Imperial College London

DrMariachiaraDi Cesare

Faculty of MedicineSchool of Public Health

Honorary Research Fellow
 
 
 
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m.di-cesare

 
 
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524Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
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80 results found

Jobling K, Quintela-Baluja M, Hassard F, Adamou P, Blackburn A, Research Team T, McIntyre-Nolan S, O'Mara O, Romalde JL, Di Cesare M, Graham DWet al., 2024, Comparison of gene targets and sampling regimes for SARS-CoV-2 quantification for wastewater epidemiology in UK prisons., J Water Health, Vol: 22, Pages: 64-76, ISSN: 1477-8920

Prisons are high-risk settings for infectious disease transmission, due to their enclosed and semi-enclosed environments. The proximity between prisoners and staff, and the diversity of prisons reduces the effectiveness of non-pharmaceutical interventions, such as social distancing. Therefore, alternative health monitoring methods, such as wastewater-based epidemiology (WBE), are needed to track pathogens, including SARS-CoV-2. This pilot study assessed WBE to quantify SARS-CoV-2 prevalence in prison wastewater to determine its utility within a health protection system for residents. The study analysed 266 samples from six prisons in England over a 12-week period for nucleoprotein 1 (N1 gene) and envelope protein (E gene) using quantitative reverse transcriptase-polymerase chain reaction. Both gene assays successfully detected SARS-CoV-2 fragments in wastewater samples, with both genes significantly correlating with COVID-19 case numbers across the prisons (p < 0.01). However, in 25% of the SARS-positive samples, only one gene target was detected, suggesting that both genes be used to reduce false-negative results. No significant differences were observed between 14- and 2-h composite samples, although 2-h samples showed greater signal variance. Population normalisation did not improve correlations between the N1 and E genes and COVID-19 case data. Overall, WBE shows considerable promise for health protection in prison settings.

Journal article

Di Cesare M, Perel P, Taylor S, Kabudula C, Bixby H, Gaziano TA, McGhie DV, Mwangi J, Pervan B, Narula J, Pineiro D, Pinto FJet al., 2024, The Heart of the World., Glob Heart, Vol: 19

Cardiovascular diseases (CVDs) are the leading cause of mortality globally. Of the 20.5 million CVD-related deaths in 2021, approximately 80% occurred in low- and middle-income countries. Using data from the Global Burden of Disease Study, NCD Risk Factor Collaboration, NCD Countdown initiative, WHO Global Health Observatory, and WHO Global Health Expenditure database, we present the burden of CVDs, associated risk factors, their association with national health expenditures, and an index of critical policy implementation. The Central Europe, Eastern Europe, and Central Asia region face the highest levels of CVD mortality globally. Although CVD mortality levels are generally lower in women than men, this is not true in almost 30% of countries in the North Africa and Middle East and Sub-Saharan regions. Raised blood pressure remains the leading global CVD risk factor, contributing to 10.8 million deaths in 2019. The regions with the highest proportion of countries achieving the maximum score for the WHF Policy Index were South Asia, Central Europe, Eastern Europe, and Central Asia, and the High-Income regions. The Sub-Saharan Africa region had the highest proportion of countries scoring two or less. Policymakers must assess their country's risk factor profile to craft effective strategies for CVD prevention and management. Fundamental strategies such as the implementation of National Tobacco Control Programmes, ensuring the availability of CVD medications, and establishing specialised units within health ministries to tackle non-communicable diseases should be embraced in all countries. Adequate healthcare system funding is equally vital, ensuring reasonable access to care for all communities.

Journal article

Hassard F, Vu M, Rahimzadeh S, Castro-Gutierrez V, Stanton I, Burczynska B, Wildeboer D, Baio G, Brown MR, Garelick H, Hofman J, Kasprzyk-Hordern B, Majeed A, Priest S, Denise H, Khalifa M, Bassano I, Wade MJ, Grimsley J, Lundy L, Singer AC, Di Cesare Met al., 2023, Wastewater monitoring for detection of public health markers during the COVID-19 pandemic: Near-source monitoring of schools in England over an academic year, PLOS ONE, Vol: 18, ISSN: 1932-6203

Journal article

Ezzati M, Mishra A, Zhou B, Rodriguez-Martinez A, Bixby H, Singleton R, Carrillo-Larco R, Sheffer K, Paciorek C, Bennett J, Lhoste V, Iurilli M, Di Cesare M, Bentham J, Phelps N, Sophiea M, Stevens G, Danaei G, Cowan M, Savin S, Riley L, Gregg E, Aekplakom W, Ahmad NA, Baker J, Chirita-Emandi A, Farzadfar F, Günther F, Heinen M, Ikeda N, Kengne AP, Khang Y-H, Laatikainen T, Laxmaiah A, Ma J, Monroy-Valle M, Padez C, Reynolds A, Soric M, Starc G, Wirth Jet al., 2023, Diminishing benefits of urban living for children and adolescents’ growth and development, Nature, Vol: 615, Pages: 874-883, ISSN: 0028-0836

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

Journal article

Liu LQ, Kelly J, Di Cesare M, Allan HT, Traynor Met al., 2023, The knowledge and attitudes regarding pressure ulcer prevention among healthcare support workers in the UK: A cross-sectional study, JOURNAL OF TISSUE VIABILITY, Vol: 32, Pages: 130-135, ISSN: 0965-206X

Journal article

Hassard F, Smith TR, Boehm AB, Nolan S, O'Mara O, Di Cesare M, Graham Det al., 2022, Wastewater surveillance for rapid identification of infectious diseases in prisons, LANCET MICROBE, Vol: 3, Pages: E556-E557

Journal article

Castro-Gutierrez V, Hassard F, Vu M, Leitao R, Burczynska B, Wildeboer D, Stanton I, Rahimzadeh S, Baio G, Garelick H, Hofman J, Kasprzyk-Hordern B, Kwiatkowska R, Majeed A, Priest S, Grimsley J, Lundy L, Singer AC, Di Cesare Met al., 2022, Monitoring occurrence of SARS-CoV-2 in school populations: A wastewater-based approach, PLoS One, Vol: 17, Pages: 1-15, ISSN: 1932-6203

Clinical testing of children in schools is challenging, with economic implications limiting its frequent use as a monitoring tool of the risks assumed by children and staff during the COVID-19 pandemic. Here, a wastewater-based epidemiology approach has been used to monitor 16 schools (10 primary, 5 secondary and 1 post-16 and further education) in England. A total of 296 samples over 9 weeks have been analysed for N1 and E genes using qPCR methods. Of the samples returned, 47.3% were positive for one or both genes with a detection frequency in line with the respective local community. WBE offers a low cost, non-invasive approach for supplementing clinical testing and can provide longitudinal insights that are impractical with traditional clinical testing.

Journal article

Cohorts Consortium of Latin America and the Caribbean CC-LAC, Carrillo Larco R, Stern D, Hambleton IR, Lotufo P, Di Cesare M, Hennis A, Ferreccio C, Irazola V, Perel P, Gregg EW, Miranda JJ, Ezzati M, Danaei Get al., 2022, Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): a pooled analysis of cohort studies, The Lancet Regional Health Americas, Vol: 9, ISSN: 2667-193X

Background: Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations. Methods: We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory-based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell’s C-statistic and calibration slopes. Findings: The C-statistic for the laboratory-based model was 72% (70%-74%), the calibration slope was 0.994 (0.934-1.055) among men and 0.852 (0.761-0.942) among women; for the office-based model the C-statistic was 71% (69%-72%) and the calibration slope was 1.028 (0.980-1.076) among men and 0.811 (0.663-0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%.Interpretation: The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC. Funding: Wellcome Trust (214185/Z/18/Z)

Journal article

Jaacks LM, Di Cesare M, 2022, The epidemiology and social determinants of obesity, Clinical Obesity in Adults and Children, 4th Edition, Pages: 17-30, ISBN: 9781119695271

The global obesity epidemic has been officially recognized by the World Health Organization since as early as 1997. The strong association between obesity and novel coronavirus (COVID-19) infection, hospitalization, admittance to intensive care units, and death may represent an important turning point for obesity prevention efforts. This chapter sets out to describe how to define excess body fat; summarize trends and current status of adult and childhood obesity, focusing on the United States; summarize trends and current status of global obesity, focusing on low-and middle-income countries; and explore how social determinants shape the prevalence of obesity. In addressing the social determinants of obesity, it is recognized that individual choices are influenced by social, economic, political, environmental, and cultural factors. Specific dimensions covered in this chapter include gender, race and ethnicity, socioeconomic status, urbanization, and culture.

Book chapter

Carrillo-Larco RM, Stern D, Hambleton IR, Hennis A, Cesare MD, Lotufo P, Ferreccio C, Irazola V, Perel P, Gregg EW, Miranda JJ, Ezzati M, Danaei G, Aguilar-Salinas CA, Alvarez-Váz R, Amadio MB, Baccino C, Bambs C, Bastos JL, Beckles G, Bernabe-Ortiz A, Bernardo CDO, Bloch KV, Blümel JE, Boggia JG, Borges PK, Bravo M, Brenes-Camacho G, Carbajal HA, Rascon MSC, Ceballos BH, Colpani V, Cooper JA, Cortes S, Cortes-Valencia A, Cunha RS, d'Orsi E, Dow WH, Espeche WG, Fuchs FD, Fuchs SC, Gimeno SGA, Gomez-Velasco D, Gonzalez-Chica DA, Gonzalez-Villalpando C, Gonzalez-Villalpando M-E, Grazioli G, Guerra RO, Gutierrez L, Herkenhoff FL, Horimoto ARVR, Huidobro A, Koch E, Lajous M, Lima-Costa MF, Lopez-Ridaura R, Maciel ACC, Manrique-Espinoza BS, Marques LP, Mill JG, Moreira LB, Muñoz OM, Ono LM, Oppermann K, Paiva KM, Peixoto SV, Pereira AC, Peres KG, Peres MA, Ramírez-Palacios P, Rech CR, Rivera-Paredez B, Rodriguez NI, Rojas-Martinez R, Rosero-Bixby L, Rubinstein A, Ruiz-Morales A, Salazar MR, Salinas-Rodriguez A, Salmerón J, Sanchez RA, Silva NAS, Silva TLN, Smeeth L, Spritzer PM, Tartaglione F, Tartaglione J, Velázquez-Cruz Ret al., 2021, Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies, The Lancet Regional Health - Americas, Vol: 4, Pages: 1-12, ISSN: 2667-193X

BackgroundEstimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown.MethodsWe pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor.ResultsOur RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana.InterpretationRRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries.FundingWellcome Trust (214185/Z/18/Z)

Journal article

Grosso G, Di Cesare M, 2021, Dietary factors and non-communicable disease risk in Europe: evidence for European nutritional guidelines?, Publisher: OXFORD UNIV PRESS, ISSN: 1101-1262

Conference paper

Sabates R, Di Cesare M, 2021, Can maternal education sustain or enhance the benefits of early life interventions? Evidence from the Young Lives Longitudinal Study, COMPARE-A JOURNAL OF COMPARATIVE AND INTERNATIONAL EDUCATION, Vol: 51, Pages: 651-669, ISSN: 0305-7925

Journal article

Rahimzadeh S, Burczynska B, Ahmadvand A, Sheidaei A, Khademioureh S, Pazhuheian F, Moghaddam SS, Bentham J, Farzadfar F, Di Cesare Met al., 2021, Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

NCD Risk Factor Collaboration NCD-RisC, Iurilli N, 2021, Heterogeneous contributions of change in population distribution of body-mass index to change in obesity and underweight, eLife, Vol: 10, ISSN: 2050-084X

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

Journal article

Kontis V, Bennett JE, Rashid T, Parks RM, Pearson-Stuttard J, Guillot M, Asaria P, Zhou B, Battaglini M, Corsetti G, McKee M, Di Cesare M, Mathers CD, Ezzati Met al., 2021, Magnitude, demographics and dynamics of the effect of the first wave of the COVID-19 pandemic on all-cause mortality in 21 industrialized countries (vol 26, pg 1919, 2020), NATURE MEDICINE, Vol: 27, Pages: 562-562, ISSN: 1078-8956

Journal article

Rezaei-Darzi E, Mehdipour P, Di Cesare M, Farzadfar F, Rahimzadeh S, Nissen L, Ahmadvand Aet al., 2021, Evaluating equality in prescribing Novel Oral Anticoagulants (NOACs) in England: The protocol of a Bayesian small area analysis, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Hassard F, Lundy L, Singer AC, Grimsley J, Di Cesare Met al., 2021, Innovation in wastewater near-source tracking for rapid identification of COVID-19 in schools Comment, LANCET MICROBE, Vol: 2, Pages: E4-E5

Journal article

Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli ML, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, Danaei G, Chirita-Emandi A, Kengne AP, Khang YH, Laxmaiah A, Malekzadeh R, Miranda JJ, Moon JS, Popovic SR, Sørensen TI, Soric M, Starc G, Zainuddin AA, Gregg EW, Bhutta ZA, Black R, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Auvinen J, Avdicová M, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Bæksgaard Jørgensen M, Baharudin A, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh Met al., 2020, Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants, The Lancet, Vol: 396, Pages: 1511-1524, ISSN: 0140-6736

SummaryBackgroundComparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.MethodsFor this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.FindingsWe pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became

Journal article

Kontis V, Bennett JE, Rashid T, Parks RM, Pearson-Stuttard J, Guillot M, Asaria P, Zhou B, Battaglini M, Corsetti G, McKee M, Di Cesare M, Mathers CD, Ezzati Met al., 2020, Magnitude, demographics and dynamics of the effect of the first wave of the COVID-19 pandemic on all-cause mortality in 21 industrialized countries, Nature Medicine, Vol: 26, Pages: 1919-1928, ISSN: 1078-8956

The Coronavirus Disease 2019 (COVID-19) pandemic has changed many social, economic, environmental and healthcare determinants of health. We applied an ensemble of 16 Bayesian models to vital statistics data to estimate the all-cause mortality effect of the pandemic for 21 industrialized countries. From mid-February through May 2020, 206,000 (95% credible interval, 178,100–231,000) more people died in these countries than would have had the pandemic not occurred. The number of excess deaths, excess deaths per 100,000 people and relative increase in deaths were similar between men and women in most countries. England and Wales and Spain experienced the largest effect: ~100 excess deaths per 100,000 people, equivalent to a 37% (30–44%) relative increase in England and Wales and 38% (31–45%) in Spain. Bulgaria, New Zealand, Slovakia, Australia, Czechia, Hungary, Poland, Norway, Denmark and Finland experienced mortality changes that ranged from possible small declines to increases of 5% or less in either sex. The heterogeneous mortality effects of the COVID-19 pandemic reflect differences in how well countries have managed the pandemic and the resilience and preparedness of the health and social care system.

Journal article

Carrillo Larco R, Bennett JE, Di Cesare M, Gregg EW, Bernabe-Ortiz Aet al., 2020, The contribution of specific non-communicable diseases to the achievement of the Sustainable Development Goal 3.4 in Peru, PLoS One, Vol: 15, ISSN: 1932-6203

BackgroundNon-communicable diseases (NCDs) have received political attention and commitment, yet surveillance is needed to measure progress and set priorities. Building on global estimates suggesting that Peru is not on target to meet the Sustainable Development Goal 3.4, we estimated the contribution of various NCDs to the change in unconditional probability of dying from NCDs in 25 regions in Peru.MethodsUsing national death registries and census data, we estimated the unconditional probability of dying between ages 30 and 69 from any and from each of the following NCDs: cardiovascular, cancer, diabetes, chronic respiratory diseases and chronic kidney disease. We estimated the contribution of each NCD to the change in the unconditional probability of dying from any of these NCDs between 2006 and 2016.ResultsThe overall unconditional probability of dying improved for men (21.4%) and women (23.3%). Cancer accounted for 10.9% in men and 13.7% in women of the overall reduction; cardiovascular diseases also contributed substantially: 11.3% in men) and 9.8% in women. Consistently in men and women and across regions, diabetes moved in the opposite direction of the overall reduction in the unconditional probability of dying from any selected NCD. Diabetes contributed a rise in the unconditional probability of 3.6% in men and 2.1% in women.ConclusionsAlthough the unconditional probability of dying from any selected NCD has decreased, diabetes would prevent Peru from meeting international targets. Policies are needed to prevent diabetes and to strengthen healthcare to avoid diabetes-related complications and delay mortality.

Journal article

Dharma S, 2020, Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction., Glob Heart, Vol: 15

The success of ST-segment elevation myocardial infarction (STEMI) networks application in Europe and the United States in delivering rapid reperfusion therapy in the community have become an inspiration to other developing countries to develop regional STEMI network in order to improve the STEMI care. Although barriers are found in the beginning phase of constructing the network, recent analysis from national or regional registries worldwide have shown improvement of the STEMI care in many countries over the years. To improve the overall care of patients with STEMI particularly in developing countries, improvements should be focusing on how to minimize the total ischemia time, and this includes care improvement at each step of care after the patient shows signs and symptoms of chest pain. Innovation in health technology to develop the electrocardiogram transmission and communication system, along with routine performance measures of the STEMI network may help bridging the disparities of STEMI system of care between guideline recommended therapy and the real world clinical practice.

Journal article

Cohorts Consortium of Latin America and the Caribbean CC-LAC, Carrillo Larco R, Gregg EW, Ezzati Met al., 2020, Cohort profile: The Cohorts Consortium of Latin America and the Caribbean (CC-LAC), International Journal of Epidemiology, Vol: 49, Pages: 1437-1437g, ISSN: 0300-5771

Journal article

Grosso G, Di Cesare M, 2020, Global trends of obesity, malnutrition and dietary risk factors, Publisher: OXFORD UNIV PRESS, Pages: V488-V488, ISSN: 1101-1262

Conference paper

NCD Risk Factor Collaboration NCD-RisC, 2020, Repositioning of the global epicentre of non-optimal cholesterol, Nature, Vol: 582, Pages: 73-77, ISSN: 0028-0836

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and per

Journal article

Taddei C, Jackson R, Zhou B, Bixby H, Danaei G, Di Cesare M, Kuulasmaa K, Hajifathalian K, Bentham J, Bennett JE, Aekplakorn W, Cifkova R, Dallongeville J, De Bacquer D, Giampaoli S, Gudnason V, Khang Y-H, Laatikainen T, Mann JI, Marques-Vidal P, Mensah GA, Müller-Nurasyid M, Ninomiya T, Petkeviciene J, Rodríguez-Artalejo F, Servais J, Söderberg S, Stavreski B, Wilsgaard T, Zdrojewski T, Zhao D, Stevens GA, Savin S, Cowan MJ, Riley LM, Ezzati Met al., 2020, National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: an analysis of trends in Asian and Western countries, International Journal of Epidemiology, Vol: 49, Pages: 173-192, ISSN: 1464-3685

Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease (CHD), multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio in Asian and Western countries.Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol, and mean total-to-HDL cholesterol ratio by country, sex and age group.Results: Since ~1980, mean TC increased in Asian countries. In Japan and South Korea, TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, ~0.4 mmol/Lper decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ~0.7 per decade in Swiss men (equivalent to ~26% decline in CHD risk per decade). The ratio increased in China. Conclusions: HDL cholesterol has risen and total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only weak correlation to changes in TC or non-HDL cholesterol.

Journal article

Bentham J, Singh GM, Danaei G, Green R, Lin JK, Stevens GA, Farzadfar F, Bennett JE, Di Cesare M, Dangour AD, Ezzati Met al., 2020, Multidimensional characterization of global food supply from 1961 to 2013, Nature Food, Vol: 1, Pages: 70-75, ISSN: 2662-1355

Food systems are increasingly globalized and interdependent and diets around the world are changing. Characterising national food supplies and how they have changed can inform food policies that ensure national food security, support access to healthy diets and enhance environmental sustainability. Here, we analysed data for 171 countries on availability of 18 food groups from the United Nations Food and Agriculture Organization to identify and track 40 multi-dimensional food supply patterns from 1961 to 2013. Four predominant food group combinations were identified that explained almost 90% of cross-country variance in food supply: animal source and sugar; vegetable; starchy root and fruit; and seafood and oilcrops. South Korea, China and Taiwan experienced the largest changes in food supply over the past five decades, with animal source foods and sugar, vegetables, and seafood and oilcrops all becoming more abundant components of food supply. In contrast, in many Western countries, the supply of animal source foods and sugar declined. Meanwhile, there was remarkably little change in food supply in countries in the sub-Saharan Africa region. These changes have led to a partial global convergence in national supply of animal source foods and sugar, and a divergence in vegetables, and seafood and oilcrops. Our analysis has generated a novel characterisation of food supply that highlights the interdependence of multiple food types in national food systems. A better understanding of how these patterns have evolved and will continue to change is needed to support the delivery of healthy and sustainable food system policies.

Journal article

Jaime Miranda J, Carrillo-Larco RM, Ferreccio C, Hambleton IR, Lotufo PA, Nieto-Martinez R, Zhou B, Bentham J, Bixby H, Hajifathalian K, Lu Y, Taddei C, Abarca-Gomez L, Acosta-Cazares B, Aguilar-Salinas CA, Andrade DS, Assuncao MCF, Barcelo A, Barros AJD, Barros MVG, Bata I, Batista RL, Benet M, Bernabe-Ortiz A, Bettiol H, Boggia JG, Boissonnet CP, Brewster LM, Cameron C, Candido APC, Cardoso VC, Chan Q, Christofaro DG, Confortin SC, Craig CL, d'Orsi E, Delisle H, de Oliveira PD, Dias-da-Costa JS, Diaz A, Donoso SP, Elliott P, Escobedo-de la Pena J, Ferguson TS, Fernandes RA, Ferrante D, Monterubio Flores E, Francis DK, Franco MDC, Fuchs FD, Fuchs SC, Goltzman D, Goncalves H, Gonzalez-Rivas JP, Bonet Gorbea M, Gregor RD, Guerrero R, Guimaraes AL, Gulliford MC, Gutierrez L, Hernandez Cadena L, Herrera VM, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Howitt C, Irazola VE, Magaly Jimenez-Acosta S, Joffres M, Kolsteren P, Landrove O, Li Y, Lilly CL, Fernanda Lima-Costa M, Louzada Strufaldi MW, Machado-Coelho GLL, Makdisse M, Margozzini P, Marques LP, Martorell R, Matijasevich A, Posso AJMD, McFarlane SR, McLean SB, Menezes AMB, Miquel JF, Mohanna S, Monterrubio EA, Moreira LB, Morejon A, Motta J, Neal WA, Nervi F, Noboa OA, Ochoa-Aviles AM, Anselmo Olinto MT, Oliveira IO, Ono LM, Ordunez P, Ortiz AP, Otero JA, Palloni A, Peixoto SV, Pereira AC, Perez CM, Reina DAR, Ribeiro R, Ritti-Dias RM, Rivera JA, Robitaille C, Rodriguez-Villamizar LA, Rojas-Martinez R, Roy JGR, Rubinstein A, Sandra Ruiz-Betancourt B, Salazar Martinez E, Sanchez-Abanto J, Santos IS, dos Santos RN, Scazufca M, Schargrodsky H, Silva AM, Santos Silva DA, Stein AD, Suarez-Medina R, Tarqui-Mamani CB, Tulloch-Reid MK, Ueda P, Ugel EE, Valdivia G, Varona P, Velasquez-Melendez G, Verstraeten R, Victora CG, Wanderley RS, Wang M-D, Wilks RJ, Wong-McClure RA, Younger-Coleman NO, Zuniga Cisneros J, Danaei G, Stevens GA, Riley LM, Ezzati M, Di Cesare Met al., 2020, Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys, The Lancet Global Health, Vol: 8, Pages: E123-E133, ISSN: 2214-109X

BackgroundDescribing the prevalence and trends of cardiometabolic risk factors that are associated with non-communicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014.MethodsWe did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), and diabetes (fasting plasma glucose ≥7·0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas.Findings389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3·9% (95% CI 2·2–6·3) in 1980, to 18·6% (14·3–23·3) in 2014, in men; and from 12·2% (8·2–17·0) in 1980, to 30·5% (25·7–35·5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5·2% (2·1–10·4) in men and 6·4% (2·6–10·4) in women in 1980, to 11·1% (6·4–17·3) in men and 13·6% (8·2–21·0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27·6% (22·3–33·2) in men and 19·9% (15·8–24·4) in women in 1980, to 15·

Journal article

Di Cesare M, Jarvis JD, Scarlatescu O, Leng X, Zaidel EJ, Burrone E, Eisele J-L, Prabhakaran D, Sliwa Ket al., 2020, NOACs Added to WHO's Essential Medicines List: Recommendations for Future Policy Actions, GLOBAL HEART, Vol: 15, ISSN: 2211-8160

Journal article

Zaidel EJ, Leng X, Adeoye AM, Hakim F, Karmacharya B, Katbeh A, Neubeck L, Partridge S, Perel P, Huffman MD, Di Cesare Met al., 2020, Inclusion in the World Health Organization Model List of Essential Medicines of Non-Vitamin K Anticoagulants for Treatment of Non-Valvular Atrial Fibrillation: A Step Towards Reducing the Burden of Cardiovascular Morbidity and Mortality, GLOBAL HEART, Vol: 15, ISSN: 2211-8160

Journal article

Di Cesare M, Soric M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, Laxmaiah A, Kengne A-P, Bentham Jet al., 2019, The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action, BMC MEDICINE, Vol: 17, ISSN: 1741-7015

Journal article

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