Cardiovascular risk status of Afro-origin populations across the spectrum of economic development: findings from the Modeling the Epidemiologic Transition Study.

Background: Cardiovascular risk factors are increasing in most developing countries. To date, however, very little standardized data has been collected on the primary risk factors across the spectrum of economic development. Data are particularly sparse from Africa.

Weight loss in Weight Watchers Online with and without an activity tracking device compared to control: A randomized trial.

Objective: To evaluate a commercial online weight loss program and activity tracker, which are popular but have unknown efficacy.

Methods: Two hundred seventy-nine participants with BMI 27 to 40 kg/m were randomized to 12 months of the Weight Watchers Online program alone (WWO) or with the ActiveLink activity tracking device (WWO+AL) or an online newsletter (Control).

Results: Weight losses at 3 months were significantly greater in WWO (2.

Early Hospital Readmissions and Mortality in Patients With Decompensated Cirrhosis Enrolled in a Large National Health Insurance Administrative Database.

Background: Patients with decompensated cirrhosis have high rates of morbidity and mortality and frequently require hospital admission. Few studies have examined early readmission as an indicator of 90 day and overall mortality. Analysis of large databases is needed to evaluate the association between early readmission and mortality in decompensated cirrhosis.

Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations.

Background: Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone . We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA).

Methods: A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period.

25-Hydroxyvitamin D and blood pressure: a plateau effect in adults with African ancestry living at different latitudes.

Objective: This study examined the association of 25-hydroxyvitamin D [25(OH)D] levels and blood pressure above and below 25(OH)D levels of 20 ng/ml in young adults with African ancestry.

Methods: This cross-sectional analysis utilized data from a pooled sample of 2242 adults with African ancestry from five different latitudes (403 in the United States, 474 in South Africa, 479 in Ghana, 448 in Jamaica, and 438 in Seychelles). Piecewise linear regression models with a single knot were fitted to determine above and below a 25(OH)D level of 20 ng/ml the slope of SBP and DBP while adjusting for covariates including calcium intake and site.

Dietary factors and fibroblast growth factor-23 levels in young adults with African ancestry.

Fibroblast growth factor-23 (FGF23), a phosphaturic hormone secreted mainly by osteocytes, maintains serum phosphate levels within a tight range by promoting phosphaturia. Previous studies have mainly focused on the link between FGF23 levels and dietary intake of phosphate, but other dietary factors may also influence FGF23 levels. This cross-sectional study pooled three populations of young adults with African ancestry (452 in Chicago, IL, USA; 477 in Victoria, Seychelles; and 482 in Kumasi, Ghana) with estimated glomerular filtration rate >80 ml/min/1.

Associations between omega fatty acid consumption and depressive symptoms among individuals seeking behavioural weight loss treatment.

Objective: The typical Western diet is deficient in omega-3 and high in omega-6 fatty acids (FAs). These FAs may play a role in depressive symptoms via inflammatory processes, especially in the context of obesity, a pro-inflammatory state. This study investigated associations between omega-3 and omega-6 FA intake and depressive symptoms in adults seeking behavioural weight loss treatment (BWLT).

Paraneoplastic Demyelinating Neuropathy, a Multifactorial Disease and Approach to Management.

We report a 53-year-old male with demyelinating polyneuropathy due to a paraneo- plastic syndrome from lymphoplasmacytic lymphoma. This syndrome is an immune-mediated event via plasma cell dyscrasia. The patient suffered near quadriplegia requiring prolonged ventilation.

Association of Nasal Mucosal Vascular Alterations, Gastrointestinal Arteriovenous Malformations, and Bleeding in Patients With Continuous-Flow Left Ventricular Assist Devices.

Objectives: This study sought to determine whether the nasal mucosa can serve as a surrogate for evaluating arteriovenous malformations (AVMs) related gastrointestinal (GI) bleeding in patients supported by continuous-flow left ventricular assist devices (CF LVADs).

Background: Bleeding from the mucosal surfaces of GI tract, particularly AVMs, is the most common complication of CF LVAD support. The pathophysiology of AVM formation during CF LVAD support is of critical interest yet poorly understood; in large part because of the length and accessibility of the GI tract.

The social patterning of risk factors for noncommunicable diseases in five countries: evidence from the modeling the epidemiologic transition study (METS).

Background: Associations between socioeconomic status (SES) and risk factors for noncommunicable diseases (NCD-RFs) may differ in populations at different stages of the epidemiological transition. We assessed the social patterning of NCD-RFs in a study including populations with different levels of socioeconomic development.

Methods: Data on SES, smoking, physical activity, body mass index, blood pressure, cholesterol and glucose were available from the Modeling the Epidemiologic Transition Study (METS), with about 500 participants aged 25-45 in each of five sites (Ghana, South Africa, Jamaica, Seychelles, United States).

Obesity-related metabolite profiles of black women spanning the epidemiologic transition.

In developed countries, specific metabolites have been associated with obesity and metabolic diseases, e.g. type 2 diabetes.

Study sensitivity: Evaluating the ability to detect effects in systematic reviews of chemical exposures.

A critical step in systematic reviews of potential health hazards is the structured evaluation of the strengths and weaknesses of the included studies; risk of bias is a term often used to represent this process, specifically with respect to the evaluation of systematic errors that can lead to inaccurate (biased) results (i.e. focusing on internal validity).

ASSOCIATION BETWEEN 25-HYDROXYVITAMIN D AND INTACT PARATHYROID HORMONE LEVELS ACROSS LATITUDE AMONG ADULTS WITH AFRICAN ANCESTRY.

Objective: To compare levels of 25-hydroxyvitamin D (25[OH]D) associated with a plateauing of intact parathyroid (iPTH) across latitudes among adults with African ancestry.

Methods: This study included approximately 500 adults of African ancestry ages 25 to 45 years living in 4 sites: Chicago, Illinois (41°N), Jamaica (17°N), Ghana (6°N), and South Africa (34°S). Multivariate linear regression models, a nonlinear logistic growth curve model, and piecewise linear models with a single knot were fitted to estimate the 25[OH]D level associated with a plateauing of iPTH with adjustment for covariates.

Fibroblast Growth Factor-23 (FGF-23) Levels Differ Across Populations by Degree of Industrialization.

Context: Compensatory increases in fibroblast growth factor 23 (FGF23) with increasing phosphate intake may adversely impact health. However, population and clinical studies examining the link between phosphate intake and FGF23 levels have focused mainly on populations living in highly industrialized societies in which phosphate exposure may be homogenous.

Objective: The objective of the study was to contrast dietary phosphate intake, urinary measures of phosphate excretion, and FGF23 levels across populations that differ by the level of industrialization.

Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans.

Current obesity prevention strategies recommend increasing daily physical activity, assuming that increased activity will lead to corresponding increases in total energy expenditure and prevent or reverse energy imbalance and weight gain [1-3]. Such Additive total energy expenditure models are supported by exercise intervention and accelerometry studies reporting positive correlations between physical activity and total energy expenditure [4] but are challenged by ecological studies in humans and other species showing that more active populations do not have higher total energy expenditure [5-8]. Here we tested a Constrained total energy expenditure model, in which total energy expenditure increases with physical activity at low activity levels but plateaus at higher activity levels as the body adapts to maintain total energy expenditure within a narrow range.

Evidence for daily and weekly rhythmicity but not lunar or seasonal rhythmicity of physical activity in a large cohort of individuals from five different countries.

Background: Biological rhythmicity has been extensively studied in animals for many decades. Although temporal patterns of physical activity have been identified in humans, no large-scale, multi-national study has been published, and no comparison has been attempted of the ubiquity of activity rhythms at different time scales (such as daily, weekly, monthly, and annual).

Methods: Using individually worn actigraphy devices, physical activity of 2,328 individuals from five different countries (adults of African descent from Ghana, South Africa, Jamaica, Seychelles, and the United States) was measured for seven consecutive days at different times of the year.

A comparison of indices of glucose metabolism in five black populations: data from modeling the epidemiologic transition study (METS).

Background: Globally, Africans and African Americans experience a disproportionate burden of type 2 diabetes, compared to other race and ethnic groups. The aim of the study was to examine the association of plasma glucose with indices of glucose metabolism in young adults of African origin from 5 different countries.

Methods: We identified participants from the Modeling the Epidemiologic Transition Study, an international study of weight change and cardiovascular disease (CVD) risk in five populations of African origin: USA (US), Jamaica, Ghana, South Africa, and Seychelles.

Indwelling peritoneal catheters in patients with cirrhosis and refractory ascites.

Background: The prevalence of spontaneous bacterial peritonitis (SBP) in hospitalised cirrhotics with ascites is 10-30%. Treatment for refractory ascites includes paracenteses, transjugular intrahepatic portosystemic shunt or drain placement; the latter is discouraged due to a perceived infection risk.

Aim: This study aimed to evaluate the risk of bacterial peritonitis (BP) with peritoneal drains in patients with Child-Pugh class B or C cirrhosis and determine their impact on survival.

Daily activity patterns of 2316 men and women from five countries differing in socioeconomic development.

Daily rhythmicity in the locomotor activity of laboratory animals has been studied in great detail for many decades, but the daily pattern of locomotor activity has not received as much attention in humans. We collected waist-worn accelerometer data from more than 2000 individuals from five countries differing in socioeconomic development and conducted a detailed analysis of human locomotor activity. Body mass index (BMI) was computed from height and weight.

Seasonal variation in natural abundance of 2H and 18O in urine samples from rural Nigeria.

The doubly labeled water (DLW) method is used to measure free-living energy expenditure in humans. Inherent to this technique is the assumption that natural abundances of stable isotopes (2)H and (18)O in body water remain constant over the course of the measurement period and after elimination of the loading dose of DLW will return to the same predose level. To determine variability in the natural abundances of (2)H and (18)O in humans living in a region with seasonal shifts in rain patterns and sources of drinking water, over the course of 12 mo we collected weekly urine samples from four individuals living in southwest Nigeria as well as samples of their drinking water.

Association of car ownership and physical activity across the spectrum of human development: Modeling the Epidemiologic Transition Study (METS).

Background: Variations in physical activity (PA) across nations may be driven by socioeconomic position. As national incomes increase, car ownership becomes within reach of more individuals. This report characterizes associations between car ownership and PA in African-origin populations across 5 sites at different levels of economic development and with different transportation infrastructures: US, Seychelles, Jamaica, South Africa, and Ghana.