Average Volume of Alcohol Consumed,Drinking Patterns,and Metabolic Syndrome in Older Korean Adults

Background

Controversial results have been reported on the relationship between alcohol intake and metabolic syndrome (MetS). We examined the association of average volume of alcohol consumed and drinking patterns with MetS and its components.

Methods

This study was conducted as a baseline survey for the Dong-gu Study of adults aged 50 years or older. Drinking patterns were assessed using a structured interview, and average volume of alcohol consumed was calculated. MetS was defined according to the updated version of the National Cholesterol Education Program.

Results

Compared with individuals who never drank, the adjusted odds ratio (OR) for the prevalence of MetS was significantly higher in men who consumed 2.1 to 4.0 drinks/day (OR, 1.53; 95% CI, 1.17–2.00) and greater than 4.0 drinks/day (OR, 1.63; 95% CI, 1.23–2.14), whereas no significant association was observed in women. Significant dose-response relationships between average volume of alcohol consumed and all metabolic components were observed in men. A usual quantity of 5 to 6 drinks/drinking day (OR, 1.57; 95% CI, 1.19–2.09), 7 or more drinks/drinking day (OR, 1.88; 95% CI, 1.45–2.44), and binge drinking on at least 1 occasion/week (OR, 1.33; 95% CI, 1.01–1.76) were associated with a significantly higher OR for prevalence of MetS in men; however, none of these drinking patterns were associated with MetS in women.

Conclusions

Unhealthy drinking patterns such as high usual quantity and binge drinking were significantly associated with MetS, suggesting that the effect of alcohol consumption on MetS should be considered in the context of drinking pattern, particularly in men.Key words: metabolic syndrome, alcohol consumption, cross-sectional study     

A cross sectional study to examine the association between dietary patterns and cognitive impairment in older Chinese people in Hong Kong

Background

Dietary patterns can be identified using a priori and a posterior approaches. Few studies have related dietary patterns with cognitive impairment in Chinese population. This study examined the risk of cognitive impairment associated with dietary patterns identified by both approaches.

Methods

Baseline data on 1,926 Chinese men and 1,744 Chinese women aged > 65 years participating in a cohort study examining the risk factors for osteoporosis in Hong Kong were analyzed. Dietary data were collected using a validated food frequency questionnaire. Adherence to a priori dietary patterns, namely the Mediterranean Diet Score (MDS) was assessed. Factor analysis (FA) identified three a posterior dietary patterns: “vegetables-fruits” pattern which was rich in vegetables, fruits, soy products and legumes, “snacks-drinks-milk products” pattern which was a mixture of healthy and unhealthy food groups including fast food, sweets and desserts, nuts, milk products and whole grains, and “meat-fish” pattern which included frequent intake of meat, fish and seafood. Cognitive function was assessed by the Community Screening Instrument for Dementia (CSI-D). Multivariate logistic regression examined the risk of cognitive impairment with adjustment for potential confounders.

Results

A total of 221 men and 656 women was classified as cognitive impaired. Neither the MDS nor the dietary patterns identified by FA were associated with risk of cognitive impairment in men. In women, higher “vegetables-fruits” pattern score was associated with reduced risk of cognitive impairment [Adjusted OR=0.73 (95% CI: 0.54–1.00) of the highest quartile of “vegetables-fruits” pattern score compared with the lowest quartile, ptrend=0.018]. Similar inverse trend was observed for “snacks-drinks-milk products” pattern score [Adjusted OR=0.65 (95% CI: 0.47–0.90) of the highest quartile of “snacks-drinks-milk products” pattern score compared with the lowest quartile, ptrend=0.003]. There was no association of “meat-fish” pattern or the MDS with risk of cognitive impairment in women.

Conclusion

Higher “vegetables-fruits” and “snacks-drinks-milk products” pattern scores were associated with reduced risk of cognitive impairment in Chinese older women in Hong Kong.     

Survival benefits of metabolic syndrome among older men aged 75 years and over in Taiwan

Background

Metabolic syndrome (MetS) was common in the elderly, but its prognostic significance in older old population remained unclear. The main purpose of this study was to evaluate the survival impact of MetS among older men aged 75 and over in Taiwan.

Methods

From 2008, residents aged 75 years and older of Banciao Veterans Home were invited for study and were followed for 3 years. All participants received history taking, physical examinations, and laboratory tests. Mortality was determined by Veteran Affairs Death Registry, which was linked to the National Death Registry.

Results

Overall, 680 men (mean age: 82.5±47 years) were enrolled for study and the prevalence of MetS was 31.6%. During the follow-up period, 140 (20.6%) participants died, and the causes of death included infectious diseases (62, 9.1%), cardiovascular disease (37, 5.4%), cancer (20, 2.9%), and others (21, 3.1%). MetS subjects had a significantly higher prevalence of hypertension, diabetes mellitus, and having higher body mass index, waist circumferences, systolic blood pressure, fasting blood glucose, serum triglyceride and lower HDL-C level than non-MetS subjects. However, MetS subjects were less likely to die during study period (16.3% vs. 22.6%, P=0.059). Multivariate logistic regression showed that older age (OR: 1.04, 95% C.I.: 1.00?C1.08, P=0.04), diabetes mellitus (OR: 2.10, 95% CI: 1.34?C3.30, P=0.001) were independent risk factors for mortality; and serum total cholesterol and triglyceride were protective factors (OR: 0.99, 95% CI: 0.99?C1.00, P=0.037 for cholesterol; OR: 0.99, 95% CI: 0.99?C1.00, P=0.013 for triglyceride). Adjusted for age, diabetes mellitus, serum levels of total cholesterol, and triglyceride, MetS played a potential trend of survival benefits among study subjects (HR: 0.71, 95% CI: 045?C1.12, P=0.144).

Conclusions

The prevalence of MetS among men aged 75 years and over was 31.6%, and the 3-year mortality rate was 20.6%. Older age, diabetes mellitus, lower serum cholesterol and lower serum triglyceride were independent risk factors for mortality. Further investigation is needed to clarify the prognostic impact of MetS in older adults.     

Applying multilevel model to the relationship of dietary patterns and colorectal cancer: an ongoing case–control study in Córdoba, Argentina

Purposes

Scientific literature has consistently shown the effects of certain diets on health but regional variations of dietary habits, and their relationship colorectal cancer (CRC) has been poorly studied in Argentina. Our aims were to identify dietary patterns and estimate their effect on CRC occurrence and to quantify the association between family history of CRC and CRC occurrence by applying multilevel models to estimate and interpret measures of variation.

Methods

Principal components factor analysis was performed to identify dietary patterns that were then used in a multilevel logistic regression applied to an ongoing case–control data about dietary exposure and CRC occurrence taking into account familiar clustering.

Results

Three dietary patterns were identified: “Southern Cone pattern” (red meat, wine, and starchy vegetables), “High-sugar drinks pattern”, and “Prudent pattern”. The study considered 41 cases and 95 controls. There was a significant promoting effects on CRC of “Southern Cone” (OR 1.5, 95%CI 1.0–2.2) and “High-sugar drinks” (OR 3.8, 95%CI 2.0–7.1) patterns, whereas “Prudent pattern” (OR 0.3, 95%CI 0.2–0.4) showed a significant protective effect at third tertile level. BMI, use of NSAIDs, and to have medical insurance showed significant effects. Variance of the random effect of family history of CRC was highly significant.

Conclusions

This novel approach for Argentina showed that Southern Cone and High-sugar drinks patterns were associated with a higher risk of CRC, whereas the Prudent pattern showed a protective effect. There was a significant clustering effect of family history of CRC.     

Functional impairment but not metabolic syndrome is associated with depression in older Taiwanese: Results from the social environment and biomarkers of Aging study

Objectives

This study examined the association of metabolic syndrome, metabolic disorders and functional impairment with depression in older (??54 years) adults.

Design

A cross-sectional study. Setting: Data of this study were from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan (2000).

Participants

A national representative sample of persons 54 years of age or older in Taiwan (N = 1023).

Results

Results showed that the presence of any number of metabolic disorders without functional impairment was not associated with depression. However, the presence of functional impairment regardless of the number of metabolic disorder was associated with a significantly higher risk of depression after adjusting for confounding factors (OR = 5.13, 95% CI = 2.13?C12.36) (p<0.05). The presence of a basic Activities of Daily Living (ADL) dependency was significantly associated with a 1.45 times higher likelihood of depression (OR = 1.45, 95% CI = 1.17?C1.79) (p<0.05).

Conclusions

Results suggest that functional impairment, but not metabolic syndrome or metabolic disorders, is associated with depression in older adults. Metabolic syndrome/disorders do not necessarily affect patient??s psychological health unless it is accompanied with functional impairment.     

Do not resuscitate orders and aging: Impact of multimorbidity on the decision-making process

Background

The “Do Not Resuscitate” orders (DNR) are defined as advance medical directives to withhold cardiopulmonary resuscitation during cardiac arrest. Age-related multimorbidity may influence the DNR decision-making process. Our objective was to perform a systematic review and meta-analysis of published data examining the relationship between DNR orders and multimorbidity in older patients.

Methods

A systematic Medline and Cochrane literature search limited to human studies published in English and French was conducted on August 2012, with no date limits, using the following Medical Subject Heading terms: “resuscitation orders” OR “do-not-resuscitate” combined with “aged, 80 and over” combined with “comorbidities” OR “chronic diseases”.

Results

Of the 65 selected studies, 22 met the selection criteria for inclusion in the qualitative analysis. DNR orders were positively associated with multimorbidity in 21 studies (95%). The meta-analysis included 7 studies with a total of 27,707 participants and 5065 DNR orders. It confirmed that multimorbidity were associated with DNR orders (summary OR = 1.25 [95% CI: 1.19–1.33]). The relationship between DNR orders and multimorbidity differed according to the nature of morbidities; the summary OR for DNR orders was 1.15 (95% CI: 1.07–1.23) for cognitive impairment, OR=2.58 (95% CI: 2.08–3.20) for cancer, OR=1.07 (95% CI: 0.92–1.24) for heart diseases (i.e., coronary heart disease or congestive heart failure), and OR=1.97 (95% CI: 1.61–2.40) for stroke.

Conclusions

This systematic review and metaanalysis showed that DNR orders are positively associated with multimorbidity, and especially with three morbidities, which are cognitive impairment, cancer and stroke.     

Associations of low muscle mass and the metabolic syndrome in Caucasian and Asian middle-aged and older adults

Objective

Age-related declines in skeletal muscle mass may confer significant metabolic consequences for older adults. Associations of low muscle mass and metabolic syndrome (MetS) in Caucasians, and comparisons with associations observed in Asian populations, have not been reported. We examined associations of low muscle mass and metabolic syndrome (MetS) in Asian and Caucasian middle-aged and older men and women using criteria for low muscle mass.

Design, Setting and Participants

Two population-based studies of Australian (Tasmanian Older Adult Cohort Study; TASOAC; N=1005) and Korean (Korean Sarcopenic Obesity Study; KSOS; N=376) community-dwelling adults, mean age 62 and 58 years, respectively.

Measurements

Appendicular lean mass (aLM) determined by dual-energy X-ray absorptiometry and normalised to height squared (aLM/Ht2), weight (aLM/Wt) or body mass index (aLM/BMI). Participants in the lowest sex-specific 20% for aLM measures were defined as having low muscle mass. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria.

Results

Although Australians demonstrated generally unfavourable anthropometric and metabolic characteristics compared to Koreans, prevalence of MetS was similar (29.5% in Australians and 31.4% in Koreans, respectively). Low aLM/Ht2 was associated with significantly reduced likelihood of MetS in both Australians (OR: 0.30, 95% CI 0.19 - 0.46) and Koreans (OR: 0.31, 95% CI 0.16 – 0.62). Conversely, low aLM/BMI was associated with increased odds for MetS in Australians (OR: 1.78, 95% CI 1.12–2.84), but not Koreans (OR: 1.33, 95% CI = 0.67–2.64).

Conclusion

Low aLM/BMI is associated with significantly increased likelihood of MetS in Australian adults, but not Koreans, suggesting potential differences in effects of low muscle mass relative to body mass on cardiometabolic health in Caucasian and Asian middle-aged and older adults. Low muscle mass relative to height is associated with reduced likelihood of MetS in both populations.

     

Association of serum glycine levels with metabolic syndrome in an elderly Chinese population

Background

Several studies have identified a negative association between serum glycine (Gly) levels and metabolic syndrome (MetS). However, this association has not been fully established in the elderly.

Methods

A total of 472 Chinese individuals (272 males and 200 females, 70.1?±?6.6?years old) participated in a population-based, cross-sectional survey in Beijing Hospital. The MetS and its components were defined based on the 2006 International Diabetes Federation (IDF) standard for Asians. Serum Gly concentration was determined using isotope dilution liquid chromatography tandem mass spectrometry.

Result

The proportion of patients with MetS decreased gradually with increasing Gly levels (p for trend <?0.001), and serum Gly concentrations declined gradually with increasing numbers of MetS components (p?=?0.03 for trend). After adjusting for age and gender, lower Gly levels were significantly associated with MetS and central obesity, with OR (95% CI) of 0.40 (0.25–0.65) and 0.46 (0.28–0.74). The stratified analysis conducted according to age showed that the OR between serum Gly levels and MetS was greater in those older than 65 (OR?=?0.66; 95% CI, 0.51–0.86) than in those younger than 65 (OR?=?0.89; 95% CI, 0.54–1.46). In the stratified analysis, using other age cut-off points, the results consistently showed that the association between serum Gly levels and MetS was more remarkable in the older groups.

Conclusions

Gly levels are associated with cardiometabolic characteristics and MetS in the elderly, and the association is more pronounced in very old people than in younger old people.

     

Influence of Dietary Patterns and Inflammatory Markers on Atherosclerosis Using Ankle Brachial Index as a Surrogate

Objective

To examine the influence of various dietary patterns on ankle-brachial index (ABI) as a surrogate of atherosclerosis, taking into account serum levels of C-reactive protein (CRP) and factors that predispose to inflammation and/or endothelial damage (homocysteine) or may be protective (tryptophan, vitamin D), as well as age, gender, and lifestyle risk factors.

Design

Cross sectional analysis.

Setting

Cohort of 4000 men and women aged 65 years living in the community in Hong Kong SAR China.

Measurements

Interviewer administered questionnaire that includes dietary intake estimation by the food frequency records (from which various dietary patterns can be characterized), socioeconomic status, smoking habit, alcohol consumption, physical activity. Clinical measurements include body weight and height, and ankle-brachial index using hand-held Doppler machine. Laboratory measurements include assays of serum 25 hydroxyvitamin D, CRP, homocysteine, and tryptophan using LC/MC methods.

Results

Compared with the lowest quintile of vitamin D level, higher quintile was associated with lower prevalence of ABI <0.9 in women only after multiple adjustments of covariates. In men the low score group of the vegetables-fruits dietary pattern was associated with increased odds of having ABI<0.9 after adjusting for all covariates (OR=16.51 (95% CI: 2.21, 123.26)). Similar findings apply to the low score group in the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay Diet) pattern (OR=2.6 (95% CI: 1.24, 5.42)). In women, ABI<0.9 was associated with low Dietary Quality Index (DQI) score (OR=2.05 (95% CI: 1.22, 3.43)), and low score group of snacks-drinks-milk products dietary pattern (OR=3.07 (95% CI: 1.05, 9.04)). No association was observed for the Mediterranean Dietary Pattern (MDS), Dietary Approaches to Stop Hypertension (DASH), Okinawan and “meat-fish” dietary patterns in either men or women.

Conclusion

We conclude that any dietary patterns emphasizing fruit and vegetable intake are associated with better vascular health using ABI as an indicator.

     

Dietary patterns and diet quality among diverse older adults: The university of Alabama at Birmingham study of aging

Objectives

To characterize dietary patterns among a diverse sample of older adults (≥ 65 years).

Design

Cross-sectional.

Setting

Five counties in west central Alabama.

Participants

Community-dwelling Medicare beneficiaries (N=416; 76.8 ±5.2 years, 56% female, 39% African American) in the University of Alabama at Birmingham (UAB) Study of Aging.

Measurements

Dietary data collected via three, unannounced 24-hour dietary recalls was used to identify dietary patterns. Foods were aggregated into 13 groups. Finite mixture modeling (FMM) was used to classify individuals into three dietary patterns. Differences across dietary patterns for nutrient intakes, sociodemographic, and anthropometric measurements were examined using chi-square and general linear models.

Results

Three dietary patterns were derived. A “More healthful” dietary pattern, with relatively higher intakes of fruit, vegetables, whole grains, eggs, nuts, legumes and dairy, was associated with lower energy density, higher quality diets as determined by Healthy Eating Index (HEI)-2005 scores and higher intakes of fiber, folate, vitamins C and B6, calcium, iron, magnesium, and zinc. The “Westernlike” pattern was defined by an intake of starchy vegetables, refined grains, meats, fried poultry and fish, oils and fats and was associated with lower HEI-2005 scores. The “Low produce, high sweets” pattern was characterized by high saturated fat, and low dietary fiber and vitamin C intakes. The strongest predictors of better diet quality were female gender and non-Hispanic white race.

Conclusion

The dietary patterns identified may provide a useful basis on which to base dietary interventions targeted at older adults. Examination of nutrient intakes regardless of the dietary pattern suggests that older adults are not meeting nutrient recommendations and should continue to be encouraged to choose high quality diets.     

Metabolic syndrome and quality of life in the elderly: age and gender differences

Purpose

The metabolic syndrome (MetS) is highly prevalent in Western older populations. MetS is an intriguing entity, because it includes potentially reversible risk factors. Some studies have suggested an inverse correlation between MetS and health-related quality of life (HRQoL), but data regarding older subjects are scanty and conflicting. The aim of this study was to assess the association between HRQoL and MetS in older, unselected community-dwelling subjects.

Methods

We analyzed data of 356 subjects aged 75+ living in Tuscania (Italy). HRQoL was assessed using the Health Utilities Index, Mark 3. Diagnosis of MetS was defined according to the National Cholesterol Education Program’s ATP-III criteria.

Results

MetS was reported by 137 (38%) participants. According to linear regression analysis, MetS was associated with significantly better HRQoL in men (B = 0.19 95% CI = 0.06–0.32; p = 0.006), but not in women. Also, when the regression model was analyzed in men, MetS was associated with better HRQoL (B = 0.17, 95% CI = 0.01–0.32; p = 0.035) only among participants aged 80+. No significant associations were found in men between HRQoL and any of the single components of MetS.

Conclusions

MetS is not associated with worse HRQoL among community-dwelling elderly; it is associated with significantly better HRQoL among the oldest men.     

Dietary patterns are associated with depressive symptoms among Chinese adults: a case–control study with propensity score matching

Purpose

Previous studies have indicated that consumption of particular foods or nutrients is associated with depressive symptoms, but little is known about the role of overall dietary patterns in depressive symptoms. We design this case–control study to evaluate the associations between dietary patterns and high depression symptoms in Chinese adults.

Methods

A total of 1351 participants with high depressive symptoms were matched with 1351 controls using the 1:1 ratio propensity score matching method. Dietary intake was assessed using a valid self-administered food frequency questionnaire, and high depressive symptoms were assessed with the Zung Self-Rating Depression Scale, wherein cutoff point of 45 was used as a definition of high depressive symptoms.

Results

Exploratory factor analysis revealed three dietary patterns (vegetables and fruits pattern; sweets pattern; and animal foods pattern) explaining 25.1 % of the total variance. Compared with the participants in the lowest quartile, the participants in the highest quartile of vegetables and fruits pattern, which was defined as a healthy pattern, were associated with reduced odds of high depressive symptoms (OR 0.65, 95 % CI 0.52–0.83, P for trend <0.001) while the sweets pattern (OR 1.33, 95 % CI 1.06–1.66) and the animal foods pattern (OR 1.79, 95 % CI 1.43–2.24, P for trend <0.0001) were associated with increased prevalence of high depressive symptoms, respectively.

Conclusion

The present study adds to the evidence that the sweets pattern and animal foods pattern are positively associated with the prevalence of high depressive symptoms. In contrast, the dietary pattern rich in vegetables, fruits, and soya bean products, but low in animal foods, candied fruits, cakes, ice cream, sugared beverages, and alcoholic drinks is negatively associated with the prevalence of high depressive symptoms.

     

A spatial analysis of dietary patterns in a large representative population in the north of The Netherlands – the Lifelines cohort study

Background

Diet is an important modifiable risk factor for chronic diseases. In the search for effective strategies to improve dietary patterns in order to promote healthy ageing, new approaches considering contextual factors in public health medicine are warranted. The aim of this study is to examine the spatial clustering of dietary patterns in a large representative sample of adults.

Methods

Dietary patterns were defined on the basis of a 111 item Food Frequency Questionnaire among n?=?117,570 adults using principal components analysis. We quantified the spatial clustering of dietary pattern scores at the neighborhood level using the Global Moran’s I spatial statistic, taking into consideration individual demographic and (neighborhood) socioeconomic indicators.

Results

Four dietary patterns explaining 27% of the variance in dietary data were extracted in this population and named the “bread and cookies” pattern, the “snack” pattern, the “meat and alcohol” pattern and the “vegetable, fruit and fish” pattern. Significant spatial clustering of high (hot spot) and low (cold spot) dietary pattern scores was found for all four dietary patterns irrespective of age and gender differences. Educational attainment and neighborhood income explained the global clustering to some extent, although clustering at smaller regional scales persisted.

Conclusion

The significant region-specific hot and cold spots of the four dietary patterns illustrate the existence of regional “food cultures” and underscore the need for interventions targeted at the sub-national level in order to tackle unhealthy dietary behavior and to stimulate people to make healthy dietary choices.

     

Dietary patterns and breast cancer risk among women in northern Tanzania: a case–control study

Background

Breast cancer is the second most common cancer among women in the Kilimanjaro Region of Tanzania. It was tested within a case–control study in this region whether a specific dietary pattern impacts on the breast cancer risk.

Methods

A validated semi-quantitative Food Frequency Questionnaire was used to assess the dietary intake of 115 female breast cancer patients and 230 healthy age-matched women living in the same districts. A logistic regression was performed to estimate breast cancer risk. Dietary patterns were obtained using principal component analysis with Varimax rotation.

Results

The adjusted logistic regression estimated an increased risk for a “Fatty Diet”, characterized by a higher consumption of milk, vegetable oils and fats, butter, lard and red meat (OR = 1.42, 95 % CI 1.08–1.87; P = 0.01), and for a “Fruity Diet”, characterized by a higher consumption of fish, mango, papaya, avocado and watery fruits (OR = 1.61, 95 % CI 1.14–2.28; P = 0.01). Both diets showed an inverse association with the ratio between polyunsaturated and saturated fatty acids (P/S ratio).

Conclusion

A diet characterized by a low P/S ratio seems to be more important for the development of breast cancer than total fat intake.     

Dietary Patterns and 12-Year Risk of Frailty: Results From the Three-City Bordeaux Study

Objective

To analyze the association between dietary patterns and the 12-year risk of frailty and its components in community-dwelling elderly French adults.

Steps/day and metabolic syndrome in African American adults: The Jackson Heart Study

Objective

To examine the relationship between pedometer-measured step count data and the Metabolic Syndrome (MetS) in African American adults.

Method

379 African American adults (mean age 60.1 years; 60% female) enrolled in the Jackson Heart Study (Jackson, MS) from 2000 to 2004 provided sufficient pedometer data for inclusion in this analysis. MetS was classified according to the International Diabetes Federation Task Force on Epidemiology and Prevention.

Results

Using steps/day categorized as tertiles (< 3717 (referent), 3717–6238, > 6238), participants taking 3717–6238 (Odds Ratio (OR)(95% Confidence Interval (CI)) = 0.34 (0.19, 0.61)) and > 6238 steps/day (OR(95% CI) = 0.43 (0.23, 0.78)) had lower odds of having MetS compared to participants in the lowest tertile. Using previously suggested steps/day cut-points (< 2500 (referent), 2500–4999, 5000–7499, ≥ 7500), the odds of having MetS were lower for participants taking 2500–4999 (OR(95% CI) = 0.32 (0.14, 0.72)), 5000–7499 (OR(95% CI) = 0.22 (0.09, 0.53)), and > 7500 (OR(95% CI) = 0.26 (0.11, 0.65)) steps/day compared to those taking < 2500 steps/day.

Conclusion

Compared to lower levels, higher levels of steps/day are associated with a lower prevalence of MetS in this older African American population.     

Metabolic syndrome and socioeconomic status in France: The French Nutrition and Health Survey (ENNS, 2006–2007)

Objectives

The main objective was to estimate, in France, the prevalence of metabolic syndrome (MetS) and to investigate the association between socioeconomic position and MetS.

Methods

The French National Nutrition and Health Survey (ENNS) cross-sectional national multistage sampling was carried out in 2006–2007. Data collection included waist circumference and blood pressure measurements, blood sample and sociodemographic and medication information. The prevalence of MetS was assessed using several definitions, including Joint Interim Statement (JIS). Association with sociodemographic covariates was assessed using logistic regression models.

Results

Among the 1,856 participants 18–74 years of age, MetS prevalence was found to vary from 14.6 % (National Cholesterol Education Program definition) to 21.1 % (JIS), with no difference between genders. After adjustment, risk of MetS increased with age in both men and women. In women, MetS risk was inversely associated with education level. Risk of MetS was higher in men born outside France than in French-born males.

Conclusions

MetS prevalence appeared to be lower in France than in most industrialised countries. The promoting of public health measures to reduce MetS, for example, lifestyle changes, is of utmost importance, particularly among less favourable socioeconomic categories and among migrants.     

Associations of Cigarette Smoking and Alcohol Consumption With Metabolic Syndrome in a Male Chinese Population: A Cross-Sectional Study

Background

Whether cigarette smoking and alcohol consumption are associated with the risk of metabolic syndrome (MetS) remains controversial. This study investigated the associations of cigarette smoking and alcohol consumption with MetS in a male population in China.

Methods

We conducted a cross-sectional study. A questionnaire was used to collect data on cigarette smoking, alcohol consumption, MetS status, and other related information from 8169 men aged 19–97 years. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between smoking and alcohol consumption and the risk of MetS.

Results

The prevalence of MetS was 15.2% in the study population. Proportions of current smokers and drinkers were 48.2% and 46.5%, respectively. Adjusted OR of MetS was 1.34 (95% CI, 1.01–1.79) among smokers who smoked ≥40 cigarettes/day compared with nonsmokers and 1.22 (95% CI 1.03–1.46) for those who consumed 0.1–99 grams of alcohol/day compared with nondrinkers. Adjusted OR was 2.32 (95% CI 1.45–3.73) among ex-drinkers who never smoked, 1.98 (95% CI 1.35–2.91) among ex-drinkers who were current smokers, and 1.34 (95% CI 1.08–1.68) among current drinkers who never smoked compared with those who neither smoked nor drank. There was a significant interaction between smoking and drinking alcohol on MetS (P for interaction is 0.001).

Conclusions

Our study indicated that smoking and drinking is associated with higher prevalence of MetS. Interactions between smoking and drinking on the risk of MetS in men in China may also exist. Our findings need to be confirmed in future case-control or cohort studies.Key words: cigarette smoking, alcohol consumption, metabolic syndrome, Chinese man, interaction     

General health status in army personnel: relations with health behaviors and psychosocial variables

Purpose

Poor self-rated health (SRH) is linked to an increased risk of injury, future healthcare services utilization, and morbidity and mortality. This study aimed to identify correlates of a single-item measure of health in 8070 US Army personnel.

Methods

Responses were collected from the Army’s global assessment tool (GAT) 2.0, an online questionnaire that assesses physical and psychosocial health. SRH was measured by the item, “How do you consider your health?” (four response categories: “poor,” “fair,” “good,” and “excellent”). Ordinal logistic regression (OLR) was used to evaluate how various health and psychosocial factors contribute to Soldiers’ ratings of SRH. Unadjusted and adjusted cumulative odds ratios (ORs) are presented and discussed.

Results

Most participants reported “good” health (57%), followed by “excellent” (24%), “fair” (17%), and “poor” (2%). Sleep quality (OR 2.48; 95% CI 2.34, 2.63) was the largest correlate of SRH, followed by obesity (OR 0.50; 95% CI 0.43, 0.58), emotional fitness (OR 1.68, 95% CI 1.56, 1.82), and Army physical fitness test (APFT) scores (OR 1.43; 95% CI 1.36, 1.51).

Conclusions

Single-item measures of self-reported health can cover a broad spectrum across physical and mental health. Among a large US Army sample, sleep quality was most strongly associated with SRH, followed by emotional fitness and APFT scores. In contrast, service-component and other sociodemographic characteristics had relatively small effects on general health. Military investigators and leaders who must rely on various subjective general health measures should interpret them as a combination of these factors.