The impact of olive oil consumption pattern on the risk of acute coronary syndromes: The CARDIO2000 case-control study

BACKGROUND: According to epidemiological and metabolic studies monounsaturated fatty acids (MUFAs) seem to exert a protection against coronary heart disease (CHD) risk. The aim of the present study was to evaluate the association between the pattern of edible oils and fats consumption and the prevalence of a first, nonfatal event of an acute coronary syndrome (ACS) in a Greek sample. METHODS: Seven hundred males and 148 females patients with first event of an ACS and 1078 population-based controls, age and sex matched, were randomly selected. Detailed information regarding their medical records, alcohol intake, physical activity and smoking habits was recorded. Nutritional habits were evaluated with a semi-quantitative food-frequency questionnaire and use of oils in daily cooking or preparation of food was also recorded. Multiple logistic regression analysis estimated the odds ratio (OR) of having ACS by types of oil used, after taking into account the effect of several confounders. RESULTS: Exclusive use of olive oil was associated with 47% (95% confidence interval (CI) 0.4-0.71) lower likelihood of having ACS, compared to nonuse, after adjusting for BMI, smoking, physical activity level, educational status, the presence of family history of CHD, as well as hypertension, hypercholesterolemia and diabetes. Consumption of olive oil in combination with other oils or fats was not significantly associated with lower odds of ACS compared to no olive oil consumption (p=0.14). CONCLUSIONS: Exclusive use of olive oil during food preparation seems to offer significant protection against CHD, irrespective of various clinical, lifestyle and other characteristics of the participants.     

Predictors of adherence to physical activity guidelines in patients with diabetes mellitus in the US in 2017: An exploratory analysis

AimsTo identify if there is an association between socio-economic or demographic factors, lifestyle habits, or chronic conditions and meeting the current exercise recommendations for adult patients with Diabetes Mellitus 2 in the United States.MethodsThis secondary analysis of a cross sectional study used data from participants who reported having diabetes and answered questions regarding physical activity in the 2017 Behavioral Risk Factor Surveillance System survey (n = 37,204; 42% women; 30% < 60 years-of-age). Respondents were dichotomized according to physical activity adherence. Predictors tested included socioeconomic and demographic characteristics, lifestyle habits, and chronic conditions. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI).ResultsOur data showed that 46.5% of participants with diabetes adhered to the physical activity guidelines. Daily smokers were 25% less likely to adhere to the physical activity recommendations (95% CI 0.59–0.95), patients with obesity were 37% less likely (95% CI 0.53–0.74), and those with chronic kidney disease were 24% (95% CI 0.61–0.94) less likely to do so. The odds of adhering to exercise guidelines were reduced by 20% (95% CI 0.70–0.92), 42% (95% CI 0.49–0.68), and 47% (95% CI 0.32–0.57) in good, fair, and poor health respectively.ConclusionPatients with poor health, daily smoking, obesity, or kidney disease may benefit from targeted interventions to accomplish their physical activity recommendations.     

Olive Oil Consumption and Cardiovascular Risk in U.S. Adults

BackgroundOlive oil intake has been associated with lower risk of cardiovascular disease (CVD) in Mediterranean populations, but little is known about these associations in the U.S population.ObjectivesThis study sought to examine whether olive oil intake is associated with total CVD, coronary heart disease (CHD), and stroke risk.MethodsThis study included 61,181 women from the Nurses’ Health Study (1990 to 2014) and 31,797 men from the Health Professionals Follow-up Study (1990 to 2014) who were free of cancer, heart disease, and stroke at baseline. Diet was assessed using food frequency questionnaires at baseline and then every 4 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring 24 years of follow-up, this study documented 9,797 incident cases of CVD, including 6,034 CHD cases and 3,802 stroke cases. After adjusting for major diet and lifestyle factors, compared with nonconsumers, those with higher olive oil intake (>0.5 tablespoon/day or >7 g/day) had 14% lower risk of CVD (pooled HR: 0.86; 95% CI: 0.79 to 0.94) and 18% lower risk of CHD (pooled HR: 0.82; 95% CI: 0.73 to 0.91). No significant associations were observed for total or ischemic stroke. Replacing 5 g/day of margarine, butter, mayonnaise, or dairy fat with the equivalent amount of olive oil was associated with 5% to 7% lower risk of total CVD and CHD. No significant associations were observed when olive oil was compared with other plant oils combined. In a subset of participants, higher olive oil intake was associated with lower levels of circulating inflammatory biomarkers and a better lipid profile.ConclusionsHigher olive oil intake was associated with lower risk of CHD and total CVD in 2 large prospective cohorts of U.S. men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil could lead to lower risk of CHD and CVD.     

The association between curry-rice consumption and hypertension,type 2 diabetes,and depression: The findings from KNHANES 2012–2016

Background and aimsWe aim to evaluate the association between curry-rice consumption, cardiovascular diseases (CVDs), type 2 diabetes (T2DB), arthritis, and depression.Methods17,625 participants aged ≥18 years were recruited to obtain data on sociodemographic characteristics, lifestyle, medical history, current medications, family history, and food consumption. The association between curry-rice consumption, CVDs, T2DB, arthritis, and depression was examined using multivariable-adjusted analyses.ResultsIn the logistic model, risks of elevated triglyceride (OR 0.89; 95% CI, 0.82–0.97, p = 0.006), elevated HbA1c (OR 0.81; 95% CI, 0.73–0.91, p < 0.001), and elevated glucose (OR 0.86; 95% CI, 0.79–0.94, p < 0.001) were significantly lower in the high curry-rice consumption group than in the low curry-rice consumption group. Risk of hypertension (OR 0.88; 95% CI, 0.78–0.98, p = 0.044), T2DB (OR, 0.82; 95% CI, 0.68–0.98, p < 0.001), and depression (OR 0.82; 95% CI, 0.70–0.97, p = 0.026) was significantly lower among the high curry-rice consumption group than in the low curry-rice consumption group. These findings were consistent with the results of the analysis when curry-rice consumption was treated as a continuous variable.ConclusionsThe potential health benefits resulting from the intake of curry-rice via an ordinary diet could protect the public from the burden of non-communicable diseases (NCDs) and mental health. These results highlight an ongoing need to understand the role of curry-rice in NCDs and mental health.     

More frequent olive oil intake is associated with reduced platelet activation in obesity

Background and aimsObesity is an independent risk factor for atherosclerotic cardiovascular disease (CVD), and platelet hyperactivation in obesity may contribute to this association. Olive oil consumption is associated with lower cardiovascular disease (CVD) risk in the general population. However, little is known for individuals with obesity. We investigated whether olive oil intake is associated with platelet activation in obesity.Methods and resultsWe assessed platelet activation (surface P-selectin expression) with and without thrombin exposure and diet composition in 63 patients with severe obesity.Among 63 subjects with obesity, the mean age was 32.2 ± 8.0 years and BMI 44.1 ± 8.5 kg/m². Olive oil intake was stratified into <1 time/week (n = 21), 1–3 times/week (n = 18), ≥4 times/week (n = 24). Strata did not differ by age, BMI or platelet count. Unstimulated P-selectin expression did not differ by olive oil consumption. Subjects with more frequent olive oil intake exhibited lower P-selectin expression on submaximal thrombin exposure.ConclusionsMore frequent olive oil intake is associated with reduced thrombin-induced platelet activation in obesity.     

Association of suicidal ideation with poor sleep quality among Ethiopian adults

Objective

The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults.

Methods

A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI).

Results

The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34–5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14–1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10–38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI.

Conclusion

Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.

     

Effect of coconut oil on cardio-metabolic risk: A systematic review and meta-analysis of interventional studies

Background and aimsHigh total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) could be major risk factors for cardiovascular disease burden among high risk populations especially in South Asians. This systematic review and meta-analysis aimed to quantify the effects of coconut oil compared with other oils and fats on cardio-metabolic parameters.MethodsPubMed, Scopus and Web of Science were systematically searched. The main outcomes included are lipid and glycemic parameters. Subgroup analyses were performed to evaluate individual comparisons of vegetable oils and animal fat with coconut oil. Data were pooled using random-effects meta-analysis.ResultsCoconut oil consumption significantly increased TC by 15.42 mg/dL (95% CI, 8.96–21.88, p < 0.001), LDL-C by 10.14 mg/dL (95% CI, 4.44–15.84, p < 0.001) and high density lipoprorein cholesterol (HDL-C) by 2.61 mg/dL (95% CI, 0.95–4.26, p = 0.002), and significantly decreased glycosylated hemoglobin (HbA1c) by 0.39 mg/dL (95% CI, −0.50 to −0.27, p < 0.001) but, it had no effects on triglycerides (TG), (4.25 mg/dL; 95% CI, −0.49-8.99, p = 0.08) when compared with the control group. Sub-group analysis demonstrated that coconut oil significantly increased TC and LDL-C over corn, palm, soybean and safflower oils and not over olive oil. Compared with butter, coconut oil showed a better pattern in cardio-metabolic markers by significantly increasing HDL-C (4.38 mg/dL, 95% CI, 0.40 to 8.36, p = 0.03) and decreasing LDL-C (−14.90 mg/dL, 95% CI, −23.02 to-6.77, p < 0.001).ConclusionsOur results suggest that coconut oil consumption results in significantly higher TC, LDL-C and HDL-C than other oils. Consumption of coconut oil can be one of the risk factors for CVDs in South Asians.     

Dairy consumption and subclinical atherosclerosis: A cross-sectional study among middle-aged Mexican women

Background and aimsMany dietary guidelines encourage low-fat dairy products; however, recent studies have found null and inverse associations between high-fat dairy intake and cardiovascular disease (CVD) risk. We examined the association between the intake of total dairy and different types of dairy and carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis, in Mexican women.Methods and resultsDairy consumption was assessed using a validated food-frequency questionnaire (FFQ) in 1759 women in the Mexican Teachers’ Cohort (MTC) study who were free of CVD or cancer. We categorized participants according to total dairy intake and consumption of four mutually exclusive dairy groups: high-fat, low-fat, yogurt, and dairy with added sugars. IMT and atherosclerotic plaque were measured by B-mode ultrasonography. Subclinical atherosclerosis was defined as an IMT ≥0.8 mm and/or the presence of plaque. Multivariable linear regression and logistic regression models were used to respectively assess the mean percentage difference of mean IMT and odds ratios (OR) for subclinical atherosclerosis across quantiles of dairy consumption. Mean (±SD) age was 45.4 ± 5.0 years and the median (interquartile range: IQR) total dairy consumption was 11.0 (6.6, 17.1) servings/week. After adjusting for lifestyle, clinical, and dietary factors, comparing the highest category of consumption, to the lowest, total dairy was associated with increased IMT (2.6%, 95% confidence interval (CI): 0.6, 4.3; p-trend<0.01). Moreover, yogurt consumption was associated with lower odds of subclinical atherosclerosis (OR = 0.65, 95% CI: 0.47, 0.91; p-trend = 0.01).ConclusionsWhile total dairy consumption was associated with carotid wall thickening, yogurt consumption was related to lower subclinical atherosclerosis.     

Allostatic load,metabolic syndrome and self-rated health in overweight/obese Non-Hispanic White,non-Hispanic Black and Mexican American adults

AimThis study examined the associations of high allostatic load (h_ALS) and metabolic syndrome (MetS) with and self-rated poor health (SRPH) in overweight/obese non-Hispanic White (NHW), non-Hispanic Black (NHB), and Mexican American (MA) adults.MethodsThe 2015–16 and 2017-18 US National Health and Nutrition Examination Survey data (n = 4403) were used for this study.ResultsRates of h_ALS in overweight/obese NHW, NHW, and MA participants were 56.9%, 58.8%, and 51.9%, respectively (P < .05). The corresponding rates for MetS were 26.9%, 31.9%, and 46.5%, respectively. High ALS was associated with 2.19 (95% CI: 1.87–4.59), 1.82 (1.42–2.58), and 1.47 (95% CI: 1.08–1.64) increased odds of SRPH in overweight/obese NHW, NHB, and MA, respectively, after adjusting for age, education, gender, income, lifestyle behaviors, and marital status. The corresponding values for MetS were 1.86 (95% CI: 1.54–2.40), 2.77 (95% CI: 1.36–5.63), and 1.22 (95% CI: 1.06–2.32), respectively.ConclusionsThe effect of h_ALS on SRPH was much stronger in NHW, while the effect of MetS was strongest among NHB overweight/obese adults. The result of this study provides further evidence in favor of race/ethnic-tailored interventions, including education and weight control to reduced risks of bodywear and tear and SRPH.     

Food consumption by degree of processing is associated with nocturnal dipping and blood pressure variability: The ELSA-Brasil study

Background and aimsAmbulatory blood pressure monitoring (ABPM) allows the assessment of cardiovascular risk markers that cannot be obtained by casual measurements; however, the evidence on the association between food consumption and blood pressure (BP) assessed by ABPM is scarce. We aimed to evaluate the association between food consumption by degree of processing and ambulatory BP.Methods and resultsCross-sectional analysis (2012–2014) of data from a subsample (n = 815) of ELSA-Brasil cohort participants who performed 24-h ABPM was conducted. Systolic (SBP) and diastolic (DBP) BP means and variability during the 24 h and subperiods (sleep and wake), nocturnal dipping, and morning surge were evaluated. Food consumption was classified according to NOVA. Associations were tested by generalized linear models. The consumption of unprocessed, minimally processed foods, and culinary ingredients (U/MPF&CI) was 63.1% of daily caloric intake, 10.8% of processed (PF), and 24.8% of ultraprocessed (UPF). A negative association was found between U/MPF&CI consumption and extreme dipping (T2: odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.55–0.58; T3: OR = 0.55; 95% CI = 0.54–0.57); and between UPF consumption and nondipping (T2: OR = 0.68, 95% CI = 0.55–0.85) and extreme dipping (T2: OR = 0.63, 95% CI = 0.61–0.65; T3: OR = 0.95, 95% CI = 0.91–0.99). There was a positive association between PF consumption and extreme dipping (T2: OR = 1.22, 95% CI = 1.18–1.27; T3: OR = 1.34, 95% CI = 1.29–1.39) and sleep SBP variability (T3: Coef = 0.56, 95% CI = 0.03–1.10).ConclusionsThe high consumption of PF was associated with greater BP variability and extreme dipping, while the U/MPF&CI and UPF consumption were negatively associated with alterations in nocturnal dipping.     

A Mediterranean lifestyle reduces the risk of cardiovascular disease in the “Seguimiento Universidad de Navarra” (SUN) cohort

Background and aimsA healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD.Methods and resultsThe “Seguimiento Universidad de Navarra” (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterranean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardiovascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) = 0.50; (95% confidence interval, 0.31–0.81) for the highest MEDLIFE scores (14–23 points) compared to the lowest scores (0–9 points), p (trend) = 0.004.ConclusionA higher level of adherence to the Mediterranean lifestyle was significantly associated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health.     

Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern

Background and aimCardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern European Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents.Methods and ResultsA cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumference and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had ≥1SD of this score. CRF was measured with the 20 m-Shuttle-Run-Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR = 9.4; 95%CI:2.6–33.3) followed by the unfit ones with high adherence to the SEADiet (OR = 6.6; 95% CI: 1.9–22.5) when compared to those who were fit and had higher adherence to SEADiet.ConclusionsUnfit adolescents showed higher odds of having high MRS, regardless of the adherence to SEADiet suggesting that high CRF may overcome the deleterious effects of low adherence to a healthy dietary pattern in adolescents.     

Prevalence and risk factors for insomnia in community-dwelling elderly in northern Taiwan

Background/PurposeTo determine the prevalence and risk factors for insomnia among community-dwelling elderly in northern Taiwan.Materials and methodsA cross-sectional survey was conducted among 1358 elderly people (601 men, 44.3%; and 757 women, 55.7%) who had received a senior-citizen health examination between March 2009 and November 2009. Responses to a clinical questionnaire on insomnia (Chinese version of the Athens insomnia scale), mental health (brief symptom rating scale), and 14 physical symptoms were measured.ResultsInsomnia syndrome was found in 41% of individuals; it was more common in women than in men (63.3.0% vs. 36.7%). Multivariate models showed that aging [≥80 years old, odds ratio (OR) = 0.67, 95% confidence interval (CI): 0.46–0.93], living with family (OR = 0.51, 95% CI: 0.35–0.76), and perceived good health status (OR = 0.58 and 0.71, p<0.05) were associated with a decreased risk of insomnia. Meanwhile, female gender (OR = 1.70, 95% CI: 1.37–2.12), receipt of medication for chronic diseases (OR = 1.64, 95% CI: 1.29–2.08), high brief symptom rating scale score (1.45, 95% CI: 1.32–1.86), perceived poor health status (OR = 1.92 and 1.80, p<0.05), and total physical symptoms (OR = 1.34, 95% CI: 1.08–1.70) were associated with an increased risk of insomnia.ConclusionThe results indicate that the aging process itself is not responsible for the increased prevalence of insomnia often reported in older people. Instead, physical symptoms, receipt of medication for chronic diseases, mental health status, living status, and perceived level of well-being affected the risk of insomnia.     

The relationship between C-Reactive protein and mortality in adults with diabetes: Influences of demographic characteristics,lifestyle behaviors,and medications

Background and aimsThis study assesses the influence of demographic, lifestyle, and medication in the association between CRP and mortality in a national sample of adults with diabetes.Methods and resultsCross-sectional study of data from 1999 to 2010 National Health and Nutrition Examination Survey (unweighted n = 3952; Weighted n = 19,064,710). Individuals were categorized as having diabetes if told by a provider they had diabetes, were taking insulin or other diabetes medications, or had a glycosylated hemoglobin A1c (HbA1c) ≥ 6.5%. CRP was classified into four categories: normal (≤0.1 mg/dL); moderate risk (0.11–0.3 mg/dL); high-risk (0.31–1.0 mg/dL); very high-risk (>1.0 mg/dL). Higher risk for mortality was associated with a very high-risk of CRP (HR = 1.88 (95% CI: 1.27–2.78), being a current (HR = 1.49 (95% CI: 1.10–2.01) or former (HR = 1.34 (95% CI: 1.03–1.73) smoker, and taking insulin (HR = 1.60 (95% CI: 1.25–2.05), taking anti-hypertensives (HR = 1.50 (95% CI: 1.22–1.85), and having co-morbidities such as cancer (HR = 1.32 (95% CI: 1.05–1.66) and hepatitis infection (HR = 1.76 (95% CI: 1.07–2.91), while taking Metformin (HR = 0.62 (95% CI: 0.50–0.76) had a lower risk of mortality.ConclusionIn this sample of adults with diabetes, demographic, lifestyle, and medication factors influenced the association between CRP and mortality. Interventions should focus on these factors to reduce mortality in adults with diabetes.     

Assessment of food environment at work and its association with cardiometabolic health among employed adults in Delhi,India

Background and aimsUnhealthy food environment at work is believed to be playing a role in the burgeoning obesity, cardiometabolic risk, diabetes and cardiovascular diseases in India. Therefore, food environment assessment at work is crucial to understand the effect of food environment and to find its association with cardiometabolic risk among adults in Delhi, India.MethodologyMix-methods study to find association between worksite food environment on the food choices, dietary behavior, and cardio-metabolic health of 455 apparently healthy adults (both males and females) aged 25–55 years was done in urban India.ResultsUnhealthy food environment, poor eating pattern and sedentary lifestyle at work resulted in clustering of CMR factors among the study participants. Work environment assessment revealed that worksites with canteens had higher overall CHEW score for all its domains (Physical, nutritional, and information environment), in comparison to worksites without or no canteens. Four out of ten apparently healthy adults had metabolic syndrome indicating poor cardiometabolic health. The odds of CMR in subjects with access to canteen (unhealthy food) were estimated to be 0.74 (CI: 0.51 to 1.07; p = 0.11) times the odds of CMR in subjects without canteen (limited access to food). Females (β:0.34; 95% CI:0.23, 0.44; p = 0.00) had high CMR factors in comparison to males. Overall cardiometabolic risk factors increased with age (β:0.01; 95% CI:0.01,0.01; p = 0.00).ConclusionFindings of the present study urge the need for dietary and lifestyle intervention along with longitudinal studies to further disentangle the association of the food and work environment on the prevalence of CMR among adults.     

Improvement in diet habits,independent of physical activity helps to reduce incident diabetes among prediabetic Asian Indian men

AimsTo assess the beneficial effects of the components of lifestyle intervention in reducing incidence of diabetes in Asian Indian men with impaired glucose tolerance (IGT) in India.MethodsThis analysis was based on a 2 year prospective, randomized controlled primary prevention trial in a cohort of Asian Indian men with IGT (n = 537) (Clinical Trial No: NCT00819455). Intervention and control groups were given standard care advice at baseline. Additionally, the intervention group received frequent, mobile phone based text message reminders on healthy lifestyle principles. Dietary intake and physical activity habits were recorded by validated questionnaires. The lifestyle goals were: reductions in consumption of carbohydrates, oil, portion size and body mass index of at least 1 unit (1 kg/m²) from baseline and maintenance of good physical activity. The association between diabetes and lifestyle goals achieved was assessed using multiple logistic regression analyses. Changes in insulin sensitivity (Matsuda's insulin sensitivity index) and oral disposition index during the follow-up were assessed.ResultsAt the end of the study, 123 (23.8%) participants developed diabetes. The mean lifestyle score was higher in the intervention group compared with control (2.59 ± 1.13 vs. 2.28 ± 1.17; P = 0.002). Among the 5 lifestyle variables, significant improvements in the 3 dietary goal were seen with intervention. Concomitant improvement in insulin sensitivity and oral disposition index was noted. Higher lifestyle score was associated with lower risk of developing diabetes (odds ratio: 0.54 [95% CI: 0.44–0.70]; P < 0.0001).ConclusionsBeneficial effects of intervention were associated with increased compliance to lifestyle goals. The plausible mechanism is through improvement in insulin sensitivity and beta cell preservation.     

The association between sleep duration,napping, and stroke stratified by self-health status among Chinese people over 65 years old from the China health and retirement longitudinal study

Purpose

Stroke is a major cause of death in China. This study aimed to investigate the association between sleep duration (nighttime sleep and daytime napping) and stroke in elderly Chinese individuals with self-reported health status.

Methods

A total of 4785 Chinese adults over 65 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS) were included. Binary logistic regression was used to estimate odds ratios and 95% confidence intervals of the association between sleep duration and stroke stratified by self-reported health status.

Results

A significant association between short sleep duration (< 7 h per day) and the risk of stroke (aOR?=?2.05; 95% CI 1.31–3.19), after controlling for sociodemographic characteristics, lifestyle factors, health status, and comorbidities. There was no significant association between short and long sleep duration and stroke in the individuals who reported good general health status. However, in individuals who reported poor health status, short sleep duration (aOR?=?2.11; 95% CI 1.30–3.44) and long sleep duration (aOR?=?1.86; 95% CI 1.08–3.21) were significantly associated with increased risk of stroke, compared with normal sleep duration (7–8 h per day). Disability was significantly associated with stroke in both self-reported good and poor health groups. Rural residence was significantly associated with a lower risk of stroke among individuals who reported poor health status.

Conclusions

Both short and long sleep duration were significantly associated with stroke among individuals who reported poor health. Stroke prevention should be focused on elderly individuals who believe that they have health problems.

     

Association between prior appendectomy and the risk and course of Crohn's disease: A systematic review and meta-analysis

Background and aimsThe appendix has an important immune function in both health and disease, and appendectomy may influence microbial ecology and immune function. This meta-analysis aims to assess the association between appendectomy and the risk and course of Crohn's disease (CD).MethodsPubMed, EMBASE, and the Cochrane Library were used to identify all studies published until June 2022. Data from studies evaluating the association between appendectomy and CD were reviewed.ResultsA total of 28 studies were included in the final analysis, comprising 22 case-control and 6 cohort studies. A positive relationship between prior appendectomy and the risk of developing CD was observed in both case-control studies (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.22–2.08) and cohort studies (relative risk [RR]: 2.28, 95% CI: 1.66–3.14). The elevated risk of CD persisted 5 years post-appendectomy (RR = 1.24, 95% CI: 1.12–1.36). The risk of developing CD was similarly elevated regardless of the presence (RR = 1.64, 95% CI: 1.17–2.31) or absence (RR = 2.77, 95% CI: 1.84–4.16) of appendicitis in patients. Moreover, significant differences were found in the proportion of terminal ileum lesions (OR = 1.63; 95% CI: 1.38–1.93) and colon lesions (OR = 0.70; 95% CI: 0.5–0.84) between CD patients with appendectomy and those without appendectomy.ConclusionsThe risk of developing CD following an appendectomy is significant and persists 5 years postoperatively. Moreover, the elevated risk of CD may mainly occur in the terminal ileum.     

Mindfulness,Mental Health and HIV Outcomes Among Female Sex Workers in the Dominican Republic and Tanzania

We examined the relationship between mindfulness, mental health and HIV outcomes among female sex workers (FSW) from the Dominican Republic (DR) (n?=?201) and Tanzania (n?=?208) using cross-sectional survey and biologic data. We employed stratified multivariate linear and logistic regression. Depression was associated with lower odds of ART adherence in the DR (AOR 0.25, 95% CI: 0.08–0.78) and of viral suppression in Tanzania (AOR 0.49, 95% CI: 0.24–0.97). In both countries, mindfulness was associated with lower odds of moderate to severe depression (AOR 0.82, 95% CI: 0.76–0.88 for the DR; AOR 0.85, 95% CI: 0.77–0.95 for Tanzania). In the DR, mindfulness was associated with lower odds of anxiety (AOR 0.83, 95% CI: 0.77–0.89), lower HIV stigma (β?=?? 0.28 per unit change, 95% CI: ? 0.37 to ? 0.19) and greater odds of viral suppression (AOR 1.09, 95% CI: 1.02–1.15). Findings demonstrate the potential of tailored mindfulness interventions to improve mental health and HIV outcomes among FSW.

     

Fatty and lean red meat consumption in China: Differential association with Chinese abdominal obesity

AimWe examined the longitudinal association between red meat (RM) consumption and the risk of abdominal obesity in Chinese adults.Methods and resultsOur data are from 16,822 adults aged 18–75 in the China Health and Nutrition Survey from 1993 to 2011. We assessed RM intake with three 24-h dietary recalls. We defined abdominal obesity as a waist circumference (WC) ≥85 centimeters (cm) for men and ≥80 cm for women. Multilevel mixed-effect regression models showed that men experienced WC increases of 0.74 cm (95% confidence interval [CI]: 0.39–1.09) from a higher total intake of fresh RM and 0.59 cm (95% CI: 0.24–0. 95) from a higher intake of fatty fresh RM but 0.14 cm (95% CI: −0.39 to 0.66) from a higher intake of lean fresh RM in the top quartile versus non-consumers when adjusted for potential confounders. In contrast, after additional adjustment for baseline WC, the odds ratios of abdominal obesity in men were attenuated for total fresh RM (1.25 [95% CI: 1.06–1.47]) and fatty fresh RM (1.22 [95% CI: 1.03–1.44]) but were still not affected by lean fresh RM (0.95 [95% CI: 0.75–1.22]). Women also showed a positive association of fatty fresh RM intake with abdominal obesity.ConclusionGreater intake of fatty fresh RM was significantly associated with higher WC (men only) and abdominal obesity risk in Chinese adults. The gender-specific differential association of fatty versus lean fresh RM warrants further study.