Socioeconomic Status and Metabolic Syndrome in Southwest Iran: Results from Hoveyzeh Cohort Study(HCS)

BackgroundSocioeconomic status (SES) is a strong predictor of morbidity and premature mortality, especially non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not yet clear. This study is to assess the relationship between socioeconomic indicators and MetS.MethodsIn this prospective cohort study, 10009 people aged 35-70 years enrolled from May 2016 to August 2018. MetS was determined based on the standard national cholesterol education program (NCEP) - adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face to face by trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, with adjustment of potential confounding variables. ResultsThe overall prevalence of MetS in participants was 39.1%. The crude odds ratios for all the assessed variables were statistically significant (p<0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p=0.006) and Townsend index (p=0.002) with MetS, while no significant associations were seen between educational level and wealth status with MetS. ConclusionThe results of our study showed that SES is related to MetS. Among four assessed SES indicators, skilled levels and Townsend score had a stronger association with MetS. We recommend considering people’s SES when interventional programs are planning and conducting on MetS in each community.

The Impact of Breastfeeding on Neurocognitive Outcome at Twelve Years – Secondary Analysis of a Prospective Cohort Study

BackgroundThe objectives of this secondary analysis were to compare the; (i) cognitive and (ii) behavioural outcomes in children born congenitally normal, non-preterm, and non-growth restricted that were breastfed beyond one month of age with those that were not breastfed or breastfed for <1-month. MethodsAn original prospective cohort study conducted on n=2097 fetuses compared children with normal fetal UAD PI (Umbilical Artery Doppler Pulsatility Index) against those with an elevated UAD PI and assessed neurocognitive development at twelve years of age using British Ability Scale Version II (BAS II) and the Achenbach Behavioural Checklist Parent Rated Version (CBCL). This secondary analysis included children where maternal breastfeeding status was known (n=252). Childhood cognitive and behavioural scores were analysed and compared for the breastfed versus the non-breastfed group. Linear regression analysis was performed, controlling for confounders including gender, age at assessment, Townsend Score, and UAD PI. Results Excluding congenitally abnormal, preterm and growth restricted babies, n=206 were included. The mean age at follow-up was 12.2 years (±0.6 SD) for both groups with 43.5% (n=20) and 50.3% (n=81) of male gender in both groups respectively. When comparing those children who were breastfed against those who were not or for <1-month, the breastfed group score higher in spelling (p<0.001) and reading (p<0.001) assessments. As was also the case in verbal (p<0.001), reasoning (p<0.001) and spatial ability scores (p<0.001). In relation to behavioural assessments, there was no difference between groups. Conclusion Term babies who are breastfed for >1-month have more optimal scores in neurocognition when analysed at 12-years with no differences in parent observed behaviour compared to non-breastfed/breastfed for <1-month counterparts. These findings must be interpreted with caution due to the presence of confounders with further research into the biological and physiological mechanisms by which breastfeeding may optimise brain development.

Socio-economic deprivation and the prevalence and prediction of depression in older community residents

BackgroundThe Townsend index is a measure of social deprivation. It can be applied to postal districts and has been employed in studies examining the ecological associations of mental illness.AimsWe examine the utility of the Townsend index in identifying older populations with a high prevalence and risk of developing depression.MethodThe study was carried out in the context of a cohort study of an age- and gender-stratified sample of 5222 community residents aged 65 years and over. Subjects were interviewed at intervals of two years. The relationships between Townsend score and psychiatric diagnoses (in particular, depression) were examined.ResultsHigh Townsend scores were associated with increased prevalence and incidence of depression and prevalence of organic psychiatric illness.ConclusionsThe Townsend index can be used to prioritise psychiatric and primary care resources so as to cater for older populations likely to suffer from depression and organic psychiatric conditions.

Salmonellosis in North Thames (East), UK: associated risk factors

We assessed the rate of salmonella infections and risk factors associated with infection in North East Thames in 1993. Cases of culture confirmed infection were identified through microbiology laboratories and environmental health officers in the North East Thames. A total of 1730 cases were reported and 209 of these individuals (those who could be contacted within a 3-week interval after onset of symptoms) and matched controls were interviewed by telephone. In addition randomly selected controls were interviewed over a 4-month period about recent gastric acid lowering medication and antimicrobial ingestion. Sixty-six serotypes were identified: S. enteritidis was isolated from 1179 (69%) cases, S. typhimurium from 221 (13%), S. virchow from 77 (4%) and S. newport 25 (1%). Infections were more frequent in summer months. Highest rates were documented in children under 2 years of age for S. enteritidis (108/100000) and under 1 year for S. typhimurium (36/100000). Using the Townsend score, highest isolation rates of S. enteritidis were in more prosperous areas (36/100000 vs. 27/100000; odds ratio (OR) 1·3, 95% confidence intervals (CIs) 1·2–1·6, P<0·0001), while for S. typhimurium, there was no relation between deprivation index and isolation rates areas (6·4/100000 vs. 6·1/100000; OR 1·1, 95% CIs 0·8–1·5, P=0·77). The case control study showed a significant association between ingestion of products containing raw eggs and S. enteritidis infection (8/111 cases vs. 0/110 controls; OR undefined, lower 95% CIs 3·4). Individuals with salmonella infection were significantly more likely to have travelled abroad in the week before the onset of illness [42/186 (23%) vs. 1/182 (0·5%) ; OR 40, 95% CIs=5·5–291, P<0·001] and to report gastroduodenal disease [11/143 (7 %) vs. 3/143 (2 %); OR 5·0, 95% CIs=1·1–23, P=0·04]. There was an association between illness and gastric acid-lowering medications [unmatched controls OR 22·3 (95% CIs 1·5–3·7, P=0·0002), matched controls OR 3·7 (95% CIs 1·0–3·8, P=0·07)], but no association with antimicrobial ingestion.