White rice linked to 11% rise in diabetes risk

A study published in BMJ.com indicates that a higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian populations.

Each serving per day of white rice consumption increases the risk of diabetes by 11 percent, according to the study.

Rice provides food for more than half of the world’s population, especially those living in some of the most populous countries, such as China, India, and Japan. And white rice—which is produced through a series of mechanized processes including hulling and milling and has higher glycemic levels than whole grains—is the predominant type of rice consumed worldwide.

The high glycemic levels of white rice, in combination with dramatically decreased levels of physical activity and increased access to unhealthy foods, has led to a rise in obesity insulin resistance in Asian countries.

In addition, the study shows that even for Western populations with typically low intake levels, relatively high white rice consumption may still modestly increase risk of diabetes.

Citation:
1. Hu EA, Pan A, Malik Va, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ 2012; 344: e1454. (open access)

Using HIV programs to support NCD services

Although HIV and non-communicable diseases (NCDs) are traditionally thought of as two very different health challenges, some of the systems, tools and approaches developed for HIV programs could be used for NCDs as well, according to an article published in the Journal of Acquired Immune Deficiency Syndromes.

The availability of treatment has transformed HIV into a chronic condition, and local HIV program in low- and middle-income countries have the capability to support continuity care. For example, the appointment books, defaulter tracking, patient counseling, medical records, standardized treatment protocols, referral networks, and linkages to laboratory and pharmacy services available through HIV clinics—and all critical for continuity care—could be used for diabetes and hypertension services.

“Strengthening health systems to deliver continuity care is likely to enhance the performance of both HIV and NCD programs and is a shared priority,” the article concludes.

Citation:
1. Rabkin M, Nishtar S. Scaling up chronic care systems: Leveraging HIV programs to support noncommunicable disease services. Journal of Acquired Immune Deficiency Syndromes 2011; 57: s87-s90. (open access)

New report on urbanization and heart disease

The World Heart Federation has released a new report, Urbanization and Cardiovascular Disease: Raising Heart-healthy Children in Today’s Cities, which shows how urban life impacts heart-healthy behavior.

Although urbanization brings with it many opportunities—such as employment choices, healthcare, educational prospects, social connections and political mobilization—city life inherently comes with obstacles to adopting heart-healthy behaviors, according to the report.

For example, foods high in salt, sugar and fats are often more cheaply and readily available than fresh fruits and vegetables in urban settings. Children are particularly vulnerable to the negative health aspects associated with city life, as they have the least independence from, and are most manipulated by, their living environment. In addition, unplanned urbanization is accompanied by limitations on space for physical activity including lack of planning, crime, and heavy and dangerous traffic.

Heart disease is not just an issue of lifestyle and individual behavior choices, it is the environment around such diseases that have a major impact, the report emphasizes.

The report presents several case studies showing that informed action by governments and key stakeholders who take a whole-of-society approach can dramatically reduce the level of cardiovascular disease risk.

Download the full report or the executive summary here: www.worldheart.org/urbanization.

Citation:
1. Smith, S. et al. Urbanization and Cardiovascular Disease: Raising Heart-healthy Children in Today’s Cities. Geneva: World Heart Federation, 2012.

Food fried in olive or sunflower oil is not linked to heart disease

Eating food fried in olive or sunflower oil is not associated with an increased risk of coronary heart disease or death, according to a study of more than 40,000 adults aged 29-69 years in Spain.

The benefits of olive or sunflower oil can be attributed to the fact that they are less prone to deteriorating during frying, compared to other oils.
The oil used for frying deteriorates, especially when reused, through oxidation and hydrogenation, leading to a loss of unsaturated fats and an increase in trans fats. When food is fried it loses water and absorbs this degredated oil, increasing its energy density.

The study researchers pointed out that these results are directly applicable only to other Mediterranean countries with frying methods similar to those in Spain. For example, oil (mainly olive and sunflower) rather than solid fat is used for frying in Spain. And these oils are not likely to be reused multiple times for foods eaten at home. Finally, consumption of fried snacks high in salt is fairly low in Spain, whereas in other countries such as the United States they provide an important percentage of energy intake.

“Frying with other types of fats, reusing oils several times, or consuming fried snacks high in salt may still be harmful,” the study concluded.

Citation:
1. Guallar-Castillón P, Rodríguez-Artalejo F, Lopez-Garcia E, et al. Consumption of fried foods and risk of coronary heart disease: Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study. BMJ 2012; 344: published 24 Jan 2012. (open access)

Adults in southern China at high risk of metabolic syndrome

A study indicates that close to eight percent of adults in Guangdong, China, have the metabolic syndrome. The metabolic syndrome is the constellation of cardiovascular risk factors including abdominal obesity, raised blood-sugar and high cholesterol. The metabolic syndrome is known to increase the risk of diabetes, heart disease and subsequent death.

The results of the study translate to a total of about four million adults age 20 years and older with the metabolic syndrome in this Chinese province of 85 million residents. More than 60 percent were found to have at least one individual component of the metabolic syndrome. Urban residence were more likely to have the syndrome than the rural population (close to 11 percent compared to four percent).

As China continues to be the fastest economic development in the world, it is expected to further increase its rate of modernization and urbanization–translating to more people consuming energy-dense diets and living increasingly sedentary lifestyles. The prevalence of the metabolic syndrome and related cardiovascular disease is therefore expected to increase enormously, according to the study.

“Urgent public health actions are needed to control this observed worsening situation in China,” the study concludes.

Citation:
1. Lao XQ, Zhang YH, Wong MCS, et al. The prevalence of metabolic syndrome and cardiovascular risk factors in adults in southern China. BMC Public Health 2012; 12: 64. (open access)

Case management guide for diabetes, heart disease and related conditions

The UK Department for International Development has made available Type 2 Diabetes, Cardiovascular Disease, Obesity and Hyperlipidaemia Care in Adults: Case Management Desk Guide. This document guides health care workers on the screening, detection and management of type 2 diabetes and its related conditions (hypertension, obesity, high cholesterol, alcoholism and smoking). The guide is currently in draft form.

Click here to access a PDF of the guide.

Poor Pakistani women unaware of smoking-related health effects

Most women living in urban slums in Pakistan are aware that smoking harms women’s and children’s health, however, a new study reports that few of these women knew about specific smoking-related health effects.

Around one-third of women in the study knew that smoking can cause lung disease, but only seven percent knew that smoking could lead to heart disease. Few knew that smoking could lead to female-related health effects such as: low birth weight (seven percent); congenital abnormalities (five percent); pregnancy loss, still birth and preterm labor (less than one percent); and infertility and osteoporosis (zero percent). Only 20 percent understood the harmful effects of secondhand smoke on their children.

The study also found that the women’s limited health knowledge was largely due to illiteracy and lower levels of education.

“Understanding and attitudes needs to be improved by increasing health awareness and education of women in these urban communities with special emphasis on the effects of smoking on women’s health,” the study concluded.

Citation:
1. Bhanji S, Andrades M, Taj F, Khuwaja AK. Factors related to knowledge and perception of women about smoking: a cross sectional study from a developing country. BMC Women’s Health 2011; 11: 16 (open access)

Family, school support key in teen physical activity

Teens are less likely to engage in physical activity if they lack support and encouragement from family, school, and the community, according to a British study of adolescents age 16-18 years of Bangladeshi, Somali or Welsh descent.

Girls exercise less than boys because female physical activity is viewed as unimportant. Boys find barriers through lack of access to exercise resources, parental fear of injury and the belief that teens should be studying or working rather than playing. Although both boys and girls would like to increase their exercise frequency, girls tend to have a negative view of physical activity, while boys think positively about it.

“Interventions should focus on changing the attitudes of parents, communities and society toward activity,” the study concluded.

Citation:
1. Brophy S, Crowley A, Mistry R. Recommendations to improve physical activity among teenagers: A qualitative study with ethnic minority and European teenagers. BMC Public Health 2011; 11: 412. (open access)

Tobacconomics: Report on the tobacco industry’s misleading economic arguments

The tobacco industry uses pseudo economic arguments to divert attention away from the health consequences of smoking to block new health regulations and ultimately protect its revenues, according to Tobacconomics, a report produced by Action on Smoking and Health.

The report debunks claims that support the three major pro-tobacco arguments developed by the industry and its lobbyists, which are recycled again and again for each new policy intervention: standing up for small businesses and defending workers’ jobs; raising the alarm about counterfeit and smuggled tobacco; and denying the effectiveness of tobacco control policies.

Citation:
1. Action on Smoking and Health. Tobacconomics: How Big Tobacco Uses Dodgy Data to ‘Throw Sand in the Gears’ of Global Health Policy. London, UK: ASH, 2011.

Mexico study: Heart disease risk determined by quality of fat

Quality, rather than quantity of fat, is the determinant of heart disease risk, according to a study conducted in Mexico. The study found that although fat intake among three-quarters of Mexicans fell within World Health Organization recommendations, their saturated fat and trans fat intake exceeded healthy diet recommendations–placing them at higher risk for heart disease.

Around 60 percent of Mexicans surveyed had a high intake of saturated fats and a low intake of polyunsaturated fats, which help reduce the risk of heart disease and promote cardiovascular health.

“Public policies should be enacted to reduce the intake of saturated fats by improving the quality of baking lard and promoting the consumption of defatted milk,” the study recommended. These two foods are among the main sources of saturated fats in the Mexican diet.

In addition, consumption of foods rich in n-3 and n-6 fatty acids (such as fish and nuts) are very low in the typical Mexican diet; thus, alternatives like promoting a larger consumption of canola or soy bean oils or addition of n-3 fatty acids to cooking oils from other sources must be considered, the study concluded.

Citation:
1. Ramírez-Silva I, Villalpando S, Moreno-Saracho JE, Bernal-Medina D. Fatty acids intake in the Mexican population. Results of the National Nutrition Survey 2006. Nutrition & Metabolism 2011; 8: 33. (open access)