Impact of obesity on trends in life expectancy among different European countries, 1975-2012

Background During the last 20 years, a threefold increase in obesity prevalence has occurred in Europe, which is likely to affect trends in life expectancy. Previous studies on the impact of obesity on populations’ life expectancy focused on the United States or only provided estimates for a single year. We assessed the impact of obesity on life expectancy for 30 European national populations over the period 1975 to 2012. Methods We calculated obesity-attributable mortality fractions by applying the weighted sum method to obesity prevalence data (NCD Risk Factor Collaboration, 2016) and age and sex specific European RRs (DYNAMO). We estimated potential gains in life expectancy (PGLE) by eliminating obesity attributable mortality using associated single decrement life tables. All-cause mortality and exposure data came from the Human Mortality Database. Results In the 30 European countries studied, the PGLE due to obesity in 2012 ranged from 0.86 to 1.73 years among men, and from 0.66 to 1.54 years among women. In all studied European countries, the PGLE increased over time, from average levels of 0.48 (men) and 0.65 (women) years in 1975, to average levels of 1.23 (men) and 1.00 (women) years in 2012. Time trends in PGLE ranged from an annual increase of 2.63 to 8.76 percent among men, and from 0.09 to 5.99 percent among women. In some countries (Denmark, Switzerland, women in Eastern European countries) the increase is leveling off. Conclusions The impact of obesity on life expectancy is increasing over time in Europe, especially among men. The leveling off as observed in some western European countries could potentially point to successful anti-obesity public health initiatives. Key messages: Important differences in the impact of obesity on life expectancy between European countries exist. Although the effect of obesity on life expectancy is generally increasing over time in Europe, some European countries witnessed a leveling off

Socioeconomic inequalities in physiological risk biomarkers and the role of lifestyles among Russians aged 35-69 years.

BACKGROUND: Socioeconomic inequalities in cardiovascular (CVD) health outcomes are well documented. While Russia has one of the highest levels of CVD mortality in the world, the literature on contemporary socio-economic inequalities in biomarker CVD risk factors is sparse. This paper aims to assess the extent and the direction of SEP inequalities in established physiological CVD risk biomarkers, and to explore the role of lifestyle factors in explaining SEP inequalities in physiological CVD risk biomarkers. METHODS: We used cross-sectional data from a general population-based survey of Russians aged 35-69 years living in two cities (n = 4540, Know Your Heart study 2015-18). Logistic models were used to assess the associations between raised physiological risk biomarkers levels (blood pressure levels, cholesterol levels, triglycerides, HbA1C, and C-reactive protein) and socioeconomic position (SEP) (education and household financial constraints) adjusting for age, obesity, smoking, alcohol and health-care seeking behavior. RESULTS: High education was negatively associated with a raised risk of blood pressure (systolic and diastolic) and C-reactive protein for both men and women. High education was positively associated with total cholesterol, with higher HDL levels among women, and with low triglycerides and HbA1c levels among men. For the remaining risk biomarkers, we found little statistical support for SEP inequalities. Adjustment for lifestyle factors, and particularly BMI and waist-hip ratio, led to a reduction in the observed SEP inequalities in raised biomarkers risk levels, especially among women. High financial constraints were weakly associated with high risk biomarkers levels, except for strong evidence for an association with C-reactive protein (men). CONCLUSIONS: Notable differences in risk biomarkers inequalities were observed according to the SEP measure employed. Clear educational inequalities in raised physiological risk biomarkers levels, particularly in blood pressure and C-reactive protein were seen in Russia and are partly explained by lifestyle factors, particularly obesity among women. These findings provide evidence-based information on the need for tackling health inequalities in the Russian population, which may help to further contribute to CVD mortality decline

Causal mechanisms proposed for the Alcohol Harm Paradox - a systematic review

Background and Aims The Alcohol Harm Paradox (AHP) posits that disadvantaged groups suffer from higher rates of alcohol-related harm compared with advantaged groups, despite reporting similar or lower levels of consumption on average. The causes of this relationship remain unclear. This study aimed to identify explanations proposed for the AHP. Secondary aims were to review the existing evidence for those explanations and investigate whether authors linked explanations to one another. Methods Systematic review. We searched MEDLINE (1946-January 2021), EMBASE (1974 – January 2021) and PsycINFO (1967 – January 2021), supplemented via manual searching of grey literature. Included papers either explored the causes of the AHP or investigated the relationship between alcohol consumption, alcohol-related harm, and socioeconomic position. Papers were set in Organisation for Economic Co-operation and Development high income countries. Explanations extracted for analysis could be evidenced in the empirical results or suggested by researchers in their narrative. Inductive thematic analysis was applied to group explanations. Results Seventy-nine papers met the inclusion criteria and initial coding revealed these papers contained 41 distinct explanations for the AHP. Following inductive thematic analysis, these explanations were grouped into 16 themes within six broad domains: Individual, Lifestyle, Contextual, Disadvantage, Upstream and Artefactual. Explanations related to risk behaviours, which fit within the Lifestyle domain, were the most frequently proposed (n=51) and analysed (n=21). Conclusions While there are many potential explanations for the Alcohol Harm Paradox, most research focuses on risk behaviours while other explanations lack empirical testing

Gender gaps in life expectancy and alcohol consumption in Eastern Europe

Female life expectancy is higher than that of males, and this gender gap is largest in Eastern Europe. Sergi Trias-Llimós and Fanny Janssen show that alcohol-attributable mortality explained more than 15% of this gap in eight Central and Eastern European (CEE) countries in 2012, and describe how the situation has evolved over time. Their results suggest that effectively tackling alcohol abuse among young men in these countries would help to reduce the gender gap in life expectancy