Quantifying urbanisation as a risk factor for non-communicable disease

Aim of this study was to investigate the poorly understood relationship between the process of urbanization and non-communicable diseases (NCDs) in Sri Lanka using a multi-component, quantitative measure of urbanicity.

NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n=4,485/5,000; response rate=89.7%). We constructed a measure of the urban environment for seven areas using a seven-item scale based on data from study clusters to develop an ―urbanicity” scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors.

Among men, urbanicity was positively associated with physical inactivity (OR: 3.22; 2.27 – 4.57), high body mass index (OR: 2.45; 95% CI: 1.88 – 3.20) and diabetes mellitus (OR: 2.44; 95% CI: 1.66 – 3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR: 2.29; 95% CI: 1.64 – 3.21), high body mass index (OR: 2.92;95% CI: 2.41 – 3.55) and diabetes mellitus (OR: 2.10; 95% CI: 1.58 – 2.80).

There is a clear relationship between urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults.

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second (‘expanded’) step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention.

Analysis of serious non-AIDS events among HIV-infected adults at Latin American sites

Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort.

Epigallocatechin-3-gallate induces the apoptosis of hepatocellular carcinoma LM6 cells but not non-cancerous liver cells

Epigallocatechin-3-gallate (EGCG) is a constituent of green tea and has been associated with anticancer activity. In the present study, the inhibitory effect of EGCG on human hepatocellular cancer cells was examined by cell viability assay, in vitro apoptosis assay and cell cycle analysis. In addition, gene expression was measured to elucidate the molecular mechanisms of action of EGCG by mitochondrial membrane potential (MMP) determination and western blot analysis. We demonstrated that EGCG induced apoptosis, decreased mitochondrial membrane potential and promoted G0/G1 phase cell cycle arrest of HCCLM6 cells but not that of non-cancerous liver cells (HL-7702). The EGCG-induced apoptosis of HCCLM6 cells was associated with a significant decrease in Bcl-2 and NF-κB expression. In addition, the expression of Bax, p53, caspase-9 and caspase-3 increased, and cytochrome c was released. These results suggest that EGCG inhibits the progression of cancer through cytocidal activity and that it is a potential therapeutic compound for hepatocellular carcinoma (HCC).

A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control.

BACKGROUND: Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. DISCUSSION: In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.

A computational search for lipases that can preferentially hydrolyze long-chain omega-3 fatty acids from fish oil triacylglycerols

Consumption of long-chain omega-3 fatty acids is known to decrease the risk of major cardiovascular events. Lipases, a class of triacylglycerol hydrolases, have been extensively tested to concentrate omega-3 fatty acids from fish oils, under mild enzymatic conditions. However, no lipases with preference for omega-3 fatty acids selectivity have yet been discovered or developed. In this study we performed an exhaustive computational study of substrate-lipase interactions by docking, both covalent and non-covalent, for 38 lipases with a large number of structured triacylglycerols containing omega-3 fatty acids. We identified some lipases that have potential to preferentially hydrolyze omega-3 fatty acids from structured triacylglycerols. However omega-3 fatty acid preferences were found to be modest. Our study provides an explanation for absence of reports of lipases with omega-3 fatty acid hydrolyzing ability and suggests methods for developing these selective lipases.

Evaluation of a knowledge translation and exchange platform to advance non-communicable disease prevention

Coordinated systems are required to ensure evidence-informed practice and evaluation of community-based interventions (CBIs). Knowledge translation and exchange (KTE) strategies show promise, but these require evaluation. This paper describes implementation and evaluation of COOPS, a national KTE platform to support best practice in obesity prevention CBIs. A logic model guides KTE activities including knowledge brokering, networking, tailored communications, training, and needs assessments. A mixed-methods evaluation includes communications data, knowledge brokering database, annual survey of CBIs, pre- and post-event questionnaires, interviews, social network analysis, and case studies. This evaluation will contribute to understanding the process of implementing a KTE platform with CBIs and its reach, quality and effectiveness.