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Kraków, Poland

Singh R.B.,Halberg Hospital and Research Institute | Fedacko J.,Pj Safaric University | Vargova V.,Pj Safaric University | Kumar A.,Government Medical College | And 4 more authors.
Acta Cardiologica | Year: 2011

Introduction: The exact causes of death in India are not known because autopsy studies are difficult to conduct due to religious considerations. There are rapid changes in diet and lifestyle amongst social classes causing changes in the pattern of risk factors and mortality. In the present study, we attempt to develop a verbal autopsy questionnaire based on medical records and interview of a family member, for the assessment of causes of death, social class, tobacco consumption and dietary intakes among urban decedents in north India. Methods: For the period 1999-2001, we studied the randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, out of 3034 death records overall from the records at the Municipal Corporation, Moradabad. Families of these decedents were contacted individually to find out the causes of death, by scientist- administered, informed-consented, verbal autopsy questionnaire, completed with the help of the spouse and local treating doctor practicing in the appropriate health care region. Clinical data and causes of death were assessed by a questionnaire based on available hospital records and a modified WHO verbal autopsy questionnaire. Dietary intakes of the dead individuals were estimated by finding out the food intake of the spouse from 3-day dietary diaries and by asking probing questions about differences in food intake by the decedents. Tobacco consumption of the victim was studied by a questionnaire administered to family members. Social classes were assessed by a questionnaire based on attributes of per capita income, occupation, education, housing and ownership of consumer luxury items in the household. The diagnoses of overweight and obesity were based on the new WHO and International College of Nutrition criteria. Results: Cardiac diseases (23.4%, n = 520) including coronary artery disease (10%), valvular heart disease (7.2%, n = 160), diabetic heart disease (2.2%, n = 49), sudden cardiac death and inflammatory cardiac disease, each (2.0%, n = 44) were the most common causes of deaths as reported using the modified verbal autopsy questionnaire. Brain diseases including stroke (7.8%, n = 175) and inflammatory brain disease were reported amongst 1.9% (n = 42) victims. Thus, NCDs (37.0%, n = 651); circulatory diseases (31.2%, n = 695) including stroke and cardiac diseases, and malignant neoplasms (5.8%, n = 131) emerged as the most common causes of death. Injury and accidents (14.0%, n = 313) including fire, falls and poisonings were also common. Miscellaneous causes of death were observed amongst 8.5% (n = 189) of victims. Pregnancy and perinatal causes (0.72%, n = 15) were not commonly recorded in our study. Renal diseases (11.2%, n = 250), pulmonary diseases (22.3%, n = 495) and liver diseases (4.8%, n =107) were also commonly recorded causes of death. It is clear that causes of death related to various body systems can be more accurately assessed by the modified verbal autopsy questionnaire. Circulatory diseases as the cause of mortality were significantly more common among higher social classes (1-3) than in lower social classes (4 and 5) who died more often, due to infections. Death due to coronary disease, stroke, hypertension, diabetes and obesity were significantly more common among higher social classes 1-3 and among victims with higher body mass index (BMI) compared to social class 4 and 5 who had lower BMI. Conclusions: This study indicates that causes of death, social class, tobacco and dietary intakes, can be accurately assessed by a modified verbal autopsy questionnaire based on medical records and by interview of family members. Circulatory diseases, injury-accidents and malignant diseases have become the major causes of death in India, apart from infections. Source


Fedacko J.,Safaric University | Vargova V.,Safaric University | Singh R.B.,Halberg Hospital and Research Institute | Anjum B.,University of Lucknow | And 6 more authors.
Open Nutraceuticals Journal | Year: 2012

Introduction: There is evidence that the Western type of diet has adverse effects, and prudent dietary patterns may have beneficial effects against deaths from cardiovascular and other chronic diseases. In the present study, we examine the association of dietary patterns with causes of deaths among urban decedents in north India. Subjects and Methods: Randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, were examined. Clinical data and causes of death were assessed by a questionnaire based on available hospital records and a modified WHO verbal autopsy questionnaire. Dietary intakes of the dead individuals were estimated by finding out the food intake of the spouse from 3-day dietary diaries and by asking probing questions about differences in food intake by the decedents. Results: The score for intake of prudent foods was significantly greater and the ratio of w-6/w-3 fatty acids of the diet significantly lower for deaths due to 'injury' and accidental causes compared to deaths due to non-communicable diseases (NCD). Multivariate logistic regression analysis revealed that after adjustment for age, total prudent foods (OR,CI: 1.11;1.06-1.18 men; 109;1.04-1.16 women) as well as fruits, vegetables, legumes and nuts (1.07; 1.02-1.12 men; 1.05; 1.99-1.11 women) were independently, inversely associated whereas Western type foods (1.02; 0.95-1.09 men; 1.00; 0.94-1.06 women); meat and eggs(1.00-0.94-1.06 men; 0.98; 0.93-1.04 women) and refined carbohydrates (0.98; 0.91-1.05 men, 0.95; 0.89-1.02 women) and high w-6/w-3 ratio of fatty acids were positively associated with deaths due to NCDs. Conclusions: Increased intake of high w-6/w-3 ratio Western type foods and decline in prudent foods intake may be a risk factor for deaths due to NCDs. © Fedacko et al. Source


Singh R.B.,Halberg Hospital and Research Institute | Anjum B.,KGMU | Takahashi T.,Fukuoka Womens University | Martirosyan D.M.,Functional Food Center Inc. | And 5 more authors.
World Heart Journal | Year: 2012

Background: The pathways for development of noncommunicable diseases (NCDs) are sedentary behaviour, common dietary habits of the Western world, tobacco use, stress, and alcoholism among individuals and populations with underlying lack of general and health education. However, some experts have observed that poverty is the primary cause of disability and deaths due to NCDs. This study examines the association of social class and social determinants of health as risk factors for deaths due to NCDs. Subjects and methods: Randomly selected death records of 2,222 (1,385 men and 837 women) decedents, aged 25-64 years at time of death, out of 3,034 death records, were studied by verbal autopsy questionnaires, during 1999-2001 from the records at the Municipal Corporation in Moradabad. All the risk factors were assessed by questionnaires which werecompleted with the help of the victim's spouse and a local treating doctor practising in the concerned field. Social classes were assessed, based on attributes of per capita income, occupation, education, housing, and ownership of consumer luxury items in the household. Poverty was considered if the total family income was Source


Singh R.B.,Halberg Hospital and Research Institute | Fedacko J.,Safaric University | Pella D.,Safaric University | Macejova Z.,Safaric University | And 10 more authors.
Acta Cardiologica | Year: 2011

Background There are few studies detailing the prevalence of prehypertension and hypertension in India. Methods Men and women, over 25 years of age were included. After completion of a dietitian-administered questionnaire followed evaluation by a physician, physical examination and blood pressure measurement. Cross-sectional survey screened 6940 subjects, (3507 men (M), 3433 women (W): 1993-96) from cities located in five corners of India (Kolkata, n = 900; Nagpur, n = 894; Mumbai, n = 1542; Thiruanantpuram, n = 1602; Moradabad, n = 2002). Prehypertension (BP 130-139/85-89 mm Hg) and hypertension (BP ≥ 140/90 mm Hg) were diagnosed according to the European Society of Cardiology criteria. Results Prevalence of prehypertension and hypertension, respectively, was significantly greater in South India (Trivandrum: W 31.5; 31.9%; M 35.1; 35.5%) and West India (Mumbai: W 30.0; 29.1%; M 34.7; 35.6%) compared to North India (Moradabad: W 24.6; 24.5%; M 26.7; 27.0%) and East India (Kolkata: W 20.9; 22.4%; M 23.5; 24.0%). Subjects with prehypertension and hypertension were older, had a higher BMI, central obesity and a sedentary lifestyle. They had a higher salt and alcohol intake, with greater oral contraceptive usage (W). Multivariable logistic regression analysis revealed strong positive associations of hypertension with age, central obesity, BMI, sedentary lifestyle, salt and alcohol intake and oral contraceptive usage (W). Fruit, vegetable and legume intake showed inverse associations, tobacco intake showed none. One in four with hypertension was aware of their diagnosis and of those receiving treatment, one in three had well-controlled hypertension. Conclusions There is little awareness that prehypertension and hypertension are public health issues in India. Ageing population, central obesity, sedentary lifestyle, excessive salt and alcohol, lower fruit, vegetable and legumes intake increase risk for blood pressure elevation. Source


Singh R.B.,Halberg Hospital and Research Institute | Reddy K.K.,Tirupati University | Fedacko J.,Safaric University | de Meester F.,Tsim Tsoum Institute | And 2 more authors.
Open Nutraceuticals Journal | Year: 2011

Nutritional status has been implicated to be in the pathogenesis of noncommunicable diseases and long-term worldwide survival. In this relevance, the teachings of Bhagwatgita, Upanishads and Indian Vedas appear to be as old as 'Human Civilization'. The dietary formulations concomitant with relevant prescriptions provided in these scriptures appear to be as scientific as observed in cohort studies and intervention trials. These studies confirm the ancient concept reflecting that fruits, vegetables, whole grains, nuts, and milk were quite protective. In this review, the traditional concepts of nutrition to western literature have been duly introduced. © R.B. Singh; Licensee Bentham Open. Source

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