Charles Apprey

Prevalence of risk factors of cardiovascular diseases among prisoners: a systematic review

Purpose Cardiovascular diseases threaten the global health system and their prevalence among the incarcerated population poses a huge economic burden to governments. The purpose of this paper is to investigate the prevalence of cardiovascular disease risk factors among prisoners. Design/methodology/approach A systematic review was done on published studies that looked at prevalence and risk factors of cardiovascular disease among either male or female prisoners or both. PubMed, PubMed Central, Google scholar, Cochrane and Medline databases were searched from a period of 6 June 2016 to 23 June 2016. Quality assessment was done for all papers based on their methodology. Findings Online search yielded a total of 58,587 papers of which 43 were appropriately titled, but 21 were rejected based on their abstracts. Five of the studies could not be included because full texts were not available; 17 studies that met inclusion criteria in terms of abstracts and methodology were included in the study. Majority of the studies assessed weight (64.7 per cent), height (64.7 per cent), body mass index (64.7 per cent) and blood pressure (17.6 per cent) of inmates. Two of the studies used secondary data and one collected qualitative information via focus group discussions. Overall, prevalence of obesity (23.3 per cent), smoking (53.4 per cent) and physical inactivity (57.5 per cent) reported were high among prisoners. Practical implications Most of the studies were conducted in developed countries and this implies that there is a paucity of data in developing countries where prevalence of cardiovascular diseases is high. There is the need for more studies to be conducted in this area among developing countries. Originality/value This paper informs stakeholders on factors that put inmates at risk of cardiovascular diseases and can initiate timely interventions to be implemented within prisons.

Effects of Antioxidant Micronutrients against CVD Risk in Type 2 Diabetes Mellitus: A Systematic Review

Diabetes mellitus is associated with hyperglycemia, which promotes oxidative stress through production of free radicals which may lead to diabetic complications such as cardiovascular diseases. However,it is proposed that dietary intakes of antioxidant micronutrients may help reduce oxidative stress in diabetes mellitus. The objective was to evaluate the protective effects of antioxidant micronutrients against CVD risk among type 2 diabetics. Method: A systematic literature review including detailed search strategy was developed to search PubMed, PMC, PLOSONE, Google scholar and cochrane. Research articles were retrieved, screened and relevant articles were extracted. The exposure for review were zinc, vitamin E, and selenium, whereas measured outcomes were effects of antioxidant micronutrients on type 2 diabetes: reduced FBG and HbA1c, reduced lipidemia, improved antioxidant status, reduced oxidative stress. Results: Among six cross-sectional studies; five studies indicated serum zinc were significantly reduced in type 2 diabetics than controls, whereas one study showed a higher serum selenium in type 2 diabetics than controls. Among five case-control studies used, two studies found serum zinc was lowered among type 2 diabetics than controls. Another study found serum vitamin E was reduced in type 2 diabetics than controls (p<0.05). The other studies showed supplementation of vitamin C, E improved significantly in levels of fasting blood glucose and glycated hemoglobin (p<0.05, p<0.001 respectively). However, a case control study between type 2 diabetics with glycated haemoglobin <7% and ≥ 7% showed no difference in serum zinc levels (p=0.168). Out of five randomized controlled trials, two studies showed significant difference in fasting blood glucose, total antioxidant capacity, malondialdehyde in type 2 diabetics who received supplemented enriched tocotrienol canola oil at the end of study. However, type 2 diabetics supplemented with omega-3 plus vitamin E, and zinc plus vitamin C showed no significant differences in cardiovascular risk markers compared to controls. Also, two studies which either supplemented type 2 diabetics with fermented diet containing supplemented chromium and zinc found no significant differences in glycated hemoglobin compared to placebo groups. Conclusion: Antioxidant micronutrients could significantly reduce risk of cardiovascular diseases in type 2 diabetes and hence require further studies to ascertain its effects.

Developing and Testing the Acceptability of Therapeutic Food for the Management of Severely Malnourished Children

Therapeutic foods for the treatment of malnutrition in children under age 5 years are mostly imported from developed countries by developing countries like Ghana. This comes with huge cost and puts pressure on health authorities when these supplies are limited. The objective of this study was therefore to develop and evaluate therapeutic food made from locally agricultural produce (banana, coconut water, soybean, sugar and vegetable oil) for the management of severely acute malnutrition in children under age 5 years. The proximate, mineral and microbial analyses were conducted on the developed product to ensure the standard falls within the requirement of WHO Protocol for the treatment of malnutrition in children. Sensory analysis was also done on the product using children under five years as the target group. The chemical analysis of product revealed energy and protein content of 95.96 kcal and 1.61 g per 100 g respectively, and percentage concentration of Calcium (0.74), Magnesium (1.09), Potassium (4.79), Sodium (0.17), Phosphorus (0.28), Iron (0.0080), Copper (0.0064), Manganese (0.0089) and Zinc (0.0174). The microbiological examination indicated aerobic plate count (20 cfu/mL), yeast count (8.5 cfu/mL), coliform count (3 cfu/mL) and zero count for both mould and E. Coli. This shows that, the developed product has the potential of treating malnutrition effectively in children under five years old.