Open access textbook on diabetes public health

Diabetes Public Health: From Data to Policy is now available open access as a Google eBook. This book provides effective approaches to prevent and manage diabetes through the practice of public health. It focuses on diabetes control in the United States and North America, and it is recommended for public health practitioners and researchers and anyone involved in health policy, administration and management.

Citation:
1. Narayan KMV, Williams D, Gregg EW, Cowie CC. Diabetes Public Health: From Data to Policy. New York: Oxford University Press, 2011.

World Health Statistics 2012

World Health Statistics 2012 is the World Health Organization’s annual report of health-related data from all 194 WHO member states. The report includes a summary of the progress made towards achieving the health-related Millennium Development Goals and associated targets. This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage.

Select data from the report:

• Measles deaths declined by 74% between 2000 and 2010.
• In 2010, 85% of children age 12-23 months worldwide were immunized against measles.
• Hypertension is considered directly responsible for 7.5 million deaths in 2004–about 12.8% of all global deaths.
• In Africa, more than one third of people are estimated to have high blood pressure and this condition is increasing.
• Globally, 2.8 million people die each year as a result of being overweight or obese.
• Worldwide prevalence of obesity almost doubled between 1980 and 2008.
• In 2008, 10% of men and 14% of women (half a billion people) in the world were obese.

The report is available in English, French and Spanish.

Citation:
1. World Health Organization. World Health Statistics 2012. Geneva: WHO, 2012.

Chronic care integration for NCDs

Partners in Health is making available the Guide to Chronic Care Integration for Endemic Non-communicable Diseases. This guide is for district-level health care providers and policy makers designing a health system for care of non-communicable diseases (NCDs) in rural Rwanda and other very low-income populations.

The guide focuses on NCDs such as cardiovascular diseases, kidney disease, diabetes, hypertension, rheumatic heart disease, and respiratory diseases. It also covers the role of community health workers, family planning, mental health and social services in the treatment of chronic disease.

Citation:
1. Bukhman G, Kidder A. The PIH Guide to Chronic Care Integration for Endemic Non-communicable Diseases. Boston: Partners in Health, 2011.

Diabetes death rates on the decline in the U.S.

Death rates among U.S. adults with diabetes has been on the decline since the late 1990s, reports a new study. The study found that between 1997 and 2006 among diabetic adults, the rate of deaths due to cardiovascular disease (CVD) declined by 40 percent and the death rate due to all causes decreased by 23 percent. There was no difference in the rates of decline between diabetic men and women.

The CVD death rate, compared with non-diabetic adults, decreased by 60 percent, while the all-cause death rate declined by 44 percent.

Although these findings are encouraging, the study points out that “diabetes prevalence is likely to rise in the future if diabetes incidence is not curtailed.”

Citation:
1. Gregg EW, Cheng YJ, Saydah S, et al. Trends in death rates among U.S. adults with and without diabetes between 1997 and 2006: findings from the National Health Interview Survey. Diabetes Care 2012; 35(6): 1252-1257. (open access)

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.