Socioeconomic Inequalities in Metabolic Syndrome by Age and Gender in a Spanish Working Population.

Lower socio-economic status (SES) is significantly associated with metabolic syndrome (MS) prevalence, possibly affecting women more than men, although evidence in Spain is still limited. The present cross-sectional study analyzed the association between MS and SES by age and gender among 42,146 working adults living in the Balearic Islands (Spain). Prevalence was higher in men (9.4% by ATP-III; 12.3% by IDF) than women (3.8% by ATP-III; 5.7% by IDF) and in the lower social class (7.9% by ATP-III; 10.7% by IDF) than the higher (4.1% by ATP-III; 5.9% by IDF). The SES gradient in MS prevalence was larger in women (PR 95% CI: 3.38, 2.50-4.58 by ATP-III; 3.06, 2.43-3.86 by IDF) than in men (1.23, 1.06-1.41 by ATP-III; 1.15, 1.03-1.30 by IDF) and was already evident from early adulthood, reaching the highest ratio at the late stages of middle adulthood (4.34, 1.11-16.98). Among men, it was significant during the late stages of early adulthood only (1.80, 1.19-2.73). Lower SES influenced MS prevalence in both genders, however, women seemed more affected than men. From a public health perspective, SES could be strongly associated with the burden of MS; in an effort to reduce its prevalence, public health policies should focus on gender differences in socio-economic inequality and consider women with low socio-economic resources as a priority.

Cluster Analysis of Health-Related Lifestyles in University Students.

Health-related lifestyles in young adults are a public health concern because they affect the risk for developing noncommunicable diseases. Although unhealthy lifestyles tend to cluster together, most studies have analyzed their effects as independent factors. This study assessed the prevalence, association, and clustering of health-related lifestyles (smoking, alcohol consumption, physical activity, and quality of diet) among university students. This cross-sectional study examined a sample of student participants from the University of the Balearic Islands (n = 444; 67.8% females; mean age: 23.1 years). A self-reported questionnaire was used to assess health-related lifestyles. Men that consumed more alcohol, had less healthy diets, were more likely to be overweight, and performed more physical activity. Women had a higher prevalence of low weight and performed less physical activity. Physical activity had a negative association with time using a computer (OR: 0.85; 95% CI: 0.76, 0.95) and a positive association with adherence to the Mediterranean diet (OR: 1.16; 95% CI: 1.02, 1.32). Adherence to the Mediterranean diet had a negative association with tobacco consumption (OR: 0.52; 95% CI: 0.30, 0.91), and positive associations with having breakfast every day (OR: 1.70; 95% CI: 1.05, 2.76) and consuming more daily meals (OR: 1.43; 95% CI: 1.10, 1.87). Cluster analysis indicated the presence of three distinct groups: Unhealthy lifestyles with moderate risk; unhealthy lifestyles with high risk; and healthy lifestyles with low risk. Health promotion interventions in the university environment that focus on multiple lifestyles could have a greater effect than interventions that target any single lifestyle.

Physical activity prescription by primary care nurses using health assets: Study design of a randomized controlled trial in patients with cardiovascular risk factors.

AIM: To analyse the efficacy of a 12-month multifactorial intervention by primary care nurses in increasing adherence to physical activity prescription (150 min/week) in patients with two or more cardiovascular risk factors and with cardiovascular risk up to 15% determined by the REGICOR equation. BACKGROUND: In Spain, cardiovascular diseases are responsible for 30.5% of deaths. Regular physical activity decreases mortality risk due to cardiovascular diseases but the effectiveness of physical activity prescription in routine in primary care settings has been shown to be low. DESIGN: Multicentre, single-blind, parallel randomized (in two different branches) clinical trial. METHODS: At least 368 participants will be recruited (184 control and 184 intervention), to show an 8% increase in adherence to the physical activity prescription (1.2% control group and 9.2% intervention group). Participants will be patients aged 35-75 years with at least two cardiovascular risk factors and with a cardiovascular risk of up to 15% measured using the Framingham-REGICOR equation. Intervention will be performed throughout baseline and three follow-up visits. A motivational interview, the trans-theoretical stages of changes of Prochaska and DiClemente and an individualized prescription of physical exercise using physical activity assets will be used in the intervention. Data will be collected at baseline and after the 1-year intervention. DISCUSSION: The present study will allow us to find out whether this brief multifactorial intervention induces greater adherence to physical activity prescription than usual practice, improving the quality of patient care. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN76069254. Protocol version 1.1, 6 July 2015.

Determinants and patterns of physical activity practice among Spanish university students.

The purpose of the present study was to investigate the socio-demographic and lifestyle determinants of physical activity practice, as well as the motivations for being or not being physically active in Spanish university students. A representative sample of students from a Spanish university (n = 2,051; 42.1% males; mean age 21.9, s = 4.8 years) participated in the present cross-sectional study. A questionnaire including questions regarding lifestyle, dietary habits, parents' characteristics, and physical activity habits was administered to the students. The socio-demographic and lifestyle determinants of physical activity practice were assessed using multivariable logistic regression. 68.4% of men and 48.4% of women reported to practise physical activity in the present sample. Those who practised physical activity consumed more fruits and were less likely to be smokers compared to non-physically active students. Also, physically inactive men spent more time in front of the computer and physically inactive women spent more time in front of the TV and were more likely to be frequent alcohol consumers. Maternal educational level and maternal physical activity habits were also important determinants of physical activity practice among men and women respectively. In conclusion, physically active students tended to engage in other healthy habits in the present population, suggesting the clustering of healthy or unhealthy lifestyle factors among specific subgroups.

Effect of continuous positive airway pressure on the risk of road accidents in sleep apnea patients.

BACKGROUND: Continuous positive airway pressure (CPAP) reduces daytime somnolence in the obstructive sleep apnea syndrome (OSAS) and may contribute to a reduction in the risk of motor vehicle accidents. OBJECTIVE: To evaluate the effects of CPAP on automobile collisions in patients with OSAS. METHODS: We compared the number of motor vehicle accidents in 80 patients with OSAS and 80 healthy subjects during the 2 years before and the 2 years after study entry, at which CPAP treatment was initiated. RESULTS: Patients with OSAS had a 2.6 times higher risk of suffering an automobile collision compared to controls (rate ratio, RR=2.57; 95% confidence interval, CI=1.30-5.05). After 2 years of CPAP treatment, the rate of collisions was reduced more than half in patients with OSAS (RR=0.41; 95% CI=0.21-0.79), but this occurred also in controls (RR=0.49; 95% CI=0.17-1.40). The magnitude of this fall between groups was not different (p for interaction=0.68), even after adjusting for body mass index, alcohol intake and Epworth scale. CONCLUSIONS: Patients with OSAS have an increased risk of suffering a traffic collision. This risk was significantly reduced after their inclusion in the study. Yet, as this reduction also occurred in the control group, this effect may not be due to CPAP therapy.