Fibre intake among the Belgian population by sex-age and sex-education groups and its association with BMI and waist circumference

The objectives of the present study were to assess total dietary fibre intake and the main contributors to fibre intake in the Belgian population by sex-age and sex-education groups and to investigate its relationship with BMI and waist circumference (WC). The participants of the Belgian food consumption survey (2004) were randomly selected. Information about food intake was collected using two repeated, non-consecutive 24 h recall interviews. A total of 3083 individuals (>= 15 years; 1546 men and 1537 women) completed both interviews. The main contributors to total fibre intake (17.8 g/d) were cereals and cereal products (34%; 5.9 g/d), potatoes and other tubers (18.6%; 3.3 g/d), fruits (14.7%; 2.8 g/d) and vegetables (14.4%; 2.6 g/d). Legume fibre intake was extremely low (0.672%; 0.139 g/d). In all sex-age and sex-education groups, total fibre intake was below the recommendations of the Belgian Superior Health Council. Men (21 g/d) consumed significantly more fibre than women (17.3 g/d) (P < 0.001). Lower educated men and higher educated women reported the highest fibre intake. A significant inverse association was found between total fibre intake and WC (beta = -0.118, P < 0.001). Fruit-derived fibre was positively associated with WC (beta = 0.731, P=0.001). In summary, total fibre intake was inversely associated with WC, whereas fruit-derived fibre intake was positively associated with WC in the Belgian population

Pregnancy outcome in primiparae of advanced maternal age

Objective: To investigate the impact of maternal age on singleton pregnancy outcome, taking into account intermediate and confounding factors. Study design: In this population-based retrospective cohort study, perinatal data of primiparous women aged 35 years or more ( n = 2970), giving birth to a singleton child of at least 500 g, were compared to data of primiparous women aged 25–29 years old ( n = 23,921). Univariate analysis was used to assess the effect of maternal age on pregnancy outcomes. The effects of intermediate (hypertension, diabetes and assisted conception) and confounding factors (level of education) were assessed through multivariable logistic regression analysis. Results: Older maternal age correlated, independently of confounding and intermediate factors, with very preterm birth (gestational age \u3c32 weeks) [adjusted odds ratio (AOR) 1.51, 95% confidence intervals (CI) 1.04–2.19], low birth weight (birth weight \u3c2500 g) (AOR 1.69, 95% CI 1.47–1.94) and perinatal death (AOR 1.68, 95% CI 1.06–2.65). Conclusion: Maternal age is an important and independent risk factor for adverse pregnancy outcome

Relative Validity and Reproducibility of a Food-Frequency Questionnaire for Estimating Food Intakes among Flemish Preschoolers

The aims of this study were to assess the relative validity and reproducibility of a semi-quantitative food-frequency questionnaire (FFQ) applied in a large region-wide survey among 2.5–6.5 year-old children for estimating food group intakes. Parents/guardians were used as a proxy. Estimated diet records (3d) were used as reference method and reproducibility was measured by repeated FFQ administrations five weeks apart. In total 650 children were included in the validity analyses and 124 in the reproducibility analyses. Comparing median FFQ1 to FFQ2 intakes, almost all evaluated food groups showed median differences within a range of ± 15%. However, for median vegetables, fruit and cheese intake, FFQ1 was > 20% higher than FFQ2. For most foods a moderate correlation (0.5–0.7) was obtained between FFQ1 and FFQ2. For cheese, sugared drinks and fruit juice intakes correlations were even > 0.7. For median differences between the 3d EDR and the FFQ, six food groups (potatoes & grains; vegetables Fruit; cheese; meat, game, poultry and fish; and sugared drinks) gave a difference > 20%. The largest corrected correlations (>0.6) were found for the intake of potatoes and grains, fruit, milk products, cheese, sugared drinks, and fruit juice, while the lowest correlations (<0.4) for bread and meat products. The proportion of subjects classified within one quartile (in the same/adjacent category) by FFQ and EDR ranged from 67% (for meat products) to 88% (for fruit juice). Extreme misclassification into the opposite quartiles was for all food groups < 10%. The results indicate that our newly developed FFQ gives reproducible estimates of food group intake. Overall, moderate levels of relative validity were observed for estimates of food group intake

Anti-MDA5 positive dermatomyositis complicated with rapidly progressive interstitial lung disease : a case report

Case presentation: We present a case of a 55-year-old Caucasian male with manifestations of dermatomyositis complicated with rapidly progressive interstitial lung disease (RP-ILD). Diagnosis of anti-MDA5 positive dermatomyositis was made. Discussion: Myositis specific antibodies (MSA) can be used for diagnosis and predicting prognosis in patients with polymyositis and dermatomyositis. Anti-MDA5 positive dermatomyositis should be considered in patients presenting with dermatomyositis and a disease course resembling antisynthetase syndrome in the absence of antisynthetase autoantibodies, especially if a remarkably high ferritin is noted. Anti-MDA5 autoantibodies have been associated with RP-ILD and adverse outcome. In patients with anti-MDA5 autoantibodies, early diagnosis and aggressive immunosuppressive treatment may improve prognosis. Conclusion: This case highlights the importance of determining MSA in patients with dermatomyositis and associated interstitial lung disease, as this has implications for diagnosis, prognosis and therapy

Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study

Background The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). Methods EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N = 5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. Results In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m2: 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m2: 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Conclusions Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors

Poor adherence to lifestyle recommendations in patients with coronary heart disease:results from the EUROASPIRE surveys

Aims  Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient’s perspective. Methods and results  In the EUROASPIRE IV and V surveys, 16 259 CHD patients were examined and interviewed during a study visit ≥6 months after hospital discharge. Data gathering was fully standardized. The Brief Illness Perception questionnaire was completed by a subsample of 2379 patients. Half of those who were smoking prior to hospital admission, were still smoking; 37% of current smokers had not attempted to quit and 51% was not considering to do so. The prevalence of obesity was 38%. Half of obese patients tried to lose weight in the past month and 61% considered weight loss in the following month. In relation to physical activity, 40% was on target with half of patients trying to do more everyday activities. Less than half had the intention to engage in planned exercise. Only 29% of all patients was at goal for all three lifestyle factors. The number of adverse lifestyles was strongly related to the way patients perceive their illness as threatening. Lifestyle modifications were more successful in those having participated in a cardiac rehabilitation and prevention programme. Patients indicated lack of self-confidence as the main barrier to change their unhealthy behaviour. Conclusion  Modern secondary prevention programmes should target behavioural change in all patients with adverse lifestyles

Dietary Sources of Fiber Intake and Its Association with Socio-Economic Factors among Flemish Preschool Children

The objectives were to assess total dietary fiber intake, identify the major sources of dietary fiber, and examine its association with socio-economic factors among Flemish preschoolers. Three-day estimated dietary records were collected from a representative sample of preschoolers 2.5–6.5 years old (n = 661; 338 boys, 323 girls). The mean dietary fiber intake (13.4 g/d) was lower than the intake level recommended by the Belgian Superior Health Council (70% boys and 81% girls below the guidelines). The most important contributor was the group of bread and cereals (29.5%), followed by fruits (17.8%), potatoes and grains (16.0%), energy-dense, low-nutritious foods (12.4%), and vegetables (11.8%). Multiple linear regression analyses showed that total fiber intake was associated with maternal education and parents’ employment. Overall, fiber intakes from high-nutritious foods (vegetables and fruits) were higher in preschoolers of higher educated mothers and those with one or both parents being employed. In conclusion, the majority of the preschoolers had dietary fiber intakes below the recommended level. Hence, dietary fiber should be promoted among parents of preschoolers and low socio-economic status families should be addressed in particular

Occupational and leisure time physical activity in contrasting relation to ambulatory blood pressure

Background: While moderate and vigorous leisure time physical activities are well documented to decrease the risk for cardiovascular disease, several studies have demonstrated an increased risk for cardiovascular disease in workers with high occupational activity. Research on the underlying causes to the contrasting effects of occupational and leisure time physical activity on cardiovascular health is lacking. The aim of this study was to examine the relation of objective and self-report measures of occupational and leisure time physical activity with 24-h ambulatory systolic blood pressure (BP). Methods: Results for self-reported physical activity are based on observations in 182 workers (60% male, mean age 51 years), while valid objective physical activity data were available in 151 participants. The usual level of physical activity was assessed by 5 items from the Job Content Questionnaire (high physical effort, lifting heavy loads, rapid physical activity, awkward body positions and awkward positions of head or arms at work) and one item asking about the general level of physical activity during non-working time. On a regular working day, participants wore an ambulatory BP monitor and an accelerometer physical activity monitor during 24 h. Associations were examined by means of Analysis of Covariance. Results: Workers with an overall high level of self-reported occupational physical activity as well as those who reported to often lift heavy loads at work had a higher mean systolic BP at work, at home and during sleep. However, no associations were observed between objectively measured occupational physical activity and BP. In contrast, those with objectively measured high proportion of moderate and vigorous leisure time physical activity had a significantly lower mean systolic BP during daytime, while no differences were observed according to self-reported level of leisure time physical activity. Conclusions: These findings suggest that workers reporting static occupational physical activities, unlike general physically demanding tasks characterized by dynamic movements of large muscle groups, are related to a higher daily systolic BP, while high objective levels of moderate and vigorous leisure time physical activity are related to lower daytime systolic BP. Ambulatory systolic BP may be a physiological explanatory factor for the contrasting effects of occupational and leisure time physical activity

INTERASPIRE:an International Survey of Coronary Patients; Their Cardiometabolic, Renal and Biomarker Status; and the Quality of Preventive Care Delivered in All WHO Regions: In Partnership with the World Heart Federation, European Society of Cardiology, Asia Pacific Society of Cardiology, InterAmerican Society of Cardiology, and PanAfrican Society of Cardiology.

Purpose of Review To describe the INTERASPIRE scientific protocol-an international survey of secondary prevention of coronary heart disease (CHD). Recent Findings This international survey is being conducted through National Societies of Cardiology in selected countries from each of the six WHO regions and has the following overall aims: (i) describe prevalence of cardiometabolic and renal risk factors together with biomarkers in CHD patients; (ii) describe current risk factor management through lifestyle changes and cardioprotective drug therapies; (iii) provide an objective assessment of clinical implementation of preventive care by comparison with the lifestyle and risk factor targets defined in international and national guidelines; (iv) investigate the reasons for variation in preventive cardiology practice between regions and countries; and (v) promote the principles of best preventive cardiology practice. This international survey will provide a unique picture of CHD patients; their cardiometabolic, renal and biomarker status; lifestyle and therapeutic management; and the quality of preventive care provided in all WHO regions