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4 results

  • Public health potential of guidelines-based dietary scores for non-communicable diseases mortality prevention: simulation study using the Preventable Risk Integrated ModEl (PRIME) model

  • Chantal Julia, Pascal Leroy, Moufidath Adjibade, Karen E Assmann, Mathilde Touvier, Serge Hercberg, Louis-Georges Soler, Emmanuelle Kesse-Guyot
  • Journal:
    Public Health Nutrition / Volume 24 / Issue 16 / November 2021
    Published online by Cambridge University Press:
    02 July 2021, pp. 5539-5549
    • Article
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  • Objective:

    Dietary indexes measure the adherence of individuals to a set of nutritional recommendations. However, the health gains associated with adherence to various dietary indexes may vary. Our objective was to compare the magnitude of estimated avoided deaths by chronic diseases obtained by improving diet quality in the French population, measured by a variety of dietary indexes.

    Design:

    Simulation study based on observational data.

    Setting:

    Weighted data from a French population-based cohort study.

    Participants:

    In participants from the NutriNet-Santé cohort, we computed dietary scores reflecting the adherence to various recommendations (Medi-Lite, Healthy Diet Indicator (HDI), Programme National Nutrition Santé/National Nutrition and Health Program – Guidelines Score, Diet Quality Index (DQI), Alternative Healthy Eating Index (AHEI) and the modified Food Standards Agency nutrient profiling system dietary index (FSAm-NPS DI)). Quintiles of the food groups’ consumption and dietary intakes were used as input in a simulation model (Preventable Risk Integrated ModEl (PRIME)), yielding the number of delayed or avoided deaths in nutrition-related non-communicable diseases, comparing between very high or very low nutritional quality of the diet and medium nutritional quality.

    Results:

    A modification of dietary intakes from medium quality to very low quality (i.e. from the middle quintile to the quintile with the lowest nutritional quality) was associated with an increased number of deaths ranging from 3485 (95 % uncertainty interval (CI) 4002, 2987) for HDI and 3379 (95 % CI 3881, 2894) for FSAm-NPS DI to 838 (95 % CI 1163, 523) for Medi-Lite. Conversely, a modification of dietary intakes from medium quality to very high quality was associated with a decrease in the number of deaths ranging from 1995 (95 % CI 1676, 2299) for Probability of Adequate Nutrient intake diet, 1986 (95 % CI 1565, 2361) for DQI-International, 1931 (95 % CI 1499, 2316) for FSAm-NPS DI and 858 (95 % CI 499, 1205) for HDI.

    Conclusions:

    Our results provide some insights as the potential impact of following various dietary guidelines to reduce mortality from nutrition-related diseases.

  • Epidemiology of Falls in Older Age

  • Nancye May Peel
  • Journal:
    Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 30 / Issue 1 / March 2011
    Published online by Cambridge University Press:
    15 March 2011, pp. 7-19

  • Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and fall-related injuries and the impact of population aging. The magnitude of the problem is described in terms of the classification of falls and measurement of outcomes, including fall incidence rates across settings, sociodemographic determinants, international trends, and costs of falls and fall-related injuries. Finally, public health approaches to minimize falls risk and consequent demand on health care resources are suggested.

  • 1 - Clinical research design: analytical studies

  • from Part I - Quantitative methods in clinical neurology
  • Albert Hofman, Erasmus Universiteit Rotterdam, Richard Mayeux, Columbia University, New York
  • Book:
    Investigating Neurological Disease
    Published online:
    29 September 2009
    Print publication:
    30 August 2001, pp 3-10

  • Summary

    Analytic studies are increasingly important for understanding relationships between diseases and their causes. They usually take the form of observational investigations, but can also include randomized clinical trials. Risk factors are antecedents that are considered to be components of the disease pathway. Appropriate study design and consideration to systematic bias and confounding helps to establish association between the exposure and disease. The purpose for maintaining the principles of causal inference and eliminating chance, bias, and confounding is to establish validity. The most serious concern in analytic studies is maintaining validity. Confounders are extraneous factors that are related to the disease and to a risk factor or exposure related to the disease. The confounder usually predicts disease in the absence of any risk factor. Investigators have to consider cost and efficiency in their design as well as the potential public health impact of any observed association.

  • 19 - Alcohol-use disorders: who should be treated and how?

  • from Part III - Unmet need: people with specific disorders
  • Edited by Gavin Andrews, University of New South Wales, Sydney, Scott Henderson, Australian National University, Canberra
  • Book:
    Unmet Need in Psychiatry
    Published online:
    21 August 2009
    Print publication:
    06 January 2000, pp 290-301

  • Summary

    Alcohol-use disorders are among the most prevalent mental disorders in the general community. The Epidemiologic Catchment Area (ECA) study involved personal interviews with 20,000 Americans in five states. In the ECA study individuals with alcohol-use disorders were at high risk of suffering from other mental disorders. The National Comorbidity Survey (NCS) is a population survey that was undertaken between 1990 and 1992 to examine the extent of comorbidity between substance-use and nonsubstance-use disorders in the USA. A public health approach adopts a broader explanation of the causes of alcohol-related health problems. Alcohol-use disorders complicated by other comorbid mental disorders have been recognized as having a poorer prognosis and being more difficult to treat than those without comorbid disorders. Public education about the risks of alcohol use may be the best way of preventing and ameliorating the public health impact of the prevalent, milder forms of alcohol disorders.