Assoziationen eines Kardioprotektiven Ernährungsindex mit der Inzidenz des akuten Myokardinfarktes und kardiovaskulären Risikofaktoren bei Männern im mittleren Alter:Ergebnisse der MONICA-KORA-Augsburg-Studien

Ich untersuchte mit den Daten von 1329 deutschen Männern im mittleren Alter, ob die Adhärenz an ein kardiopräventives Ernährungsmuster das Herzinfarktrisiko und die Verteilungen kardiovaskulärer Risikofaktoren günstig beeinflusst. Dafür entwickelte ich einen Ernährungsindex, der Herz-Kreislauf-relevante Nahrungsfaktoren erfasst. Im Längsschnitt wies ich für den Vergleich der extremen Indexkategorien ein adjustiertes Herzinfarktrisiko von 0,60 (95%-Konfidenzintervall: 0,26–1,40) nach. Unter den Männern ohne hohes prävalentes Koronarrisiko betrug dieses Maß 0,35 (0,10–1,17). Im Querschnitt fand ich in einer Subgruppe in der obersten Indexkategorie niedrigere Blutdruck- und Serumcholesterolmittelwerte. Die Daten weisen darauf hin, dass ein höherer Verzehr von pflanzlichen Lebensmitteln und Fisch sowie von Linolsäure im Austausch gegen gesättigte Fettsäuren das Herzinfarktrisiko in der Bevölkerung deutlich senken könnte, möglicherweise zum Teil vermittelt über eine Senkung von Blutdruck und Serumcholesterol

Evaluating selection bias in a population-based cohort study with low baseline participation: the LIFE-Adult-Study

Background: Participation in epidemiologic studies is steadily declining, which may result in selection bias. It is therefore an ongoing challenge to clarify the determinants of participation to judge possible selection effects and to derive measures to minimise that bias. We evaluated the potential for selection bias in a recent population-based cohort study with low baseline participation and investigated reasons for nonparticipation. Methods: LIFE-Adult is a cohort study in the general population of the city of Leipzig (Germany) designed to gain insights into the distribution and development of civilisation diseases. Nine thousand one hundred forty-five participants aged 40–79 years were randomly sampled in 2011–2014. We compared LIFE-Adult participants with both the Leipzig population and nonparticipants using official statistics and short questionnaire data. We applied descriptive statistics and logistic regression analysis to evaluate the determinants of study participation. Results: Thirty-one percent of the invited persons participated in the LIFE-Adult baseline examination. Study participants were less often elderly women and more often married, highly educated, employed, and current nonsmokers compared to both the Leipzig population and nonparticipants. They further reported better health than nonparticipants. The observed differences were considerable in education and health variables. They were generally stronger in men than in women. For example, in male study participants aged 50–69, the frequency of high education was 1.5 times that of the general population, and the frequency of myocardial infarction was half that of nonparticipants. Lack of time and interest, as well as health problems were the main reasons for nonparticipation. Conclusions: Our investigation suggests that the low baseline participation in LIFE-Adult is associated with the typical selection of study participants with higher social status and healthier lifestyle, and additionally less disease. Notably, education and health status seem to be crucial selection factors. Consequently, frequencies of major health conditions in the general population will likely be underestimated. A differential selection related to sex might also distort effect estimates. The extent of the assessment, the interest in the research topic, and health problems of potential participants should in future be considered in LIFE-Adult and in similar studies to raise participation and to minimise selection bias

Less Animal-Based Food, Better Weight Status: Associations of the Restriction of Animal-Based Product Intake with Body-Mass-Index, Depressive Symptoms and Personality in the General Population

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity

Determinants of Willingness to Pay for Health Insurance in Germany—Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study)

Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis (n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about e240 which corresponds to ∼14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population

Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study

Background: Obesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association. Methods: We used data of 9599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education. Results: A substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC. Conclusions: Our investigation indicates an association between income and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions

Less Animal-Based Food, Better Weight Status: Associations of the Restriction of Animal-Based Product Intake with Body-Mass-Index, Depressive Symptoms and Personality in the General Population

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity

Less Animal-Based Food, Better Weight Status: Associations of the Restriction of Animal-Based Product Intake with Body-Mass-Index, Depressive Symptoms and Personality in the General Population

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity

Social factors and the prevalence of social isolation in a population-based adult cohort

Purpose!#!Social isolation has negative effects on physical and brain health across the lifespan. However, the prevalence of social isolation, specifically with regard to sociodemographic and socioeconomic factors, is not well known.!##!Methods!#!Database was the Leipzig population-based study of adults (LIFE-Adult Study, n = 10,000). The short form of the Lubben Social Network Scale (LSNS-6) was used to assess social isolation (cutoff &amp;lt; 12 points). Sampling weights were applied to account for differences in sampling fractions.!##!Results!#!Data were available for 9392 study participants; 51.6% were women, the mean age was 45.2 years (SD = 17.3). The prevalence of social isolation was 12.3% (95% CI 11.6-13.0) across ages 18-79 years. Social isolation was more prevalent in men (13.8%, 95% CI 12.8-14.8) compared to women (10.9%, 95% CI 10.0-11.8; [Formula: see text] (1) = 18.83, p &amp;lt; .001), and it showed an increase with increasing age from 5.4% (95% CI 4.7-6.0) in the youngest age group (18-39 years) to 21.7% (95% CI 19.5-24.0) in the oldest age group (70-79 years; [Formula: see text] (4) = 389.51, p &amp;lt; .001). Prevalence differed largely with regard to socioeconomic status (SES); showing lower prevalence in high SES (7.2%, 95% CI 6.0-8.4) and higher prevalence in low SES (18.6%, 95% CI 16.9-20.3; [Formula: see text] (2) = 115.78; p &amp;lt; .001).!##!Conclusion!#!More than one in ten individuals in the adult population reported social isolation, and prevalence varied strongly with regard to sociodemographic and socioeconomic factors. Social isolation was particularly frequent in disadvantaged socioeconomic groups. From a public health perspective, effective prevention of and intervention against social isolation should be a desired target as social isolation leads to poor health. Countermeasures should especially take into account the socioeconomic determinants of social isolation, applying a life-course perspective

Determinants of Willingness to Pay for Health Insurance in Germany—Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study)

Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis (n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about e240 which corresponds to ∼14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population

Determinants of Willingness to Pay for Health Insurance in Germany—Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study)

Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis (n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about e240 which corresponds to ∼14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population