#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Urbanicity and Lifestyle Risk Factors for Cardiometabolic Diseases in Rural Uganda: A Cross-Sectional Study


Background:
Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.

Methods and Findings:
Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77).

Conclusions:
This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA.

Please see later in the article for the Editors' Summary


Vyšlo v časopise: Urbanicity and Lifestyle Risk Factors for Cardiometabolic Diseases in Rural Uganda: A Cross-Sectional Study. PLoS Med 11(7): e32767. doi:10.1371/journal.pmed.1001683
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001683

Souhrn

Background:
Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.

Methods and Findings:
Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77).

Conclusions:
This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA.

Please see later in the article for the Editors' Summary


Zdroje

1. ShawJE, SicreeRA, ZimmetPZ (2010) Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 87: 4–14.

2. WuZ, ZhouJ, PankajP, PengB (2012) Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis: an evaluation of immunity. Surg Endosc 26: 3557–3564.

3. YusufS, ReddyS, OunpuuS, AnandS (2001) Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 104: 2746–2753.

4. PopkinBM, Gordon-LarsenP (2004) The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord 28 (Suppl 3)S2–S9.

5. EzzatiM, Vander HoornS, LawesCM, LeachR, JamesWP, et al. (2005) Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med 2: e133.

6. SodjinouR, AguehV, FayomiB, DelisleH (2008) Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns. BMC Public Health 8: 84.

7. CohenB (2006) Urbanization in developing countries: current trends, future projections, and key challenges for sustainability. Technol Soc 28: 63–80.

8. ChenXD, HeFQ, YangL, YuYY, ZhouZG (2013) Laparoscopic splenectomy with or without devascularization of the stomach for liver cirrhosis and portal hypertension: a systematic review. ANZ J Surg 83: 122–128.

9. Champion AG, Hugo G (2004) New forms of urbanization: beyond the urban-rural dichotomy. Aldershot (UK): Ashgate Publishing.

10. AllenderS, FosterC, HutchinsonL, ArambepolaC (2008) Quantification of urbanization in relation to chronic diseases in developing countries: a systematic review. J Urban Health 85: 938–951.

11. AllenderS, LaceyB, WebsterP, RaynerM, DeepaM, et al. (2010) Level of urbanization and noncommunicable disease risk factors in Tamil Nadu, India. Bull World Health Organ 88: 297–304.

12. AllenderS, WickramasingheK, GoldacreM, MatthewsD, KatulandaP (2011) Quantifying urbanization as a risk factor for noncommunicable disease. J Urban Health 88: 906–918.

13. Jones-SmithJC, PopkinBM (2010) Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med 71: 1436–1446.

14. NovakNL, AllenderS, ScarboroughP, WestD (2012) The development and validation of an urbanicity scale in a multi-country study. BMC Public Health 12: 530.

15. Van de PoelE, O’DonnellO, Van DoorslaerE (2009) Urbanization and the spread of diseases of affluence in China. Econ Hum Biol 7: 200–216.

16. MondaKL, Gordon-LarsenP, StevensJ, PopkinBM (2007) China’s transition: the effect of rapid urbanization on adult occupational physical activity. Soc Sci Med 64: 858–870.

17. PoelE, O’DonnellO, DoorslaerE (2012) Is there a health penalty of China’s rapid urbanization? Health Econ 21: 367–385.

18. DahlyDL, AdairLS (2007) Quantifying the urban environment: a scale measure of urbanicity outperforms the urban-rural dichotomy. Soc Sci Med 64: 1407–1419.

19. United Nations Population Division Department of Economic and Social Affairs (2012) World urbanization prospects: the 2011 revision, CD-ROM edition. New York: United Nations Population Division.

20. Kalungu District Administration (2011) Kyamulibwa Local Government Council 111 approved five year development plan 2010/2011–2014/2015. Kalungu (Uganda): Kalungu District Administration.

21. AsikiG, MurphyG, Nakiyingi-MiiroJ, SeeleyJ, NsubugaRN, et al. (2013) The general population cohort in rural south-western Uganda: a platform for communicable and non-communicable disease studies. Int J Epidemiol 42: 129–141.

22. DalyMC, DuncanGJ, McDonoughP, WilliamsDR (2002) Optimal indicators of socioeconomic status for health research. Am J Public Health 92: 1151–1157.

23. GalobardesB, ShawM, LawlorDA, LynchJW, Davey SmithG (2006) Indicators of socioeconomic position (part 1). J Epidemiol Community Health 60: 7–12.

24. EvansGW, KantrowitzE (2002) Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health 23: 303–331.

25. AriasE, DeVosS (1996) Using housing items to indicate socioeconomic status: Latin America. Soc Indic Res 38: 53–80.

26. AdlerNE, NewmanK (2002) Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood) 21: 60–76.

27. World Health Organization (2014) STEPS manual. Available: http://www.who.int/chp/steps/manual/en/index.html. Accessed 24 June 2014.

28. World Health Organization (2008) WHO global strategy on diet, physical activity and health: a framework to monitor and evaluate implementation. Department of Chronic Diseases and Health Promotion.

29. Joint Food and Agriculture Organization/World Health Organization (2004) Fruit and vegetables for health: report of a joint FAO/WHO workshop. WHO, Kobe, Japan.

30. World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization.

31. World Health Organization–International Society of Hypertension Guidelines Subcommittee (1999) 1999 World Health Organization–International Society of Hypertension guidelines for the management of hypertension. J Hypertens 17: 151–183.

32. World Health Organization (2009) Global physical activity surveillance. Available: http://www.who.int/chp/steps/GPAQ/en/index.html. Accessed 24 June 2014.

33. World Health Organization (1990) Diet, nutrition and the prevention of chronic diseases. Technical Report Series 797. Geneva: World Health Organization.

34. World Health Organization/Food and Agriculture Organization (2003) Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. WHO, Geneva, Switzerland.

35. European Society of Hypertension–European Society of Cardiology Guidelines Committe (2003) European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 21: 1011–1053.

36. International Diabetes Federation (2006) The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation.

37. KaplanGA, KeilJE (1993) Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 88: 1973–1998.

38. HoweLD, GalobardesB, MatijasevichA, GordonD, JohnstonD, et al. (2012) Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper. Int J Epidemiol 41: 871–886.

39. VlahovD, GaleaS (2002) Urbanization, urbanicity, and health. J Urban Health 79: S1–S12.

40. NovakNL, AllenderS, ScarboroughP, WestD (2012) The development and validation of an urbanicity scale in a multi-country study. BMC Public Health 12: 530.

41. VorsterHH (2002) The emergence of cardiovascular disease during urbanisation of Africans. Public Health Nutr 5: 239–243.

42. HernandezAV, PasupuletiV, DeshpandeA, Bernabe-OrtizA, MirandaJJ (2012) Effect of rural-to-urban within-country migration on cardiovascular risk factors in low- and middle-income countries: a systematic review. Heart 98: 185–194.

43. KinraS, AndersenE, Ben-ShlomoY, BowenL, LyngdohT, et al. (2011) Association between urban life-years and cardiometabolic risk: the Indian migration study. Am J Epidemiol 174: 154–164.

44. EbrahimS, KinraS, BowenL, AndersenE, Ben-ShlomoY, et al. (2010) The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLoS Med 7: e1000268.

45. SobngwiE, MbanyaJC, UnwinNC, PorcherR, KengneAP, et al. (2004) Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon. Int J Epidemiol 33: 769–776.

46. AntecolH, BedardK (2006) Unhealthy assimilation: why do immigrants converge to American health status levels? Demography 43: 337–360.

47. CyrilS, OldroydJC, RenzahoA (2013) Urbanisation, urbanicity, and health: a systematic review of the reliability and validity of urbanicity scales. BMC Public Health 13: 513.

48. MaletnlemaTN (2002) A Tanzanian perspective on the nutrition transition and its implications for health. Public Health Nutr 5: 163–168.

49. CohenB (2004) Urban growth in developing countries: a review of current trends and a caution regarding existing forecasts. World Dev 32: 23–51.

50. WardDS, EvensonKR, VaughnA, RodgersAB, TroianoRP (2005) Accelerometer use in physical activity: best practices and research recommendations. Med Sci Sports Exerc 37: S582–S588.

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2014 Číslo 7
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#