Association between eating time interval and frequency with ideal cardiovascular health: Results from a random sample Czech urban population.

BACKGROUND AND AIMS: The frequency and timing of meals may affect cardiovascular health (CVH) outcomes, but large-scale epidemiological studies are lacking. The aim of this study was to understand the relationship between eating time interval and frequency, and measures of ideal CVH in the Kardiovize Brno cohort study, a random urban sample population in Central Europe. METHODS AND RESULTS: 1659 members of the Kardiovize Brno 2030 cohort were included in a cross-sectional study (mean age = 46.86 years; 44.6% male). Exposure variables were eating time interval and frequency, and skipping meals. Primary outcomes were indices of CVH, including body mass index, diet, physical activity, smoking, blood pressure, glucose and cholesterol, and the composite CVH score. Cluster analysis and binary logistic regression analysis were used to evaluate eating habits and the association between variables. After adjustment for well-known risk factors, subjects who skipped breakfast or the afternoon snack had a higher risk of poor CVH (OR = 1.613; 95%CI = 1.121-2.320; p = 0.010; OR = 1.409; 95%CI = 1.110-1.788; p = 0.005, respectively). Moreover, we identified three clusters of individuals based on eating habits; from cluster 1 to cluster 3, eating time interval and frequency increased and this was associated with increases in CVH score from 8.70 (SEM = 0.10) in cluster 1, and 9.06 (SEM = 0.08) in cluster 2 to 9.42 (SEM = 0.09) in cluster 3 (p-trend = 0.019). CONCLUSIONS: Our findings suggest that skipping breakfast or the afternoon snack are risk factors for poor CVH, while higher eating time interval and frequency may promote ideal CVH.

Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis.

BACKGROUND: The ideal means of identifying obesity in children and adolescents has not been determined although body mass index (BMI) is the most widely used screening tool. OBJECTIVE: We performed a systematic review and meta-analysis of studies assessing the diagnostic performance of BMI to detect adiposity in children up to 18 years. METHODS: Data sources were EMBASE, MEDLINE, Cochrane, Database of Systematic Reviews Cochrane CENTRAL, Web of Science and SCOPUS up to March 2013. Studies providing measures of diagnostic performance of BMI and using body composition technique for body fat percentage measurement were included. RESULTS: Thirty-seven eligible studies that evaluated 53 521 patients, with mean age ranging from 4 to 18 years were included in the meta-analysis. Commonly used BMI cut-offs for obesity showed pooled sensitivity to detect high adiposity of 0.73 (confidence interval [CI] 0.67-0.79), specificity of 0.93 (CI 0.88-0.96) and diagnostic odds ratio of 36.93 (CI 20.75-65.71). Males had lower sensitivity. Moderate heterogeneity was observed (I(2) = 48%) explained in meta-regression by differences across studies in race, BMI cut-off, BMI reference criteria (Center for Disease Control vs. International Obesity Task Force) and reference standard method assessing adiposity. CONCLUSION: BMI has high specificity but low sensitivity to detect excess adiposity and fails to identify over a quarter of children with excess body fat percentage.

[Assessment of changes in peripheral microcirculation in type I diabetics with laser doppler flowmetry]. / Zmeny periferní mikrocirkulace u diabetiku 1. typu sledované laser dopplerem.

GOAL: To make out a methodology and assessment of peripheral microcirculation with laser Doppler flowmetry (LDF) in patients with type I diabetes mellitus and to compare their results to findings in healthy control people using frequency analyses. METHODOLOGY: A group of 32 patients suffering from type I diabetes on an average for 14 years (group A) has been examined. The patients suffered from a basic angiology disorder in arteries of lower extremities. Peripheral circulation in lower extremities has been examined via laser Doppler flowmetry. The same tests have been done in a group of 40 healthy people (group B). RESULTS: Basic evaluation revealed no statistical differences between groups A and B at rest (TO). Significant differences showed up during vasodilation test (T2). Intensity of perfusion in group A was 37 +/- 23 arbitrary perfusion units (PU) compared to 81 +/- 43 PU in group B (p < 0.001). During perfusion following ischemisation (T1) levels of blood circulation in groups A and B were 71 +/- 39 PU compared to 121 +/- 89 PU (p < 0.018). During frequency analyses the intensity of slow vasomotion (SV) in group A was already generally lower at rest (TO) 0.46 +/- 0.42 PU compared to 1.12 +/- 0.62 PU (p < 0.011) in group B. During the reperfusion phase following ischemisation (T1) intensity of SV was 1.8 +/- 0.78 PU compared to 2.82 +/- 1.58 (p < 0.17). Following vasodilation test (T2) perfusion was 0.79 +/- 0.65 PU compared to 1.86 +/- 1.31 (p < 0.009). In areas of fast vasomotion (FV; frequency 0.210 - 0.420 Hz) there were significant differences between group A and B at rest (TO) and during vasodilation test (T2). At rest 0.08 +/- 0.02 PU compared to 0.19 +/- 0.05 PU (p < 0.006). During vasodilation test 0.14 +/- 0.03 PU compared to 0.28 +/- 0.11 PU (p < 0.004). CONCLUSION: This study presents an original examination protocol and findings. Significant differences were identified in peripheral circulation of patients suffering from solely type I diabetes mellitus and control people. So called spontaneous venous reactivity (vasomotion) was in type I diabetics significantly lower already at rest and especially in reaction to vasodilation stimulus. The differences can't be still clearly explained but there is a suspicion they are a result of an impaired endotelial and autonomous function in type I diabetes mellitus. The method of frequency analyses of LDF records enables to give precision to peripheral blood circulation evaluation. It could be used to detect early changes in blood circulation as early as at rest.