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Biomedical subjects

Anwar T Merchant

Publications and source records attributed to Anwar T Merchant.

At least 19 recordsLinked to original sources
PubMed2007

Diet, physical activity, and adiposity in children in poor and rich neighbourhoods: a cross-sectional comparison.

BACKGROUND: Obesity in Canadian children increased three-fold in twenty years. Children living in low-income neighborhoods exercise less and are more overweight than those living in more affluent neighborhoods after accounting for family socio-economic status. Strategies to prevent obesity in children have focused on personal habits, ignoring neighborhood characteristics. It is essential to evaluate diet and physical activity patterns in relation to socio-economic conditions to understand the determinants of obesity. The objective of this pilot study was to compare diet, physical activity, and the built environment in two Hamilton area elementary schools serving socio-economically different communities. METHODS: We conducted a cross-sectional study (November 2005-March 2006) in two public elementary schools in Hamilton, Ontario, School A and School B, located in low and high socioeconomic areas respectively. We assessed dietary intake, physical activity, dietary restraint, and anthropometric measures in consenting children in grades 1 and higher. From their parents we assessed family characteristics and walkability of the built environment. RESULTS: 160 children (n = 48, School A and n = 112, School B), and 156 parents (n = 43, School A and n = 113, School B) participated in this study. The parents with children at School A were less educated and had lower incomes than those at School B. The School A neighborhood was perceived to be less walkable than the School B neighborhood. Children at School A consumed more baked foods, chips, sodas, gelatin desserts, and candies and less low fat dairy, and dark bread than those at School B. Children at School A watched more television and spent more time in front of the computer than children studying at School B, but reported spending less time sitting on weekdays and weekends. Children at both schools were overweight but there was no difference in their mean BMI z-scores (School A = 0.65 versus School B = 0.81, p-value = 0.38). CONCLUSION: The determinants of overweight in children may be more complex than imagined. In future intervention programs researchers may consider addressing environmental factors, and customizing lifestyle interventions so that they are closer to community needs.

Adiposity↗
PubMed2007

Carbohydrate intake and HDL in a multiethnic population.

BACKGROUND: Ethnic differences in serum lipids are not explained by genetics, central adiposity, lifestyle, or diet, possibly because dietary carbohydrate has not been considered. OBJECTIVE: The aim was to evaluate the relation between carbohydrate intake and HDL and triacylglycerol concentrations in a multiethnic population. DESIGN: We conducted a population-based cross-sectional study of 619 Canadians of Aboriginal, South Asian, Chinese, and European origin with no previously diagnosed medical conditions. Energy-adjusted carbohydrate intake was measured by a validated food-frequency questionnaire. RESULTS: South Asians consumed the most carbohydrate, followed by European, Aboriginal, and Chinese persons. Mean (95% CI) HDL concentrations in the lowest and highest categories of carbohydrate intake after adjustment for age, sex, ethnicity, physical activity, smoking, the waist-to-hip ratio, body mass index, alcohol intake, and intakes of total energy, protein, and fiber were 1.21 mmol/L (1.16, 1.27 mmol/L) and 1.08 mmol/L (1.02, 1.13 mmol/L), respectively, and HDL cholesterol was significantly (P < 0.01) higher in the lowest tertile of carbohydrate intake than in the highest tertile. High carbohydrate intake was associated with higher fasting triacylglycerols (P = 0.04); the adjusted mean fasting triacylglycerol concentrations in the lowest and highest categories of carbohydrate intake were 1.43 mmol/L (1.28, 1.60 mmol/L) and 1.71 mmol/L (1.57, 1.87 mmol/L), respectively. Fewer servings of sugar-containing soft drinks, juices, and snacks were associated with higher HDL (P for trend = 0.02); the multivariate-adjusted mean HDL in the lowest and highest categories of carbohydrate intake was 1.22 mmol/L (1.17, 1.27 mmol/L) and 1.11 mmol/L (1.06, 1.26 mmol/L), respectively. CONCLUSIONS: Differences in HDL and triacylglycerols observed in different ethnic groups may be due in part to carbohydrate intake. Reducing the frequency of intake of sugar-containing soft drinks, juices, and snacks may be beneficial.

Beverages↗
PubMed2006

Percutaneous injuries among dental professionals in Washington State.

BACKGROUND: Percutaneous exposure incidents facilitate transmission of bloodborne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). This study was conducted to identify the circumstances and equipment related to percutaneous injuries among dental professionals. METHODS: We used workers' compensation claims submitted to the Department of Labor and Industries State Fund during a 7-year period (1995 through 2001) in Washington State for this study. We used the statement submitted by the injured worker on the workers' compensation claim form to determine the circumstances surrounding the injury including the type of activity and device involved. RESULTS: Of a total of 4,695 accepted State Fund percutaneous injury claims by health care workers (HCWs), 924 (20%) were submitted by dental professionals. Out of 924 percutaneous injuries reported by dental professionals 894 (97%) were among dental health care workers in non-hospital settings, including dentists (66, 7%), dental hygienists (61, 18%) and dental assistants (667, 75%). The majority of those reporting were females (638, 71%). Most (781, 87%) of the injuries involved syringes, dental instruments (77, 9%), and suture needles (23%). A large proportion (90%) of injuries occurred in offices and clinics of dentists, while remainder occurred in offices of clinics and of doctors of medicine (9%), and a few in specialty outpatient facilities (1%). Of the 894 dental health care workers with percutaneous injuries, there was evidence of HBV in 6 persons, HCV in 30 persons, HIV in 3 persons and both HBV and HVC (n = 2) exposure. CONCLUSION: Out of hospital percutaneous injuries are a substantial risk to dental health professionals in Washington State. Improved work practices and safer devices are needed to address this risk.

Accidents, Occupational↗
PubMed2006

Food composition database development for between country comparisons.

Nutritional assessment by diet analysis is a two-stepped process consisting of evaluation of food consumption, and conversion of food into nutrient intake by using a food composition database, which lists the mean nutritional values for a given food portion. Most reports in the literature focus on minimizing errors in estimation of food consumption but the selection of a specific food composition table used in nutrient estimation is also a source of errors. We are conducting a large prospective study internationally and need to compare diet, assessed by food frequency questionnaires, in a comparable manner between different countries. We have prepared a multi-country food composition database for nutrient estimation in all the countries participating in our study. The nutrient database is primarily based on the USDA food composition database, modified appropriately with reference to local food composition tables, and supplemented with recipes of locally eaten mixed dishes. By doing so we have ensured that the units of measurement, method of selection of foods for testing, and assays used for nutrient estimation are consistent and as current as possible, and yet have taken into account some local variations. Using this common metric for nutrient assessment will reduce differential errors in nutrient estimation and improve the validity of between-country comparisons.

Agriculture↗
PubMed2006

Whole-grain and fiber intakes and periodontitis risk in men.

BACKGROUND: Diabetes and hyperglycemia increase periodontitis risk, severity, and extent. Increased whole-grain and fiber intakes are associated with improved insulin sensitivity and may therefore affect periodontitis risk. OBJECTIVE: The objective was to examine the associations between whole-grain and fiber intakes and periodontitis risk. DESIGN: We prospectively followed 34,160 male US health professionals aged 40-75 y at the outset. We updated medical and lifestyle information biennially with questionnaires and diet every 4 y by using a validated food-frequency questionnaire. We excluded men reporting periodontitis, myocardial infarction, stroke, and hypercholesterolemia before 1986 and those with incomplete dietary data. All diabetics were excluded. Periodontitis was determined by a report of professionally diagnosed disease and validated by a diagnosis of periodontitis by a periodontist from a blinded review of radiographs. RESULTS: Men in the highest quintile of whole-grain intake were 23% less likely to get periodontitis than were those in the lowest quintile (multivariate RR: 0.77; 95% CI: 0.66, 0.89; P for trend < 0.001) after adjustment for age, smoking, body mass index, alcohol intake, physical activity, and total energy intake. Periodontitis was not associated with refined-grain intake (multivariate RR comparing extreme quintiles of intake: 1.04; 95% CI: 0.89, 1.23; P for trend = 0.37). Cereal fiber was inversely related to periodontitis risk (multivariate RR comparing extreme quintiles of intake: 0.85; 95% CI: 0.73, 0.99; P for trend = 0.03), but the association was not significant after adjustment for whole-grain intake. CONCLUSION: Increasing whole grain in the diet without increasing total energy intake may reduce periodontitis risk.

Adult↗
PubMed2005

Nutrient estimation from an FFQ developed for a Black Zimbabwean population.

BACKGROUND: There is little information in the literature on methods of food composition database development to calculate nutrient intake from food frequency questionnaire (FFQ) data. The aim of this study is to describe the development of an FFQ and a food composition table to calculate nutrient intake in a Black Zimbabwean population. METHODS: Trained interviewers collected 24-hour dietary recalls (24 hr DR) from high and low income families in urban and rural Zimbabwe. Based on these data and input from local experts we developed an FFQ, containing a list of frequently consumed foods, standard portion sizes, and categories of consumption frequency. We created a food composition table of the foods found in the FFQ so that we could compute nutrient intake. We used the USDA nutrient database as the main resource because it is relatively complete, updated, and easily accessible. To choose the food item in the USDA nutrient database that most closely matched the nutrient content of the local food we referred to a local food composition table. RESULTS: Almost all the participants ate sadza (maize porridge) at least 5 times a week, and about half had matemba (fish) and caterpillar more than once a month. Nutrient estimates obtained from the FFQ data by using the USDA and Zimbabwean food composition tables were similar for total energy intake intra class correlation (ICC) = 0.99, and carbohydrate (ICC = 0.99), but different for vitamin A (ICC = 0.53), and total folate (ICC = 0.68). CONCLUSION: We have described a standardized process of FFQ and food composition database development for a Black Zimbabwean population.

Adult↗
PubMed2005

Childhood obesity, prevalence and prevention.

Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.

Child↗
PubMed2005

Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods.

BACKGROUND: The Food Frequency Questionnaire (FFQ) is one of the most commonly used tools in epidemiologic studies to assess long-term nutritional exposure. The purpose of this study is to describe the development of a culture specific FFQ for Arab populations in the United Arab Emirates (UAE) and Kuwait. METHODS: We interviewed samples of Arab populations over 18 years old in UAE and Kuwait assessing their dietary intakes using 24-hour dietary recall. Based on the most commonly reported foods and portion sizes, we constructed a food list with the units of measurement. The food list was converted to a Semi-Quantitative Food Frequency Questionnaire (SFFQ) format following the basic pattern of SFFQ using usual reported portions. The long SFFQ was field-tested, shortened and developed into the final SFFQ. To estimate nutrients from mixed dishes we collected recipes of those mixed dishes that were commonly eaten, and estimated their nutritional content by using nutrient values of the ingredients that took into account method of preparation from the US Department of Agriculture's Food Composition Database. RESULTS: The SFFQs consist of 153 and 152 items for UAE and Kuwait, respectively. The participants reported average intakes over the past year. On average the participants reported eating 3.4 servings/d of fruits and 3.1 servings/d of vegetables in UAE versus 2.8 servings/d of fruits and 3.2 servings/d of vegetables in Kuwait. Participants reported eating cereals 4.8 times/d in UAE and 5.3 times/d in Kuwait. The mean intake of dairy products was 2.2/d in UAE and 3.4 among Kuwaiti. CONCLUSION: We have developed SFFQs to measure diet in UAE and Kuwait that will serve the needs of public health researchers and clinicians and are currently validating those instruments.

Adult↗
PubMed2005

Intake of n-6 and n-3 fatty acids and fish and risk of community-acquired pneumonia in US men.

BACKGROUND: Essential fatty acids modulate inflammation and glucose metabolism and may alter infection risk. OBJECTIVE: We examined the association between intakes of n-6 and n-3 fatty acids and fish and the risk of community-acquired pneumonia. DESIGN: We prospectively evaluated 38,378 male US health professionals aged 44-79 y at the outset. We updated medical and lifestyle information biennially through questionnaires and diet every 4 y with the use of a validated food-frequency questionnaire. We excluded men who reported pneumonia, myocardial infarction, stroke, other heart disease, arterial surgery, cancer, or asthma before 1990 or those with incomplete dietary data. Community-acquired pneumonia was determined by blinded medical record review of chest radiographs. RESULTS: During 10 y of follow-up, there were 441 new cases of nonfatal community-acquired pneumonia. Pneumonia risk was lower in men in the highest energy-adjusted quintiles of intake than in men in the lowest quintiles of intake of linoleic acid [multivariate relative risk (RR): 0.70; 95% CI: 0.51, 0.96; P for trend = 0.01] and alpha-linolenic acid (multivariate RR: 0.68; 95% CI: 0.50, 0.93; P for trend = 0.01). Pneumonia risk decreased 4% for every 1-g/d increase in linoleic acid intake (multivariate RR: 0.96; 95% CI: 0.93, 0.99). Pneumonia risk was reduced by 31% for every 1-g/d increase in alpha-linolenic acid intake (multivariate RR: 0.69; 95% CI: 0.51, 0.93). Intakes of eicosapentaenoic acid and docosahexaenoic acid were not significantly related to pneumonia risk. CONCLUSION: Higher intakes of alpha-linolenic and linoleic acids and possibly of fish may reduce the risk of pneumonia.

Adult↗
PubMed2005

Protein intake is inversely associated with abdominal obesity in a multi-ethnic population.

Abdominal obesity is related to significant morbidity and mortality and differs by ethnicity; however, the relation between diet and abdominal obesity has not been extensively studied. The aim of this study was to evaluate the dietary and lifestyle determinants of abdominal obesity in a multi-ethnic population. We conducted a cross-sectional study among 617 Canadians of Aboriginal, South Asian, Chinese, and European origins, with diet evaluated using validated, culture specific, interviewer-administered FFQs, and abdominal obesity measured as waist-hip ratio (WHR). The mean proportion of energy intake from protein in the diet was 17.4 vs. 15.8% comparing the lowest and highest tertiles of WHR. Energy-adjusted protein substituted for an equivalent amount of carbohydrate was associated with a reduction in WHR (difference in WHR for every g/d increase in protein intake = -0.0005, P = 0.01) after accounting for age, sex, ethnicity, smoking status, BMI, alcohol intake, height, physical activity, and total energy. Fat or total energy were not related to WHR in the same linear regression model. Smoking was positively and physical activity inversely related to WHR in the multivariate model independent of BMI and other potential confounders. Substituting a modest amount of protein for carbohydrate may reduce abdominal obesity in a diverse multi-ethnic population. Smoking was positively related to abdominal obesity after accounting for BMI.

Abdomen↗
PubMed2005

Multivitamin supplementation of HIV-positive women during pregnancy reduces hypertension.

Hypertension during pregnancy increases fetal growth retardation, preterm deliveries, and perinatal deaths, and yet its causes remain unclear. In HIV-infected women, preterm birth additionally increases the risk of HIV transmission to the infant. Oxidative stress and endothelial cell dysfunction of the placenta have been implicated in the development of hypertension during pregnancy. Vitamin intake can reduce oxidative stress and improve endothelial function. We therefore evaluated the effect of multivitamin (20 mg thiamine, 20 mg riboflavin, 25 mg B-6, 50 microg B-12, 500 mg C, 30 mg E, and 0.8 mg folic acid) and vitamin A supplements (30 mg beta-carotene plus 5000 IU preformed vitamin A) in relation to hypertension during pregnancy (systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg at any time during pregnancy). In a double-blind, placebo-controlled, randomized, clinical trial, conducted among 1078 HIV-positive pregnant Tanzanian women, those who received multivitamins were 38% less likely to develop hypertension during pregnancy than those who did not [relative risk (RR) = 0.62, 95% CI 0.40-0.94, P = 0.03]. There was no overall effect of vitamin A on hypertension during pregnancy (RR = 1.00, 95% CI 0.66-1.51, P = 0.98). Hypertension during pregnancy was more likely in women with high baseline systolic blood pressure (>120 vs. < or = 120 mm Hg) (RR = 6.02, 95%CI 2.59-13.97, P < 0.001), and those with higher mid-upper arm circumference (RR = 1.12, 95% CI 1.04-1.19, P = 0.002). Taking multivitamins containing vitamins B, C, and E during pregnancy may be an inexpensive and effective strategy to improve the health of the mother and baby.

Adult↗
PubMed2004

Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men.

PURPOSE: To assess the relation between the duration of diabetes and the risk of peripheral arterial disease among men. METHODS: A total of 48,607 men in the Health Professionals Follow-up Study who returned a questionnaire in 1986 were followed for 12 years. Peripheral arterial disease (intermittent claudication or surgery for peripheral arterial diseases in the lower extremities) was ascertained by biennial questionnaire and confirmed by medical record review. Diabetes status and other cardiovascular risk factors were also ascertained by biennial questionnaire. RESULTS: During follow-up (534,588 person-years), we documented 387 cases of peripheral arterial disease. After adjusting for cardiovascular risk factors, the relative risk of developing peripheral arterial disease among men with diabetes compared with men without diabetes was 2.61 (95% confidence interval [CI]: 1.98 to 3.45). Compared with men without diabetes, the relative risk of peripheral arterial disease among men with diabetes increased with duration of disease, even after adjusting for cardiovascular risk factors: 1.39 (95% CI: 0.82 to 2.36) for 1 to 5 years of diabetes, 3.63 (95% CI: 2.23 to 5.88) for 6 to 10 years, 2.55 (95% CI: 1.50 to 4.32) for 11 to 25 years, and 4.53 (95% CI: 2.39 to 8.58) for >25 years of diabetes (P for trend < or =0.0001). CONCLUSION: These results indicate that duration of type 2 diabetes is associated strongly with the risk of developing peripheral arterial disease.

Adult↗
PubMed2004

Vitamin intake is not associated with community-acquired pneumonia in U.S. men.

The age-related decline in immune function may predispose individuals to increased infection risk. Nutrition is an important determinant of immunocompetence, but vitamin supplementation in relation to infection has not been evaluated extensively in well-nourished populations. We evaluated the associations between intakes of antioxidants and B vitamins and risk of community-acquired pneumonia in well-nourished, middle-aged and older men. This was a prospective study conducted between 1990 and 2000 among 38,378 male, U.S. health professionals, aged 44 to 79 y in 1990. Participants answered a detailed 131-item FFQ to assess diet and also provided information on vitamin supplement use. We included those who at the onset had no history of pneumonia, myocardial infarction, stroke, other heart disease, arterial surgery, cancer or asthma, and also had complete dietary data. There were 446 new cases of nonfatal community-acquired pneumonia during 145,878 person-years of follow-up. After adjustment for age, smoking, BMI, alcohol use, physical activity, diabetes and total energy intake, there were no associations between total intakes of antioxidants or B vitamins and pneumonia risk. After excluding men who took vitamin E supplements, vitamin E intake from food sources only was inversely associated with pneumonia risk (multivariate relative risk comparing extreme quintiles = 0.58, 95% CI, 0.39-0.86, P-value test for trend = 0.01). Vitamin supplements are unlikely to reduce pneumonia risk in well-nourished, middle-aged and older men.

Adult↗