Retirement is associated with a decrease in dietary quality.

Retirement has been associated with changes in dietary intake. We evaluated dietary intake and compliance to dietary guidelines after retirement in a population-based survey. Data from a prospective study conducted in Lausanne, Switzerland. Dietary intake was assessed using a validated food frequency questionnaire in 2009-2012 (first survey) and 2014-2017 (second survey). Total energy intake (TEI), macro and micronutrients, foods, dietary scores and compliance to dietary guidelines were assessed. Three approaches were used comparing changes in dietary intake: 1) before and after retiring (paired analysis); 2) in participants who retired with gender- and age-matched participants who did not retire (two-group comparison), and 3) in participants who retired, who did not retire or who were retired at both surveys (analysis of variance). Using the first approach, newly retired participants (n = 215) increased their intake of total (median and [interquartile range]: 15.2 [13.7-17.5] vs. 14.9 [13.3-17.1] % of TEI) and animal (11.1 [9.1-13.0] vs. 10.0 [8.5-12.6] %TEI) protein; total (35.8 [32.1-40.7] vs. 34.6 [30.0-39.1] %TEI), saturated and monounsaturated fat; alcohol; cholesterol; vitamin D and fish, and decreased their intake of vegetable protein; total carbohydrates and monosaccharides, and of the Mediterranean diet score. Those findings were confirmed for total and saturated fat, alcohol, total carbohydrates and monosaccharides; vitamin D and fish intake, and of the Mediterranean diet score in the other two approaches. Retirement was associated with an unhealthier dietary intake

Intergenerational differences in cardiovascular risk factor levels in Switzerland

Background: There is little information regarding cardiovascular risk factor (CV RF) trends in Switzerland. We aimed at assessing generation differences in CV RFs by comparing CV RFs levels within selected age groups separated by a 20 year time lag. Design: Two population-based surveys. Methods: Data from the Monica (1984-1986) and Colaus (2004-2006) surveys were used. Analyses were stratified by sex and age groups (35-44, 45-54, 55-64 and 65-75 years). Results: No changes were found for BMI levels and status between surveys: in men, 26}3, 26}3, 27}4 and 27}4 kg/m2 for age groups 35-44, 45-54, 55-64 and 65-74, respectively, in MONICA, vs. 26}4, 26}4, 27}4 and 28}4 kg/m2 in COLAUS, p=NS, in women: 24}4, 26}4, 26}4 and 26}5 kg/m2 in MONICA, vs. 24}5, 25}5, 26}5 and 26}5 kg/m2 in COLAUS, p=NS. Similar results were found after adjusting for education. Smoking prevalence increased in men: 28, 30, 22 and 15% for age groups 35-44, 45-54, 55-64 and 65-74, respectively, in MONICA, vs. 35, 29, 28 and 21% in COLAUS. In women, changes differed according to age: 39, 26, 16 and 18%, in MONICA vs. 28, 30, 22 and 15% in COLAUS. Blood pressure decreased in the younger age groups and remained constant in the older ones: in men, systolic blood pressure was 129}15, 133}16, 138}18 and 143}21 mm Hg in MONICA, vs. 125}12, 129}15, 137}16 and 144}19 mm Hg in COLAUS, p<0.01. Similar findings were obtained after adjusting for education. Prevalence of hypertension increased, due to an increase in the prevalence of treated subjects, in men : 4, 8, 16 and 19% for age groups 35-44, 45-54, 55-64 and 65-74, respectively, in MONICA, vs. 5, 14, 31 and 46% in COLAUS, p<0.05; in women: 2, 10, 16, and 24% in MONICA, vs. 4, 12, 24, and 34% in COLAUS, p<0.05. This increase was stronger in men: 14, 17, 23 and 31% for age groups 35-44, 45-54, 55-64 and 65-74, respectively, in MONICA vs. 10, 21, 41 and 55% in COLAUS, p<0.01 and smaller in women: 6, 15, 24 and 44% in MONICA vs. 6, 16, 30 and 42% in COLAUS, p=NS. Similar findings were obtained after adjusting for education. Conclusion: With the exception of BMI, the newer Swiss generations appear to have a worse CV profile than the older generations. This is especially true regarding smoking and hypertension

Prevalence and determinants of weight misperception in an urban Swiss population.

Weight misperception precludes effective management of pre-obesity and obesity, but little is known regarding its status in the Swiss population. Our study aimed to assess the prevalence and determinants of weight over- and underestimation in an adult urban Swiss population. Cross-sectional study conducted between 2009 and 2012 in the city of Lausanne. Height and weight were measured using standardised procedures. Weight perception and other socio-demographic variables were collected through questionnaires. Data from 4284 participants (2261 women, 57.5 ± 10.4 years) were analysed. Overall, almost one-fifth (18%) of participants underestimated their weight, while only 7% overestimated it. One quarter of women and half of men with overweight underestimated their weight; the corresponding values for obese subjects were 7% and 10%. Multivariate analysis showed male gender (odds ratio [OR] 3.09, 95% confidence interval [CI] 2.54-3.76), increasing age or body mass index (p-value for trend <0.001), being born in Portugal (OR 2.10, 95% CI 1.42-3.10), low education (OR 1.90, 95% CI 1.47-2.47), and absence of diagnosis of pre-obesity or obesity by the doctor (OR 5.61, 95% CI 4.51-7.00) to be associated with weight underestimation. Overestimation was significantly higher in women (19.6%) than in men (8.5%). Weight overestimation was negatively associated with male gender (OR 0.29, 95% CI 0.22-0.39), increasing age (p-value for trend <0.001), being born in Portugal (OR 0.37, 95% CI 0.16-0.87) and positively associated with absence of diagnosis (OR 3.11, 95% CI 2.23-4.34). Almost one quarter of the Swiss population aged 40 to 80 has weight misperception, underestimation being over twice as frequent as overestimation. Adequate diagnosis of overweight or obesity might be the best deterrent against weight misperception

Factors Associated with Readmission of Patients with Congenital Heart Disease in a Swiss University Hospital.

Congenital heart defects (CHD) lead to extensive use of healthcare resources. Still, there is little information available regarding readmission rates or associated factors. We sought to evaluate readmission rates and their determinants among patients with CHD hospitalized in a Swiss university hospital. We conducted a retrospective study using data from all non-adult (<18 years) patients hospitalized between 2002 and 2014 at the University Hospital of Lausanne with an International Classification of Diseases version 10 code Q20-Q25. Overall, 996 patients (460 girls, 332 undergoing surgery, mean age 2.7 years) were assessed, 96 of whom (9.6%) were readmitted within 30 days after discharge. Among the 96 readmissions, 83 (86.5%) were related to the CHD. Median time to readmission was 10 days (interquartile range 6-20) and median length of readmission was 12 days (interquartile range 6-20). After multivariate adjustment, foreign nationality, greater distance to hospital and length of index hospitalization <14 days predisposed to readmission. Patients who underwent surgery were less likely to be readmitted (8.7%). We conclude that readmissions were frequent, almost 1 in 10 patients, and associated with several socio-clinical factors. Providing patients who live far from hospital with specialized care closer to home may help reduce the rate of readmission

Impact of COVID-19 pandemic on cardiovascular diseases hospitalisation, management and mortality in Switzerland.

COVID-19 pandemic led to a reduction in hospital admissions and intervention for other diseases in many countries. We aimed to assess the effect of COVID-19 pandemic on cardiovascular disease (CVD) hospitalisations, management and mortality in Switzerland. Swiss hospital discharge and mortality data for period 2017-2020. CVD hospitalisations, CVD interventions and CVD mortality were assessed before (2017-2019) and during (2020) the pandemic. Expected numbers of admissions, interventions and deaths for 2020 were computed using simple linear regression model. Compared with 2017-2019, 2020 was characterised by a reduction of CVD admissions in age groups 65-84 and ≥85 by approximately 3700 and 1700 cases, respectively, and by an increase in the percentage of admissions with a Charlson index >8. The total number of CVD-related deaths decreased from 21 042 in 2017 to 19 901 in 2019, and increased to 20 511 in 2020, with an estimated excess of 1139 deaths. This increase was due to out-of-hospital deaths (+1342), while the number of in-hospital deaths decreased from 5030 in 2019 to 4796 in 2020, which concerned mostly subjects aged ≥85 years. The total number of admissions with cardiovascular interventions increased from 55 181 in 2017 to 57 864 in 2019, and decreased in 2020, with an estimated reduction of 4414 admissions; percutaneous transluminal coronary angioplasty (PTCA) was the exception, as the number and percentage of emergency admissions with PTCA increased. The preventive measures applied against COVID-19 inverted the seasonal pattern of CVD admissions, the highest number of admissions being found in summer and the lowest in winter. The COVID-19 pandemic led to a reduction in CVD hospital admissions, planned CVD interventions, an increase in total and out-of-hospital CVD deaths and a change in seasonal patterns

Angiotensin receptor blockers are not associated with reduced inflammatory markers in the general population.

OBJECTIVE: Angiotensin receptor blockers (ARBs) have been suggested to reduce inflammation in randomized controlled trials. We assessed the association between ARBs and inflammatory markers in a general population setting. METHODS: This is a population-based prospective study conducted in Lausanne, Switzerland. Baseline data from 933 participants on antihypertensive drugs (424 on ARBs) was collected in 2003-2006. Follow-up data from 1120 participants (572 on ARBs) was collected in 2009-2012. C-reactive protein (CRP), interleukins 1β and 6 and tumor necrosis factor alpha (TNF-α) were assessed and categorized in quartiles. RESULTS: At baseline, no differences were found between participants taking or not taking ARBs for all inflammatory markers studied, and this association persisted after multivariate adjustment: odds ratios (ORs) and (95% confidence interval) for being in the highest quartile of interleukin-1β, interleukin-6, TNF-α and CRP for participants on ARB compared to participants not on ARB were 1.23 (0.89-1.70), 1.26 (0.93-1.70), 1.14 (0.85-1.53) and 1.27 (0.96-1.69) respectively (P > 0.05). These findings were further replicated in the follow-up study: OR and (95% CI) of 1.10 (0.78-1.55), 0.87 (0.64-1.19), 0.83 (0.61-1.14) and 0.91 (0.68-1.22) for interleukin-1β, interleukin-6, TNF-α and CRP respectively (P > 0.05). Finally, no effect of ARBs was found when comparing participants who received ARBs throughout the 5.4-year follow-up with participants on other antihypertensive drugs: OR and (95% CI) of 0.93 (0.61-1.42), 0.80 (0.54-1.17), 0.86 (0.59-1.25) and 0.95 (0.67-1.35) for interleukin-1β, interleukin-6, TNF-α and CRP respectively (P > 0.05). CONCLUSION: ARBs are not associated with reduced levels of inflammatory markers in the general population

No association between grip strength and cardiovascular risk: The CoLaus population-based study.

Decreased grip strength (GS) is predictive of cardiovascular (CV) disease but whether it improves CV risk prediction has not been evaluated. We assessed the predictive value of low GS on incident CV events and overall mortality taking into account CV risk equations in a population-based study from Switzerland. 2707 adults (54.8% women, age range 50-75years) were followed for a median time of 5.4years. GS was assessed using a hydraulic hand dynamometer. CV absolute risk at baseline was assessed using recalibrated SCORE, Framingham and PROCAM risk equations. Incident CV events were adjudicated by an independent committee. 160 deaths and 188 incident CV events occurred during follow-up. On bivariate analysis, low GS was associated with increased incident CV events: hazard ratio (HR) and (95% confidence interval) 1.76 (1.13-2.76), p<0.01 but not with overall mortality: HR=1.51 (0.94-2.45), p=0.09. The association between low GS and incident CV events disappeared after adjusting for baseline CV risk: HR=1.23 (0.79-1.94), p=0.36; 1.34 (0.86-2.10), p=0.20 and 1.47 (0.94-2.31), p=0.09 after adjusting for SCORE, Framingham and PROCAM scores, respectively. Low GS is not predictive of incident CV events when taking into account CV absolute risk

Of weekend warriors and couch potatoes: Socio-economic determinants of physical activity in Swiss middle-aged adults.

Determinants of the interplay between physical activity (PA) and sedentary (SE) status are poorly known. We assessed the socio-economic determinants of PA and SE behaviours and patterns in a population-based study (The CoLaus study, Lausanne, Switzerland, 2014-2017). 2229 adults (51.8% women, age range 45-86 years) had PA and SE levels measured for 14 days using a wrist-worn accelerometer. Four activity behaviours: (1) 'Couch potato': low PA & high SE; (2) 'Light mover': low PA & low SE; (3) 'Sedentary exerciser': high PA & high SE, and (4) 'Busy bee': high PA & low SE; and three activity patterns: (1) 'Inactive', (2) 'Weekend warrior', and (3) 'Regularly active' were defined. Employment, household income and educational level were collected by questionnaire. For activity behaviours, relative to 'Couch potatoes', multivariate analysis showed that being employed and having a low educational level were positively associated with 'Light movers': relative risk ratios and (95% confidence interval): 1.54 (1.00-2.37) and 1.73 (1.11-2.69), respectively, and also with 'Busy bees': 1.49 (1.09-2.04) and 1.71 (1.26-2.32), respectively. High household income was negatively associated with 'Light movers': 0.58 (0.34-0.97) and positively with 'Sedentary exercisers': 1.85 (1.10-3.10). For activity patterns, relative to 'Inactives', being employed and having a high household income were positively associated with 'Weekend warriors': 1.78 (1.26-2.50) and 1.59 (1.07-2.36), respectively, while having a low educational level was positively associated with 'Regularly actives': 1.76 (1.32-2.34). Employment, educational level and household income are significantly but differently associated with activity behaviours and patterns

Differing trends in the association between obesity and self-reported health in Portugal and Switzerland. Data from national health surveys 1992-2007.

The escalating prevalence of obesity might prompt obese subjects to consider themselves as normal, as this condition is gradually becoming as frequent as normal weight. In this study, we aimed to assess the trends in the associations between obesity and self-rated health in two countries. Data from the Portuguese (years 1995-6, 1998-6 and 2005-6) and Swiss (1992-3, 1997, 2002 and 2007) National Health Surveys were used, corresponding to more than 130,000 adults (64,793 for Portugal and 65,829 for Switzerland). Body mass index and self-rated health were derived from self-reported data. Obesity levels were higher in Portugal (17.5% in 2005-6 vs. 8.9% in 2007 in Switzerland, p < 0.001) and increased in both countries. The prevalence of participants rating their health as "bad" or "very bad" was higher in Portugal than in Switzerland (21.8% in 2005-6 vs 3.9% in 2007, p < 0.001). In both countries, obese participants rated more frequently their health as "bad" or "very bad" than participants with regular weight. In Switzerland, the prevalence of "bad" or "very bad" rates among obese participants, increased from 6.5% in 1992-3 to 9.8% in 2007, while in Portugal it decreased from 41.3% to 32.3%. After multivariate adjustment, the odds ratio (OR) of stating one self's health as "bad" or "very bad" among obese relative to normal weight participants, almost doubled in Switzerland: from 1.38 (95% confidence interval, CI: 1.01-1.87) in 1992-3 to 2.64 (95% CI: 2.14-3.26) in 2007, and similar findings were obtained after sample weighting. Conversely, no such trend was found in Portugal: 1.35 (95% CI: 1.23-1.48) in 1995-6 and 1.52 (95% CI: 1.37-1.70) in 2005-6. Obesity is increasing in Switzerland and Portugal. Obesity is increasingly associated with poorer self-health ratings in Switzerland but not in Portugal

Not as bad as you think: a comparison of the nutrient content of best price and brand name food products in Switzerland.

Several studies have shown that low-cost foods have an equivalent nutrient composition compared to high-cost foods, but such information is lacking in Switzerland. Thus, we compared the caloric and nutrient content of "best price" (BPF) and brand name foods (BNF) in Switzerland using the version 5.0 (April 2015) of the Swiss Food and Nutrient composition database. Over 4000 processed food items were included and 26 food categories were compared regarding total energy, protein, fat and carbohydrates, saturated fatty acids, sugar, fiber and sodium. BPF, namely core food categories like Bread, Red meat, White meat and Fish products, were 42%, 39%, 42% and 46% less expensive than their BNF equivalents, respectively. No differences were found between BPF and BNF regarding total energy and protein, fat and carbohydrates for most food categories. In the Cheese category, BPF had a lower caloric content than BNF [Median (interquartile range, IQR): 307 (249-355) vs. 365 (308-395) kcal/100 g, respectively, p < 0.001]; BPF also had lower fat and saturated fatty acid content but higher carbohydrate content than BNF (both p < 0.01). In the Creams and puddings group, BPF had lower fat 1.3 (0.9-1.7) vs. 6.0 (3.5-11.0) g/100 g and saturated fatty acid 0.6 (0.6-0.8) vs. 2.9 (2.3-6.0) g/100 g content than BNF (both p < 0.005). In the Tinned fruits and vegetables group, BPF had lower sodium content than BNF: 175 (0-330) vs. 370 (150-600) mg/100 g, p = 0.006. BPF might be a reasonable and eventually healthier alternative of BNF for economically deprived people in Switzerland