January 2010


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By Debbie Hilaire

Mirroring the global increase in the prevalence of chronic disease, recent data coming out of Trinidad reveals the emergence of non-communicable diseases as the main causes of death during the past decade. The impact of diet and environment in the development of these lifestyle diseases has been well documented and therefore an assessment of the current eating patterns and lifestyle behaviours, which have changed during the past decade due to various national as well as international triggers, is necessary for understanding, and subsequently addressing the problem. With limited national data available, a comprehensive study of a sub-sample of the population has provided a unique opportunity to examine several facets of the local culture such as diet and physical activity, to determine the burden of disease in a high risk sample, with particular focus on the prevalence of chronic disease risk factors and to plan and execute a risk reduction programme.

To determine health status and identify risk factors for chronic disease, a proportionate cross-sectional study design was employed, comprising 273 randomly selected full-time employees of The University of the West Indies. The following standardized methods were employed: (i) anthropometry, to determine BMI and waist circumference; (ii) biochemical analysis of a fasting blood sample for glucose, total cholesterol, HDL-C and LDL-C and triglycerides (iii) duplicate blood pressure measurements using a random zero sphygmomanometer (iv) dietary assessment using 24-hr recalls to define nutrition status and identify dietary behaviours and associations between current health status and chronic disease risk factors; (v) physical examinations to identify signs of nutrient deficiency or toxicity. Questionnaires also provided data on demographics, family history/health status, behaviour and lifestyle, physical activity and health-related quality of life. All statistical analyses were performed with the use of SPSS 17.0 (SPSS Inc., Chicago, USA). A p-value < 0.05 was considered significant. Descriptive statistics, independent t-tests and ANOVA and Pearson’s correlations were used to assess the burden of disease and to identify associations between chronic disease risk factors i.e. central obesity, high blood pressure, elevated glucose, cholesterol, blood triglycerides and LDL, low HDL and (i) dietary intakes (ii) physical activity and (iii) quality of life. Post ANOVA comparisons explored the differences between persons with and without risk factors. Associations between independent risk factor components and anthropometry, dietary/nutrient intakes, physical activity and quality of life were detected by the use of correlation and regression techniques.

Dietary intake as well as nutrient composition of foods were analyzed with the use of a nutrition software program, Nutribase, and food composition tables, after recipes were collected for 89 commonly consumed foods. The frequency with which specific foods were consumed facilitated the development of a culture-specific draft food frequency questionnaire which would more appropriately guide community-based interventions aimed at reducing chronic disease risk factors in Trinidad.

The data gleaned about the diet and lifestyle behaviours of the sample has provided insight into factors which are associated with the prevalence of chronic disease risk factors. It also formed the basis for the development of risk reduction strategies that can improve overall health, as well as enhance well-being and improve the quality of life of staff members, and by extension, the wider Trinidad community.

Mirroring the global increase in the prevalence of chronic disease, recent data coming out of Trinidad reveals the emergence of non-communicable diseases as the main causes of death during the past decade. The impact of diet and environment in the development of these lifestyle diseases has been well documented and therefore an assessment of the current eating patterns and lifestyle behaviours, which have changed during the past decade due to various national as well as international triggers, is necessary for understanding, and subsequently addressing the problem. With limited national data available, a comprehensive study of a sub-sample of the population has provided a unique opportunity to examine several facets of the local culture such as diet and physical activity, to determine the burden of disease in a high risk sample, with particular focus on the prevalence of chronic disease risk factors and to plan and execute a risk reduction programme.

To determine health status and identify risk factors for chronic disease, a proportionate cross-sectional study design was employed, comprising 273 randomly selected full-time employees of The University of the West Indies. The following standardized methods were employed: (i) anthropometry, to determine BMI and waist circumference; (ii) biochemical analysis of a fasting blood sample for glucose, total cholesterol, HDL-C and LDL-C and triglycerides (iii) duplicate blood pressure measurements using a random zero sphygmomanometer (iv) dietary assessment using 24-hr recalls to define nutrition status and identify dietary behaviours and associations between current health status and chronic disease risk factors; (v) physical examinations to identify signs of nutrient deficiency or toxicity. Questionnaires also provided data on demographics, family history/health status, behaviour and lifestyle, physical activity and health-related quality of life. All statistical analyses were performed with the use of SPSS 17.0 (SPSS Inc., Chicago, USA). A p-value < 0.05 was considered significant. Descriptive statistics, independent t-tests and ANOVA and Pearson’s correlations were used to assess the burden of disease and to identify associations between chronic disease risk factors i.e. central obesity, high blood pressure, elevated glucose, cholesterol, blood triglycerides and LDL, low HDL and (i) dietary intakes (ii) physical activity and (iii) quality of life. Post ANOVA comparisons explored the differences between persons with and without risk factors. Associations between independent risk factor components and anthropometry, dietary/nutrient intakes, physical activity and quality of life were detected by the use of correlation and regression techniques.

Dietary intake as well as nutrient composition of foods were analyzed with the use of a nutrition software program, Nutribase, and food composition tables, after recipes were collected for 89 commonly consumed foods. The frequency with which specific foods were consumed facilitated the development of a culture-specific draft food frequency questionnaire which would more appropriately guide community-based interventions aimed at reducing chronic disease risk factors in Trinidad.

The data gleaned about the diet and lifestyle behaviours of the sample has provided insight into factors which are associated with the prevalence of chronic disease risk factors. It also formed the basis for the development of risk reduction strategies that can improve overall health, as well as enhance well-being and improve the quality of life of staff members, and by extension, the wider Trinidad community.

-This is a summary of a presentation made by UWI PhD Nutrition candidate, Debbie Hilaire, titled, “Assessing the Burden of Disease and Lifestyle Behaviours among University Staff provides opportunities for culturally appropriate interventions.”