jennifer Servais, Antonio M Silva, Victoria E Soto-Rojas, Karen Sparrenberger, Aryeh D Stein, Ramón Suárez-Medina, Moyses Szklo, William R Tebar, Tania Tello, Marshall K Tulloch-Reid, Peter Ueda, Eunice Ugel, Gonzalo Valdivia, Gustavo Velasquez-Melendez, Roosmarijn Verstraeten, Cesar G Victora, Rildo S Wanderley Jr, Ming-Dong Wang, Rainford J Wilks, Roy A Wong-McClure, Novie O Younger-Coleman, Maria Elisa Zapata, Yanina Zocalo, Julio Zuñiga Cisneros, Goodarz Danaei, Gretchen A Stevens, Leanne M Riley, Majid Ezzati, Mariachiara Di Cesare, Universidad Peruana Cayetano Heredia, Imperial College London, Pontificia Universidad Catolica de Chile, University of the West Indies, Universidade de São Paulo (USP), Miami Veterans Affairs Healthcare System, University of Kent, Cleveland Clinic, Yale University, Caja Costarricense de Seguro Social, Instituto Mexicano Del Seguro Social, Instituto Nacional de Ciencias Medicas y Nutricion, Universidad de Cuenca, Federal University of Pelotas, Pan American Health Organization, University of Pernambuco, Dalhousie University, Federal University of Maranhao, CAFAM University Foundation, University Medical Science, Universidad de la Republica, Centro de Educacion Medica e Investigaciones Clinicas, University of Amsterdam, Canadian Fitness and Lifestyle Research Institute, Universidade Federal de Juiz de Fora, Universidade Estadual Paulista (UNESP), Universidade Federal de Santa Catarina (UFSC), University of Montreal, Universidade Do Vale Do Rio Dos Sinos, National Council of Scientific and Technical Research, Ministry of Health, Instituto Nacional de Salud Publica, Hospital de Clinicas de Porto Alegre, Universidade Federal Do Rio Grande Do sul, McGill University, Andes Clinic of Cardio-Metabolic Studies, Epidemiology and Microbiology, Universidad Icesi, State University of Montes Claros, King's College London, Institute for Clinical Effectiveness and Health Policy, National Institute of Public Health, Universidad Autonoma de Bucaramanga, Kingston General Hospital, Heart Institute, Fundacion Oftalmologica de Santander, Simon Fraser University, Institute of Tropical Medicine, Ministerio de Salud Publica, Harvard TH Chan School of Public Health, West Virginia University, Oswaldo Cruz Foundation Rene Rachou Research Institute, Universidade Federal de Ouro Preto, Hospital Israelita Albert Einstein, Emory University, Gorgas Memorial Institute of Health Studies, Statistics Canada, Gorgas Memorial Institute of Public Health, University of Vale Do Rio Dos Sinos, University of Puerto Rico Medical Sciences Campus, University of Wisconsin-Madison, Minas Gerais State Secretariat for Health, Universidade Nove de Julho, Public Health Agency of Canada, Universidad Industrial de Santander, National Institute of Health, Hospital Italiano de Buenos Aires, Universidad Centro-Occidental Lisandro Alvarado, Epidemiology and Microbiology Institute, Universidade Federal de Minas Gerais (UFMG), World Health Organization, Middlesex University, and Wellcome Trust
Subjects: AWARENESS, Latin Americans, 030231 tropical medicine, Population, 1117 Public Health and Health Services, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, NCD Risk Factor Collaboration (NCD-RisC)—Americas Working Group, Medicine, 030212 general & internal medicine, education, Public, Environmental & Occupational Health, Cardiometabolic risk, education.field_of_study, Science & Technology, HYPERTENSION, business.industry, 1. No poverty, LATIN-AMERICA, General Medicine, Anthropometry, medicine.disease, Obesity, PREVALENCE, 3. Good health, Blood pressure, Pooled analysis, WORLDWIDE TRENDS, OBESITY, business, Life Sciences & Biomedicine, purl.org/pe-repo/ocde/ford#3.02.18 [http], 0605 Microbiology, Demography
Abstract: Made available in DSpace on 2022-04-28T19:28:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 National Cancer Institute National Institute of Mental Health National Heart, Lung, and Blood Institute Fogarty International Center Alliance for Health Policy and Systems Research Medical Research Council Background Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure =140 mm Hg or diastolic blood pressure =90 mm Hg), and diabetes (fasting plasma glucose =7.0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3.9% (95% CI 2.2-6.3) in 1980, to 18.6% (14.3-23.3) in 2014, in men; and from 12.2% (8.2-17.0) in 1980, to 30.5% (25.7-35.5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5.2% (2.1-10.4) in men and 6.4% (2.6-10.4) in women in 1980, to 11.1% (6.4-17.3) in men and 13.6% (8.2-21.0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27.6% (22.3-33.2) in men and 19.9% (15.8-24.4) in women in 1980, to 15.5% (11.1-20.9) in men and 10.7% (7.7-14.5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countries. Universidad Peruana Cayetano Heredia Imperial College London Pontificia Universidad Catolica de Chile University of the West Indies University of Sao Paulo Miami Veterans Affairs Healthcare System University of Kent Cleveland Clinic Yale University Caja Costarricense de Seguro Social Instituto Mexicano Del Seguro Social Instituto Nacional de Ciencias Medicas y Nutricion Universidad de Cuenca Federal University of Pelotas Pan American Health Organization University of Pernambuco Dalhousie University Federal University of Maranhao CAFAM University Foundation University Medical Science Universidad de la Republica Centro de Educacion Medica e Investigaciones Clinicas University of Amsterdam Canadian Fitness and Lifestyle Research Institute Universidade Federal de Juiz de Fora Universidade Estadual Paulista Universidade Federal de Santa Catarina University of Montreal Universidade Do Vale Do Rio Dos Sinos National Council of Scientific and Technical Research Ministry of Health Instituto Nacional de Salud Publica Federal University of Sao Paulo Hospital de Clinicas de Porto Alegre Universidade Federal Do Rio Grande Do sul McGill University Andes Clinic of Cardio-Metabolic Studies National Institute of Hygiene Epidemiology and Microbiology Universidad Icesi State University of Montes Claros King's College London Institute for Clinical Effectiveness and Health Policy National Institute of Public Health Universidad Autonoma de Bucaramanga Kingston General Hospital Heart Institute Fundacion Oftalmologica de Santander Simon Fraser University Institute of Tropical Medicine Ministerio de Salud Publica Harvard TH Chan School of Public Health West Virginia University Oswaldo Cruz Foundation Rene Rachou Research Institute Universidade Federal de Ouro Preto Hospital Israelita Albert Einstein Emory University Gorgas Memorial Institute of Health Studies Statistics Canada Gorgas Memorial Institute of Public Health University of Vale Do Rio Dos Sinos University of Puerto Rico Medical Sciences Campus University of Wisconsin-Madison Minas Gerais State Secretariat for Health Universidade Nove de Julho Public Health Agency of Canada Universidad Industrial de Santander National Institute of Health University of Sao Paulo Clinics Hospital Hospital Italiano de Buenos Aires Federal University of Santa Catarina Universidad Centro-Occidental Lisandro Alvarado Epidemiology and Microbiology Institute Universidade Federal de Minas Gerais World Health Organization Middlesex University Universidade Estadual Paulista National Cancer Institute: 1P20CA217231 National Institute of Mental Health: 1U19MH098780 National Heart, Lung, and Blood Institute: 1UM1HL134590 National Heart, Lung, and Blood Institute: 5U01HL114180 Fogarty International Center: D71TW010877 National Heart, Lung, and Blood Institute: HHSN268200900033C Alliance for Health Policy and Systems Research: HQHSR1206660 Medical Research Council: MR/P008984/1 Medical Research Council: MR/P02386X/1 Medical Research Council: MR/P024408/1 Fogarty International Center: R21TW009982
Published: 2020

22. Author Correction: Association study in African-admixed populations across the Americas recapitulates asthma risk loci in non-African populations

Author: Eugene R. Bleecker, Alvaro A. Cruz, Meher Preethi Boorgula, Rasika A. Mathias, Camila Alexandrina Figueiredo, Monica Campbell, Dara G. Torgerson, Trevor Maul, Carlos Bustamante, Trevor S. Ferguson, Genevieve L. Wojcik, Nicolas Vince, Olufunmilayo I. Olopade, Charles N. Rotimi, Henry Richard Johnston, Zhaohui S. Qin, Rajesh Kumar, Silvia Jiménez, Antoine Lizee, Ingo Ruczinski, Maria Ilma Araujo, Ryan D. Hernandez, Rainford J. Wilks, Ethan M. Lange, Terri H. Beaty, Caapa, Ricardo Riccio Oliveira, Edwin Francisco Herrera-Paz, Eimear E. Kenny, Leslie A. Lange, Alvaro Mayorga, Pedro C. Avila, Christopher R. Gignoux, Harold Watson, Nicholas Rafaels, Pissamai Maul, Margaret A. Taub, Carole Ober, Mezbah U. Faruque, Luis Caraballo, Aniket Shetty, Michelle Daya, Sameer Chavan, Timothy D. O’Connor, Weiniu Gan, Steven L. Salzberg, Nadia N. Hansel, Deborah A. Meyers, Albert M. Levin, Gillian M. Belbin, Pierre-Antoine Gourraud, Victor E. Ortega, Georgia M. Dunston, Jean G. Ford, Celeste Eng, Nathalie Acevedo, Dan L. Nicolae, L. Keoki Williams, Christopher O. Olopade, Candelaria Vergara, Esteban G. Burchard, Jennifer Knight-Madden, Ayo P. Doumatey, Tonya M. Brunetti, Kathleen C. Barnes, and James G. Wilson
Subjects: 0301 basic medicine, Science, media_common.quotation_subject, General Physics and Astronomy, 02 engineering and technology, Genome-wide association studies, Polymorphism, Single Nucleotide, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, CAAPA, Immunogenetics, Humans, Genetic Predisposition to Disease, Genetic variation, lcsh:Science, Author Correction, media_common, Chromosomes, Human, Pair 12, Multidisciplinary, Hispanic or Latino, General Chemistry, Art, 021001 nanoscience & nanotechnology, Asthma, United States, Black or African American, 030104 developmental biology, Genetic Loci, lcsh:Q, 0210 nano-technology, Humanities, Chromosomes, Human, Pair 17, Chromosomes, Human, Pair 8, Genome-Wide Association Study
Abstract: Author(s): Daya, Michelle; Rafaels, Nicholas; Brunetti, Tonya M; Chavan, Sameer; Levin, Albert M; Shetty, Aniket; Gignoux, Christopher R; Boorgula, Meher Preethi; Wojcik, Genevieve; Campbell, Monica; Vergara, Candelaria; Torgerson, Dara G; Ortega, Victor E; Doumatey, Ayo; Johnston, Henry Richard; Acevedo, Nathalie; Araujo, Maria Ilma; Avila, Pedro C; Belbin, Gillian; Bleecker, Eugene; Bustamante, Carlos; Caraballo, Luis; Cruz, Alvaro; Dunston, Georgia M; Eng, Celeste; Faruque, Mezbah U; Ferguson, Trevor S; Figueiredo, Camila; Ford, Jean G; Gan, Weiniu; Gourraud, Pierre-Antoine; Hansel, Nadia N; Hernandez, Ryan D; Herrera-Paz, Edwin Francisco; Jimenez, Silvia; Kenny, Eimear E; Knight-Madden, Jennifer; Kumar, Rajesh; Lange, Leslie A; Lange, Ethan M; Lizee, Antoine; Maul, Pissamai; Maul, Trevor; Mayorga, Alvaro; Meyers, Deborah; Nicolae, Dan L; O'Connor, Timothy D; Oliveira, Ricardo Riccio; Olopade, Christopher O; Olopade, Olufunmilayo; Qin, Zhaohui S; Rotimi, Charles; Vince, Nicolas; Watson, Harold; Wilks, Rainford J; Wilson, James G; Salzberg, Steven; Ober, Carole; Burchard, Esteban G; Williams, L Keoki; Beaty, Terri H; Taub, Margaret A; Ruczinski, Ingo; Mathias, Rasika A; Barnes, Kathleen C; CAAPA | Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Published: 2019

23. Blood Pressure Screening Campaign in Jamaica: May Measurement Month 2017

Author: E N Barton, Rainford J. Wilks, Hiu Wong, Natalie Whylie, Magdalene Nwokocha, Wendel D. Abel, Rohan Wilks, Cesar A. Romero, Chukwuemeka R. Nwokocha, Sheena Francis, Mark Hosang, Joan Lietch, Cheryl Holder, Paul D. Brown, and Tomlin J. Paul
Subjects: Adult, Male, medicine.medical_specialty, Jamaica, Time Factors, Adolescent, Population, Blood Pressure, Afro-Caribbean, Health Promotion, 030204 cardiovascular system & hematology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Prevalence, Humans, Mass Screening, In patient, 030212 general & internal medicine, education, Disease burden, Antihypertensive Agents, Antihypertensive medication, Aged, Aged, 80 and over, education.field_of_study, business.industry, Blood Pressure Determination, Middle Aged, medicine.disease, Blood pressure, Hypertension, Female, business, Body mass index
Abstract: BACKGROUND Hypertension (HTN) is responsible for a significant disease burden in Jamaica. We are reporting the results of the 2017 blood pressure (BP) screening campaign May Measurement Month in Jamaica that aimed to increase the awareness of HTN. METHODS Adults, 18 years old and older, from different parishes of Jamaica were invited to participate during May to June 2017. Demographic data were collected. BP, weight, and height were measured and recorded. RESULTS Five hundred sixty-six participants (n = 566) were enrolled, 91.6% (519) from urban areas, and 72.6% (410) were females. The average age was 53.7 (18–95) years old and body mass index was 28.2 ± 6.6 kg/m2. The prevalence of HTN was 47.3% (267/566), without gender or living areas differences (both P > 0.1). Prevalence of HTN was lower in those who self-identified as Interracial ethnicity, in comparison with Afro-Caribbean (33% vs. 48.3%; P = 0.04). About third of the hypertensive patients were not aware of the high BP (89/267; 35.6%). Between hypertensive patients, 64.4% (172/267) were receiving antihypertensive drugs. The rate of BP control was 32% of the hypertensive patients and 50% of those receiving antihypertensive medication. Significant lower BP control was observed between diabetic vs. nondiabetic patients (34.3% vs. 60%; P < 0.001). CONCLUSION We found a high prevalence of HTN in this population, especially in patients with diabetes or previous cardiovascular diseases. We report an increase in HTN awareness in Jamaica but more advances need to be performed to increase HTN treatment and control.
Published: 2019

24. Urban Renewal and Sustainable Development in Jamaica: Progress, Challenges and New Directions

Author: Mona Sue Ho, Rainford J. Wilks, Carol Archer, Jasneth Mullings, and Leith Lorraine Dunn
Subjects: Sustainable development, Economic growth, Land use, Urban planning, Corporate governance, Paradigm shift, Political science, InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL, Context (language use), Human capital, Gender mainstreaming, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries)
Abstract: The chapter discusses the history and context of urban renewal in Jamaica and shares the country’s integrated model for urban renewal, as well as the lessons learned from over two decades of implementation. As the urban planning landscape evolves there is a call to move in new directions, incorporating concepts which embody the development of human capital. One call is to re-position urban renewal as a public health tool to reduce crime and violence, communicable and non-communicable diseases, especially for the urban poor and urban youth who share a greater burden of Jamaica’s status as a Low/Middle Income Country (LMIC) and Small Island Developing State (SIDS). The call for the paradigm shift from gender-blind to gender-sensitive urban planning is expected to promote policy coherence between commitments to gender mainstreaming and gender equality and urban development modalities. There is also the need for a new governance framework to support the active participation of the average resident in the decision making process for land use management and other aspects of urban renewal to meet the goals of the New Urban Agenda and to realize Vision 2030 Jamaica, making “Jamaica, the place of choice to live, work, raise families and do business”.
Published: 2018

25. Ideal cardiovascular health in urban Jamaica: prevalence estimates and relationship to community property value, household assets and educational attainment: a cross-sectional study

Author: Rainford J. Wilks, Marshall K. Tulloch-Reid, Novie Younger, Karen Webster-Kerr, Damian Francis, Renee Walters, Trevor S. Ferguson, Ishtar Govia, Shelly R. McFarlane, Joette A. McKenzie, Andriene Grant, Nadia R. Bennett, David R. Williams, and Tamu Davidson
Subjects: Male, Jamaica, Epidemiology, Cross-sectional study, Cardiovascular health, Logistic regression, Cardiovascular System, Community property, Odds, urban health, socioeconomic status, Risk Factors, ideal cardiovascular health, Prevalence, Humans, Medicine, cardiovascular diseases, household assets, Neighbourhood (mathematics), Socioeconomic status, education, business.industry, General Medicine, Middle Aged, Educational attainment, nervous system diseases, Cross-Sectional Studies, Social Class, Cardiovascular Diseases, Educational Status, Female, business, neighbourhood, Demography
Abstract: ObjectiveIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES).DesignCross-sectional study.SettingUrban communities in Jamaica.Participants360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016–2017.ExposuresCommunity SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level.Primary outcomeThe main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations.ResultsThe prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women.ConclusionLiving in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.
Published: 2020

26. Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies

Author: Novie O. Younger-Coleman, Lisa Gaye Greene, Trevor S. Ferguson, Parris Lyew-Ayee, Jasneth Mullings, Damian Francis, and Rainford J. Wilks
Subjects: Jamaica, Youth, Epidemiology, Cardiology, lcsh:Medicine, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Internal Medicine, Medicine, 030212 general & internal medicine, Neighbourhood (mathematics), Socioeconomic status, Caribbean, 030505 public health, Neighborhood, business.industry, General Neuroscience, lcsh:R, Multilevel model, social sciences, General Medicine, Anthropometry, Cardiovascular risk, Health equity, Blood pressure, Pooled analysis, Black, Hypertension, population characteristics, Observational study, Public Health, Health disparities, 0305 other medical science, General Agricultural and Biological Sciences, business, Demography
Abstract: Introduction Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15–24 years old, in Jamaica. Methods A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005–2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models. Results Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI −2.11, −0.84] mmHg, p p = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [z-score -1 to 0] (β4.09 [1.49, 6.69], p = 0.002), but with lower systolic BP at spline 3 [z-core 0 to 1] (β-2.81 [−5.04, −0.59], p = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males. Conclusion Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females.
Published: 2020

27. Social determinants of prostate cancer in the Caribbean: a systematic review and meta-analysis

Author: Madhuvanti M. Murphy, Ian Hambleton, Catherine R. Brown, E. Nigel Harris, Rainford J. Wilks, Louis W. Sullivan, Natasha Sobers-Grannum, Shawn M. Hercules, Marlene Y. MacLeish, Nigel Unwin, and Apollo - University of Cambridge Repository
Subjects: Gerontology, Adult, Male, medicine.medical_specialty, Social Determinants of Health, Health Status, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Risk Factors, Cause of Death, Epidemiology, Ethnicity, Prevalence, Medicine, Humans, 030212 general & internal medicine, Social determinants of health, Prospective Studies, 10. No inequality, Social determinants, Aged, Caribbean, Aged, 80 and over, business.industry, lcsh:Public aspects of medicine, Public health, Disparity, Public Health, Environmental and Occupational Health, Cancer, Prostatic Neoplasms, lcsh:RA1-1270, Middle Aged, medicine.disease, 3. Good health, Cross-Sectional Studies, Inequality, Caribbean Region, Socioeconomic Factors, 030220 oncology & carcinogenesis, Meta-analysis, Systematic review, Observational study, Biostatistics, business, Research Article
Abstract: Background Prostate cancer remains the leading cause of cancer deaths among Caribbean men. However, little data exists on the influence of social factors on prostate cancer in the Caribbean setting. This article supports the 2011 Rio Political Declaration on addressing health inequalities by presenting a systematic review of evidence on the role of social determinants on prostate cancer in Caribbean men. It aims to determine the distribution, by known social determinants of health, of the frequency and adverse outcomes of prostate cancer among Caribbean populations. Methods Observational studies reporting an association between a social determinant and prostate cancer frequency and outcomes were sought in MEDLINE, EMBASE, SciELO, CINAHL, CUMED, LILACS, and IBECS databases. Fourteen social determinants and 7 prostate cancer endpoints were chosen, providing 98 possible relationship groups exploring the role of social determinants on prostate cancer. Observational studies with > 50 participants conducted in Caribbean territories between 2004 and 2016 were eligible. The review was conducted according to STROBE and PRISMA guidelines. Random-effects meta-analyses were performed. Results From 843 potentially relevant citations, 13 articles from 9 studies were included. From these included studies, 24 relationships were reported looking at 11 distinct relationship groups, leaving 90 relationship groups (92% of all relationship groups) unexplored. Study heterogeneity and risk of bias restricted results to a narrative synthesis in most instances. Meta-analyses showed more diagnosed prostate cancer among men with less formal education (n = 2 studies, OR 1.60, 95%CI 1.18–2.19) and among men who were married (n = 3 studies, OR 1.54, 95%CI 1.22–1.95). Conclusions This review highlights limited evidence for a higher occurrence of diagnosed prostate cancer among Caribbean men with lower levels of education and among men who are married. The role of social determinants on prostate cancer among Caribbean men remains poorly understood. Improvements in study quantity and quality, and reduced variability in outcomes and reporting are needed. This report represents the current evidence, and provides a roadmap to future research priorities for a better understanding of Caribbean prostate cancer inequalities. Electronic supplementary material The online version of this article (10.1186/s12889-018-5696-y) contains supplementary material, which is available to authorized users.
Published: 2018

28. Prevalence of Overweight and Obesity among Children Six to Ten Years of Age in the North-East Health Region of Jamaica

Author: Colin A. McKenzie, S S Win, Rainford J. Wilks, Christine Powell, J Van den Broeck, Novie Younger, B E Blake-Scarlettl, and S Edwards
Subjects: Pediatrics, medicine.medical_specialty, business.industry, 05 social sciences, Prevalence, 050109 social psychology, General Medicine, Odds ratio, North east, Overweight, medicine.disease, Obesity, World health, Confidence interval, medicine, 0501 psychology and cognitive sciences, medicine.symptom, business, Body mass index, Demography
Abstract: Objective To estimate the prevalence and correlates of overweight and obesity among children six to ten years old in the North-East Health Region (NEHR) ofJamaica. Methods Weights and heights were measured in a representative sample of 5710 children between the ages of six and ten years in 34 schools between October 2008 and March 2009. Overweight and obesity were defined as body mass index (BMI) Z-score > 1SD and >2SD, respectively based on the World Health Organization (WHO)-endorsed age and gender-specific growth standards for children. Point prevalence estimates of overweight and obesity were calculated. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between overweight and obesity and age, gender and school location. Results Overweight and obesity prevalence among children six to ten years old in NEHR, Jamaica, was 10.6% and 7.1%, respectively. Overweight (OR = 1.11, 95% CI: 1.04, 1.18) and obesity (OR = 1.17, 95% CI: 1.08, 1.26) prevalence increased significantly with age. Overweight (OR = 1.51, 95% CI: 1.27, 1.80) and obesity (OR = 1.36, 95% CI: 1.11, 1.67) prevalence was significantly higher among girls than boys. Children attending rural-public schools had less risk of being overweight (OR = 0.57, 95% CI: 0.46, 0.70) and obese (OR = 0.35, 95% CI: 0.28, 0.44) when compared with urban-public schools and private schools. Both overweight (OR = 2.11, 95% CI: 1.60, 2.78) and obesity (OR = 1.68, 95% CI: 1.24, 2.28) were significantly more common among children attending private schools. After adjusting for age and gender the results still remained statistically significant. Conclusions Overweight/obesity prevalence among children six to ten years old in NEHR of Jamaica is 17.7% with older children and girls having higher rates. Children attending urban-public and private schools have higher prevalence than those attending rural schools. Appropriately targeted interventions are needed to combat this problem.
Published: 2018

29. Diabetic Foot Complications among Patients Attending a Specialist Diabetes Clinic in Jamaica: Prevalence and Associated Factors

Author: Michael S. Boyne, R Wright-Pascoe, Rainford J. Wilks, Shelly R. McFarlane, DK Francis, Marshall K. Tulloch-Reid, Trevor S. Ferguson, and Nom Younger
Subjects: medicine.medical_specialty, business.industry, Cross-sectional study, 030209 endocrinology & metabolism, General Medicine, Anthropometry, medicine.disease, Diabetic foot, 03 medical and health sciences, 0302 clinical medicine, Blood pressure, Peripheral neuropathy, Diabetes mellitus, Internal medicine, Emergency medicine, Medicine, 030212 general & internal medicine, Complication, business, Foot (unit)
Abstract: Objectives To estimate the prevalence of diabetic foot complications among patients at a specialist diabetes clinic in Jamaica and identify factors associated with foot complications. Methods A stratified random sample of 188 patients were interviewed and examined between 2009 and 2010. Trained nurses obtained demographic and clinical data, measured anthropometrics and performedfoot examinations including inspection for amputations, ulcers or infection and assessment of pain, vibration and pressure perception. Results Participants included 143 women and 45 men (mean age 56years; mean diabetes duration 16 years). The prevalence of amputations was 8.5% (95% CI 4.5, 12.5%) and was higher among men (22.2%) compared to women (4.2%, p or = 130/80 mmHg) or peripheral neuropathy In multivariable logistic regression models, factors associated with foot complications were: neuropathy (OR 9.3 [95% CI 2.8, 30.3]), high BP (OR 7.9 [1.3, 49.7]) and diabetes duration (OR 1.32 [1.02, 1.72]). Conclusion Approximately one of every eight patients in this specialist clinic had a major foot complication. Associated factors were neuropathy, high blood pressure and longer duration of diabetes.
Published: 2018

30. Using the HIV Treatment Cascade to Identify Implementation Gaps in Hypertension Management in Jamaica

Author: Figueroa Jp, Rainford J. Wilks, Novie O. Younger-Coleman, Jacqueline Duncan, and Marshall K. Tulloch-Reid
Subjects: medicine.medical_specialty, business.industry, medicine, Hypertension management, General Medicine, Hiv treatment, Intensive care medicine, business
Published: 2018

31. Associations between neighborhood effects and physical activity, obesity, and diabetes: The Jamaica Health and Lifestyle Survey 2008

Author: Katherine P. Theall, Georgiana Gordon-Strachan, Rainford J. Wilks, Shelly R. McFarlane, Damian K Francis, Emily Mabile, Marshall K. Tulloch-Reid, Novie Younger, and Colette Cunningham-Myrie
Subjects: Adult, Male, Gerontology, Jamaica, Adolescent, Epidemiology, Intraclass correlation, Motor Activity, Overweight, Logistic regression, Residence Characteristics, Risk Factors, Diabetes mellitus, Diabetes Mellitus, Prevalence, Humans, Medicine, Obesity, Developing Countries, Life Style, Aged, business.industry, Multilevel model, Odds ratio, Middle Aged, medicine.disease, Health Surveys, Confidence interval, Female, medicine.symptom, business, Demography
Abstract: Objective To examine the impact of neighborhood disorder, perceived neighborhood safety, and availability of recreational facilities on prevalence of physical activity (PA), obesity, and diabetes mellitus (DM). Study Design and Setting Multilevel analyses were conducted among 2,848 respondents from the 2007–08 Jamaica Health and Lifestyle Survey. Neighborhood effects were based on aggregated interviewer responses to systematic social observation questions. Mixed-effect logistic regression models were created to assess the relationship between neighborhood indicators and DM and the modifiable risk factors PA and overweight/obesity. Results There was significant clustering in PA levels of 20 minutes at least once per week (intraclass correlation coefficient [ICC] = 10.7%), low/no PA (ICC = 7.22%), diabetes (ICC = 5.44%), and obesity (ICC = 3.33%) across neighborhoods. Greater levels of neighborhood disorder, home disorder, and counterintuitively recreational space availability were associated with higher levels of low/no PA among women. There was significant interaction by sex between neighborhood infrastructure and overweight/obesity with a significant association in men (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 1.05, 1.28) but not women (OR = 1.01; 95% CI = 0.95, 1.07). Conclusion Differences in PA and obesity-related outcomes among Jamaicans may be partially explained by characteristics of the neighborhood environment and differ by sex. Future studies must be conducted to determine the mechanistic pathways through which the neighborhood environment may impact such outcomes to better inform prevention efforts.
Published: 2015

32. Elevated blood pressure and illness beliefs: a cross-sectional study of emergency department patients in Jamaica

Author: Taneisha Wilson, S Dasgupta, Maxine Gossel-Williams, Elizabeth M. Goldberg, Rainford J. Wilks, Georgiana Gordon-Strachan, P. Levy, Eric W. Williams, and J Williams-Johnson
Subjects: medicine.medical_specialty, Medical staff, Cross-sectional study, Psychological intervention, Afro-Caribbean, 030204 cardiovascular system & hematology, Elevated blood, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, cardiovascular diseases, Socioeconomic status, Angiology, Original Research, Illness beliefs, business.industry, Emergency department, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RC86-88.9, Medication self-efficacy, Hypertension, Emergency Medicine, business
Abstract: Background Elevated blood pressure (BP) is common among emergency department (ED) patients. While some data exist on the association between ED BP and hypertension (HTN) in the USA, little is known about this relationship in Afro-Caribbean nations. The aim of the study was to evaluate the relationship between elevated systolic BP in the ED and a previous diagnosis of HTN, accounting for potential factors that could contribute to poor HTN control among those with a previous diagnosis: socioeconomic status, health-seeking behavior, underlying HTN illness beliefs, medication adherence, and perceived adherence self-efficacy. Methods This was a cross-sectional survey over 6 weeks, from November 19 through December 30, 2014. Those surveyed were non-critically ill or injured adult ED patients (≥ 18 years) presenting to an Afro-Caribbean hospital. Descriptive statistics were derived for study patients as a whole, by HTN history and by presenting BP subgroup (with systolic BP ≥ 140 mmHg considered elevated). Data between groups were compared using chi-square and t tests, where appropriate. Results A total of 307 patients were included: 145 (47.2%) had a prior history of HTN, 126 (41.4%) had elevated BP, and 89 (61.4%) of those presenting with elevated blood pressure had a previous diagnosis of HTN. Those with less formal education were significantly more likely to present with elevated BP (52.1 vs. 28.8% for those with some high school and 19.2% for those with a college education; p = 0.001). Among those with a history of HTN, only 56 (30.9%) had a normal presenting BP. Those with a history of HTN and normal ED presenting BP were no different from patients with elevated BP when comparing the in duration of HTN, medication compliance, location of usual follow-up care, and HTN-specific illness beliefs. Conclusions In this single-center study, two out of every five Jamaican ED patients had elevated presenting BP, the majority of whom had a previous diagnosis of HTN. Among those with a history of HTN, 60% had an elevated presenting BP. The ED can be an important location to identify patients with chronic disease in need of greater disease-specific education. Further studies should evaluate if brief interventions provided by ED medical staff improve HTN control in this patient population. Electronic supplementary material The online version of this article (10.1186/s12245-018-0187-6) contains supplementary material, which is available to authorized users.
Published: 2017

33. Educational Health Disparities in Cardiovascular Disease Risk Factors: Findings from Jamaica Health and Lifestyle Survey 2007–2008

Author: E. Nigel Harris, Anselm Hennis, Marshall K. Tulloch-Reid, Trevor S. Ferguson, Rainford J. Wilks, Aurelian Bidulescu, Damian K Francis, Novie O. Younger-Coleman, Nadia R. Bennett, Louis W. Sullivan, Ian Hambleton, Marlene Y. MacLeish, and Shelly R. McFarlane
Subjects: Gerontology, medicine.medical_specialty, obesity, lcsh:Diseases of the circulatory (Cardiovascular) system, hypertension, Disease, Cardiovascular Medicine, socioeconomic status, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, cardiovascular disease, Diabetes mellitus, Medicine, 030212 general & internal medicine, Poisson regression, Socioeconomic status, Original Research, education, 030505 public health, hypercholesterolemia, diabetes, business.industry, Public health, 1. No poverty, Anthropometry, medicine.disease, Obesity, Health equity, 3. Good health, lcsh:RC666-701, symbols, 0305 other medical science, Cardiology and Cardiovascular Medicine, business, health disparity, Demography
Abstract: Objectives Socioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD) risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity), among Jamaican adults. Methods We analyzed data from the Jamaica Health and Lifestyle Survey 2007–2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates. Results The sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p
Published: 2017

34. Genome-wide association study of asthma in individuals of African ancestry reveals novel asthma susceptibility loci

Author: Michelle Daya, Nicholas Rafaels, Sameer Chavan, Henry Richard Johnston, Aniket Shetty, Christopher R. Gignoux, Meher Preethi Boorgula, Monica Campbell, Pissamai Maul, Trevor Maul, Candelaria Vergara, Albert M. Levin, Genevieve Wojcik, Dara G. Torgerson, Victor E. Ortega, Ayo Doumatey, Maria Ilma Araujo, Pedro C. Avila, Eugene Bleecker, Carlos Bustamante, Luis Caraballo, Georgia M. Dunston, Mezbah U. Faruque, Trevor S. Ferguson, Camila Figueiredo, Jean G. Ford, Pierre-Antoine Gourraud, Nadia N. Hansel, Ryan D. Hernandez, Edwin Francisco Herrera-Paz, Eimear E. Kenny, Jennifer Knight-Madden, Rajesh Kumar, Lesli A. Lange, Ethan M. Lange, Antoine Lizee, Alvaro Mayorga, Deborah Meyers, Dan L. Nicolae, Timothy D. O’Connor, Ricardo Riccio Oliveira, Christopher O. Olopade, Olufunmilayo Olopade, Zhaohui S. Qin, Charles Rotimi, Harold Watson, Rainford J. Wilks, L. Keoki Williams, James G. Wilson, Carole Ober, Esteban G. Burchard, Terri H. Beaty, Margaret A. Taub, Ingo Ruczinski, Rasika Ann Mathias, Kathleen C. Barnes, Ayola Akim Adegnika, Ganiyu Arinola, Ulysse Ateba-Ngoa, Gerardo Ayestas, Adolfo Correa, Francisco M. De La Vega, Celeste Eng, Said Omar Leiva Erazo, Marilyn G. Foreman, Cassandra Foster, Li Gao, Jingjing Gao, Kimberly Gietzen, Leslie Grammer, Linda Gutierrez, Mark Hansen, Tina Hartert, Yijuan Hu, Kwang-Youn A. Kim, Pamela Landaverde-Torres, Javier Marrugo, Beatriz Martinez, Rosella Martinez, Luis F. Mayorga, Delmy-Aracely Mejia-Mejia, Catherine Meza, Solomon Musani, Shaila Musharoff, Oluwafemi Oluwole, Maria Pino-Yanes, Hector Ramos, Allan Saenz, Steven Salzberg, Maureen Samms-Vaughan, Robert Schleimer, Alan F. Scott, Suyash S. Shringarpure, Wei Song, Zachary A. Szpiech, Raul Torres, Gloria Varela, Olga Marina Vasquez, Lorraine B. Ware, and Maria Yazdanbakhsh
Subjects: Genetics, Genotype, medicine, Chromosome, SNP, Genetic admixture, Single-nucleotide polymorphism, Genome-wide association study, Allele, Biology, medicine.disease, Asthma
Abstract: BACKGROUNDAsthma is a complex disease with striking disparities across racial and ethnic groups, which may be partly attributable to genetic factors. One of the main goals of the Consortium on Asthma among African-ancestry Populations in the Americas (CAAPA) is to discover genes conferring risk to asthma in populations of African descent.METHODSWe performed a genome-wide meta-analysis of asthma across 11 CAAPA datasets (4,827 asthma cases and 5,397 controls), genotyped on the African Diaspora Power Chip (ADPC) and including existing GWAS array data. The genotype data were imputed up to a whole genome sequence reference panel from n=880 African ancestry individuals for a total of 61,904,576 SNPs. Statistical models appropriate to each study design were used to test for association, and results were combined using the weighted Z-score method. We also used admixture mapping as a complementary approach to identify loci involved in asthma pathogenesis in subjects of African ancestry.RESULTSSNPs rs787160 and rs17834780 on chromosome 2q22.3 were significantly associated with asthma (p=6.57 × 10−9 and 2.97 × 10−8, respectively). These SNPs lie in the intergenic region between the Rho GTPase Activating Protein 15 (ARHGAP15) and Glycosyltransferase Like Domain Containing 1 (GTDC1) genes. Four low frequency variants on chromosome 1q21.3, which may be involved in the “atopic march” and which are not polymorphic in Europeans, also showed evidence for association with asthma (1.18 ×10−6 ≤ p ≤ 3.06 ×10−6). SNP rs11264909 on chromosome 1q23.1, close to a region previously identified by the EVE asthma meta-analysis as having a putative African ancestry specific effect, only showed differences in counts in subjects homozygous for alleles of African ancestry. Admixture mapping also identified a significantly associated region on chromosome 6q23.2, which includes the Transcription Factor 21 (TCF21) gene, previously shown to be differentially expressed in bronchial tissues of asthmatics and non-asthmatics.CONCLUSIONSWe have identified a number of novel asthma association signals warranting further investigation.
Published: 2017
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35. Cardiovascular health in urban poor and middle income communities in Jamaica: impact of psychosocial stress, social networks, and social support

Author: Ferguson, Trevor S, Tulloch-Reid, Marshall K, Novie O Younger-Coleman, Ishtar Govia, Rainford J Wilks, and Williams, David R
Published: 2017
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36. Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys

Author: Peter Ueda, Rihab Al-Wotayan, Nayu Ikeda, James Bentham, Alireza Ahmadvand, Gerald Mutungi, Fereidoun Azizi, Mariachiara Di Cesare, Sophal Oum, Fernando Rodríguez-Artalejo, Mark Woodward, Bin Zhou, Kyungwon Oh, Gretchen A Stevens, Luz M. León-Muñoz, Paula Margozzini, Joshua A. Salomon, Kelias P. Msyamboza, Majid Ezzati, Young-Ho Khang, Jonathan E. Shaw, Vera Lanska, Rainford J. Wilks, Carlos A. Aguilar-Salinas, Kaveh Hajifathalian, Davood Khalili, Rosalba Rojas-Martínez, Goodarz Danaei, Renata Cifkova, Janne Schurmann Tolstrup, Dianna J. Magliano, Farshad Farzadfar, Trevor S. Ferguson, Louise Eriksen, Yuan Lu, and Gonzalo Valdivia
Subjects: Adult, Male, Endocrinology, Diabetes and Metabolism, Population, Risk management tools, 030204 cardiovascular system & hematology, Global Health, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Environmental health, Journal Article, Internal Medicine, Global health, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Risk factor, education, Prospective cohort study, Aged, education.field_of_study, Framingham Risk Score, business.industry, Middle Aged, Hazard, Cardiovascular Diseases, Female, Risk assessment, business
Abstract: BACKGROUND: Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and without laboratory-based measurements, and the corresponding risk charts for 182 countries to predict 10-year risk of fatal and non-fatal CVD in adults aged 40-74 years.METHODS: Based on our previous laboratory-based prediction model (Globorisk), we used data from eight prospective studies to estimate coefficients of the risk equations using proportional hazard regressions. The laboratory-based risk score included age, sex, smoking, blood pressure, diabetes, and total cholesterol; in the non-laboratory (office-based) risk score, we replaced diabetes and total cholesterol with BMI. We recalibrated risk scores for each sex and age group in each country using country-specific mean risk factor levels and CVD rates. We used recalibrated risk scores and data from national surveys (using data from adults aged 40-64 years) to estimate the proportion of the population at different levels of CVD risk for ten countries from different world regions as examples of the information the risk scores provide; we applied a risk threshold for high risk of at least 10% for high-income countries (HICs) and at least 20% for low-income and middle-income countries (LMICs) on the basis of national and international guidelines for CVD prevention. We estimated the proportion of men and women who were similarly categorised as high risk or low risk by the two risk scores.FINDINGS: Predicted risks for the same risk factor profile were generally lower in HICs than in LMICs, with the highest risks in countries in central and southeast Asia and eastern Europe, including China and Russia. In HICs, the proportion of people aged 40-64 years at high risk of CVD ranged from 1% for South Korean women to 42% for Czech men (using a ≥10% risk threshold), and in low-income countries ranged from 2% in Uganda (men and women) to 13% in Iranian men (using a ≥20% risk threshold). More than 80% of adults were similarly classified as low or high risk by the laboratory-based and office-based risk scores. However, the office-based model substantially underestimated the risk among patients with diabetes.INTERPRETATION: Our risk charts provide risk assessment tools that are recalibrated for each country and make the estimation of CVD risk possible without using laboratory-based measurements.FUNDING: National Institutes of Health.
Published: 2017

37. Relationship between self-monitoring of blood glucose and glycaemic control among patients attending a specialist diabetes clinic in Jamaica

Author: Novie O. Younger-Coleman, Rainford J. Wilks, KK Francis, Marshall K. Tulloch-Reid, R Wright-Pascoe, Boyne, and Trevor S. Ferguson
Subjects: medicine.medical_specialty, endocrine system diseases, business.industry, Endocrinology, Diabetes and Metabolism, Poor glycemic control, nutritional and metabolic diseases, Logistic regression, medicine.disease, Capillary blood sample, Surgery, Odds, Diabetes clinic, Diabetes management, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Self-monitoring, business
Abstract: Self-monitoring of blood glucose (SMBG) is recommended as an integral part of diabetes management. This study aimed to estimate the frequency of SMBG among patients attending a specialist diabetes clinic in Jamaica and to evaluate whether SMBG was associated with better glycaemic control. This cross-sectional study analyzed data from 188 patients, randomly selected from the University Hospital of the West Indies (UHWI) Diabetes Clinic. Self-reported data on blood glucose testing was obtained by a structured interviewer-administered questionnaire. Haemoglobin A1c (HbA1c) was measured from a capillary blood sample. Linear and logistic regression analyses were used to determine the relationship between SMBG and glycaemic control. Among 188 participants (145 females, 43 males, mean age 56 ± 15 years), 60 % (95%CI 52–67 %) performed SMBG. Thirty-one percent of participants monitored their blood glucose at least once daily. Participants less than 40 years old, persons with post-secondary education and those taking insulin were more likely to perform SMBG. Multivariable linear regression showed that performing SMBG was associated with a lower HbA1c after adjusting for age, sex and insulin use (β = −0.102), p = 0.004). In multivariable logistic regression models adjusted for the same variables, SMBG was also associated with lower odds of having poor glycemic control [HbA1c >9 %], OR 0.20, p
Published: 2014

38. Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study

Author: Georgiana Gordon-Strachan, Rainford J. Wilks, Novie Younger, Ishtar Govia, Katherine P. Theall, Emily Mabile, Damian K Francis, Parris Lyew-Ayee, Shelly R. McFarlane, Colette Cunningham-Myrie, Lisa-Gaye Greene, and Marshall K. Tulloch-Reid
Subjects: Adult, Male, Jamaica, Waist, Adolescent, Intraclass correlation, Cross-sectional study, Population, Developing country, Biological Factors, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Residence Characteristics, Risk Factors, Surveys and Questionnaires, Humans, Medicine, 030212 general & internal medicine, education, Life Style, Neighbourhood (mathematics), Aged, education.field_of_study, 030505 public health, business.industry, Research, Multilevel model, developing country, neighbourhoods, Environmental Exposure, General Medicine, Middle Aged, Health Surveys, Cross-Sectional Studies, cumulative biological risk, Female, Public Health, women, 0305 other medical science, business, Body mass index, Biomarkers, Demography
Abstract: ObjectiveTo examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs).DesignCross-sectional studySettingA population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs).Participants2544 persons aged 15–74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded.Primary outcomeA summary measure CBR was created using seven markers—systolic and diastolic blood pressure readings, waist circumference, body mass index, total cholesterol, fasting blood glucose levels and self-reported asthma. Weighted multilevel models examined clustering, using the intraclass correlation coefficient (ICC), of CBR across neighbourhoods and the impact of neighbourhood characteristics (recreational space availability and neighbourhood disorder) on CBR.ResultsWomen had significantly higher mean CBR scores than men across all age groups. There was significant clustering of CBR by ED, and among women versus men (ICC: F=6.9%, M=0.7%). Women living in more disordered neighbourhoods were 26% more likely to have high CBR as those in less disordered ones (aOR=1.26, 95% CI=1.08 to 1.47; pConclusionsPolicy-makers in Jamaica should pay greater attention to neighbourhood factors such as recreational space availability and neighbourhood disorder that may contribute to CBR in any effort to curtail the epidemic of NCDs.
Published: 2018

39. Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country

Author: Colette Cunningham-Myrie, Georgiana Gordon-Strachan, Rainford J. Wilks, Shelly R. McFarlane, Trevor S. Ferguson, Novie O. Younger-Coleman, Damian K Francis, and Marshall K. Tulloch-Reid
Subjects: Adult, Male, Gerontology, Jamaica, Diabetes risk, Waist, Adolescent, Urban Population, Overweight, Young Adult, Sex Factors, Risk Factors, Diabetes mellitus, Diabetes Mellitus, Prevalence, Humans, Medicine, Obesity, Healthcare Disparities, Socioeconomic status, Aged, Insurance, Health, business.industry, Incidence (epidemiology), Age Factors, Public Health, Environmental and Occupational Health, Disease Management, Health Status Disparities, Awareness, Middle Aged, medicine.disease, Infectious Diseases, Income, Women's Health, Female, Parasitology, Sedentary Behavior, Waist Circumference, medicine.symptom, business, Body mass index, Demography
Abstract: objective The objective of this study was to provide valid estimates of the burden of and risk factors for diabetes mellitus by sex in Jamaica, a predominantly Black, middle-income and developing country. methods The Jamaica Health and Lifestyle Survey 2008 examined a nationally representative sample of 2848 Jamaicans aged 15–74. Parameter estimates and 95% confidence intervals [CI] were weighted for non-response as well as age and sex of the source population. Sex differences in risk factors and diabetes prevalence, awareness, treatment and control were estimated in multivariable models. Population-attributable fractions (PAFs) of obesity on diabetes mellitus were estimated in both sexes. results The prevalence of diabetes mellitus was 7.9% (95% CI: 6.7–9.1%), significantly higher in women than men 9.3% vs. 6.4% (P = 0.02) and increasing with age. Seventy-six percentage of persons with diabetes mellitus were aware of their status; urban women and rural men were less likely to be aware. Diabetes control (43% overall) was less common in higher-income men, but more common in higher-income women. Persons without health insurance were less likely to control their diabetes. The prevalence of diabetes risk factors was higher in women than men. Increased waist circumference (≥94 cm [men]/≥80 cm [women]), overweight/obesity (body mass index ≥ 25 kg/m 2 ) and low physical activity/inactivity were associated with PAFs for diabetes mellitus of 27%, 37% and 15%, respectively, in men and 77%, 54% and 24%, respectively, in women. conclusions Prevalence of diabetes mellitus and its risk factors is high in Jamaica, especially among women, and national programmes to stem the diabetes mellitus epidemic should take these sex differences into consideration.
Published: 2013

40. Risk behaviours and adolescent depression in Jamaica

Author: Novie Younger, Georgiana Gordon-Strachan, Damian K Francis, Rainford J. Wilks, and Shelly R. McFarlane
Subjects: medicine.medical_specialty, Health (social science), Risk behaviour, Unsafe sexual practices, Logistic regression, medicine.disease, Odds, Substance abuse, medicine, Christian ministry, Risk factor, Psychology, Psychiatry, Depression (differential diagnoses), Demography
Abstract: The objective of this study was to assess the prevalence of depression and the associated risk factors in Jamaican youth aged 15–19 years. A nationally represented sample of youth aged 15–19 years was surveyed using multistage cluster sampling. Risk behaviours such as sexual activity, alcohol and marijuana use were obtained by interviewer-administered questionnaire; depression was assessed using the Ministry of Health screening tool. Multivariate logistic regression was used to obtain the odds of depression for any given risk factor. Data showed that 15.5% (males = 596, females = 716), of the youth recruited were classified as depressed (males = 9.7%, females = 21.3%, p
Published: 2013

41. Abstract P259: Social and Biological Correlates of Elevated Blood Pressure in Afro-Caribbean Youth: Effect of Individual Risk Factors and Risk Factor Clustering

Author: Rainford J. Wilks, Novie O. Younger-Coleman, Deanna Ashley, Marshall K. Tulloch-Reid, Jennifer Knight-Madden, Trevor S. Ferguson, and Maureen Samms-Vaughan
Subjects: Individual risk factors, Biological correlates, business.industry, Internal Medicine, Medicine, Afro-Caribbean, Risk factor, Cluster analysis, business, Elevated blood, Demography
Abstract: Background: We aimed to estimate the relative risk for elevated blood pressure (BP ≥ 120/80 mmHg) for cardiovascular disease (CVD) risk factors among Afro-Caribbean youth in Jamaica and to evaluate the association between clustering of risk factors and elevated BP. Methods: We analysed data from 898 young adults, 18-20 years old (409 males; 489 females) from the Jamaica 1986 Birth Cohort Study. BP was measured with a mercury sphygmomanometer after the participant had been seated for 5 minutes. Anthropometric measurements were done and venous blood obtained to measure fasting glucose, lipids and insulin. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution. Insulin resistance was estimated using the Homeostasis Model Assessment (HOMA-IR). Relative risks were computed using odds ratios (OR) from logistic regression models. Results: Prevalence of elevated BP was 30% among males and 13% among females (p Conclusion: Factors associated with elevated BP among Jamaican young adults include measures of obesity and insulin resistance, with significant differences by sex. Lower SES was associated with elevated BP among females. Clustering of risk factors was associated with markedly higher odds of elevated BP among males, but less so among females.
Published: 2016

42. Assessing the neighbourhood: an emerging dialogue for health and development programming in Small Island Developing States

Author: Rainford J. Wilks, Carol Archer, Novie O. Younger-Coleman, Affette McCaw-Binns, and Jasneth Mullings
Subjects: Geography, Regional science, General Earth and Planetary Sciences, Health and development, Small Island Developing States, Neighbourhood (mathematics), General Environmental Science
Published: 2016

43. Cost of care of chronic non-communicable diseases in Jamaican patients: the role of obesity

Author: Rainford J. Wilks, Abdullahi O. Abdulkadri, Christine M. Fray-Aiken, and Affette McCaw-Binns
Subjects: obesity, lcsh:R5-920, business.industry, Gallbladder disease, medicine.disease, Obesity, Indirect costs, cost-of-illness, Breast cancer, Economic cost, Absenteeism, medicine, Per capita, Chronic non-communicable diseases, Cost-of-illness, Health Economics, Nutrition, Medical emergency, Medical prescription, lcsh:Medicine (General), business, chronic non-communicable diseases, health care economics and organizations, Demography
Abstract: OBJECTIVE: To estimate the economic cost of Chronic Non-Communicable Diseases (CNCDs) and the portion attributable to obesity among patients in Jamaica.METHODS: The cost-of-illness approach was used to estimate the cost of care in a hospital setting in Jamaica for type 2 diabetes mellitus, hypertension, coronary heart disease, stroke, gallbladder disease, breast cancer, colon cancer, osteoarthritis, and high cholesterol. Cost and service utilization data were collected from the hospital records of all patients with these diseases who visited the University Hospital of the West Indies (UHWI) during 2006. Patients were included in the study if they were between15 and 74 years of age and if female, were not pregnant during that year. Costs were categorized as direct or indirect. Direct costs included costs for prescription drugs, consultation visits (emergency and clinic visits), hospitalizations, allied health services, diagnostic and treatment procedures. Indirect costs included costs attributed to premature mortality, disability (permanent and temporary), and absenteeism. Indirect costs were discounted at 3% rate.RESULTS: The sample consisted of 554 patients (40%) males (60%) females. The economic burden of the nine diseases was estimated at US$ 5,672,618 (males 37%; females 63%) and the portion attributable to obesity amounted to US$ 1,157,173 (males 23%; females 77%). Total direct cost was estimated at US$ 3,740,377 with female patients accounting for 69.9% of this cost. Total indirect cost was estimated at US$ 1,932,241 with female patients accounting for 50.6% of this cost. The greater cost among women was not found to be statistically significant. Overall, on a per capita basis, males and females accrued similar costs-of-illness (US$ 9,451.75 vs. US$ 10,758.18).CONCLUSIONS: In a country with per capita GDP of less than US$ 5,300, a per capita annual cost of illness of US$ 10,239 for CNCDs is excessive and has detrimental implications for the health and development of Jamaica.
Published: 2016

44. The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals

Author: Timo A. Lakka, Kathleen Stirrups, Jean Ferrières, Ying Wu, Gulum Kosova, Toby Johnson, Heather M. Stringham, Bruce M. Psaty, Bruna Gigante, Göran Hallmans, Cornelia M. van Duijn, Kae Woei Liang, Niclas Eriksson, N. William Rayner, Lynda M. Rose, Stavroula Kanoni, Xueling Sim, Evangelos Evangelou, Philippe Froguel, Michel Burnier, Andrew P. Morris, Olle Melander, Martin Farrall, Albert V. Smith, Brendan J. Keating, Thomas Illig, Johan Sundström, Dorret I. Boomsma, Kate Witkowska, Ellen M. Schmidt, Aki S. Havulinna, Ann-Kristin Petersen, Paul F. O'Reilly, Young Jin Kim, Kari Kuulasmaa, Tom Wilsgaard, John D. Eicher, Marcus E. Kleber, Francis S. Collins, Rona J. Strawbridge, Ronald M. Krauss, Fotios Drenos, Stuart K. Kim, Ken K. Ong, Pascal Bovet, Danish Saleheen, Jaspal S. Kooner, Karl-Heinz Herzig, Tien Yin Wong, Benjamin F. Voight, Stefania Bandinelli, Stéphane Lobbens, Colin A. McKenzie, Jing Hua Zhao, Terrence Forrester, Louise A. Donnelly, Alice Stanton, Jean Dallongeville, Kirill V. Tarasov, Narisu Narisu, Jürgen Gräßler, Luigi Ferrucci, Peter S. Sever, Paul Elliott, Tune H. Pers, Andrew J. Smith, Tomas Axelsson, Young Ah Shin, Nora Franceschini, James F. Wilson, Vilmundur Gudnason, Kati Kristiansson, Andrew A. Hicks, Kent D. Taylor, Genovefa Kolovou, Andrew D. Morris, André G. Uitterlinden, Serena Sanna, Xiuqing Guo, Honghuang Lin, Aravinda Chakravarti, Wayne Huey-Herng Sheu, Panos Deloukas, Linda S. Adair, Diana Kuh, Murielle Bochud, Eric Boerwinkle, Inger Njølstad, Meena Kumari, Norman Klopp, Leo-Pekka Lyytikäinen, Steven C. Hunt, Weihua Zhang, Tõnu Esko, Pierre Meneton, Markus Perola, Erik P A Van Iperen, Georg Ehret, Veikko Salomaa, Lars Lind, Zoltán Kutalik, Cristiano Fava, Caroline Hayward, Hugh S. Markus, Teresa Ferreira, Stefan R. Bornstein, Vasyl Pihur, Patricia B. Munroe, Anne U. Jackson, Eirini Marouli, Gabriele Müller, Damiano Baldassarre, Jacques E. Rossouw, Dan E. Arking, Maija Hassinen, Nicholas J. Wareham, Robert Roberts, Daniel I. Chasman, I. Shou Chang, Sylvain Sebert, Tove Fall, Roby Joehanes, Patrik K. E. Magnusson, John C. Chambers, Peter Vollenweider, Wen Jane Lee, Dmitry Shungin, Mathias Gorski, Christopher Newton-Cheh, Anders Franco-Cereceda, Ching-Yu Cheng, Yun Kyoung Kim, Ruth J. F. Loos, Lude Franke, Karen L. Mohlke, Yii-Der Ida Chen, Carlos Iribarren, Martina Müller-Nurasyid, Alexander Teumer, Andrew D. Johnson, Antonella Mulas, Ulf Gyllensten, Martin D. Tobin, George Dedoussis, Rainford J. Wilks, Joshua C. Bis, Beverley Balkau, Jie Yao, Frida Renström, Themistocles L. Assimes, Morris Brown, Inês Barroso, Hyun Min Kang, Loic Yengo, Mika Kähönen, Christopher J. Groves, Kirsti Kvaløy, Rainer Rauramaa, Heribert Schunkert, Satu Männistö, Marjo-Riitta Järvelin, Nancy L. Pedersen, Karl Gertow, Rick Jansen, Thomas Quertermous, Jarmo Virtamo, Lazaros Lataniotis, Serge Hercberg, Paul M. Ridker, Osorio Meirelles, Jostein Holmen, Phil Howard, G. Kees Hovingh, Jeanette Erdmann, Jong-Young Lee, Peter Schwarz, Ramaiah Nagaraja, Elizabeth Theusch, Wei Zhao, Sonia Shah, Chao A. Hsiung, Santhi K. Ganesh, Richard S. Cooper, John M. C. Connell, Jian'an Luan, Graciela E. Delgado, Eric Kim, Daniel Levy, Li Lin, Jerome I. Rotter, Andres Metspalu, Nabila Bouatia-Naji, Christopher J. O'Donnell, Roberto Elosua, Andrew Wong, Alanna C. Morrison, Juha Saltevo, Michael R. Barnes, Alan B. Weder, Kay-Tee Khaw, Leena Moilanen, Peter S. Chines, Claudia Langenberg, Marika Kaakinen, Asif Rasheed, Annette Peters, Angela Döring, Alena Stančáková, Richard A. Jensen, Jaana Lindström, Alison H. Goodall, Toshiko Tanaka, Loukianos S. Rallidis, Dabeeru C. Rao, Ann-Christine Syvänen, Alun Evans, Brenda W.J.H. Penninx, Sarah Edkins, Xiaohui Li, Neil Poulter, Jouko Saramies, Ulf de Faire, Walter Palmas, Jaakko Tuomilehto, Louise V. Wain, Cristina Menni, Stephen Bevan, Maria X. Sosa, Nanette R. Lee, Anuj Goel, Germaine C. Verwoert, Kjell Nikus, Helen R. Warren, May E. Montasser, Ren-Hua Chung, Francesco Gianfagna, Kristian Hveem, Rainer Rettig, Unnur Thorsteinsdottir, Lori L. Bonnycastle, Tim D. Spector, Paul W. Franks, Bamidele O. Tayo, Ilja M. Nolte, John Danesh, E. Shyong Tai, Mika Kivimäki, Devin Absher, Oddgeir L. Holmen, Per Eriksson, Pirjo Komulainen, Peter P. Pramstaller, Cameron D. Palmer, He Gao, Elena Tremoli, H.-Erich Wichmann, Myriam Fornage, Gyda Bjornsdottir, Afshin Parsa, Anders Hamsten, Terho Lehtimäki, Lasse Folkersen, Janine F. Felix, Anna F. Dominiczak, Hinco J. Gierman, Edward G. Lakatta, Alex S. F. Doney, Erik Ingelsson, Colin N. A. Palmer, Najaf Amin, Hugh Watkins, Johanna Kuusisto, Vladan Mijatovic, Mark I. McCarthy, Joel N. Hirschhorn, Winfried März, Nilesh J. Samani, Stefan Enroth, Mark J. Caulfield, Gudmar Thorleifsson, Tsun-Po Yang, François Mach, Cristen J. Willer, Claudia P. Cabrera, Aline Wagner, Michael Boehnke, Elias Salfati, Sekar Kathiresan, Ramachandran S. Vasan, Franco Giulianini, Harm-Jan Westra, Harold Snieder, Mark O. Goodarzi, M. Arfan Ikram, Fred Paccaud, Johannes H. Smit, Anna-Liisa Hartikainen, Xiaofeng Zhu, Markku Laakso, Ahmad Vaez, Albert Hofman, Amy J. Swift, Maria Hughes, I. Te Lee, Aroon D. Hingorani, Matti Uusitupa, Oscar H. Franco, Kenneth Rice, Veronique Vitart, Ross M. Fraser, Jouke-Jan Hottenga, Kari Stefansson, Dhananjay Vaidya, Johns Hopkins University, School of Medicine, Hôpitaux Universitaires de Genève (HUG), Saw Swee Hock School of Public Health, National University of Singapore (NUS), The Wellcome Trust Centre for Human Genetics [Oxford], University of Oxford [Oxford], Brigham and Women's Hospital [Boston], Harvard Medical School [Boston] (HMS), Department of Biostatistics, University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, University of Michigan System, Department of Computational Medicine and Bioinformatics (DCM&B), Queen Mary University of London (QMUL), GlaxoSmithKline, Glaxo Smith Kline, deCODE genetics [Reykjavik], University of Cambridge [UK] (CAM), University of Dundee, German Research Center for Environmental Health - Helmholtz Center München (GmbH), Karolinska University Hospital [Stockholm], Umea University Hospital, Lund University [Lund], Queen's University [Belfast] (QUB), National Institutes of Health, Department of Genomics of Common Disease, Imperial College London, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), National Institute of Health and Welfare, Institute for Molecular Medicine Finland (FIMM), University College London Hospitals (UCLH), University Hospital of Heidelberg, Harbor UCLA Medical Center [Torrance, Ca.], University of Tampere, University of Verona (UNIVR), Uppsala University Hospital, Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Stanford University School of Medicine [CA, USA], Medical School University of Athens, Partenaires INRAE, Children's Hospital Oakland Research Institute, Boston Children's Hospital, Broad Institute of Harvard and MIT, University of Copenhagen = Københavns Universitet (KU), Statens Serum Institut [Copenhagen], Framingham Heart Dis Epidemiol Study, Department of Psychiatry, VU University Medical Center [Amsterdam], National Heart, Lung and Blood Institute, Osong Health Technology Administration Complex, University of Pennsylvania, Department of Genetics, University of North Carolina at Chapel Hill (UNC), Loyola University [Chicago], Centre Hospitalier Universitaire Vaudois (CHUV), Hudson Alpha Institute for Biotechnology, Erasmus University Rotterdam, Department of Medical Sciences, Uppsala University, Università degli Studi di Milano [Milano] (UNIMI), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Université Paris-Sud - Paris 11 (UP11), Azienda Sanitaria Firenze, Wellcome Trust Genome Campus, The Wellcome Trust Sanger Institute [Cambridge], University of Lincoln, University of Washington [Seattle], Amgen Inc., The University of Texas Health Science Center at Houston (UTHealth), VU University Amsterdam, University of Dresden Medical School, Université de Lausanne (UNIL), Healthcare NHS Trust, National Health Research Institutes, National University Health System [Singapore] (NUHS), Duke-NUS Medical School [Singapore], Singapore Eye Research Institute [Singapore] (SERI), National Human Genome Research Institute (NHGRI), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Psychiatry, Amsterdam Neuroscience - Complex Trait Genetics, Radiology and nuclear medicine, EMGO - Mental health, Lin, Li, Mach, François, ProdInra, Migration, University of Oxford, Università degli studi di Verona = University of Verona (UNIVR), University of Copenhagen = Københavns Universitet (UCPH), Università degli Studi di Milano = University of Milan (UNIMI), Vrije Universiteit Amsterdam [Amsterdam] (VU), Université de Lausanne = University of Lausanne (UNIL), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Vrije universiteit = Free university of Amsterdam [Amsterdam] (VU), EMGO+ - Lifestyle, Overweight and Diabetes, Biological Psychology, APH - Amsterdam Public Health, Epidemiology and Data Science, Graduate School, Other departments, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, Luan, Jian'an [0000-0003-3137-6337], Barroso, Ines [0000-0001-5800-4520], Danesh, John [0000-0003-1158-6791], Khaw, Kay-Tee [0000-0002-8802-2903], Markus, Hugh [0000-0002-9794-5996], Ong, Kenneth [0000-0003-4689-7530], Johnson, Kathleen [0000-0002-6823-3252], Wareham, Nicholas [0000-0003-1422-2993], Zhao, Jing Hua [0000-0003-4930-3582], Langenberg, Claudia [0000-0002-5017-7344], Apollo - University of Cambridge Repository, Life Course Epidemiology (LCE), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Stem Cell Aging Leukemia and Lymphoma (SALL), CHARGE-EchoGen Consortium, CHARGE-HF Consortium, Wellcome Trust Case Control Consortium, Medical Microbiology & Infectious Diseases, Epidemiology, Neurology, Radiology & Nuclear Medicine, Internal Medicine, Clinical Genetics, Biochemistry, National Institute for Health Research, and Medical Research Council (MRC)
Subjects: 0301 basic medicine, Netherlands Twin Register (NTR), CHROMATIN, [SDV]Life Sciences [q-bio], LOCI, Genome-wide association study, Blood Pressure, SUSCEPTIBILITY, Bioinformatics, Cardiovascular, Genome-wide association studies, Medical and Health Sciences, single nucleotide polymorphism, CHARGE-EchoGen consortium, GWAS, 2.1 Biological and endogenous factors, Aetiology, Cells, Cultured, African Continental Ancestry Group, Genetics & Heredity, Genetics, ddc:616, Kidney, Framingham Risk Score, Cultured, COMMON VARIANTS, 11 Medical And Health Sciences, Single Nucleotide, Biological Sciences, African Continental Ancestry Group/genetics, Asian Continental Ancestry Group/genetics, Blood Pressure/genetics, Genome-Wide Association Study, Humans, Hypertension/genetics, Hypertension/pathology, Microarray Analysis, Polymorphism, Single Nucleotide, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Hypertension/genetics/pathology, Hypertension, Medical genetics, Wellcome Trust Case Control Consortium, Life Sciences & Biomedicine, TRAITS, Biotechnology, Asian Continental Ancestry Group, medicine.medical_specialty, CHARGE-EchoGen Consortium, Cells, Black People, BIOLOGY, Single-nucleotide polymorphism, Biology, Blood pressure, hypertension, genetics, single nucleotide polymorphism, GWAS, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Asian People, medicine, Polymorphism, GENOME-WIDE ASSOCIATION, CELL-TYPES, METAANALYSIS, Genetic association, Science & Technology, CHARGE-HF consortium, 06 Biological Sciences, Genetic architecture, 030104 developmental biology, Blood pressure, CHARGE-HF Consortium, ARTERIAL-HYPERTENSION, Developmental Biology
Abstract: To dissect the genetic architecture of blood pressure (BP) and assess how its elevation promotes downstream cardiovascular diseases, we analyzed 128,272 SNPs from targeted and genome-wide arrays in 201,529 individuals of European ancestry. Genotypes from an additional 140,886 individuals of European ancestry were used as validation for loci reaching genome-wide significance but without prior support in the literature. We identified 66 BP loci, of which 17 were novel and 15 harbored multiple distinct association signals, and which together explain up to 3.5% of BP variation. The 66 index SNPs were enriched for cis-regulatory elements, particularly in vascular endothelial cells, consistent with a primary role in BP control through modulating blood vessel tone and fluid filtration across multiple tissues, not solely the kidney. Importantly, the 66 index SNPs combined in a risk score showed comparable effects in 64,421 individuals of non-European descent (South-Asian, East-Asian and African), confirming that these are ancestral physiological effects that arose prior to human migration out of Africa. The 66-SNP BP risk score was significantly associated with target-organ damage in multiple tissues, with minor effects in the kidney. Our data expand current knowledge of BP pathways, and also, highlight that BP regulation and its effects may occur in multiple organs and tissues beyond the classic renal system.
Published: 2016

45. National Health Surveys and Health Policy: Impact of the Jamaica Health and Lifestyle Surveys and the Reproductive Health Surveys

Author: Trevor S. Ferguson, Rainford J. Wilks, Marshall K. Tulloch-Reid, Hamilton P, and Georgiana Gordon-Strachan
Subjects: Jamaica, medicine.medical_specialty, business.industry, Health Policy, Health Status, Public health, Health Behavior, International health, Developing country, General Medicine, Health Surveys, Health promotion, Environmental health, Chronic Disease, Health care, medicine, Humans, Health education, business, Life Style, Health policy, Reproductive health
Abstract: Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health policy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica's Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction infertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned pregnancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major policy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health policy, there will need to be effective collaborations between academia, policy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health policy and result in improvement of the nation's health status and by extension national development.
Published: 2012

46. Genome-wide association of anthropometric traits in African- and African-derived populations

Author: Helen N. Lyon, Rachel Hackett, Xiaofeng Zhu, Ilze Berzins, Johannah L. Butler, Bamidele O. Tayo, Kristin G. Ardlie, Joel N. Hirschhorn, Charleston W. K. Chiang, Richard S. Cooper, Colin A. McKenzie, Rainford J. Wilks, Amy Luke, Candace Guiducci, Guillaume Lettre, Thutrang T. Nguyen, Cameron D. Palmer, Adebowale Adeyemo, Terrence Forrester, Sun J. Kang, Daniel Shriner, Charles N. Rotimi, and Tao Feng
Subjects: Adult, Jamaica, Adolescent, DNA Copy Number Variations, Genotype, Black People, Nigeria, Single-nucleotide polymorphism, Genome-wide association study, Biology, Polymorphism, Single Nucleotide, Young Adult, Genetics, Humans, Copy-number variation, Molecular Biology, Genetics (clinical), Aged, Models, Statistical, Anthropometry, Association Studies Articles, General Medicine, Middle Aged, Black or African American, Sample size determination, Illinois, Body mass index, Imputation (genetics), Genome-Wide Association Study
Abstract: Genome-wide association (GWA) studies have identified common variants that are associated with a variety of traits and diseases, but most studies have been performed in European-derived populations. Here, we describe the first genome-wide analyses of imputed genotype and copy number variants (CNVs) for anthropometric measures in African-derived populations: 1188 Nigerians from Igbo-Ora and Ibadan, Nigeria, and 743 African-Americans from Maywood, IL. To improve the reach of our study, we used imputation to estimate genotypes at approximately 2.1 million single-nucleotide polymorphisms (SNPs) and also tested CNVs for association. No SNPs or common CNVs reached a genome-wide significance level for association with height or body mass index (BMI), and the best signals from a meta-analysis of the two cohorts did not replicate in approximately 3700 African-Americans and Jamaicans. However, several loci previously confirmed in European populations showed evidence of replication in our GWA panel of African-derived populations, including variants near IHH and DLEU7 for height and MC4R for BMI. Analysis of global burden of rare CNVs suggested that lean individuals possess greater total burden of CNVs, but this finding was not supported in an independent European population. Our results suggest that there are not multiple loci with strong effects on anthropometric traits in African-derived populations and that sample sizes comparable to those needed in European GWA studies will be required to identify replicable associations. Meta-analysis of this data set with additional studies in African-ancestry populations will be helpful to improve power to detect novel associations.
Published: 2010

47. Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study

Author: Novie O. Younger-Coleman, Trevor S. Ferguson, Marshall K. Tulloch-Reid, Rainford J. Wilks, Deanna Ashley, Maureen Samms-Vaughan, Amanda Rousseau, Jennifer Knight-Madden, and Nadia R. Bennett
Subjects: Jamaica, Epidemiology, Cross-sectional study, Cardiology, lcsh:Medicine, Cardiovascular disease risk factors, 030204 cardiovascular system & hematology, Global Health, Logistic regression, General Biochemistry, Genetics and Molecular Biology, Prehypertension, 03 medical and health sciences, 0302 clinical medicine, Internal Medicine, Elevated blood pressure, Medicine, 030212 general & internal medicine, Young adult, Caribbean, business.industry, General Neuroscience, lcsh:R, General Medicine, Odds ratio, Blacks, Anthropometry, Blood pressure, Relative risk, Hypertension, Socioeconomic status, Public Health, General Agricultural and Biological Sciences, business, Young adults, Demography
Abstract: Background Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. Methods Data from 898 young adults, 18–20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. Results Prevalence of EBP/HTN was 30% among males and 13% among females (p p p = 0.008), while high HOMA-IR did not achieve statistical significance (OR 2.08, CI [0.94–4.58], p = 0.069). In similar models for women, high triglycerides (OR 1.98, CI [1.03–3.81], p = 0.040) and high HOMA-IR (OR 2.07, CI [1.03–4.12], p = 0.039) were positively associated with EBP/HTN. Lower SES was also associated with higher odds for EBP/HTN (OR 4.63, CI [1.31–16.4], p = 0.017, for moderate vs. high household possessions; OR 2.61, CI [0.70–9.77], p = 0.154 for low vs. high household possessions). Alcohol consumption was associated with lower odds of EBP/HTN among females only; OR 0.41 (CI [0.18–0.90], p = 0.026) for drinking p = 0.012) for drinking ≥3 times per week vs. never drinkers. Physical activity was inversely associated with EBP/HTN in both males and females. Conclusion Factors associated with EBP/HTN among Jamaican young adults include obesity, high glucose, high triglycerides and high HOMA-IR, with some significant differences by sex. Among women lower SES was positively associated with EBP/HTN, while moderate alcohol consumption was associated lower odds of EBP/HTN.
Published: 2018

48. The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica

Author: Rainford J. Wilks, Novie Yonger-Coleman, Lovney Kanguru, Affette McCaw-Binns, Jacqueline Sarah Bell, and Julia Hussein
Subjects: Physiology, Maternal Health, lcsh:Medicine, Blood Pressure, 030204 cardiovascular system & hematology, Overweight, Vascular Medicine, Geographical locations, Body Mass Index, Endocrinology, 0302 clinical medicine, Pregnancy, Medicine and Health Sciences, 030212 general & internal medicine, lcsh:Science, Multidisciplinary, Gravidity and parity, Obstetrics and Gynecology, Physiological Parameters, Hypertension, Income, Female, Maternal death, medicine.symptom, Research Article, Jamaica, medicine.medical_specialty, Endocrine Disorders, Hypertension in Pregnancy, 03 medical and health sciences, Hypertensive Disorders in Pregnancy, Environmental health, Diabetes Mellitus, Journal Article, medicine, Humans, Obesity, Caribbean, business.industry, Public health, Body Weight, lcsh:R, Biology and Life Sciences, medicine.disease, Metabolic Disorders, North America, Women's Health, lcsh:Q, People and places, business, Body mass index
Abstract: INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death.MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities. A national maternal mortality surveillance database (1998-2012) of 798 maternal deaths was used to investigate maternal deaths in obese women. Chi-squared and Fisher exact tests were used.RESULTS: High BMI (> = 25kg/m2) occurred in 63% of women aged between 15 and 49 years. It was associated with increasing age, high gravidity and parity, and full time employment (pCONCLUSIONS: This is one of a few studies from a middle-income setting to explore maternal burden of obesity during pregnancy, which contributes to improving the knowledge base, identifying the gaps in information and increasing awareness of the growing problem of maternal overweight and obesity. While survey diagnostic conditions require cautious interpretation of findings, it is clear that obesity and related medical conditions present a substantial public health problem for emerging LMICs like Jamaica. There is an urgent need for global consensus on routine measures of the burden and risk factors associated with obesity and development of culturally appropriate interventions.
Published: 2017

49. Fast-food and sweetened beverage consumption: association with overweight and high waist circumference in adolescents

Author: Damian K Francis, Andrienne Grant, Kimberley Rudder, Rainford J. Wilks, Jan Van den Broeck, Shelly R. McFarlane, Georgianna Gordon-Strachan, Ayesha Johnson, Novie Younger, and Marshall K. Tulloch-Reid
Subjects: Male, Jamaica, Restaurants, Waist, Adolescent, Medicine (miscellaneous), Overweight, Logistic regression, Beverages, Young Adult, Sex Factors, Dietary Sucrose, Reference Values, Surveys and Questionnaires, Environmental health, Vegetables, Prevalence, Humans, Medicine, Obesity, Young adult, Beverage consumption, Nutrition and Dietetics, business.industry, Confounding, Public Health, Environmental and Occupational Health, Circumference, medicine.disease, Dietary Fats, Diet, Logistic Models, Fruit, Female, Waist Circumference, medicine.symptom, business
Abstract: ObjectiveOverweight and obesity have increased to epidemic proportions among adolescents and are associated with chronic non-communicable diseases and excess mortality in adulthood. The association of overweight/obesity with poor dietary habits has not been studied in adolescents in middle-income developing countries. The present study aimed to estimate the prevalence of overweight, obesity and high waist circumference (WC) in 15–19-year-old Jamaican adolescents and to investigate the association with fast-food and sweetened beverage consumption.DesignThe study enrolled 1317 (598 male, 719 female) adolescents aged 15–19 years using multistage, nationally representative sampling. Age-specific prevalence calculation used internalZ-score lines connecting with the WHO adult cut-off points. Logistic regression was used to examine the association of overweight or high WC with fast-food and sweetened beverage consumption, adjusting for potential confounders.ResultsThe overall prevalence of overweight, obesity and high WC was approximately 15 %, 6 % and 10 %, respectively. Prevalence estimated using internalZ-scores was similar to that using the International Obesity Taskforce cut-off points. Obesity (8·0 % in females, 3·3 % in males) and high WC (16·2 % in females, 1·7 % in males) were significantly more prevalent in females when using internalZ-score cut-offs. High WC was associated with the absence of fruit consumption (P= 0·043) and overweight with high sweetened beverage consumption (P= 0·018).ConclusionOverweight occurs frequently among Jamaican 15–19-year-olds and is associated with increased consumption of sweetened beverages. High WC is more prevalent among females and is related to low consumption of fruits and vegetables. Measures to reduce the consumption of sweetened beverages and increase fruit intake may reduce the prevalence of excess body fat among adolescents.
Published: 2009

50. Autoantibodies in Caribbean youth with diabetes mellitus

Author: Rainford J. Wilks, R Wright-Pascoe, Michael S. Boyne, Parkes Rh, E N Barton, Palmer-Levy Ml, Choo-Kang E, Monica Smikle, and Marshall K. Tulloch-Reid
Subjects: Autoimmune disease, Type 1 diabetes, medicine.medical_specialty, Lipoatrophic diabetes, business.industry, Immunology, Autoantibody, General Medicine, medicine.disease_cause, medicine.disease, Autoimmunity, Endocrinology, Internal medicine, Diabetes mellitus, medicine, Immunology and Allergy, Rheumatoid factor, Age of onset, business
Abstract: The prevalence of diabetes and other autoantibodies in patients with recently diagnosed youth onset diabetes was evaluated. Fifty-seven patients (95% black, age 19 +/- 5 years, 36% male, diabetes duration 2.6 +/- 2.2 years) were clinically diagnosed as having type 1 (n = 35), type 2 (n = 13) and lipoatrophic diabetes (n = 3) while 6 remained untyped. GAD65 was the most common diabetes-associated autoantibody in patients with type 1A diabetes (12/17; 71%). The prevalence of any diabetes-associated autoantibodies decreased with diabetes duration (OR[95%CI]/yr after diagnosis 0.50[0.31,0.82]) and was not associated with age of onset, duration or gender. Rheumatoid factor (13/57; 23%), smooth muscle (6/57; 11%), gastric-parietal cell (5/57; 9%) and thyroid microsomal antibodies (5/57; 9%) were the most frequent non-diabetes associated autoantibodies and were more common in patients with type 1A diabetes. Only one patient had clinical autoimmune disease (hypothyroidism). Type 1A diabetes may constitute up to half the cases of newly diagnosed type 1 diabetes in Jamaican youth and is associated with a higher prevalence of other organ-specific autoantibodies.
Published: 2008

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