Most cited article - PubMed ID 32249142
The association of social and behavioral factors with dietary risks in adults: Evidence from the Kardiovize Brno 2030 study
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
High consumption of sugar-sweetened beverages (SSBs) is associated with a higher risk of cardiovascular disease (CVD). The last report on the prevalence of SSBs consumption in Czechia was 17 years ago, an updated analysis will enable the design of appropriate public health policies. This study aimed to determine the prevalence of SSBs consumption in a Czech city during 2020 and 2022, and its association with cardiometabolic biomarkers, behavioral risk factors, and socioeconomic determinants. A total of 730 participants (33 to 73 years) were assessed from a random population-based survey. SSBs consumption was evaluated using two methods: by calorie amount, with a 24 h dietary recall, and by frequency, with a food frequency questionnaire. By calorie amount, the prevalence of SSBs consumption was none: 52.5%, low: 30.0%, and moderate−high: 17.5%; by frequency was never: 16.0%, occasionally: 64.1%, and daily: 19.9%. SSBs intake was higher in men (p < 0.001) and younger participants (p = 0.001). Men consuming daily had higher waist circumference and visceral fat area compared to both occasional and never consumers. Higher SSBs consumption was associated with low household income, middle education level, and high total energy intake. In total, 20% drank SSBs daily and 17.5% of participants consumed moderate−high calorie amounts of SSBs. These results represent an increase in the prevalence of SSBs consumption in the last two decades. Public health policies should target men of younger age and people with low education and income.
- Keywords
- Czechia, cardiovascular disease, epidemiology, soft drinks, sugar-sweetened beverages,
- MeSH
- Sugar-Sweetened Beverages * adverse effects MeSH
- Diet MeSH
- Adult MeSH
- Humans MeSH
- Beverages adverse effects MeSH
- Risk Factors MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
Ideal cardiovascular health (CVH) is defined for the presence of ideal behavioral and health metrics known to prevent cardiovascular disease (CVD). The association of circulatory phospho- and sphingo-lipids to primary reduction in cardiovascular risk is unclear. Our aim was to determine the association of CVH metrics with the circulating lipid profile of a population-based cohort. Serum sphingolipid and phospholipid species were extracted from 461 patients of the randomly selected prospective Kardiovize study based on Brno, Czech Republic. Lipids species were measured by a hyphenated mass spectrometry technique, and were associated with poor CVH scores, as defined by the American Heart Association. Phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE) species were significantly lower in ideal and intermediate scores of health dietary metric, blood pressure, total cholesterol and blood fasting glucose compared to poor scores. Current smokers presented higher levels of PC, PE and LPE individual species compared to non-smokers. Ceramide (Cer) d18:1/14:0 was altered in poor blood pressure, total cholesterol and fasting blood glucose metrics. Poor cardiovascular health metric is associated with a specific phospho- and sphingolipid pattern. Circulatory lipid profiling is a potential biomarker to refine cardiovascular health status in primary prevention strategies.
- Keywords
- cardiovascular health, lipidomics, mass spectrometry, phospholipids, sphingolipids,
- Publication type
- Journal Article 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
Existing data have described benefits and drawbacks of alcohol consumption on cardiovascular diseases (CVD), but no research has evaluated its association with the cardiovascular health (CVH) score proposed by the American Heart Association. Here, we conducted a cross-sectional analysis on the Kardiovize cohort (Brno, Czech Republic), to investigate the relationship between alcohol consumption and CVH. We included 1773 subjects (aged 25-64 years; 44.2% men) with no history of CVD. We compared CVD risk factors, CVH metrics (i.e., BMI, healthy diet, physical activity level, smoking status, blood pressure, fasting glucose, and total cholesterol) and CVH score between and within several drinking categories. We found that the relationship between drinking habits and CVH was related to the amount of alcohol consumed, drinking patterns, and beverage choices. Heavy drinkers were more likely to smoke tobacco, and to report diastolic blood pressure, fasting glucose, triglycerides, and low-density lipoprotein (LDL)-cholesterol at higher level than non-drinkers. Among drinkers, however, people who exclusively drank wine exhibited better CVH than those who exclusively drank beer. Although our findings supported the hypothesis that drinking alcohol was related to the CVH in general, further prospective research is needed to understand whether the assessment of CVH should incorporate information on alcohol consumption.
- Keywords
- cardiometabolic health, cardiovascular disease, drinking habits, nutritional epidemiology, public health,
- MeSH
- Adult MeSH
- Ethanol administration & dosage MeSH
- Cardiovascular Diseases chemically induced MeSH
- Tobacco Smoking MeSH
- Blood Glucose MeSH
- Blood Pressure MeSH
- Middle Aged MeSH
- Humans MeSH
- Alcohol Drinking adverse effects MeSH
- Beer MeSH
- Risk Factors MeSH
- Wine MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Ethanol MeSH
- Blood Glucose MeSH