The role of modifiable risk factors in the development of dementia in Central and Eastern Europe remains understudied. We aimed to examine the association between 12 risk factors and the incidence of dementia in the Czech Republic and estimate the proportion of new dementia cases that can be attributed to these risk factors. Data of 3805 Czech participants in the Survey of Health, Ageing, and Retirement in Europe (mean age: 70 years, median 6.5-year follow-up) were analyzed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox hazard models for the association between the risk factors (low education, alcohol use, living alone, obesity, smoking, physical inactivity, high blood pressure, high cholesterol, diabetes mellitus, hearing loss, vision problem, and depression) and probable dementia diagnosis defined based on adapted Lang-Weir algorithm. We estimated the proportion of dementia cases attributable to each risk factor using weighted population attributable fractions (wPAFs). Four risk factors, low education (HR 1.72), depression (HR 1.42), diabetes mellitus (HR 1.53), and physical inactivity (HR 2.13), were significantly associated with dementia and accounted for the largest proportion of attributable risk. The total weighted PAF for all factors was 39.18%. If all risk factors for dementia were eliminated, almost 40% of dementia cases in the Czech Republic could be prevented. More systematic approach is essential for mitigating the adverse impact of risk factors on the incidence of dementia, such as improving education, preventing and treating depression and diabetes mellitus, and promoting physical.

• MeSH
• demence * epidemiologie   MeSH
• deprese epidemiologie   MeSH
• důchod statistika a číselné údaje   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• proporcionální rizikové modely MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zdravotnické přehledy MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   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
• adipozita * MeSH
• analýza mediace MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   psychologie   MeSH
• průřezové studie MeSH
• sedavý životní styl MeSH
• socioekonomické faktory * MeSH
• stupeň vzdělání * MeSH
• životní styl * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND AND AIMS: Uncovering the main determinants of diet quality is one of the greatest challenges for Public Health, since it could guide future strategies and interventions against cardiovascular diseases (CVDs). The present cross-sectional analysis of the Kardiovize cohort evaluates the prevalence of dietary risk factors for CVDs and their association with social and behavioural characteristics in a random sample of 1536 adults (aged 25-64 years) from Brno, Czech Republic. METHODS AND RESULTS: A face-to-face health interview guided by structured questionnaires was carried out on socio-demographic characteristics (age, sex, educational level, employment, marital status, income, and household size) and behaviours (smoking status, physical activity, and sleep habits). Twelve dietary risk factors covered by the Global Burden of Diseases comparative risk assessment framework were assessed using a Food Frequency Questionnaire. In general, we observed that the consumption of nearly all healthy foods and nutrients was suboptimal, and that it was also aggravated by high intake of foods and nutrients that constituted dietary risk factors. Moreover, we found several associations of social and behavioural characteristics with specific dietary risk factors. Particularly, being male (β = 0.466; SE = 0.079; p < 0.001), increasing household size (β = 0.130; SE = 0.047; p = 0.006), low income (β = 0.192; SE = 0.091; p = 0.035), and decreasing physical activity level (β = 0.172; SE = 0.054; p = 0.002) were associated with increasing number of dietary risk factors. CONCLUSION: Thus, our study raises an urgent need for Public Health strategies promoting healthy eating in adulthood, which should be based on traditional and novel determinants of dietary risk.

• Klíčová slova
• Behaviours, Cardiovascular risk, Diet, Epidemiology, Public health, Sociodemographic factors,
• MeSH
• cvičení MeSH
• dieta škodlivé účinky   MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kardiovaskulární nemoci diagnóza   epidemiologie   MeSH
• kouření škodlivé účinky   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manželský stav MeSH
• nutriční hodnota MeSH
• příjem MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• sedavý životní styl MeSH
• sexuální faktory MeSH
• sociální determinanty zdraví * MeSH
• spánek MeSH
• stravovací zvyklosti * MeSH
• stupeň vzdělání MeSH
• věkové faktory MeSH
• zaměstnanost MeSH
• zdravé chování * MeSH
• zvyky MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

AIMS: Cardiovascular disease (CVD) risk prediction models are used in Western European countries, but less so in Eastern European countries where rates of CVD can be two to four times higher. We recalibrated the SCORE prediction model for three Eastern European countries and evaluated the impact of adding seven behavioural and psychosocial risk factors to the model. METHODS AND RESULTS: We developed and validated models using data from the prospective HAPIEE cohort study with 14 598 participants from Russia, Poland, and the Czech Republic (derivation cohort, median follow-up 7.2 years, 338 fatal CVD cases) and Estonian Biobank data with 4632 participants (validation cohort, median follow-up 8.3 years, 91 fatal CVD cases). The first model (recalibrated SCORE) used the same risk factors as in the SCORE model. The second model (HAPIEE SCORE) added education, employment, marital status, depression, body mass index, physical inactivity, and antihypertensive use. Discrimination of the original SCORE model (C-statistic 0.78 in the derivation and 0.83 in the validation cohorts) was improved in recalibrated SCORE (0.82 and 0.85) and HAPIEE SCORE (0.84 and 0.87) models. After dichotomizing risk at the clinically meaningful threshold of 5%, and when comparing the final HAPIEE SCORE model against the original SCORE model, the net reclassification improvement was 0.07 [95% confidence interval (CI) 0.02-0.11] in the derivation cohort and 0.14 (95% CI 0.04-0.25) in the validation cohort. CONCLUSION: Our recalibrated SCORE may be more appropriate than the conventional SCORE for some Eastern European populations. The addition of seven quick, non-invasive, and cheap predictors further improved prediction accuracy.

• Klíčová slova
• Cardiovascular diseases, Eastern Europe, Psychosocial deprivation, Risk prediction, Sensitivity and specificity, Socioeconomic factors,
• MeSH
• hodnocení rizik MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• kohortové studie MeSH
• lidé MeSH
• prospektivní studie MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika MeSH
• Polsko MeSH
• Rusko MeSH

BACKGROUND: Previous studies have shown that deprived neighbourhoods have higher cardiovascular mortality and morbidity rates. Inequalities in the distribution of behaviour related risk factors are one possible explanation for this trend. In our study, we examined the association between cardiovascular risk factors and neighbourhood characteristics. To assess the consistency of associations the design is cross-national with data from nine industrial towns from the Czech Republic and Germany. METHODS: We combined datasets from two population based studies, one in Germany ('Heinz Nixdorf Recall (HNR) Study'), and one in the Czech Republic ('Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) Study'). Participation rates were 56% in the HNR and 55% in the HAPIEE study. The subsample for this particular analysis consists of 11,554 men and women from nine German and Czech towns. Census based information on social characteristics of 326 neighbourhoods were collected from local administrative authorities. We used unemployment rate and overcrowding as area-level markers of socioeconomic status (SES). The cardiovascular risk factors obesity, hypertension, smoking and physical inactivity were used as response variables. Regression models were complemented by individual-level social status (education) and relevant covariates. RESULTS: Smoking, obesity and low physical activity were more common in deprived neighbourhoods in Germany, even when personal characteristics including individual education were controlled for. For hypertension associations were weak. In the Czech Republic associations were observed for smoking and physical inactivity, but not for obesity and hypertension when individual-level covariates were adjusted for. The strongest association was found for smoking in both countries: in the fully adjusted model the odds ratio for 'high unemployment rate' was 1.30 [95% CI 1.02-1.66] in the Czech Republic and 1.60 [95% CI 1.29-1.98] in Germany. CONCLUSION: In this comparative study, the effects of neighbourhood deprivation varied by country and risk factor; the strongest and most consistent effects were found for smoking. Results indicate that area level SES is associated with health related lifestyles, which might be a possible pathway linking social status and cardiovascular disease. Individual-level education had a considerable influence on the association between neighbourhood characteristics and risk factors.

• MeSH
• charakteristiky bydlení * MeSH
• chudé oblasti * MeSH
• cvičení fyziologie   MeSH
• hypertenze epidemiologie   MeSH
• kardiovaskulární nemoci ekonomika   epidemiologie   MeSH
• kouření škodlivé účinky   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nahuštění v prostoru MeSH
• nezaměstnanost statistika a číselné údaje   MeSH
• obezita MeSH
• prevalence MeSH
• regresní analýza MeSH
• rizikové faktory MeSH
• senioři MeSH
• společenská třída * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Německo epidemiologie   MeSH

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

• Klíčová slova
• physical activity, sedentary behavior, sleep hygiene, social inequalities,
• MeSH
• chování dětí MeSH
• cvičení MeSH
• dítě MeSH
• lidé MeSH
• obezita dětí a dospívajících * epidemiologie   MeSH
• průřezové studie MeSH
• sedavý životní styl * MeSH
• socioekonomické faktory MeSH
• spánek MeSH
• společenská třída MeSH
• Světová zdravotnická organizace MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Purpose: Tracking of physical activity (PA) and sport participation (SP) during motherhood is poorly understood. The purpose of the study was to analyze the extent of tracking of maternal PA and SP. Methods: In this investigation, data were collected from the Czech ELSPAC study subsample of 4811 and 2609 women measured postnatally (1991-1992) and after 11 years of follow-up (2002-2003), respectively. The structured questionnaire was used to assess the participation and average weekly time spent in PA, and the frequency of engaging in different sports (running, cycling, strength training, racket sports, swimming, and team sports). Tracking was calculated using generalized estimating equations (GEE) with beta coefficients (β), odds ratios (ORs), and 95% confidence intervals (95% CI). Results: Moderately high tracking coefficients were observed for cycling (β = 0.69, 95% 0.67-0.72), strength training (β = 0.59, 95% 0.56-0.63), and weekly time spent in PA (β = 0.53, 95% 0.38-0.66); meanwhile, moderate tracking coefficients were generated for swimming (β = 0.48, 95% 0.44-0.52), team sports (β = 0.44, 95% 0.39-0.48), racket sports (β = 0.44, 95% 0.39-0.48), and running (β = 0.35, 95% 0.30-0.40). Mothers who did not participate in PA at baseline were 81% more likely not to participate in it at follow-up (OR = 1.81, 95% CI 1.53-2.13). Conclusion: Cycling- and strength-related activities and weekly PA were tracked moderately-to-moderately high during motherhood. Moreover, the strong tracking of physical inactivity indicates that the detection of this risk factor before pregnancy should be advocated.

• Klíčová slova
• longitudinal analysis, motherhood, sport participation, stability,
• MeSH
• cvičení MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• sedavý životní styl MeSH
• sporty * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: The aim was to assess the association between physical activity and screen-based activities in adolescents and selected school factors and urbanization and whether these associations were modified by degree of urbanization. METHODS: We obtained data regarding the fifth-ninth grade students from 130 schools in 2014 via the Health Behaviour in School-aged Children cross-sectional study in Slovakia (n = 9743, mean age = 13.5, 50.3% boys). We explored the associations using multilevel logistic regression. RESULTS: We found significant associations between physical activity and the accessibility of an area for skating/tennis court [odds ratio (OR) = 1.20 and 95% confidence interval (CI) 1.01-1.42], and between physical activity and active breaks (OR = 0.83 and 95% CI 0.69-0.99). The rates of screen-based activities were higher in small towns (OR = 1.63, 95% CI 1.29-2.06), towns (OR = 1.30, 95% CI 1.08-1.57), and cities (OR = 1.40, 95% CI 1.04-1.87) than in villages. CONCLUSIONS: School environment and degree of urbanization are associated with adolescents' physical activity and screen-based activities. This holds positively for access to an area for skating/tennis court and negatively for active breaks regarding physical activity and for living in villages regarding less use of screens.

• Klíčová slova
• Accessibility of sports facilities at school, Active breaks, Adolescence, Degree of urbanization, Physical activity, Screen-based activities,
• MeSH
• cvičení * MeSH
• dítě MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• odds ratio MeSH
• průřezové studie MeSH
• sedavý životní styl * MeSH
• školy statistika a číselné údaje   MeSH
• urbanizace * MeSH
• velkoměsta MeSH
• veřejná zařízení MeSH
• životní prostředí MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH
• velkoměsta 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.

• Klíčová slova
• adiposity, cardiometabolic risk, cardiovascular disease, chronic disease, dysglycemia, insulin resistance, nutrition, obesity, type 2 diabetes,
• MeSH
• adipozita etnologie   MeSH
• běloši statistika a číselné údaje   MeSH
• chronická nemoc epidemiologie   etnologie   MeSH
• diabetes mellitus 2. typu epidemiologie   etnologie   MeSH
• dieta škodlivé účinky   etnologie   MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• dyslipidemie epidemiologie   etnologie   MeSH
• hypertenze epidemiologie   etnologie   MeSH
• kardiometabolické riziko MeSH
• kardiovaskulární nemoci epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolický syndrom epidemiologie   etnologie   MeSH
• obezita epidemiologie   etnologie   MeSH
• porucha glukózové tolerance epidemiologie   etnologie   MeSH
• prediabetes epidemiologie   etnologie   MeSH
• prevalence MeSH
• sedavý životní styl etnologie   MeSH
• sociální determinanty zdraví etnologie   MeSH
• stravovací zvyklosti etnologie   MeSH
• zdravotní gramotnost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: In the late 1980s, Czechia was among the countries which had the highest cardiovascular mortality in the world. In spite of enormous improvements since that time, there are still large opportunities in further improving cardiovascular health. METHODS: Based on the Czech Health, Alcohol and Psychosocial Factors in Eastern Europe sample (n=8449 at baseline, 12 years of follow-up, 494 cardiovascular disease (CVD) deaths up to 2015-events), the impact of selected covariates such as education, smoking habits, high blood pressure, blood cholesterol level, diabetes, obesity, physical activity and binge drinking and their multifactorial effects on cardiovascular mortality was evaluated by Cox regression. In addition, population attributable fractions (PAFs) were used to quantify the impact of these factors on CVD mortality in the population. RESULTS: Education was found as the strongest determinant of CVD mortality (primary vs university, HR 2.77, P<0.001; PAF=50.5%). CVD risk was two times higher for persons with diabetes compared with those without (HR 2.02, P<0.001, PAF=23.2%). Furthermore, significant factors found were smoking (smoker vs non-smoker, HR 1.91, P<0.001; PAF=26.5%), high blood pressure (HR 1.73, P<0.001; PAF=35.3%) and physical inactivity (none vs sufficient, HR 1.60, P<0.001; PAF=22.9%). Conversely, the effect of obesity was low (HR 1.29, P value =0.020), and binge drinking and high blood cholesterol level were not significant at all. CONCLUSIONS: Education had the largest impact on cardiovascular mortality among the Czech population. More than 50% of CVD death would be prevented if the whole population had the same risk values as the highest educated population. Reducing disparities in health related to education should benefit from attention to cardiovascular health literacy.

• Klíčová slova
• cohort studies, demography, epidemiology of cardiovascular disease, lifestyle, mortality,
• MeSH
• cholesterol MeSH
• diabetes mellitus epidemiologie   MeSH
• dospělí MeSH
• hypertenze epidemiologie   MeSH
• kardiovaskulární nemoci epidemiologie   mortalita   MeSH
• komorbidita MeSH
• kouření MeSH
• lidé středního věku MeSH
• lidé MeSH
• nárazové pití alkoholu MeSH
• následné studie MeSH
• pití alkoholu epidemiologie   MeSH
• senioři MeSH
• socioekonomické faktory MeSH
• stupeň vzdělání MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• cholesterol MeSH