Phthalate exposure associated with self-reported diabetes among Mexican women

Background

Phthalates are ubiquitous industrial chemicals used as plasticizers in plastics made of polyvinyl chloride (PVC) to confer flexibility and durability. They are also present in products used for personal-care, industry and in medical devices. Phthalates have been associated with several adverse health effects, and recently it has been proposed that exposure to phthalates, could have an effect on metabolic homeostasis. This exploratory cross-sectional study evaluated the possible association between phthalate exposure and self-reported diabetes among adult Mexican women.

Methods

As part of an on-going case-control study for breast cancer, only controls were selected, which constituted 221 healthy women matched by age (±5 years) and place of residence with the cases. Women with diabetes were identified by self-report. Urinary concentrations of nine phthalate metabolites were measured by online solid phase extraction coupled to high performance liquid chromatography-isotope-dilution tandem mass spectrometry.

Results

Participants with diabetes had significantly higher concentrations of di(2-ethylhexyl) pththalate (DEHP) metabolites: mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) but lower levels of monobenzyl phthalate (MBzP) a metabolite of benzylbutyl phthalate, compared to participants without diabetes. A marginally significant positive associations with diabetes status were observed over tertiles with MEHHP (OR_{T3 vs. T1}=2.66; 95% CI: 0.97–7.33; p for trend=0.063) and MEOHP (OR_{T3 vs. T1}=2.27; 95% CI; 0.90–5.75; P for trend=0.079) even after adjusting for important confounders.

Conclusions

The results suggest that levels of some phthalates may play a role in the genesis of diabetes.     

The dietary intake of people with non-insulin-dependent diabetes (NIDDM): how valid is self-reported intake?

Background: In diabetes care, an accurate assessment of dietary intake is essential for clinical management. This study assessed the validity of dietary records from people with NIDDM by comparing reported energy and protein intakes with estimated total energy expenditure (TEE) and urinary nitrogen excretion.
Method: To assess energy and nutrient intake 185 patients kept dietary records for two 3-day periods. Basal metabolic rate (BMR^est) was estimated to calculate reported energy intake/BMR^est. Appropriate age and sex-specific physical activity levels (PAL=TEE/BMR) from published doubly-labelled water studies of TEE, were used to calculate a cut-off PAL for energy intake/BMR^est, below which intakes were statistically unlikely to be valid. A subgroup (46 patients) collected a complete 24-h urine sample to compare nitrogen excretion with protein intake.
Results: The mean value of energy intake/BMR^est (1.14±0.3) was markedly below the calculated cut-off point (1.58±0.06) suggesting widespread underreporting. Protein intake (82.5±21.3) was also lower than estimated protein losses (92.5±19.4). Obese and female NIDDS were more likely to underreport and their intakes were closer to the diabetes dietary recommendations. Conclusion: This study found that people with NIDDM were likely to underreport their food intake.     

成年居民每日膳食盐摄入量与肥胖关系

目的 探讨成人膳食盐摄入量与肥胖关系。方法 于2013年4月采用多阶段整群随机抽样方法抽取徐州市≥18岁常住人口30 572人进行调查。结果 30 572名成年居民平均膳食盐摄入量（14.53±11.04）g/d,超重率为32.17%（9 834/30 572）,肥胖率为7.09%（2 169/30 572）,中心性肥胖率为45.58%（13 934/30 572）;校正潜在的混杂因素后,膳食盐摄入量对肥胖和中心性肥胖的OR值（95%CI）分别为1.467（1.267~1.698）、1.155（1.080~1.234）。结论 膳食盐摄入量与肥胖的发生有关联。降低膳食盐摄入量有助于减少肥胖的发生,对居民进行低盐饮食相关健康教育刻不容缓。     

Epidemiology of factors related to self-reported diabetes among adults

Analyzing data from some 8,000 adults in the United States reveals that adult diabetes is highly associated with age but not with sex. Older adults are more likely to have diabetes than younger adults. For younger adults diabetes is associated with body mass and blood pressure but not with physical activity level. Those who are above the median in body mass or who are hypertensive have higher risks of being afflicted with diabetes than those who are below the median in body mass or who are normotensive. For older adults diabetes is not associated with blood pressure but is highly associated with physical activity level and a measure of body mass based on maximum reported weight. Those who are lighter or who are physically active are much less likely to be diabetic than those who are heavier or who are physically inactive. We further found that for these adults the association between physical activity level and diabetes is independent of body mass. The epidemiological evidence strongly supports the conventional wisdom of dealing with diabetes by reducing body weight, lowering blood pressure, and particularly for older adults, engaging in some kind of regular physical activity.     

The relationship between nutrient intake, dental status and family cohesion among older Brazilians

The aim of this study was to investigate the relationship between inadequate nutrient intake, oral health and family cohesion. This was a cross-sectional study with a sample of 887 non-institutionalized elderly people from Vitória, Espírito Santo State, Brazil. Oral examination was performed by trained and calibrated examiners and three measurements were considered: number of posterior occluding pairs of natural teeth (POP), number of teeth and overall dental status. Nutrient intake was assessed by a 24-hour diet recall interview. The elderly person's perception of family cohesion was assessed using the family adaptability and cohesion scale. People with no POP were more likely than those with 5 or more POP to have inadequate intake of vitamin C (OR = 2.79; 95%CI: 1.16-6.71), calcium (OR = 3.74; 95%CI: 1.69-8.25), riboflavin (OR = 2.49; 95%CI: 1.10-5.64) and zinc (OR = 3.43; 95%CI: 1.07-10.94). There was no association between elderly people's perceptions of family cohesion and inadequate intakes. It was concluded that oral health is related to inadequate intake of important nutrients among non-institutionalized elderly people.     

2012年中国公民健康素养监测方案简介

  目的  探讨自报慢性病患病与健康素养水平的关系,为预防控制慢性病和提高居民健康水平提供科学依据。  方法  2015年5月 — 12月采用分层多阶段与人口规模成比例抽样（PPS）方法,在辽宁省抽取15～69岁常住人口使用统一编定的问卷进行调查,并应用多因素logistic回归分析自报慢性病患病情况与健康素养水平的相关性。  结果  辽宁省居民自报慢性病患病率为22.08 %,其中城市22.72 %,农村21.37 %,差异有统计学意义（P < 0.05）。多因素logistic回归分析显示,城市居民,随着年龄组升高,居民自报慢性病患病率升高（OR = 2.002）;文化程度越高,居民自报慢性病患病率下降（OR = 0.881）;与公务员相比,学生的自报慢性病患病率低（OR = 0.123）;具备传染病防治素养的居民自报慢性病患病率较低（OR = 0.751）。农村居民,女性自报慢性病患病率高于男性（OR = 1.380）;随着年龄组升高,居民自报慢性病患病率增加（OR = 1.950）;教师、医务人员、学生、工人的自报慢性病患病率较公务员低（OR = 0.491、0.489、0.402、0.446）;具备健康信息素养的居民自报慢性病患病率较低（OR = 0.776）。  结论  提高居民,尤其是农村男性的自我保健意识,提高慢性病检出率,以老年人、文化程度较低者为重点人群开展针对性的健康教育干预措施,预防和控制慢性病的发生。     

Association between dietary saccharide intake and self-reported memory performance in middle-aged adults

The aims of the present study were to assess dietary intake of saccharides in middle-aged adults, and to determine whether intakes of these sugar nutrients were related to self-reported memory performance. A population-based sample of 1183 men and women (aged 40-60 years) completed questionnaires assessing everyday memory function. Dietary intake status of saccharides was estimated using a self-completed, quantified FFQ. After controlling for demographic and health measures (for example, time spent exercising, smoking and alcohol consumption), saccharide intake was related to better self-reported memory functioning. Thus, longer-term intakes of saccharides through the usual diet may be positively related to perceived memory performance in mid-life.     

Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population

BACKGROUND: Elevated blood concentrations of total homocysteine (tHcy) have been implicated in the pathogenesis of atherosclerotic cardiovascular disease. Previous studies identified suboptimal nutritional status and dietary intake of folate, vitamin B-6, and vitamin B-12 as determinants of elevated tHcy. OBJECTIVE: We identified other nutritional factors associated with tHcy in 260 retired schoolteachers in the Baltimore metropolitan area. DESIGN: We performed observational analyses of baseline and 2-4-mo follow-up data collected in a study designed to test the feasibility of conducting a large-scale clinical trial of vitamin supplements by mail. The study population consisted of 151 women and 109 men with a median age of 64 y. At baseline, each participant completed a food-frequency questionnaire. At follow-up, fasting serum tHcy was measured. RESULTS: In multivariable linear regression and generalized linear models, there was an independent, inverse dose-response relation between dietary protein and In tHcy (P = 0.002) and a positive, significant dose-response relation between coffee consumption and In tHcy (P for trend = 0.01). Other significant predictors of In tHcy were creatinine (positive; P = 0.0001) and prestudy use of supplemental B vitamins (inverse; P = 0.03). In stratified analyses restricted to persons receiving standard multivitamin therapy, the association of 1n tHcy with dietary protein and coffee persisted. CONCLUSIONS: These results support the hypothesis that increased protein intake and decreased coffee consumption may reduce tHcy and potentially prevent atherosclerotic cardiovascular disease and other disease outcomes.     

Fruit and vegetable intake among urban community gardeners

ObjectiveTo determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults.DesignData were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented.SettingFlint, MichiganParticipants766 adultsVariables MeasuredFruit and vegetable intake was measured using questionnaire items from the Behavioral Risk Factor Surveillance System. Household participation in a community garden was assessed by asking the respondent if he or she, or any member of the household, had participated in a community garden project in the last year.AnalysisGeneralized linear models and logistic regression models assessed the association between household participation in a community garden and fruit and vegetable intake, controlling for demographic, neighborhood participation, and health variables.ResultsAdults with a household member who participated in a community garden consumed fruits and vegetables 1.4 more times per day than those who did not participate, and they were 3.5 times more likely to consume fruits and vegetables at least 5 times daily.Conclusions and ImplicationsHousehold participation in a community garden may improve fruit and vegetable intake among urban adults.     

Association of coffee consumption with gallbladder disease

Coffee consumption was recently shown to protect against symptomatic gallbladder disease in men. The authors examined the relation of ultrasound-documented gallbladder disease with coffee drinking in 13,938 adult participants in the Third National Health and Nutrition Examination Survey, 1988-1994. The prevalence of total gallbladder disease was unrelated to coffee consumption in either men or women. However, among women a decreased prevalence of previously diagnosed gallbladder disease was found with increasing coffee drinking (p = 0.027). These findings do not support a protective effect of coffee consumption on total gallbladder disease, although coffee may decrease the risk of symptomatic gallstones in women.     

Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians

The study examines the relationship between fruit and vegetable intake (g/d) and CVD risk factors in urban south Indians. The study population comprised of 983 individuals aged > or = 20 years selected from the Chennai Urban Rural Epidemiological Study (CURES), a population-based cross-sectional study on a representative population of Chennai in southern India. Fruit and vegetable intake (g/d) was measured using a validated semi-quantitative FFQ. Linear regression analysis revealed that after adjusting for potential confounders such as age, sex, smoking, alcohol, BMI and total energy intake, the highest quartile of fruit and vegetable intake (g/d) showed a significant inverse association with systolic blood pressure (beta = - 2.6 (95 % CI - 5.92, - 1.02) mmHg; P = 0.027), BMI (beta = - 2.3 (95 % CI - 2.96, - 1.57) kg/m2; P < 0.0001), waist circumference (beta = - 2.6 (95 % CI - 3.69, - 1.46) cm; P < 0.0001), total cholesterol (beta = - 50 (95 % CI - 113.9, - 13.6) mg/l; P = 0.017) and LDL-cholesterol concentration (beta = - 55 (95 % CI - 110.8, - 11.1) mg/l; P = 0.039) when compared with the lowest quartile. A higher intake of fruit and vegetables explained 48 % of the protective effect against CVD risk factors. Increased intake of fruits and vegetables could play a protective role against CVD in Asian Indians who have high rates of premature coronary artery disease.     

Dietary fat intake among urban, African American adolescents

This study examined commonly consumed high-fat food sources to estimate dietary fat intake among 314 urban, African American adolescents (mean age (SD)=12.57 (.98) years; 66% female; 91% African American non-Hispanic; and 9% African American Hispanic). Youths' fat intake was measured using the Block Fat Screener. Most (77%) participants had diets very high in fat (i.e., 40% to 50% of energy). Mean frequencies of consumption revealed youths' preferences for the following high-fat food items: corn chips, potato chips, popcorn, and crackers; fried chicken; and doughnuts, pastries, cake, and cookies. Total fat intake differed based on youths' age. Urban, African American adolescents can benefit from intervention to lower their fat intake. Programs that target and address the food preferences and eating habits of this population are clearly needed.     

Association between self-reported hearing impairment and diabetes: a Brazilian population-based study

Background

Some studies have already explored the relationship between diabetes and hearing loss; however, this relationship has still not been well established, especially due to methodological limitations related to lack of control for confounders. The aim of this study was to analyze the association between self-reported hearing impairment and diabetes among adults in Brazil, controlling for sociodemographic and occupational exposure to ototoxic agents.

Methods

This is a cross-sectional study based on data collected by the National Health Survey of 2013 in Brazil. A total of 60,202 individuals aged≥18 years were interviewed. Crude and adjusted prevalence ratios were calculated using the Poisson regression model with robust estimation of the variance. All analyzes were performed considering the appropriated weights imposed by the complex sample design.

Results

Hearing loss prevalence was 2.56% (95%CI: 2.34–2.79). It was higher in males, older age groups, white and individuals with lower levels of schooling. Diabetes was positively and significantly associated with hearing loss in the crude analysis (PR_crude?=?2.92; 95%CI: 2.75–3.11) and also in the analysis adjusted for gender, age, skin color, schooling, smoking, alcohol consumption and occupational exposure (PR_adj?=?1.46; 95%CI: 1.32–1.61).

Conclusions

The present results suggest that individuals with diabetes have higher prevalence of hearing impairment. There is the need of longitudinal studies to investigate if diabetes is a risk factor to hearing impairment.

     

Health-related behaviors moderate the association between age and self-reported health literacy among Taiwanese women

ABSTRACT

The role of health-related behaviors in the association between age and health literacy has not been well-elucidated. The present cross-sectional study evaluated the interactions between age and health-related behaviors in 942 women in Taiwan between February and October 2013. Women aged 18–78 years were randomly sampled and recruited from the national administrative system. Self-reported health literacy was measured by the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in Mandarin, asking about sociodemographics and essential health-related behaviors (watching health-related television, community involvement). The interviews were conducted confidentially by well-trained interviewers after having participants’ consent. In multiple linear regression models adjusted for education attainment, self-perceived social status, ability to pay for medication, and health-related behaviors, health literacy was significantly negatively related to age (unstandardized regression coefficient, B = ?0.04; 95% confidence interval [CI] = (?0.07; 0.00); p = .03). The lower health literacy among older women was significantly modified by watching health-related television programs (from “rarely/not-at-all”, B = ?0.08 (?0.12, ?0.04), p < .001 to “often”; B = 0.10 (0.07, 0.12); p < .001) and community involvement (from “rarely/not-at-all”, B = ?0.06 (?0.10, ?0.03); p = .001 to “often”, B = 0.06 (0.03, 0.08); p < .001). Specific health behaviors were protective of older women’s health literacy and likely their health.     

Correlates of the incidence of disability and mortality among older adult Brazilians with and without diabetes mellitus and stroke

ABSTRACT: BACKGROUND: The combined effect of diabetes and stroke on disability and mortality remains largely unexplored in Brazil and Latin America. Previous studies have been based primarily on data from developed countries. This study addresses the empirical gap by evaluating the combined impact of diabetes and stroke on disability and mortality in Brazil. METHODS: The sample was drawn from two waves of the Survey on Health and Well-being of the Elderly, which followed 2,143 older adults in Sao Paulo, Brazil, from 2000 to 2006. Disability was assessed via measures of activities of daily living (ADL) limitations, severe ADL limitations, and receiving assistance to perform these activities. Logistic and multinomial regression models controlling for sociodemographic and health conditions were used to address the influence of diabetes and stroke on disability and mortality. RESULTS: By itself, the presence of diabetes did not increase the risk of disability or the need for assistance; however, diabetes was related to increased risks when assessed in combination with stroke. After controlling for demographic, social and health conditions, individuals who had experienced stroke but not diabetes were 3.4 times more likely to have ADL limitations than those with neither condition (95% CI 2.26-5.04). This elevated risk more than doubled for those suffering from a combination of diabetes and stroke (OR 7.34, 95% CI 3.73-14.46). Similar effects from the combination of diabetes and stroke were observed for severe ADL limitations (OR 19.75, 95% CI 9.81- 39.76) and receiving ADL assistance (OR 16.57, 95% CI 8.39-32.73). Over time, older adults who had experienced a stroke were at higher risk of remaining disabled (RRR 4.28, 95% CI 1.53,11.95) and of mortality (RRR 3.42, 95% CI 1.65,7.09). However, risks were even higher for those who had experienced both diabetes and stroke. Diabetes was associated with higher mortality. CONCLUSIONS: Findings indicate that a combined history of stroke and diabetes has a great impact on disability prevalence and mortality among older adults in Sao Paulo, Brazil.     

Validity and reproducibility of self-reported intake of fruit and vegetable among 6th graders

OBJECTIVE: Reproducible and valid methods for measuring fruit and vegetable consumption among young school children are urgently needed. The aim of this study was to test the reproducibility and the validity of a newly developed questionnaire on the intake of fruit and vegetable among Norwegian 6th graders. The questionnaire consisted of a 24-h recall part and a food frequency part. DESIGN: A total of 114 pupils completed the questionnaire two times 14 days apart, and another 85 pupils completed the questionnaire and 7-day food diaries. SUBJECTS: Pupils of 6th grade with a mean age of 11.9 y. RESULTS: Spearman correlation coefficients between the frequency part of the questionnaire administered two times varied from 0.62 for fruit to 0.83 for potato, and no difference was seen between the average intakes from the two 24-h recalls. The 24-h recall part of the questionnaire gave higher estimates for the average intake of fruit and juice compared to the 7-day record, while no difference was observed for vegetable intake. Spearman correlation coefficients between the frequency part and the records varied from 0.21 for fruit and potato to 0.32 for the total intake of fruit and vegetable. CONCLUSION: Both the 24-h recall and the frequency part gave a consistent response on separate occasions over the test-retest study period. The 6th graders were capable of recording yesterday's intake of vegetable, but overestimated the intake of fruit and juice. The ability to rank subjects based on the frequency part was rather low.