Exposures to social and environmental stressors arise individual behavioural response and thus indirectly affect cardiometabolic health. The aim of this study was to investigate several social and environmental stressors and the paths of their influence on cardiometabolic health. The data of 2154 participants (aged 25-64 years) from the cross-sectional population-based study were analysed. The composite score of metabolic disorders (MS score) was calculated based on 5 biomarkers: waist circumference, blood pressure, fasting blood glucose, HDL-cholesterol, triglycerides. The effects of social stressors (education level, income), environmental stressors (NO2, noise) and behavioural factors (unhealthy diet, smoking, alcohol consumption, sedentary behaviours) on MS score were assessed using a structural model. We observed a direct effect of education on MS score, as well as an indirect effect mediated via an unhealthy diet, smoking, and sedentary behaviours. We also observed a significant indirect effect of income via sedentary behaviours. The only environmental stressor predicting MS was noise, which also mediated the effect of education. In summary, the effect of social stressors on the development of cardiometabolic risk had a higher magnitude than the effect of the assessed environmental factors. Social stressors lead to an individual's unhealthy behaviour and might predispose individuals to higher levels of environmental stressors exposures.

• MeSH
• Biomarkers blood   MeSH
• Adult MeSH
• Cholesterol, HDL blood   MeSH
• Cardiovascular Diseases etiology   epidemiology   MeSH
• Smoking adverse effects   MeSH
• Blood Glucose metabolism   MeSH
• Blood Pressure MeSH
• Middle Aged MeSH
• Humans MeSH
• Metabolic Diseases etiology   epidemiology   MeSH
• Waist Circumference MeSH
• Cross-Sectional Studies MeSH
• Stress, Psychological MeSH
• Risk Factors MeSH
• Sedentary Behavior * MeSH
• Triglycerides blood   MeSH
• Environmental Exposure adverse effects   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Biomarkers MeSH
• Cholesterol, HDL MeSH
• Blood Glucose MeSH
• Triglycerides MeSH

BACKGROUND: The inverse association between education and obesity was previously found in numerous studies. This study aims to assess several possible mediators in the educational disparities in adiposity. We hypothesize the potential mediating role of lifestyle, socioeconomic, and mental health factors in the association between education and adiposity. METHODS: Cross-sectional population-based sample from Czechia included 2,154 25-64 years old subjects (54.6% women). Education was classified as high, middle, and low. Adiposity was assessed as a latent variable based on body fat percentage, BMI, waist circumference, and visceral fat. The mediation potential of unhealthy dietary behavior, alcohol intake, smoking, sedentary behaviors, income, stress, depression, and quality of life was assessed in age-adjusted sex-specific multiple mediation models. RESULTS: The negative direct effect of education on adiposity was statistically significant at 5% level of significance in both sexes. For men, the indirect effect was statistically significant via sedentary behavior (β = 0.041; 95% CI [0.025-0.062]) with a mediation ratio of 23.7%. In women, the indirect effect was statistically significant via dietary risk (β = -0.023, 95% CI [-0.037, -0.013]), alcohol intake (β = -0.006; 95% CI [-0.014, -0.001]), sedentary behavior (β = 0.012, 95% CI [0.004,0.023]), income (β = -0.022; 95% CI [-0.041, -0.004]), and mental health (β = -0.007; 95% CI [-0.019, -0.001]). The total mediation ratio in women was 30.5%. CONCLUSIONS: Sedentary behaviors had mediating role in the association between education and adiposity in both sexes, with more important role in men. In addition, unhealthy diet and lower income partially mediated the educational gradient in adiposity in women.

• MeSH
• Adiposity * MeSH
• Mediation Analysis MeSH
• Health Status Disparities MeSH
• Adult MeSH
• Mental Health * MeSH
• Middle Aged MeSH
• Humans MeSH
• Obesity epidemiology   psychology   MeSH
• Cross-Sectional Studies MeSH
• Sedentary Behavior MeSH
• Socioeconomic Factors * MeSH
• Educational Status * MeSH
• Life Style * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

• Keywords
• adiposity, cardiometabolic risk, cardiovascular disease, chronic disease, dysglycemia, insulin resistance, nutrition, obesity, type 2 diabetes,
• MeSH
• Adiposity ethnology   MeSH
• White People statistics & numerical data   MeSH
• Chronic Disease epidemiology   ethnology   MeSH
• Diabetes Mellitus, Type 2 epidemiology   ethnology   MeSH
• Diet adverse effects   ethnology   MeSH
• Health Status Disparities MeSH
• Adult MeSH
• Dyslipidemias epidemiology   ethnology   MeSH
• Hypertension epidemiology   ethnology   MeSH
• Cardiometabolic Risk Factors MeSH
• Cardiovascular Diseases epidemiology   etiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Metabolic Syndrome epidemiology   ethnology   MeSH
• Obesity epidemiology   ethnology   MeSH
• Glucose Intolerance epidemiology   ethnology   MeSH
• Prediabetic State epidemiology   ethnology   MeSH
• Prevalence MeSH
• Sedentary Behavior ethnology   MeSH
• Social Determinants of Health ethnology   MeSH
• Feeding Behavior ethnology   MeSH
• Health Literacy MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

PURPOSE: We aimed to study the association of educational attainment with occurrence of mental disorders in the Czech Republic. METHODS: Data were derived from the CZEch Mental health Study (CZEMS), a cross-sectional study of community-dwelling individuals. Mental disorders were assessed with Mini International Neuropsychiatric Interview (M.I.N.I.), and information on completed education was acquired as a part of a paper and pencil interview. Logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals (CI) for the association of educational attainment with all mental disorders as well as with specific groups (affective, anxiety, alcohol use and substance use disorders), stepwise adjusting for socio-demographic, social and health-related characteristics. RESULTS: We studied 3175 individuals (average age 50 years, range 18-96 years; 54% women). Compared to individuals with higher education, those educated below high school graduation had higher odds of mental disorders (OR 2.07; 95% CI 1.58-1.71), even after adjustment for all covariates (OR 1.64; 95% CI 1.21-2.23). Education showed the strongest association with alcohol use disorders, even when covariates were adjusted for, but was not related to anxiety disorders. The association of education with affective as well as substance use disorders was explained by covariates. CONCLUSIONS: Interventions aimed at reducing the burden of mental disorders should target individuals with low education. Strategies to improve population mental health need to go hand in hand with policies to enhance education as well as reduce alcohol consumption in the Czech Republic.

• Keywords
• Education, Inequality, Mental disorder, Population,
• MeSH
• Alcoholism * MeSH
• Adult MeSH
• Mental Disorders * epidemiology   MeSH
• Mental Health MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Cross-Sectional Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Educational Status MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

BACKGROUND: Increasing educational level of the population could be a strategy to prevent depression. We investigated whether education may offer a greater benefit for mental health to women and to individuals living in socioeconomically disadvantaged areas. METHODS: We performed a cross-sectional study using data on 6964 Czech participants of the Health, Alcohol and Psychosocial factors in Eastern Europe study (on average 58 years old; 53% women). Binary logistic regression was used to examine the association of education with depressive symptoms, adjusting for several groups of covariates. Interactions were tested between education and sex as well as between education and socioeconomic advantage of the area of residence. RESULTS: Higher education was strongly associated with lower odds of depressive symptoms, independently of sociodemographic characteristics, health behavior and somatic diseases. This association was attenuated after adjusting for other markers of individual socioeconomic position (work activity, material deprivation and household items). There were no interactions between education and either sex or socioeconomic advantage of the area of residence. CONCLUSIONS: We did not find an independent association between education and depressive symptoms after controlling for other socioeconomic markers in a sample with a formative history of communistic ideologies. Women or individuals from socioeconomically disadvantaged areas do not seem to gain a larger mental health benefit from education.

• MeSH
• Depression * epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Socioeconomic Factors MeSH
• Educational Status MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Europe, Eastern MeSH

BACKGROUND: Czech nutrition recommendations prioritize health aspects without considering affordability. Low socio-economic groups have the highest risk of nutrition-related noncommunicable diseases and cost has been identified as an obstacle to achieve a healthy diet, making the implementation of affordability into dietary guidelines necessary. The aim of this study was to develop a food basket (FB) for a low income Czech family of four that is nutritionally adequate, health-promoting and culturally acceptable at an affordable price. METHODS: Linear programming optimisation was used to ascertain that the FB covered the recommended nutrient intakes from the Czech Nutrition Society and from the World Health Organization (WHO). Cost of the FB was calculated on the basis of more than 3900 prices of 330 foods. Within a given cost constraint, all FBs were optimized for the highest possible similarity to the reported food group intake according to the most recent Czech National Food Consumption survey, which was used as a proxy for cultural acceptability. RESULTS: The optimised FB affordable at a daily food budget for a Czech family on minimum wage (CZK 177, ~ € 6.8) contained 76 foods and had an average relative deviation of 10% per food category from reported intake. The main deviations were: 72% less sweets and confectionery; 66% less salt; 52% less meat; 50% less milk products; 8% less potatoes; and 484% more milk; 69% more oils and fats; 20% more cereals; and 6% more vegetables. CONCLUSIONS: The optimised FB can help to guide the development of food-based dietary guidelines for low income households in Czech Republic.

• Keywords
• Affordable diet, Cultural acceptability, Food-based dietary guidelines (FBDGs), Linear programming, Low socio-economic status, Nutritionally adequate diet,
• MeSH
• Poverty economics   MeSH
• Diet economics   methods   MeSH
• Child MeSH
• Adult MeSH
• Culturally Competent Care methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Nutritive Value MeSH
• Health Promotion economics   methods   MeSH
• Nutrition Policy economics   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

• Keywords
• Cardiovascular health, Central Europe, Eastern Europe, Health inequalities, Public health,
• Publication type
• Journal Article MeSH
• Review MeSH

This article investigates the health outcomes and determinants between two different European populations, Portuguese and Czech, on two hierarchical levels: country and metropolitan area. At first, the decomposition method of age and cause of death were compared on the country level, and then health was examined based on a factor analysis at the municipality level of Prague and Lisbon. The results clearly indicate problematic diabetes mortality among the Portuguese population, and especially in the Lisbon Metropolitan Area, and confirm the dominant role of circulatory mortality and cancer mortality among Czech, especially the Prague population. The social and economic deprivations were revealed as the major drivers for both metropolitan areas, although with differences between them, requiring interventions that go beyond the health sector.

• Keywords
• Czechia, Portugal, health determinants, health inequalities, health outcomes, population health,
• MeSH
• Poverty MeSH
• Diabetes Mellitus epidemiology   MeSH
• Health Status Disparities * MeSH
• Child MeSH
• Adult MeSH
• Cardiovascular Diseases epidemiology   MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Neoplasms epidemiology   MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Aged MeSH
• Socioeconomic Factors MeSH
• Cities MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Portugal epidemiology   MeSH
• Cities MeSH