Search Results (625)

Background: The global shift to sustainable diets has raised interest in plant-based protein sources, particularly pulses, due to their nutritional value, health benefits, and low environmental impact. Pulses are rich in protein, dietary fiber, and a variety of bioactive compounds that may influence gut microbiota and metabolic health. Objective: This narrative review aims to evaluate the role of pulse consumption in modulating gut microbiota, improving metabolic health, and contributing to the prevention of non-communicable diseases (NCDs), while considering the impact of processing techniques such as fermentation and sustainability aspects. Methods: A comprehensive literature search was conducted using major scientific databases to identify relevant studies published during the last 10 years. Evidence from in vitro, in vivo experimental and human studies was included, focusing on pulse composition, bioactive compounds, gut microbiota modulation, metabolic outcomes, and the effects of processing methods such as fermentation. Results: Pulses demonstrate promising potential to improve gut health by promoting beneficial microbiota, increasing short-chain fatty acid production, and enhancing intestinal barrier function. Evidence also suggests favorable effects on lipid metabolism, glycemic control, and inflammation. Processing techniques, particularly fermentation, improve nutrient bioavailability, digestibility, and bioactive profiles. Beyond health outcomes, this review places pulses in the larger context, emphasizing their contribution to healthy, sustainable diets. Conclusions: Pulses are key components for achieving sustainable, health-promoting diets with promising effects on gut and metabolic health. However, current evidence is largely derived from preclinical studies, highlighting the need for long-term human interventions and scalable processing strategies to fully realize their potential. Full article

Background/Objectives: Non-communicable diseases (NCDs) are a leading cause of death globally, particularly in low- and middle-income countries undergoing rapid epidemiological transition. Apolipoprotein E (APOE) polymorphisms have been implicated in modulating risk for cardiovascular and neurodegenerative diseases. This study characterizes the distribution of APOE alleles and genotypes in an Angolan population sample and explores associations with demographic variables. Methods: A cross-sectional study was conducted in Huambo Province, Angola, with 200 unrelated adults aged 40–70 years. Genotyping for ε2, ε3, and ε4 was performed via real-time PCR. Allelic and genotypic frequencies were calculated and tested for Hardy–Weinberg equilibrium. Associations with sex, age (≤54 vs. >54 years), and urban vs. rural residence were analyzed. Results: ε3 was the most frequent allele (63%), followed by ε4 (24.8%) and ε2 (12.2%). The ε3 homozygous genotype was prevalent (44%), with ε3/ε4 (19%) and ε2/ε3 (18%) also common. Significant Hardy–Weinberg disequilibrium was observed due to excess ε4 homozygotes and deficit of certain heterozygotes; possible contributing factors, including population structuring, convenience sampling, and technical aspects of genotyping, are discussed. ε4 prevalence was higher in urban residents and older individuals, while ε3 and ε2 were more common in rural areas and younger participants. Conclusions: Our results reveal notable genetic heterogeneity and highlight the epidemiological and evolutionary importance of ε4 in Angola. The findings underscore the need for integrating population genomics into public health strategies targeting NCD prevention, especially in rapidly urbanizing African contexts. Full article

Non-communicable diseases (NCDs), including type 2 diabetes mellitus (DM), hypertension (HTA), obesity (OB), and cardiovascular disease (CVD), represent a major global health burden and disproportionately affect socially vulnerable populations. Small extracellular vesicles (EVs) are stable carriers of proteins and regulatory RNAs that may reflect endothelial dysfunction and cardiometabolic stress. This study explored plasma-derived EV-associated biomarkers in adults from La Guajira, Colombia, with emphasis on miR-126-3p, miR-21-5p, miR-92a-3p, and SNAIL. Anthropometric, clinical, and biochemical data were obtained from a cross-sectional cohort. Representative plasma samples were selected for EVs isolation by size-exclusion chromatography. Vesicles were characterized by nanoparticle tracking analysis, scanning transmission electron microscopy, protein quantification, Western blotting, and bead-based flow cytometry. Candidate miRNAs were identified by small RNA sequencing and validated by stem-loop RT-qPCR. Bioinformatic enrichment analyses were performed using miRNet 2.0 and KEGG pathway analysis. The epidemiological cohort showed a high cardiometabolic burden, with waist-to-height ratio (WHtR) and triglyceride-glucose (TyG) index emerging as key markers of central adiposity and metabolic dysfunction. Plasma-derived EVs displayed the expected nanoscale morphology and expressed canonical vesicle markers. Protein cargo analyses revealed EMT- and remodeling-associated proteins, including SNAIL and GAL-3. EV-associated miR-126-3p, miR-21-5p, and miR-92a-3p were enriched predominantly in hypertensive and hypertensive-diabetic groups. In an exploratory sub-cohort, CD31-positive EVs showed a trend toward increased expression in individuals with previous myocardial infarction or stroke (p = 0.057). KEGG enrichment analysis linked the identified miRNA signature to pathways involved in endothelial dysfunction, inflammation, vascular remodeling, apoptosis, and extracellular matrix organization. Plasma-derived EVs from individuals with cardiometabolic disorders carry molecular signatures consistent with endothelial stress and vascular remodeling. These findings identify miR-126-3p, miR-21-5p, miR-92a-3p, SNAIL, and CD31-positive EVs as exploratory candidate biomarkers that require validation in larger prospective cohorts. Full article

Background/Objectives: Sleep disorders are common among older adults and have been increasingly linked to metabolic abnormalities and non-communicable diseases (NCDs). However, evidence on the relationship between sleep quality and health-related clinical outcomes and biomarkers in rural Northern Thailand remains limited. This study aimed to assess the association between sleep quality and health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. Methods: A cross-sectional study was conducted among 424 older adults in Phayao Province, rural Northern Thailand. Quota sampling was employed to ensure equal representation of participants with and without NCDs (n = 212 per group). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Physical health status was evaluated through measurements of blood pressure (BP), including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and fasting blood sugar (FBS). Results: The participants’ mean PSQI score was 8.03 ± 4.86, and 29.7% had poor sleep quality (PSQI > 5). Hypertension (35.4%) and diabetes mellitus (17.5%) were the most common underlying diseases. The mean fasting blood sugar level was 116.33 ± 30.84 mg/dL, with 21.0% of participants presenting abnormal levels (≥126 mg/dL). Multivariable binary logistic regression demonstrated that each one-point increase in the overall PSQI score was significantly associated with higher odds of having an underlying disease (adjusted odds ratio [AOR] = 2.37; 95% confidence interval [CI]: 2.00–2.81), hypertension (AOR = 1.51; 95% CI: 1.37–1.66), diabetes mellitus (AOR = 1.42; 95% CI: 1.28–1.58), other non-communicable diseases (AOR = 1.94; 95% CI: 1.64–2.29), abnormal fasting blood sugar (AOR = 1.47; 95% CI: 1.33–1.63), elevated systolic blood pressure (AOR = 1.39; 95% CI: 1.28–1.51), and elevated diastolic blood pressure (AOR = 1.30; 95% CI: 1.19–1.43). Subjective sleep quality, sleep duration, and habitual sleep efficiency were also significantly associated with multiple health-related clinical outcomes and biomarkers. Although sparse data and quasi-complete separation may have influenced the precision of some regression estimates, the overall pattern of associations remained consistent and should be interpreted with appropriate caution. Conclusions: Higher overall PSQI scores were significantly associated with adverse health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. These findings highlight the clinical importance of routinely assessing sleep quality in older adults, particularly those with chronic conditions or increased cardiometabolic risk. Because of the cross-sectional design and the statistical uncertainty associated with sparse data in some regression models, the findings should be interpreted as evidence of associations rather than causal relationships. The observed associations are consistent with the likely bidirectional relationship between sleep disturbances and chronic diseases. Integrating sleep quality screening into routine health assessments, alongside comprehensive chronic disease management, may facilitate the early identification of older adults at increased cardiometabolic risk and support evidence-based health promotion strategies. Full article

Non-communicable diseases (NCDs) represent a growing challenge for developing countries, as they are among the leading causes of morbidity and mortality within the working-age population. Beyond their effects on health outcomes, NCDs are associated with reductions in labor productivity, which may influence long-term development dynamics through human capital. This study estimates the conditional labor productivity penalty associated with Non-Communicable Diseases (NCDs) among employed workers in Mexico using an observational high-dimensional framework. By addressing high-dimensional confounding under the Conditional Independence Assumption (CIA), the analysis isolates the relationship between NCD status and hourly labor earnings. Using microdata from the Mexican National Survey of Household Income and Expenditure, labor productivity is defined as the ratio of labor income to hours worked. To obtain robust causal estimates, a Double Machine Learning (DML) framework is implemented, integrating regularized regression and machine learning algorithms to control for high-dimensional confounding factors. These covariates include socioeconomic, demographic, and health-related variables, allowing for flexible adjustment of observable heterogeneity across individuals. The empirical findings demonstrate a statistically significant conditional negative penalty of −11.44% (p = 1.03 × 10⁻¹¹, 95% CI: [−14.59, −8.40]) on hourly labor earnings under the cross-fitted DML specification using XGBoost and Random Forest. To resolve an observational measurement artifact where chronic individuals report artificially inflated hourly wages due to severe hours contraction, a presenteeism adjustment factor ($\theta *=0.8125$) was calibrated. Incorporating this presenteeism correction, the aggregate national economic burden among the employed population is estimated at approximately 496.82 billion pesos annually. The findings suggest that NCDs constitute a relevant constraint on labor productivity at the microeconomic level. The study highlights the importance of prevention-oriented health strategies, workplace health promotion, and early disease management. From a methodological perspective, the results illustrate the usefulness of Double Machine Learning for purging high-dimensional confounding in cross-sectional survey data, providing robust conditional empirical benchmarks for public health policy. Full article

Background/Objectives: Non-communicable diseases (NCDs), including cardiovascular disease and diabetes, present an increasing challenge in humanitarian settings. While healthcare services in refugee camps have traditionally prioritised acute and communicable diseases, the long-term management of chronic conditions remains difficult, particularly among older adults. This study explored healthcare providers’ perspectives on barriers to cardiovascular disease and diabetes care among elderly Rohingya refugees living in Cox’s Bazar, Bangladesh. Methods: A qualitative study was conducted using semi-structured interviews with six physicians working in Rohingya refugee camps in Cox’s Bazar, Bangladesh. Participants were recruited through purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. Results: Three overarching categories of barriers were identified: service delivery barriers, physical and environmental barriers, and socio-cultural barriers. Healthcare providers described limited diagnostic capacity, restricted medication availability, fragmented continuity of care, transport difficulties, challenging camp terrain, language barriers, low health literacy, and reliance on informal healthcare providers as key challenges affecting long-term management of cardiovascular disease and diabetes. These interconnected barriers were perceived to reduce healthcare access and continuity of care for elderly Rohingya refugees. Conclusions: The findings suggest that humanitarian healthcare systems should strengthen long-term management of non-communicable diseases among ageing refugee populations. Improving diagnostic capacity, ensuring reliable access to essential medicines, enhancing continuity of care, and supporting culturally appropriate health education and outreach services may improve chronic disease management in humanitarian settings. Further research exploring the perspectives of elderly Rohingya refugees is needed to complement healthcare provider perspectives. Full article

Non-communicable diseases (NCDs) account for more than 40 million deaths annually worldwide, including approximately 18 million premature deaths (before 70 years of age), highlighting the urgent need for effective preventive strategies. In this context, mushroom-enriched functional beverages have emerged as promising dietary approaches for the prevention and management of NCDs. This review synthesizes current evidence on mushroom-derived bioactive compounds and their application in beverage systems, integrating biochemical, technological, and regulatory perspectives. Key compounds, including β-glucans, phenolics, terpenoids, and bioactive peptides, exhibit antioxidant, anti-inflammatory, and metabolic regulatory properties, with reported effects on glycemic control, lipid metabolism, and gut microbiota modulation. Evidence from experimental and clinical studies indicates improvements such as reductions in glycated hemoglobin (HbA1c), postprandial glucose, and lipid markers, although studies specifically evaluating beverages remain limited. A patent analysis (2021–2026) identified 398 applications, of which 356 were selected, demonstrating growing technological innovation, particularly in Asia and North America. However, recent years show fewer visible applications (e.g., 60 in 2024 and 30 in 2025), likely due to confidentiality periods. Despite their functional potential, challenges related to bioavailability, clinical validation, and regulatory harmonization persist. Overall, mushroom-enriched beverages represent a promising, yet still emerging, strategy requiring further translational and clinical research to support their large-scale application in public health. Full article

Latin America and Africa face complex public health challenges shaped by social, environmental, and epidemiological factors. This study conducts a comparative analysis of publicly available national health strategies and national policy documents from 52 countries in Africa and 12 countries from Latin America, supplemented with data from the World Health Organization (WHO) and Pan American Health Organization (PAHO). The analysis focuses on five domains: social determinants of health, environmental health, infectious diseases, non-communicable diseases (NCDs), and immunization. This study examines how these health priorities are represented in national policy frameworks. Across the reviewed country sample, national policy documents tend to emphasize challenges related to health care access, the growing burden of NCDs, and environmental risks. In selected Latin American countries, migration-related pressures, health system fragmentation, and uneven vaccination coverage are primarily highlighted. In selected African countries, policy priorities tend to focus on communicable diseases, infrastructure limitations, and large zero-dose populations. The study underscores policy priorities and highlights opportunities for cross-regional learning. Strengthening primary health care, improving domestic health financing, and enhancing environmental health governance emerge as key areas for policy development. These findings support the value of comparative policy analysis in informing context-sensitive and equity-oriented health strategies. Full article

Ultra-processed foods (UPFs) are increasingly consumed worldwide, and higher consumption has been linked to higher risk of non-communicable diseases (NCDs). This study examined the nutritional composition and quality, energy density, and hyperpalatability of UPFs available in the Italian food market according to their literature-derived NCD-risk categories. Products were classified into main food groups and subgroups and further categorized according to reported associations with NCD risk: positive, negative, or no reported association. Differences between the main food groups were analyzed in RStudio using non-parametric tests, with results summarized using medians and interquartile ranges. A total of 13,025 UPF products were included in the analysis. UPFs showed substantial variation in nutritional composition, nutritional quality, nutrients-of-concern levels, energy density, and hyperpalatability across the main food groups and literature-derived NCD-risk categories. Snacks represented the largest UPF group and showed the most consistently unfavorable profile, including high median energy, carbohydrate, saturated fat, and sugar contents, a high proportion of Nutri-Score D and E products, and the highest proportion of medium- and high-energy-density products. Overall, 64.3% of UPFs were classified as Nutri-Score D or E, indicating generally lower nutritional quality. However, unfavorable nutritional characteristics were not limited to UPF subgroups reportedly associated with increased NCD risk; some subgroups reportedly associated with lower or no reported NCD risk also contained products with poor nutritional quality, high energy density, or hyperpalatable profiles. These findings suggest that UPFs are not nutritionally uniform and that assessment of UPF-related health relevance should consider food group, subgroup, nutrient profile, energy density, and hyperpalatability in addition to processing classification. Full article

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, and chronic respiratory disease, are major causes of death worldwide; addressing NCDs is thus essential. NCDs may contribute to health disparities between rural and urban areas. The COVID-19 pandemic has altered medical and social environments, and NCD management approaches may have changed accordingly. This scoping review aimed to examine themes of reported rural healthcare challenges related to NCD management before and after the COVID-19 pandemic. A literature search of original articles was conducted via PubMed. A thematic analysis was applied to compare the content of studies classified as pre-pandemic and post-pandemic. A total of 23 articles were identified, including 12 studies classified as pre-pandemic and 11 studies classified as post-pandemic. Before the pandemic, commonly reported challenges included low management rates of hypertension and diabetes, instability in pharmaceutical supply, and insufficient training of healthcare personnel. We integrated these into a theme related to “healthcare”. After the pandemic, in addition to the low management rates, studies increasingly addressed mental and nutritional health, multimorbidity, and socioeconomic disparities. We integrated there into a theme related to “society”. Namely, studies classified as pre-pandemic primarily reported healthcare-related aspects, whereas studies classified as post-pandemic more frequently reported broader societal aspects in addition to healthcare-related aspects. These findings may reflect changes in how rural healthcare challenges related to NCDs have been recognized and discussed following the COVID-19 pandemic. Further research is needed to clarify the significance and implications of these reported themes. Full article

Exposure to physical inactivity (PI) may be a risk factor for the development of one or more noncommunicable chronic diseases (NCDs). The present study examined the prevalence of diabetes, hypertension, and obesity, as well as their various combinations, among the Brazilian population exposed to PI. A total of 323,448 Brazilian men and women aged 18 to 59 years from the 26 state capitals and the Federal District were contacted by telephone and answered questions regarding their physical activity (PA) and health conditions, including medical diagnoses of NCDs. Participants who reported not engaging in any type of PA at home, at work, during commuting, or during leisure time were assigned to the PI group, whereas the remaining participants comprised the control group. Physical inactivity was associated (p < 0.05) with a 16% and 28% higher prevalence of obesity among middle-aged female and male participants, respectively. It was also associated (p < 0.05) with a higher prevalence of combined diabetes and hypertension, diabetes and obesity, and hypertension and obesity, ranging from 49–273%, 60–113%, and 20–71%, respectively. Additionally, physical inactivity was associated (p < 0.05) with a 73–106% higher prevalence of the coexistence of diabetes, hypertension, and obesity. Full article

The ever-increasing disparity between lifespan and healthspan represents a challenging global issue, with metabolic dysregulation playing a central role in the initiation and progression of chronic non-communicable diseases (NCDs). This review highlights the importance of maintaining optimal redox homeostasis, with particular emphasis on reduced glutathione (GSH), for preserving metabolic health during aging. GSH participates in several physiological processes, including antioxidant defense, xenobiotic detoxification, redox signaling, and metabolic regulation. Diminished GSH levels are consistently reported in obesity, insulin resistance, type 2 diabetes mellitus, non-alcoholic fatty liver, and cardiovascular diseases. Current evidence from human clinical studies indicates that foods rich in bioactive constituents can enhance GSH levels and stimulate GSH-dependent enzyme activity, with the Nrf2/Are signaling pathway being a central mechanistic link. Fasting may promote adaptive redox responses by inducing mild oxidative stress and activating the same molecular mechanism, although the effects on GSH-related antioxidant mechanisms remain heterogeneous across fasting protocols and study populations. Altogether, the available clinical evidence suggests that these nutritional and lifestyle interventions exhibit more consistent beneficial effects in individuals characterized by increased oxidative burden and underlying metabolic dysfunction. Interindividual differences in GSH responses further underscore the need for targeted, tailor-made approaches that account for genetic, epigenetic, and lifestyle factors. Collectively, targeting GSH homeostasis through nutritional and lifestyle interventions represents a promising strategy for improving metabolic health and may further contribute to healthy aging, positioning redox biology at the forefront of aging research and NCD prevention. Full article

Background/Objectives: Self-reported physical activity is widely used in non-communicable disease (NCD) surveillance, yet its individual-level agreement with field-based markers of cardiorespiratory fitness remains poorly characterised in Gulf Cooperation Council (GCC) populations. This study examined the association, agreement, and directional discordance between self-reported physical activity (IPAQ Short Form, IPAQ-SF) and field-assessed functional capacity (Incremental Shuttle Walk Test, ISWT) among university students in Kuwait. Methods: In 389 students (76.3% female; mean age 20.2 ± 2.3 years) in Kuwait, IPAQ-SF activity was classified as low, moderate, or high and ISWT distance into sample-derived tertiles. Spearman correlations, Kruskal–Wallis tests with Dunn pairwise comparisons, cross-tabulation, and unweighted, linear-weighted, and quadratic-weighted Cohen’s kappa were used. Results: IPAQ activity showed a weak but significant correlation with ISWT distance (ρ = 0.209, p < 0.001). ISWT performance did not differ between the low- and moderate-IPAQ categories (Bonferroni-adjusted Dunn p = 0.162). Agreement was slight across all kappa estimates (unweighted κ = 0.083; linear-weighted κ = 0.137; quadratic-weighted κ = 0.192), with matching category assignment in only 38.8% of participants; lower-than-tertile IPAQ classification occurred in 42.9% and higher-than-tertile in 18.3%. Directional discordance differed significantly by sex (p < 0.001). A rank-based partial correlation adjusting for BMI, age, and sex was attenuated but remained significant (r = 0.144, p = 0.004). Conclusions: IPAQ-SF categories showed poor individual-level agreement with sample-derived ISWT functional-capacity tertiles among university students in Kuwait. Self-reported physical activity and field-based functional capacity should therefore be interpreted as complementary rather than interchangeable measures. Larger multi-university studies across the GCC are needed to confirm these findings. Full article

Background/Objectives: Previous publications have primarily examined the individual roles of nutrients during fetal development. However, growing evidence suggests that one-carbon (1C) metabolism nutrients, including choline and key B vitamins, act synergistically within interconnected metabolic pathways that modulate epigenetic regulation and may have implications for the health of future generations. Methods: This narrative integrative review examined evidence relating to the roles of choline and B vitamins (B1, B2, B6, folate (B9) and B12) in fetal development and offspring health. Peer-reviewed literature was identified through PubMed, Science Direct and Semantic Scholar. Results: Current evidence indicates that periconceptional and maternal intake and status of 1C metabolism nutrients are associated with DNA methylation processes involved in developmental programming and the risk of non-communicable diseases (NCDs) in childhood and adulthood. Habitual intakes of several 1C metabolism nutrients are frequently below recommended levels during pregnancy and lactation, particularly for choline and folate. Inadequate intakes, each contributing differently to 1C metabolism, may disrupt 1C metabolic pathways and alter DNA methylation patterns during critical windows of fetal programming. Homocysteine metabolism is intricately linked to 1C metabolism and is modulated by choline and B vitamins. Collectively, these pathways have potential implications for the health of the next generation, including effects on growth, neural tube closure, brain development and increased susceptibility to diseases later in life, e.g., cardiovascular disease, diabetes, obesity and other chronic conditions. Adequate maternal intakes of choline and B vitamins may help mitigate the ‘early life origin’ of certain NCDs by promoting healthy neurodevelopment, reducing inflammation, and regulating central metabolic pathways. Conclusions: Greater awareness of the roles and importance of 1C metabolism nutrients, including choline and key B vitamins (B1, B2, B6, folate and B12), during the early life course is warranted. Furthermore, there is also a need for organizations and policy makers to formalize intake recommendations for 1C metabolism nutrients beyond the individualized simplicity of folate/folic acid, and to extend this to include other methyl-donor nutrients with epigenetic effects, such as choline and key B vitamins, given their interconnected roles in 1C metabolism and fetal development. Full article

Background/Objectives: Italy is among the countries with the highest life expectancy and extreme longevity worldwide, yet marked regional disparities persist. This nationwide ecological study examined temporal trends in population aging and extreme longevity across the 20 Italian regions (1982–2025) and explored regional correlates non-communicable disease (NCD) mortality and contemporary behavioral/nutritional indicators, with attention to emerging southern hotspots such as Cilento. Methods: Longevity indicators (Aging Tendency, Longevity Index [LI%], Centenarity Index [CI%], 85+ and 90+ ratios) were derived from ISTAT demographic data. Age-standardized mortality rates for five major NCDs (1990–2023) were obtained from WHO HFA-DB. Behavioral and nutritional indicators for adults aged ≥65 years (2024) were extracted from HFA-Italy. Regional associations were assessed using Spearman correlations within an ecological, hypothesis-generating framework. Results: All longevity indicators increased steadily from 1982 to 2025, with northern and central regions showing the highest values. Lower long-term mortality from diabetes mellitus and cerebrovascular diseases showed the strongest regional correlations with higher LI% and CI%. Nutritional profiles were generally more favorable in northern regions. The Cilento area emerged as a notable southern hotspot, displaying longevity indicators comparable to Sardinia and above the regional average. Conclusions: Regional patterns of extreme longevity in Italy reflect the interplay of demographic dynamics, NCD mortality burden, and contemporary lifestyle profiles. While northern regions maintain a clear advantage, specific southern areas such as Cilento demonstrate that favorable longevity outcomes can emerge in diverse macro-regional contexts. These findings highlight the value of regionally tailored strategies to promote healthy aging and reduce geographical disparities. Full article