195 research outputs found
Microsoft Word - MPH maseterarbeit Anhang_070807
No full textFAEH, MPH-Master-Thesis: Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and Abstract Background Impaired glucose regulation (IGR) is associated with detrimental cardiovascular outcomes such as cardiovascular disease risk factors (CVD risk factors) or intima-media thickness (IMT). Our aim was to examine whether these associations are mediated by body mass index (BMI), waist circumference (waist) or fasting serum insulin (insulin) in a population in the African region. Methods Major CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25-64 in the Seychelles (n=1255, participation rate: 80.2%). According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n=496). Results Age-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend <0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results. Conclusions We found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of David FAEH, MPH-Master-Thesis: Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposit
BMI–mortality association: shape independent of smoking status but different for chronic lung disease and lung cancer
No full textDavid Faeh,1,2 Marco Kaufmann,1 Sarah R Haile,1 Matthias Bopp1 On behalf of the Swiss National Cohort Study Group 1Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland; 2Health Department – Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland Background: Besides smoking, low or high body mass index (BMI) is associated with chronic lung disease (CLD). It is unclear how CLD is associated with BMI, whether smoking interacts with this association, and how the associations differ from the patterns known for lung cancer.Population and Methods: Our population comprised 35,212 individuals aged 14–99, who participated in population-based surveys conducted in 1977–1993 in Switzerland (mortality follow-up until 2014). We categorized smokers into never, former, light, and heavy; and BMI into underweight, normal weight, overweight, and obese. Hazard ratios (HRs) were obtained with multivariable Cox proportional hazards models.Results: CLD mortality was strongly associated with being underweight. This was mainly due to the effect in men (HR 5.04 [2.63–9.66]) and also prevailed in never smokers (HR 1.81 [1.11–3.00]). Obesity was also associated with CLD mortality (HR men: 1.37 [1.01–1.86], women: 1.39 [0.90–2.17]), but not with lung cancer mortality. In line with lung cancer, for CLD, the BMI–mortality association followed the same shape in all smoking categories, suggesting that this association was largely independent of smoking status.Conclusion: The shape of the BMI–mortality association was inversely linear for lung cancer but followed a U-shape for CLD. Further research should examine the potentially protective effect of obesity on lung cancer occurrence and the possibly hazardous impact of underweight on CLD development. Keywords: chronic lung disease, lung cancer, mortality, body mass index, underweight, obesity, smokin
Independent at heart: persistent association of altitude with ischaemic heart disease mortality after consideration of climate, topography and built environment.
No full textBACKGROUND
Living at higher altitude was dose-dependently associated with lower risk of ischaemic heart disease (IHD). Higher altitudes have different climatic, topographic and built environment properties than lowland regions. It is unclear whether these environmental factors mediate/confound the association between altitude and IHD. We examined how much of the altitude-IHD association is explained by variations in exposure at place of residence to sunshine, temperature, precipitation, aspect, slope and distance to main road.
METHODS
We included 4.2 million individuals aged 40-84 at baseline living in Switzerland at altitudes 195-2971 m above sea level (ie, full range of residence), providing 77 127 IHD deaths. Mortality data 2000-2008, sociodemographic/economic information and coordinates of residence were obtained from the Swiss National Cohort, a longitudinal, census-based record linkage study. Environment information was modelled to residence level using Weibull regression models.
RESULTS
In the model not adjusted for other environmental factors, IHD mortality linearly decreased with increasing altitude resulting in a lower risk (HR, 95% CI 0.67, 0.60 to 0.74) for those living >1500 m (vs<600 m). This association remained after adjustment for all other environmental factors 0.74 (0.66 to 0.82).
CONCLUSIONS
The benefit of living at higher altitude was only partially confounded by variations in climate, topography and built environment. Rather, physical environment factors appear to have an independent effect and may impact on cardiovascular health in a cumulative way. Inclusion of additional modifiable factors as well as individual information on traditional IHD risk factors in our combined environmental model could help to identify strategies for the reduction of inequalities in IHD mortality
FOOD RECOGNITION IN ASSESSING THE MEDITERRANEAN DIET: A HIERARCHICAL APPROACH
No full textBackground and aims: The Mediterranean diet (MD) is an eating pattern that can lower the risk of non-communicable diseases, including diabetes. The Mediterranean Diet Adherence (MDA) index determines how closely individuals follow MD, based on their consumed meals. The index can be automatically evaluated with a system which accurately recognises the food items that appear in a photo of a person’s meal.
Methods: We propose a novel hierarchical algorithm to address the problem of multi-label automatic food recognition. The input of the system is an image of a meal and the outputs are the MD-related food categories it contains. Firstly, a convolutional neural network (CNN) is trained to recognise the food items that exist in an image. The food categories are often confused by the CNN but are merged into coarse classes. Then, a newly introduced CNN following a hierarchical architecture learns to output from the coarse to the MD-related food categories.
Results: We used a dataset that contains 5778 food images captured under free living conditions. The images are annotated into 31 food categories of interest for MD, from which the MDA index is defined. For the 31 MD-related food categories, the hierarchical model achieved a mean Average Precision of 52.71%.
Conclusions: The proposed algorithm can more accurately predict the food items that appear in an image than the baseline method and will be integrated into a smartphone application that estimates the weekly MDA on the basis of each consumed meal/drink
Ultraprocessed Food Consumption is Strongly and Dose‐Dependently Associated with Excess Body Weight in Swiss Women
No full textObjective: This study investigated the association between ultraprocessed food consumption and excess body weight in a Swiss nationally representative study.
Methods: Data stem from the cross-sectional Swiss National Nutrition Survey menuCH (n = 2,057). Dietary information was collected with 24-hour dietary recalls, and food items were categorized into non-ultraprocessed or ultraprocessed using the NOVA food classification system. The following three excess body weight indicators were considered: BMI, waist circumference (WC), and a BMI-WC composite outcome. Multinomial logistic regression models stratified by sex were fitted.
Results: Women in the highest quintile of ultraprocessed food weight proportion had significantly higher odds of having obesity (odds ratio [OR] 3.01, 95% CI: 1.48-6.11), having abdominal obesity (OR 2.69, 95% CI: 1.43-5.05), and being in the highest category of the BMI-WC composite outcome (OR 3.28, 95% CI: 1.59-6.77). No relevant associations were observed in men.
Conclusions: Ultraprocessed food weight proportion was strongly and dose-dependently associated with excess body weight in women but not in men. Further studies are required to elucidate potential mechanisms behind this association. Increasing evidence of the detrimental effect of ultraprocessed food consumption on health stresses the need to consider these products in future public health strategies
La structure de l'épidémie de l'obésité
No full textDepuis toujours, l'homme a transformé son environnement physique et social de façon à satisfaire ses besoins. Cet environnement influence à son tour le comportement de l'homme. Ces structures génèrent des besoins et influencent les modes de consommation et de déplacement de ceux qui vivent en leur sein. De plus en plus de gens habitent dans un environnement fortement structuré, si bien que ce dernier accroît son importance comme facteur déterminant pour la santé, notamment en ce qui concerne la masse corporelle. Alors que les pollutions de l'environnement avec un impact destructeur direct sur l'homme s'amenuisent, on assiste à une évolution vers un environnement qui favorise l'inactivité physique et la forte consommation de calories. A l'heure de la globalisation, le développement vers des structures favorisant l'obésité, même et particulièrement dans les pays en développement, se poursuit à un rythme effréné. [Auteur
Impact of Diet on Disease Prevention and Progression in Heart Failure Patients: What\u27s the Evidence?
No full textSimilar to other developed countries..
Begehrt das Herz Bergluft? Einfluss der Meereshöhe auf das Herz-Kreislauf-Risiko
No full textGemäss den meisten Studien haben Menschen, die in der Höhe leben oder dort geboren sind, ein niedrigeres Risiko an einem Herz- oder Gehirninfarkt zu sterben als Flachländer.
Dabei ist der Höheneffekt ausgeprägter für Herz-, als für Hirnschlag und generell stärker bei Männern als bei Frauen. Möglicherweise beeinflusst die Exposition an einer gewissen Meereshöhe das Herz-Kreislauf-Risiko ein Leben lang. Dass Unterschiede bei den klassischenHerz-Kreislauf-Risikofaktoren für den Höheneffekt verantwortlich sind, ist unwahrscheinlich. Hingegen könnten höhenabhängige Umweltbedingungen eine Rolle spielen.
According to most studies, persons living or being born at higher altitude have a lower risk of fatal myocardial infarction or stroke than lowlanders. The altitude effect is more pronounced for myocardial infarction than for stroke and generally stronger in men than in women. Possibly, exposure to a certain altitude impacts on cardiovascular risk for the entire life span. It is unlikely that classical cardiovascular risk factors substantially influence the altitude effect. In contrast, environmental conditions that depend on altitude could play a role
Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insuline resistance and adiposity
No full textBackground Impaired glucose regulation (IGR) is associated with detrimental cardiovascular outcomes such as cardiovascular disease risk factors (CVD risk factors) or intima-media thickness (IMT). Our aim was to examine whether these associations are mediated by body mass index (BMI), waist circumference (waist) or fasting serum insulin (insulin) in a population in the African region.
Methods Major CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25-64 in the Seychelles (n=1255, participation rate: 80.2%). According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n=496).
Results Age-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend <0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results.
Conclusions We found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of adiposity and insulin resistance. The results also imply that IGR and associated major CVD risk factors should be systematically screened and appropriately managed
Should we go nuts about nuts?
No full textSince the beginning of the 1990s, increasing evidence supports beneficial effects of nut consumption on health. A new analysis of the Spanish PREDIMED trial, published in BMC Medicine, has expanded our knowledge. The study showed that individuals eating nuts more than three times per week died less often from cardiovascular disease and cancer than non-consumers. The study also adds an important finding that previous epidemiological studies could not provide: a protective effect on premature mortality was only seen in the intervention group in which nut consumption increased during the 4.8 years of follow-up, not in the intervention group with additional olive oil consumption or in the control group. Nut consumption actually decreased during follow-up in the latter two groups. Questions remain to be answered on the quantity of nuts to be consumed for health benefits, on possible mechanisms of action, and on whether some types of nuts should be favored
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