Publications by authors named "Pascal Bovet"

Given rising diabetes prevalence globally, access to diabetes treatments is gaining urgency. Yet, it remains unknown which glucose-lowering medication types people with diabetes across low- and middle-income countries (LMICs) use. In this cross-sectional analysis, we pooled nationally representative data of 223,283 adults aged ≥25 years in 62 LMICs from 2009 to 2019.

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Global economic development has been associated with an increased prevalence of obesity and related health problems. Increased caloric intake and reduced energy expenditure are both cited as development-related contributors to the obesity crisis, but their relative importance remains unresolved. Here, we examine energy expenditure and two measures of obesity (body fat percentage and body mass index, BMI) for 4,213 adults from 34 populations across six continents and a wide range of lifestyles and economies, including hunter-gatherer, pastoralist, farming, and industrialized populations.

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For the Spanish, French, Arabic, Russian and Chinese translations of the abstract see Supplementary Materials section.

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Background: Sleep health is emerging as a public health priority due to its strong associations with several key domains of health. However, most of the existing literature are from studies located in high income settings and may not be representative of low-middle income settings. Leveraging the Modeling the Epidemiologic Transition Study, a study of cardiometabolic disease risk in five diverse African-origin populations, we explored differences in objectively measured sleep behavior across cohorts from Ghana, South Africa, Jamaica, Seychelles, and the United States.

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Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs. measured techniques across different settings and populations.

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Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs measured techniques across different settings and populations. We measured the association between moderate-to-vigorous intensity PA (MVPA) and prospective weight change across five African-origin populations and the extent to which MVPA attenuated weight change over time.

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Background: Physical activity (PA) is an important preventive factor of non-communicable diseases (NCDs), particularly cardiovascular disease, yet progress towards reducing physical inactivity in populations is slow. Population-levels of PA are most often estimated using self-report questionnaires in population surveys, such as the Global PA Questionnaire (GPAQ), which may not accurately reflect objectively measured PA, such as accelerometers. The aim of the current study was to compare self-report vs objectively measured PA across 5 African-origin populations.

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Objective: It is well-established that overweight/obesity is a major risk factor for left ventricular hypertrophy (LVH) in childhood. However, it is still unclear if reversing from overweight/obesity to normal weight is associated with decreased LVH in children. This study aimed to examine the association between weight status change during four years and LVH among Chinese children based on a prospective cohort study.

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Objective: This cross-sectional study aims to assess the associations between serum leptin, adiponectin, leptin-to-adiponectin ratio (L/A ratio), and metabolic syndrome (MS) and HOMA-IR in five African-origin populations: Ghana, South Africa, Jamaica, Seychelles, and US.

Methods: Clinical measures included serum glucose, insulin, adipokines, blood pressure and anthropometric measures. MS was determined using the Harmonized criteria.

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Article Synopsis
  • Exposure to toxic metals like lead and arsenic is linked to increased risks of obesity and type 2 diabetes (T2DM), but the exact mechanisms are still unclear.
  • A study analyzed the impacts of these metals on gut microbiota and cardiometabolic health in 178 adults of African descent, revealing significant associations between high metal levels and various health markers such as BMI and blood glucose.
  • The findings suggest that specific gut microbiome taxa are influenced by lead and arsenic exposure, potentially contributing to metabolic issues, particularly through pathways related to porphyrin metabolism.
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  • Doubly labeled water is the most reliable method for measuring total energy expenditure (TEE), but its accuracy can be affected by the isotope dilution space ratio (DSR).
  • This study explored factors like age, sex, ethnicity, body composition, and geographical elevation to see how they influence DSR, using various statistical analysis methods.
  • Results showed that while DSR decreased with age in individuals 60 and older, no significant effects were found from other variables, suggesting that previous estimates of TEE might be overestimating values for older individuals, especially those around 90 years old.
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Background: The association of maternal cigarette smoking during pregnancy with severe neonatal morbidity (SNM) is still inconclusive. We aimed to examine the associations of the timing and the intensity of maternal cigarette smoking with infant SNM in the USA.

Methods: We used birth certificate data of 12 150 535 women aged 18-49 years who had live singleton births from the 2016-2019 US National Vital Statistics System.

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Article Synopsis
  • - Individuals in low- and middle-income countries (LMICs) have a high prevalence of multiple cardiovascular disease (CVD) risk factors, particularly hypertension and diabetes, which were examined using data from 55 population-based surveys from 2009-2019.
  • - The study included nearly 119,000 non-pregnant adults aged 40-69, revealing that those with both hypertension and diabetes had higher awareness of their diagnosis (64.1%) compared to those with just one condition (47.4% for hypertension and 46.7% for diabetes).
  • - Despite higher awareness and treatment for those with concurrent conditions, only 7% of individuals effectively managed both hypertension and diabetes simultaneously, highlighting significant gaps
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Objectives: Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual's body image can inform obesity prevention and management. This study's objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension.

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Background: The global burden of diabetes is rising rapidly, yet there is little evidence on individual-level diabetes prevention activities undertaken by health systems in low-income and middle-income countries (LMICs). Here we describe the population at high risk of developing diabetes, estimate diabetes prevention activities, and explore sociodemographic variation in these activities across LMICs.

Methods: We performed a pooled, cross-sectional analysis of individual-level data from nationally representative, population-based surveys conducted in 44 LMICs between October, 2009, and May, 2019.

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There is considerably greater variation in metabolic rates between men than between women, in terms of basal, activity and total (daily) energy expenditure (EE). One possible explanation is that EE is associated with male sexual characteristics (which are known to vary more than other traits) such as musculature and athletic capacity. Such traits might be predicted to be most prominent during periods of adolescence and young adulthood, when sexual behaviour develops and peaks.

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Background: Several cardiovascular (CV) risk factors are reported to be associated with abnormal cardiac structure in children and adults. However, no study has assessed the association between clustering of multiple CV risk factors and left ventricular geometric (LVG) remodeling. We examined the association between clustering of CV risk factors and LVG remodeling among Chinese children.

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The relationship between microbiota, short chain fatty acids (SCFAs), and obesity remains enigmatic. We employ amplicon sequencing and targeted metabolomics in a large (n = 1904) African origin cohort from Ghana, South Africa, Jamaica, Seychelles, and the US. Microbiota diversity and fecal SCFAs are greatest in Ghanaians, and lowest in Americans, representing each end of the urbanization spectrum.

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Article Synopsis
  • The study investigates the testing rates for cardiovascular disease risk factors (hypertension, diabetes, and hypercholesterolaemia) in low- and middle-income countries (LMICs), focusing on sociodemographic inequalities.
  • Data from nearly 1 million adults across 57 surveys reveal that only a small percentage meet the WHO criteria for testing: 19.1% for hypertension, 23.8% for diabetes, and 27.4% for hypercholesterolaemia.
  • Testing rates varied significantly by sex, wealth, and education, with women showing higher testing rates for hypertension compared to men.
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Background: This study was aimed to examine the association between cigarette smoking in childhood and mortality in adulthood, and the impact of non-smoking duration among smokers who subsequently quit smoking.

Methods: We used data from 472,887 adults aged 18-85 years examined once in the US National Health Interview Survey in 1997-2014, which was linked to mortality data from the National Death Index up to 31 December 2015. Cigarette smoking status in childhood (age 6 to 17 years) and adulthood (age 18 to 85 years) was self-reported using a standard questionnaire at the time of participation in the survey.

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Background: The recently published "Life's Essential 8" (LE8) by the American Heart Association has overcome some limitations in evaluating cardiovascular health (CVH) in the previous "Life's Simple 7."

Objective: We aimed to examine the secular trends in CVH, as assessed by the LE8, in US adults from 2005 to 2018.

Methods: Using cross-sectional data from the National Health and Nutrition Examination Survey between 2005-2006 and 2017-2018, we calculated the age-standardized mean scores of overall CVH and each of the LE8 components, where a higher score (range 0-100 points) means a better health status.

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Obesity is caused by a prolonged positive energy balance. Whether reduced energy expenditure stemming from reduced activity levels contributes is debated. Here we show that in both sexes, total energy expenditure (TEE) adjusted for body composition and age declined since the late 1980s, while adjusted activity energy expenditure increased over time.

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The relationship between gut microbiota, short chain fatty acid (SCFA) metabolism, and obesity is still not well understood. Here we investigated these associations in a large (n=1904) African origin cohort from Ghana, South Africa, Jamaica, Seychelles, and the US. Fecal microbiota diversity and SCFA concentration were greatest in Ghanaians, and lowest in the US population, representing the lowest and highest end of the epidemiologic transition spectrum, respectively.

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Background: It is well documented that birth weight and childhood weight are associated with the blood pressure (BP) levels in childhood. However, the impact of weight status change from birth to childhood on BP among children is less well described. We aimed to assess the association between changes in weight status from birth to childhood and high BP in childhood.

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The relationship between the gut microbiota, short chain fatty acid (SCFA) metabolism, and obesity remains unclear due to conflicting reports from studies with limited statistical power. Additionally, this association has rarely been explored in large scale diverse populations. Here, we investigated associations between fecal microbial composition, predicted metabolic potential, SCFA concentrations, and obesity in a large ( = 1,934) adult cohort of African-origin spanning the epidemiologic transition, from Ghana, South Africa, Jamaica, Seychelles, and the United States (US).

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