Prevalence and Predictors of Double Burden of Malnutrition within Households in Africa: A Systematic Review

In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.

Production of antihypertensive and antidiabetic peptide fractions from quinoa(Chenopodium quinoa Willd.)by electrodialysis with ultrafi ltration membranes

Processing bioactive peptides from natural sources using electrodialysis with ultrafiltration membranes(EDUF)have gained attention since it can fractionate in terms of their charge and molecular weight.Quinoa is a pseudo-cereal highlighted by its high protein content,amino acid profile and adapting growing conditions.The present work aimed at the production of quinoa peptides through fractionation using EDUF and to test the fractions according to antihypertensive and antidiabetic activity.Experimental data showed the production of peptides ranging between 0.4 and 1.5 k Da.Cationic(CQPF)(3.01%),anionic(AQPF)(1.18%)and the electrically neutral fraction quinoa protein hydrolysate(QPH)-EDUF(~95%)were obtained.In-vitro studies showed the highest glucose uptake modulation in L6 cell skeletal myoblasts in presence of QPH-EDUF and AQPF(17%and 11%)indicating potential antidiabetic activity.The antihypertensive effect studied in-vivo in spontaneously hypertensive rats(SHR),showed a decrease in systolic blood pressure in presence of the fractionated peptides,being 100 mg/kg a dose comparable to Captopril(positive control).These results contribute to the current knowledge of bioactive peptides from quinoa by reporting the relevance of EDUF as tool to produce selected peptide fractions.Nevertheless,further characterization is needed towards peptide sequencing,their respective role in the metabolism and scaling-up production using EDUF.

Fasting biochemical hypoglycemia and related-factors in nondiabetic population: Kanagawa Investigation of Total Check-up Data from National Database-8

BACKGROUND In healthy people,the lowest daily blood glucose concentration is usually observed in the early morning,after overnight fasting.However,the clinical relevance and the prevalence of fasting biochemical hypoglycemia(FBH)are poorly understood in people who do not have diabetes,although the clinical implications of such hypoglycemia have been extensively studied in patients with diabetes.FBH can be influenced by many factors,including age,sex,body mass,smoking,alcohol drinking,exercise levels,medications,and eating behaviors,such as breakfast skipping and late-night eating.AIM To determine the prevalence of FBH and investigated its association with potential risk factors in a population without diabetes.METHODS Clinical parameters and lifestyle-related factors were assessed in a cross-sectional study of 695613 people aged 40-74 years who had undergone a health check-up(390282 men and 305331 women).FBH was defined as fasting plasma glucose<70 mg/dL(3.9 mmol/L)after overnight fasting,regardless of any symptoms.The absence of diabetes was defined as HbA1c<6.5%,fasting plasma glucose<126 mg/dL(7.0 mmol/L),and no pharmacotherapy for diabetes.Multivariate logistic regression analysis,with adjustment for confounding factors,was used to identify associations.RESULTS FBH was present in 1842 participants(0.26%).There were significantly more women in the FBH group(59.1%)than in the non-FBH group(43.9%).Values of most of the clinical parameters,but not age,were significantly lower in the FBH group than in the non-FBH group.Logistic regression analysis showed that a body mass index of≤20.9 kg/m2(reference:21-22.9 kg/m2)and current smoking were significantly associated with FBH,and this was not altered by adjustment for age,sex,and pharmacotherapy for hypertension or dyslipidemia.Female sex was associated with FBH.When the data were analyzed according to sex,men in their 60s or 70s appeared more likely to experience FBH compared with their 40s,whereas men in their 50s and women aged≥50 years appeared less likely to experience FBH.The relationships of FBH with other factors including alcohol drinking and pharmacotherapies for hypertension and dyslipidemia also differed between men and women.CONCLUSION FBH occurs even in non-diabetic people,albeit at a very low frequency.FBH is robustly associated with low body mass and smoking,and its relationship with lifestyle factors varies according to sex.

Unhealthy eating habits around sleep and sleep duration: To eat or fast?

Traditionally, breakfast skipping(BS), and recently latenight dinner eating(LNDE), have attracted attention in public health because they can predispose to cardiometabolic conditions such as obesity and type 2 diabetes. Intriguingly, it has become evident that short duration of sleep elicits similar health risks. As LNDE, BS, and short sleep can be closely related and can aggravate each other, these three should not be considered separately. In this context, LNDE(or its equivalents, snacking or heavy alcohol consumption after dinner) and BS may be representative unhealthy eating habits around sleep(UEHAS). While it is important to take energy in the early morning for physical and intellectual activities, attaining a fasting state is essential for metabolic homeostasis. Our previous UEHAS studies have shown that BS without LNDE, i.e., BS alone, is not associated with obesity and diabetes, suggesting the possibility that BS or taking a very low energy breakfast, which could yield fasting for a while, may prevent obesity and diabetes in people with inevitable LNDE. Further studies considering UEHAS and short sleep simultaneously are needed to elucidate the effects of these unhealthy lifestyles on cardiometabolic diseases.

Age-dependent changes in the association between sleep duration and impaired glucose metabolism

AIM To investigate whether the association between sleep duration and impaired glucose metabolism varies among younger and older populations.METHODS We reviewed data of self-reported habitual sleep duration per night, HbA1c levels, and clinically relevant factors in a cross-sectional checkup database of 75472 Japanese from the general population aged 20-79 years(51695 men and 23777 women). Associations of prediabetes(HbA1c ≥ 5.7% and/or diabetic pharmacotherapy) or diabetes(HbA1c ≥ 6.5% and/or diabetic pharmacotherapy) with short and long sleep durations compared with a reference sleep duration(7 h) were investigated by multivariate logistic regression analysis. We controlled for potential relevant confounders, including age, sex, and work duration per day according to younger and older subjects.RESULTS As age advanced, sleep duration became longer and this increase in the 40 s and 50 s was two times greater in men than in women. This finding was accompanied by a deterioration in HbA1c levels. In subjects aged youngerthan 40 years(n = 32929), HbA1c levels were inversely and linearly correlated with sleep duration in both sexes. However, in subjects aged 40 years or older(n = 42543), HbA1c levels showed a non-linear relationship against sleep duration with a nadir at 7 h. Multivariate logistic regression analysis showed that in younger subjects, short durations of sleep(≤ 5 h and 6 h) were positively associated with prediabetes(both P < 0.001), but a long duration of sleep(≥ 8 h) was inversely associated with prediabetes(P < 0.001). These associations remained significant after adjustment for relevant confounders, including age, sex, and work duration per day(ORs = 1.20, 95%CI: 1.05-1.37, P < 0.001; ORs = 1.12, 95%CI: 1.02-1.24, P < 0.05; and ORs = 0.84, 95%CI: 0.72-0.99, P < 0.05, respectively). In contrast, in older subjects, besides an association of prediabetes with a short duration of sleep(≤ 5 h)(ORs = 1.12, 95%CI: 1.03-1.21, P < 0.01), diabetes was significantly associated with a long duration of sleep(≥ 8 h)(ORs = 1.11, 95%CI: 1.02-1.25, P < 0.05). CONCLUSION A short sleep duration may be associated with prediabetes throughout life. However, the association between a long sleep duration and glucose metabolism can change with aging.