Purpose

Few models have been developed specifically for the epidemiology of diabetes. Diabetes incidence is critical in predicting diabetes prevalence. However, reliable estimates of disease incidence rates are difficult to obtain. The aim of this study was to propose a mathematical framework for predicting diabetes prevalence using incidence rates estimated within the model using body mass index (BMI) data.

Methods

A generic mechanistic model was proposed considering birth, death, migration, aging, and diabetes incidence dynamics. Diabetes incidence rates were determined within the model using their relationships with BMI represented by the Hill equation. The Hill equation parameters were estimated by fitting the model to National Health and Nutrition Examination Survey (NHANES) 1999-2010 data and used to predict diabetes prevalence pertaining to each NHANES survey year. The prevalences were also predicted using diabetes incidence rates calculated from the NHANES data themselves. The model was used to estimate death rate parameters and to quantify sensitivities of prevalence to each population dynamic.

Results

The model using incidence rate estimates from the Hill equations successfully predicted diabetes prevalence of younger, middle-aged, and older adults (prediction error, 20.0%, 9.64%, and 7.58% respectively). Diabetes prevalence was positively associated with diabetes incidence in every age group, but the associations among younger adults were stronger. In contrast, diabetes prevalence was more sensitive to death rates in older adults than younger adults. Both diabetes incidence and prevalence were strongly sensitive to BMI at younger ages, but sensitivity gradually declined as age progressed. Younger and middle aged adults diagnosed with diabetes had at least a two-fold greater risk of death than their nondiabetic counterparts. Nondiabetic older adults were found to be under slightly higher death risk (0.079) than those diagnosed with diabetes (0.073).

Conclusions

The proposed model predicts diagnosed diabetes incidence and prevalence reasonably well using the link between BMI and diabetes development risk. Ethnic group and gender-specific model parameter estimates could further improve predictions. Model prediction accuracy and applicability need to be comprehensively evaluated with independent data sets.

This review examined methane (CH4) and nitrous oxide (N2O) mitigation strategies for Canadian dairy farms. The primary focus was research conducted in Canada and cold climatic regions with similar dairy systems. Meta-analyses were conducted to assess the impact of a given strategy when sufficient data were available. Results indicated that options to reduce enteric CH4 from dairy cows were increasing the dietary starch content and dietary lipid supplementation. Replacing barley or alfalfa silage with corn silage with higher starch content decreased enteric CH4 per unit of milk by 6%. Increasing dietary lipids from 3% to 6% of dry matter (DM) reduced enteric CH4 yield by 9%. Strategies such as nitrate supplementation and 3-nitrooxypropanol additive indicated potential for reducing enteric CH4 by about 30% but require extensive research on toxicology and consumer acceptance. Strategies to reduce emissions from manure are anaerobic digestion, composting, solid-liquid separation, covering slurry storage and flaring CH4, and reducing methanogen inoculum by complete emptying of slurry storage at spring application. These strategies have potential to reduce emissions from manure by up to 50%. An integrated approach of combining strategies through diet and manure management is necessary for significant GHG mitigation and lowering carbon footprint of milk produced in Canada.

Organic compounds in dairy manure undergo a series of reactions producing pollutants such as ammonia and methane. Because various organic compounds have different reaction rates, the emissions could be accurately determined if amounts and concentrations of individual nutrients in manure are known. A set of empirical models were developed for predicting faecal and urinary water, carbon (C), nitrogen (N), acid detergent fibre and neutral detergent fibre output (kg/day) from lactating Holstein cows. Dietary nutrient contents, milk yield and composition, bodyweight, age and days in milk were used with or without dry matter intake (DMI) as potential predictor variables. Multi-collinearity, goodness of fit, model complexity, and random study and animal effects were taken into account during model development, which used 742 measured faecal or urinary nutrient output observations (kg/day). The models were evaluated with an independent dataset (n ≤ 364). When DMI was used as a predictor variable, the models predicted faecal and urinary nutrient outputs successfully with root mean square prediction error as a percentage of average observed values (RMSPE%) ranging from 9.1% to 20.7%. All the predictions except urine output had RMSPE% ranging from 18.3% to 24.6% when DMI was not used. The nutrient output predictions were in reasonable agreement with observed values throughout the data range (systematic bias <14% of total bias). Fresh manure C:N ratio predictions were acceptable (RMSPE% ≤ 14.3-15.2%) although the systematic bias were notable (17.1-20.7% of total bias). The models could be integrated successfully with process-based manure or soil models to assess nutrient transformation in dairy production systems.

Background and aims

Fasting insulin (FI), fasting glucose (FG), systolic blood pressure (SBP), high density lipoproteins (HDL), triacylglycerides (TAG), and body mass index (BMI) are well-known risk factors for type 2 diabetes. Reliable estimates of lifestyle intervention effects on these factors allow diabetes risk to be predicted accurately. The present meta-analyses were conducted to quantitatively summarize effects of diet and exercise intervention programs on FI, FG, SBP, HDL, TAG and BMI in adults without diabetes.

Materials and methods

MEDLINE and EMBASE were searched to find studies involving diet plus exercise interventions. Studies were required to use adults not diagnosed with type 2 diabetes, involve both dietary and exercise counseling, and include changes in diabetes risk factors as outcome measures. Data from 18, 24, 23, 30, 29 and 29 studies were used for the analyses of FI, FG, SBP, HDL, TAG and BMI, respectively. About 60% of the studies included exclusively overweight or obese adults. Mean age and BMI of participants at baseline were 48 years and 30.1 kg/m(2). Heterogeneity of intervention effects was first estimated using random-effect models and explained further with mixed-effects models.

Results

Adults receiving diet and exercise education for approximately one year experienced significant (P <0.001) reductions in FI (-2.56 ± 0.58 mU/L), FG (-0.18 ± 0.04 mmol/L), SBP (-2.77 ± 0.56 mm Hg), TAG (-0.258 ± 0.037 mmol/L) and BMI (-1.61 ± 0.13 kg/m(2)). These risk factor changes were related to a mean calorie intake reduction of 273 kcal/d, a mean total fat intake reduction of 6.3%, and 40 minutes of moderate intensity aerobic exercise four times a week. Lifestyle intervention did not have an impact on HDL. More than 99% of total variability in the intervention effects was due to heterogeneity. Variability in calorie and fat intake restrictions, exercise type and duration, length of the intervention period, and the presence or absence of glucose, insulin, or lipid abnormalities explained 23-63% of the heterogeneity.

Conclusions

Calorie and total fat intake restrictions coupled with moderate intensity aerobic exercises significantly improved diabetes risk factors in healthy normoglycemic adults although normoglycemic adults with glucose, insulin, and lipid abnormalities appear to benefit more.

Monensin is a widely used feed additive with the potential to minimize methane (CH4) emissions from cattle. Several studies have investigated the effects of monensin on CH4, but findings have been inconsistent. The objective of the present study was to conduct meta-analyses to quantitatively summarize the effect of monensin on CH4 production (g/d) and the percentage of dietary gross energy lost as CH4 (Ym) in dairy cows and beef steers. Data from 22 controlled studies were used. Heterogeneity of the monensin effects were estimated using random effect models. Due to significant heterogeneity (>68%) in both dairy and beef studies, the random effect models were then extended to mixed effect models by including fixed effects of DMI, dietary nutrient contents, monensin dose, and length of monensin treatment period. Monensin reduced Ym from 5.97 to 5.43% and diets with greater neutral detergent fiber contents (g/kg of dry matter) tended to enhance the monensin effect on CH4 in beef steers. When adjusted for the neutral detergent fiber effect, monensin supplementation [average 32 mg/kg of dry matter intake (DMI)] reduced CH4 emissions from beef steers by 19±4 g/d. Dietary ether extract content and DMI had a positive and a negative effect on monensin in dairy cows, respectively. When adjusted for these 2 effects in the final mixed-effect model, monensin feeding (average 21 mg/kg of DMI) was associated with a 6±3 g/d reduction in CH4 emissions in dairy cows. When analyzed across dairy and beef cattle studies, DMI or monensin dose (mg/kg of DMI) tended to decrease or increase the effect of monensin in reducing methane emissions, respectively. Methane mitigation effects of monensin in dairy cows (-12±6 g/d) and beef steers (-14±6 g/d) became similar when adjusted for the monensin dose differences between dairy cow and beef steer studies. When adjusted for DMI differences, monensin reduced Ym in dairy cows (-0.23±0.14) and beef steers (-0.33±0.16). Monensin treatment period length did not significantly modify the monensin effects in dairy cow or beef steer studies. Overall, monensin had stronger antimethanogenic effects in beef steers than dairy cows, but the effects in dairy cows could potentially be improved by dietary composition modifications and increasing the monensin dose.