Epidemiologic merit of obese-years, the combination of degree and duration of obesity

This study aims to test the effect of combining the degree and the duration of obesity into a single variable-obese-years-and to examine whether obese-years is a better predictor of the risk of diabetes than simply body mass index (BMI) or duration of obesity. Of the original cohort of the Framingham Heart Study, 5,036 participants were followed up every 2 years for up to 48 years (from 1948). The variable, obese-years, was defined by multiplying for each participant the number of BMI units above 30 kg/m(2) by the number of years lived at that BMI. Associations with diabetes were analyzed by using time-dependent Cox proportional hazards regression models adjusted for potential confounders. The incidence of type-2 diabetes increased as the number of obese-years increased, with adjusted hazard ratios of 1.07 (95% confidence interval: 1.06, 1.09) per additional 10 obese-years. The dose-response relation between diabetes incidence and obese-years varied by sex and smoking status. The Akaike Information Criterion was lowest in the model containing obese-years compared with models containing either the degree or duration of obesity alone. A construct of obese-years is strongly associated with risk of diabetes and could be a better indicator of the health risks associated with increasing body weight than BMI or duration of obesity alone.

Comparing trends in BMI and waist circumference

The nature of excess body weight may be changing over time to one of greater central adiposity. The aim of this study is to determine whether BMI and waist circumference (WC) are increasing proportionately among population subgroups and the range of bodyweight, and to examine the public health implications of the findings. Our data are from two cross-sectional surveys (the US National Health and Nutrition Examination Studies (NHANES) in 1988–1994 (NHANES III) and 2005–2006), from which we have used samples of 15,349 and 4,176 participants aged ≥20 years. Between 1988–1994 and 2005–2006 BMI increased by an average of 1.8 kg/m2 and WC by 4.7 cm (adjusted for sex, age, race-ethnicity, and education). The increase in WC was more than could be attributed simply to increases in BMI. This independent increase in WC (of on average, 0.9 cm) was consistent across the different BMI categories, sexes, education levels, and race-ethnicity groups. It occurred in younger but not older age groups. Overall in each BMI category, the prevalence of low-risk WC decreased and the prevalence of increased-risk or substantially increased-risk WC increased. These results suggest that the adverse health consequences associated with obesity may be increasingly underestimated by trends in BMI alone. Since WC is closely linked to adverse cardiovascular outcomes, it is important to know the prevailing trends in both of these parameters.

The effect of modifiable risk factors on geographic mortality differentials : a modelling study

Background Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown.

Methods We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy.

Results Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas--accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men-- accounting for 8.8% and 6.3% respectively-- and only smoking contributing to the difference in women--accounting for 12.3%.

Conclusions These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas. Background: Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown. Methods. We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy. Results: Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas - accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men - accounting for 8.8% and 6.3% respectively - and only smoking contributing to the difference in women - accounting for 12.3%. Conclusions: These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas.

SAS macros for point and interval estimation of area under the receiver operating characteristic curve for non-proportional and proportional hazards Weibull models

Aims and objectives  For prediction of risk of cardiovascular end points using survival models the proportional hazards assumption is often not met. Thus, non-proportional hazards models are more appropriate for developing risk prediction equations in such situations. However, computer program for evaluating the prediction performance of such models has been rarely addressed. We therefore developed SAS macro programs for evaluating the discriminative ability of a non-proportional hazards Weibull model developed by Anderson (1991) and that of a proportional hazards Weibull model using the area under receiver operating characteristic (ROC) curve.

Method  Two SAS macro programs for non-proportional hazards Weibull model using Proc NLIN and Proc NLP respectively and model validation using area under ROC curve (with its confidence limits) were written with SAS IML language. A similar SAS macro for proportional hazards Weibull model was also written.

Results  The computer program was applied to data on coronary heart disease incidence for a Framingham population cohort. The five risk factors considered were current smoking, age, blood pressure, cholesterol and obesity. The predictive ability of the non-proportional hazard Weibull model was slightly higher than that of its proportional hazard counterpart. An advantage of SAS Proc NLP in terms of the example provided here is that it provides significance level for the parameter estimates whereas Proc NLIN does not.

Conclusion  The program is very useful for evaluating the predictive performance of non-proportional and proportional hazards Weibull models.

Projected age- and sex-specific prevalence of cardiovascular diseases in Western Australian adults from 2005-2045

For decades, the incidence and mortality of cardiovascular diseases (CVDs) have declined. More recently, we have seen a halting in these declines, especially at younger ages. It is difficult to predict how these changing trends will impact CVD prevalence. We aimed to predict future prevalence of CVDs in Western Australian adults from 2005-2045 based on current incidence and mortality probabilities, population growth and ageing.

Utilização de nutrientes de dietas contendo mananoligossacarídeo e/ou complexo enzimático para frangos de corte

Avaliaram-se a digestibilidade ileal e a retenção de alguns nutrientes e os valores de energia de dietas contendo mananoligossacarídeo (MOS) e/ou complexo enzimático (CE) para frangos de corte. Foram utilizadas 275 aves em delineamento em blocos ao acaso e arranjo fatorial 2 x 2 + 1, com dois níveis de MOS (0 e 0,1%), dois níveis de complexo enzimático (0 e 0,05%) e uma dieta controle positivo com antibióticos. O óxido crômico (0,5%) foi adicionado às dietas para estimativa do fator de indigestibilidade. O experimento teve início quando as aves completaram 13 dias de idade; a coleta de excretas foi realizada do 20º ao 22º dia e a de digesta, no 23º dia de idade das aves. A interação MOS × CE foi significativa para a retenção de PB e P e de energia metabolizável aparente (EMA), cujos valores foram maiores nas dietas com MOS e CE. A inclusão do CE melhorou a retenção de MS e os coeficientes de digestibilidade ileal de MS, PB, Ca e P na retenção de cálcio e nos valores de energia digestível com a inclusão de mananoligossacarídeo. Os coeficientes de digestibilidade ileal da MS, a retenção de MS, PB, Ca e P e os valores de energia digestível e de EMA das dietas contendo MOS e/ou CE foram superiores aos obtidos com a dieta contendo antibióticos.

Mananoligossacarídeos e complexo enzimático em dietas para frangos de corte

Avaliou-se o efeito de dietas com mananoligossacarídeos e complexo enzimático (CE) sobre o desempenho, a morfologia intestinal e a qualidade da cama de frangos aos 42 dias de idade. Foram utilizadas 750 aves em delineamento inteiramente casualizado em esquema fatorial 2 × 2 + 1, com dois níveis de mananoligossacarídeos (0 e 0,1% de 1 a 21 dias e 0,05% de 22 a 42 dias de idade), dois níveis de complexo enzimático (0 e 0,05%) e uma dieta com antibióticos (CP), totalizando cinco dietas com cinco repetições. Aos 42 dias de criação, o desempenho foi avaliado e, após o abate das aves, foram coletadas amostras de intestino e de cama e avaliado o desempenho. A inclusão de mananoligossacarídeos e/ou complexo enzimático na dieta não afetou o desempenho das aves, o perímetro e a altura dos vilos duodenais, a profundidade de criptas, a densidade de vilos no duodeno, jejuno e íleo, os teores de matéria seca e nitrogênio total e o pH das camas. A interação mananoligossacarídeos × complexo enzimático foi significativa para perímetro e altura de vilos no jejuno, que foram maiores nas aves alimentadas com as rações sem complexo enzimático e mananoligossacarídeos, mesmo comportamento observado para perímetro e altura de vilos ileais. Entretanto, quando adicionados mananoligossacarídeos e complexo enzimático, os valores dessas variáveis reduziram. A volatilização de amônia aumentou em camas de frango tratados com antibióticos e diminuiu com a adição de mananoligossacarídeos à dieta. A adição de mananoligossacarídeos ou complexo enzimático às dietas aumentou o perímetro e altura de vilos da mucosa do jejuno e do íleo e reduziu a volatilização de amônia da cama.

Mananoligossacarídeos em dietas para frangos de corte

Objetivou-se avaliar dietas contendo mananoligossacarídeos (MOS) como aditivo alternativo aos promotores de crescimento por meio do estudo da morfometria do intestino e do desempenho de frangos de corte. Para tanto, 1280 pintos de corte foram distribuídos em delineamento inteiramente casualizado com quatro tratamentos (controle negativo, CN: dieta isenta de antibiótico; controle positivo, CP: dieta contendo antibiótico e duas dietas, MOS 1 e MOS 2, nas quais foram adicionadas ao CN duas fontes distintas de MOS) e oito repetições, sendo a unidade experimental composta por 40 aves. Para submeter as aves ao desafio sanitário, foi formulada uma dieta basal com milho, farelo de soja e farinha de carne e ossos. Adotou-se cama reutilizada, limpeza dos bebedouros duas vezes por semana e oferta semanal de água contaminada com cama. Foram avaliadas altura de vilo e profundidade de cripta do duodeno, jejuno e íleo, consumo da dieta, peso médio, ganho de peso e conversão alimentar das aves. Houve melhora na profundidade de cripta no jejuno e na altura de vilo no íleo das aves alimentadas com dietas contendo MOS. A adição de MOS, independente da fonte, resultou em melhor conversão alimentar em relação às aves do CN, sendo similares às aves do CP. Os mananoligossacarídeos podem ser utilizados como aditivo alternativo aos promotores de crescimento em dietas para frangos de corte, porém, dependendo da fonte, esta pode acarretar em pequenas diferenças no desempenho das aves.

Humoral immune response of broilers fed diets containing yeast extract and prebiotics in the prestarter phase and raised at different temperatures

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Functional characterization and target discovery of glycoside hydrolases from the digestome of the lower termite Coptotermes gestroi

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Anti-Candida targets and cytotoxicity of casuarinin isolated from Plinia cauliflora leaves in a bioactivity-guided study

In addition to the bio-guided investigation of the antifungal activity of Plinia cauliflora leaves against different Candida species, the major aim of the present study was the search for targets on the fungal cell. The most active antifungal fraction was purified by chromatography and characterized by NMR and mass spectrometry. The antifungal activity was evaluated against five Candida strains according to referenced guidelines. Cytotoxicity against fibroblast cells was determined. The likely targets of Candida albicans cells were assessed through interactions with ergosterol and cell wall composition, porosity and architecture. The chemical major component within the most active antifungal fraction of P. cauliflora leaves identified was the hydrolysable tannin casuarinin. The cytotoxic concentration was higher than the antifungal one. The first indication of plant target on cellular integrity was suggested by the antifungal activity ameliorated when using an osmotic support. The most important target for the tannin fraction studied was suggested by ultrastructural analysis of yeast cell walls revealing a denser mannan outer layer and wall porosity reduced. It is possible to imply that P. cauliflora targeted the C. albicans cell wall inducing some changes in the architecture, notably the outer glycoprotein layer, affecting the cell wall porosity without alteration of the polysaccharide or protein level. © 2013 by the authors.