Appréciation des facteurs de risque cardiovasculaires dans le secteur informel: une étude transversale chez des femmes fumeuses de poissons au sud du Bénin / Screening for cardiovascular risk factors in the informal sector: a cross-sectional study among fish-smoking women in southern Benin

Introduction : Les maladies non transmissibles (MNT) sont en augmentation dans plusieurs secteurs d'activité. L'objectif de l'étude était de décrire les facteurs de risque des MNT chez des femmes fumeuses de poissons sur deux sites au Bénin relevant du secteur informel. Méthodes : Il s'agissait d'une étude transversale descriptive qui s'est déroulée pendant un mois du 25 Avril au 26 Mai 2019. La population d'étude a été constituée des femmes fumeuses de poissons des sites de Xwlacodji et de Djeffa ayant au moins deux années d'ancienneté. Les variables étudiées étaient relatives aux caractéristiques socioprofessionnelles, aux facteurs comportementaux et bio cliniques. Le recrutement des participants a été exhaustif. Un questionnaire standardisé inspiré de celui du STEPS-OMS a été utilisé pour la collecte des données. Une analyse descriptive a été effectuée. Résultats : Au total, 81femmes ont été incluses. L'âge médian des femmes était de 40 ans, avec un intervalle interquartile de [25-75] ; 17 (21%) étaient scolarisées ; 39 (48,14%) ont une ancienneté de plus de 20 ans. Les facteurs comportementaux se présentaient comme suit :1,23% tabagisme (cigarette) ; 69,14% consommation régulière de l'alcool ; 46,91% d'insuffisance d'activité physique ; 100% de consommation insuffisante de FEL. En ce qui concerne les facteurs biocliniques il y avait 56,78% de surcharge pondérale ; 32,1% pression artérielle élevée prenant en compte la prise d'antihypertenseur ; 5,4% d'hyperglycémie. Conclusion : La fréquence de certains facteurs de risque des MNT est élevée, la mise en place d'un programme de sensibilisation est nécessaire.

Introduction: Non-communicable diseases (NCDs) are on the increase in several sectors of activity. The aim of the study was to describe the risk factors for NCDs among women fish smokers in two Benin sites in the informal sector. Methods: This was a descriptive cross-sectional study conducted over a one-month period from April 25 to May 26, 2019. The study population consisted of fish-smoking women from the Xwlacodji and Djeffa sites with at least two years of seniority. Variables studied included socioprofessional characteristics, behavioral and bio-clinical factors. Participants were recruited exhaustively. A standardized questionnaire based on the STEPS-OMS questionnaire was used forn data collection. Descriptive analysis was performed. Results: A total of 81 women were included. The median age of the women was 40 years, with an interquartile range of [25-75]; 17 (21%) had attended school; 39 (48.14%) had attended school for more than 20 years. Behavioural factors were: 1.23% smoking; 69.14% regular alcohol consumption; 46.91% insufficient physical activity; 100% insufficient FEL consumption. Bioclinical factors were: 56.78% overweight; 32.1% hypertension with antihypertensive medication; 5.4% hyperglycemia. Conclusion: The frequency of certain risk factors for non-communicable diseases is high, and an awareness program is needed.

Comportamentos alimentares de portadores de DCNT que frequentam uma clínica integrada no extremo sul catarinense / Dietary behaviors of patients with NCDs who are attending an integrated clinic in southern Santa Catarina / Comportamientos alimentarios de pacientes con ENT que asisten a una clínica integrada en el extremo sur de Santa Catarina

Objetivo: verificar os comportamentos alimentares de indivíduos com doenças crônicas não transmissíveis. Método: Estudo descritivo, transversal, quantitativo com coleta de dados primários. Resultados: Sobre os comportamentos alimentares 48,6% (36) relataram realizar refeições em frente às telas, a maioria executa café da manhã, almoço e jantar e grande parte do grupo expôs consumir alimentos protetores e ultraprocessados. Conclusão: Os comportamentos alimentares encontrados entres os indivíduos com DCNT foram em geral desfavoráveis, mesmo com uma divisão adequada e inclusão de alguns bons alimentos, houve prevalência no consumo de biscoitos recheados, doces e bebidas adoçadas, além do péssimo hábito de se alimentar em frente a televisão.

Objective: to assess the dietary behaviors of individuals with chronic non-communicable diseases. Method: The study followed a descriptive, cross-sectional, quantitative approach with primary data collection. Results: The results revealed that 48.6% (36) reported having meals in front of screens, and the majority of the participants had breakfast, lunch, and dinner. A significant portion of the group reported consuming both protective foods and ultra-processed foods. Conclusion: In conclusion, the dietary behaviors observed among individuals with NCDs were generally unfavorable. Despite proper meal distribution and the inclusion of some healthy foods, there was a prevalence of consumption of filled cookies, sweets, and sugary beverages, along with the detrimental habit of eating in front of the television.

Objetivo: verificar los comportamientos alimentarios de individuos con enfermedades crónicas no transmisibles que asisten a una clínica integrada en el extremo sur de Santa Catarina. Método: Se llevó a cabo un estudio descriptivo, transversal y cuantitativo con recolección de datos primarios. Resultados: En cuanto a los comportamientos alimentarios, el 48,6% (36) informó realizar comidas frente a las pantallas, y la mayoría de los participantes desayunaban, almorzaban y cenaban. Además, una parte significativa del grupo declaró consumir alimentos protectores y ultraprocesados. Conclusión: Los comportamientos alimentarios encontrados entre los individuos con enfermedades crónicas no transmisibles fueron generalmente desfavorables. A pesar de una adecuada distribución de las comidas e inclusión de algunos alimentos saludables, hubo una prevalencia en el consumo de galletas rellenas, dulces y bebidas azucaradas, además del mal hábito de comer frente al televisor.

Effect of the coronavirus pandemic on nutrition and health of adults in Calabar, Nigeria: A post-lockdown analysis

Background: The food security and nutrition of millions of people around the world is currently being threatened by the coronavirus disease 2019 (COVID-19) pandemic, an evolving health crisis. Aim: To evaluate the effect of the COVID-19 pandemic on nutrition and health of adults in Calabar, especially after the hard lockdown.Setting: Online cross-sectional survey in Calabar, Nigeria. Method: After sample size determination, an online questionnaire was designed, content-validated by nutrition experts and piloted on 20 respondents. The questionnaire link was circulated for 6 weeks (April­May, 2021). The questionnaire was structured to gather socio-economic data, lifestyles of the participants (especially younger adults) and changes in dietary intake and health. Descriptive statistics and Pearson's correlation were used to define the proportion of responses for each question and check for association. Results: No glaring nutrition or health problems was observed in the surveyed population (385 respondents), but many (50%) earned very low monthly income (< 50 000 naira). A drop in finances seemed to have indirectly caused a decrease in food consumption post-lockdown. A strong association between age and health risks was observed; similarly, alcohol intake was significantly affected by income and age. Conclusion: The pandemic caused many changes in people's dietary habits and lifestyles, including financial setbacks. Apparently, education and proper enlightenment play a major role in food choices (despite limited resources), thus ensuring adequate nutrition and reducing health risks in the face of a pandemic. Contribution: This study has affirmed the efficacy of nutrition education and proper awareness in ensuring healthy dietary choices, optimal health and reduced risks of diseases.

Prevalence of cancer among the urban and rural community of Surendranagar district, Gujarat

Background: Non-communicable diseases (NCDs) are mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes-are the world’s biggest killers. In developing countries, cancer is among the ten most common causes of mortality. Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. The most conspicuous feature of the distribution of cancers between the sexes is the male predominance of lung cancer. Prostate, colorectal, stomach and liver cancer are also much more common in males. Cancer of breast, colorectal, cervix, uteri, lung and stomach are common in females. This study was conducted to identify the prevalence of various types of cancers in rural and urban community of Surendranagar district.Methods: It was a cross-sectional study carried out among 300 rural and 300 urban families selected by simple random sampling. Data was collected and analysed by Statistical Package for Social Sciences and Microsoft Excel have been used to generate graphs, tables, etc.Results: Study revealed that out of total study population (2053), 37 participants were having cancer. The prevalence of cancer was 1.80% in our study. Out of 37 respondents who were having cancer, majority cases were oral cancer 11 (29.73%) and 9 (24.32%) lung cancer, followed by cancer breast 5 (13.51%), cancer colorectal 5 (13.51%) and other cancers 7 (18.92%).Conclusions: Prevalence of cancer was increasing with the age. Higher number of cancer cases was found amongst older age than younger age. Significant difference was found between cancer prevalence and gender.

Why Do Some People Still Fail to Utilize Affordable Non-Communicable Diseases (NCDs) Screening Services?: a Qualitative Study Among White Collar Workers in Depok, West Java, Indonesia

Background: Indonesia Basic Health Research (IBHR) 2013 results show that Depok citizens were at risk of non-communicable diseases (NCDs). However, participation on NCDs screening test among white collar workers was still 46.4%. Aim & Objective: The aim of this study is to explore barriers and challenges in accessing and implementing NCDs screening service at City Hall Depok. Methods and Material: This research used qualitative method. The data were collected through focus group discussion, in-depth interview, and document review. Results: The knowledge of informants about NCDs and NCDs screening needs improvement. The barriers for participating in NCDs screening were: tight work schedule, lack of information about NCDs screening programs, long queue, fear of an existing disease, and attention to the privacy of participants. Conclusions: Policy support and cooperation both across programs and sectors will be needed for future improvement. Education concerning NCDs and NCDs screening must be improved to engage utilization.

Shared risk factors of non-communicable diseases: A community based study among adults in an urban resettlement colony of Delhi

As urbanisation is increasing, the problem of communicable as well as non-communicable diseases (NCDs) is also increasing. Hypertension, diabetes, obesity, cardiovascular diseases constitute most of the NCDs whose risk factors are almost similar. They could be modifiable like physical activity, waist circumference, diet, smoking, alcohol intake . Objective: To study the magnitude of shared risk factors for Non-communicable diseases in adults of an urban resettlement colony of Delhi. Material and Methods: A cross sectional survey was conducted on adults >30 years (n=580) in both genders in an urban resettlement colony of Delhi in 2014. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile was used. Data was entered and analyzed in SPSS 12 Results: Out of the total 580 subjects (313)53.96% were women and 267(46.03%) were men. Majority 405(69.8%) of the study subjects were taking inadequate fruits and vegetables (<5 times/day) and 212 (36.6%) were taking >5 gm salt per day. About 181(31.2%) of the study subjects were sedentary workers, the proportion was more among women 99(31.6%). 223(83.5%) men had waist circumference within normal limits whereas 178 (56.9%) women had waist circumference more than 88 cm. One in four men were smokers. Nearly 49(18.4 %) of the men were current tobacco chewers as compared to 17(1.6%) of women. Only 33 (12.4%) men were currently consuming alcohol. Results of multiple logistic regression showed increasing age, education and marital status as significant socio demographic factors for increased prevalence of risk factors for NCDs. Conclusion: Promotion of lifestyle change to address these risk factors that can be modified including weight reduction, increased physical activity and healthy eating should be encouraged along with changing of behavioural factors like quitting smoking and alcohol.

Prevalence Of Ncds And Its Correlates Among Young Population Of Jhansi, Uttar Pradesh: A Cross-Sectional Community-Based Study

Background– Non–communicable diseases (NCD), also known as chronic diseases include cardiovascular diseases, diabetes, stroke, most forms of cancers and injuries. Changes in lifestyles, behavioral patterns, demographic profile, socio–cultural and technological advancements are leading to sharp increases in the prevalence of NCDs among young population. Objectives– To assess the burden of non communicable diseases and their correlation with various factors present among young population of Jhansi, Uttar Pradesh. Methods– Surveys were collected from a total of 770 participants chosen by simple random sampling. Semi–structured schedule was used to collect information and STEP–wise Approach to surveillance (STEPS) by World Health Organization was followed. Data analysis was done by using Epi–info software 7.2.1.1. Results– Amongst total 770 respondents, 462 (60%) males and 308 (40%) females. Out of total 431(55.97%) had presence of one of the non communicable diseases (CVS, Diabetes, Hypertension and Cancer) in their parents. The main risk factors were lack of physical activity, eating unhealthy diet and lifestyle changes. Conclusion– The young population needs to motivate and government has to implement promotive services about the lifestyle changes and dietary modifications for good health. Make recommendations for the improvement of health services of young population.

Prevalence of risk factors for non-communicable diseases in Bangladesh: Results from STEPS survey 2010.

Background: Nationally representative data on noncommunicable disease (NCD) risk factors are lacking in Bangladesh. This study was done to determine the prevalence of common risk factors for major NCDs among men and women of rural and urban areas of Bangladesh. Materials and Methods: This survey was done with 9,275 individuals aged 25 years or older randomly drawn from all over the country. Information on diet, physical activity, tobacco and alcohol, and treatment history for hypertension and diabetes were collected. Height, weight, waist circumference, and blood pressure (BP) were measured. Results: There were 4,312 men and 4,963 women with the mean age of 42 years (standard deviation 13 years). Half of them (54%) used tobacco in some form, <1% consumed alcohol within the past 30 days, 92% did not consume adequate fruit and vegetables (five servings or more), and 35% had low physical activity level [<600 metabolic equivalent (MET) min per week]. Documented diabetes was found in 4% of the participants. Seventeen percent were overweight [body mass index (BMI) ≥25 kg/m 2 and 21% had abdominal obesity (men ≥94, women ≥80 cm). Overall, 21% people had hypertension (blood pressure ≥140/90 mmHg or medication). Physical inactivity, alcohol intake, hypertension, obesity, and diabetes were more prevalent in urban areas, as opposed to tobacco. Tobacco intake showed a decreasing gradient, but hypertension, obesity, diabetes, and low physical activity showed an increasing gradient across the wealth quartiles. Conclusion: Risk factors are widely prevalent in Bangladeshi people across sexes and across both rural and urban areas of residences. NCD prevention through risk factor control, and early detection and treatment of hypertension and diabetes are warranted.

Review of current situation and future strategies on prevention and control of Noncommunicable diseases (NCDs) in the Pacific Island States / 国際保健医療

<p>  In the Pacific island states, in addition to the traditional health issues common in developing countries, such as maternal and child health and communicable diseases, the increase in noncommunicable diseases (NCDs), e.g., obesity and diabetes, has become a serious problem. NCDs account for 80% of all deaths in this region, and the increase in early deaths of people younger than 70 years old is of particular concern. It has also been pointed out that the cost of countermeasures against NCDs are constricting government finances, and enhancing a health system that supports such countermeasures is also an urgent challenge. However, with respect to international health cooperation in Japan, the present status of NCDs and the associated statistical data in the Pacific island states are not likely to be addressed. Therefore, in this report, we comprehensively explain the present status of and approaches to NCDs around the world based on the World Health Organization (WHO), including those in the Pacific island states. By taking advantage of health indicators, we confirm the disease structure present in the 10 Pacific island states that cooperate bilaterally with Japan and then discuss the approaches in these states. As a result, although countermeasures against NCDs have been actively implemented in the Pacific island states in accordance with the WHO strategies, no tendency for the prevalence of NCDs to improve has been seen. To promote countermeasures against NCDs in the Pacific island states in the future, it will be necessary to engage in analysis and discussion of the present situation, to develop human resources, taking into consideration the region-specific characteristics of the islands, and to accumulate sufficient numbers of successful local stories consistent with the local strategies.</p>

Factores Psicosociales e Intervención Psicológica en Enfermedades Crónicas No Transmisibles / Psychosocial Factors and Psychological Intervention in Chronic Non-Communicable Diseases / Fatores Psicossociais e Intervenção Psicológica em Doenças Crônicas Não Transmissíveis

Los cambios que experimentan las personas diagnosticadas con Enfermedades Crónicas no Trasmisibles (ECNT) a nivel individual, familiar o social evidencian la importancia de la intervención psicológica desde el modelo cognoscitivo-conductual. En este artículo se recoge literatura que demuestra la efectividad de este modelo para facilitar ajustes en el estilo de vida, generar mayor adherencia al tratamiento, minimizar los riesgos de recaída y mantener el nivel de calidad de vida del paciente y de quienes lo rodean. Se concluye que es fundamental que la intervención psicológica se brinde con calidad, equidad, oportunidad y pertinencia, lo que reducirá a mediano plazo los costos instrumentales, temporales y profesionales en el manejo de las ECNT.

Changes experienced by people diagnosed with Chronic Non-Communicable Diseases (NCDs), at the individual, familial, or social levels show the importance of psychological interventions based on the cognitive-behavioral model. This article reviews literature showing the effectiveness of this model in facilitating adjustments in lifestyle, generating greater compliance with the treatment, minimizing risks of relapse, and maintaining the patients' and their families' quality of life level. The conclusion is that it is essential for psychological interventions to be carried out with quality, equality, timeliness, and pertinence, in order to reduce the instrumental, temporal, and professional costs of treating NCDs in the medium term.

As mudanças que as pessoas diagnosticadas com Doenças Crônicas não Transmissíveis (DCNT) experimentam no âmbito individual, familiar ou social, evidenciam a importância da intervenção psicológica a partir do modelo cognitivo-comportamental. Neste artigo, faz-se uso de literatura que demonstra a efetividade desse modelo para facilitar ajustes no estilo de vida, gerar maior comprometimento ao tratamento, minimizar riscos de recaída e manter o nível de qualidade de vida do paciente e dos que o rodeiam. Conclui-se que é fundamental que a intervenção psicológica seja oferecida com qualidade, equidade, oportunidade e pertinência, o que reduzirá em médio prazo os custos instrumentais, temporais e profissionais na administração das DCNT.

Myanmar diabetes care model: Bridging the gap between urban and rural healthcare delivery / Journal of the ASEAN Federation of Endocrine Societies

@#There has been significant magnitude of problems of diabetes in Myanmar, according to the estimates of International Diabetes Federation (IDF) and the recent National Survey on the prevalence of diabetes. There has been a wide gap of equity between the urban and rural healthcare delivery for diabetes. Myanmar Diabetes Care Model (MMDCM) aims to deliver equitable diabetes care throughout the country, to stem the tide of rising burden of diabetes and also to facilitate to achieve the targets of the Global Action Plan for the Prevention and Control of NCDs (2013-2020). It is aimed to deliver standard of care for diabetes through the health system strengthening at all level. MMDCM was developed based on the available health system, resources and the country's need. Implementation for the model was also discussed.

Hypertension-the Major Cause of Morbidity, Hospitalisation and Mortality among Non-communicable Diseases in the Gambia.

Aim: This study aimed at investigating the major cause of morbidity, hospitalisation and mortality among Non-communicable Diseases (NCDs) in The Gambia, in an effort to raise awareness on the alarming trend and thus stimulating appropriate responses from stakeholders. Method: Descriptive and inferential statistics were used to analyse a nation-wide routine hospital-based data on NCDs in The Gambia. Data were also presented in tables showing the trend of morbidity (in and out-patient case), hospitalisation and mortality between 2008 and 2011. Result: Hypertension as a risk factor for cardiovascular diseases constitutes more than half (55%) of all hospital admissions due to NCDs while cardiovascular diseases as a whole constitute well over 60% of all hospital admissions from NCDs. Of all NCDs studied, morbidity due to hypertension constitutes 80%, nearly responsible for all morbidities due to cardiovascular diseases for the years considered. Seventy percent (70%) of all deaths due to NCDs were caused by cardiovascular diseases, and hypertension was an important factor for NCDs related mortality (47.9% in 2008 to 55.8% in 2011;p-value=0.13). There were increments in morbidity and mortality due to hypertension and cardiovascular diseases between 2008 and 2011. However, there was reduction in hospitalisation due to cardiovascular diseases, but not the case with hypertension (incremental change). The differences in morbidity and hospitalisation were statistically significant for cardiovascular diseases (p<0.0001 and p=0.034 respectively) while only increment in morbidity due to hypertension was statistically significant (p<0.0001). Conclusion: This study shows that hypertension as a risk factor for cardiovascular disease is the greatest cause of morbidity, hospitalisation and mortality among NCDs in The Gambia. Hence, a holistic approach tailored towards preventing the acquisition/onset of the modifiable risk factors (of hypertension and CVD) should be instituted as well as programmes capable of preventing target organ damage among the population already affected.

Morbilidad cardiovascular por autoreporte y suasociaci¾n con factores biopsicosociales, Tolima,Colombia / Self reported cardiovascular disease and association with biopsychosocial factors, Tolima, Colombia

Objetivo: establecer la prevalencia de morbilidadcardiovascular por autoreporte en adultos de 18 a 69 a±os, enel Tolima, y explorar su asociaci¾n con factores biol¾gicos,psicol¾gicos y sociales, a partir de la Encuesta Nacionalde Salud 2007. MetodologÝa: estudio epidemiol¾gicoobservacional, con un componente descriptivo-transversaly otro analÝtico-transversal de asociaci¾n, que emple¾ 1219registros de personas entre 18 y 69 a±os del departamento delTolima, provenientes de la Encuesta Nacional de Salud 2007.Se describieron las caracterÝsticas demogrßficas y se determin¾la prevalencia de factores de riesgo biopsicosociales paraenfermedad cardiovascular por auto-reporte. Se exploraronasociaciones entre esos factores y enfermedad cardiovasculargrave. Resultados: los factores de riesgo mßs prevalentes enlas personas que desarrollaron un evento cardiovascular fueronhipertensi¾n: 16,8%; dependencia al alcohol: 14,1%; niveleducativo nulo: 14%; la prevalencia de eventos cardiovascularesgraves es del 5,5%. Al ajustar por variables de sexo y edadse encontr¾ que los factores de riesgo para enfermedadcardiovascular grave son el autoreporte de problemasde salud mental, hipertensi¾n, dependencia al alcohol,hipercolesterolemia e hipertrigliceridemia. Conclusiones:ademßs de los factores biol¾gicos reconocidos, se encontr¾que el autoreporte de problemßticas mentales tambiÚn es unfactor de riesgo para la enfermedad cardiovascular grave autoreportada...

Objective: to determine the prevalence of self-reportedcardiovascular disease in adults aged 18 to 69 in Tolima andto explore their association with biological, psychologicaland social factors from the 2007 National Health Survey.Methodology: an observational epidemiological study witha descriptive component and an analytic cross section ofassociation, employing 1219 records of people between theages of 18 and 69 in the Tolima department, taken from the2007 National Health Survey. Demographic characteristicswere described and the prevalence of biopsychosocial riskfactors for cardiovascular disease by self-reporting wasdetermined. The relationships between these factors andsevere cardiovascular disease were explored. Results:the most prevalent risk factors in people who developeda cardiovascular event were high blood pressure: 16.8%;alcohol dependence: 14.1%; lack of education: 14%. Theprevalence of major cardiovascular events was 5.5%. Afteradjusting for age and sex variables it was found that riskfactors for major cardiovascular disease are: self-reporting ofmental health problems, hypertension, alcohol dependence,hypercholesterolemia and hypertriglyceridemia. Conclusions:in addition to the biological factors that were identified, it wasfound that self-reporting mental health issues is also a riskfactor for self-reported serious cardiovascular disease...

Barriers to medication adherence among patients with non-communicable diseases: Fijian health professionals’ perceptions / 国際保健医療

<b>Objective</b><BR>  The purpose of this study was to examine health professionals’ perceptions of barriers to medication adherence in patients with non-communicable diseases (NCDs) in Fiji.<BR>Methods: Interviews were conducted with 25 health professionals (physicians and pharmacists) treating patients with NCDs in Fiji. The interview contained questions regarding barriers to medication adherence for specific NCDs. <BR><b>Results</b><BR>  Health professionals’ perception of these barriers were identified and divided into patient-related and non-patient-related factors. The patient-related factors included lifestyle, knowledge, technique, language, and beliefs and culture. The non-patient-related factors were cost and access to medication, therapy-related factors, and support from other people.<BR><b>Conclusion</b><BR>  Traditional medical beliefs, medication access and affordability, negative lifestyle habits, and insufficient knowledge about illnesses, medical devices, and medications were identified as barriers to medication adherence in Fiji. Barriers to medication adherence differ according to diagnosis. Knowledge was considered an important factor with respect to adherence to medication regimens, particularly for patients with asymptomatic conditions (e.g., diabetes, hypertension, and stable asthma).

Potential Functional Implications of Pearl millet (Pennisetum glaucum) in Health and Disease.

Pearl millet (Pennisetum glaucum), also known as Bajra, is one of the four most important cereals (rice, maize, sorghum and millets) grown in tropical semi-arid regions of the world primarily in Africa and Asia. Our aim is to review the potential health benefits of pearl millet. Desk reviews from Gujarat Agricultural Universities, libraries, PubMed and other web sources, key informant interviews of farmers (n=30), local leaders (sarpanch) (n=30) and women (n=960) from pearl millet belt of Banaskantha district of Gujarat. Pearl millet is rich in several nutrients as well as non-nutrients such as phenols. It has high energy, has less starch, high fiber (1.2g/100g, most of which is insoluble), 8-15 times greater α-amylase activity as compared to wheat, has low glycemic index (55) and is gluten free. The protein content ranges from 8 to 19% and it is low in lysine, tryptophan, threonine and the sulfur-containing amino acids. The energy of millet is greater than sorghum and nearly equal to that of brown rice because the lipid content is generally higher (3 to 6%). Pearl millet can be recommended in the treatment of celiac diseases, constipation and several non-communicable diseases. Nutritional studies on the population living in the pearl millet belts of the world and clinical trials on the impact of pearl millet in specific disease conditions are needed.

Obesity prevention: the key to non-communicable disease control / Prevención de la obesidad: clave del control de las enfermedades no comunicables

Non-communicable diseases (NCDs) are the main public health problem in the Caribbean and they place a severe economic burden on the health systems in the region. This paper contends that preventing obesity is a critical factor in controlling NCDs. The paper further argues that obesity prevention is more likely to come from structural and policy-related changes to the environment than from medical interventions targeted at the individual. Rolling back the rapid increase in obesity in the Caribbean requires much more than the traditional passive approach that relied almost entirely on education for individual behavioural change. The traditional models of obesity control have generally failed globally and a new public policy approach needs to be instituted to attack this epidemic in a multisectoral way. Effective control of obesity will require a shift away from the traditional focus on clinical management and individual behaviour change towards strategies which deal with the environment in which such behaviours occur. Outlined in this paper are key policy changes required by the various sectors whose inputs are vital to the success of prevention efforts.

Las enfermedades no comunicables (ENCs) constituyen el problema principal de la salud pública en el Caribe y representan una pesada carga económica para los sistemas de salud en la región. Este trabajo sostiene que la prevención de la obesidad es un factor crítico a la hora de controlar las ENCs. El trabajo sostiene además que la prevención de la obesidad tiene mayor probabilidad de producirse como consecuencia de cambios estructurales y relacionados con las políticas hacia el medio ambient, que como resultado de intervenciones médicas dirigidas al individuo. El retroceso del rápido aumento de los niveles de obesidad en el Caribe requiere mucho más que el enfoque tradicional pasivo basado casi totalmente en la educación encaminada a cambios en la conducta individual. Los modelos tradicionales de control de la obesidad han fallado por lo general globalmente. Se necesita instaurar un nuevo enfoque en materia de políticas públicas para atacar esta epidemia de una manera multisectorial. El control efectivo de la obesidad requerirá un cambio del foco de atención - tradicionalmente centrado en el tratamiento clínico y el cambio de comportamiento individual - hacia estrategias que traten con el ambiente en que tales comportamientos ocurren. El trabajo bosqueja cambios claves en materia de políticas, requeridos por diversos sectores cuya contribución es vital para el éxito de los esfuerzos por la prevención.