Sociodemographic and behavioral factors associated with controlled hypertension after 9 years of observation of a PURE Poland cohort study.

Introduction: Despite some improvement in awareness and treatment of hypertension, blood pressure control is still below expectations in Poland. The aim of the study was to analyze the secular trend of hypertension prevalence in the PURE Poland cohort study over 9 years of observation and to analyze factors associated with controlled HT. Methods: The study group consisted of 1,598 participants enrolled in a Prospective Urban and Rural Epidemiological Study (PURE), who participated both in baseline (2007-2010) and 9-year follow-up (2016-2019). Hypertension was ascertained on the basis of (1) self-reported hypertension previously diagnosed by the physician, (2) self-reported anti-hypertensive medication, and/or (3) an average of two blood pressure measurements ≥140 mmHg systolic BP and/or ≥90 mmHg diastolic BP. Results: The prevalence of hypertension increased from 69.4% at baseline to 85.9% at 9-year follow-up. The chance of HT was 8.6-fold higher in the oldest vs. the youngest age group [OR 8.55; CI 4.47-16.1]. Male sex increased the chance for hypertension over 3-fold [OR 3.23; CI 2.26-4.73]. Obesity, according to BMI, increased the chance of HT 8-fold [OR 8.01; CI 5.20-12.8] in comparison with normal body weight. Male sex decreased the chance of controlled HT after 9 years [OR 0.68; CI 0.50-0.92]. There was no statistically significant association between controlled HT and age or place of residence. Higher and secondary education increased the chance of controlled HT over 2-fold in comparison with primary education [OR 2.35; CI 1.27-4.34, OR 2.34; CI 1.33-4.11]. Obesity significantly decreased the chance of controlled HT after 9 years in comparison with normal body weight [OR 0.54; CI 0.35-0.83]. Conclusion: Factors significantly increasing the chance for controlled hypertension after 9 years were female sex, secondary and tertiary education, normal body weight, and avoiding alcohol drinking. Changes in lifestyle, with special emphasis on maintaining normal body weight, should be the basis of prevention and control of HT.

Physical activity and sedentary behaviors in Polish children and adolescents.

OBJECTIVE: Participating in physical activity (PA) is essential for children's proper development. Promoting physical activity from early school years is considered a highly important prevention task for good health. The aim of this study was to evaluate the level of PA and sedentary behavior of children and adolescents aged 6-17 years attending primary and junior high schools in Wroclaw, Lower Silesia, Poland. The study assessed the frequency of various forms of PA and sedentary behavior in children and adolescents. The age differences in PA and sedentary behavior in the cohort studied was also analyzed. DESIGN: Survey study to assess children's and adolescents' physical activity and sedentary behavior were based on a parent-reported questionnaire. PARTICIPANTS: A total of 2913 children and adolescents aged 6-17 years (average age, 11.38 years) from Wroclaw, Poland, who participated in a pro-health campaign "Let's Get the Kids Moving." This project promotes a healthy lifestyle among primary and middle school students. RESULTS: The frequency of physical activity significantly decreased as children grew older (p < 0.0001). As many as 18.6% of adolescents 13-17 years old undertook the recommended level of physical activity less than once a week. Time spent in front of the television or computer by pupils in group 3 was longer than in younger children (p < 0.0001). Nearly 19% of adolescents (13-17 years old) spent 5 h or more daily in a sitting position in front of the television or computer on weekends. CONCLUSIONS: Polish children and adolescents do not spend the recommended level of time on physical activity and spend excessive time in front of the television and other electronic devices. The level of physical activity decreases as the number of hours spent in a sitting position increases with increasing age. Actions should be taken to avoid the long-term consequences of these behaviors.

Dietary habits, physical activity, and self-reported rhinosinusitis in children and adolescents.

Background: Pediatric paranasal rhinosinusitis is one of the more common pediatric diseases of the upper respiratory tract and it entails significant morbidity. Most commonly, it is caused by a viral infection of the nasal mucosa, which spreads through the natural passages within the cavities of the paranasal sinuses, leading to inflammation of the mucosa that lines the nasal cavity and paranasal sinuses. Methods: The objective of this cohort study was to assess whether there is a correlation between pediatric rhinosinusitis, physical activity, and selected dietary habits among pupils aged 6 to 16 years from elementary schools in Wroclaw, Poland. This study - as part of the pro-health program "Let us Get the Kids Moving" - is also aimed at establishing factors that potentially predispose children to developing RS. The survey study was conducted on a group of 2,458 children and adolescents from elementary schools in Wroclaw. The age of the examined children ranged from 6 to 17 years (mean = 10.8 years; standard deviation = 2.7). Results: Rhinosinusitis was more common in the children aged 13-17 years than in those aged 6-9 years (6.4% vs. 1.5%; p < 0.001) or 10-12 years (6.4 vs. 2.6%; p < 0.001). The study revealed a significant positive correlation between rhinosinusitis development and several variables: age > 11 years, attending swimming classes fewer than 1-2 times a week, using a computer, consuming milk, salty snacks, and carbonated sweet drinks, consuming fruit fewer than 1-2 times a week, not attending physical education classes, eating fewer than 4 meals, and not eating breakfast at home (p < 0.05). Conclusion: It is of great importance to establish preventive measures against recurrent upper respiratory tract infections that may predispose children to rhinosinusitis. Introducing healthier, traditional dietary habits and regular physical activity in children and adolescents may result in normal and adequate immune response and proper functioning of the inflammatory control system.

Characteristics of paediatric foot arches according to body mass among primary school students in Wroclaw, Poland.

BACKGROUND: The purpose of this study, conducted within the framework of the project entitled 'Let's get the kids moving', was to determine the associations between children's longitudinal and transverse foot arch and their weight, gender and age. METHOD: The pro-health initiative 'Let's get the kids moving' was created by researchers of the Medical University and the Run for Health Foundation. A total of 655 children (51.5% boys) aged 7 to 10 years from primary schools in south-western Poland participated in the study. The mean age of the subjects was 8.7 ± 0.8 years. In all the children, we assessed anthropometric measurements (weight and height) and the longitudinal and transverse arch of the foot under the load of their weight. A two-dimensional foot scanner (Sensor Medica, Italy) was used to examine the plantar part of the children's feet. RESULTS: The data collected from the 655 subjects revealed that excessive weight predisposed them to less longitudinal and transverse arching. The foot shape was not differentiated by gender or age. CONCLUSIONS: Screening school-aged children's footprints can detect abnormalities in the shape of children's feet early on, which allows for early diagnosis of functional or structural flatfoot in children.

The Plasma Oxylipin Signature Provides a Deep Phenotyping of Metabolic Syndrome Complementary to the Clinical Criteria.

Metabolic syndrome (MetS) is a complex condition encompassing a constellation of cardiometabolic abnormalities. Oxylipins are a superfamily of lipid mediators regulating many cardiometabolic functions. Plasma oxylipin signature could provide a new clinical tool to enhance the phenotyping of MetS pathophysiology. A high-throughput validated mass spectrometry method, allowing for the quantitative profiling of over 130 oxylipins, was applied to identify and validate the oxylipin signature of MetS in two independent nested case/control studies involving 476 participants. We identified an oxylipin signature of MetS (coined OxyScore), including 23 oxylipins and having high performances in classification and replicability (cross-validated AUCROC of 89%, 95% CI: 85-93% and 78%, 95% CI: 72-85% in the Discovery and Replication studies, respectively). Correlation analysis and comparison with a classification model incorporating the MetS criteria showed that the oxylipin signature brings consistent and complementary information to the clinical criteria. Being linked with the regulation of various biological processes, the candidate oxylipins provide an integrative phenotyping of MetS regarding the activation and/or negative feedback regulation of crucial molecular pathways. This may help identify patients at higher risk of cardiometabolic diseases. The oxylipin signature of patients with metabolic syndrome enhances MetS phenotyping and may ultimately help to better stratify the risk of cardiometabolic diseases.

Assessment of the elementary school students' schoolbag weight in the urban environment in Poland: A cross-sectional study carried out as a part of the 'Lightweight Schoolbag' and 'Let's Get the Kids Moving' projects.

BACKGROUND: Carrying a properly weighted schoolbag is an important factor in preventing the occurrence of muscular skeletal disorder in early school age children. OBJECTIVE: The purpose of this cross- sectional observational study was to examine the schoolbag weight and to determine the percentage of children were carrying overloaded schoolbag. METHODS: The study group included pupils from five primary public schools in Wroclaw, Poland. Anthropometrical measurements such body weight (BW) and height were conducted on 650 children (51.1% of boys). Children's age, gender, Cole's Index was juxtaposed with schoolbag weight. The mean age of the examined students was 8.7±0.8 years (range 7 to 10 years). RESULTS: The mean schoolbags weight was 3.7±0.92 kg, which represented 13.0±3.8% of pupils' BW. The percentage of pupils carry the schoolbags weighing more than 10% of their BW was 77.9%. More than a quarter of Polish children carry school backpack above 15% of their BW. The majority (96.8%) had schoolbags which may be carried on both shoulders. A significant negative correlation was observed between relative schoolbag weight and Cole's Index (rho = -0.44, p < 0.05). CONCLUSIONS: The problem of overloaded schoolbags among elementary school children was frequent. Pupils ought to be educated in the proper packing of their school backpacks. Additionally, parents and teachers should pay attention regarding the contents carried by children in their respective schoolbags.

Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries.

Importance: High amounts of sitting time are associated with increased risks of cardiovascular disease (CVD) and mortality in high-income countries, but it is unknown whether risks also increase in low- and middle-income countries. Objective: To investigate the association of sitting time with mortality and major CVD in countries at different economic levels using data from the Prospective Urban Rural Epidemiology study. Design, Setting, and Participants: This population-based cohort study included participants aged 35 to 70 years recruited from January 1, 2003, and followed up until August 31, 2021, in 21 high-income, middle-income, and low-income countries with a median follow-up of 11.1 years. Exposures: Daily sitting time measured using the International Physical Activity Questionnaire. Main Outcomes and Measures: The composite of all-cause mortality and major CVD (defined as cardiovascular death, myocardial infarction, stroke, or heart failure). Results: Of 105 677 participants, 61 925 (58.6%) were women, and the mean (SD) age was 50.4 (9.6) years. During a median follow-up of 11.1 (IQR, 8.6-12.2) years, 6233 deaths and 5696 major cardiovascular events (2349 myocardial infarctions, 2966 strokes, 671 heart failure, and 1792 cardiovascular deaths) were documented. Compared with the reference group (<4 hours per day of sitting), higher sitting time (≥8 hours per day) was associated with an increased risk of the composite outcome (hazard ratio [HR], 1.19; 95% CI, 1.11-1.28; Pfor trend < .001), all-cause mortality (HR, 1.20; 95% CI, 1.10-1.31; Pfor trend < .001), and major CVD (HR, 1.21; 95% CI, 1.10-1.34; Pfor trend < .001). When stratified by country income levels, the association of sitting time with the composite outcome was stronger in low-income and lower-middle-income countries (≥8 hours per day: HR, 1.29; 95% CI, 1.16-1.44) compared with high-income and upper-middle-income countries (HR, 1.08; 95% CI, 0.98-1.19; P for interaction = .02). Compared with those who reported sitting time less than 4 hours per day and high physical activity level, participants who sat for 8 or more hours per day experienced a 17% to 50% higher associated risk of the composite outcome across physical activity levels; and the risk was attenuated along with increased physical activity levels. Conclusions and Relevance: High amounts of sitting time were associated with increased risk of all-cause mortality and CVD in economically diverse settings, especially in low-income and lower-middle-income countries. Reducing sedentary time along with increasing physical activity might be an important strategy for easing the global burden of premature deaths and CVD.

Nutritional habits according to age and BMI of 6-17-year-old children from the urban municipality in Poland.

BACKGROUND: Balanced nutrition is crucial for adolescent's proper physical and mental development. Dietary habits change significantly with a child's development. Along with increasing age and the shift towards adolescence, unhealthy diet-related habits become more common. The objective of the survey study was to determine the differences in nutritional habits between children and adolescents according to their age and body mass index (BMI). METHODS: "Let's get the kids moving" campaign (pol. "Uruchamiamy dzieciaki") was launched in 2016. Within the campaign, the survey study was conducted in 2913 participants between 6 and 17 years old from primary and junior high schools in Wroclaw (Poland). The survey was anonymous, and its supplement was voluntary. Participants were divided into age groups. The study group of 2913 consisted of 29.8% of 6-9-year-olds, 32.7% of 10-12-year-olds, and 37.5% of 13-17-year-olds. Body mass index (BMI) was calculated and further interpreted as a BMI z-scores depending on children's age and gender. RESULTS: A total of 19.3% of participants consumed 3 meals a day or less. Children from the oldest age group (13-17) consumed statistically significantly fewer meals per day than younger children (p < 0.001). Children from the oldest age group (13-17) consumed breakfast statistically less often than children of age group 10-12 years (75.0% vs. 83.6%; p < 0.001) and children of age group 6-9 years (75.0% vs. 84.0%; p < 0.001). Severely thin children consumed breakfast significantly more often than overweight (85.8% vs. 76.3%; p = 0.004) and children with obesity (85.8% vs. 75.9%; p = 0.021). Children with obesity consumed vegetables significantly less often than severely thin (p < 0.008), thin (p < 0.001), and children with normal body weight (p < 0.007). The oldest children (13-17 years) consumed Coca-Cola and SSB (p < 0.001) and fruit-flavored beverages (p < 0.05) significantly more often than children from other age groups. Boys consumed carbonated beverages with added sugar significantly more often than girls (p < 0.01). CONCLUSIONS: Unhealthy diet-related behaviors in children and adolescents may promote overweight and obesity and should be targeted in health promotion programs. Special attention should be paid to 13-17-year-olds, as adolescents from this group made more unhealthy choices than younger children.

A study on health and the association between overweight/obesity and otorhinolaryngological diseases in 6- to 17-year-old children from Wroclaw, Poland.

Introduction: Childhood overweight and obesity have become a global problem in the past three decades. There are very few studies which examine the correlation between body mass index (BMI) and the development of otorhinolaryngological diseases in children. The objective of the study was to determine the association between overweight or obesity in children and the occurrence of otorhinolaryngological diseases. Material and methods: The survey study was based on a parent-reported multidisciplinary questionnaire on children's medical status among elementary and junior high school children in the city of Wroclaw, the capital city of Poland's Lower Silesia region. The children were taking part in the pro-health campaign "Let's Get the Kids Moving". Results: The study was conducted among 2,913 children. A statistically significant correlation was observed between the assessment of the children's BMI and the occurrence of adenoid hypertrophy. Adenoid hypertrophy was more common in the overweight and obese children. The children with adenoid hypertrophy had higher BMI than the children without adenoid hypertrophy. There was a statistically significant correlation between BMI and the incidence of adenoidectomy. There was a statistically significant correlation between BMI and the incidence of tonsillectomy. Conclusions: The development and introduction of preventive programs like "Let's Get the Kids Moving" in the future will contribute to building a healthier society. The study findings suggest that primal prevention may lead to a decrease in the development of otorhinolaryngological diseases. We also showed that higher body mass correlates with higher prevalence of otorhinolaryngological diseases. Further studies are needed to establish the etiopathology of this association.

Characteristic of FINDRISC Score and Association with Diabetes Development in 6-Year Follow-Up in PURE Poland Cohort Study.

PURPOSE: The aim of the study was to assess if FINDRISC score was associated with diabetes development after 6 years of observation. METHODS: Polish cohort is a part of global PURE study. Hereby analysis presents data from baseline (2007-2010) and 6-year follow-up (2013-2016) and was conducted on 1090 participants (702 women) from urban and rural areas in Lower Silesia region (Poland) without diabetes at the baseline and with complete data throughout course of the study. RESULTS: At the baseline, women had significantly higher FINDRISC score than men (10.43 vs 8.91; p=0.000) and participants from rural areas had higher score than from urban areas (10.97 vs 9.33; p=0.000). At the baseline, 25.87% of the participants had low risk of diabetes according to FINDRISC score, 38.90% had slightly elevated risk, 16.79% moderate risk, 16.42% high risk and 2.02% very high risk. Participants, who were healthy at baseline, but developed diabetes after 6 years of observation had significantly higher FINDRISC, than those who did not (13.39 vs 9.36; p=0.000). In 6-year follow-up, diabetes was diagnosed in 2.8% of participants, who were ascertained to "low risk" according to FINDRISC score in baseline; in 9.9% of participants of "slightly elevated risk", 17.5% of participants of "moderate risk", 26.8% in participants of "high risk" and 50.0% of participants of "very high risk". CONCLUSIONS: Results of PURE Poland cohort study indicates that higher FINDRISC score at the baseline was associated with higher risk of diabetes development during 6 years of observation.

Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems.

(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007-2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64-10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03-2.17; OR 1.66, CI 1.27-2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05-2.85; OR 1.76, CI 1.22-2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.

Obesity and Chosen Non-Communicable Diseases in PURE Poland Cohort Study.

INTRODUCTION: Obesity has been associated with a higher risk of morbidity, disability, and death. The objective of this study was to assess the prevalence of obesity and chosen non-communicable diseases (NCDs) in the PURE Poland cohort study. MATERIAL AND METHODS: The study covers a group of 2035 people (1281 women and 754 men), who live in urban and rural areas of Lower Silesian voivodeship. The baseline study was conducted between 2007-2010. The data on demographic status and history of diseases were collected using questionnaires. The anthropometric parameters, blood pressure, blood lipids, and glucose level were measured. RESULTS: Normal body weight was observed in 28.1% of participants, whereas overweight and obesity were observed in 40.1% and 31.1% of participants, respectively. Moreover, there was a significant difference in the body weight between genders. Prevalence of obesity was similar in men and women (31.0% and 31.1%, respectively). Obesity was more prevalent in rural vs. urban residents (38.5% and 26.0%, respectively). In a logistic regression analysis, the odds for obesity was two-fold higher in participants aged >64 years and rural inhabitants (OR 1.91; 95% CI 1.36-2.70; OR 1.79; 95% CI 1.48-2.16, respectively). Participants with obesity had 2.5-fold higher odds for diabetes and hypertension and two-fold higher odds for CHD in comparison with non-obese individuals (OR 2.74; 95% CI 2.01-3.73, OR 2.54; 95% CI 2.03-3.17, OR 1.88; 95% CI 1.26-2.80, respectively). CONCLUSIONS: Taken together, the prevalence of obesity was associated with particular socio-demographic factors (age, place of residence, and level of education) as well as diabetes, hypertension, and coronary heart disease.

Sleep Duration and Bedtime in the PURE Poland Cohort Study and the Link with Noncommunicable Diseases.

(1) Background: The objective was to investigate the association between sleep duration, bedtime, and noncommunicable diseases in the PURE Poland cohort study. (2) Methods: The baseline study was conducted in 2007-2010. The study group comprised 2023 adult inhabitants of urban and rural areas in Lower Silesia, Poland. The study protocol included questionnaires, blood pressure measurements, blood draws, and anthropometric measurements. Sleep duration and bedtime were self-reported. (3) Results: The median sleep duration of women was 30 min longer than men (8 h vs. 7.5 h; p = 0.001). The average time of sleep increased along with the age of the participants. A sleep duration of >8 h was more common in rural than in urban participants (40.2% vs. 27.1%; respectively; p < 0.001). The relative risk of diabetes, stroke, hypertension, cardiovascular diseases (CVD), and obesity was significantly higher in participants who went to bed between 6 p.m. and 10 p.m. in comparison to those who went to bed between 10 p.m. and 12 a.m. (RR 2.23, 95% CI 1.06-4.67; RR 2.52, 95% CI 1.28 to 4.97; RR 1.12, 95% CI 1.04-1.20; RR 1.36; 95% CI 1.1-1.68; RR 1.38; 95% CI 1.15-1.66, respectively). The relative risk of respiratory diseases was two-fold higher in those who went to bed after midnight in comparison to those who went to bed between 10 p.m. and 12 a.m. (RR 2.24; 95% CI 1.19-4.22). (4) Conclusions: In our study, an earlier bedtime was associated with a higher risk of diabetes, stroke, obesity, hypertension, and CVD.

Changes in diabetes prevalence and corresponding risk factors - findings from 3- and 6-year follow-up of PURE Poland cohort study.

BACKGROUND: Diabetes mellitus (DM) is one of the greatest challenges for public health worldwide. The aim of the study was the analysis of diabetes development in participants with normoglycemia and Impaired Fasting Glucose (IFG) in 3-year and 6-year follow-up of PURE Poland cohort study. METHODS: The analysis was conducted in Polish cohort enrolled into Prospective Urban and Rural Epidemiology (PURE) Study. The following study presents results of 1330 participants that have partaken both in the baseline study, in 3-year and in the 6-year follow up. The analysis of the impact of risk factors on diabetes development was performed using multivariate Cox frailty analysis. Population Attributable Risk (PAR) was computed individually for every risk factor. RESULTS: Diabetes prevalence increased from 17.7% at baseline to 23.98% in 3-year- and 28.27% in 6-year follow-up. The risk of diabetes was higher in participants with obesity [HR = 5.7, 95%Cl 2,56-12,82], overweight [HR = 3.4, 95%Cl 1,56-7,54] and IFG [HR = 2.7, 95%Cl 1,87-3,85]. The risk of diabetes development was almost 2-fold higher in men than in women [HR = 1.826; 95%CI =1,24 - 2,69]. In 6 years, diabetes developed in 23.8% of participants with IFG and 7.9% of participants with normoglycemia. According to PAR, overweight and obesity accounted for 80.8%, hypertension for 67.6% and IFG for 38.3% of diabetes cases in our population. CONCLUSIONS: Our study reveals alarming increase in prevalence of diabetes during 6 years of observation. In our population, most diabetes cases can be attributed to overweight, obesity, hypertension and IFG. Findings add strong rationale to implement targeted preventive measures in population of high risk.

Association of nut intake with risk factors, cardiovascular disease, and mortality in 16 countries from 5 continents: analysis from the Prospective Urban and Rural Epidemiology (PURE) study.

BACKGROUND: The association of nuts with cardiovascular disease and deaths has been investigated mostly in Europe, the USA, and East Asia, with few data available from other regions of the world or from low- and middle-income countries. OBJECTIVE: To assess the association of nuts with mortality and cardiovascular disease (CVD). METHODS: The Prospective Urban Rural Epidemiology study is a large multinational prospective cohort study of adults aged 35-70 y from 16 low-, middle-, and high-income countries on 5 continents. Nut intake (tree nuts and ground nuts) was measured at the baseline visit, using country-specific validated FFQs. The primary outcome was a composite of mortality or major cardiovascular event [nonfatal myocardial infarction (MI), stroke, or heart failure]. RESULTS: We followed 124,329 participants (age = 50.7 y, SD = 10.2; 41.5% male) for a median of 9.5 y. We recorded 10,928 composite events [deaths (n = 8,662) or major cardiovascular events (n = 5,979)]. Higher nut intake (>120 g per wk compared with <30 g per mo) was associated with a lower risk of the primary composite outcome of mortality or major cardiovascular event [multivariate HR (mvHR): 0.88; 95% CI: 0.80, 0.96; P-trend = 0.0048]. Significant reductions in total (mvHR: 0.77; 95% CI: 0.69, 0.87; P-trend <0.0001), cardiovascular (mvHR: 0.72; 95% CI: 0.56, 0.92; P-trend = 0.048), and noncardiovascular mortality (mvHR: 0.82; 95% CI: 0.70, 0.96; P-trend = 0.0046) with a trend to reduced cancer mortality (mvHR: 0.81; 95% CI: 0.65, 1.00; P-trend = 0.081) were observed. No significant associations of nuts were seen with major CVD (mvHR: 0.91; 95% CI: 0.81, 1.02; P-trend = 0.14), stroke (mvHR: 0.98; 95% CI: 0.84, 1.14; P-trend = 0.76), or MI (mvHR: 0.86; 95% CI: 0.72, 1.04; P-trend = 0.29). CONCLUSIONS: Higher nut intake was associated with lower mortality risk from both cardiovascular and noncardiovascular causes in low-, middle-, and high-income countries.

Lifestyle-related factors differentiating the prevalence of otorhinolaryngological diseases among 6-17-year-olds from Wroclaw, Poland.

An increased prevalence of sedentary behavior (SB) and a decrease in physical activity (PA) has been noted in recent decades. The aim of the study was to determine the association between the development of otorhinolaryngological diseases, PA and SB. Study draws on data collected from "Let's Get the Kids Moving" study ("Uruchamiamy dzieciaki"), a school-based survey study examining lifestyle factors among a population of elementary- and junior-high-school children in the city of Wroclaw, Poland. The respondents were asked about SB, PA and the prevalence of conditions or groups of otorhinolaryngological conditions: adenoid hypertrophy (AH), rhinosinusitis (RS) and allergic rhinitis (AR). There was a statistically significant association between the frequency of cleaning/vacuuming and the prevalence of AH. There was a statistically significant correlation between the prevalence of RS and screen-based activities on weekdays. AR was more prevalent in children who run less often, are less often engaged in team sports, spend less time outdoors on school days and weekends and spend more time in front of the computer on school days. Our study provides support for the linkage between PA, SB and an increased prevalence of otorhinolaryngological diseases.

Food groups in dietary prevention of type 2 diabetes

According to the World Health Organization diabetes will be the seventh leading cause of death worldwide in 2030. Majority of diabetic patients suffer from type 2 diabetes (T2DM), which is mostly avoidable. The most important modifiable risk factors of type 2 diabetes are: overweight and obesity, improper diet, sedentary lifestyle and tobacco smoking. Even in prediabetic state, improving diet and physical activity can slow down or even stop progression to diabetes. In the view of health burden of diabetes it is essential to thoroughly investigate the risk factors and develop more specific preventive strategies. Recently published studies focus on food groups rather than individual products to assess the link between nutrition and risk of type 2 diabetes. Identifying food groups of possible beneficial and deleterious effect on the risk of type 2 diabetes could facilitate the dietary counselling. The aim of the overview is to summarize the possible association between consumption of food groups on the risk of type 2 diabetes on the basis of available literature. Observations from studies and meta-analyses indicate on an inverse association between consumption of fresh vegetables and fruit, whole grains, lean dairy, fish, nuts and the risk of type 2 diabetes. Food groups that seemed to increase the risk of type 2 diabetes are: red and processed meat, refined grains, sugar-sweetened beverages. It is important to note, that no individual nutrients, but diverse dietary pattern, composed of every recommended food group in adequate amounts can contribute to healthy lifestyle and T2DM prevention.