Examinando por Autor "Prasad Varma, Ravi"

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  • Publicación
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    Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries
    (BMJ Journals, 2020-05-18) Bhavadharini, Balaji; Dehghan, Mahshid; Mente, Andrew; Rangarajan, Sumathy; Sheridan, Patrick; Mohan, Viswanathan; Iqbal, Romaina; Gupta, Rajeev; Lear, Scott; Wentzel-Viljoen, Edelweiss; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Mony, Prem; Prasad Varma, Ravi; Kumar, Rajesh; Chifamba, Jephat; Alhabib, Khalid F; Mohammadifard, Noushin; Oguz, Aytekin; Lanas, Fernando; Rozanska, Dorota; Bengtsson Bostrom, Kristina; Yusoff, Khalid; Tsolkile, Lungiswa P; Dans, Antonio; Yusufali, Afzalhussein; Orlandini, Andres; Poirier, Paul; Khatib, Rasha; Hu, Bo; Wei, Li; Yin, Lu; Deeraili, Ai; Yeates, Karen; Yusuf, Rita; Ismail, Noorhassim; Mozaffarian, Dariush; Teo, Koon; Anand, Sonia S; Yusuf, Salim; Everest
    Objective Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study. Methods The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes). Results In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome. Conclusions Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.
  • Publicación
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    Association of ultra-processed food intake with risk of inflammatory bowel disease. Prospective cohort study
    (BMJ Journals, 2021-07-14) Narula, Neeraj; Wong, Emily C.L.; Dehghan, Mahshid; Mente, Andrew; Rangarajan, Sumathy; Lanas, Fernando; Lopez-Jaramillo, Patricio; Rohatgi, Priyanka; Lakshmi, P. V. M.; Prasad Varma, Ravi; Orlandini, Andres; Avezum, Alvaro; Wielgosz, Andreas; Poirier, Paul; Almadi, Majid A.; Altuntas, Yuksel; Ng, Kien Keat; Chifamba, Jephat; Yeates, Karen; Puoane, Thandi; Khatib, Rasha; Yusuf, Rita; Bengtsson Boström, Kristina; Zatonska, Katarzyna; Iqbal, Romaina; Weida, Liu; Yibing, Zhu; Sidong, Li; Dans, Antonio; Yusufali, Afzalhussein; Mohammadifard, Noushin; Marshall, John K.; Moayyedi, Paul; Reinisch, Walter; Yusuf, Salim; Masira
    OBJECTIVE To evaluate the relation between intake of ultraprocessed food and risk of inflammatory bowel disease (IBD). DESIGN Prospective cohort study. SETTING 21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China). PARTICIPANTS 116087 adults aged 35-70 years with at least one cycle of follow-up and complete baseline food frequency questionnaire (FFQ) data (country specific validated FFQs were used to document baseline dietary intake). Participants were followed prospectively at least every three years. MAIN OUTCOME MEASURES The main outcome was development of IBD, including Crohn’s disease or ulcerative colitis. Associations between ultra-processed food intake and risk of IBD were assessed using Cox proportional hazard multivariable models. Results are presented as hazard ratios with 95% confidence intervals. RESULTS Participants were enrolled in the study between 2003 and 2016. During the median follow-up of 9.7 years (interquartile range 8.9-11.2 years), 467 participants developed incident IBD (90 with Crohn’s disease and 377 with ulcerative colitis). After adjustment for potential confounding factors, higher intake of ultra-processed food was associated with a higher risk of incident IBD (hazard ratio 1.82, 95% confidence interval 1.22 to 2.72 for ≥5 servings/day and 1.67, 1.18 to 2.37 for 1-4 servings/day compared with <1 serving/day, P=0.006 for trend). Different subgroups of ultra-processed food, including soft drinks, refined sweetened foods, salty snacks, and processed meat, each were associated with higher hazard ratios for IBD. Results were consistent for Crohn’s disease and ulcerative colitis with low heterogeneity. Intakes of white meat, red meat, dairy, starch, and fruit, vegetables, and legumes were not associated with incident IBD. CONCLUSIONS Higher intake of ultra-processed food was positively associated with risk of IBD. Further studies are needed to identify the contributory factors within ultraprocessed foods. STUDY REGISTRATION ClinicalTrials.gov NCT03225586.
  • Publicación
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    Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study
    (IOP Publishing Ltd, 2019-07-29) Shupler, Matthew; Hystad, Perry; Gustafson, Paul; Rangarajan, Sumathy; Mushtaha, Maha; Jayachtria, K.G.; Mony, Prem K.; Mohan, Deepa; Kumar, Parthiban; Lakshmi, P.V.M.; Sagar, Vivek; Gupta, Rajeev; Mohan, Indu; Nair, Sanjeev; Prasad Varma, Ravi; Li, Wei; Hu, Bo; You, Kai; Ncube, Tatenda; Ncube, Brian; Chifamba, Jephat; West, Nicola; Yeates, Karen; Iqbal, Romaina; Khawaja, Rehman; Yusuf, Rita; Khan, Afreen; Seron, Pamela; Lanas, Fernando; Lopez-Jaramillo, Patricio; Camacho López, Paul Anthony; Puoane, Thandi; Yusuf, Salim; Brauer, Michael; The Prospective Urban Rural Epidemiology (PURE) study; Everest
    Introduction. Switching from polluting (e.g. wood, crop waste, coal) to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions. While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods. We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study. We assessed household-level primary cooking fuel switching during a median of 10 years of follow up (∼2005–2015). We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households (12 369) reported changing their primary cooking fuels between baseline and follow up surveys. Of these, 61% (7582) switched from polluting (wood, dung, agricultural waste, charcoal, coal, kerosene) to clean (gas, electricity) fuels, 26% (3109) switched between different polluting fuels, 10% (1164) switched from clean to polluting fuels and 3% (522) switched between different clean fuels. Among the 17 830 households using polluting cooking fuels at baseline, household-level factors (e.g. larger household size, higher wealth, higher education level) were most strongly associated with switching from polluting to clean fuels in India; in all other countries, community-level factors (e.g. larger population density in 2010, larger increase in population density between 2005 and 2015) were the strongest predictors of polluting-to-clean fuel switching. Conclusions. The importance of community and sub-national factors relative to household characteristics in determining polluting-to-clean fuel switching varied dramatically across the nine countries examined. This highlights the potential importance of national and other contextual factors in shaping large-scale clean cooking transitions among rural communities in low- and middle-income countries.