Patients' and healthcare providers' perspectives of diabetes management in Cambodia: a qualitative study.

Objective: This study aimed to explore the challenges encountered by patients and healthcare providers and opportunities for improvement in managing diabetes mellitus (DM) in a low- and middle-income country (LMIC) facing a rise in DM prevalence.

Design: Qualitative cross-sectional study.

Setting: Urban, semiurban, and rural areas in Cambodia.

Multi-ancestry study of blood lipid levels identifies four loci interacting with physical activity.

Many genetic loci affect circulating lipid levels, but it remains unknown whether lifestyle factors, such as physical activity, modify these genetic effects. To identify lipid loci interacting with physical activity, we performed genome-wide analyses of circulating HDL cholesterol, LDL cholesterol, and triglyceride levels in up to 120,979 individuals of European, African, Asian, Hispanic, and Brazilian ancestry, with follow-up of suggestive associations in an additional 131,012 individuals. We find four loci, in/near CLASP1, LHX1, SNTA1, and CNTNAP2, that are associated with circulating lipid levels through interaction with physical activity; higher levels of physical activity enhance the HDL cholesterol-increasing effects of the CLASP1, LHX1, and SNTA1 loci and attenuate the LDL cholesterol-increasing effect of the CNTNAP2 locus.

Epicardial and visceral adipose tissue in relation to subclinical atherosclerosis in a Chinese population.

Background: Body fatness is associated with risk of coronary heart disease and it has been postulated that epicardial adipose tissue (EAT) may have a particularly detrimental effect because of its localized toxic effects. We therefore aimed to examine the association between EAT and coronary artery calcification and compared this with associations for visceral adipose tissue (VAT) and other regional fat depots.

Methods: We conducted a cross-sectional study of 487 Chinese participants aged 50 years old and above, living in Singapore.

Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action.

Background: Our aims were to evaluate critically the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health and to identify the potential mechanisms of action involved.

Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included systematic reviews was utilised.

Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial.

Background: Despite the increasing popularity of activity trackers, little evidence exists that they can improve health outcomes. We aimed to investigate whether use of activity trackers, alone or in combination with cash incentives or charitable donations, lead to increases in physical activity and improvements in health outcomes.

Methods: In this randomised controlled trial, employees from 13 organisations in Singapore were randomly assigned (1:1:1:1) with a computer generated assignment schedule to control (no tracker or incentives), Fitbit Zip activity tracker, tracker plus charity incentives, or tracker plus cash incentives.

Association of Television Viewing Time with Body Composition and Calcified Subclinical Atherosclerosis in Singapore Chinese.

Objective: Sedentary behavior such as television viewing may be an independent risk factor for coronary heart disease. However, few studies have assessed the impact of television viewing time on coronary artery calcification and it remains unclear how body fat contributes to this relationship. The aim of this study is to evaluate the association between television viewing time and subclinical atherosclerosis and whether effects on visceral or subcutaneous fat may mediate any associations observed.

Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): a randomized controlled trial of a six month pedometer program with financial incentives.

Non-communicable diseases (NCDs) are emerging as the predominant global health challenge of this century. Physical inactivity is one of the primary risk factors for NCDs. Therefore, increasing physical activity levels is a public health imperative.

Television screen time, but not computer use and reading time, is associated with cardio-metabolic biomarkers in a multiethnic Asian population: a cross-sectional study.

Background: Recent evidence shows that sedentary behaviour may be an independent risk factor for cardiovascular diseases, diabetes, cancers and all-cause mortality. However, results are not consistent and different types of sedentary behaviour might have different effects on health. Thus the aim of this study was to evaluate the association between television screen time, computer/reading time and cardio-metabolic biomarkers in a multiethnic urban Asian population.

Validity of the International Physical Activity Questionnaire and the Singapore Prospective Study Program physical activity questionnaire in a multiethnic urban Asian population.

Background: Physical activity patterns of a population remain mostly assessed by the questionnaires. However, few physical activity questionnaires have been validated in Asian populations. We previously utilized a combination of different questionnaires to assess leisure time, transportation, occupational and household physical activity in the Singapore Prospective Study Program (SP2).

Associations of physical activity and television viewing time with retinal vascular caliber in a multiethnic Asian population.

PURPOSE. The aim of this study was to examine the relationship of physical activity and television (TV) viewing time with retinal vascular caliber in a multiethnic Asian population. METHODS.

Distribution of ankle--brachial index and the risk factors of peripheral artery disease in a multi-ethnic Asian population.

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis and is associated with increased cardiovascular morbidity and mortality. We describe the prevalence and risk factors of PAD in a multi-ethnic Asian population (Chinese, Malays and Indians) in Singapore. The Singapore Prospective Study Program recruited 4132 individuals between 2004 and 2006 in which the ankle-brachial index (ABI) was measured using the Smartdop™ 20EX bi-directional blood flow detector.

Patterns of physical activity in different domains and implications for intervention in a multi-ethnic Asian population: a cross-sectional study.

Background: The benefits of regular physical activity for quality of life and disease prevention have been well documented. Identification of low activity groups would facilitate interventional programs. Many studies have focussed on leisure time activity, which may not capture the spectrum of physical activity relevant to disease prevention.

Is there a clear threshold for fasting plasma glucose that differentiates between those with and without neuropathy and chronic kidney disease?: the Singapore Prospective Study Program.

Recent studies suggest that no distinct glycemic threshold consistently differentiates individuals with or without retinopathy. The authors sought to determine whether the same was true for other microvascular complications. They studied 5,094 participants with fasting plasma glucose values and concurrent microvascular complications from 4 previous cross-sectional surveys carried out in Singapore (1982-1998) who attended a follow-up examination in 2004-2007.