Educational level and family structure influence the dietary changes after the diagnosis of type 2 diabetes: evidence from the E3N study

Type 2 diabetes (T2D) has no cure but can be controlled by medication, diet, and lifestyle changes. It has been suggested that diabetes dietary self-management is more difficult for people with socioeconomic difficulties. The objective of our study was to test the hypothesis that socioeconomic factors impact the change of diet after T2D diagnosis. The 57 304 French women included in the present study answered food frequency questionnaires in 1993 and 2005 and questionnaires on socioeconomic factors, and were free from T2D in 1993. Between 1993 and 2005, 1249 women developed T2D. Linear regression models evaluated whether having T2D diagnosed had an impact on energy and nutrient intakes and whether socioeconomic factors were implicated. T2D was associated with a reduction of energy (β = -312.54 kJ/d, P < .001), carbohydrate (β = −9.29 g/d, P < .001), lipid (β = −2.01 g/d, P < .001), and alcohol (β = −2.74 g/d, P = .002) intakes, whereas there was no association with changes in protein or fiber intakes. The main socioeconomic factors that had an impact on dietary change were the level of education of T2D patients and whether or not they had a family (having a partner and/or children). The present study provides evidence that socioeconomic factors impact the way people with T2D change their dietary habits after diagnosis. Furthermore, the family plays a crucial role in dietary self-management, probably encouraging T2D patients to follow dietary recommendations.     

Dietary intakes of essential nutrients among Arab and Berber ethnic groups on rural Tunisian island

ObjectiveThe dietary intake was investigated and food sources were identified among Tunisian ethnic groups from Jerba Island in the south of Tunisia.MethodsNinety-four subjects of moderate socioeconomic status (47 Berbers and 47 Arabs) aged 32 to 64 y completed a 1-mo qualitative food-frequency questionnaire and a single 24-h dietary recall, and dietary intakes and demographic status were observed from 2006 to 2007.ResultsThe prevalence of overweight and obesity was not significantly associated with Arab men compared with Berber men. Therefore, obesity was significantly associated with Berber women (P < 0.001). Height was significantly different between Arab and Berber women (P < 0.001). There were no significant differences in energy intake between men and women. Protein intake was not significantly different between ethnic groups. Milk and dairy products in the Berber group were significantly different from the Arab group. Intakes of calcium, zinc, iron, and folate were below recommended nutrient intakes in men and women in the two ethnic groups. Vitamin E intake was greater in Berbers than in Arabs (P < 0.01).ConclusionEthnicity was significantly associated with dietary intakes in the two ethnic groups of Jerba Island.     

Risk factors for overweight and obesity in French adolescents: Physical activity,sedentary behavior and parental characteristics

ObjectiveWe determined the prevalence by age and sex and associated factors of overweight and obesity in French adolescents.MethodsWe conducted a cross-sectional study of 2385 adolescents aged 11–18 y (1213 boys and 1172 girls) from middle and high schools in the Aquitaine region (southwest France) in 2004–2005. Weight and height were measured, and adolescents filled in a questionnaire about their characteristics and those of their parents. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task force.ResultsPrevalence of overweight (obesity included) was greater in boys and younger children. The odds ratio (OR) for an adolescent being overweight increased with parents' being overweight (at least one parent overweight, OR 1.97, 1.48–2.62, P < 0.0001), low paternal socioeconomic status (OR 1.78, 1.22–2.60, P < 0.01) and sedentary behavior (22 h/wk, OR 1.33, 1.02–1.74, P < 0.05), and decreased with physical activity of parents (at least one parent active, OR 0.67, 0.51–0.89, P = 0.01).ConclusionOur data support the hypothesis that parental overweight and low socioeconomic status and adolescents' sedentary behavior are strong risk factors for adolescent overweight and obesity, and that parents active lifestyle is associated with a lower risk of overweight in their adolescents.     

Neighborhood socioeconomic status in relation to dietary intake and body mass index in female Japanese dietetic students

ObjectiveAn increasing number of studies conducted in Western countries have shown that living in a socioeconomically disadvantaged neighborhood is associated with unfavorable dietary intake patterns and an unfavorable health status. However, information on such neighborhood socioeconomic differences in diet and health among different cultural settings, including Japan, is absolutely lacking. This cross-sectional study examined the association of neighborhood socioeconomic status (SES) with dietary intake and body mass index (BMI) in a group of young Japanese women.MethodsSubjects were 3892 female Japanese dietetic students 18–20 y of age from 53 institutions, residing in 1033 municipalities in 47 prefectures in Japan. Neighborhood SES index was defined by seven municipal-level variables, namely unemployment, household overcrowding, poverty, education, income, home ownership, and vulnerable groups, with an increasing index signifying increasing neighborhood socioeconomic disadvantage. Dietary intake was estimated using a validated, comprehensive self-administered diet history questionnaire. BMI was computed from self-reported body weight and height.ResultsNeighborhood SES index was not materially associated with most of the dietary variables. However, neighborhood SES index was positively associated with BMI, with significance (P for trend = 0.020). This significant association remained after adjustment for potential confounding or mediating factors including household SES, dietary, other lifestyle, and geographic factors (P for trend = 0.037).ConclusionAlthough no material association was seen between neighborhood SES and dietary intake, increasing neighborhood socioeconomic disadvantage was independently associated with increasing BMI in a group of young Japanese women.     

Role of an electronic armband in motor function monitoring in patients with Parkinson's disease

ObjectiveLevodopa replacement still is the gold standard for the management of Parkinson's disease (PD). Long-term treatment with levodopa is frequently associated with motor fluctuations. A low-protein (LP) dietary regimen has proved to be effective in reducing this adverse effect, but has been associated with weight loss, probably due to increased energy expenditure. A new wearable device (SenseWear Armband [SWA]) has recently been introduced into clinical practice. It is designed to monitor physical activity continuously and provide estimates of energy consumption. We assessed its role in measuring the effects of dietary regimens on motor function in PD.MethodsSix patients with levodopa-treated PD and motor fluctuations were asked to follow a balanced diet (protein 1 g · kg^?1 · d^?1) for 7 d and then to cross over to a isocaloric LP (protein 0.7 g · kg^?1 · d^?1) dietary regimen. Total daily energy expenditures, physical activity, number of steps, and metabolic rate were assessed continuously (14 d) by the SWA. Motor control was evaluated by daily diaries.ResultsThe SWA proved that, during the LP diet, mean total daily energy expenditure was higher (P < 0.05) and so were physical activity (P = 0.05) and average metabolic rate (P = 0.01), despite no change in the number of steps. The duration of periods with dyskinesias was also increased (P < 0.05). These data support the role of upper-extremity involuntary movements in increasing total daily energy expenditure during an LP diet.ConclusionThe SWA may help in monitoring patients with PD because it can assist in evaluating motor response to treatment and changes in physical activity and daily calorie needs.     

Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students

BackgroundOverweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco.MethodsA cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity.ResultsThe prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P < 0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR = 1.76; [1.18–2.63]; P < 0.01), father's income ≥ 5000 MAD (OR = 1.32; [1.02–1.70]; P < 0.05), father's overweight (including obesity) (OR = 1.87; [1.38–2.54]; P < 0.001) and female sex (OR = 1.31; [1.02–1.68]; P < 0.05).ConclusionThe prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.     

Profils métabolique et clinique avant,pendant et après la période du ramadan chez des Maliens atteints de diabète de type 2

ObjectivesTo document the effects of fasting on metabolic and clinical parameters among Malians with type 2 diabetes during Ramadan in Mali.MethodsThis study was conducted with 25 subjects attending the Centre national de lutte contre le diabète in Bamako. Only those that intended to observe the Ramadan fasting in 2010 were selected. Biological and clinical parameters were measured in 25 participants at three different periods: before Ramadan (T0), during the fourth week of Ramadan (T1) and one month after Ramadan (T2).ResultsCompared to T0, an increase was noted at T1 in fasting blood glucose (P < 0.05) and systolic blood pressure (P < 0.01), although not maintained at T2. Glycosylated haemoglobin was also higher at T2 compared to T0 (P < 0.02). Degradation of glycemic control was more marked among patients who had stopped or reduced their doses of medication at T1 (P < 0.01). Also, a decrease in LDL-cholesterol (P < 0.03), total cholesterol (P < 0.05) and total cholesterol/HDL-cholesterol ratio (P < 0.01) were observed at T1, along with a slight weight loss (P < 0.01). Reductions in weight, levels of LDL-cholesterol and total cholesterol/HDL-cholesterol ratio were maintained at T2.ConclusionsThis study showed an adverse effect of fasting on glycemic control among the participants, likely related to the non-observance of oral medication during Ramadan. However, blood lipids sharply improved during Ramadan, and even after.     

Contribution of maternal diabetes to visceral fat accumulation in offspring

Background/objectivesGenetic and epidemiological studies provide evidence supporting the contribution of a genetic background of diabetes to the development of obesity and further suggest differences in the metabolic and cardiovascular risks between offspring with a paternal versus maternal family history of diabetes (FHD). The goal of this study was to explore the contribution of a parental FHD to visceral fat area (VFA).Subjects/methodsThis study enrolled 1875 subjects with normal glucose tolerance (age range: 20–78 years). VFA was assessed with magnetic resonance imaging.ResultsThe study population consisted of 1573 subjects without a FHD, 115 subjects with a paternal FHD, and 187 subjects with a maternal FHD. For both genders, VFA was greater in offspring with a maternal FHD compared with those without a FHD (both P < 0.05). For both genders, only VFA was an independent factor associated with a maternal FHD (both P < 0.01). Compared with those without a FHD, men and women with a maternal FHD, but not those with a paternal FHD, were more likely to develop abdominal obesity (both P < 0.05). After adjustment for independent factors related to VFA, VFA was increased by 9.60 cm² (standardized β = 0.069, P = 0.012) and 4.57 cm² (standardized β = 0.056, P = 0.007) in men and women with a maternal FHD, respectively.ConclusionA maternal FHD contributed to visceral fat accumulation independently in both genders. Maternal transmission had a pronounced effect on obesity and related cardiovascular risk factors.     

Rapid impact of rotavirus vaccine introduction to the National Immunization Plan in Southern Israel: Comparison between 2 distinct populations

BackgroundRotavirus vaccines were licensed in Israel in 2007, and in 2011 the pentavalent-vaccine (RV5) was introduced into the Israeli National Immunization plan.AimTo determine the effect of rotavirus-vaccines on the incidence of hospital visits due to rotavirus gastroenteritis (RVGE) and all-cause diarrhea in Jewish and Bedouin children <5 year residing in southern Israel.MethodsWe conducted a population-based, prospective, observational study. Data from 2006 through 2013 were analyzed. Our hospital is the only medical center in the region, enabling age-specific incidences calculation.ResultsIn the pre-vaccine period, the overall RVGE hospital visits rates per 1000 in children <12, 12–23 and 24–59 m were 16.1, 18.6 and 1.4 in Jewish children, respectively. The respective rates in Bedouin children were 26.4, 12.5 and 0.7 (P < 0.001 for <12 m).Hospitalization rates were higher among Bedouin than among Jewish children (60.0% vs. 39.7%, P < 0.001). Vaccine uptake was faster in the Jewish vs. the Bedouin population.In the year following RV5 introduction, RVGE hospital visits rates declined by 82%, 70% (P < 0.001 both) and 36% (P = 0.092) in Jewish children <12, 12–23 and 24–59 m, respectively. In Bedouin children, the respective RVGE rates declined by 70% (P < 0.001), 21% (P = ns) and 14% (P = ns).Throughout the study, RVGE rates declined significantly in children <12, and 12–23 m by 80% and 88% in Jewish children, respectively, and by 62 and 75% in Bedouin children, respectively (P < 0.001 for all declines). In children 24–59 m, RVGE rates declined by 46% (P = 0.025) in Jewish children, but no reduction was observed in Bedouin children. The dynamics of all-cause diarrhea rates were similar to that of RVGE.ConclusionsSignificant reductions of RVGE rates were observed, following Rota-vaccine introduction in southern Israel in both Jewish and Bedouin children. However, the impact was faster and more profound in Jewish children, probably related to higher vaccine uptake and possibly to lifestyle differences.     

Effects of cafeteria diet on the jejunum in sedentary and physically trained rats

ObjectiveThe effects of a cafeteria diet on the small intestine were investigated in adult Wistar rats under sedentary conditions and after physical training.MethodsParameters including morphometry, enzyme activities, and total myenteric populations in the jejunum were evaluated.ResultsThe cafeteria diet, characterized as hyperlipidic, produced obese rats, corroborated by increases in the Lee index and the weights of the periepididymal and retroperitoneal adipose tissues (P < 0.01). Obesity caused increases in the length of the small intestine, villi height, crypt depth, whole-wall thickness (P < 0.05), and the enzymatic activities of alkaline phosphatase, lipase, and sucrase (P < 0.01), in addition to a reduction in the number of goblet cells (P < 0.05). With reference to the jejunal intrinsic innervations, the total number and area of myenteric neurons was unchanged regardless of the group. Physical training promoted 1) a reduction of the weight in the retroperitoneal and periepididymal adipose tissues (P < 0.05) and 2) an increase in the thickness of the muscular layer (P < 0.05).ConclusionThe cafeteria diet promoted obesity in rodents, leading to alterations in morphometry and enzymatic intestinal parameters, which were partily attenuated by physical training.     

Factors related to vaccine uptake by young adult women in the catch-up phase of the National HPV Vaccination Program in Australia: Results from an observational study

BackgroundAustralia commenced a publically-funded, National Human Papillomavirus (HPV) Vaccination Program in 2007 with a two year catch-up phase for females aged 12–26 years.ObjectiveTo identify the factors associated with the uptake of the HPV vaccine (which has a recommended 3-dose schedule in Australia) by young adult women vaccinated by general practitioners and community-based programs within the catch-up phase.Methods1139 women who were eligible to receive the free HPV vaccine during the catch-up period were recruited in 2008–2009 (age 20–29 years at recruitment), in New South Wales, after having a normal (negative) cervical smear result recorded on the NSW Pap Test Register. Participants completed a self-administered questionnaire providing information on vaccination status, and sociodemographic and other factors.ResultsOverall, 880 (77%) women reported receiving ≥1 dose of the vaccine and 777 women (68%) reported receiving ≥2 doses. In multivariable analysis (adjusting for the period for which each woman was eligible for free HPV vaccination), uptake of ≥1 dose of the vaccine was significantly associated with being born in Australia (p < 0.01), being single (p = 0.02), being nulliparous (p < 0.01), living in a higher socioeconomic status area (p-trend = 0.03), living in more remote areas (p = 0.03), drinking alcohol (p < 0.01) and using hormonal contraceptives (p < 0.01). Although vaccinated women were more likely to have fewer sexual partners than unvaccinated women (p-trend = 0.02), they were also more likely to report a prior sexually transmitted infection (STI) (p = 0.03). Similar factors were associated with receiving ≥2 doses.ConclusionsIn this group, women living in higher socioeconomic status areas were more likely to be vaccinated against HPV in the catch-up phase of the national program. Although vaccinated women tended to have fewer sexual partners, they also reported prior STIs, which may be a marker of increased risk of prior exposure to HPV. The findings of this study reinforce the continuing need to prioritise equitable delivery of vaccination to various population subgroups.     

A simple dietary message to improve dietary quality: Results from a pilot investigation

ObjectiveThe present study compared the feasibility of two simple messages (a high-fiber diet or a low saturated fat diet) to a combination message (high fiber/low saturated fat) on their potential to affect dietary quality and metabolic health.MethodsThirty-six subjects were randomized to one of three intervention conditions and received individual dietary counseling sessions. Study assessments occurred at baseline, 3 mo, and 6 mo.ResultsThe sample was 84% female and 94% Caucasian. Mean body mass index was 31 kg/m². At the 6-mo assessment phase, we retained all 12 patients in the high-fiber diet condition, 10 of 12 in the low saturated fat condition, and 9 of 12 in the combination condition. Participants reported that the dietary fiber intervention was easier to maintain compared with the other two intervention conditions (83% for high dietary fiber versus 60% for low saturated fat versus 33% for the combination, P = 0.008). Overall dietary quality improved in all three conditions during the study (P = 0.01). In addition to increasing fiber, the high-fiber condition decreased their saturated fat intake, even though a reduction in saturated fat was not a part of that intervention condition. Participants in all three conditions lost an average of 9 lb from baseline weight (P < 0.001).ConclusionA simple dietary message is feasible and can improve overall dietary quality. Results support the need for a larger randomized controlled trial that is powered to detect the efficacy of a simplified dietary recommendation for dietary quality and metabolic health.     

Twenty-four hour dietary recalls by fourth-grade children were not influenced by observations of school meals

ObjectiveTo investigate whether school-meal observations influenced children's 24-hour dietary recalls.Study Design and SettingOver three school years, 555 randomly selected fourth-grade children were interviewed to obtain a 24-hour dietary recall; before being interviewed, 374 children were observed eating two school meals (breakfast, lunch), and 181 children were not observed. Within observation-status groups (observed, unobserved), children were randomized within sex to one of six combinations from two target periods (prior 24 hours, previous day) crossed with three interview times (morning, afternoon, evening).ResultsFor each of the five variables (interview length, meals/snacks, meal components, items, kilocalories), naïve and adjusted equivalence tests rejected that observation-status groups were different, indicating that school-meal observations did not influence children's 24-hour dietary recalls. There was a target-period effect on length (P < 0.0001) (longer for prior-24-hour recalls), a school year effect on length (P = 0.0002) (longer for third year), and a target period–interview time interaction on items (P = 0.0110) and kilocalories (P = 0.0047) (both smaller for previous-day recalls in the afternoon than prior-24-hour recalls in the afternoon and previous-day recalls in the evening), indicating that variables were sufficiently sensitive and psychometrically reliable.ConclusionConclusions about 24-hour dietary recalls by fourth-grade children observed eating school meals in validation studies are generalizable to 24-hour dietary recalls by comparable but unobserved children in nonvalidation studies.     

Dietary glycemic index is inversely associated with the risk of Parkinson's disease: A case–control study in Japan

ObjectiveHigh glycemic index (GI) or glycemic load (GL) carbohydrates might be expected to decrease the risk of Parkinson's disease (PD) by an insulin-induced increase in brain dopamine. We conducted a hospital-based case–control study in Japan to examine associations between dietary GI and GL and other dietary carbohydrate variables, including intake of available carbohydrate and dietary fiber, and PD.MethodsPatients with PD diagnosed using the U.K. Parkinson's Disease Society Brain Bank criteria (n = 249) and controls without neurodegenerative diseases (n = 368) were recruited. Dietary intake during the preceding month was assessed at the time of study recruitment using a validated, self-administered, semiquantitative, comprehensive diet history questionnaire.ResultsAfter adjustment for potential dietary and non-dietary confounding factors, dietary GI was significantly inversely associated with the risk of PD. Multivariate odds ratios (95% confidence intervals) for PD in the first, second, third, and fourth quartiles of dietary GI were 1.00 (reference), 1.03 (0.64–1.66), 0.68 (0.41–1.15), and 0.61 (0.34–1.09), respectively (P for trend = 0.04). Conversely, no significant association was observed for other dietary carbohydrates, including dietary GL (P for trend = 0.77), available carbohydrate intake (P for trend = 0.28), or dietary fiber intake (P for trend = 0.73).ConclusionThis preliminary case–control study based on current dietary habits found an independent inverse relation between dietary GI and PD. Considering the plausibility of the putative mechanism, further investigation using a case–control design with accurate assessment of past dietary habits or a prospective design is warranted.     

Evaluation of pneumococcal urinary antigen testing for respiratory tract infection investigations

ObjectiveThe pneumococcal urinary antigen test enables rapid bacteriological diagnosis in respiratory tract infections. The objective was to identify factors associated with a positive pneumococcal urinary antigen test result.Patients and methodsThis seven-year retrospective monocentric study was performed on consecutive patients presenting with respiratory tract infections reported as pneumococcal-positive. Epidemiological, biological, and radiological factors were analyzed, and severity scores were calculated.ResultsA total of 223 patients were included. Significant associations were observed between positive test results and age over 65 years (P = 0.01), positive test results and immunosuppression factors (blood disease [25% Ag+ group vs. 4% Ag− group, P = 0.001], immunosuppressive therapy [10% Ag+ group vs. 0% Ag− group, P = 0.02]). Clinically, fever (64% Ag+ group vs. 42% Ag− group, P = 0.01) and cough (46% Ag+ group vs. 19% Ag− group, P < 0.01) were associated with a positive result, as were radiological alveolar opacities (67% Ag+ group vs. 44% Ag− group, P = 0.01). High PSI score was associated with the Ag+ group (79% vs. 56% Ag− group, P = 0.001).ConclusionAge, immunosuppressive factors, typical pneumococcal symptoms, and PSI scores were associated with a positive pneumococcal urinary antigen result.     

Differences in the Associations between Body Dissatisfaction and Eating Outcomes by Gender? A Lebanese Population Study

BackgroundThe objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults.MethodsThis cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6 ± 11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale.ResultsBody dissatisfaction was positively correlated to restrained eating (r = 0.293, P < 0.001), emotional eating (r = 0.073, P = 0.042) and binge eating (r = 0.250, P < 0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta = 0.01, P < 0.001) and orthorexia nervosa (Beta = ?0.09, P < 0.001), but not with emotional (Beta = ?0.43, P = 0.103) and binge eating (Beta = ?0.08, P = 0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only.ConclusionThe interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.     

Higher dietary intake of alpha-linolenic acid is associated with lower insulin resistance in middle-aged Japanese

ObjectiveTo investigate the associations between dietary intake of n-3 polyunsaturated fatty acids (plant-derived alpha-linolenic acid: ALA, and marine-derived eicosapentaenoic and docosahexaenoic acid: EPA + DHA) and insulin resistance (IR) in a lean population with high n-3 PUFA intake.MethodWe cross-sectionally studied 3383 Japanese local government workers aged 35–66 in 2002. IR was defined as the highest quartile of homeostasis model assessment, and nutrient intake was estimated from a diet history questionnaire. The odds ratios (ORs) of IR taking the lowest quartile of ALA or EPA + DHA intake as the reference were calculated by logistic regression analysis.ResultsMean age, body mass index (BMI), and dietary ALA, and median of dietary EPA + DHA were 47.9 years, 22.9 kg/m², and 1.90 g/day (0.88%E) and 0.77 g/day (0.36%E), respectively. The ORs of IR decreased across the quartiles of ALA intake (multivariate-adjusted OR for Q4 versus Q1 = 0.74, P for trend = 0.01) and the association was observed only in subjects with a BMI of < 25 kg/m² (P for interaction = 0.033). However EPA + DHA showed no such associations consistently.ConclusionHigher ALA intake was significantly associated with a lower prevalence of IR in normal weight individuals of middle-aged Japanese men and women.     

The free vaccination policy of influenza in Beijing,China: The vaccine coverage and its associated factors

BackgroundIn order to improve influenza vaccination coverage, the coverage rate and reasons for non-vaccination need to be determined. In 2007, the Beijing Government published a policy providing free influenza vaccinations to elderly people living in Beijing who are older than 60. This study examines the vaccination coverage after the policy was carried out and factors influencing vaccination among the elderly in Beijing.MethodsA cross-sectional survey was conducted through the use of questionnaires in 2013. A total of 1673 eligible participants were selected by multistage stratified random sampling in Beijing using anonymous questionnaires in-person. They were surveyed to determine vaccination status and social demographic information.ResultsThe influenza vaccination coverage was 38.7% among elderly people in Beijing in 2012. The most common reason for not being vaccinated was people thinking they did not need to have a flu shot. After controlling for age, gender, income, self-reported health status, and the acceptance of health promotion, the rate in rural areas was 2.566 (95% confidence interval [CI], 1.801–3.655, P < 0.010) times greater than that in urban areas. Different mechanisms of health education and health promotion have different influences on vaccination uptake. Those whom received information through television, community boards, or doctors were more likely to get vaccinated compared to those who did not (Odds Ratio [OR] = 1.403, P < 0.010; OR = 1.812, P < 0.010; OR = 2.647, P < 0.010).ConclusionThe influenza vaccine coverage in Beijing is much lower than that of developed countries with similar policies. The rural–urban disparity in coverage rate (64.1% versus 33.5%), may be explained by differing health provision systems and personal attitudes toward free services due to socioeconomic factors. Methods for increasing vaccination levels include increasing the focus on primary care and health education programs, particularly recommendations from doctors, to the distinct target populations, especially with a focus on expanding these efforts in urban areas.     

The nucleotide changes within HBV core promoter/precore during the first 12 weeks of nucleos(t)ide treatment might be associated with a better virological response

ObjectivesWe aimed to study the dynamic changes of hepatitis B virus (HBV) core promoter/precore (CP/preC) sequences during antiviral treatment and their associations with virological responses.Materials and methodsThe baseline and 12-week CP/preC sequences (nts 1655–2014) were obtained from 52 chronic hepatitis B patients with positive hepatitis B e antigen (HBeAg), who received a 104-week lamivudine and adefovir dipivoxil combination therapy. The mutations within the CP/preC were analyzed against genotype specific reference sequences. The nucleotide change rates in individuals during therapy were analyzed in a pairwise comparison manner.ResultsThere was no significant difference of the mutation rate at each nucleotide site between baseline and week 12 of treatment (P > 0.05). The mutation rates of A1762T/G1764A and G1896A were found to decrease from 46.2% (24/52) at baseline to 36.5% (19/52) at week 12 (P = 0.426) and from 28.8% (15/52) to 21.2% (11/52) (P = 0.497), respectively. The nucleotide change rates varied from 0.0% - 7.8% in individuals [0.0% in Group 1 (N = 26); 0.3% - 7.8% in Group 2 (N = 26)] during the first 12-week treatment. HBV DNA levels in Group 2 were significantly lower than those in Group 1 throughout therapy (P < 0.01) (e.g., 1.5 ± 1.3 log₁₀ IU/ml vs. 2.6 ± 1.0 log₁₀ IU/ml at week 104, P = 0.001). At week 104 the rates of HBV DNA undetectable and HBeAg loss in Group 2 were significantly higher than those in Group 1 (P < 0.05). Along with the increased nucleotide change rates, the rate of HBV DNA undetectable at week 104 tended to increase (odds ratio = 0.323, 95% confidence interval = 0.138–0.758, P < 0.001).ConclusionOur findings suggested that the nucleotide changes within HBV CP/preC region during the first 12-week treatment might be associated with a better virological response.