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BACKGROUND: Lifestyle behavioural risk factors have been linked to increased cardiovascular disease. Recent data have shown increased atherosclerotic cardiovascular disease (ASCVD) burden in Ghana. This study aimed to describe the behavioural and nutritional risk factors for ASCVD among Ghanaians, and how these risk factors vary by ethnicity, demography and residence. METHODS: We used data from the Ghana Heart Study, a community-based cross-sectional study that recruited participants from eight communities from four regions using a multi-stage sampling technique. Information about various lifestyle behaviours (LBs), including cigarette smoking, alcohol intake, physical inactivity, and fruit and vegetable intake, was obtained using a questionnaire. Data was analysed using IBM SPSS statistics 25. Univariate and multivariate analysis was used to test associations between demographic characteristics and various LBs. RESULTS: The participants' median (interquartile) age was 46.0 (27.0) years. Of the 1,106 participants (58% females, 80.4% urban dwellers), 8.6% reported using tobacco, 48.9% alcohol, 83.7% physically inactive, 81.4% and 84.9% inadequate fruit and vegetable intake, respectively. Age, sex, ethnicity, and religion were associated with tobacco use, whereas age, sex, educational level, marital status, ethnicity, employment status, and region of residence were associated with physical inactivity. Similarly, ethnicity, employment status, and residence region were associated with inadequate fruit and vegetable intake. Rural dwellers were more likely to be physically inactive and consume inadequate fruits and vegetables. Almost 92% had a combination of two or more LBs. The main predictors of two or more LBs for ASCVD were educational level, marital status, ethnicity, and employment status. CONCLUSION: Lifestyle risk factors for ASCVD were highly prevalent in Ghana, with significant age, sex, ethnic, and regional differences. These risky lifestyle behaviors tend to occur together and must be considered in tailoring public health education. TRIAL REGISTRATION: The study was registered at http://www.chictr.org.cn as ChiCTR1800017374.

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BACKGROUND: Umbilical cord blood transplantation (UCBT) is a curable therapy for hematological disease; however, the impact of nutritional status on UCBT outcomes remains controversial. To evaluate the joint effect of clinical characteristics and nutritional status on the prognosis of patients who underwent UCBT, we screened various factors to establish a predictive model of overall survival (OS) after UCBT. METHODS: We performed an integrated clinical characteristic and nutritional risk factor analysis and established a predictive model that could be used to identify UCBT recipients with poor OS. Internal validation was performed by using the bootstrap method with 500 repetitions. RESULTS: Four factors, including disease status, conditioning regimen, calf skinfold thickness and albumin level, were identified and used to develop a risk score for OS, which showed a positive predictive value of 84.0%. A high-risk score (≥ 2.225) was associated with inferior 3-year OS post-UCBT [67.5% (95% CI 51.1-79.4%), P = 0.001]. Then, we built a nomogram based on the four factors that showed good discrimination with a C-index of 0.833 (95% CI 0.743-0.922). The optimism-corrected C-index value of the bootstrapping was 0.804. Multivariate analysis suggested that a high calf skinfold thickness (≥ 20.5 mm) and a low albumin level (< 33.6 g/L) conferred poor disease-free survival (DFS). CONCLUSION: The predictive model combining clinical and nutritional factors could be used to predict OS in UCBT recipients, thereby promoting preemptive treatment.

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Introducción: los pacientes sometidos a cirugía mayor abdominal, y más si se trata de pacientes oncológicos, son pacientes en riesgo de desnutrición, lo que conlleva una peor evolución posoperatoria y un aumento de las complicaciones. Objetivos: conocer la prevalencia de la desnutrición en los pacientes sometidos a cirugía de colon y recto en nuestro medio hospitalario e identificar los distintos factores de riesgo de desnutrición. Métodos: estudio de cohortes retrospectivo incluyendo a todos los pacientes intervenidos de cáncer colorrectal de forma programada en nuestro medio hospitalario. Resultados: se incluyeron en el estudio 382 pacientes con una edad media de 69.93 años. Considerando distintos factores de riesgo de desnutrición, obtuvimos que un 50.6 % de los pacientes tenían alterado alguno de los indicadores de riesgo de desnutrición en el momento del ingreso. Las variables que mostraron ser factores independientes relacionados con la desnutrición fueron la edad, la DM, la desnutrición basal y la cardiopatía. La desnutrición preoperatoria resultó ser el factor de mayor riesgo para presentar desnutrición moderada/grave en el posoperatorio con un OR de 3.83 (2.1-6.9; p < 0.001) y además se asoció a una mayor incidencia de complicaciones posoperatorias y a estancias hospitalarias más prolongadas. Obtuvimos que el porcentaje de complicaciones posoperatorias fue significativamente mayor en el grupo de pacientes diagnosticados de desnutrición peroperatoria (36.3 % vs. 22.0 %, p = 0.004). Conclusiones: el porcentaje de desnutrición en los pacientes con cáncer colorrectal es elevado, aspecto subestimado en la mayoría de los servicios quirúrgicos. La desnutrición conlleva en nuestro estudio una peor evolución con un incremento de las complicaciones. (AU)

Introduction: patients undergoing major abdominal surgery, including colorectal surgery, particularly if they are oncological patients, are at risk of Malnutrition with a worse postoperative evolution and an increase in complications. Objectives: to assess the prevalence of Malnutrition in patients undergoing colon and rectal surgery in our hospital, and to identify the different risk factors for Malnutrition. Methods: a retrospective cohort study including all patients operated on for colorectal cancer in our environment. Results: a total of 382 patients with a mean age of 69,93 years were included in the study. Considering different risk factors for Malnutrition, we obtained that 50,6 % of the patients had some of the risk indicators for Malnutrition altered at the time of admission. The variables that proved to be independent factors related to Malnutrition were age, DM, baseline Malnutrition, and heart disease. Preoperative Malnutrition turned out to be the greatest risk factor for presenting moderate/severe Malnutrition in the postoperative period with an OR of 3,83 (2,1-6,9; p < 0,001), and was also associated with a higher incidence of postoperative complications and longer hospital stays. We obtained that the percentage of postoperative complications was significantly higher in the group of patients diagnosed with peroperative Malnutrition (36,3 % vs 22,0 %, p = 0,004). Conclusions: the percentage of Malnutrition in patients with colorectal cancer is high, an aspect that is underestimated in most surgical services. In our study, Malnutrition leads to worse outcomes with an increase in complications. (AU)

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AIM: The combination of iron deficiency and anaemia is a major health problem, and adolescents are an at-risk group. The main aim of this study was to explore the magnitude of these conditions among adolescents aged 15-19 and identify possible associated risk factors. METHODS: This population-based longitudinal study of adolescents in North Norway was conducted in 2010-2011, with a follow-up two years later. Repeated measurements of iron deficiency and anaemia and its possible risk factors were studied in 309 girls and 273 boys. RESULTS: Iron deficiency and anaemia were found in 18.1% and 19.9% of girls and 1.6% and 2.9% of boys in the first study and about half of the cases were chronic two years later. Most girls had moderate iron deficiency (14.5%) and mild anaemia (16.0%). Daily milk consumption was associated with increased iron deficiency in girls (odds ratio 2.3, 95% confidence interval 1.1-4.9), and the most physically active girls had the lowest levels of iron deficiency (odds ratio 0.4, 95% confidence intervaI 0.2-0.9). Iron deficiency was the most important risk factor for chronic anaemia in girls. CONCLUSION: The results of this study highlight the importance of iron deficiency screening and treatment for adolescent girls.

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BACKGROUND: The consumption of dairy products in pregnancy is widely extended. However, whether the consumption of low or high fat dairy produce is more beneficial for maternofetal health has yet to be established. RESEARCH DESIGN AND METHODS: This prospective cohort study evaluated the effect of consumption of dairy products during pregnancy on the frequency of gestational diabetes mellitus (GDM) and a composite of adverse maternofetal outcomes (CMFO). Pregnant women receiving obstetric care between 2014 and 2017 were eligible. Those who consumed ≥3 servings/day of dairy products at 24-28 gestational weeks (GWs) were included and analyzed (n=2004). The population was stratified into three groups according to intake of fat-free dairy products-skimmed milk and fat-free yoghurt and cheese-(days/week): infrequent (1-2), average (3-6) and regular (7). Logistic regression analysis compared ORs (95% CI) for GDM and CMFO between the three groups (where the group of reference was the 'infrequent' intake group). RESULTS: After adjusting for confounding factors, no significant associations were found between the degree of consumption of fat-free dairy products and the risk of GDM and a CMFO. Moreover, when categorized by the degree of adherence to the Mediterranean diet (above or below the median score), associations were found between the 'regular' intake group and an increased risk of having a CMFO in women with a high adherence to the Mediterranean diet (OR: 1.50; 95% CI: 1.01 to 2.22; p<0.05). Weight gain during pregnancy did not differ among groups. CONCLUSIONS: The consumption of fat-free dairy products during pregnancy does not seem to be beneficial for maternofetal health.

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While breast cancer is the most common cancer in women around the world, it is necessary to know the nutritional factors that can have both protective and negative effects on the risk of breast cancer. Unfortunately, the results of the research still do not give a definite answer to the question: which food products or food ingredients reduce, and which increase the risk of breast cancer. At a time when the main source of knowledge of health for the majority of society is the internet, myths about this disease are still being replicated. Only on the basis of clear scientific evidence can we build an effective prevention program that can save millions of women from breast cancer. In this review, we decided to present nutritional risk factors whose impact on the risk of breast cancer was examined, however, the results are not conclusive, like: fibre, milk products

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With the focus of care shifting from the hospital to the community, supportive nutritional care to old people is to become an important issue to address in the community, since undernutrition has serious consequences, both for the quality of life and for the health care costs. Several modifiable nutritional risk factors relate to undernutrition. Unfortunately, the problem with (risk of) undernutrition is aggravated due to a lack of alertness among e.g. health care staff, leading to insufficient attention for systemic screening and nutritional care. Only a few of the existing screening tools have been validated among old people receiving support at home. Few studies have assessed the beneficial effect of nutritional support among old people in their own home, and recently, it was concluded that such have shown limited effects. One reason may be that the nutritional interventions performed have not taken the multiple nutritional risk factors afore-mentioned into consideration when formulating the action/treatment plan and hence not used a multidisciplinary approach. Another reason may be that the intervention studies have not used validated screening tools to identify those old people most likely to benefit from the nutritional support. However, three recent studies have used a multidisciplinary approach and two have proven a beneficial effect on the quality of life of the old people and the health care costs. These findings suggest that when planning nutritional intervention studies for old people receiving support at home, modifiable nutritional risk factors should be taken into consideration, and a multidisciplinary approach considered.

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To study the nutritional risk factors and status of serum 25(OH)D levels in patients with breast cancer. A total of 100 women (cases) with confirmed breast cancer (BC) matched with equal number of healthy females (controls) of similar age and socioeconomic status (SES) were included in study. Controls included were nonbreast cancer patients who accompanied the patients to a tertiary care hospital. All the subjects (cases and controls) were administered a questionnaires to collect data on socioeconomic status, dietary pattern and the frequency of food consumption using a validated food frequency questionnaire. Anthropometric assessment was done for waist and hip circumference to calculate waist to hip ratio (WHR). Non fasting blood samples were collected for serum 25-hydroxyvitamin D [25(OH)D] levels estimation using chemiluminescent immunoassay technique and total serum calcium levels by colorimetric assay technique. Serum 25(OH)D and total calcium levels were expressed in ng/ml and mg/dl. Vitamin D deficiency was defined as per the guidelines set by United States Endocrine Society. The mean age of cases and controls was 45±9 and 46±10 years respectively. On multivariate analysis, an inverse association with BC was found for less frequency of fruits consumption with an adjusted (ORs, 95% CI) (2.7, 0.5-15.7) respectively. Mushroom intake was inversely associated with risk of BC (ORs, 95% CI) (5.6, 1.9-16.6). Saturated fat intake and high WHR were significantly associated with high risk of BC with adjusted ORs, 95% CI of (3.4, 1.4-8.1) and (5, 1.4-17). A significant association (p<0.05) was found between low serum 25(OH)D levels and the risk of BC with adjusted ORs, 95% CI of (2.5, 0.9-7.4). Majority of the patients with BC were suffering from vitamin D deficiency. Dietary intake of mushrooms containing vitamin D naturally was found to be associated with decreased risk of breast cancer. A significant association was found between low serum 25(OH)D levels (<20ng/ml) with the risk of BC. Obesity as a consequence of nutritional risk factors determined by higher WHR was found to be significantly associated with the risk of BC.

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BACKGROUND: In this study, we aimed to determine comprehensive maternal characteristics associated with birth weight using Bayesian modeling. MATERIALS AND METHODS: A total of 526 participants were included in this prospective study. Nutritional status, supplement consumption during the pregnancy, demographic and socioeconomic characteristics, anthropometric measures, physical activity, and pregnancy outcomes were considered as effective variables on the birth weight. Bayesian approach of complex statistical models using Markov chain Monte Carlo approach was used for modeling the data considering the real distribution of the response variable. RESULTS: There was strong positive correlation between infant birth weight and the maternal intake of Vitamin C, folic acid, Vitamin B3, Vitamin A, selenium, calcium, iron, phosphorus, potassium, magnesium as micronutrients, and fiber and protein as macronutrients based on the 95% high posterior density regions for parameters in the Bayesian model. None of the maternal characteristics had statistical association with birth weight. CONCLUSION: Higher maternal macro- and micro-nutrient intake during pregnancy was associated with a lower risk of delivering low birth weight infants. These findings support recommendations to expand intake of nutrients during pregnancy to high level.