119 research outputs found
Sitting time and mortality in older adults with disability: A national cohort study
The progressive aging of the population has increased the number of older adults with disabilities. Regular physical activity has shown to improve health among these individuals, but the effects of sedentary behavior are mostly unknown. Thus, this study examined the association between sitting time and mortality in older adults with disability. Methods Prospective cohort of 2470 people aged â„60 years. In 2000â2011, the study participants reported their sitting time and physical activity levels and were subsequently followed up through 2011 to ascertain mortality. Results During an average follow-up of 8.7 years, 982 deaths occurred. Compared with people who spent seated <4 hours/d, the hazard ratio (95% confidence interval) of mortality was 1.27 (1.07â1.51) in those seated during 4â6 hours/d and 1.55 (1.29â1.87) in those seated for >6 hours/d. Each increment of 1 hour/day in sitting time was linked to a 7% increase in mortality. Compared with active individuals who spent seated <4 hours/day, those who were inactive and spent seated >6 hours/d showed the highest mortality (hazard ratio 1.82, 95% confidence interval 1.37â2.42). Conclusions Sitting time is associated with higher mortality in older people with disability. Interventions combining the reduction of sedentary behavior with increased physical activity should be developed and evaluated in this group of populationThis work was supported by FIS grant 12/1166 (Instituto de Salud Carlos IIII and FEDER/FSE), MINECO I+D+i grant DEP2013-47786-R, FP7-HEALTH-2012-Proposal No. 305483-2 (FRAILOMIC Initiative), and by the Catedra UAM de EpidemiologĂa y Control del Riesgo Cardiovascula
Habitual yogurt consumption and health-related quality of life: A prospective cohort study
BACKGROUND:
Health-related quality of life (HRQL) is a global indicator of perceived health status, which includes physical and mental domains. Several biological mechanisms might support an association between consumption of yogurt and better HRQL.
OBJECTIVE:
Our aim was to assess the association between habitual yogurt consumption and HRQL in the general adult population.
DESIGN:
We conducted a prospective study with 4,445 individuals aged 18 years and older who were recruited in 2008 to 2010 and were followed up to 2012. Habitual yogurt consumption was assessed at baseline with a validated diet history. HRQL was measured with the Physical Composite Summary and the Mental Composite Summary of the Spanish version of the SF-12 Health Survey. The analysis of the association between baseline yogurt consumption and HRQL at 2012 was performed with linear regression and adjusted for the main confounders, including baseline HRQL.
RESULTS:
Mean follow-up was 3.5 years (standard deviation=0.6 years). Compared with nonconsumers of yogurt, the Physical Composite Summary scores were similar in habitual consumers of â€6 servings/week (ÎČ=.40; P=0.20) and in consumers of â„1 serving/day (ÎČ=.25; P=0.45). A suggestion of tendency toward a lower Mental Composite Summary score was found among daily yogurt consumers (ÎČ=-.65; P=0.09; P for trend across categories=0.07). Results were similar among individuals without morbidity, never smokers, and individuals with higher adherence to the Mediterranean diet.
CONCLUSIONS:
Habitual yogurt consumption did not show an association with improved HRQL
Exposure to dietary polychlorinated biphenyls and dioxins, and its relationship with subclinical coronary atherosclerosis: The Aragon workers' health study
Background: Experimental evidence has revealed that exposure to polychlorinated biphenyls (PCBs) and dioxins
directly impairs endothelial function and induces atherosclerosis progression. In the general population, despite
a small number of recent studies finding a link between PCBs, and stroke and myocardial infraction, the association
with early coronary atherosclerosis has not been examined yet.
Objective: To examine whether dietary exposure to PCBs and dioxins is associated with subclinical coronary
atherosclerosis in a middle-aged men.
Design: Cross-sectional analysis comprising 1844 men in their 50 s and free of cardiovascular disease, who
participated in the Aragon Workers' Health Study (AWHS). Individual dietary exposures to PCBs and dioxins
were estimated by the contaminantâs concentration in food coupled with the corresponding consumption and
then participants were classified into quartiles of consumption. Coronary artery calcium score (CACS) was assessed
by computerized tomography. We conducted ordered logistic regressions to estimate the odds ratio (OR)
and 95% confidence intervals (CIs) for progression to the categories of more coronary artery calcium, adjusting
for potential confounders.
Results: Among the participants, coronary calcium was not shown in 60.1% (n=1108), 29.8% had a CACS > 0
and<100 (n=550), and the remaining 10.1% (n=186) had a CACSâ„100. Compared with those in the first
quartile of PCBs exposure, those in the fourth one had an increased odds for having coronary calcium (OR 2.02,
95% CI [1.18, 3.47], p trend 0.019) and for having progressed to categories of more intense calcification (OR
2.03, 95% CI [1.21, 3.40], p trend 0.012). However, no association was found between dietary dioxins exposure
and prevalent coronary artery calcium.
Conclusions: In this general male population, dietary exposure to PCBs, but not to dioxins, was associated with a
higher prevalence of coronary calcium and to more intense subclinical coronary atherosclerosis. PCBs exposure
seems to increase the risk of coronary disease in men from the very early stagesThis work was supported by the Instituto Aragonés de Ciencias de la
Salud (I+CS) of the regional Government of AragĂłn, the National
Center for Cardiovascular Research (CNIC) of the Instituto de Salud
Carlos III, and Opel Spain. This study was also partially supported by
grants: PI17/1709 (State Secretary of R+D and FEDER/FSE), and
Excellence Integrated Projects in Health Research Institutes PIE16/
00022 (State Secretary of R+D and FEDER/FSE), the ATHLOS project
(EU H2020-Project ID: 635316), CIBERCV and CIBERESP from the
Instituto de Salud Carlos III. Madrid, Spain. We also acknowledge the
Juan de la Cierva-formaciĂłn (Spanish State Research Agency) for
funding grant to Carolina Donat-Varga
The inflammatory potential of diet is related to incident frailty and slow walking in older adults
Background: Certain foods and dietary patterns have been associated with both inflammation and frailty. As chronic inflammation may play a role in frailty and disability, we examined the association of the inflammatory potential of diet with these outcomes.
Methods: Data were taken from 1948 community-dwelling individuals =60 years old from the Seniors-ENRICA cohort, who were recruited in 2008â2010 and followed-up through 2012. Baseline diet data, obtained with a validated diet history, was used to calculate Shivappa's Dietary Inflammatory Index (DII), an âa prioriâ pattern score which is based on known associations of foods and nutrients with inflammation, and Tabung's Empirical Dietary Inflammatory Index (EDII), an âa posterioriâ pattern score which was statistically derived from an epidemiological study. At follow-up, incident frailty was assessed with Fried's criteria, and incident limitation in instrumental activities of daily living (IADL) with the Lawton-Brody index. Statistical analyses were performed with logistic regression, and adjusted for the main confounders.
Results: Compared with individuals in the lowest tertile of DII, those in the highest tertile showed higher risk of frailty (odds ratio [OR] 2.48; 95% confidence interval [CI]: 1.42, 4.44, p-trend = 0.001) and IADL disability (OR: 1.96; 95% CI: 1.03, 3.86, p-trend = 0.035). By contrast, EDII did not show an association with these outcomes. The DII score was associated with slow gait speed, both as a low score in the Short Physical Performance Battery test (OR: 1.82; 95% CI: 1.27, 2.62, p-trend = 0.001) and as a positive Fried's criterion (OR: 1.64; 95% CI: 1.08, 2.51, p-trend = 0.021), which use different thresholds.
Conclusions: DII predicted frailty and IADL while EDII did not. DII is able to measure diet healthiness in terms of physical decline in addition to avoidance of inflammation
The Southern European Atlantic Diet is associated with lower concentrations of markers of coronary risk
Objective: The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and Galicia, a region in northwest Spain. The SEAD has been associated with a lower risk of non-fatal acute myocardial infarction, but the mechanisms of this association have not yet been investigated. Thus, we examined the association between the SEAD and numerous biomarkers of coronary risk, blood pressure and anthropometrics.
Methods: Cross-sectional study conducted in 2008â2010 among 10,231 individuals representative of the population aged 18 years and older in Spain. Diet was assessed with a validated computerized diet history. SEAD adherence was measured with an index including 9 food components (fresh fish, cod, red meat and pork products, dairy products, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine), which ranges from 0 (lowest adherence) to 9 (highest adherence). C-reactive protein, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose, glycated hemoglobin, insulin, leptin, fibrinogen, were determined in 12-h fasting blood samples, while creatinine and urine albumin were determined in urine.
Results: Mean SEAD score was 2.9 points (inter-quartile range 2â4 points). Higher SEAD adherence was associated with a lower level of plasma C-reactive protein (adjusted difference in geometric means between the highest and lowest SEAD quartiles â0.2 mg/l; p for trend <0.001), plasma triglycerides (â3.4 mg/dl; p for trend 0.012), insulin (â0.5 mU/l; p for trend <0.001), HOMA-IR (â0.12; p for trend <0.001), urine albumin (â0.8 mg/l; p for trend <0.001), urine albumin-creatinine ratio (â0.3 mg/g creatinine; p for trend <0.034), and systolic blood pressure (â1.6 mm Hg; p for trend <0.001).
Conclusions: This study identifies possible mediators of the effect of SEAD on myocardial infarction, because SEAD is associated with a lower concentration of markers of inflammation and with reduced triglycerides, insulin, insulin resistance, and systolic blood pressure
Repositioning of the global epicentre of non-optimal cholesterol
ArtĂculo con numerosos autores, sĂłlo se mencionan el primero, los de la UAM y el grupo colectivoHigh 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 cholesterolâwhich is a marker of cardiovascular riskâ
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 millionâ4.2 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
personal interventions to improve nutrition and enhance access to treatment
throughout the world.This study was funded by a Wellcome Trust (Biomedical Resource & Multi-User Equipment grant 01506/Z/13/Z) and the British Heart Foundation (Centre of Research Excellence grant RE/18/4/34215). C.T. was supported by a Wellcome Trust Research Training Fellowship (203616/Z/16/Z
Rationale of the association between Mediterranean diet and the risk of frailty in older adults and systematic review and meta-analysis
Frailty is a geriatric syndrome whose frequency is increasing in parallel with population aging and is of great interest due to its dire consequences: increased disability, hospitalizations, falls and fractures, institutionalization, and mortality. Frailty is multifactorial but nutritional factors, which are modifiable, play a crucial role in its pathogenesis. Epidemiologic evidence supports that high-quality dietary patterns can prevent, delay or even reverse the occurrence of frailty. In order to add new knowledge bridging the gap as the main purpose of the present article we performed a comprehensive review of the rationale behind the association of MedDiet with frailty and a systematic review and meta-analysis updating the latest ones published in 2018 specifically examining the relationship of Mediterranean diet (MedDiet) and incident frailty. Adding the updated information, our results confirmed a robust association of a higher adherence to MedDiet with reduced incident frailty. Key components of the MedDiet, i.e., abundant consumption of vegetables and fruit as well as the use of olive oil as the main source of fat, all of which have been associated with a lower incidence of frailty, may help explain the observed benefit. Future well-designed and sufficiently large intervention studies are needed to confirm the encouraging findings of the current observational evidence. Meanwhile, based on the existing evidence, the promotion of MedDiet, a high-quality dietary pattern, adapted to the conditions and traditions of each region, and considering lifelong and person-tailored strategies, is an open opportunity to reduced incident frailty. This could also help counteract the worrying trend towards the spread of unhealthy eating and lifestyle models such as those of Western diets that greatly contribute to the genesis of chronic non-communicable diseases and disability
Smoking Status, Changes in Smoking Status and Health-Related Quality of Life: Findings from the SUN (âSeguimiento Universidad de Navarraâ) Cohort
We aimed to evaluate the association between smoking, changes in smoking, and quality of life in a cohort of Spanish university graduates. Smoking habits were self-reported at baseline and four years later. Quality of life was assessed using the Short Form-36 (SF-36) at year 4. Statistical differences in SF-36 scores between groups were determined using ANCOVA with age and sex as covariates. Out of 5,234 eligible participants over 2000â2006, there were 2,639 non-smoker participants, 1,419 ex-smokers, and 1,048 smokers. Within the previous four years, 435 participants became recent quitters and 205 starters. Comparing smoking and health status in year 4, non-smokers showed better scores than the other categories of ever smoking in all dimensions except in the vitality scale value, which was similar in non-smokers and in those smoking less than 15 cigarettes/day. Comparing changes in smoking and health in year 4, continuing smokers had statistically significant worse scores than non-smokers in general health, social functioning, role-emotional and mental health, whereas recent quitters showed statistically significant improvements in role-emotional and mental health over those who had continued smoking or those who became smokers. Our findings support a dose-response relationship between cigarette consumption and a worse quality of life in general and mental health in particular. They also support that changes in smoking have an impact on health
Predictors and moderators of quality of life in caregivers of amputee patients by type 2 diabetes
BackgroundThe amputation of a foot or a leg is one of the complications caused by diabetes that creates fear. After the amputation, the patient becomes dependent on a caregiver, who is often not prepared for this new phase of life. Knowing the factors that influence care delivery in caregivers of amputee type 2 diabetes patients is important from an heuristic point of view, since very few studies have focused on this population.ObjectivesThis study analysed the predictors and moderators of quality of life, in caregivers of amputee patients due to type 2 diabetes.MethodsThis study has a cross-sectional design. All ethical standards were followed in the conduct of this study. The sample comprised 101 caregivers who answered the following instruments: Carer's Assessment of Managing Index, Burden Assessment Scale, Depression Anxiety Stress Scales, Revised Impact of Events Scale, Family Assessment Device, Family Disruption from Illness Scale and the Short Form Health Survey-36.ResultsThe practice of physical activity, lower burden, better family functioning and less traumatic symptoms were predictors of better mental quality of life. Having no chronic disease and less physical symptoms predicted better physical quality of life. Duration of care moderated the relationship between traumatic symptoms and mental quality of life, but not with physical quality of life. Receiving help in caregiving moderated the relationship between traumatic symptoms and mental quality of life. The limitations of this study include the exclusive use of self-report instruments and the fact that the caregivers who have participated in this study were those who accompanied the patient to the hospital.ConclusionIn order to promote physical quality of life, future intervention programmes should consider the presence of chronic disease in the caregiver and the duration of care, as well as the caregivers' physical symptoms.- This study was supported by a scholarship from the Coordination Foundation for the Improvement of Higher Education Personnel/Full Doctoral Program Abroad Financed by CAPES - Brazil (reference number 1010-14)
Low Rates of Both Lipid-Lowering Therapy Use and Achievement of Low-Density Lipoprotein Cholesterol Targets in Individuals at High-Risk for Cardiovascular Disease across Europe
Aims
To analyse the treatment and control of dyslipidaemia in patients at high and very high cardiovascular
risk being treated for the primary prevention of cardiovascular disease (CVD) in
Europe.
Methods and Results
Data were assessed from the European Study on Cardiovascular Risk Prevention and Management
in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336),
which included a randomly sampled population of primary CVD prevention patients from 12
European countries (n = 7641). Patientsâ 10-year risk of CVD-related mortality was calculated
using the Systematic Coronary Risk Evaluation (SCORE) algorithm, identifying 5019
patients at high cardiovascular risk (SCORE 5% and/or receiving lipid-lowering therapy),
and 2970 patients at very high cardiovascular risk (SCORE 10% or with diabetes
mellitus). Among high-risk individuals, 65.3% were receiving lipid-lowering therapy, and
61.3% of treated patients had uncontrolled low-density lipoprotein cholesterol (LDL-C)
levels ( 2.5 mmol/L). For very-high-risk patients (uncontrolled LDL-C levels defined as
1.8 mmol/L) these figures were 49.5% and 82.9%, respectively. Excess 10-year risk of
CVD-related mortality (according to SCORE) attributable to lack of control of dyslipidaemia
was estimated to be 0.72%and 1.61% among high-risk and very-high-risk patients, respectively.
Among high-risk individuals with uncontrolled LDL-C levels, only 8.7% were receiving
a high-intensity statin (atorvastatin 40 mg/day or rosuvastatin 20 mg/day). Among veryhigh-
risk patients, this figure was 8.4%.
Conclusions
There is a considerable opportunity for improvement in rates of lipid-lowering therapy use
and achievement of lipid-level targets in high-risk and very-high-risk patients being treated
for primary CVD prevention in EuropeWriting support was provided by Oxford
PharmaGenesis Ltd, Oxford, UK, and was
funded by AstraZenec
- âŠ