Association of elevated body mass index and hypertension with mortality: the CroHort study

Aim of this study was to investigate association of elevated body mass index and hypertension with general mortality in the cohort from Croatian Adult Health Cohort Study (CroHort). Risk of death according to body mass index (BMI) and blood pressure category, in period 2003/08, was calculated for 7,490 respondents, out of which 6,682 were alive and 808 were dead in 2008. Among men aged 65 and more, elevated BMI was associated with lower risk of death, in accordance with obesity paradox recorded in some previous studies which showed that older men with higher BMI have lower risk of death. Among women aged 50-64 years, being hypertensive was associated with increased risk of death compared to normotensive respondents. Despite obesity paradox which should be further explored, activities on primary and secondary prevention of excess weight and hypertension should be encouraged as means to prevent premature mortality in Croatian population.     

Association of behavioral cardiovascular risk factors with mortality in Croatian adult population: the CroHort study

This study examined individual and combined influence of smoking, physical inactivity, alcohol drinking, and unhealthy diet on total mortality. Relationship between individual and combined poor health behaviours and total mortality were examined using Cox proportional hazards regression. Out of 7490 individuals included in the study, during 5 years follow up 808 died. Adjusted hazard ratios (HRs), and 95% confidence intervals (95% CIs) for men with health behaviour scores 1, 2, 3, and 4 compared with those with score 0 were 1.67 (1.24-2.24), 2.28 (1.64-3.18), 2.24 (1.32-3.84), and 2.86 (0.77-11.70), respectively (p value for trend < 0.001). Adjusted HRs (95% CIs) for women with health behaviour scores 1, 2, and 3 compared with those with score 0 were 1.17 (0.97-1.42), 1.37 (1.02-1.86), and 1.20 (0.37-3.61), respectively (p value for trend = 0.04). A unit of the health behaviour score increased mortality risk equivalent to being 5.9 and 2.9 years older, for man and woman respectively.     

Association of the psychological distress and cardiovascular risk behaviors, conditions and diseases: the CroHort study

Aim of this study was to explore and compare association of PD (psychological distress) and cardiovascular risk behaviors, conditions and diseases in Croatian adult population. The sample of this study consisted of 3,229 respondents. Psychological distress status was measured by the five-item Mental Health Scale (MHI-5) of the Short Form questionnaire (SF-36), hence one distinguished subgroup consisted of population with PD and other without PD. Prevalence of cardiovascular risk behaviors, cardiovascular risk conditions and self-reported cardiovascular diseases within each subgroup were calculated. During the follow up period physical inactivity remained the only risk behavior showing significant difference between PD status subgroups for both genders demonstrating higher prevalence in men and women with PD. During follow up period hypertension, myocardial infarction, angina pectoris and self-reported heart failure in women remained constant in showing statistically significant prevalence difference among population with and without PD. In men that type of constant association was shown only for heart failure.     

Risks of maternal prepregnancy overweight/obesity,excessive gestational weight gain,and bottle-feeding in infancy rapid weight gain: evidence from a cohort study in China

Rapid weight gain(RWG) in infants is associated with numerous health problems, and its risk factors are still unclear. We assessed 98,097 maternal-infant pairs from a population-based cohort study and followed up with them until the infants were6 months old. We assessed the associations between maternal prepregnancy weight status; gestational weight gain; feeding pattern; and infants' RWG at 0–1, 0–3, 1–3, and 3–6 months using multivariate unconditional logistic regression models, with controlled confounders. We found that maternal prepregnancy weight status, gestational weight gain, and feeding pattern at the1 st, 3 rd, and 6 th months had significant impacts on the infants' RWG at each time period(P0.05). Infants with overweight/obese mothers had a higher risk of RWG after birth, whereas those of mothers who experienced excessive gestational weight gain had higher risks of RWG from birth than the other groups(P0.01). Infants who were formula-fed had a higher risk of RWG than breastfed infants at the same time point(P0.01). In conclusion, maternal prepregnancy obesity, excessive gestational weight gain, and formula-feeding were risk factors for infants' RWG during the first 6 months of life.     

孕期体重增长和母儿远期健康的研究进展

孕期体重增长过多或不足不仅对近期妊娠结局产生不良影响,而且对母儿的远期健康也起着不可忽视的作用.孕期体重增长过多可能引起母亲远期肥胖、糖尿病及高血压等,对子代则会造成其儿童期及成年期超重、肥胖及高血压.孕期体重增长过少亦可能引起子代远期肥胖,且可导致成年期糖代谢紊乱,以至发展为糖尿病.运动及饮食调节可以控制孕期增重,孕期体重合理增长对减少不良妊娠预后有重要意义.现将近年来孕期体重增长和母儿远期健康的研究进展作一综述.     

Case oriented approach to co-occurrence of risk lifestyle behavior with overweight, excess abdominal fat and high blood pressure: the CroHort study

Objective of this paper is to estimate interim risk factors (INTF) proportions and changes within 5-years of groups with at least one risk health behavior (BEHF) in CroHort population. Results show that CroHort 2008 group has higher proportions of excess abdominal fat and overweight. Men older than 65 without any BEHF have smaller proportions of INTF in 2008 than in 2003. Proportion of people with high blood pressure is smaller in 2008 for all groups except for young women who show increase. Analysis of middle age group shows significant increase in all INTF in women smokers while men smokers have the highest increase in abdominal fat. Physical inactivity in women is associated with increase of all INTF, while men have decrease in overweight INTF. Alcohol intake has protective effect on middle aged men, except for increase in waist circumference. Women show constant increase in all INTF with heavy alcohol intake.     

Characteristics of people with the perceived stress in croatia: the CroHort study

This study aimed to assess levels of stress in Croatian adult population using PSS, in a population study (Croatian Adult Cohort Health Study - CroHort). Our results show that the levels of stress were 17.46 (SD = 6.73) for men and 18.32 (SD = 6.46) for women in Croatia. The lowest levels of stress experienced men living in urban area while women living in rural area had the highest level. Men and women who had university degree had significantly lower level of stress. The lowest levels of stress experienced participants who had much better financial condition than average. In men, stress was associated to weak heart, lower back pain, poor financial condition of the household and high alcohol consumption. In women, stress was associated to poor mental health, poor social functioning, poorer financial condition of the household, higher age, lower education, low monthly income of the household and poor general health.     

Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9

Background

Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9.

Methodology/Principal Findings

Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity.

Conclusions/Significance

Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.     

Metabolic syndrome--community nursing evaluation and intervention: the CroHort study

This prospective study of 1277 participants investigated patient risk self-assessment, motivation for changes in main determinants of the metabolic syndrome and the impact of community nursing intervention on cardiovascular risk reduction. Observed values of metabolic syndrome determinants indicated an elevated cardiovascular risk. Participants showed greatest motivation for positive changes regarding blood pressure, (3.70 +/- 1.26) then hyperglycemia (3.55 +/- 1.28), hyperlipidemia (3.46 +/- 1.30), overweight and obesity (3.43 +/- 1.28), and physical activity habits (3.29 +/- 1.31). Changes in physical activity and nutritional habits were not related to self-reported motivation regardless of the age and sex (p > 0.05). The most pronounced median improvements were observed in cholesterol (men 4.43%, women 4.89%) and triglycerides (men 3.41%, women 1.49%), with only slight changes in BMI (men 1.08%, women 1.18%) and no change in waist-to-hip ratio and glucose. This study revealed that, although aware and motivated, patients often do not succeed in changing habits. Concomitant changes of the environment and multisectoral prevention approach is necessary.     

Physical inactivity changes in Croatia: the CroHort study

The aim of this paper was to compare the surveys conducted respectively in 2003 and 2008 within the Croatian Adult Health Cohort Study (CroHort) regarding the physical activity/inactivity of the inhabitants of the Republic of Croatia. The collected data show a significant decline in the intensity of physical activity in 2008 with regards to 2003, regarding the way of getting to work (60.7%), the level of physical strain at work (72.2%), and the frequency of physical activity taken in the subjects' spare time (55.8%). In order to prevent the risk of cardiovascular diseases and to raise the public awareness of the potential health threat physical inactivity poses, a number of thoroughly conceived health promotion strategies should be implemented, which would equally encompass all the segments of Croatian society.     

Prevalence and five-year cumulative incidence of psychological distress: the CroHort study

The aims of this paper are to investigate the change in prevalence of psychological distress (PD), to investigate the cumulative incidence of the psychological distress and to indicate are there any differences between genders and various age groups in Croatian adult population. Psychological distress status was measured by the five-item Mental Health Scale (MHI-5) of the Short Form questionnaire (SF-36). Psychological distress was present in 28.5% (95% CI 25.7%-31.2%) of men and 32.1% (95% CI 30.1%-34.0%) of women in 2003. In 2008 PD was present in 33.0% (95% CI 30.1%-35.9%) of men and 34.1% (95% CI 32.1%-36.0%) of women. The highest incidence of PD, both for men and women, was in the oldest age group (> 65 years). Results of this study demonstrating the fact that every third adult men and woman in Croatia are in psychological distress, the fact that there is an increase in PD prevalence for men and women should be taken into account in the future mental health policy planning.     

The changing pattern of cardiovascular risk factors: the CroHort study

Croatia has a long tradition of non-communicable disease prevention, but also obstacles to the implementation of preventive programs related to the general attenuation of public health and primary health care sector. The aim of this study was to determine trends in behavioral and biomedical risk factors and evaluate primary non-communicable disease and cardiovascular prevention. Physical inactivity was a leading risk factor with increasing trend and prevalence of 33.9% and 38.9% in men and women in 2008. In 2008, obesity was present in 26.1% and 34.1%, and hypertension in 65.8% and 59.7% of men and women. During the follow-up only smoking and alcohol consumption in men decreased significantly, while alcohol consumption and obesity in women, and hypertension in both sexes significantly increased. In the present situation, with the existing trends and environment it will not be possible to stop negative trends. Revitalization of public health activities and primary health care is essential.     

Five-year cumulative incidence of obesity in adults in Croatia: the CroHort study

The objective of this paper was to evaluate the 5-year incidence of obesity on a sample of 3229 adults and investigate the potential effect of several sociodemographic and lifestyle habits on weight change and obesity incidence in these individuals. The average annual rate of increase in the prevalence of obese adults between 2003 and 2008 was 10.60% for men and 11.08% for women. Analysis showed that development of obesity in 5-year period in women in Croatia is significantly positively associated with frequent consumption of "hidden" fats of animal origin and significantly negative with each higher education level. No significant predictor of obesity has been found in men. Obesity remains a serious health problem for the Croatian population; the alarming rates of excess body weight continue to increase. Preventive measures should urgently be undertaken.     

Five-year cumulative incidence of smoking in adult Croatian population: the CroHort study

The aim of this paper is to investigate the incidence of smoking and changes in smoking habits in Croatia during a 5-year period. Data from the Croatian Adult Health Study of 2003 and 2008 was used for the study (N = 3229). The results of this study suggest that the incidence of smoking is the highest in youngest men and decreases with age. In ages 35 to 64 and older than 65 the incidence was higher in women than men. The cumulative smoking incidence is low in Croatia, but particularly alarming is a higher incidence in women than in men.     

Five-years cumulative incidence of alcohol consumption in Croatian adult population: the CroHort study

Alcohol consumption is traditionally part of most human cultures, and with the onset of industrial revolution it was recognized as a health and social problem. The aim of this article is to investigate cumulative incidence of alcohol consumption in Croatia. Data were obtained from the Croatian Adult health Survey in 2003 followed by 2008. The cohort consisted of 3229 participants. Questions regarding alcohol consumption were calculated into two factors describing existence or non-existence of risk behavior. Results revealed higher incidence of risk alcohol consumption in man than in women and highest in the 35-65, age group. Due to the some study limitations results might be underestimated. Present problem of alcohol is alarming, even more so, in women's population it might be only the tip of the iceberg. Cultural and regional differences should be taken into account when educational programs are constructed, especially due to the different type of alcohol consumed.     

Five-year cumulative incidence of physical inactivity in adult Croatian population: the CroHort study

The aim of this study was to analyze gender and age differences in physical inactivity in Croatia and physical inactivity pattern changes during the five-year period. The study is based on the data obtained from the Croatian Adult Health Cohort Study which was carried out in 2003 and 2008. The prevalence of physical inactivity in 2008 was 37.7%, 36.8% in men and 38.1% in women. In both study waves the prevalence was increasing with age in both men and women. The prevalence is statistically significantly higher in subjects older than 64 years than in younger age groups. The incidence of physical inactivity in the five-year period in total was 29.9%, 27.2% in men and 31.1% in women. The increase in prevalence of physical inactivity despite the number of preventive activities carried out periodically emphasizes the need for systematic and comprehensive approach in increasing the number of regularly physically active individuals.