The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015) / 예방의학회지

OBJECTIVES: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. METHODS: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. RESULTS: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). CONCLUSIONS: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study / 예방의학회지

OBJECTIVES: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. METHODS: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (14 years). RESULTS: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. CONCLUSIONS: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Perinatal and family factors associated with preadolescence overweight/obesity in Greece: the GRECO study

To explore associations of perinatal and family factors with preadolescence overweight and obesity in a sample of Greek schoolchildren. A nationwide cross-sectional study among 2093 students [10.9 +/- 0.72 years, 44.9% boys] and their parents were conducted. Anthropometric [e.g., height, weight, mother's body mass index [BMI] at the time of the study and at conception], socio-demographic [e.g., age, education, socio-economic status], diet and other major lifestyle characteristics [e.g., smoking, alcohol intake, physical activity and inactivity] and perinatal factors [e.g., breast- and formula-feeding] were collected with validated questionnaires. Height and weight of students were measured. Overweight/obesity was classified using IOTF cut-offs. Multivariable logistic and linear regression analyses were used to identify major independent factors of overweight/obesity among preadolescents and factors related with the percentage change of mother's BMI, respectively. Increased age at pregnancy [odds ratios [OR] = 0.95, 95% Confidence Interval [CI]: 0.93-0.97], higher BMI at conception [OR = 1.17, 95% CI: 1.12-1.22] and heavy smoking [OR = 2.02, 95% CI: 1.23-3.33] were positively associated with child's overweight/obesity status. Moreover, mother's age and TV viewing, indicating inactivity, were the strongest factors of the percentage increase in mother's BMI [b +/- se = 0.23 +/- 0.07, p = 0.002; b +/- se = 0.32 +/- 0.10, p = 0.002, respectively]. Preadolescent obesity is associated with mother's pre-pregnancy weight, age and heavy smoking at conception and mother's BMI change after gestation

Long-Term Tea Intake is Associated with Reduced Prevalence of (Type 2) Diabetes Mellitus among Elderly People from Mediterranean Islands: MEDIS Epidemiological Study

PURPOSE: We sought to evaluate the link between long-term tea intake and prevalence of type 2 diabetes mellitus, in a sample of elderly adults. MATERIALS AND METHODS: During 2005-2007, 300 men and women from Cyprus, 142 from Mitilini, 100 from Samothraki, 114 from Kefalonia, 131 from Crete, 150 from Corfu and 103 from Zakynthos (aged 65 to 100 years) were enrolled. Dietary habits (including tea consumption) were assessed through a food frequency questionnaire. Among various factors, fasting blood glucose was measured and prevalence of (type 2) diabetes mellitus was estimated. RESULTS: 54% of the participants reported that they consume tea at least once a week (mean intake 1.6 +/- 1.1 cup/day). The majority of the participants (98%) reported green or black tea consumption. The participants reported that they consume tea for at least 30 years of their life. After adjusting for various confounders, tea intake was inversely associated with lower blood glucose levels (b +/- SEM per 1 cup: - 5.9 +/- 2.6 mg/dL, p = 0.02). Moreover, multiple logistic regression revealed that moderate tea consumption (1 - 2 cups/day) was associated with 70% (95% CI 41% to 86%) lower odds of having (type 2) diabetes, irrespective of age, sex, body mass, smoking, physical activity status, dietary habits and other clinical characteristics. CONCLUSION: The presented findings suggest that long-term tea intake is associated with reduced levels of fasting blood glucose and lower prevalence of diabetes, in a cohort of elderly people living in Mediterranean islands.

Age-dependent dichotomous effect of superoxide dismutase Ala16Val polymorphism on oxidized LDL levels

We investigated the association between superoxide dismutase (SOD) Ala16Val polymorphism and the levels of oxidized LDL lipoprotein-C (ox-LDL-C) in two age-different Greek cohorts. Four hundred fifteen middle-aged (n=147 females: 43.2+/-13 years, n=268 males: 43.3+/-14 years) Caucasian Greek subjects consisted the middle aged cohort. One hundred seventy five elderly (n=88 females: 79.9+/-4 years; n=87 males: 80.6+/-4 years) were selected from the elderly cohort. Genotype data were obtained for all of them. Multiple linear regression analysis, stratified by gender and adjusted for age, smoking habits and body mass index as covariates, showed higher ox-LDL-C levels for the middle aged men with the Val/Val genotype, compared to the other allele (Ala/Ala and Ala/Val) carriers (65.9+/-25.7 vs. 55.7+/-20.5 mg/dl; standardized beta coefficient=0.192, P=0.012). On the contrary, elderly women with the Val/Val genotype occurred with lower ox-LDL-C levels compared to the Ala/Ala or Ala/Val genotype (74.2+/-22.1 vs. 86.5+/-26.6 mg/dl; standardized beta coefficient= -0.269, P=0.015). The same trend was also recorded in elderly men, however without reaching statistical significance (standardized b coefficient= -0.187, P=0.077). Moreover, elderly men and women with the Ala/Ala or Ala/Val genotype presented higher triglycerides levels compared to Val/Val (women: 145.2+/-68.7 vs. 114.3+/-34.3 mg/dl, P= 0.027; men: 147.8+/-72.4 vs. 103.7 +/-38.0 mg/dl, P=0.002). Additionally, middle aged men with the Val/Val genotype had higher HDL-C levels compared to the Ala allele carriers. The results suggest that SOD Ala16Val polymorphism is an age-dependent modulator of ox-LDL-C levels in middle-aged men and elderly women.