| 11. |
- Islam, Mohammad Redwanul, 1986-, et al.
(författare)
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Accelerometer-measured physical activity, fitness and indicators of cardiometabolic risk among rural adolescents: a cross-sectional study at 15-year follow-up of the MINIMat cohort
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among adolescents in resource-limited settings of low- and middle-income countries. We sought to examine the associations of accelerometer-measured PA and objective measures of physical fitness with conventional indicators of cardiometabolic risk along with difference in associations by gender in a birth cohort of rural adolescents. Methods: This cross-sectional study availed data from the 15-year follow-up of the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort in southeast Bangladesh (n = 2253). Wrist-mounted ActiGraph wGT3x-BT devices were used to estimate sedentary time (ST), total PA and time spent in intensity-specific PA. Fitness was assessed through: handgrip strength, standing long jump and maximal oxygen consumption (VO2max) estimated from Chester Step Test. Anthropometric parameters and systolic blood pressure (SBP) were recorded. Fasting plasma triglyceride (TG), total cholesterol (TC), low- and high-density lipoproteins (LDL and HDL), insulin and glucose levels were measured. We calculated insulin resistance (IR) using the Homeostasis Model Assessment equation (HOMA-IR). Three right-skewed outcome variables were natural log (Ln) transformed: WC, TG and HOMA-IR. Omnibus and gender-specific multiple linear regression models were fitted.Results: Total PA displayed weak, negative associations; whereas ST showed weak, positive associations with WC and IR. A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% CI: 2.9%–6.8%; P < 0.001) lower WC, 3.2 mm of Hg (95% CI: 1.5–4.8; P < 0.001) lower SBP, 10.4% (95% CI: 2.9%–17.3%; P = 0.008) lower TG, 24.4% (95% CI: 11.3%–34.9%; P < 0.001) lower IR. Time engaged in moderate-to-vigorous PA showed similar associations of notably smaller magnitude with the indicators. Except for WC, the associations were more pronounced among the boys. Weight-normalized grip strength was favorably associated with all seven indicators and the unstandardized effect sizes were considerably large. Higher VO2max was only associated with a small reduction in HOMA-IR. Conclusion: Our findings highlight the beneficial role of VPA, moderate-to-vigorous PA and muscular fitness in shaping cardiometabolic risk profile at mid-adolescence. VPA and handgrip strength represent potential targets for preventive strategies targeting adolescents in a rural context.
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| 12. |
- Islam, Mohammad Redwanul, 1986-, et al.
(författare)
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Dietary patterns and indicators of cardiometabolic risk among rural adolescents : A cross-sectional study at 15-year follow-up of the MINIMat cohort
- 2023
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Ingår i: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diet being a modifiable factor, its relationship with cardiometabolicrisk is of public health interest. The vast majority of studies on associations ofdietary patterns with cardiometabolic risk indicators among adolescents are fromhigh-income countries and urban settings. We sought to describe dietary patternsand examine their associations with selected cardiometabolic risk indicators–waist circumference (WC), systolic blood pressure, fasting lipid profile and insulinresistance–along with its gender stratification among adolescents in a low-income,rural setting.Methods: This cross-sectional study utilized data from the 15-year follow-up ofthe Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort insoutheast Bangladesh. The children who were born as singletons to the mothersrandomized in the MINIMat trial and had valid birth anthropometrics were eligiblefor the follow-up. We employed a single, qualitative 24-hour recall to assess diet.Dietary patterns were derived from simple K-means cluster analysis, and calculationof dietary diversity score (DDS) using a validated instrument. Anthropometricparameters and systolic blood pressure were recorded. Fasting plasma triglyceride,total cholesterol, low- and high-density lipoproteins, insulin and glucose levels weremeasured. We calculated insulin resistance using the Homeostasis Model Assessmentequation (HOMA-IR). Three right-skewed outcome variables were natural log (Ln)transformed: WC, triglyceride and HOMA-IR. Omnibus and gender-specific multiplelinear regression models were fitted.Results: Among 2,253 adolescents (52.1% girls, 7.1% overweight/obese), we identifiedfour diet clusters: Traditional, Fish-dominant, Meat-dominant, and High-variety.No significant associations were found between the clusters and indicators. Ongender-stratification, triglyceride levels were lower among boys in the Fish-dominant (Ln-triglyceride βadjusted: −0.09; 95% confidence interval (CI): −0.15, −0.02) andMeat-dominant (Ln-triglyceride βadjusted: −0.08; 95% CI: −0.15, −0.004) clusters thanamong boys in the Traditional cluster. Compared to boys in the bottom quartile of DDS, boys in the top quartile had 2.1 mm of Hg (95% CI: 0.5, 3.6) higher systolic bloodpressure and 1.9% (95% CI: 0.01–3.8%) higher WC.Conclusion: While statistically significant, the gender-specific differences intriglyceride, systolic blood pressure, and waist circumference across dietarypatterns were small. Associations between dietary patterns and cardiometabolic riskindicators may require a time lag beyond mid-adolescence to manifest in a ruralsetting. Prospective studies are warranted to delineate the magnitude and directionof those associations.
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| 13. |
- Islam, Mohammad Redwanul, et al.
(författare)
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Sociocultural Influences on Dietary Practices and Physical Activity Behaviors of Rural Adolescents : A Qualitative Exploration
- 2019
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- In the aftermath of nutrition transition and ever-increasing sedentarism, adolescents globally are exposed to negative health consequences. Diverse sociocultural influences play a critical role in their adoption of unhealthy dietary practices and suboptimal physical activity behaviors. Context-specific understandings of how these sociocultural influences shape adolescents' dietary and physical activity patterns in a rural, resource-limited setting remained elusive. Aiming to address the gap, this qualitative study explored adolescents' and mothers' perception of broader sociocultural aspects that sculpt the food choices, eating habits and physical activity behaviors of adolescents in Matlab, Bangladesh. Six digitally-recorded focus group discussions were transcribed verbatim, translated into English and analyzed thematically. Marked taste-driven dietary preference of adolescents and its prioritization within family by the mothers, popularity of street foods, better understanding of the importance of food hygiene and safety contrasting with narrow perception of balance and diversity in diet, peer influence along with deficient school and community food environment, internalization and rigidity of gender norms were found to be exerting major influence. The findings highlighted key targets for community-based nutrition interventions and endorsed thorough consideration of socio-cultural factors in formulating strategies to promote healthful eating and physical activity behaviors among the adolescents.
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| 14. |
- Malin Igra, Annachiara, et al.
(författare)
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Environmental metal exposure and growth to 10 years of age in a longitudinal mother-child cohort in rural Bangladesh
- 2021
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 156
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early-life exposure to arsenic (As), cadmium (Cd), and lead (Pb) has been linked to smaller birth and early childhood anthropometry, but little is known beyond the first years in life.Objectives: To evaluate the impact of gestational and childhood exposures to As, Cd, and Pb on growth up to 10 years of age.Methods: We studied 1530 mother-child dyads from a nested sub-cohort of the MINIMat trial in rural Matlab, Bangladesh. Metal concentrations in maternal erythrocytes during pregnancy and in children's urine at 10y were measured by inductively coupled plasma mass spectroscopy. Child height and weight were measured at 19 occasions from birth until 10y and converted to height-for-age Z-scores (HAZ) and weight-for-age Z-scores (WAZ). Associations between log2-transformed metal concentrations and growth parameters were assessed with multivariable-adjusted regression models.Results: Children's concurrent urinary Cd (median 0.24 µg/L), reflecting long-term exposure, was inversely associated with WAZ (B: -0.072; 95% confidence interval (CI): -0.12, -0.020; p = 0.007), and possibly HAZ (B: -0.046; 95% CI: -0.096, 0.0014; p = 0.057), at 10y. The association with WAZ was stronger in boys than in girls. Maternal erythrocyte Cd (median 0.90 µg/kg) during pregnancy was inversely associated with WAZ during childhood only in boys (B: -0.071, 95% CI: -0.14, -0.0047, p = 0.036). Concurrent urinary Pb (median 1.6 µg/L) was inversely associated with WAZ (B: -0.084; 95% CI: -0.16, -0.0085; p = 0.029) and HAZ (B: -0.087; 95% CI: -0.15, -0.021; p = 0.010) in boys, but not in girls. Neither gestational nor childhood As exposure (median maternal erythrocyte As 4.3 µg/kg and children's urinary As 57 µg/L) was associated with growth up to 10y.Conclusions: While all effect estimates were small, environmental exposure to Cd and Pb is common and impaired growth is of public health concern, especially for children already at risk of reduced growth due to malnutrition. Gender differences in susceptibility need further investigation.
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| 15. |
- Moshfiqur Rahman, Syed, et al.
(författare)
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Polycyclic aromatic hydrocarbon (PAH) exposure during pregnancy and child anthropometry from birth to 10 years of age : Sex-specific evidence from a cohort study in rural Bangladesh
- 2023
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Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 227
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Tidskriftsartikel (refereegranskat)abstract
- Polycyclic aromatic hydrocarbons (PAHs) have endocrine disrupting properties and they cross the placental barrier, but studies on gestational exposure and child anthropometry are inconclusive. We aimed to elucidate the impact of early gestational PAH exposure on anthropometry from birth to 10 years of age in 1295 mother-child pairs from a nested sub-cohort of the MINIMat trial in Bangladesh. Several PAH metabolites [1-hydroxyphenanthrene (1-OH-Phe), Σ2-,3-hydroxyphenanthrene (Σ2-,3-OH-Phe), 4-hydroxyphenanthrene (4-OH-Phe), 1-hydroxypyrene (1-OH-Pyr), Σ2-,3-hydroxyfluorene (Σ2-,3-OH-Flu)] were quantified in spot urine collected around gestational week 8 using LC-MS/MS. Child weight and height were measured at 19 occasions from birth to 10 years. Multivariable-adjusted regression models were used to assess associations of maternal PAH metabolites (log 2-transformed) with child anthropometry. The median concentration of 1-OH-Phe, Σ2-,3-OH-Phe, 4-OH-Phe, 1-OH-Pyr and Σ2-,3-OH-Flu was 1.5, 1.9, 0.14, 2.5, and 2.0 ng/mL, respectively. All maternal urinary PAH metabolites were positively associated with newborn weight and length and all associations were more pronounced in boys than in girls (p interaction for all <0.14). In boys, the strongest associations were observed with Σ2-,3-OH-Phe and Σ2-,3-OH-Flu for which each doubling increased mean birth weight by 41 g (95% CI: 13; 69 and 12; 70) and length by 0.23 cm (0.075; 0.39) and 0.21 cm (0.045; 0.37), respectively. Maternal urinary PAH metabolites were not associated with child anthropometry at 10 years. In longitudinal analysis, however, maternal urinary PAH metabolites were positively associated with boys' weight-for-age (WAZ) and height-for-age Z-scores (HAZ) from birth to 10 years, but only the association of 4-OH-Phe with HAZ was significant (B: 0.080 Z-scores; 95% CI 0.013, 0.15). No associations were observed with girls' WAZ or HAZ. In conclusion, gestational PAH exposure was positively associated with fetal and early childhood growth, especially in boys. Further studies are needed to confirm causality and to explore long-term health effects.
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| 16. |
- Rahman, Anisur, 1962-, et al.
(författare)
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Association of Arsenic Exposure during Pregnancy with Fetal Loss and Infant Death : A Cohort Study in Bangladesh
- 2007
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 165:12, s. 1389-1396
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Tidskriftsartikel (refereegranskat)abstract
- The authors evaluated the effect of arsenic exposure on fetal and infant survival in a cohort of 29,134 pregnancies identified by the health and demographic surveillance system in Matlab, Bangladesh, in 1991-2000. Arsenic exposure, reflected by drinking water history and analysis of arsenic concentrations in tube-well water used by women during pregnancy, was assessed in a separate survey conducted in 2002-2003. Data on vital events, including pregnancy outcome and infant mortality, were collected by monthly surveillance at the household level. The risk of fetal loss and infant death in relation to arsenic exposure was estimated by a Cox proportional hazards model. Drinking tube-well water with more than 50 microg of arsenic per liter during pregnancy significantly increased the risks of fetal loss (relative risk = 1.14, 95% confidence interval: 1.04, 1.25) and infant death (relative risk = 1.17, 95% confidence interval: 1.03, 1.32). There was a significant dose response of arsenic exposure to risk of infant death (p = 0.02). Women of reproductive age should urgently be prioritized for mitigation activities where drinking water is contaminated by arsenic.
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| 17. |
- Rahman, Anisur, et al.
(författare)
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Time trends and sociodemographic determinants of preterm births in pregnancy cohorts in Matlab, Bangladesh, 1990-2014
- 2019
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Ingår i: BMJ Global Health. - : BMJ. - 2059-7908. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionPreterm birth is the major cause of under-five mortality. Population-based data on determinants and proportions of children born preterm are limited, especially from low-income countries. This study aimed at assessing time trends and social, reproductive and environmental determinants of preterm births based on a population-based pregnancy cohort over 25 years in rural Bangladesh.Methods In this cohort study in Matlab, a rural area in Bangladesh, we used data from the Health and Demographic Surveillance System from 1990 to 2014. Gestational age at birth was based on the reported last menstrual period and verified by ultrasound assessments. Preterm birth proportions were assessed within strata of social and reproductive characteristics, and time series analysis was performed with decomposition for trend and seasonality. We also determined the prevented fractions of preterm birth reduction associated with social and demographic changes during the follow-up period.ResultsAnalyses were based on 63 063 live births. Preterm birth decreased from 29% (95% CI 28.6 to 30.1) in 1990-1994 to 11% (95% CI 10.5 to 11.6) in 2010-2014. Low education, older age and multi-parity were associated with higher proportions of preterm births across the study period. Preterm births had a marked seasonal variation. A rapid increase in women's educational level and decrease in parity were associated with the decline in preterm births, and 27% of the reduction observed from 1990 to 2014 could be attributed to these educational and reproductive changes.Conclusion The reduction in preterm birth was to a large extent associated with the sociodemographic transition, especially changes in maternal education and parity. The persistent seasonal variation in the proportion of preterm birth may reflect the environmental stressors for pregnant women across the study period. Continued investments in girls' education and family planning programmes may contribute to further reduction of preterm births in Bangladesh.
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| 18. |
- Rahman, Syed Moshfiqur, et al.
(författare)
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Association between maternal plasma ferritin level and infants' size at birth : a prospective cohort study in rural Bangladesh
- 2021
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Iron supplementation in pregnancy is recommended by the WHO to prevent a major public health problem, namely, maternal iron deficiency and its consequences. There are gaps in the existing evidence regarding maternal and neonatal benefits and harms of universal iron supplementation.Objective: To evaluate the association between maternal iron status during pregnancy and infant size at birth (birth weight and length).Method: This present prospective cohort study was nested in a food and micronutrient supplementation trial conducted in Matlab (MINIMat study), rural Bangladesh. We randomly selected 573 women recruited into the MINIMat study from January - December 2002 who delivered singletons with available birth anthropometric information. The plasma ferritin of each mother was measured at gestational week 14 (GW14; before the start of micronutrient supplementation) and at week 30 (GW30).Results: Multivariable linear regression revealed no association between plasma ferritin at GW14 and birth weight. However, newborns of women in the highest tertile of plasma ferritin at GW30 (median = 29 mu g/L) had on average a 93-gm lower birth weight (95% CI: -172, - 14; p = 0.021) than the newborns of womehemoglobin (Hb) synthesisn in the lowest tertile (median = 8 mu g/L). Logistic regression showed that odds of low birth weight were approximately two times higher [odds ratio (OR) = 2.27; 95% CI: 1.40, 3.67] among those with mothers in the highest ferritin tertile than in the lowest tertile at GW30. No association was found between maternal plasma ferritin and birth length.Conclusion: We observed an inverse association between high plasma ferritin in the last trimester (GW30) and birth weight but not birth length. The results suggested that elevated plasma ferritin in pregnancy could have an untoward effect on birth weight.
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| 19. |
- Sohel, Nazmul, 1962-, et al.
(författare)
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Spatial patterns of fetal loss and infant death in an arsenic-affected area in Bangladesh
- 2010
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 9, s. 53-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Arsenic exposure in pregnancy is associated with adverse pregnancy outcome and infant mortality. Knowledge of the spatial characteristics of the outcomes and their possible link to arsenic exposure are important for planning effective mitigation activities. The aim of this study was to identify spatial and spatiotemporal clustering of fetal loss and infant death, and spatial relationships between high and low clusters of fetal loss and infant death rates and high and low clusters of arsenic concentrations in tube-well water used for drinking.Methods: Pregnant women from Matlab, Bangladesh, who used tube-well water for drinking while pregnant between 1991 and 2000, were included in this study. In total 29,134 pregnancies were identified. A spatial scan test was used to identify unique non-random spatial and spatiotemporal clusters of fetal loss and infant death using a retrospective spatial and spatiotemporal permutation and Poisson probability models.Results: Two significant clusters of fetal loss and infant death were identified and these clusters remained stable after adjustment for covariates. One cluster of higher rates of fetal loss and infant death was in the vicinity of the Meghna River, and the other cluster of lower rates was in the center of Matlab. The average concentration of arsenic in the water differed between these clusters (319 μg/L for the high cluster and 174 μg/L for the low cluster). The spatial patterns of arsenic concentrations in tube-well water were found to be linked with the adverse pregnancy outcome clusters. In the spatiotemporal analysis, only one high fetal loss and infant death cluster was identified in the same high cluster area obtained from purely spatial analysis. However, the cluster was no longer significant after adjustment for the covariates.Conclusion: The finding of this study suggests that given the geographical variation in tube-well water contamination, higher fetal loss and infant deaths were observed in the areas of higher arsenic concentrations in groundwater. This illustrates a possible link between arsenic contamination in tube-well water and adverse pregnancy outcome. Thus, these areas should be considered a priority in arsenic mitigation programs.
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| 20. |
- Vahter, Marie E., et al.
(författare)
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Arsenic exposure in pregnancy : A population-based study in Matlab, Bangladesh
- 2006
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Ingår i: Journal of Health, Population and Nutrition. - 1606-0997 .- 2072-1315. ; 24:2, s. 236-245
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Tidskriftsartikel (refereegranskat)abstract
- This study assessed the exposure of pregnant women to arsenic in Matlab, Bangladesh, an area with highly-elevated concentrations of arsenic in tubewells, by measuring concentrations of arsenic in urine. In a defined administrative area, all new pregnancies were identified by urine test in gestational week 6-8, and women were asked to participate in the assessment of arsenic exposure. Urine for analysis of arsenic was collected immediately and in gestational week 30. In total, 3,426 pregnant women provided urine samples during January 2002-March 2003. There was a considerable variation in urinary concentrations of arsenic (total range 1-1,470 mu g/L, adjusted to specific gravity 1.012 g/mL), with an overall median concentration of 80 mu g/L (25th and 75th percentiles were 37 and 208 mu g/L respectively). Similar concentrations were found in gestational week 30, indicating no trend of decreasing exposure, despite the initiation of mitigation activities in the area. Arsenic exposure was negatively associated with socioeconomic classes and achieved educational level. There were marked geographical variations in exposure. The results emphasize the urgent need for efficient mitigation activities and investigations of arsenic-related reproductive effects.
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