1. |
- Islam, Mohammad Redwanul, 1986-, et al.
(author)
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Consumption of ultra-processed and deep-fried foods among rural adolescents : a cross-sectional study from Matlab, Bangladesh
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Other publication (other academic/artistic)abstract
- Objective: We aimed to describe ultra-processed and deep-fried food consumption among rural adolescents by gender and socio-economic factors, and to explore their relative importance in shaping consumption.Design: Cross-sectional study based on a household survey. We assessed consumption of four ultra-processed food (UPF) groups: ready-to-eat or “instant” foods; confectionery, sweets and similar packaged products; savory snacks; sugar-sweetened beverage (SSB); and of deep-fried foods with a 24-hour, qualitative recall. Proportion of consumption was calculated and compared between groups. Logistic regression models were fitted to isolate socio-demographic variables associated with consumption.Setting: Matlab, a rural sub-district in Bangladesh.Participants: Analytic sample comprised 2463 adolescents.Results: Approximately 83% (81.5-84.4) adolescents consumed at least one ultra-processed or deep-fried food. Confectioneries were the most consumed (53.5%), whereas SSB the least consumed (12%). Boys had greater odds of consumption than girls for all food groups. The association was strongest for SSB (adjusted odds ratio (aOR) = 2.57; 95% CI: 1.97, 3.37), followed by deep-fried foods (aOR = 1.96; 95% CI: 1.66, 2.32) and ready-to-eat foods (aOR = 1.85; 95% CI: 1.45, 2.38). Belonging to the richest households was associated with ready-to-eat food consumption (aOR = 1.55; 95% CI: 1.12, 2.16). Adolescents with higher educational attainment had lower odds of consuming SSB (aOR = 0.73; 95% CI: 0.54, 0.98).Conclusion: Consumption of packaged confectioneries, savory snacks, and deep-fried foods appeared common, whereas SSB consumption was relatively low. Role of gender was pre-eminent as consumption was more likely among boys across the food groups.
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2. |
- Islam, Mohammad Redwanul, 1986-, et al.
(author)
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Gender and socio-economic stratification of ultra-processed and deep-fried food consumption among rural adolescents : A cross-sectional study from Bangladesh
- 2022
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:7
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Journal article (peer-reviewed)abstract
- BackgroundAlthough consumption of ultra-processed and deep-fried foods among adolescents is a global health concern, little is known about its gender and socio-economic stratification in rural settings of low- and middle-income countries. We, thus, aimed to describe ultra-processed and deep-fried food consumption among rural adolescents by gender and socio-economic factors, and to explore their relative importance in shaping consumption.MethodsThis cross-sectional study drew on data from a household survey in Matlab, a rural sub-district in Bangladesh. The analytic sample comprised 2463 adolescents. We assessed consumption of four ultra-processed food groups: ready-to-eat or “instant” foods; confectionery, sweets and similar packaged products; savory snacks; sugar-sweetened beverage; and of deep-fried foods with a 24-hour, qualitative recall. Asset scores were constructed. Proportion of consumption was calculated and compared by gender and household wealth. Logistic regression models were fitted to isolate socio-demographic variables associated with consumption.ResultsApproximately 83% (81.5–84.4) adolescents consumed at least one ultra-processed or deep-fried item. Confectioneries were the most consumed (53.5%), whereas sugar-sweetened beverage was the least consumed (12%) group. Boys had greater odds of consumption than girls for all food groups. The association was strongest for sugar-sweetened beverage (adjusted odds ratio = 2.57; 95% CI: 1.97, 3.37), followed by deep-fried foods (adjusted odds ratio = 1.96; 95% CI: 1.66, 2.32) and ready-to-eat foods (adjusted odds ratio = 1.85; 95% CI: 1.45, 2.38). Belonging to the richest households was associated with ready-to-eat food consumption (adjusted odds ratio = 1.55; 95% CI: 1.12, 2.16). Adolescents with higher educational attainment had lower odds of consuming sugar-sweetened beverage (adjusted odds ratio = 0.73; 95% CI: 0.54, 0.98).ConclusionConsumption of packaged confectioneries, savory snacks, and deep-fried foods appeared common, while SSB consumption was relatively low. Role of gender was pre-eminent as consumption was more likely among boys across the food groups. This may disproportionately expose them to the risk of diet-related non-communicable diseases.
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3. |
- Pervin, Jesmin, et al.
(author)
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Association between antenatal care visit and preterm birth : a cohort study in rural Bangladesh.
- 2020
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In: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Strengthening the antenatal care programme is suggested as one of the public health strategies to reduce preterm birth burden at a population level. However, the evidence so far available is inconclusive.OBJECTIVES: To evaluate the association between antenatal care (ANC) visit and preterm birth; and also to explore to what extent the increased usage of ANC after the initiation of the Maternal, Neonatal and Child Health (MNCH) project in Matlab, Bangladesh, contributed to the reduction of preterm birth.SETTING: This population-based cohort study was conducted in Matlab, a subdistrict under Chandpur. The analysis was based on data collected from 2005 to 2009. In 2007, an MNCH project was initiated in the area that strengthened the ongoing ANC services.PARTICIPANTS: In total, 12 980 live births with their mothers during the study period were included in the analysis.ANALYSIS: We performed logistic regression with generalised estimating equation models to evaluate the associations.OUTCOME MEASURES: Preterm birth.RESULTS: The number of ANC visits was associated with preterm birth in a dose-dependent way (p for linear trend <0.001). The adjusted odds of preterm birth were 2.4-times higher (OR 2.37, 95% CI 2.07 to 2.70) among women who received ≤1 ANC compared with women who received ≥3 ANC. We observed a significant reduction of preterm birth rates (OR 0.69, 95% CI 0.61 to 0.77) in the period after (2008 to 2009) MNCH project initiation in comparison to the period before (2005 to 2006). Controlling for ANC visits substantially attenuated this observed effect of the MNCH project on preterm birth (OR 0.88, 95% CI 0.77 to 0.99) (Sobel test of mediation p<0.001).CONCLUSIONS: ANC visits are associated with decreased occurrences of preterm births. Strengthening the ANC services should be prioritised in countries with high preterm birth rates to reduce the preterm birth burden at the population level.
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4. |
- Hossain, Sheikh Jamal, et al.
(author)
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Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh
- 2024
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In: Child Care Health and Development. - : John Wiley & Sons. - 0305-1862 .- 1365-2214. ; 50:1
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Journal article (peer-reviewed)abstract
- Background: Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development.Methods: This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors.Results: Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development.Conclusion: Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.
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5. |
- Igra, Annachiara Malin, et al.
(author)
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Maternal exposure to polycyclic aromatic hydrocarbons during pregnancy and timing of pubertal onset in a longitudinal mother-child cohort in rural Bangladesh
- 2024
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In: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 189
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Journal article (peer-reviewed)abstract
- Background: In experimental studies, several polycyclic aromatic hydrocarbons (PAHs) have shown endocrine disrupting properties, but very few epidemiological studies have examined their impact on pubertal development and results have been heterogenous. Objective: To explore if maternal PAH exposure during pregnancy was associated with the offspring's timing of pubertal onset. Methods: We studied 582 mother-daughter dyads originating from a population-based cohort in a rural setting in Bangladesh. Maternal urinary samples, collected in early pregnancy (on average, gestational week 8), were analyzed for monohydroxylated metabolites of phenanthrene (1-OH-Phe, E2-,3-OH-Phe, and 4-OH-Phe), fluorene (E2-,3-OH-Flu), and pyrene (1-OH-Pyr) using liquid chromatography with tandem mass spectrometry (LCMS/MS). The girls were interviewed on two separate occasions concerning date of menarche, as well as breast and pubic hair development according to Tanner. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox proportional hazards regression or ordered logistic regression. Results: In early pregnancy, the mothers' median urinary concentrations of E1-,2-,3-,4-OH-Phe, E2-,3-OH-Flu, and 1-OH-Pyr were 3.25 ng/mL, 2.0 ng/mL, and 2.3 ng/mL respectively. At the second follow-up, 78 % of the girls had reached menarche, and the median age of menarche was 12.7 +/- 0.81 years. Girls whose mothers belonged to the second and third quintiles of EOH-Phe metabolites had a higher rate of menarche, indicating a younger menarcheal age (HR 1.39; 95 % CI 1.04, 1.86, and HR 1.41; 95 % CI 1.05, 1.88, respectively), than girls of mothers in the lowest quintile. This trend was not observed in relation to either breast or pubic hair development. None of the other maternal urinary PAH metabolites or the sum of all thereof in early pregnancy were associated with age at menarche or pubertal stage. Conclusions: Indications of non-monotonic associations of prenatal phenanthrene exposure with the daughters' age of menarche were found, warranting further investigation.
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6. |
- Islam, Mohammad Redwanul, 1986-, et al.
(author)
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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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Other publication (other academic/artistic)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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7. |
- Islam, Mohammad Redwanul, 1986-, et al.
(author)
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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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In: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 10
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Journal article (peer-reviewed)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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8. |
- Islam, Mohammad Redwanul, et al.
(author)
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Sociocultural Influences on Dietary Practices and Physical Activity Behaviors of Rural Adolescents : A Qualitative Exploration
- 2019
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In: Nutrients. - : MDPI. - 2072-6643. ; 11:12
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Journal article (peer-reviewed)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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9. |
- Malin Igra, Annachiara, et al.
(author)
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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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In: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 156
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Journal article (peer-reviewed)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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10. |
- Rahman, Anisur, 1962-, et al.
(author)
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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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In: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 165:12, s. 1389-1396
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Journal article (peer-reviewed)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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