Journal of Health, Population, and Nutrition最新文献

{"title":"Triangulating evidence, expertise, and maternal experience to design a gestational age-specific stimulation protocol for preterm infants in indian neonatal intensive care units.","authors":"Abishek J R, Vadivelan Kanniappan, Manisha Srinivasan, Karthikeyan Saravanan","doi":"10.1186/s41043-026-01339-1","DOIUrl":"10.1186/s41043-026-01339-1","url":null,"abstract":"<p><strong>Background: </strong>Early stimulation is increasingly recognised as essential for optimising neurodevelopmental outcomes in preterm infants admitted to Neonatal Intensive Care Units (NICUs). However, most existing stimulation protocols are derived from controlled research settings and lack guidance in gestational age (GA) -specific timing, caregiver role allocation, and cultural applicability, limiting their translation into routine practice in resource-constrained settings like India.</p><p><strong>Aim: </strong>To develop a GA-specific early stimulation protocol for preterm infants using structured triangulation of trial evidence, therapist-informed practice patterns and maternal experience in Indian NICU settings.</p><p><strong>Methods: </strong>A sequential exploratory mixed-method design was employed. First, a systematic review of randomised controlled trials (2010-2023) mapped stimulation modalities and GA characteristics. Second, a semi-structured interview was conducted with 16 NICU physiotherapists across eight Indian states to capture feasibility-driven clinical expertise. Third, in-depth interviews with 12 mothers of preterm infants explored maternal readiness, emotional acceptance and culturally embedded caregiving practices. Data were integrated using joint display analysis and a fixed decision algorithm.</p><p><strong>Results: </strong>Triangulation classified modalities into four categories: five with strong convergence, five requiring conditional implementation, two restricted to specialist delivery and two excluded from the protocol. These findings were synthesised into a novel, colour-coded week x modality matrix, operationalising developmental sequencing, modality layering and transitions from therapist-led to parent-led delivery across GA.</p><p><strong>Conclusion: </strong>This study presents the foundational development of a contextually grounded GA-specific early stimulation protocol that maps twelve modalities across 26-40 weeks with colour-coded transitions from therapist-led to parent-led care. By integrating evidence, expertise and lived experience, the framework offers a transparent and culturally informed basis for subsequent feasibility testing, validation and implementation.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of fertility knowledge and attitudes towards parenthood and fertility preservation among tertiary-educated youths in Singapore.","authors":"Kia Hui Lim, See Ling Loy, Chee Wai Ku, Shu Qi Tan, Tat Xin Ee, Sadhana Nadarajah","doi":"10.1186/s41043-026-01322-w","DOIUrl":"10.1186/s41043-026-01322-w","url":null,"abstract":"<p><strong>Background: </strong>Total fertility rates (TFRs) are declining globally, with Singapore among the lowest at 0.87 in 2025. To develop effective strategies that promote informed reproductive choices and improve fertility outcomes, it is essential to understand the evolving perspectives of tertiary-educated youths, who play a pivotal role in shaping the nation's future demographic trends.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among university undergraduates aged 18-25 in Singapore between August 3 and 17, 2023. The 45-item questionnaire assessed attitudes toward childbearing (3 items), fertility knowledge (22 items), and perceptions towards fertility assessment, treatment and preservation (11 items). Internal consistency of the questionnaire was good (Cronbach's alpha 0.87). Categorical variables were compared using chi-square or Fisher's exact tests, and continuous variables using independent t-tests. Multiple linear regression analyses were conducted to examine the association between demographic factors and desire for childbearing and fertility knowledge scores.</p><p><strong>Results: </strong>Among 220 respondents (50.0% female), 62.3% desired biological children, with 52.6% preferring to conceive between ages 26-30. Childbearing considerations varied by age: education (75.0%) was prioritised at ages 21-25, career satisfaction (33.3%) at 26-30, and financial stability (50.0%) at 36-40. Demographic factors were not significantly associated with desire for childbearing. Although 62.7% reported confidence in their fertility knowledge, substantial misconceptions were observed regarding the impact of metabolic health on fertility (94.5%), age of fertility decline (71.8%), conception probabilities (74.5%), and the fertile window (54.1%). Although 74.1% were aware of elective egg freezing (EEF), 73.2% did not know how to access it. Students from healthcare-related faculties had higher fertility knowledge scores than those from non-healthcare faculties (β = 0.17, 95% CI: 0.28, 3.72). While 51.3% considered EEF, only 36.4% were open to in-vitro fertilisation (IVF). In a hypothetical subfertility scenario, 82.7% indicated they would seek help, primarily medical attention (68.6%), although 68.2% would not consider earlier childbearing. Interest in fertility testing (54.5%) and fertility interventions (60.0%) were high.</p><p><strong>Conclusions: </strong>Our study revealed a notable discrepancy between reproductive intentions, fertility knowledge, and prospective behaviours. Enhancing fertility education and access to assessments and preservation methods empowers individuals to make informed reproductive choices aligned with biological realities, thereby supporting long-term fertility outcomes.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the spread of nutrition-based misinformation by TikTok influencers: an experimental analysis of trust among young adults.","authors":"Grace Fox, Lisa van der Werff, Guto Santos, Antonia Egli, Charles Wood, Theo Lynn","doi":"10.1186/s41043-026-01321-x","DOIUrl":"10.1186/s41043-026-01321-x","url":null,"abstract":"<p><strong>Background: </strong>Nutrition misinformation spreads rapidly on social media. Young adults particularly rely on influencers and platforms, such as TikTok, for nutrition information. This study examined young adult TikTok users' trust in nutrition information and nutrition influencers, exploring whether influencer qualifications and message accuracy influence trust.</p><p><strong>Methods: </strong>We conducted an online experiment using Prolific and Centiment. A total of 1,035 TikTok users aged 18-26 years were recruited from four countries (USA, UK, Australia, Canada), with 1,016 included in the final analysis. Participants were randomly assigned to view one of six TikTok videos manipulating (1) influencer qualification (qualified vs neutral vs not qualified) and (2) information accuracy (accurate vs misinformation). Outcomes were self-reported trust in the influencer and trust in the message content, measured using validated multi-item scales. Differences across conditions were analysed using factorial ANCOVA models in SPSS.</p><p><strong>Results: </strong>Trust in the influencer and trust in the message differed by qualification condition, with the highest trust observed when the influencer reported a nutrition qualification. Trust in both outcomes was also higher when the video contained accurate information compared with misinformation, with mean differences across conditions ranging from approximately 0.47 to 0.50 points on the scale. Post hoc analyses indicated lower trust in both the influencer and the message among Canadian participants relative to other countries.</p><p><strong>Conclusions: </strong>Influencer qualifications and information accuracy independently increase young adults' trust in TikTok nutrition content. These findings support encouraging qualified nutrition professionals to prominently disclose relevant credentials, ensure accuracy in original posts, and actively counter inaccurate nutrition content shared by others.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of nutritional intervention on interleukin-18 and alpha-2-macroglobulin in women with obesity and metabolic dysfunction-associated fatty liver disease: a prospective cohort study.","authors":"Salwa M El Shebini, Eman R Youness, Nihad H Ahmed, Hisham A Orban, Rehab A Mohamed, Maha I A Moaty","doi":"10.1186/s41043-026-01324-8","DOIUrl":"10.1186/s41043-026-01324-8","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is closely linked to metabolic abnormalities, including central obesity, dyslipidaemia, hypertension, hyperglycaemia, and impaired liver function. Identifying effective lifestyle interventions and reliable noninvasive biomarkers remains a public health priority.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of dietary modification on metabolic and hepatic parameters in women with MAFLD and to assess the potential role of interleukin-18 (IL-18) and alpha-2-macroglobulin (A2M) as noninvasive biomarkers.</p><p><strong>Methods: </strong>A prospective interventional study was conducted on 54 women with obesity and at least one criterion of metabolic syndrome. Participants were categorized into mild MAFLD, moderate MAFLD, or healthy liver groups based on ultrasonographic findings. All participants followed a calorie-restricted, balanced diet (1000-1200 kcal/day) for eight weeks. Anthropometric measurements, 24-hour dietary recall, and biochemical parameters, including IL-18, A2M, and liver enzymes, were assessed at baseline and post-intervention.</p><p><strong>Results: </strong>At baseline, women with moderate MAFLD exhibited significantly higher body mass index (BMI), minimal waist circumference (MWC), low-density lipoprotein cholesterol (LDL-C), and LDL/HDL ratio, along with lower high-density lipoprotein cholesterol (HDL-C), reflecting an adverse metabolic profile. They also reported higher macronutrient intake and lower dietary fiber consumption. A strong positive correlation between IL-18 and A2M (p ≤ 0.01) was observed across all groups and was associated with an unfavorable metabolic status. Following the intervention, significant improvements (p ≤ 0.05) were observed in weight, BMI, MWC, LDL-C, and gamma-glutamyl transferase (GGT), along with increased HDL-C levels. A highly significant reduction (p ≤ 0.01) in IL-18 was observed only among participants with MAFLD, while A2M levels decreased significantly (p ≤ 0.05-0.01) across all groups.</p><p><strong>Concluions: </strong>A calorie-restricted, balanced diet significantly improves metabolic and hepatic parameters in women with MAFLD. These findings highlight the beneficial impact of dietary intervention on liver enzymes and inflammatory markers, particularly GGT, IL-18, and A2M, and support the potential utility of A2M as a noninvasive biomarker and therapeutic target.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of nutrition education on food insecurity, food literacy, and dietary intake: a single-arm pre-post intervention study.","authors":"Mahitab Hanbazaza, Lama Alaklabi","doi":"10.1186/s41043-026-01332-8","DOIUrl":"10.1186/s41043-026-01332-8","url":null,"abstract":"<p><strong>Background: </strong>Poor food literacy behaviours may exacerbate food insecurity. Therefore, food literacy interventions have been increasingly utilized to improve food security and enhance dietary intake among low-socioeconomic adults. This study aimed to evaluate the impact of a nutrition education intervention on food security, food literacy, and dietary intake among low-income Saudi families.</p><p><strong>Methods: </strong>This single-arm pre-post intervention study was conducted between June and August 2024. Seventy-three adults completed the pre-survey and 67 completed the post-survey. The survey included questions on food security, food literacy, and dietary intake.</p><p><strong>Results: </strong>The intervention was significantly associated with improvements in both food insecurity and food literacy. The mean food insecurity score decreased from 4.06 ± 2.98 pre-intervention to 2.71 ± 2.58 post-intervention, with a mean reduction of - 1.35 ± 1.62 (P < 0.001; Cohen's d = 0.83). In terms of food literacy, the mean score increased from 46.4 ± 10.9 to 58.4 ± 7.1, with a mean increase of 12 ± 9.07 (P < 0.001; Cohen's d = 1.32). Dietary intake also improved following the intervention. After adjustment for multiple comparisons, significant improvements remained for fruit intake, red and white meat intake, legumes, and bread and cereals.</p><p><strong>Conclusions: </strong>The intervention showed short-term improvement in food insecurity and food literacy, along with favorable changes in dietary intake among low-income Saudi families.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From broad strokes to fine details: qualitative research on the challenges of smart hospitals in Iran.","authors":"Neda Hoseini Abforosh, Hasan Abolghasem Gorji, Naser Derakhshani","doi":"10.1186/s41043-026-01334-6","DOIUrl":"10.1186/s41043-026-01334-6","url":null,"abstract":"<p><strong>Background: </strong>Nascent smart hospitals are developing as an essential yet challenging response to the healthcare industry's digital revolution. However, there is limited understanding of the lived experiences of the stakeholders involved in this transition, especially in countries like Iran, characterized by distinct structural, cultural, and technological factors that complicate the process.</p><p><strong>Methods: </strong>This qualitative, interview-based study involved 17 key stakeholders, including presidents, managers, experts, consultants, and healthcare professionals who engaged in the planning, development, or implementation of smart hospitals. Semi-structured interviews were conducted between February and April 2025, lasting from 20 to 126 min, and were analyzed using Braun and Clarke's six-phase thematic analysis approach.</p><p><strong>Results: </strong>The qualitative data analysis identified 10 themes, 25 sub-themes, and 151 detailed codes. These findings highlight the multifaceted challenges to smart hospital transformation, including systemic performance weaknesses, technological limitations, organizational inefficiencies, security and ethical risks, insufficient skills and literacy, weak decision-making and adoption, governance and policy gaps, financial and investment inefficiencies, global crises, and conceptual deficiencies. Overall, the results emphasize the multidimensional and context-dependent nature of the smartization process in healthcare.</p><p><strong>Conclusion: </strong>This study elucidates the challenges as well as the structural, cultural, and strategic requirements that must be addressed for the successful implementation of smart hospitals in Iran. The insights provided extend beyond a single national context, serving as a guide for understanding and navigating the global challenges of smart healthcare transformation for policymakers, hospital managers, investors, technology developers, consultants, and global health leaders who must collectively define the future of smart healthcare.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in prevalence and patterns of non-communicable disease multimorbidity across socioeconomic spectra in rural Southwest China.","authors":"Lan Liu, Jing-Jing Huang, Guo-Hui Li, Qing-Rou Bao, Rui-Min Shi, Fan Gu, Allison Rabkin Golden, Yuan Zhao, Le Cai","doi":"10.1186/s41043-026-01328-4","DOIUrl":"10.1186/s41043-026-01328-4","url":null,"abstract":"<p><strong>Background: </strong>Globally, the burden of non-communicable diseases (NCDs) and multimorbidity continues to grow. This study aimed to uncover the changes in the prevalence and patterns of multimorbidity involving eight common NCDs across socioeconomic gradients in rural Southwest China.</p><p><strong>Methods: </strong>Data were collected through two waves of community-based, cross-sectional health interviews and physical examinations among individuals aged ≥ 35 years in rural Southwest China. Individual socioeconomic position (SEP) was constructed using principal component analysis. Association rule mining was employed to identify the NCD multimorbidity patterns of eight chronic conditions. Anthropometric measurements, blood pressure, fasting blood glucose, and post-bronchodilator spirometry were recorded for all participants. The survey's response rates of 98.9% in 2014 and 98.2% in 2024.</p><p><strong>Results: </strong>From 2014 to 2024, the age-standardized prevalence of hypertension (35.6% vs. 52.4%), diabetes (8.9% vs. 10.4%), dyslipidemia (4.4% vs. 6.8%), obesity (7.3% vs. 11.7%), CHD (3.0% vs. 5.0%), stroke (2.3% vs. 3.3%), chronic obstructive pulmonary disease (3.4% vs. 4.2%), and multimorbidity of eight NCDs (14.5% vs. 22.8%) increased significantly (P < 0.01). This increasing rate was also observed across all subgroups by sex, age, level of education, level of income, access to medical services, and SEP (P < 0.05). In both 2014 and 2024, all NCD multimorbidity patterns involved hypertension. The most prevalent NCDs combination was hypertension + obesity in 2014 and hypertension + diabetes in 2024. Over this decade, the number of identified NCDs multimorbidity patterns increased across SEP subgroups, with the most pronounced increase observed in those with high SEP.</p><p><strong>Conclusions: </strong>The prevalence of NCDs multimorbidity rose substantially across socioeconomic gradients from 2014 to 2024, and significant socioeconomic disparities were observed in temporal trends of NCDs multimorbidity patterns in rural Southwest China. Future interventions to improve prevention and management of NCDs multimorbidity must be tailored to account for socioeconomic factors.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional medicine use among adults living with hypertension in Cape Verde: A WHO STEPWISE study.","authors":"Joshua Okyere, Castro Ayebeng, Kwamena Sekyi Dickson","doi":"10.1186/s41043-026-01330-w","DOIUrl":"10.1186/s41043-026-01330-w","url":null,"abstract":"<p><strong>Background: </strong>Like many African countries, the people of Cape Verde hold strongly to traditional heritage and customs, including the use of traditional medicine in treating ailments. While existing studies in Cape Verde have explored the use of traditional medicine in treating and managing infectious and parasitic diseases, such as malaria, little is known about its use among adults living with hypertension. Given the high prevalence of hypertension in Cape Verde, it is imperative to understand whether those living with the condition use traditional medicine. As such, we assess the factors associated with traditional medicine use among adults living with hypertension in the archipelago nation of Cape Verde.</p><p><strong>Methods: </strong>We analyzed the 2020 WHO STEPS survey for Cape Verde. With a sample size of 1,008 men and women, we performed descriptive analysis as well as bivariable and multivariable logistic regression in STATA 18. Variables were selected into the multivariable logistic regression through a stepwise approach.</p><p><strong>Results: </strong>The results indicate that 35.7% (95%CI: 31.5-40.2) of adults living with hypertension used traditional medicine. Women had more than twice the odds of using traditional medicine compared to men (AOR = 2.08, 95%CI: 1.48-2.92). Individuals aged 50 years and older had higher odds of using traditional medicine than those aged 18-29 years (AOR = 2.20; 95%CI: 1.01-4.81). Furthermore, those who did not consume alcohol had significantly higher odds of using traditional medicine compared to those who did (AOR = 1.48, 95%CI: 1.10-1.99). Also, individuals in a hypertensive crisis stage had over twice the odds of using traditional medicine compared to those in the elevated hypertension stage (AOR = 2.45, 95%CI: 1.25-4.80).</p><p><strong>Conclusion: </strong>This study provides population level evidence that traditional medicine use is common among adults living with hypertension in Cape Verde, with more than one third reporting its use. It is shaped by demographic and behavioral factors including sex, age, alcohol consumption, and hypertensive crisis. These findings highlight the importance of routine clinical engagement and patient centered discussions regarding traditional medicine use among individuals with hypertension to support safe and coordinated disease management.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body roundness index modified the association between sleep changes and multimorbidity in middle-aged and older adults: a nationwide cohort study.","authors":"Jianping Liu, Yang Shi, Chunmei Song, Shufang Wang, Siyu Gu, Qinghe Li, Haijuan Chen","doi":"10.1186/s41043-026-01329-3","DOIUrl":"10.1186/s41043-026-01329-3","url":null,"abstract":"<p><strong>Background: </strong>Despite established individual associations of poor sleep quality and obesity with multimorbidity, their potential joint association remains inadequately characterized. This study aimed to investigate how longitudinal changes in sleep patterns, combined with Body Roundness Index (BRI), a novel abdominal obesity indicator, impact the development of multimorbidity in middle-aged and older individuals.</p><p><strong>Methods: </strong>This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2018. Longitudinal changes in sleep quality and sleep duration were categorized as \"Stable Good\", \"Deteriorated\", \"Improved\", or \"Stable Poor\". Multivariable logistic regression models were employed to assess independent and joint associations with incident multimorbidity, adjusting for sociodemographic and lifestyle confounders.</p><p><strong>Results: </strong>A total of 1,822 participants aged ≥ 45 years who were free of multimorbidity at baseline were included. During the follow-up period, 185 participants (10.2%) developed multimorbidity. In the overall population, elevated BRI change (OR = 1.31, 95% CI: 1.07-1.61) and adverse sleep trajectories were significantly associated with incident multimorbidity. Specifically, participants with \"Deteriorated\" and \"Stable Poor\" sleep quality exhibited ORs of 2.21 (95% CI: 1.17-4.12) and 2.91 (95% CI: 1.57-5.37), respectively. Similarly, \"Deteriorated\" (OR = 1.63, 95% CI: 1.09-2.39) and \"Stable Poor\" (OR = 1.59, 95% CI: 1.01-2.46) sleep duration were associated with increased risk. Crucially, stratified analyses revealed that BRI changes significantly modified these associations. In the low BRI change group, sleep quality trajectories showed no significant association with multimorbidity. Conversely, in the high BRI change group, the risk was markedly amplified for those with \"Deteriorated\" (OR = 2.74, 95% CI: 1.11-6.71) and \"Stable Poor\" (OR = 4.48, 95% CI: 1.95-10.06) sleep quality. Regarding sleep duration, a significant association was exclusively observed in the \"Deteriorated\" group within the high BRI change group (OR = 2.36, 95% CI: 1.09-5.05).</p><p><strong>Conclusions: </strong>This study demonstrates that adverse sleep trajectories and increasing BRI are independent risk factors for incident multimorbidity, and their combination synergistically amplifies risk. These findings highlight the importance of integrated interventions targeting both sleep health and abdominal obesity for multimorbidity prevention in aging populations.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition among men in Ghana: socio-demographic factors and rural-urban differences.","authors":"Fidelia A A Dake, Aaron Kobina Christian","doi":"10.1186/s41043-026-01325-7","DOIUrl":"10.1186/s41043-026-01325-7","url":null,"abstract":"<p><strong>Background: </strong>Research on malnutrition in sub-Saharan Africa, including Ghana, has primarily focused on women and children, with less attention paid to men. We estimate the prevalence and examine the correlates and place differentials in malnutrition among Ghanaian adult males aged 20 to 59 years.</p><p><strong>Methods: </strong>We analyzed data from the seventh round of the Ghana Living Standards Survey. The analytical sample includes 8,117 (weighted) adult males who had valid data on anthropometric measures and sociodemographic characteristics of interest. Malnutrition was assessed using respondents' body mass index (BMI). Respondents were classified as being underweight, normal weight, overweight/obese using the standard World Health Organization BMI cut-off points. Descriptive and multinomial logistic regression analysis techniques were employed in analyzing the data.</p><p><strong>Results: </strong>One in four (25.3%) adult males aged 20-59 years in Ghana were identified to be overweight/obese. Increasing age, being married, having at least junior high school education, being of middle or high wealth status and being a Christian or Moslem were associated with increased odds of being overweight/obese while living in a rural area and having access to improved water sources were associated with a lower likelihood of being overweight/obese.</p><p><strong>Conclusion: </strong>Interventions on lifestyle behavior changes aimed at addressing overweight and obesity, including eating healthy diets and being physically active should target married, educated and wealthy men who are most at risk of being overweight/obese. Additionally, men need to be educated on the increased risk of overweight/obesity associated with increasing age and encouraged to adopt healthier lifestyles as they age.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}