Browsing by Author "Sewram, Vikash"

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    Consumption of processed food dietary patterns in four African populations
    (Public Health Nutrition, 2018) Holmes, Michelle D.; Dalal, Shona; Sewram, Vikash; Diamond, Megan B.; Adebamowo, Sally N.; Ajayi, Ikeoluwapo O.; Adebamowo, Clement; Chiwanga, Faraja S.; Njelekela, Marina; Laurence, Carien; Volmink, Jimmy; Bajunirwe, Francis; Nankya-Mutyoba, Joan; Guwatudde, David; Reid, Todd G.; Willett, Walter C.; Adami, Hans-Olov; Fung, Teresa T.
    To identify predominant dietary patterns in four African populations and examine their association with obesity. Design: Cross-sectional study. Setting/Subjects: We used data from the Africa/Harvard School of Public Health Partnership for Cohort Research and Training (PaCT) pilot study established to investigate the feasibility of a multi-country longitudinal study of noncommunicable chronic disease in sub-Saharan Africa. We applied principal component analysis to dietary intake data collected from an FFQ developed for PaCT to ascertain dietary patterns in Tanzania, South Africa, and peri-urban and rural Uganda. The sample consisted of 444 women and 294 men. Results: We identified two dietary patterns: the Mixed Diet pattern characterized by high intakes of unprocessed foods such as vegetables and fresh fish, but also cold cuts and refined grains; and the Processed Diet pattern characterized by high intakes of salad dressing, cold cuts and sweets. Women in the highest tertile of the Processed Diet pattern score were 3·00 times more likely to be overweight (95 % CI 1·66, 5·45; prevalence=74 %) and 4·24 times more likely to be obese (95 % CI 2·23, 8·05; prevalence=44 %) than women in this pattern’s lowest tertile (both P<0·0001; prevalence=47 and 14 %, respectively). We found similarly strong associations in men. There was no association between the Mixed Diet pattern and overweight or obesity. Conclusions: We identified two major dietary patterns in several African populations, a Mixed Diet pattern and a Processed Diet pattern. The Processed Diet pattern was associated with obesity.
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    Neighborhood greenness and burden of non-communicable diseases in Sub-Saharan Africa: A multi-country cross-sectional study
    (Environmental Research, 2021) Iyer, Hari S.; James, Peter; Valeri, Linda; Bajunirwe, Francis; Nankya-Mutyoba, Joan; Njelekela, Marina; Chiwanga, Faraja; Sewram, Vikash; Ajayi, IkeOluwapo; Adebamowo, Clement; Dalal, Shona; Reid, Todd G.; Rebbeck, Timothy R.; Adami, Hans-Olov; Holmes, Michelle D.
    Population growth, demographic transitions and urbanization in sub-Saharan Africa (SSA) will increase non-communicable disease (NCD) burden. We studied the association between neighborhood greenness and NCDs in a multi-country cross-sectional study. Among 1178 participants, in adjusted models, a 0.11 unit NDVI increase was associated with lower BMI (β: −1.01, 95% CI: −1.35, −0.67), and lower odds of overweight/obesity (aOR: 0.73, 95% CI: 0.62, 0.85), diabetes (aOR: 0.77, 95% CI: 0.62, 0.96), and having ≥3 allostatic load components compared to none (aOR: 0.66, 95% CI: 0.52, 0.85). Except for diabetes, these remained statistically significant after Bonferroni correction. We observed no association between NDVI and hypertension or cholesterol. Our findings are consistent with health benefits of neighborhood greenness reported in other countries, suggesting greening strategies could be considered as part of broader public health interventions for NCDs.