Physical activity participation and the risk of chronic diseases among South Asian adults: a systematic review and meta-analysis.
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ABSTRACT:
SUBMITTER: Paudel S
PROVIDER: S-EPMC6611898 | biostudies-other | 2019 Jul
REPOSITORIES: biostudies-other
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Physical activity participation and the risk of chronic diseases among South Asian adults: a systematic review and meta-analysis.
Paudel Susan S Owen Alice J AJ Owusu-Addo Ebenezer E Smith Ben J BJ
Scientific reports 20190705 1
South Asia specific reviews on the role of physical activity (PA) domains on chronic disease prevention are lacking. This study aimed to systematically review published literature to identify the association between PA domains and chronic diseases and to provide summary estimates of the strength of association. Nine electronic databases were searched using the predefined inclusion criteria which included population (South Asian adults 40 years or older), exposure (PA or sedentary behaviour) and ...[more]
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Project description:BackgroundChronic diseases contribute to about half of the adult disease burden in the South Asian region. Meanwhile, physical activity levels are declining despite the global evidence of its role in the prevention of chronic diseases. While there are a plethora of systematic reviews on the effects of physical activity on chronic diseases, there has not yet been a synthesis of the evidence concerning the nature of this relationship among people living in South Asian countries incorporating multiple chronic diseases and a focus on physical activity domains. The aim of this protocol is to describe the rationale and methods for a systematic review of published research to identify the association between physical activity and selected chronic diseases and their markers and analysis of the strength of association with a focus on physical activity domains among South Asian adults 40 years and older.MethodsNine electronic databases including Medline, PsycINFO, Embase, CENTRAL, CINAHL Plus, AgeLine, SPORTDiscus, Scopus and Web of Science will be systematically searched for papers reporting the association between physical activity and selected chronic diseases (type 2 diabetes mellitus, breast cancer, colorectal cancer, coronary heart disease, stroke, vascular diseases and musculoskeletal diseases (osteoarthritis, osteoporosis, back and neck pain)) and their markers using predefined search terms. Searches will be limited to peer-reviewed, English language papers with a quantitative design. In addition, a manual search of references of relevant systematic reviews as well as citations and references of eligible studies will also be carried out. The methodological appraisal will be performed using the National Institutes of Health quality assessment checklist for observational studies and the Effective Public Health Practice Project quality assessment tool for intervention studies. The overall quality of evidence for the study outcomes across the study designs will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The review results will be presented in the form of narrative synthesis, and a random effects meta-analysis is planned depending on the nature of included studies and available data.DiscussionThis review will summarise the strength of the association between physical activity and selected chronic diseases and their markers among South Asian adults 40 years or older. The findings will provide an evidence base to guide public health policy and interventions in the South Asian region and to inform future research to address the rising burden of chronic diseases.Systematic review registrationPROSPERO CRD42018096505.
| S-EPMC6208083 | biostudies-literature
Project description:Physical activity (PA) has many beneficial physical and mental health effects. Physical inactivity is considered the fourth leading risk factor for global mortality. At present there are no systematic reviews on PA patterns among South Asian adults residing in the region. The present study aims to systematically evaluate studies on PA patterns in South Asian countries. A five-staged comprehensive search of the literature was conducted in Medline, Web of Science and SciVerse Scopus using keywords 'Exercise', 'Walking', 'Physical activity', 'Inactivity', 'Physical Activity Questionnaire', 'International Physical Activity Questionnaire', 'IPAQ', 'Global Physical Activity Questionnaire' and 'GPAQ', combined with individual country names. The search was restricted to English language articles conducted in humans and published before 31st December 2012. To obtain additional data a manual search of the reference lists of articles was performed. Data were also retrieved from the search of relevant web sites and online resources. The total number of hits obtained from the initial search was 1,771. The total number of research articles included in the present review is eleven (India-8, Sri Lanka-2, Pakistan-1). In addition, eleven country reports (Nepal-3, Bangladesh-2, India-2, Sri Lanka-2, Bhutan-1, Maldives-1) of World Health Organization STEPS survey from the South-Asian countries were retrieved online. In the research articles the overall prevalence of inactivity was as follows; India (18.5%-88.4%), Pakistan (60.1%) and Sri Lanka (11.0%-31.8%). STEPS survey reports were available from all countries except Pakistan. Overall in majority of STEPS surveys females were more inactive compared to males. Furthermore, leisure related inactivity was >75% in studies reporting inactivity in this domain and people were more active in transport domain when compared with the other domains. In conclusion, our results show that there is a wide variation in the prevalence of physical inactivity among South-Asian adults within and between countries. Furthermore, physical inactivity in South Asian adults was associated with several socio-demographic characteristics. Majority of South Asian adults were inactive during their leisure time. These Factors need to be considered when planning future interventions and research aimed at improving PA in the region.
| S-EPMC3854453 | biostudies-other
Project description:The metabolic risks associated with obesity are greater for South Asian populations compared with White or other ethnic groups, and levels of obesity in childhood are known to track into adulthood. Tackling obesity in South Asians is therefore a high priority. The rationale for this systematic review is the suggestion that there may be differential effectiveness in diet and physical activity interventions in South Asian populations compared with other ethnicities. The research territory of the present review is an emergent, rather than mature, field of enquiry, but is urgently needed. Thus the aim of this systematic review and meta-analysis was to assess the effectiveness of diet and physical activity interventions to prevent or treat obesity in South Asians living in or outside of South Asia and to describe the characteristics of effective interventions.Systematic review of any type of lifestyle intervention, of any length of follow-up that reported any anthropometric measure for children or adults of South Asian ethnicity. There was no restriction on the type of comparator; randomised controlled trials, controlled clinical trials, and before-after studies were included. A comprehensive search strategy was implemented in five electronic databases: ASSIA, Cochrane Controlled Trials Register, Embase, Medline and Social Sciences Citation Index. The search was limited to English language abstracts published between January 2006 and January 2014. References were screened; data extraction and quality assessment were carried out by two reviewers. RESULTS are presented in narrative synthesis and meta-analysis.Twenty-nine studies were included, seven children, 21 adult and one mixed age. No studies in children under six were identified. Sixteen studies were conducted in South Asia, ten in Europe and three in USA. Effective or promising trials include physical activity interventions in South Asian men in Norway and South Asian school-children in the UK. A home-based, family-orientated diet and physical activity intervention improved obesity outcomes in South Asian adults in the UK, when adjusted for baseline differences. Meta-analyses of interventions in children showed no significant difference between intervention and control for body mass index or waist circumference. Meta-analyses of adult interventions showed significant improvement in weight in data from two trials adjusted for baseline differences (mean difference -1.82 kgs, 95% confidence interval -2.48 to -1.16) and in unadjusted data from three trials following sensitivity analysis (mean difference -1.20 kgs, 95% confidence interval -2.23 to -0.17). Meta-analyses showed no significant differences in body mass index and waist circumference for adults. Twenty of 24 intervention groups showed improvements in adult body mass index from baseline to follow-up; average change in high quality studies (n = 7) ranged from 0.31 to -0.8 kg/m2. There was no evidence that interventions were more or less effective according to whether the intervention was set in South Asia or not, or by socio-economic status.Meta-analysis of a limited number of controlled trials found an unclear picture of the effects of interventions on body mass index for South Asian children. Meta-analyses of a limited number of controlled trials showed significant improvement in weight for adults but no significant differences in body mass index and waist circumference. One high quality study in South Asian children found that a school-based physical activity intervention that was delivered within the normal school day which was culturally sensitive, was effective. There is also evidence of culturally appropriate approaches to, and characteristics of, effective interventions in adults which we believe could be transferred and used to develop effective interventions in children.
| S-EPMC4306880 | biostudies-other
Project description:Intervention trials and guidelines for the prevention of type 2 diabetes (T2D) in populations of South Asian origin often include strategies to improve diet and physical activity that are based on those developed for other populations. These may be suboptimal for the South Asian target populations. We aimed to provide an overview of included recommended dietary and physical activity components, and to identify whether these were supported by evidence of their effectiveness. Databases were searched until September 2017 for intervention studies and guidelines with an adult South Asian population without T2D. The protocol was registered in PROSPERO, registration number: CRD42015207067. The quality of included studies and guidelines was assessed. Dietary and physical activity components, and effects on T2D incidence, glycemic status and adiposity measures, were summarized in tabular format and evaluated narratively. Eighteen intervention studies and four guidelines were identified. Dietary and physical activity components were similar to recommendations for the general population. Intervention studies and guidelines did not reference evidence to support the effectiveness of components included in the intervention for South Asian populations in particular. Moreover, we were unable to assess patterns of components to determine the effects of specific components. Evaluation of current and emerging components among South Asian populations and subgroups seems necessary to formulate more specific recommendations in future intervention studies and guidelines.
| S-EPMC6047810 | biostudies-other
Project description:BackgroundSouth Asians are one of the fastest growing ethnic groups in western countries with a high incidence of chronic diseases like metabolic syndrome and cardiovascular disease occurring at younger ages and lower body weight compared with white Europeans. Physically active lifestyle and reduced sedentary time are modifiable risk factors that can decrease burden of chronic diseases. Population-level surveys based on self-report show South Asians engage in low levels of physical activity. Because of known limitations with self-report data, we aimed to synthesize available evidence to generate a physical activity /sedentary time profile of South Asians from studies using accelerometry.MethodsWe systematically searched Medline, EMBASE, CINAHL, PsycINFO, and SportDiscus. We included studies applying accelerometry to measure physical activity /sedentary time under free-living. Studies with an exclusive focus on drugs or including participants with health conditions/physical disability, and special populations (athletes/pregnant women) were excluded. Two authors independently adjudicated inclusion of citations at title/abstract and full text. We applied a standardized data abstraction form to extract relevant data. We evaluated methodological quality using Newcastle Ottawa Quality Assessment Scale. Due to variability and inconsistencies in measurement and reporting of physical activity /sedentary time, we only provide a narrative synthesis.FindingsWe identified only 14 studies(n = 1,338). Despite using similar accelerometry assumptions, we noted variability in reported outcomes for physical activity and sedentary time. Sedentary time ranged from 482(98) to 587 min/day. Mean light physical activity ranged from 211.69(67. 38) to 574(227) min/day. Moderate to vigorous physical activity among South Asian women ranged from 17-41 min/day and among men, 32-43 min/day.ConclusionSouth Asians exhibited higher levels of physical activity when compared to the Canadian population level survey but not when compared to the American population level survey. Overall, fewer studies, and small sample sizes led to considerable variability limiting any effective comparisons. Results highlight the importance of conducting methodologically robust studies based on random sampling to advance the field, and to capture true levels of sedentary time and physical activity in the South Asian population.
| S-EPMC7406035 | biostudies-literature
Project description:INTRODUCTION:Type 2 diabetes (T2D) is a major health concern among populations of South Asian ethnicity. Although dietary and physical activity interventions may reduce the risk of T2D, the effectiveness has been moderate among South Asians. This might (in part) be because this subgroup follows strategies that were originally developed for interventions among other populations. Therefore, this review aims to assess the evidence for the current dietary and physical activity strategies recommended in T2D prevention intervention studies and guidelines for South Asians. METHODS AND ANALYSIS:Included will be all studies and guidelines on dietary and/or physical activity strategies to prevent T2D in adult South Asians. Two reviewers will search online databases from their start until the present date for published and unpublished experimental/quasiexperimental studies, with at least an abstract in English. References of identified articles and key reviews will be screened for additional studies. Guidelines will be identified by searches in online databases and websites of public organisations. Finally, expert consultations will be held to supplement any missing information. Trial quality will be assessed with the Quality Assessment Tool for Quantitative Studies Data, and guidelines with the Appraisal of Guidelines for Research & Evaluation II. Data on the strategies recommended, targeting and evidence on effectiveness will be extracted by two reviewers and presented in tabular and narrative forms. Recommendations will be compared with the National Institute for Health and Care Excellence guidelines [PH35]. Overall findings on dietary and physical activity recommendations, as well as findings for specific subgroups (eg, by sex), will be discussed. ETHICS AND DISSEMINATION:Ethics assessment is not required. Start date: 1 January 2016, finishing and reporting date 31 July 2016. Results will be published in a peer-reviewed scientific journal, the project report of EuroDHYAN (www.eurodhyan.eu) and in a PhD dissertation. TRIAL REGISTRATION NUMBER:The protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42015027067.
| S-EPMC5734198 | biostudies-other
Project description:BackgroundVitamin-D deficiency is linked to a wide range of chronic and infectious diseases. Body of literature suggested that the prevalence of this deficiency can have geographical variation. Although vitamin D deficiency is frequently reported in the South Asian population, the scarcity of systematic reviews and meta-analysis means the true extent of the disease and the underlying factors causing it are poorly characterized.MethodsA systematic search was performed using two databases (PubMed and Scopus) and one search engine (Google Scholar) for original studies on the South Asian population (published from January 1, 2001, to December 31, 2019). Following the search, a random effect meta-analysis was performed to calculate population-level weighted average, the pooled prevalence of deficiency, and heterogeneity of vitamin D among different countries and genders; in addition to South Asia as a whole.ResultsOur study, based on our selection criteria was narrowed down to a total of 44,717 participants; which spanned over 65 studies from five South Asian countries. Overall, the pooled prevalence of deficiency was 68% [95% CI: 64 to 72%] with significant heterogeneity (I2 = 98%; p = 0.00). The average level of vitamin D ranged from 4.7 to 32 ng/mL, with a weighted mean of 19.15 ng/mL (weighted standard deviation 11.59 ng/mL). The highest prevalence of vitamin D deficiency was found in Pakistan (73%;95% CI: 63 to 83%) followed by Bangladesh (67%; 95% CI: 50 to 83%), India (67%; 95% CI: 61 to 73%), Nepal (57%; 95% CI: 53 to 60%) and Sri Lanka (48%; 95% CI: 41 to 55%), respectively. This finding indicated a high degree of heterogeneity among the population. (I2 = 98.76%), Furthermore, a gender-wise analysis suggested that in South Asia, the prevalence of vitamin D deficiency was higher in females than males.ConclusionOur findings reveal highly prevalent and variable vitamin D deficiency among the adults of different South Asian countries. Findings from this review would be helpful to generate hypotheses and explore the factors affecting the inter-country variability, alongside strengthening evidence for governments to prioritize mitigation strategies in this region.
| S-EPMC8501935 | biostudies-literature
Project description:BACKGROUND:We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults. METHODS:Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ?20 years in Delhi, Chennai and Karachi in 2010-11 followed for an average of 38 months. Multimorbidity was defined as having ?2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models. RESULTS:The adjusted prevalence of multimorbidity was 9.4%; multimorbidity was highest in adults who were aged ?60 years (37%), consumed alcohol (12.3%), body mass index ?25 m/kg2 (14.1%), high waist circumference (17.1%) and had family history of a chronic condition (12.4%). Compared with adults with no chronic conditions, the fully adjusted relative hazard of death was twice as high in adults with two morbidities (hazard ratio [HR] = 2.3; 95% confidence interval [CI]: 1.6, 3.3) and thrice as high in adults with ?3 morbidities (HR = 3.1; 95% CI: 1.9, 5.1). CONCLUSION:Multimorbidity affects nearly 1 in 10 urban South Asians, and each additional morbidity carries a progressively higher risk of death. Identifying locally appropriate strategies for prevention and coordinated management of multimorbidity will benefit population health in the region.
| S-EPMC7304513 | biostudies-literature
Project description:This study aimed to systematically review total daily sedentary time in South Asian adults. Seven electronic databases were searched, identifying relevant articles published in peer-reviewed journals between March 1990 and March 2021. The study was designed in accordance with PRISMA guidelines. Prospective or cross-sectional design studies reporting total daily sedentary time in South Asian adults (aged ≥18 years), reported in English, were included. Study quality and risk of bias were assessed, and the weighted mean total daily sedentary time was calculated. Fourteen full texts were included in this systematic review from studies that were conducted in Bangladesh, India, Norway, Singapore, and the United Kingdom. Pooled sedentary time across all studies was 424 ± 8 min/day. Sedentary time was measured using self-report questionnaires in seven studies, with a weighted mean daily sedentary time of 416 ± 19 min/day. Eight studies used accelerometers and inclinometers with a weighted mean sedentary time of 527 ± 11 min/day. South Asian adults spend a large proportion of their time being sedentary, especially when recorded using objective measures (~9 h/day). These findings suggest that South Asians are an important target population for public health efforts to reduced sedentary time, and researchers and practitioners should seek to standardise and carefully consider the tools used when measuring sedentary time in this population.
| S-EPMC8431135 | biostudies-literature
Project description:IntroductionDepression is a global-scale public health problem, and a significant association has been established between depression and chronic physical diseases. This growing comorbidity poses a challenge to healthcare systems. We aim to assess the effectiveness of the management of major depressive episodes/disorder in adults with comorbid chronic physical diseases.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised clinical trials. Two databases MEDLINE and Cochrane Library (Cochrane Database for Systematic Reviews and CENTRAL), as well as the reference lists of the included articles, will be searched for studies either in English or Spanish with published results within the 2005-2015 period. Studies must fulfil the following conditions: (1) participants aged 18 years or older, diagnosed as having a major depressive episodes/disorder according to standardised criteria and chronic physical diseases; (2)interventions (be it pharmacological, psychological, psychosocial or a combination) must be compared with control conditions (other 'active' intervention, treatment as usual, waiting list or placebo); (3)and must report reduction in depressive symptoms after treatment, response to treatment, remission of major depressive episodes/disorder and significant improvement in quality of life. Data extraction, risk of bias evaluation, results summarisation and quality of the evidence (GRADE) will be performed as recommended by the Cochrane Collaboration. A qualitative synthesis and a random effects meta-analysis will be carried out. Effect sizes will be calculated (relative risk and Cohen's d), I2 and Q statistics will be employed to study heterogeneity and publication bias analysis will be performed. Subgroup analyses and meta-regression will be carried out.Ethics and disseminationResults are expected to be published in specialised peer-reviewed journals (preferred topics: Mental Health, Psychology, Psychiatry and/or Systematic Reviews) and dissemination activities will be targeted to all the healthcare providers.Trial registration numberInternational Prospective Register of Systematic Reviews (CRD42016029166) submitted on 11 January 2016.
| S-EPMC5541516 | biostudies-literature