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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 35527

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Dr. Daniel Boateng

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Guest Editor

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
Interests: Migration, Cardiovascular disease, Implementation Science, Global health, Multimorbidity, Low- and middle-income countries

Dr. Hibbah Araba Osei-Kwasi

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Guest Editor

Department of Geography, University of Sheffield, Sheffield S10 2TN, UK
Interests: Migration, Diet-related Noncommunicable Diseases, Acculturation, Nutrition Transition in Low and middle -income countries, food security

Special Issue Information

Dear Colleagues,

Migration has been an important human activity since ancient times. Yearly, the number of migrants across the globe continues to rise, and currently, there are more people than ever who live in a country other than the one which they were born (https://www.un.org/en/sections/issues-depth/migration/index.html). Migrants’ health is an important public health issue, and for the first time, the 2030 Agenda for Sustainable Development recognizes the important contribution of migration to sustainable development, with 11 out of the 17 Sustainable Development Goals (SDGs) having targets and indicators that are relevant to migration or mobility. There is growing evidence supporting the role of migration in the development of non-communicable diseases (NCDs), including cardiovascular diseases (CVD), obesity and diabetes (Bo, Zinckernagel, Krasnik, Petersen, and Norredam, 2015). While most evidence points to worse CVD and diabetes outcomes among migrants, there are few that show better CVD risk profile among migrants than the host population (Tu et al., 2015). This shows the role of diverse factors in explaining the differences in CVD risk among migrant populations.

The complex interplay between origin, epidemiologic, and socioeconomic transitions results in differences in disease risk and prevalence between and within populations. Migrant populations carry along disease characteristics, inherited from their place of origin (Bedi, Singh, Syed, Aryafar, and Arora, 2006) which affect future health risk. As migrants are exposed to new factors (including acculturative stress resulting from the feeling of isolation, discrimination, alienation and dislocation, lifestyle changes and adaptations, and access to healthcare) in their host environment, their risk of CVDs and diabetes may change over time. Current research has, however, not been able to completely unravel the effect of migration on CVDs and diabetes. This Special Issue invites papers addressing the burden and risk factors of CVDs, obesity, and diabetes among migrants globally.

Dr. Daniel Boateng
Dr. Hibbah Araba Osei-Kwasi
Guest Editors

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Keywords

migration
migrants
cardiovascular disease
diabetes
obesity
acculturation
dietary changes
non-communicable diseases

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Published Papers (11 papers)

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Research

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12 pages, 1107 KiB

Open AccessArticle

Association of Longitudinal Nutrient Patterns with Body Composition in Black Middle-Aged South African Women: A Five-Year Follow-Up Study

by Caroline B. T. Makura-Kankwende, Philippe J. Gradidge, Nigel J. Crowther, Tshifhiwa Ratshikombo, Julia H. Goedecke, Lisa K. Micklesfield, Shane A. Norris and Tinashe Chikowore

Int. J. Environ. Res. Public Health 2022, 19(19), 12792; https://doi.org/10.3390/ijerph191912792 - 6 Oct 2022

Cited by 1 | Viewed by 1555

Abstract

This study aimed to evaluate the association of longitudinal nutrient patterns with body composition in a cohort of 132 black South African middle-aged women over five years. Nutrient patterns were identified using principal component analysis at baseline and follow-up 5 years later. Associations between nutrient patterns and repeated body composition measures were evaluated using generalized estimating equations, before and after adjusting for baseline education and repeated measures of age, socio-economic status, physical activity and employment. The animal-driven nutrient pattern was associated with increases in repeated measures of visceral adipose tissue (VAT) (β coefficient, 5.79 [95% CI, 0.01–11.57] cm²), fat mass index (FMI) (0.47 [0.01–0.93] kg·m⁻²) and lean mass index (LMI) (0.50 [0.18–1.17] kg·m⁻²) (p < 0.05) after adjustment. Vitamin C, sugar, and potassium-driven nutrient pattern was associated with higher FMI (0.50 [0.12–0.88] kg·m⁻²) and LMI (0.58 [0.07–1.10] kg·m⁻²) before and after adjustment (p < 0.05). These findings suggest that dietary interventions to curb obesity in black middle-aged South African women should focus on attenuation of nutrient patterns centred on added sugar, animal fat and animal protein. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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14 pages, 1580 KiB

Open AccessArticle

Risk Factors Attributable to Hypertension among HIV-Infected Patients on Antiretroviral Therapy in Selected Rural Districts of the Eastern Cape Province, South Africa

by Urgent Tsuro, Kelechi E. Oladimeji, Guillermo-Alfredo Pulido-Estrada and Teke R. Apalata

Int. J. Environ. Res. Public Health 2022, 19(18), 11196; https://doi.org/10.3390/ijerph191811196 - 6 Sep 2022

Cited by 6 | Viewed by 2943

Abstract

Background: Antiretroviral therapy has improved HIV patients’ quality of life and life expectancy. However, complications have emerged in the form of hypertension. In the rural Eastern Cape, there is minimal information about HIV-infected people. The current study intended to evaluate the factors associated with hypertension in HIV-infected individuals receiving antiretroviral therapy in rural areas of South Africa’s Eastern Cape. Methods: For this cohort study, HIV-positive people taking antiretroviral therapy aged 15 and up were recruited at random from several rural locations in the Eastern Cape. Using Cox univariate and multivariate analyses, the key predictors of hypertension were found. Results: Of the total participants (n = 361), 53% of individuals had hypertension. In the Cox multivariate model, patients that had hypertension heredity, BMI ≥ 25 kg/m², eGFR < 60 mL/min/1.73 m², advanced and severe CD4 counts, 1TFE and 1T3E regimens, and the male gender were found to be at greater risk of hypertension. Conclusions: The findings of this study indicate that hypertension is a prevalent concern among HIV patients receiving antiretroviral therapy. HIV patients should have their blood pressure checked regularly, and they should be screened for high blood pressure and given treatment for it. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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8 pages, 453 KiB

Open AccessArticle

Acculturation Profiles of Weight Perception Status among US Foreign-Born Hispanic/Latino Adults: A Mixture Model Approach

by Kevin Villalobos, Francisco A. Montiel Ishino and Faustine Williams

Int. J. Environ. Res. Public Health 2022, 19(15), 9704; https://doi.org/10.3390/ijerph19159704 - 6 Aug 2022

Viewed by 1900

Abstract

The objective of this study was to identify profiles of acculturation and weight-by-weight perception status among United States (US) foreign-born Hispanic/Latino adults using a person-centered approach. We conducted a latent class analysis (LCA) on 1999–2004 National Health and Nutrition Examination Survey (NHANES) data from US foreign-born Hispanic/Latino adults 18 years and older (N = 4944). Acculturation was assessed by self-reported linguistic acculturation questions from the Short Acculturation Scale for Hispanics. Weight was assessed by body mass index (BMI). Covariates included weight perception and sociodemographic factors to compare and further differentiate profiles. Three profiles were identified: bicultural (15% of sample), low acculturation (84%), and non-integrated (1%). All the profiles had a BMI that was considered overweight or obese. The low acculturated profile was less likely (odds ratio (OR): 0.62, 95% confidence interval (CI): 0.43–0.91) to perceive themselves as overweight relative to the bicultural class. The low accultured profile was also more likely to be female and a US citizen (OR: 1.45, 95% CI: 1.09–1.92 and OR: 2.29, 95% CI: 1.57–3.34) in comparison to the bicultural class. Our study is among the first to use LCA to examine weight perception on acculturation status and weight profiles among US foreign-born Hispanic/Latino adults. The findings of our study are a step towards building a foundation to mitigate weight disparities among underserved/underrepresented US foreign-born individuals, especially Hispanics/Latinos. Our results can also inform the development of tailored interventions. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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19 pages, 1802 KiB

Open AccessArticle

Acceptability, Usability and Weight Loss Outcomes in a Randomized Cross-Over Study of Commercially Available Portion Size Tools in an Overweight South Asian Community

by Basma Ellahi, Amanda Aitken, Derya Dikmen, Bilge Seyhan-Erdoğan, Munibah Makda and Rifat Razaq

Int. J. Environ. Res. Public Health 2022, 19(13), 7714; https://doi.org/10.3390/ijerph19137714 - 23 Jun 2022

Cited by 3 | Viewed by 2480

Abstract

South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardiovascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically designed tableware helps individuals to manage weight by controlling food portion sizes. Thirty-one (n = 31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess the efficacy, acceptance, and weight change of two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet diaries. Scores describing acceptance, ease of use, and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p = 0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, and perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group is warranted. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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14 pages, 562 KiB

Open AccessArticle

Drivers to Obesity—A Study of the Association between Time Spent Commuting Daily and Obesity in the Nepean Blue Mountains Area

by Ivan Parise, Penelope Abbott and Steven Trankle

Int. J. Environ. Res. Public Health 2022, 19(1), 410; https://doi.org/10.3390/ijerph19010410 - 31 Dec 2021

Cited by 7 | Viewed by 2563

Abstract

Obesity has become a public health challenge in every country on this planet, with a substantial contribution to global mortality and morbidity. Studies of the built environment have shown some promise in understanding the drivers of this obesity pandemic. This paper contributes to this knowledge, by focusing on one aspect of the urban environment and asking whether there is an association between commuting and obesity in residents of the Nepean Blue Mountains area on the fringes of Sydney. This is a cross-sectional study with obesity being the dependent variable, and commuting the independent variable, where 45 min or less was defined as local and distant commute was more than 45 min. In the sample of 158 respondents, the risk of obesity was twice as likely in the distant commuters than in the local commuters (OR 2.04, 95% CI 1.051 to 3.962, p = 0.034). Investigation of possible mediators of this association was limited by sample size; however, mode of transport was found to be a significant mediator. The results support the design of cities to provide health supporting environments for all residents, including equitable access to employment at a reasonable distance and effective public transport. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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16 pages, 361 KiB

Open AccessArticle

Exploring Factors Associated with Diabetic Retinopathy Treatment Compliance Behaviour in Cape Town, South Africa

by Annalie Wentzel and Zandile June-Rose Mchiza

Int. J. Environ. Res. Public Health 2021, 18(22), 12209; https://doi.org/10.3390/ijerph182212209 - 20 Nov 2021

Cited by 2 | Viewed by 3092

Abstract

Complete patient adherence to treatment for diabetic retinopathy (DR) is critical to limit vision loss. There is a dearth of evidence regarding the reasons why South African patients referred for suspected vision-threatening DR stay compliant to or default their treatment. The current study sought to explore factors associated with treatment compliance among patients living with diabetes who have been referred for suspected vision-threatening DR in the Northern/Tygerberg sub-Structure (NTSS) public health care system of Cape Town, South Africa. A qualitative research approach was used where semi-structured in-depth interviews were conducted with 13 adult patients living with DR, and 2 key informants who are primary eye care providers. Thematic data analysis was conducted using taguette.org. Fear of going blind was the most notable patient-related factor associated with compliance. Notable patient-related barriers reported were forgetfulness and a poor state of health. Notable institution-related barriers included suboptimal information received from health care service providers, poor referral management by the organisation delivering retinal screening services, as well as the inaccessibility of the main NTSS hospital via telephone calls. All these factors were confirmed by the key informants of the current study. Finally, all patients and key informants agreed that SARS-CoV-2 negatively affected patients’ adherence to their DR treatment. Hence, scaling up of health care, referral, and appointment setting services could increase the uptake of treatment and retinal screenings among patients attending the Cape Town, NTSS public health care system. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

17 pages, 583 KiB

Open AccessArticle

Obesity Measures as Predictors of Type 2 Diabetes and Cardiovascular Diseases among the Jordanian Population: A Cross-Sectional Study

by Hana Alkhalidy, Aliaa Orabi, Khadeejah Alnaser, Islam Al-Shami, Tamara Alzboun, Mohammad D. Obeidat and Dongmin Liu

Int. J. Environ. Res. Public Health 2021, 18(22), 12187; https://doi.org/10.3390/ijerph182212187 - 20 Nov 2021

Cited by 7 | Viewed by 3536

Abstract

Obesity is strongly associated with cardiovascular diseases (CVD) and type 2 diabetes (T2D). This study aimed to use obesity measures, body mass index (BMI) and waist circumference (WC) to predict the CVD and T2D risk and to determine the best predictor of these diseases among Jordanian adults. A cross-sectional study was conducted at the governmental and military hospitals across Jordan. The study participants were healthy or previously diagnosed with CVD or T2D. The continuous variables were compared using ANOVA, and the categorical variables were compared using the X2 test. The multivariate logistic regression was used to predict CVD and T2D risk through their association with BMI and WC. The final sample consisted of 6000 Jordanian adults with a mean age of 41.5 ± 14.7 years, 73.6% females. The BMI (OR = 1.7, CI: 1.30–2.30, p < 0.001) was associated with a higher risk of T2D compared to WC (OR = 1.3, CI: 1.04–1.52, p = 0.016). However, our results showed that BMI was not associated with CVD risk, while the WC was significantly and positively associated with CVD risk (OR = 1.9, CI: 1.47–2.47, p < 0.001). In conclusion, an elevated BMI predicts a higher risk of T2D, while WC is more efficient in predicting CVD risk. Our results can be used to construct a population-specific intervention to reduce the risk of CVD and T2D among adults in Jordan and other countries with similar backgrounds. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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10 pages, 688 KiB

Open AccessArticle

The Impact of War-Related Stress on Coronary Artery Disease Severity in War Survivors: A SYNTAX Study

by Hanna Al-Makhamreh, Dana Alkhulaifat, Abdallah Al-Ani, Baraa Mafrachi, Aseel Saadeh, Hashim Al-Ani, Amjad Bani Hani and Saif Aldeen AlRyalat

Int. J. Environ. Res. Public Health 2021, 18(6), 3233; https://doi.org/10.3390/ijerph18063233 - 21 Mar 2021

Cited by 11 | Viewed by 2708

Abstract

Background: Due to the strong relationship between stress and heart disease, particularly acute myocardial infarction (MI), this study investigated the complexity of coronary artery disease (CAD) among Syrian refugee patients referred to Jordan University Hospital and its relation to war-related stressors. Methods: This is a retrospective study that utilized the SYNTAX I score in order to evaluate all Syrian refugees that underwent coronary artery catheterization at Jordan University Hospital during the period between May of 2014 and December of 2017. Results: There was a significant association between war-related stressors and high SYNTAX score (SX score), thus indicating a higher complexity of CAD in Syrian war survivors with higher stress scores. The strongest war-related correlation was observed with crossing green-lines, in which Syrian refugee patients who had crossed such lines had significantly higher SYNTAX scores. Regression analysis demonstrated that war stressors were positive predictors of increased SYNTAX scores even when adjusted for conventional CAD risk factors. Surprisingly, none of the CAD risk factors were significantly associated with SYNTAX score. Conclusion: Our findings suggest that exposure to multiple war-related stressors may increase the complexity and severity of CAD in Syrian war survivors. Thus, special attention, efforts, and resources should be allocated to screen for such vulnerable patients in order to provide them with the appropriate healthcare. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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13 pages, 760 KiB

Open AccessArticle

Association between Practising Religion and Cardiovascular Disease Risk among Ghanaian Non-Migrants and Migrants in Europe: The RODAM Study

by Jessica Michgelsen, Daniel Boateng, Karlijn A.C. Meeks, Erik Beune, Juliet Addo, Silver Bahendeka, Karien Stronks and Charles Agyemang

Int. J. Environ. Res. Public Health 2021, 18(5), 2451; https://doi.org/10.3390/ijerph18052451 - 2 Mar 2021

Cited by 2 | Viewed by 2400

Abstract

(1) Background: Sub-Saharan African migrants residing in high-income countries are more affected by cardiovascular diseases (CVDs) and associated risk factors than host populations for unclear reasons. The aim was to explore the associations of religion and religious affiliations with CVD risk among Ghanaian non-migrants and migrants in Europe. (2) Methods: The 10-year CVD risk was estimated using pooled cohort equations for 3004 participants from the cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic regression analyses were conducted to assess associations between religion and elevated CVD risk (score ≥ 7.5) with adjustment for covariates. (3) Results: Religious men in Europe had a lower 10-year CVD risk compared with non-religious men (adjusted OR 0.51; 95% confidence interval 0.30–0.85), specifically men affiliated with Seventh-Day Adventism (0.24; 0.11–0.53) followed by other affiliations (0.32; 0.11–0.94) and Roman Catholicism (0.42; 0.21–0.86). The opposite was found in Ghana, with religious women having higher odds for elevated 10-year CVD risk (1.53; 1.02–2.30) compared with their non-religious counterparts, specifically women affiliated with Reformed Christianity (1.73; 1.03–2.90) and other denominations (2.81; 1.20–6.54). Associations were not significant for men in Ghana and women in Europe. Adjustments for social support, stress, and health behaviors did not meaningfully alter the associations. (4) Conclusions: Christian religious Ghanaian men living in Europe seem to have lower CVD risk compared with their non-religious counterparts, while Christian religious women in Ghana appear to have increased CVD risk. Further unravelling the contributing factors and the differences between sex and environmental settings is needed. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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Review

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22 pages, 1568 KiB

Open AccessReview

Effectiveness of Body Roundness Index (BRI) and a Body Shape Index (ABSI) in Predicting Hypertension: A Systematic Review and Meta-Analysis of Observational Studies

by Julián F. Calderón-García, Raúl Roncero-Martín, Sergio Rico-Martín, Jorge M. De Nicolás-Jiménez, Fidel López-Espuela, Esperanza Santano-Mogena, Pilar Alfageme-García and Juan F. Sánchez Muñoz-Torrero

Int. J. Environ. Res. Public Health 2021, 18(21), 11607; https://doi.org/10.3390/ijerph182111607 - 4 Nov 2021

Cited by 52 | Viewed by 6967

Abstract

Introduction: The body roundness index (BRI) and a body shape index (ABSI) are novel anthropometric indices established to determine both the amount visceral adipose tissue and body fat. Objective: to investigate whether BRI and ABSI are better predictors of hypertension than body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR). Methods: A systematic search was conducted in the Scopus, PubMed and Web of Science databases up until 31 December 2020. Results: The estimated pooled area under curve [AUC (95% CI)] for BRI [0.67 (0.65–0.70)] for the prediction of hypertension were superior to that of ABSI (0.58 (0.56–0.60)), similar to that of BMI [0.67 (0.64–0.69)], and lower than those WC [0.68 (0.66–0.70)] and WHtR [0.68 (0.66–0.71)]. Nevertheless, the difference of BRI compared to WC and WHtR in the context of predicting hypertension was non-significant. ABSI was significantly lower (p < 0.05) than BRI, BMI, WC and WHtR. Similar findings were observed with the summary receiver operating characteristic curve (AUC-SROC). There were no significant differences between subgroups according to type of population or diagnostic criteria of hypertension. The diagnostic odds ratio (dORs) proved that increased BRI and ABSI were related with an elevated hypertension risk. Conclusions: BRI and ABSI have discriminatory power for hypertension in adult women and men from different populations. Although, WHtR and WC provided the best performance when assessing hypertension, no significant differences were found for BRI. Finally, BRI was significantly better predictor of hypertension than ABSI. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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Other

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20 pages, 608 KiB

Open AccessSystematic Review

Socioeconomic Determinants of Cardiovascular Diseases, Obesity, and Diabetes among Migrants in the United Kingdom: A Systematic Review

by Sanda Umar Ismail, Evans Atiah Asamane, Hibbah Araba Osei-Kwasi and Daniel Boateng

Int. J. Environ. Res. Public Health 2022, 19(5), 3070; https://doi.org/10.3390/ijerph19053070 - 5 Mar 2022

Cited by 6 | Viewed by 3742

Abstract

There has been little agreement on the role that socioeconomic factors play in the aetiology of cardiovascular diseases (CVDs), obesity, and diabetes among migrants in the United Kingdom (UK). We systematically reviewed the existing evidence on this association to contribute to filling this gap in the literature. Two reviewers were involved at each stage of the review process to ensure validity. We comprehensively searched through several electronic databases and grey literature sources to identify potentially eligible papers for our review. We extracted data from our finally included studies and appraised the methodological rigour of our studies. A narrative synthesis approach was used to synthesise and interpret the extracted data. We sieved through 2485 records identified from our search and finally obtained 10 studies that met our inclusion criteria. The findings of this review show that there is a trend towards an association between socioeconomic factors and CVDs, diabetes, and obesity among migrants in the UK. However, the picture was more complex when specific socioeconomic variables and migrant subgroups were analysed. The evidence for this association is inconclusive and its causal relationship remains speculative. There is, therefore, the need for further research to understand the exact association between socioeconomic factors and CVD, diabetes, and obesity among migrants in the UK. Full article

(This article belongs to the Special Issue The Risk of Obesity, Cardiovascular Disease and Diabetes)

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