The epidemiologic transition to chronic diseases in developing countries: cardiovascular mortality, morbidity, and risk factors in Seychelles (Indian Ocean).

The occurrence of cardiovascular diseases (CVD) and related risk factors was evaluated in Seychelles, a middle level income country, as accumulating evidence supports increasing rates of CVD in developing countries. CVD mortality was obtained from vital statistics for two periods, 1984-5 and 1991-3. CVD morbidity was estimated by retrospective review of discharge diagnoses for all admissions to medical wards in 1990-1992. Levels of CVD risk factors in the population were assessed in 1989 through a population-based survey. In 1991-93, standardized mortality rates were in males and females respectively, 80.9 and 38.8 for cerebrovascular disease and 92.9 and 47.0 for ischemic heart disease. CVD accounted for 25.2% of all admissions to medical wards. Among the general population aged 35-64, 30% had high blood pressure, 52% of males smoked, and 28% of females were obese. These findings substantiate the current health transition to CVD in Seychelles. More generally, epidemiologic data on CVD mortality, morbidity, and related risk factors, as well as similar indicators for other chronic diseases, should more consistently appear in national and international reports of human development to help emphasize, in the health policy making scene, the current transition to chronic diseases in developing countries and the subsequent need for appropriate control and prevention programs.

Geology of the NW Indian Himalaya

This review paper deals with the geology of the NW Indian Himalaya situated in the states of Jammu and Kashmir, Himachal Pradesh and Garhwal. The models and mechanisms discussed, concerning the tectonic and metamorphic history of the Himalayan range, are based on a new compilation of a geological map and cross sections, as well as on paleomagnetic, stratigraphic, petrologic, structural, metamorphic, thermobarometric and radiometric data. The protolith of the Himalayan range, the North Indian flexural passive margin of the Neo-Tethys ocean, consists of a Lower Proterozoic basement, intruded by 1.8-1.9 Ga bimodal magmatites, overlain by a horizontally stratified sequence of Upper Proterozoic to Paleocene sediments, intruded by 470-500 Ma old Ordovician mainly peraluminous s-type granites, Carboniferous tholeiitic to alkaline basalts and intruded and overlain by Permian tholeiitic continental flood basalts. No elements of the Archaen crystalline basement of the South Indian shield have been identified in the Himalayan range. Deformation of the Himalayan accretionary wedge resulted from the continental collision of India and Asia beginning some 65-55 Ma ago, after the NE-directed underthrusting of the Neo-Tethys oceanic crust below Asia and the formation of the Andean-type 103-50 (-41) Ma old Ladakh batholith to the north of the Indus Suture. Cylindrical in geometry, the Himalayan range consists, from NE to SW, from older to younger tectonic elements, of the following zones: 1) The 25 km wide Ladakh batholith and the Asian mantle wedge form the backstop of the growing Himalayan accretionary wedge. 2) The Indus Suture zone is composed of obducted slices of the oceanic crust, island arcs, like the Dras arc, overlain by Late Cretaceous fore arc basin sediments and the mainly Paleocene to Early Eocene and Miocene epi-sutural intra-continental Indus molasse. 3) The Late Paleocene to Eocene North Himalayan nappe stack, up to 40 km thick prior to erosion, consists of Upper Proterozoic to Paleocene rocks, with the eclogitic and coesite bearing Tso Morari gneiss nappe at its base. It includes a branch of the Central Himalayan detachment, the 22-18 Ma old Zanskar Shear zone that is intruded and dated by the 22 Ma Gumburanjun leucogranite; it reactivates the frontal thrusts of the SW-verging North Himalayan nappes. 4) The late Eocene-Miocene SW-directed High Himalayan or ``Crystalline'' nappe comprises Upper Proterozoic to Mesozoic sediments and Ordovician granites, identical to those of the North Himalayan nappes. The Main Central thrust at its base was created in a zone of Eocene to Early Oligocene anatexis by ductile detachment of the subducted Indian crust, below the pre-existing 25-35 km thick NE-directed Shikar Beh and SW-directed North Himalayan nappe stacks. 5) The late Miocene Lesser Himalayan thrust with the Main Boundary Thrust at its base consists of early Proterozoic to Cambrian rocks intruded by 1.8-1.9 Ga bimodal magmatites. The Subhimalaya is a thrust wedge of Himalayan fore deep basin sediments, composed of the Early Eocene marine Subathu marls and sandstones as well as the up to 8'000 m-thick Miocene to recent Ganga molasse, a coarsening upwards sequence of shales, sandstones and conglomerates. The active frontal thrust is covered by the sediments of the Indus-Ganga plains.

Patterns of alcohol consumption in the Seychelles Islands (Indian Ocean).

Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week ('regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages.

Secular trends in height and weight among children and adolescents of the Seychelles, 1956-2006.

BACKGROUND: Height of individuals has long been considered as a significant index of nutrition and health of a population; still, there is little information regarding the trends of height and weight among developing or transitional countries. We assessed the secular trends in height and weight in children of the Seychelles, a rapidly developing island state in the Indian Ocean (African region). METHODS: Height and weight were measured in all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th grades) for the periods 1998-9 (6391 children) and 2005-6 (8582 children). Data for 1956-7 was extracted from a previously published report. RESULTS: At age 15.5 years, boys/girls were on average 10/13 cm taller and 15/9 kg heavier in 2005-6 than in 1956-7. Height increased in boys/girls by 1.62/0.93 cm/decade between 1956-7 and 1998-9 and by 1.14/1.82 cm/decade between 1998-9 and 2005-6. For weight, the linear increase in boys/girls was 1.38/1.10 kg/decade between 1956-7 and 1998-9 and 2.21/2.50 kg/decade between 1998-9 and 2005-6. Overall, the relative increase in weight between 1956-7 and 2005-6 was 5-fold higher than the relative increase in height. CONCLUSION: Height and weight increased markedly over time in children aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50-year interval. The markedly steeper increase in weight than height over time is consistent with an epidemic of overweight and obesity.

Prevalence and determinants of obesity in children in public schools of Sintra, Portugal

OBJECTIVE: To assess the prevalence of and the factors related to overweight and obesity in a sample of children from the region of Sintra, Portugal. METHODS AND PROCEDURES: Cross-sectional study, stratified for freguesia with random selection of schools. Height, weight, triceps skinfold, upper arm and waist circumferences were measured, and overweight/obesity defined according to international criteria. Breast-feeding, number of daily meals and parents' height and weight data were also collected. RESULTS: One thousand two hundred and twenty-five children aged 6-10 years were assessed. Overall prevalence of overweight and obesity was 35.6% (23% overweight and 12.6% obesity). Overweight or obese children had higher triceps skinfold, upper arm circumference, arm muscle area, and waist circumference than their normal weight counterparts (P < 0.001). On multivariate analysis, relatively to a child without obese progenitors, a child with one obese progenitor had an obesity risk multiplied by 2.78 (95% confidence interval (CI): 1.76-4.38), while a child with two obese progenitors had a risk multiplied by 6.47 (95% CI: 5.59-16.19). Conversely, being picky was significantly related with a smaller risk of obesity: for boys, odds ratio (OR) = 0.15 (95% CI: 0.04-0.63); for girls, OR = 0.19 (95% CI: 0.06-0.64). Finally, no relationships were found between obesity, birth weight, birth height or breast-feeding. DISCUSSION: Prevalence of overweight and obesity are elevated among children of the Sintra region in Portugal compared to most other regions of Europe. The relationship with the parents' nutritional state stresses the need to target families for preventing obesity.

Association between growth and blood pressure during the life course in children and adolescents

Background: Little is known on the relative importance of growth at different periods between birth and adolescence on blood pressure (BP). Objective: To assess the association between birth weight, change in body weight (growth) and BP across the entire span of childhood and adolescence. Methods: School-based surveys were conducted annually between 1998 and 2006 among all children in four school grades (kindergarten, 4th, 7th, and 10th year of compulsory school) in the Seychelles, Indian Ocean. Height and weight and BP were measured. Three cohorts of children examined twice were analyzed: 1606 children surveyed at age 5.5 and 9.1, 2557 at age 9.2 and 12.5, and 2065 at age 12.5 and 15.5, respectively. Weights at birth and at one year were extracted from medical files. Weights were expressed as Z-scores and growth was defined as a change in weight Z-scores (corresponding to weight centile crossing). The association between BP (at age 5.5, 9.2, 12.5, and 15.5) and weight at different times was assessed by linear regression. Using results of regression models of BP on all successive weights, life course plots were drawn by plotting regression coefficients against age at which weight was measured. The figure shows a life course plot of systolic BP in boys aged 15.5. Results: Without adjustment for current weight (at the time of BP measurement), birth weight was not associated with current BP, irrespective of age, excepted for girls at age 15.5 for whom a modest positive association was found. When adjusted for current weight, birth weight was negatively and modestly associated with current BP. BP was strongly associated with current weight, irrespective of age. Life course plots showed that BP was strongly associated with growth during the few preceding years but not with growth during earlier years, except for growth during the first year of life which tended to be associated with systolic BP. Conclusions: Our findings suggest that BP during childhood and adolescence is mainly determined by current body weight and recent growth.

Structural, metamorphic and geochronological relations between the Zanskar Shear Zone and the Miyar Shear Zone (NW Indian Himalaya): Evidence for two distinct tectonic structures and implications for the evolution of the High Himalayan Crystalline of Zanskar

The geologic structures and metamorphic zonation of the northwestern Indian Himalaya contrast significantly with those in the central and eastern parts of the range, where the high-grade metamorphic rocks of the High Himalayan Crystalline (HHC) thrust southward over the weakly metamorphosed sediments of the Lesser Himalaya along the Main Central Thrust (MCT). Indeed, the hanging wall of the MCT in the NW Himalaya mainly consists of the greenschist facies metasediments of the Chamba zone, whereas HHC high-grade rocks are exposed more internally in the range as a large-scale dome called the Gianbul dome. This Gianbul dome is bounded by two oppositely directed shear zones, the NE-dipping Zanskar Shear Zone (ZSZ) on the northern flank and the SW-dipping Miyar Shear Zone (MSZ) on the southern limb. Current models for the emplacement of the HHC in NW India as a dome structure differ mainly in terms of the roles played by both the ZSZ and the MSZ during the tectonothermal evolution of the HHC. In both the channel flow model and wedge extrusion model, the ZSZ acts as a backstop normal fault along which the high-grade metamorphic rocks of the HHC of Zanskar are exhumed. In contrast, the recently proposed tectonic wedging model argues that the ZSZ and the MSZ correspond to one single detachment system that operates as a subhorizontal backthrust off of the MCT. Thus, the kinematic evolution of the two shear zones, the ZSZ and the MSZ, and their structural, metamorphic and chronological relations appear to be diagnostic features for discriminating the different models. In this paper, structural, metamorphic and geochronological data demonstrate that the MSZ and the ZSZ experienced two distinct kinematic evolutions. As such, the data presented in this paper rule out the hypothesis that the MSZ and the ZSZ constitute one single detachment system, as postulated by the tectonic wedging model. Structural, metamorphic and geochronological data are used to present an alternative tectonic model for the large-scale doming in the NW Indian Himalaya involving early NE-directed tectonics, weakness in the upper crust, reduced erosion at the orogenic front and rapid exhumation along both the ZSZ and the MSZ.

Prevalence of overweight and underweight in public and private schools in the Seychelles.

Abstract Objective. We compared the prevalence of body weight categories between public and private schools in the Seychelles, a rapidly developing small island state in the African region. Methods. In 2004-2006, weight and height were measured and self-reported information on physical activity collected in children of three selected grades in all schools in the country. Overweight, obesity and thinness were defined according to standard criteria. Results. Based on 8 462 students (377 in private schools), the prevalence of overweight (including obesity) was markedly higher in private than public schools (boys: 37% [95% CI: 31-44] vs. 15% [14-16]; girls: 33% [26-41] vs. 20% [19-22]). The prevalence of thinness grade 1 was lower in private than public schools (boys: 9% [5-13] vs. 20% [19-21]; girls: 13% [8-18] vs. 19% [18-20]). Students in private schools reported more physical activity at leisure time while students in public schools reported larger weekly walking time. Conclusions. Our findings suggest that school type may be a useful indicator for assessing the association between socio-economic status and overweight in children, and that overweight affects wealthy children more often than others in developing countries.

Food traditions and landscape histories of the Indian Ocean World : theoretical and methodological reflections

Environmental histories of plant exchanges have largely centred on their eco- nomic importance in international trade and on their ecological and social impacts in the places where they were introduced. Yet few studies have at- tempted to examine how plants brought from elsewhere become incorporated over time into the regional cultures of material life and agricultural landscapes. This essay considers the theoretical and methodological problems in inves- tigating the environmental history, diversity and distribution of food plants transferred across the Indian Ocean over several millennia. It brings together concepts of creolisation, syncretism, and hybridity to outline a framework for understanding how biotic exchanges and diffusions have been translated into regional landscape histories through food traditions, ritual practices and articu- lation of cultural identity. We use the banana plant - which underwent early domestication across New Guinea, South-east Asia and peninsular India and reached East Africa roughly two thousand years ago - as an example for il- lustrating the diverse patterns of incorporation into the cultural symbolism, material life and regional landscapes of the Indian Ocean World. We show that this cultural evolutionary approach allows new historical insights to emerge and enriches ongoing debates regarding the antiquity of the plant's diffusion from South-east Asia to Africa.