Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults.

BACKGROUND: Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status. AIM: Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep. METHODS: A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio. RESULTS: Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport. CONCLUSIONS: Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.

Assessment of health risks associated with heavy metal concentration in seafood from North-Western Croatia.

The following study aims at assessing the health risks associated with the consumption of the most commonly consumed seafood in the north-western part of Croatia due to the presence of heavy metals. Samples of seafood were collected and analysed for lead (Pb), cadmium (Cd), and mercury (Hg) content. Analyses of Cd and Pb were carried out by inductively coupled plasma mass spectrometry (ICP-MS) whereas Hg content was measured using atomic absorption spectrometry (AAS). Metal concentrations were in the following order Hg > Pb > Cd for the gilthead seabream, European hake, sardines, and tuna fish whereas in the Patagonian squid cadmium (Cd) was the heavy metal with the highest concentration, with the order of other metals being Cd > Hg > Pb. The heavy metal concentrations have been used to address the health risks using the Estimated Weekly Intake (EWI), Target Hazard Quotients (THQ), and Hazard Indices (HI). The findings revealed that the concentrations of the tested heavy metals, expressed on a per wet weight basis, did not exceed the Maximum Residue Levels (MRL) for those compounds mandated by national Croatian legislation. However, the HI for Hg was above 1, indicating a risk of adverse health effects due to the presence of this heavy metal in the consumed seafood. We conclude that the consumption of certain type of seafood such as the tuna fish should be limited when sensitive segments of the population such as children, elderly and pregnant women are concerned. Our results strongly advocate for a more stringent seafood quality control in the region.

The Outcome of COVID-19 Lockdown on Changes in Body Mass Index and Lifestyle among Croatian Schoolchildren: A Cross-Sectional Study.

Globally, the COVID-19 pandemic altered adults' and children's lifestyles and habits, causing an increase in body weight. Adolescents are sensitive to habit changes and, because of their insufficient capacity to deal with the unexpected COVID-19 changes, were at greater risk of noncommunicable disease development due to the consequences of adopting unhealthy habits. The survey aimed to reveal the changes in nutritional status and lifestyle habits of school children in Croatia and to assess their nutrition knowledge and emotional state and feelings about COVID-19 lockdown. Self-reported data from 1370 school children aged 10 to 15 years were obtained to examine the influence of the lockdown on their nutritional status, lifestyle and emotional status, and to assess their nutrition knowledge. The study revealed that the COVID-19 lockdown has caused an increase in the proportion of overweight and obesity among Croatian school children who changed their lifestyle habits towards being less physically active, spending more time using screen-based media and revealing potential psychological distress. However, the schoolchildren had a high adherence to the Mediterranean diet assessed with the Mediterranean Diet Quality Index for children and adolescents KIDMED index and had good nutrition knowledge. Public health programs promoting a healthy lifestyle and involving the whole family, in a school environment, could provide children with a healthy adulthood.

Metabolic and Hepatic Effects of Energy-Reduced Anti-Inflammatory Diet in Younger Adults with Obesity.

Background: Associated with epidemics of obesity, nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide. The cornerstone of therapy for NAFLD is lifestyle intervention, mainly focused on weight loss. Significant weight loss results from energy-restricted diets, regardless of macronutrient distribution. An anti-inflammatory diet was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. This study aims to evaluate the effect of an energy-reduced anti-inflammatory diet on liver status in younger adults with obesity after a 6-month follow-up. Methods: A two-arm randomized controlled trial surveyed 81 participants' (mean age, 43 years) anthropometric and body composition changes. Metabolic status was determined with glycaemic and lipid status, inflammatory status with hs-CRP, IL-6, and TNF-α, and liver status with liver enzymes, NAFLD-FLS, FLI, and FIB-4 indices. The inflammatory potential of the diet was assessed by the Dietary Inflammatory Index, DII®. Results: Energy-restricted anti-inflammatory diet resulted in significant weight loss (-7.1%, p < 0.001), in reducing the visceral adiposity (-22.3%, p < 0.001), metabolic (HOMA-IR, -15.5%; total cholesterol, -5.3%; LDL-C, -4.6%; triglycerides, -12.2%), and inflammatory biomarkers (hs-CRP, -29.5%; IL-6, -18.2%; TNF-α, -34.2%), with significant improvement of liver parameters (NAFLD-FLS, -143.4%; FLI, -14.3%; FIB-4, -2.5%). Conclusion: The study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD.

The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults.

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants' cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.

NUTRITIONAL RISK SCREENING IN GASTROENTEROLOGICAL PATIENTS AT THE RIJEKA UNIVERSITY HOSPITAL CENTRE.

Malnutrition is usually related to some diseases such as inflammatory bowel disease, chronic pancreatitis, chronic liver disease and malignant tumors. It is characterized by weight loss, protein deficiency, and deficit of specific nutrients. The aim was to estimate the prevalence of nutritional risk among 160 gastrointestinal patients by use of the Nutritional Risk Screening (NRS-2002) score at hospital admission and discharge. The patients stayed in the hospital between 5 and 15 days or longer. Results showed that 40% of patients at admission and 36.2% at discharge were malnourished. There were 53.1% of patients with recognized malnutrition at admission that received nutritional support, whereas at discharge 34.4% of patients at risk were not dietary supported. Malnourished patients were significantly older, had lower body mass index, longer hospital stay and higher rate of malignant diseases than properly nourished patients. Regular screening for malnutrition should be conveyed in hospitals as to provide appropriate dietary support for all patients at risk.

The association between the Mediterranean diet and high physical activity among the working population in Croatia.

BACKGROUND: Unhealthy eating habits and physical inactivity constitute an emerging public health problem. The working population is of special interest for public health monitoring and evaluation because workers' unhealthy lifestyles may lead to reduced work ability. The aim of this study was to determine diet quality and adherence to the Mediterranean diet (MD), according to the level of physical activity, and to detect variables associated with the working population's being highly physically active. MATERIAL AND METHODS: At the Institute for Occupational Medicine 400 full-time workers were examined for obesity factors, filled in the short version of International Physical Activity Questionnaire (IPAQ-short) and a validated food frequency questionnaire for adherence to the Mediterranean diet using Mediterranean Diet Score (MDS). The workers were divided into low, moderate and high physical activity groups according to the IPAQ-short scoring protocol. Hierarchical linear regression was performed to determine the variables associated with being highly active. RESULTS: One-third of the participants were highly physically active and their diet adhered to the MD (MeMDS = 7). Significant variables associated with a high level of physical activity were gender (p < 0.001), age (p = 0.02), waist-to-hip ratio (WHR) (p < 0.001), sitting level (p = 0.044) and occupational type (p < 0.001). CONCLUSIONS: It was found that the participants displaying a high level of physical activity had a better quality diet that adhered to the Mediterranean diet but not to a significant degree. The variables associated with a high level of physical activity were male gender, younger age, normal WHR, non-sedentary occupation and reduced sitting time. The study findings could serve the purpose of improving future public health promotion of physical activity and the Mediterranean diet. Med Pr. 2019;70(2):169-76.

Associations between Adherence to the Mediterranean Diet and Lifestyle Assessed with the MEDLIFE Index among the Working Population.

The adherence to the Mediterranean diet is beneficial for cardiovascular diseases prevention. The study aim is to use Mediterranean lifestyle (MEDLIFE) questionnaire for estimation of Mediterranean lifestyle habits among the working population and to establish MEDLIFE score correlation with the risk factors for cardiovascular diseases. In the study has participated 366 workers from Croatia, which fulfilled MEDLIFE and validated food frequency questionnaire (FFQ) questionnaire. The multivariate logistic regression was performed to evaluate the association between MEDLIFE index, workers' obesity and cardiovascular diseases risk. The lowest adherence to Mediterranean lifestyle was associated to younger, low education, body fat above acceptable ranges and unfavorable lipid profile. Significant association to Mediterranean lifestyle was more among women (p = 0.002), middle aged (p = 0.02), highly physically active (p = 0.009) and those who play collective sports >2 h/w (p = 0.001), having body fat within acceptable range (p = 0.003), total cholesterol less (p = 0.03) and high-density lipoproteins (HDL-C) (p = 0.04) more than recommended. Inverse significant association was for high educational level (p = 0.02). The Mediterranean lifestyle adherence is associated to lower risk factors for cardiovascular diseases among studied working population. MEDLIFE index revealed that physical activity and conviviality are better ingrained among younger population but not the Mediterranean diet.