Browsing by Author "Dugas, Lara"
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- ItemOpen AccessAssociation between smoking and total energy expenditure in a multi-country study(2014-10-04) Gonseth, Semira; Dugas, Lara; Viswanathan, Barathi; Forrester, Terrence; Lambert, Vicki; Plange-Rhule, Jacob; Durazo-Arvizu, Ramon; Luke, Amy; Schoeller, Dale A; Bovet, PascalAbstract Background The association between smoking and total energy expenditure (TEE) is still controversial. We examined this association in a multi-country study where TEE was measured in a subset of participants by the doubly labeled water (DLW) method, the gold standard for this measurement. Methods This study includes 236 participants from five different African origin populations who underwent DLW measurements and had complete data on the main covariates of interest. Self-reported smoking status was categorized as either light (<7 cig/day) or high (≥7 cig/day). Lean body mass was assessed by deuterium dilution and physical activity (PA) by accelerometry. Results The prevalence of smoking was 55% in men and 16% in women with a median of 6.5 cigarettes/day. There was a trend toward lower BMI in smokers than non-smokers (not statistically significant). TEE was strongly correlated with fat-free mass (men: 0.70; women: 0.79) and with body weight (0.59 in both sexes). Using linear regression and adjusting for body weight, study site, age, PA, alcohol intake and occupation, TEE was larger in high smokers than in never smokers among men (difference of 298 kcal/day, p = 0.045) but not among women (162 kcal/day, p = 0.170). The association became slightly weaker in men (254 kcal/day, p = 0.058) and disappeared in women (−76 kcal/day, p = 0.380) when adjusting for fat-free mass instead of body weight. Conclusion There was an association between smoking and TEE among men. However, the lack of an association among women, which may be partly related to the small number of smoking women, also suggests a role of unaccounted confounding factors.
- ItemOpen AccessAssociations between objective physical activity and metabolic syndrome in African-origin adults from five countries(2025) Bheemraj, Kalisha; Dugas, LaraMetabolic syndrome affects approximately 25% of adults worldwide. Physical inactivity has been identified as a key modifiable risk factor for metabolic syndrome, but studies are conflicting when using different methods to measure physical activity (PA), including both objective measures versus self-report. Furthermore, there is a lack of studies exploring these relationships in African-origin populations, who present with a higher prevalence compared to other race/ethic groups. The aim of this study was to explore the association between objectively-measured PA and metabolic syndrome in 5 African-origin populations spanning the epidemiologic transition. 2500 adults from Ghana, South Africa, Jamaica, Seychelles and the United States were recruited between 2010-2011 in the Modeling the Epidemiologic Transition Study (METS). Data collection, included clinical and laboratory measures, anthropometrics, and 7-days of accelerometer-measured moderate-to-vigorous PA (MVPA), observed in mean minutes per day. Study procedures were identical in the 5 sites. Metabolic syndrome was defined as having any three of the following five risk factors: large waist circumference, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure and elevated fasting glucose. The prevalence of metabolic syndrome and its constituent risk factors was stratified by sex and site. Logistic regression analysis was used to explore the association between MVPA and metabolic syndrome in the pooled cohort, adjusting for lifestyle factors (alcohol use, smoking status and sleep duration), age, sex, BMI and body fat percentage. Of 1167 male participants (median age 35, IQR: 30-40 years) and 1339 female participants (median age 35, IQR: 29-40), males had a lower BMI (23.6 kg/m2 , IQR: 20.9-27.5) compared to females (26 kg/m2 , IQR: 22-31). Across all sites, the prevalence of metabolic syndrome was 17% (n=431), and higher among females (n=287, 11%) compared to males (n=144, 6%). After adjusting for covariates, MVPA was not associated with metabolic syndrome (aOR 1.00, 0.99-1.00), nor meeting the PA guidelines of ≥30 mins/day (aOR = 0.76, 0.57- 1.01). Our results suggest that other environmental lifestyle factors may play a more significant role in the development of metabolic syndrome in this population of African-origin adults. Future research should focus on understanding the relationship between other environmental lifestyle factors, including sleep, and dietary intake, and metabolic syndrome
- ItemOpen AccessDepression and metabolic syndrome across epidemiological transition(2025) Dikoko, Viwe; Dugas, Lara; Mtintsilana, AsandaBackground: Depression and metabolic syndrome (MetS) are growing global health concerns, but limited research focuses on African-origin populations. This study investigates the association between MetS and depression among individuals in Ghana, South Africa (SA), Jamaica, Seychelles, and the United States (US), emphasizing gender and regional disparities. Methods: Secondary data of 446 participants from the METS (2008-2010) and METS- Microbiome study (2017-2019), a prospective cohort, were analyzed. MetS was defined as meeting at least three of the following criteria: elevated blood pressure, low HDL(High- Density Lipoprotein), elevated triglycerides, or high glucose. Depression was assessed using the CES-D scale (score ≥16 indicating depressive symptoms). Depression was assessed only at follow-up (2019), while MetS was measured at baseline (2010). Logistic regression examined the MetS-depression relationship, stratified by gender, adjusting for demographic and behavioural factors. Findings: The prevalence of MetS was 12% in Ghana (N=23), 17% in SA (N=9), 29% in Jamaica (N=26), 27% in Seychelles (N=33), and 39% in the US (N=36). The prevalence of depression was 15% in Ghana (N=29), 25% in SA (N=13), 18% in Jamaica (N=16), 9% in Seychelles (N=11) and 33% in the US (N=30). No significant overall association between MetS and depression was found. However, in men, individual MetS components showed weak associations at p < 0.1. High blood pressure (OR = 3.46, p<0.1) and low HDL (OR = 3.45, p<0.1) were associated with higher odds of depression, while obesity appeared protective (OR = 0.20, p<0.1). Women showed higher rates of obesity, abdominal adiposity, and depression, particularly in Jamaica, Seychelles, and the US. Age inversely correlated with depression in both genders, with older individuals reporting fewer symptoms. Regionally, living in Ghana, Seychelles, and Jamaica was linked to lower odds of depression compared to the US. Interpretation: This study highlights significant gender and regional differences in the MetS-depression relationship. Women face greater vulnerabilities related to obesity and psychological distress, while men are at higher risk due to elevated blood pressure and low HDL. Tailored public health strategies are needed to address these distinct risks and regional disparities, focusing on mitigating the dual burden of metabolic and mental health challenges. Policy strategies should prioritize integrated screening, targeted education, and community-based services—particularly in low-resource settings—to reduce the dual burden of MetS and depression in populations of African origin.
- ItemOpen AccessDoes temperature alter the relationship between sleep behaviour and non-communicable diseases in five different populations?(2025) Marekerah, Queen Marvelous; Dugas, Lara; Mukonda, EltonNon-communicable diseases (NCDs) account for 71% of global deaths, with over 15 million annual fatalities occurring between the ages of 30 and 69. Emerging evidence links climate change, particularly rising temperatures, to disrupted sleep behaviours. However, the potential role of temperature in modifying the relationship between sleep disruption and NCDs remains underexplored, especially in low- and middle-income countries (LMICs). This study examines whether ambient nighttime temperatures alter the relationship between sleep behaviours and NCDs, focusing on African-origin populations across five diverse geographic locations. A case study approach was used, utilizing clinical data from the longitudinal Modelling the Epidemiologic Transition Study (METS, 2008-2013) and its ancillary studies, including METS-Microbiome (2017-2022) and METS-Sleep (2019-2024). Objective sleep measurements were obtained using actigraphy, while temperature data were sourced from the Iowa Environmental Mesonet (IEM) database. Sleep parameters included sleep onset time, wake-up time, sleep duration, wake after sleep onset (WASO), and sleep efficiency. Data from 809 African-origin adults (aged 35-55 years, 63% women) across Ghana, South Africa, Jamaica, Seychelles, and the US revealed significant variations in nighttime temperatures, ranging from 5°C to 32°C across the sites. Higher nighttime temperatures were associated with longer sleep duration but poorer sleep quality, as indicated by decreased sleep efficiency (-0.05, p < 0.001) and increased WASO (-0.005, p < 0.02). Poor sleep quality was linked to elevated risks of obesity, hypertension, and diabetes. Temperature minimally mediated the relationship between sleep and hypertension, with no significant mediation for obesity and diabetes. The project is structured into five sections: Part A (Protocol) reviews existing literature on NCDs, sleep, and climate change in LMICs, outlines the study population, and describes methodologies. Part B (Literature Review) explores how climate change-induced temperature variations may alter the relationship between sleep behaviours and NCDs. Part C (Journal-Ready Article) presents the study's findings, highlighting the complex interplay between temperature, sleep quality, and NCDs. Part D (Appendices) includes supplementary analyses, ethics approvals, and research permissions. Part E (Editorial/Policy Brief) discusses public health policy implications, emphasizing the need to consider temperature and sleep quality in addressing the global NCD burden. This study highlights the influence of nighttime ambient temperatures on sleep behaviours and their association with NCDs across diverse African-origin populations. The findings underscore the need to integrate climate variables into public health strategies aimed at mitigating the growing burden of NCDs.
- ItemOpen AccessFasting substrate oxidation in relation to habitual dietary fat intake and insulin resistance in non-diabetic women: a case for metabolic flexibility?(BioMed Central Ltd, 2013) Carstens, Madelaine; Goedecke, Julia; Dugas, Lara; Evans, Juliet; Kroff, Jacolene; Levitt, Naomi; Lambert, EstelleBACKGROUND: Metabolic flexibility described as "the capacity of the body to match fuel oxidation to fuel availability" has been implicated in insulin resistance. We examined fasting substrate oxidation in relation to dietary macronutrient intake, and markers of insulin resistance in otherwise healthy women, with and without a family history of diabetes mellitus (FH DM). METHODS: We measured body composition (dual x-ray absorptiometry), visceral and subcutaneous adipose tissue area (VAT, SAT, using Computerised Tomography), fasting [glucose], [insulin], [free fatty acids], [blood lipids], insulin resistance (HOMA-IR), resting energy expenditure (REE), respiratory exchange ratio(RER) and self-reported physical activity in a convenience sample of 180 women (18-45 yrs). A food frequency questionnaire was used to assess energy intake (EI) and calculate the RER: Food Quotient (FQ) ratio. Only those with EI:REE (1.05 -2.28) were included (N=140). Insulin resistance was defined HOMA-IR (>1.95). RESULTS: The Insulin Resistant (IR) group had higher energy, carbohydrate and protein intakes (p<0.05) and lower PA levels than Insulin Sensitive (IS) group (P<0.001), but there were no differences in RER or RER:FQ between groups. However, nearly 50% of the variance in HOMA-IR was explained by age, body fat %, VAT, RER:FQ and FH DM (adjusted R2=0.50, p<0.0001). Insulin-resistant women, and those with FH DM had a higher RER:FQ than their counterparts (p<0.01), independent of body fat % or distribution. CONCLUSION: In these apparently healthy, weight-stable women, insulin resistance and FH DM were associated with lower fat oxidation in relation to dietary fat intake, suggesting lower metabolic flexibility.
- ItemOpen AccessProtocol for the modeling the epidemiologic transition study: a longitudinal observational study of energy balance and change in body weight, diabetes and cardiovascular disease risk(BioMed Central Ltd, 2011) Luke, Amy; Bovet, Pascal; Forrester , Terrence; Lambert, Estelle; Plange-Rhule, Jacob; Schoeller, Dale; Dugas, Lara; Durazo-Arvizu, Ramon; Shoham, David; Cooper, Richard; Brage, Soren; Ekelund, Ulf; Steyn, NeliaBACKGROUND: The prevalence of obesity has increased in societies of all socio-cultural backgrounds. To date, guidelines set forward to prevent obesity have universally emphasized optimal levels of physical activity. However there are few empirical data to support the assertion that low levels of energy expenditure in activity is a causal factor in the current obesity epidemic are very limited. METHODS/DESIGN: The Modeling the Epidemiologic Transition Study (METS) is a cohort study designed to assess the association between physical activity levels and relative weight, weight gain and diabetes and cardiovascular disease risk in five population-based samples at different stages of economic development. Twenty-five hundred young adults, ages 25-45, were enrolled in the study; 500 from sites in Ghana, South Africa, Seychelles, Jamaica and the United States. At baseline, physical activity levels were assessed using accelerometry and a questionnaire in all participants and by doubly labeled water in a subsample of 75 per site. We assessed dietary intake using two separate 24-hour recalls, body composition using bioelectrical impedance analysis, and health history, social and economic indicators by questionnaire. Blood pressure was measured and blood samples collected for measurement of lipids, glucose, insulin and adipokines. Full examination including physical activity using accelerometry, anthropometric data and fasting glucose will take place at 12 and 24 months. The distribution of the main variables and the associations between physical activity, independent of energy intake, glucose metabolism and anthropometric measures will be assessed using cross-section and longitudinal analysis within and between sites. DISCUSSION: METS will provide insight on the relative contribution of physical activity and diet to excess weight, age-related weight gain and incident glucose impairment in five populations' samples of young adults at different stages of economic development. These data should be useful for the development of empirically-based public health policy aimed at the prevention of obesity and associated chronic diseases.
- ItemOpen AccessThe 8-year incidence of obesity and type 2 diabetes in five African-origin populations(2024) Conradie, Catharina Beatrix; Dugas, LaraObesity and type 2 diabetes (T2D) have become worldwide pandemics, particularly in low middle-income countries and among African-origin populations. The Modeling of Epidemiological Transition Study (METS, 2009) enrolled 2,506 African-origin participants, aged 25-45, from five countries and its ancillary study; METS-Microbiome, continued yearly research visits in 2,085 participants (2018-2019). The countries represent the full epidemiological transition spectrum, represented by the Human Development Index: Ghana (low), South Africa and Jamaica, (middle), Seychelles (high) and the United States (US) (very high). Research visits included anthropometrics, body composition measurements, social history, socio-demographics and health questionnaires, physical activity by accelerometer and clinical measurements. Overall, 732 participants had complete measurements from both METS (baseline) and METS-Microbiome (follow-up). At baseline, the US participants had the highest obesity prevalence (61.0%) and Ghanaians the lowest (11.5%). However, the obesity prevalence increased significantly, most notably among the Ghanaians (125%; p<0.001), and Seychellois (60.7%; p<0.01). Significant obesity predictors included being females, waist circumference and fat mass (p<0.001). The interaction term for follow-up length and site was significant with higher odds of obesity compared to baseline; Ghana (OR 6.62, 95%CI 1.56-28.35), Jamaica (OR 4.57, 95%CI 1.06-8.88) and Seychelles (OR 4.31, 95%CI 1.12-16.57). The US participants had the highest T2D prevalence (10,0%) and Jamaicans (0%) at baseline. However, the Seychellois experienced a 600% increase in T2D prevalence (p<0.01) accompanied by the highest T2D and obesity incidence rate. The interaction term for follow up length and site was similarly significant with higher odds of T2D at follow-up; Seychellois (OR 10.00, 95%CI 1.83-54.52) and US (OR 2.33, 95%CI 1.17-4.66). Age (p=0.002) and waist circumference (p=0.016) were significant T2D predictors. In conclusion, the study underscores significant increases in obesity and T2D rates, not only in high-income countries but also in rapid transitioning settings, highlighting concerns about healthcare resources readiness for the growing global burden of non-communicable diseases.