26 results on '"Tumas N"'
Search Results
2. Trends in mortality from breast cancer in Córdoba, Argentina, 1986-2011: Some socio-historical interpretations | Tendencias de mortalidad por cáncer de mama en Córdoba, Argentina, 1986-2011: algunas interpretaciones sociohistóricas
- Author
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Tumas, N., Niclis, C., Alberto Osella, Del Pilar Díaz, M., and Carbonetti, A.
3. Are Women’s Empowerment and Income Inequality Associated with Excess Weight in Latin American Cities?
- Author
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Tumas, Natalia, Rodríguez López, Santiago, Mazariegos, Mónica, Ortigoza, Ana, Anza Ramírez, Cecilia, Pérez Ferrer, Carolina, Moore, Kari, Yamada, Goro, Menezes, Mariana Carvalho, Sarmiento, Olga L., Pericàs, Juan M., Belvis Costes, Francesc, Lazo, Mariana, Benach, Joan, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Tumas N] Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain. Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain. Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científcas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina. [Rodríguez López S] Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científcas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina. Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina. [Mazariegos M] INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala. [Ortigoza A] Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA. [Anza Ramírez C] CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú. [Pérez Ferrer C] National Institute of Public Health, Cuernavaca, Mexico. [Pericàs JM] Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain. Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Hepàtica, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Male ,Health (social science) ,Women’s empowerment ,Dones ,Women's empowerment ,Population Studies in Public Health::Population::Population Characteristics::Residence Characteristics::Urban Area::Cities [PUBLIC HEALTH] ,Ciutats ,Humans ,Obesity ,Other::Other::Female [Other] ,afecciones patológicas, signos y síntomas::signos y síntomas::peso corporal::sobrepeso::obesidad [ENFERMEDADES] ,Income inequality ,Cities ,Public Health, Environmental and Occupational Health ,Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight::Obesity [DISEASES] ,Overweight ,Otros::Otros::femenino [Otros] ,Renda ,Urban Studies ,Latin America ,Estudios Poblacionales en Salud Pública::Población::Características de la Población::características de la residencia::Área urbana::ciudades [SALUD PÚBLICA] ,Obesitat ,Population Characteristics::Socioeconomic Factors::Income [HEALTH CARE] ,Female ,Características de la Población::factores socioeconómicos::renta [ATENCIÓN DE SALUD] - Abstract
While income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specific associations between city-level women’s empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America). The sample included 79,422 individuals (58.0% women), living in 538 sub-cities, 187 cities, and 8 countries. We used gender-stratified Poisson multilevel models to estimate the Prevalence Rate Ratios (PRR) for overweight/obesity (body mass index ≥ 25 kg/m2) per a unit change in city-level women’s empowerment (proxied by a score that measures gender inequalities in employment and education) and income inequality (proxied by income-based Gini coefficient). We also tested whether individual education or sub-city living conditions modified such associations. Higher city labor women’s empowerment (in women) and higher city Gini coefficient (in men) were associated with a lower prevalence of overweight/obesity (PRR = 0.97 (95%CI 0.94, 0.99) and PRR = 0.94 (95%CI 0.90, 0.97), respectively). The associations varied by individual education and sub-city living conditions. For labor women’s empowerment, we observed weakened associations towards the null effect in women with lower education and in residents of sub-cities with worse living conditions (men and women). For the Gini coefficient, the association was stronger among men with primary education, and a negative association was observed in women with primary education. Our findings highlight the need for promoting equity-based policies and interventions to tackle the high prevalence of excess weight in Latin American cities. This work received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement Nº 89102 (Dr. Tumas was supported by this grant). Joan Benach gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.
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- 2022
4. What Do We Know about Inequalities in NAFLD Distribution and Outcomes? A Scoping Review
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Juan M. Pericàs, Joan Benach, Mar Talens, Natalia Tumas, Jeffrey V. Lazarus, Institut Català de la Salut, [Talens M] Research Group on Health Inequalities, Environment, and Employment Conditions, Department of Social and Political Science, Pompeu Fabra University, Barcelona, Spain. [Tumas N] Research Group on Health Inequalities, Environment, and Employment Conditions, Department of Social and Political Science, Pompeu Fabra University, Barcelona, Spain. Public Policy Center (UPF-BSM), Johns Hopkins University-Pompeu Fabra University, Barcelona, Spain. Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas y Universidad Nacional de Córdoba, Córdoba, Argentina. [Lazarus JV] Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. [Benach J] Research Group on Health Inequalities, Environment, and Employment Conditions, Department of Social and Political Science, Pompeu Fabra University, Barcelona, Spain. Public Policy Center (UPF-BSM), Johns Hopkins University-Pompeu Fabra University, Barcelona, Spain. Transdisciplinary Research Group on Socioecological Transitions (GinTrans2), Universidad Autónoma de Madrid, Madrid, Spain. [Pericàs JM] Research Group on Health Inequalities, Environment, and Employment Conditions, Department of Social and Political Science, Pompeu Fabra University, Barcelona, Spain. Public Policy Center (UPF-BSM), Johns Hopkins University-Pompeu Fabra University, Barcelona, Spain. Unitat del Fetge, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
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enfermedades del sistema digestivo::enfermedades hepáticas::hígado graso::esteatosis hepática no alcohólica [ENFERMEDADES] ,Population ,Ethnic group ,atención a la salud (salud pública)::niveles de atención a la salud::atención a la salud (salud pública)::disparidades poblacionales del estado de salud [SALUD PÚBLICA] ,Review ,Disease ,Global health ,Medicine ,Social determinants of health ,education ,Socioeconomic status ,Esteatosi hepàtica ,education.field_of_study ,Desigualtat social ,business.industry ,Digestive System Diseases::Liver Diseases::Fatty Liver::Non-alcoholic Fatty Liver Disease [DISEASES] ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::morbilidad::prevalencia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,non-alcoholic fatty liver disease ,nutritional and metabolic diseases ,health inequalities ,General Medicine ,Health Care (Public Health)::Health Care Levels::Health Care (Public Health)::Health Status Disparities [PUBLIC HEALTH] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,medicine.disease ,Obesity ,digestive system diseases ,Health equity ,social determinants of health ,business ,Assistència sanitària - Utilització ,Demography - Abstract
Desigualtats en salut; Malaltia del fetge gras no alcohòlic; Determinants socials de la salut Desigualdades en salud; Enfermedad del higado graso no alcoholico; Determinantes sociales de la salud Health inequalities; Non-alcoholic fatty liver disease; Social determinants of health With prevalence high and rising given the close relationship with obesity and diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) is progressively becoming the most common chronic liver condition worldwide. However, little is known about the health inequalities in NAFLD distribution and outcomes. This review aims to analyze health inequalities in NAFLD distribution globally and to assess the health disparities in NAFLD-related outcomes. We conducted a scoping review of global health inequalities in NAFLD distribution and outcomes according to gender/sex, ethnicity/race, and socioeconomic position from PubMed’s inception to May 2021. Ultimately, 20 articles were included in the review, most (75%) of them carried out in the United States. Males were found to have a higher NAFLD prevalence (three articles), while available evidence suggests that women have an overall higher burden of advanced liver disease and complications (four articles), whereas they are less likely to be liver-transplanted once cirrhosis develops (one article). In the US, the Hispanic population had the highest NAFLD prevalence and poorer outcomes (seven articles), whereas Whites had fewer complications than other ethnicities (two articles). Patients with low socioeconomic status had higher NAFLD prevalence (four articles) and a higher likelihood of progression and complications (five articles). In conclusion, globally there is a lack of studies analyzing NAFLD prevalence and outcomes according to various axes of inequality through joint intersectional appraisals, and most studies included in our review were based on the US population. Available evidence suggests that NAFLD distribution and outcomes show large inequalities by social group. Further research on this issue is warranted. This work has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement N◦ 89102 (Natalia Tumas was supported by this grant). Joan Benach gratefully acknowledges the financial support by ICREA under the ICREA Academia program. JVL acknowledges support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Programme (CEX2018-000806-S), and from the Government of Catalonia, Spain, through the CERCA Programme.
- Published
- 2021
5. Social determinants of breast cancer screening: a multilevel analysis of proximal and distal factors related to the practice of mammography.
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Sarmiento DD, Tumas N, Pereyra SA, Scruzzi GF, and Pou SA
- Abstract
Background: Mammography is crucial for early breast cancer detection. In Latin America, Argentina faces a significant breast cancer burden, with varying mammography rates. The social factors influencing mammography practices remain unclear. This study aimed to identify the proximal and distal social determinants of this practice among Argentinean women using a multilevel approach., Methods: This nationwide cross-sectional study included 4,924 women aged 50-70 participating in the 2018 National Risk Factor Survey of Argentina. Two-level logistic models were used to estimate measures of association (ORs) between timely mammography practice (within the last 2 years) and selected covariates (sociodemographics, proximal environment, and distal-level variables). The intraclass correlation coefficient (ICC) and proportional change in variance (PCV) were calculated., Results: 62.8% of women underwent timely mammography. Age (OR=0.96; 95%CI 0.94-0.97), health insurance (OR=2.22; 95%CI 1.87-2.63), education (OR=2.1; 95%CI 1.74-2.64), and income (OR=1.56; 95%CI 1.23-1.97) were associated with mammography practice. Women in non-marital (OR=0.61; 95%CI 0.52-0.72) or larger households (OR=0.61; 95%CI 0.51-0.63) were less likely to have timely mammograph; living in a larger city was positively associated (OR=1.28; 95%CI 1.12-1.46). Women in provinces with higher physician density (OR=1.06; 95%CI 1.01-1.11) and lower maternal mortality ratio (OR=0.9; 95%CI 0.87-0.96) had higher chances of timely mammography. The ICC and PCV suggested that the explored healthcare indicators largely explained the macro-contextual effect., Conclusions: Multilevel factors influenced mammography practices in Argentina. The results highlight disparities linked to sociodemographic characteristics and healthcare resources., Impact: Efforts to address social inequalities in breast cancer screening must consider multilevel determinants, including in healthcare settings.
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- 2024
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6. [Public policies and interventions to prevent excess weight in Mexico: analysis from an intersectional perspective].
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Tumas N, Vega C, Navarro MG, Cash-Gibson L, Carreño P, Pericàs JM, and Benach J
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- Mexico epidemiology, Humans, Adult, Socioeconomic Factors, Health Policy, Policy Making, Obesity prevention & control, Obesity epidemiology, Overweight prevention & control, Overweight epidemiology, Public Policy
- Abstract
The scope of this article is to analyze public policies and interventions (PPI) prevailing in 2022 at the national level for the prevention of excess weight (overweight and obesity) in the adult population of Mexico, from an intersectional perspective. We performed documental analysis of PPI to prevent excess weight in Mexico in adulthood by applying a methodology for policy analysis based on intersectionality (Intersectionality-Based Policy Analysis Framework). A total of nine PPI were analyzed. The extent to which the PPI design considers an intersectional perspective is heterogeneous in the documents analyzed. In the definition of the problem, we identified two main tendencies, namely reductionist and holistic. Both are combined in a variable way in the PPI, revealing internal contradictions in their design. Most PPI consider relatively few cases of social inequality, and as an additive rather than an intersectional consideration. Overall, the PPI consider social inequalities predominantly in the definition of the problem and, to a far lesser extent, in the proposed solutions and in the consultation and negotiation processes. The consideration of the intersectional nature of the problem of excess weight in PPI is important to address the unequal epidemic of excess weight.
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- 2024
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7. Double burden of underweight and obesity: insights from new global evidence.
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Tumas N and López SR
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- Humans, Obesity epidemiology, Overweight, Prevalence, Socioeconomic Factors, Body Mass Index, Thinness epidemiology, Malnutrition
- Abstract
Competing Interests: We declare no competing interests.
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- 2024
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8. The urban built environment and adult BMI, obesity, and diabetes in Latin American cities.
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Anza-Ramirez C, Lazo M, Zafra-Tanaka JH, Avila-Palencia I, Bilal U, Hernández-Vásquez A, Knoll C, Lopez-Olmedo N, Mazariegos M, Moore K, Rodriguez DA, Sarmiento OL, Stern D, Tumas N, and Miranda JJ
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- Adult, Humans, Body Mass Index, Cities epidemiology, Latin America epidemiology, Obesity epidemiology, Built Environment, Diabetes Mellitus, Type 2 epidemiology
- Abstract
Latin America is the world's most urbanized region and its heterogeneous urban development may impact chronic diseases. Here, we evaluated the association of built environment characteristics at the sub-city -intersection density, greenness, and population density- and city-level -fragmentation and isolation- with body mass index (BMI), obesity, and type 2 diabetes (T2D). Data from 93,280 (BMI and obesity) and 122,211 individuals (T2D) was analysed across 10 countries. Living in areas with higher intersection density was positively associated with BMI and obesity, whereas living in more fragmented and greener areas were negatively associated. T2D was positively associated with intersection density, but negatively associated with greenness and population density. The rapid urban expansion experienced by Latin America provides unique insights and vastly expand opportunities for population-wide urban interventions aimed at reducing obesity and T2D burden., (© 2022. The Author(s).)
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- 2022
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9. Are Women's Empowerment and Income Inequality Associated with Excess Weight in Latin American Cities?
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Tumas N, Rodríguez López S, Mazariegos M, Ortigoza A, Anza Ramírez C, Pérez Ferrer C, Moore K, Yamada G, Menezes MC, Sarmiento OL, Pericàs JM, Belvis Costes F, Lazo M, and Benach J
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- Female, Humans, Male, Latin America epidemiology, Cities, Obesity epidemiology
- Abstract
While income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specific associations between city-level women's empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America). The sample included 79,422 individuals (58.0% women), living in 538 sub-cities, 187 cities, and 8 countries. We used gender-stratified Poisson multilevel models to estimate the Prevalence Rate Ratios (PRR) for overweight/obesity (body mass index ≥ 25 kg/m
2 ) per a unit change in city-level women's empowerment (proxied by a score that measures gender inequalities in employment and education) and income inequality (proxied by income-based Gini coefficient). We also tested whether individual education or sub-city living conditions modified such associations. Higher city labor women's empowerment (in women) and higher city Gini coefficient (in men) were associated with a lower prevalence of overweight/obesity (PRR = 0.97 (95%CI 0.94, 0.99) and PRR = 0.94 (95%CI 0.90, 0.97), respectively). The associations varied by individual education and sub-city living conditions. For labor women's empowerment, we observed weakened associations towards the null effect in women with lower education and in residents of sub-cities with worse living conditions (men and women). For the Gini coefficient, the association was stronger among men with primary education, and a negative association was observed in women with primary education. Our findings highlight the need for promoting equity-based policies and interventions to tackle the high prevalence of excess weight in Latin American cities., (© 2022. The Author(s).)- Published
- 2022
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10. Intraurban socioeconomic inequalities in life expectancy: a population-based cross-sectional analysis in the city of Córdoba, Argentina (2015-2018).
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Rodríguez López S, Tumas N, Bilal U, Moore KA, Acharya B, Quick H, Quistberg DA, Acevedo GE, and Diez Roux AV
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- Adult, Male, Infant, Newborn, Humans, Female, Cities, Cross-Sectional Studies, Argentina, Socioeconomic Factors, Life Expectancy, Health Status Disparities
- Abstract
Objectives: To evaluate variability in life expectancy at birth in small areas, describe the spatial pattern of life expectancy, and examine associations between small-area socioeconomic characteristics and life expectancy in a mid-sized city of a middle-income country., Design: Cross-sectional, using data from death registries (2015-2018) and socioeconomic characteristics data from the 2010 national population census., Participants/setting: 40 898 death records in 99 small areas of the city of Córdoba, Argentina. We summarised variability in life expectancy at birth by using the difference between the 90th and 10th percentile of the distribution of life expectancy across small areas (P90-P10 gap) and evaluated associations with small-area socioeconomic characteristics by calculating a Slope Index of Inequality in linear regression., Primary Outcome: Life expectancy at birth., Results: The median life expectancy at birth was 80.3 years in women (P90-P10 gap=3.2 years) and 75.1 years in men (P90-P10 gap=4.6 years). We found higher life expectancies in the core and northwest parts of the city, especially among women. We found positive associations between life expectancy and better small-area socioeconomic characteristics, especially among men. Mean differences in life expectancy between the highest versus the lowest decile of area characteristics in men (women) were 3.03 (2.58), 3.52 (2.56) and 2.97 (2.31) years for % adults with high school education or above, % persons aged 15-17 attending school, and % households with water inside the dwelling, respectively. Lower values of % overcrowded households and unemployment rate were associated with longer life expectancy: mean differences comparing the lowest versus the highest decile were 3.03 and 2.73 in men and 2.57 and 2.34 years in women, respectively., Conclusion: Life expectancy is substantially heterogeneous and patterned by socioeconomic characteristics in a mid-sized city of a middle-income country, suggesting that small-area inequities in life expectancy are not limited to large cities or high-income countries., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
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- 2022
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11. Urban social determinants of non-communicable diseases risk factors in Argentina.
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Tumas N, Rodríguez López S, Bilal U, Ortigoza AF, and Diez Roux AV
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- Adult, Argentina epidemiology, Humans, Obesity epidemiology, Risk Factors, Social Determinants of Health, Noncommunicable Diseases epidemiology
- Abstract
We examined associations of individual-, neighborhood- and city-level education -as proxies of SES at different levels-, with diabetes, hypertension, obesity, smoking and binge drinking (non-communicable disease risk factors -NCD/RF) among Argentinian adults. We estimated mixed models based on 21,415 individuals from the 2013 National Survey of Risk Factors, living in 2,698 neighborhoods and 33 cities. Gradients by individual-level education differed by gender and NCD/RF, and some were modified by city education. In addition, we identified contextual effects of neighborhood and city education on some NCD/RF. Urban efforts to tackle NCD/RF in Argentina should be context- and gender-sensitive, and mainly focused on socially disadvantaged groups., Competing Interests: Declaration of competing interest None., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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12. [Comparison of a community-based nutritional intervention and a conventional nutritional intervention in Mayan communities in Mexico].
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Figueroa-González AR, Hernandez-Escalante VM, Cabrera-Araujo Z, Marín-Cárdenas A, Castro-Sansores C, Tumas N, Juárez-Ramírez C, Sansores-España D, and Torres-Escalante JL
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- Adult, Brazil, Female, Fruit, Humans, Mexico, Diet, Energy Intake
- Abstract
Poor nutritional conditions persist in many Mayan communities in Yucatán, Mexico, even though various programs have been implemented. The study aimed to compare the effects of a community-based nutritional intervention with an intercultural focus versus a conventional nutritional intervention on body mass index (BMI) and diet in women in Mayan communities in Yucatán. The sample included adult women with BMI ≥ 25kg/m2 from neighboring rural Mayan villages. Both interventions lasted three months with 11 sessions and followed the prevailing guidelines. The community-based intervention used an intercultural tool called Good Mayan Food [Plato del Bien Comer Maya], besides strategies designed according to information obtained from a prior qualitative study phase using interviews. The group that received the community-based intervention (n = 7), compared to the conventional intervention group (n = 9), showed larger decreases in BMI (-0.58 ± 0.70 kg/m2 and +0.27 ± 0.64kg/m2; p = 0.042), waist circumference (-2.15 ± 2.60 cm and -0.50 ± 0.75 cm; p = 0.042), and consumption of fats (-53.23 ± 21.92 grams and -7.34 ± 25.77 grams; p = 0.004), as well as higher increases in weekly consumption of some local foods such as nance fruit (p = 0.012), tamarind (p = 0.001), and chili peppers (p = 0.004). The community-based intervention was the only one to show a significant decrease in daily calorie intake (baseline: 2,067 ± 91 kcal/day, at three months: 1,474 ± 31 kcal/day; p = 0.018), and both groups showed decreases in the consumption of ultra-processed foods, but without significant differences between the two groups. The community-based intervention group showed better results than the conventional intervention group.
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- 2022
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13. What Do We Know about Inequalities in NAFLD Distribution and Outcomes? A Scoping Review.
- Author
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Talens M, Tumas N, Lazarus JV, Benach J, and Pericàs JM
- Abstract
With prevalence high and rising given the close relationship with obesity and diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) is progressively becoming the most common chronic liver condition worldwide. However, little is known about the health inequalities in NAFLD distribution and outcomes. This review aims to analyze health inequalities in NAFLD distribution globally and to assess the health disparities in NAFLD-related outcomes. We conducted a scoping review of global health inequalities in NAFLD distribution and outcomes according to gender/sex, ethnicity/race, and socioeconomic position from PubMed's inception to May 2021. Ultimately, 20 articles were included in the review, most (75%) of them carried out in the United States. Males were found to have a higher NAFLD prevalence (three articles), while available evidence suggests that women have an overall higher burden of advanced liver disease and complications (four articles), whereas they are less likely to be liver-transplanted once cirrhosis develops (one article). In the US, the Hispanic population had the highest NAFLD prevalence and poorer outcomes (seven articles), whereas Whites had fewer complications than other ethnicities (two articles). Patients with low socioeconomic status had higher NAFLD prevalence (four articles) and a higher likelihood of progression and complications (five articles). In conclusion, globally there is a lack of studies analyzing NAFLD prevalence and outcomes according to various axes of inequality through joint intersectional appraisals, and most studies included in our review were based on the US population. Available evidence suggests that NAFLD distribution and outcomes show large inequalities by social group. Further research on this issue is warranted.
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- 2021
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14. [Profiles of epidemiological-nutritional transition and burden of morbimortality from COVID-19 in Argentina: an ecological study].
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Scruzzi GF, Tumas N, and Pou SA
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- Argentina epidemiology, Brazil, Humans, SARS-CoV-2, COVID-19, Communicable Diseases
- Abstract
The study aimed to identify epidemiological-nutritional profiles in Argentina and to compare the burden of morbimortality from COVID-19. A multigroup ecological study was conducted with 24 geographic units in Argentina. We estimated the percent change from 2005 to 2018 in indicators of the epidemiological-nutritional transition and sociodemographic indicators according to geographic unit. We performed principal components analysis and hierarchical cluster analysis to identify geographic groupings to define profiles in the epidemiological-nutritional transition. By group, we calculated summary measures of COVID-19 cumulative incidence (CI), mortality, and case fatality (epidemiological week 50), establishing comparisons via Student's t test. Three profiles were identified: (1) reemergence of infectious diseases, (2) persistence of cardiovascular diseases despite social, health, and lifestyle improvements, and (3) consolidation of the triad obesity-sedentarism-cardiometabolic diseases. Mean COVID-19 cumulative incidence and mortality were higher in provinces with profile 1 compared to profile 2 (CI: p = 0.0159; mortality: p = 0.0187) and profile 3 (CI: p = 0.0205). Case-fatality was higher in profile 3, which includes provinces with more unfavorable socioeconomic conditions, showing significant differences from profile 2 (p=0.0307). In conclusion, there are distinct epidemiological-nutritional profiles in Argentina which tend to differ in terms of their COVID-19 epidemiological situation. Strategies to fight COVID-19 should consider the underlying epidemiological, nutritional, and sociodemographic characteristics.
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- 2021
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15. Urban social environment and low birth weight in 360 Latin American cities.
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Rodríguez López S, Tumas N, Ortigoza A, de Lima Friche AA, and Diez-Roux AV
- Subjects
- Americas, Birth Weight, Cities, Female, Guatemala, Hispanic or Latino, Humans, Infant, Newborn, Latin America epidemiology, Peru, Socioeconomic Factors, Infant, Low Birth Weight, Social Environment
- Abstract
Objective: Using data compiled by the SALURBAL project (Urban Health in Latin America; 'Salud Urbana en América Latina') we quantified variability in low birth weight (LBW) across cities in Latin America, and evaluated the associations of socio-economic characteristics at various levels (maternal, sub-city and city) with the prevalence of LBW., Methods: The sample included 8 countries, 360 cities, 1321 administrative areas within cities (sub-city units) and birth registers of more than 4.5 million births for the year 2014. We linked maternal education from birth registers to data on socioeconomic characteristics of sub-cities and cities using the closest available national population census in each country. We applied linear and Poisson random-intercept multilevel models for aggregated data., Results: The median prevalence of city LBW by country ranged from a high of 13% in Guatemala to a low of 5% in Peru (median across all cities was 7.8%). Most of the LBW variability across sub-cities was between countries, but there were also significant proportions between cities within a country, and within cities. Low maternal education was associated with higher prevalence of LBW (Prevalence rate ratios (PRR) for less than primary vs. completed secondary or more 1.12 95% CI 1.10, 1.13) in the fully adjusted model. In contrast, higher sub-city education and a better city social environment index were independently associated with higher LBW prevalence after adjustment for maternal education and age, city population size and city gross domestic product (PRR 1.04 95% CI 1.03, 1.04 per SD higher sub-city education and PRR 1.02 95% CI 1.00, 1.04 per SD higher SEI). Larger city size was associated with a higher prevalence of LBW (PRR 1.06; 95% CI 1.01, 1.12)., Conclusion: Our findings highlight the presence of heterogeneity in the distribution of LBW and the importance of maternal education, local and broader social environments in shaping LBW in urban settings of Latin America. Implementing context-sensitive interventions guided to improve women's education is recommended to tackle LBW in the region.
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- 2021
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16. The Inflammatory Potential of Diet is Associated with Breast Cancer Risk in Urban Argentina: A Multilevel Analysis.
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Niclis C, Shivappa N, Hébert JR, Tumas N, and Díaz MDP
- Subjects
- Argentina epidemiology, Case-Control Studies, Child, Diet, Female, Humans, Inflammation etiology, Multilevel Analysis, Risk Factors, Breast Neoplasms epidemiology, Breast Neoplasms etiology
- Abstract
Dietary patterns have been associated with breast cancer (BC) in Argentina. However, little evidence exists relating the inflammatory potential of diet and BC in Latin American countries and how this may relate to rurality.The aim of the present study was to evaluate the association between the Dietary Inflammatory Index (DII
® ) and BC considering urbanization contexts in Córdoba, Argentina.A frequency-matched case-control study (317 BC cases, 526 controls) was conducted from 2008 through 2016. DII scores were computed based on dietary intake assessed by a validated food frequency questionnaire. Multi-level logistic regression models were fit to evaluate the association between DII and BC, following adjustment for age, body mass index, age at menarche, number of children, smoking habits, socio-economic status and family history of BC as first-level covariates and urbanization level as the contextual variable.Increasing DII score showed significant positive associations with BC risk (ORtertile3vs.tertile1 1.34; 95%CI 1.05, 1.70). The association was stronger in overweight and obese women (ORtertile3vs.tertile1 1.98; 95%CI 1.86, 2.10). The DII effect on BC was higher with increased urbanization.A pro-inflammatory diet, reflected by higher DII scores, was positively associated with BC, especially in overweight women and with increased urbanization.- Published
- 2021
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17. [Emotions, concerns and reflections regarding the COVID-19 pandemic in Argentina].
- Author
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Johnson MC, Saletti-Cuesta L, and Tumas N
- Subjects
- Adult, Age Factors, Aged, Anxiety epidemiology, Argentina epidemiology, COVID-19, Coronavirus Infections prevention & control, Cross-Sectional Studies, Educational Status, Fear, Female, Health Care Surveys statistics & numerical data, Health Impact Assessment statistics & numerical data, Humans, Male, Mental Health, Middle Aged, Pneumonia, Viral prevention & control, SARS-CoV-2, Uncertainty, Vulnerable Populations psychology, Betacoronavirus, Coronavirus Infections epidemiology, Coronavirus Infections psychology, Emotions, Pandemics prevention & control, Pneumonia, Viral epidemiology, Pneumonia, Viral psychology
- Abstract
The scope of this work is to explore the feelings and expectations that COVID-19 has generated in Argentina during the first stage of the pandemic. A survey of the World Health Organization adapted to the local context was applied. Open-ended questions were included to study people's feelings about COVID-19, and content analysis was subsequently conducted. In terms of results, it is revealed that the population surveyed feels uncertainty, fear and anguish, albeit a feeling of responsibility and care in the face of COVID-19 also emerges. Moreover, positive feelings regarding society stand out as an achievement of social interdependence. The results obtained show that the impact on mental health differs in accordance with gender, educational level, and perceived comfort in the home. The study concludes that the emotional and bonding dimensions of people are central to confronting the COVID-19 pandemic in Argentina. It is recommended that these dimensions, as well as their subjective and differential social impact among the different population groups, should be considered in the planning of policies to address the COVID-19 pandemic.
- Published
- 2020
- Full Text
- View/download PDF
18. Nutrition transition profiles and obesity burden in Argentina.
- Author
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Tumas N, Rodríguez Junyent C, Aballay LR, Scruzzi GF, and Pou SA
- Subjects
- Adolescent, Adult, Argentina, Child, Cluster Analysis, Cost of Illness, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Multilevel Analysis, Nutrition Surveys, Poverty statistics & numerical data, Prevalence, Regression Analysis, Risk Factors, Socioeconomic Factors, Urban Population statistics & numerical data, Young Adult, Malnutrition epidemiology, Obesity epidemiology, Overweight epidemiology, Thinness epidemiology
- Abstract
Objective: The present study aimed to identify nutrition transition (NT) profiles in Argentina (2005-2013) and assess their association with obesity in the adult population., Design: A large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence., Setting: First, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.ParticipantsTwenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people., Results: Three NT profiles were identified: 'Socionutritional lag' (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); 'Double burden of malnutrition' (undernutrition and overweight in highly urbanized scenarios; profile 2); and 'Incipient socionutritional improvement' (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3., Conclusions: Argentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.
- Published
- 2019
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19. [Adolescents opinions regarding Plato del Bien Comer Maya as nutrition health promotion tool.]
- Author
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Cabrera-Araujo ZM, Hernández-Escalante VM, Marín-Cárdenas AD, Murguía-Argüelles R, Magaña-Be N, Ramón-Escobar K, Hirose-López J, Tuz-Chi L, Salas-Góngora A, Peña-Alcocer J, Tumas N, Castro-Sansores CJ, and Juárez-Ramírez C
- Subjects
- Adolescent, Child, Choice Behavior, Culture, Data Display, Ethnicity psychology, Feeding Behavior, Female, Focus Groups, Food classification, Food Supply, Health Promotion methods, Humans, Indians, North American, Male, Rural Population, Attitude, Nutrition Policy, Psychology, Adolescent
- Abstract
Objective: To know opinions of adolescents from Cholul, Yucatán, about Plato del Bien Comer Maya in order to improve it as health promotion tool., Materials and Methods: Qualitative study, formative research. Three focus groups were carried out, participating 28 adolescents: 12-16 years old. Criteria of inclusion: studying middle school; to have native family from the town. Analysis of the data made manually., Results: Comparatively with the national Plato del Bien Comer, the Plato Maya was better identified because have local food products easier to obtain and cheaper. The principal finding was to understand Fruto is a linguistic variation word which represents in Maya context both fruits and vegetables. This might be an important key to improve health promotion activities with that population., Conclusions: In order to have better results in nutritional interventions, it is necessary to design educational-communicative strategies in accordance with the local culture., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.
- Published
- 2019
- Full Text
- View/download PDF
20. [Inequities in health: socio-demographic and spatial analysis of breast cancer in women from Córdoba, Argentina].
- Author
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Tumas N, Pou SA, and Díaz MDP
- Subjects
- Adult, Argentina epidemiology, Cross-Sectional Studies, Female, Humans, Incidence, Social Determinants of Health, Spatial Analysis, Breast Neoplasms epidemiology, Health Status Disparities
- Abstract
Objective: To identify sociodemographic determinants associated with the spatial distribution of the breast cancer incidence in the province of Córdoba, Argentina, in order to reveal underlying social inequities., Method: An ecological study was developed in Córdoba (26 counties as geographical units of analysis). The spatial autocorrelation of the crude and standardised incidence rates of breast cancer, and the sociodemographic indicators of urbanization, fertility and population ageing were estimated using Moran's index. These variables were entered into a Geographic Information System for mapping. Poisson multilevel regression models were adjusted, establishing the breast cancer incidence rates as the response variable, and by selecting sociodemographic indicators as covariables and the percentage of households with unmet basic needs as adjustment variables., Results: In Córdoba, Argentina, a non-random pattern in the spatial distribution of breast cancer incidence rates and in certain sociodemographic indicators was found. The mean increase in annual urban population was inversely associated with breast cancer, whereas the proportion of households with unmet basic needs was directly associated with this cancer., Conclusions: Our results define social inequity scenarios that partially explain the geographical differentials in the breast cancer burden in Córdoba, Argentina. Women residing in socioeconomically disadvantaged households and in less urbanized areas merit special attention in future studies and in breast cancer public health activities., (Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
- Full Text
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21. Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011.
- Author
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Pou SA, Tumas N, Coquet JB, Niclis C, Román MD, and Díaz MD
- Subjects
- Argentina epidemiology, Breast Neoplasms mortality, Female, Humans, Male, Mortality trends, Prostatic Neoplasms mortality, Retrospective Studies, Risk Factors, Neoplasms mortality, Population Dynamics
- Abstract
The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.
- Published
- 2017
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22. Breast Cancer and Modifiable Lifestyle Factors in Argentinean Women: Addressing Missing Data in a Case-Control Study
- Author
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Becaria Coquet J, Tumas N, Osella AR, Tanzi M, Franco I, and Diaz Mdel P
- Abstract
A number of studies have evidenced the effect of modifiable lifestyle factors such as diet, breastfeeding and nutritional status on breast cancer risk. However, none have addressed the missing data problem in nutritional epidemiologic research in South America. Missing data is a frequent problem in breast cancer studies and epidemiological settings in general. Estimates of effect obtained from these studies may be biased, if no appropriate method for handling missing data is applied. We performed Multiple Imputation for missing values on covariates in a breast cancer case-control study of Córdoba (Argentina) to optimize risk estimates. Data was obtained from a breast cancer case control study from 2008 to 2015 (318 cases, 526 controls). Complete case analysis and multiple imputation using chained equations were the methods applied to estimate the effects of a Traditional dietary pattern and other recognized factors associated with breast cancer. Physical activity and socioeconomic status were imputed. Logistic regression models were performed. When complete case analysis was performed only 31% of women were considered. Although a positive association of Traditional dietary pattern and breast cancer was observed from both approaches (complete case analysis OR=1.3, 95%CI=1.0-1.7; multiple imputation OR=1.4, 95%CI=1.2-1.7), effects of other covariates, like BMI and breastfeeding, were only identified when multiple imputation was considered. A Traditional dietary pattern, BMI and breastfeeding are associated with the occurrence of breast cancer in this Argentinean population when multiple imputation is appropriately performed. Multiple Imputation is suggested in Latin America’s epidemiologic studies to optimize effect estimates in the future., (Creative Commons Attribution License)
- Published
- 2016
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- View/download PDF
23. [Trends in mortality from breast cancer in Córdoba, Argentina, 1986-2011: some socio-historical interpretations].
- Author
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Tumas N, Niclis C, Osella A, Díaz Mdel P, and Carbonetti A
- Subjects
- Adult, Aged, Argentina epidemiology, Demography trends, Female, Health Services Accessibility trends, Humans, Middle Aged, Models, Theoretical, Mortality trends, Politics, Risk, Social Change, Breast Neoplasms mortality, Social Determinants of Health
- Abstract
Objective: Analyze and interpret trends in mortality from breast cancer in recent decades in the province of Córdoba, Argentina, relative to demographic changes and the sociopolitical context., Methods: Raw, standardized (direct method), and age-specific mortality from breast cancer was calculated for 1986-2011 in Córdoba. Using RiskDiff® software, variations in the 1986 to 2011 raw rates were analyzed. Joinpoint regression models were adjusted to standardized and specific rates by age group. Secondary data sources (laws, decrees, health programs) were consulted for information on the sociopolitical context of the period., Results: Raw mortality due to breast cancer increased 24.97% from 1986 to 2011, an increase that can be attributed to the increase in the risk of dying (5.22%), to structural changes (19.75%), and to population size (39.66%). Standardized mortality from breast cancer shows a rising trend up to 1996 (annual percentage change [APC] = 1.62%; P <0.05), and then begins to decline (APC = -2.1%; P <0.05), slowing around the year 2001. For socio-historical interpretations, the analysis focused on demographic, epidemiological, and health-related changes, as well as the socioeconomic and political events of the period studied., Conclusions: The behavior of mortality from breast cancer in this period is associated with contextual factors (demographic, historical, economic, and political). The results of this study will help define actions and policies in breast cancer and women's health care.
- Published
- 2015
24. Tobacco smoking patterns and differential food effects on prostate and breast cancers among smokers and nonsmokers in Córdoba, Argentina.
- Author
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Román MD, Niclis C, Tumas N, Díaz Mdel P, Osella AR, and Muñoz SE
- Subjects
- Aged, Aged, 80 and over, Argentina epidemiology, Beverages, Case-Control Studies, Diet, High-Fat statistics & numerical data, Dietary Sucrose, Female, Humans, Male, Meat, Middle Aged, Multilevel Analysis, Odds Ratio, Risk Factors, Vegetables, Breast Neoplasms epidemiology, Diet statistics & numerical data, Feeding Behavior, Prostatic Neoplasms epidemiology, Smoking epidemiology
- Abstract
The aim of this study was to estimate the effect of diet on prostate and breast cancer (PC and BC) risks in smokers and nonsmokers and to explore the effect modification between smoking and dietary patterns. PC or BC incidence rates were assessed spatially according to tobacco exposure, age-adjusted standardization using lung cancer mortality as a proxy. Two case-control studies were carried out in Argentina (2008-2012). Participants were interviewed about their diet, smoking habits, and other lifestyle factors. Multilevel models were fitted including family history of cancer as the random intercept for the second level, and diet and lifestyle variables as covariates. Tobacco exposure was aggregated spatially. Family history of cancer significantly accounts for PC and BC. In smokers, high intake of fat meat increased PC and BC risks [odds ratio (OR) 1.56, 95% confidence interval (CI) 0.81-3.05 and OR 6.01, 95% CI 1.99-8.19, respectively]. PC and BC risks were also greater in smokers with high intakes of fatty foods (OR 1.95, 95% CI 1.09-3.50 and OR 24.2, 95% CI 0.82-7.21, respectively). Moderate intake of nonstarchy vegetables and risk of PC were inversely associated in nonsmokers (OR 0.55, 95% CI 0.20-1.48). In smoker women, BC risk was associated with sweet drink consumption (OR 2.96, 95% CI 1.10-7.92) and ethanol intake (OR 5.15, 95% CI 1.88-14.16). Spatial distributions of cancer incidence rates match those of tobacco exposure. Differential effects of diet on PC and BC risks were found in smokers and nonsmokers.
- Published
- 2014
- Full Text
- View/download PDF
25. [Cancer and its association with dietary patterns in Córdoba (Argentina)].
- Author
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Pou SA, Niclis C, Aballay LR, Tumas N, Román MD, Muñoz SE, Coquet JB, and Díaz Mdel P
- Subjects
- Adult, Aged, Argentina epidemiology, Case-Control Studies, Female, Humans, Male, Middle Aged, Risk Assessment, Feeding Behavior, Neoplasms epidemiology
- Abstract
Introduction: Feeding habits play a prominent role in carcinogenesis. The dietary patterns approach applied to the study of chronic diseases is of increasing interest in nutritional epidemiology. Nevertheless, it has been seldom used in Latin America., Objective: To identify dietary patterns in adult population in Córdoba (Argentina) and to estimate their effects on the risk of colon-rectal (CRC), urothelial (UC), breast (BC) and prostate (PC) cancers., Methods: Four case control studies were conducted, 2006-2012 for CRC, PC, BC and UC. To identify the dietary patterns, a Principal Components Factor Analysis was conducted. A multilevel logistic regression was adjusted for the risk analyses., Results: Characteristic dietary patterns in the whole population, and in women and men independently, were identified. In the whole population South Cone and Sweet Beverages patterns behaved as promoters for CRC and UC while the Prudent Pattern had a protective effect. Female South Cone, Rural and Starchy patterns were associated to a higher BC risk. Prudent Pattern lowered BC risk. In men, South Cone, Sweet Beverages and Typical Measured patterns promoted PC., Conclusion: It is necessary to promote a regular intake of vegetables, fruits and diary products (although a moderate intake for men), and to reduce red meat (especially fat meat), processed meat, starchy vegetables, wine and sweet beverages intakes, to prevent the occurrence of cancer. In men, it is recommended a moderate intake of egg. In women, it is advised a moderate intake of refined grains, bakery products, oils and mayonnaise intake., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
26. Traditional dietary pattern of South America is linked to breast cancer: an ongoing case-control study in Argentina.
- Author
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Tumas N, Niclis C, Aballay LR, Osella AR, and Díaz Mdel P
- Subjects
- Aged, Argentina epidemiology, Body Mass Index, Case-Control Studies, Dietary Carbohydrates administration & dosage, Dietary Fats administration & dosage, Energy Intake, Exercise, Female, Food, Fruit, Humans, Meat, Menopause, Middle Aged, Plant Oils administration & dosage, Risk Factors, Starch administration & dosage, Surveys and Questionnaires, Vegetables, Breast Neoplasms epidemiology, Culture, Diet
- Abstract
Introduction: Several studies have shown the effect of dietary patterns on breast cancer risk, but none has been conducted in Argentina. The aim of this study was to extract dietary patterns from Food Frequency Questioner, to estimate their effect on breast cancer occurrence while taking into account aggregation factors (family history of breast cancer) and to explore the sensitivity of the estimates to changes in the assumptions., Methods: A principal component exploratory factor analysis was applied to identify dietary patterns, which were then included as covariates in a multilevel logistic regression. Family history of BC was considered as a clustering variable. A multiple probabilistic sensitivity analysis was also performed., Results: The study included 100 cases and 294 controls. Four dietary patterns were identified. Traditional (fat meats, bakery products, and vegetable oil and mayonnaise) (OR III tertile vs I 3.13, 95% CI 2.58-3.78), Rural (processed meat) (OR III tertile vs I 2.02, 95% CI 1.21-3.37) and Starchy (refined grains) (OR III tertile vs I 1.82, 95 % CI 1.18-2.79) dietary patterns were positively associated with BC risk, whereas the Prudent pattern (fruit and non-starchy vegetables) (OR III tertile vs I 0.56, 95% CI 0.41-0.77) showed a protective effect. For Traditional pattern, the median bias-adjusted ORs (3.52) were higher than the conventional (2.76)., Conclusions: While the Prudent pattern was associated with a reduced risk of BC, Traditional, Rural and Starchy patterns showed a promoting effect. Despite the threats to validity, the nature of associations was not strongly affected.
- Published
- 2014
- Full Text
- View/download PDF
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