Does Obesity Modify the Relationship between Exposure to Occupational Factors and Musculoskeletal Pain in Men? Results from the GAZEL Cohort Study

Objective: To analyze relationships between physical occupational exposures, post-retirement shoulder/knee pain, and obesity. Methods: 9 415 male participants (aged 63–73 in 2012) from the French GAZEL cohort answered self-administered questionnaires in 2006 and 2012. Occupational exposures retrospectively assessed in 2006 included arm elevation and squatting (never, <10 years, ≥10 years). “Severe” shoulder and knee pain were defined as ≥5 on an 8-point scale. BMI was self-reported. Results: Mean BMI was 26.59 kg/m2 +/−3.5 in 2012. Long-term occupational exposure to arm elevation and squatting predicted severe shoulder and knee pain after retirement. Obesity (BMI≥30 kg/m2) was a risk factor for severe shoulder pain (adjusted OR 1.28; 95% CI 1.03, 1.90). Overweight (adjusted OR 1.71; 1.28,2.29) and obesity (adjusted OR 3.21; 1.90,5.41) were risk factors for severe knee pain. In stratified models, associations between long-term squatting and severe knee pain varied by BMI. Conclusion: Obesity plays a role in relationships between occupational exposures and musculoskeletal pain. Further prospective studies should use BMI in analyses of musculoskeletal pain and occupational factors, and continue to clarify this relationship

Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region

BACKGROUND: Elevated levels of body mass index (BMI) and smoking are well established lifestyle risk factors for coronary heart disease (CHD) and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. METHODS: A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs) and 95% confidence intervals (CIs) for BMI by cigarette smoking status were estimated using Cox proportional hazard models. RESULTS: During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs) associated with a 2 kg/m2 higher BMI were 1.13 (1.10-1.17) in current smokers and 1.09 (1.06-1.11) in non-smokers (p-value for interaction=0.04). CONCLUSION: Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD.published_or_final_versio

Is the relationship between common mental disorder and adiposity bidirectional? Prospective analyses of a UK general population-based study

The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged >= 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 - 1.64; men, 1.05, 0.81 -1.38) and obese (women, 1.26, 0.82 - 1.94; men, OR: 2.10, 1.23 - 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 - 2.04) and severe (1.48, 1.09 - 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse

International collaborative project to compare and track the nutritional composition of fast foods

Background: Chronic diseases are the leading cause of premature death and disability in the world with over-nutrition a primary cause of diet-related ill health. Excess quantities of energy, saturated fat, sugar and salt derived from fast foods contribute importantly to this disease burden. Our objective is to collate and compare nutrient composition data for fast foods as a means of supporting improvements in product formulation. METHODS/DESIGN: Surveys of fast foods will be done in each participating country each year. Information on the nutrient composition for each product will be sought either through direct chemical analysis, from fast food companies, in-store materials or from company websites. Foods will be categorized into major groups for the primary analyses which will compare mean levels of saturated fat, sugar, sodium, energy and serving size at baseline and over time. Countries currently involved include Australia, New Zealand, France, UK, USA, India, Spain, China and Canada, with more anticipated to follow. DISCUSSION: This collaborative approach to the collation and sharing of data will enable low-cost tracking of fast food composition around the world. This project represents a significant step forward in the objective and transparent monitoring of industry and government commitments to improve the quality of fast foods.E Dunford is supported by a Sydney Medical School Foundation scholarship and B Neal by an Australian Research Council Future Fellowship.http://www.biomedcentral.com/1471-2458/12/559am201

Les habitudes alimentaires dans la cohorte Constances : équilibre perçu et adéquation aux recommandations nutritionnelles françaises

Objectives – The main objective of this study was to investigate the association between self-perceived diet andcompliance with nutritional guidelines from the French National Nutrition and Health Program (PNNS) based ondata from the French CONSTANCES cohort.Methods – The survey included 38,129 cases from CONSTANCES. A PNNS adequacy score was computed froma qualitative food frequency questionnaire after multiple imputations of partial non-responses. The question “Doyou think your diet is balanced?” measured self-perceived diet. We estimated linear regressions predicting theanswer to this question according to PNNS score after controlling for age, sex, education and the marital status.Results – Each additional point at the PNNS score increased perceived dietary balance (rated from 1 to 8) by0.23 [0.22-0.24]. After controlling for the PNNS score, men and women perceived their diet as equally balanced.The participants who declare a limited consumption of snacks and ready-prepared meals also perceived theirdiet as more balanced. These results after imputations of partial non-responses are not different from thoseobtained on the complete cases.Conclusion  – The PNNS score based on a qualitative food frequency questionnaire was significantly andpositively associated to self-perceived dietary balance. Dietary balance was also associated to other dimensionsof food habits, such as limiting snacking and ready-prepared meal consumption. Our results confirm that bothnutrition information campaigns and more comprehensive food policies and interventions are necessary inorder to facilitate the adoption of healthier food habits.Objectifs – L’objectif principal de cette étude était d’analyser les liens entre l’équilibre alimentaire perçu et lerespect des recommandations nutritionnelles selon le Programme national nutrition santé (PNNS), à partir desdonnées d’inclusion de la cohorte Constances.Méthodes – L’étude a inclus 38 129 participants à la cohorte Constances. Le respect des recommandations aété mesuré par un score PNNS construit d’après un fréquentiel alimentaire qualitatif, après imputation multipledes non-réponses partielles. La perception de l’alimentation a été mesurée par la question « Pensez-vous quevotre alimentation est équilibrée ? ». Des régressions linéaires ont été utilisées pour modéliser la relation entreperception de l’alimentation et score PNNS, avec ajustement sur les variables suivantes : âge, sexe, diplôme etsituation conjugale.Résultats – L’augmentation d’un point du score PNNS était associée à une augmentation de 0,23 [0,22-0,24]point de l’équilibre perçu (noté de 1 à 8). À score PNNS égal, l’équilibre perçu ne diffèrait pas significativementchez les hommes et chez les femmes. Les participants jugaient aussi leur alimentation plus équilibrée quand ilsconsommaient peu de plats préparés et de fast foods et peu de produits de grignotage. Après imputation desnon-réponses partielles, ces résultats ne diffèrent pas de ceux obtenus sur les cas complets.Conclusion – Le score PNNS mesuré d’après un questionnaire fréquentiel qualitatif était significativement etpositivement associé à l’équilibre alimentaire perçu. L’équilibre perçu était aussi positivement associé à d’autresdimensions des habitudes alimentaires, comme le fait de limiter sa consommation de produits de grignotageet de plats préparés. Nos résultats réaffirment la nécessité non seulement de campagnes d’information, maisaussi d’interventions et de politiques alimentaires plus globales pour faciliter l’adoption d’habitudes alimentairesplus conformes aux recommandations nutritionnelles

Detection of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans after systemic administration of Amoxicillin plus Metronidazole as an adjunct to non-surgical periodontal therapy: A Systematic Review and meta-analysis.

Objective: To evaluate the variations in the detection of Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after systemic administration of amoxicillin plus metronidazole in association with non-surgical periodontal therapy.Background: The adjunctive use of antibiotics has been advocated to improve the clinical outcomes of non-surgical periodontal therapy. However, no systematic review has investigated the microbiological benefit of this combination. Material and Methods: An electronic search was conducted up to December 2015. Randomized clinical trials comparing the number of patients testing positive for Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after non-surgical periodontal therapy with (test group) or without (control group) amoxicillin plus metronidazole were included. The difference between groups in the variation of positive patients was calculated using the inverse variance method with a random effects model.Results: The frequency of patients positive for Aggregatibacter actinomycetemcomitans was decreased by 30 % (p=0.002) and by 25 % (p=0.01) in the test group compared to the control group at 3-month and 6-month follow-up, respectively. Similar findings were observed when considering the frequency of patients positive for Porphyromonas gingivalis, with a reduction by 28 % (p<0.0001), 32% (p<0.0001) and 34% (p=0.03) in the test group compared to the control group at 3-month, 6-month and 12-month follow-up, respectively. Conclusion: The systemic administration of amoxicillin plus metronidazole as an adjunct to non-surgical periodontal therapy significantly decreased the number of patients positive for Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans compared with periodontal therapy alone or with a placebo

Obesity moderates the benefit of retirement on health: A 21-year prospective study in the GAZEL cohort

International audienceSelf-rated health and depressive symptoms have been shown to improve upon retirement. Participants with obesity might benefit more of retirement because of the extra work-related burden they are carrying. The present study aimed to investigate whether the association between retirement and health changes may depend upon obesity in the large French GAZEL occupational cohort during 21 years of follow-up. Methods: 17,655 men and women were included in the analyses. Self-rated health was measured on a scale from 1 to 8 with 8 being very bad. Depressive symptoms were measured at four time points by the CES-D score. Mixed models examined the association of self-rated health or depressive symptoms with time (i.e. from −10 years before to +10 years after retirement), retirement, body mass index (BMI), and their interactions. Results: Regardless of retirement, BMI was associated with poorer health. Positive BMI by time interactions showed a less favorable time course of both health indicators in the presence versus the absence of obesity (0.024 versus 0.014 and − 0.19 versus −0.07 points per year for self-rated health and depressive symptoms, respectively). However, negative BMI by retirement interactions showed that the improvement of health observed upon retirement was stronger in with the presence versus the absence of obesity (−0.4 versus −0.3 and − 2.42 versus −1.70 points for self-rated health and depressive symptoms, respectively). Conclusion: Improvement upon retirement was observed in the presence of obesity and was even higher than in the presence of normal weight and overweight

Cardiovascular effects of B-vitamins and/or N-3 fatty acids: The Su.Fol.Om3 trial

International audienceBackground: Mechanisms involved in coronary stenosis evolution are different than those involved in clinical events. Because of differential vascular effects, N-3 polyunsatured fatty acids (PUFA) and B vitamins could have differential effects on different types of cardiovascular clinical events in high-risk patients. Methods: We analyzed the effects of n-3 PUFA and of B vitamins on both coronary revascularization and on hard coronary events risks in a subgroup of the SU.FOL.OM3 trial, a randomized, double-blind, placebo-controlled secondary prevention trial. Data were analyzed according to the intention-to-treat principle, with the use of Cox proportional-hazards models. Results: After a mean follow-up of 4.2 +/- 1.0 years among the 1,863 participants with coronary heart disease, 163 coronary revascularizations were performed, and 95 patients experienced a hard coronary event. Neither treatment with n-3 PUFA, nor treatment with B vitamins was associated with any significant effect on the occurrence of hard coronary events. Allocation to n-3 PUFA was not associated with any significant effect on coronary revascularization. However, treatment with B vitamins was associated with a statistically significant 52% increase in the risk of coronary revascularization (multivariate HR: 1.52; 95% CI: [1.11-2.10]; p=0.01). Conclusions: Neither n-3 PUFA, nor B vitamins reduced the rates of hard coronary events and of coronary revascularization. Furthermore, B vitamins significantly increased the rate of coronary revascularization. Consistent with the findings of previous trials, our results do not support the routine use of dietary supplements containing n-3 PUFA and argue against using dietary supplements containing B-vitamins in coronary patients in secondary cardiovascular prevention. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Time of Bariatric Surgery and Hospitalization for SARS-CoV-2: a Nationwide Study

International audienc

Machine learning approach to assess the association between anthropometric, metabolic, and nutritional status and semen parameters

International audienceMany lifestyle factors, such as nutritional imbalance leading to obesity, metabolic disorders, and nutritional deficiency, have been identified as potential risk factors for male infertility. The aim of this study was to evaluate the relationship between semen parameters and anthropometric, metabolic and nutritional parameters. Relationship was first assessed individually, then after the application of a previously constructed and validated machine learning score that allows their combination. Anthropometric, metabolic, antioxidant, micronutrient, and sperm parameters from 75 men suffering from idiopathic infertility from four infertility centers in France (Jean-Verdier ART Center Hospital, Bondy; North Hospital ART Center, Saint-Étienne; Navarre Polyclinic ART Center, Pau; and Cochin Hospital ART Center, Paris) between September 2009 and December 2013 were collected. After assessing standard correlation analysis, a previously built machine learning model, providing a score ranging from 0 (the poorest) to 1 (the most favorable), was calculated for each man in the study cohort. This machine learning model, which separates infertile/fertile men with unexplained infertility on the basis of their bioclinical signature, provides a more holistic evaluation of the influence of the considered markers (anthropometric, metabolic, and oxidative status). We observed a significant correlation of some anthropometric, metabolic, and nutritional disorders with some sperm characteristics. Moreover, an unfavorable machine learning score was associated with a high level of sperm DNA fragmentation. Favorable anthropometric, metabolic, and oxidative patterns, which may reflect an appropriate lifestyle, appear to positively impact overall health, in particular reproductive function. This study, consistent with previous publications, suggests that beyond semen quality parameters, in an essential assessment of male fertility, other key factors should be taken into account. In this regard, the application of emerging artificial intelligence techniques may provide a unique opportunity to integrate all these parameters and deliver personalized care