RESUMEN
Exposure to anti-retroviral therapy in HIV infection has been associated with hypertension, but whether and to what extent HIV-related factors and anti-retroviral treatment contribute to hypertension is not well defined; in addition, data are particularly scarce in Sub-Saharan Africa. Aim of the study was to investigate prevalence and awareness of hypertension in a cohort of people living with HIV (PLWHIV) on anti-retroviral therapy in rural Tanzania, and to identify possible predictors of hypertension. A cross-sectional study on hypertension in PLWHIV was conducted at Tosamaganga District Hospital, Iringa Region, Tanzania. Subjects on anti-retroviral therapy, age 26-80 years and with monthly attendance to the HIV clinic, were considered eligible. A total number of 242 patients were included in the analysis. Sixty-two subjects (26%) had hypertension, the majority (77%) of them not aware of the condition and/or not on treatment. Older age, higher BMI and lower baseline T-CD4 count were predictors of hypertension at multivariate analysis. The results of the study suggest that hypertension screening should become part of ordinary care of PLWHIV in Tanzania, particularly in subjects with more severe immunosuppression. Leveraging already existing HIV services could be an option to prevent the burden of non-AIDS complication and related deaths.
Asunto(s)
Antirretrovirales , Infecciones por VIH , Hipertensión , Adulto , Humanos , Persona de Mediana Edad , Antirretrovirales/efectos adversos , Estudios Transversales , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Hipertensión/epidemiología , Hipertensión/psicología , Prevalencia , Factores de Riesgo , Tanzanía/epidemiología , Población Rural/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Masculino , FemeninoRESUMEN
BACKGROUND: The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. METHODS: One hundred women (16-44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. RESULTS: Women were divided into "SGA group" vs. "non-SGA group". The MD was adopted by 71% of women and its adherence was higher in the "non-SGA group" (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the "SGA group" (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. CONCLUSIONS: MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.
Asunto(s)
Dieta Mediterránea/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Recién Nacido Pequeño para la Edad Gestacional , Estilo de Vida , Complicaciones del Embarazo/epidemiología , Adolescente , Adulto , Femenino , Edad Gestacional , Ganancia de Peso Gestacional , Humanos , Recién Nacido , Italia/epidemiología , Modelos Logísticos , Fenómenos Fisiologicos Nutricionales Maternos , Política Nutricional , Embarazo , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: COVID-19 pandemic has imposed a period of contingency measures, including total or partial lockdowns all over the world leading to several changes in lifestyle/eating behaviours. This retrospective cohort study aimed at investigating Italian adult population lifestyle changes during COVID-19 pandemic "Phase 1" lockdown (8 March-4 May 2020) and discriminate between positive and negative changes and BMI (body mass index) variations (ΔBMI). METHODS: A multiple-choice web-form survey was used to collect retrospective data regarding lifestyle/eating behaviours during "Phase 1" in the Italian adult population. According to changes in lifestyle/eating behaviours, the sample was divided into three classes of changes: "negative change", "no change", "positive change". For each class, correlations with ΔBMI were investigated. RESULTS: Data were collected from 1304 subjects (973F/331M). Mean ΔBMI differed significantly (p < 0.001) between classes, and was significantly related to water intake, alcohol consumption, physical activity, frequency of "craving or snacking between meals", dessert/sweets consumption at lunch. CONCLUSIONS: During "Phase 1", many people faced several negative changes in lifestyle/eating behaviours with potential negative impact on health. These findings highlight that pandemic exacerbates nutritional issues and most efforts need to be done to provide nutrition counselling and public health services to support general population needs.
Asunto(s)
Índice de Masa Corporal , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Estilo de Vida , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , COVID-19/complicaciones , COVID-19/prevención & control , Niño , Dieta/psicología , Dieta/estadística & datos numéricos , Ingestión de Líquidos , Ejercicio Físico , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Several studies have described a positive association between elevated BMI and birth defects risk. Data on plasma concentration of folate in pregnant women with obesity have shown values far below those recommended, regardless of diet, while folate levels should increase before pregnancy to reduce neural tube defects. We report a descriptive review of the most recent studies (from 2005 to 2015) to evaluate folate status through a population of women of childbearing age affected by obesity. The literature contains few studies, which present conflicting results regarding folate status in non-pregnant women of childbearing age affected by obesity, and it appears that there is a modification in folate metabolism, with a reduction in plasma folate levels and an increase in erythrocyte folate uptake. In conclusion, the folate status in women of childbearing age should be assessed by both plasma and erythrocyte levels to start a personalised and more adequate supplementation before conception. Further studies need to be conducted in a larger population, which take into account variables that can affect folate metabolism, such as dietary intake, lifestyle and genetic factors, oral contraceptives or other drug use, previous weight-loss programmes, or a history of bariatric surgery.