Two-decade trends and factors associated with overweight and obesity among young adults in Nepal

Abstract Background Young adults are vulnerable to obesity due to different life stresses and challenges, leading to risks of cardiovascular and metabolic disorders. Studies on the long-term trends of overweight and obesity, especially among young people in Nepal are scanty. The problems among this productive age group should be checked and prevented at the earliest. The study aimed to assess more than two decades of trends from 1996 to 2019 of overweight and obesity among Nepalese young adults (18-29 years) and the socio-demographic factors associated with it. Methods We utilized data from the nationwide Demographic and Health Survey (DHS) and WHO STEPwise approach to surveillance (STEPS) survey. These surveys adopted multistage stratified cluster sampling techniques and used house-to-house structured interviews for data collection. We assessed the prevalence of overweight (BMI 25-29.9 kg/m2) and obesity (BMI≥30 kg/m2) in 1996, 2001, 2006, 2011, 2012, 2016, and 2019 among 18,714 young adults in total, and evaluated the associated socio-demographic factors from the 2016 survey, using logistic regression model. Results The preliminary study findings showed that from 1996 to 2019, overweight in women increased from 1.5% to 17.0%, and obesity from 0.1% to 3.4%. For men, overweight rose from 14.4% to 16.6%, and obesity from 1.3% to 2.5% from 2012 to 2019. Higher age was associated with higher odds of overweight and obesity compared to a younger age. Men were less likely to have overweight (AOR: 0.68, CI: 0.53-0.88) and obesity (AOR: 0.42, CI: 0.23-0.78) compared to women. Moreover, urban residents had higher odds of having obesity (AOR: 2.35, CI: 1.25-4.44) compared to rural residents. Conclusions Overweight and obesity have rising trends among young adults in Nepal. Older age, female and urban residence were associated with higher odds of overweight and obesity. Therefore, the interventions targeted to the risk groups can help in curbing the increasing obesity trends in Nepal. Key messages • The information on trends and the factors associated with overweight and obesity may help to identify needs and opportunities to halt the rising obesity trend and prevent risk factors. • The study findings can guide in formulating a national strategy to combat overweight and obesity among Nepalese youths.


Background:
High-density lipoprotein (HDL) cholesterol levels are inversely associated with cardiovascular risk (CVR).However, HDL cholesterol is not a homogeneous lipid and can be subdivided into subfractions, which are not uniformly associated with CVR.Among Roma populations, the prevalence of reduced HDL cholesterol levels and, consequently, that of cardiovascular diseases is very high.However, it is not known how this reduction affects the different HDL subfractions and whether changes in their representation are associated with changes in CVR.

Methods:
The study aimed to investigate whether there is a difference in the HDL subfraction profile between the Hungarian general (HG) and Roma populations and to determine the association of the different subfractions with the CVR estimated by the Framingham Risk Score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms.HDL cholesterol was separated using the Lipoprint system, which separates 10 subfractions into three classes: large HDL (HDL-L), medium HDL (HDL-I), and small HDL (HDL-S).Analyses were carried out on samples of 100 control subjects (50 Hungarian general and 50 Roma individuals with normal lipid profiles) and 277 individuals with reduced HDL-C levels.

Results:
Our results show that Roma has reduced levels of the overall HDL subfraction profile, with significant decreases in HDL-6, and -7.Regardless of the estimation method, elevated levels (in mmol/L) of HDL-1 to 3 and HDL-L were significantly associated with reduced risk.A higher representation (in %) of HDL-1 to 3 subfractions have a significant risk-reducing, while HDL-8 to 10 have a risk-increasing effect estimated by FRS.

Conclusions:
The results of our study show that levels of CVR protective HDL subfractions are significantly lower in Roma individuals and their reduced levels are associated with increased CVR, suggesting that the distribution of HDL subfractions contributes to the overall unfavourable CVR profile of Roma.

Key messages:
Levels of HDL-6 and -7 subfractions were significantly lower in the Roma population than in the Hungarian general one.
The HDL subfraction profile of the Roma population is associated with a higher cardiovascular risk among them.

Background:
Typ1 Diabetes (T1D) us a complicated condition that requires constant monitoring and making many decisions.Living with T1D means to check blood sugar levels, inject oneself insulin, and be careful what you eat.In the life of a young adult there are a lot of things going on and youngsters don't want to control themselves all day and night.They want to rebel and feel free.

Methods:
Teenagers living with T1D are actively involved in the research process from data collection to data interpretation.Following the photo voice method the teenagers documented their everyday life with T1D by photographs and recordings (Summer 2021), and discussed their need and resources in group discussions.The visual and audio-data was structured on a muti-touchscreen for which a software was developed during the project.From the inductively formed categories, measures were derived together with the young people and transferred into an action plan, which was presented and discussed with decision-makers.

Results:
During the photo voice process, the teenagers identified 26 categories (i.e.nutrition, coping strategies, autonomy, etc.) that were important for describing their life with diabetes and there categories were categorized into 4 dimension: psychosocial, time, subject and space.The project-team used a systematic action planning process to develop 9 goals for an action plan to improve their life with T1D.They presented their action plan to local political leaders and stakeholders from different setting, such as health care and youth work.The responses during the stakeholder dialog were positively and there was agreement to achieve the defined goals.

Conclusions:
The photo-voice method was helpful in immersing the participants in the lives of young people with type 1 diabetes.
Structuring and organizing the visual-and audio-data together was beneficial for the participatory process.Together, an action plan could be developed and discussed with decision makers.

Key messages:
The photo voive method using digital tools (like smartphones and multitouchscreen) is a route to empower young people and give them a voice.The participating patients are experts for their bodies and the disease and should be perceived and taken seriously as such. Abstract

Background:
In 2017 the amount of people globally affected by dementia was estimated about 50 million and is predicted to increase to 132 million by 2050.Coping with dementia is one of the most important challenges of governmental organizations' agenda.
The objective of this study is to analyse the hospital admissions trends and monitor the overall mortality in a population of older patients with dementia over the last two decades in northern Italy.

Methods:
This study is based on the healthcare utilization database of the Lombardy region (Italy), considering on hospital discharge records and death registry flows.Primary or secondary diagnosis at admission of dementia was coded according to the ICD9-CM.We carried out descriptive analyses of hospital admissions' data from 1 Jan 1999 to 31 Dec 2020 of older patients aged 65 or more.We then conducted a temporal analysis of mortality rate over the study period.

Results:
A total of 15,683,024 hospital admissions occurred during the study period.Over the last two decades, the prevalence of dementia among patients admitted to acute care hospitals remained around 1.1-1.3%.Considering the total of 183,268 patients with dementia over the study period, the average age at admission increased from 80.2 in 1999 to 83.3 years old in 2020, whereas annual mortality rate increased from about 1,950 to 3,230 deaths per 10,000 person-years.The mortality rate ratio of patients with versus without dementia fluctuated between 1.28 and 1.70.

Conclusions:
Our findings suggest that there is an ever-greater appropriateness of hospitalizations over the last two decades, supported by out-of-hospital care that led patients to hospitalization in increasingly late and serious phases of the disease.The present study has a great future potential as well as limitations, due to the dependence on a correct coding of cases by clinicians according to the ICD9-CM system.

Key messages:
We observed an increased mortality among older people with dementia admitted to hospital over the last two decades.
Our descriptive study, based on the Lombardy regional healthcare database, provides evidence of an increasing appropriateness of hospitalizations.
Overweight and obesity have rising trends among young adults in Nepal.Older age, female and urban residence were associated with higher odds of overweight and obesity.Therefore, the interventions targeted to the risk groups can help in curbing the increasing obesity trends in Nepal.
1 Faculty of Social Sciences, Tampere University, Tampere, Finland Contact: sujata_8@iom.edu.npBackground:Youngadults are vulnerable to obesity due to different life stresses and challenges, leading to risks of cardiovascular and metabolic disorders.Studies on the long-term trends of overweight and obesity, especially among young people in Nepal are scanty.The problems among this productive age group should be checked and prevented at the earliest.The study aimed to assess more than two decades of trends from 1996 to 2019 of overweight and obesity among Nepalese young adults (18-29 years) and the socio-demographic factors associated with it.Methods:We utilized data from the nationwide Demographic and Health Survey (DHS) and WHO STEPwise approach to surveillance (STEPS) survey.These surveys adopted multistage stratified cluster sampling techniques and used house-to-house structured interviews for data collection.We assessed the prevalence of overweight (BMI 25-29.9kg/m2) and obesity