Independent association of FTO rs9939609 polymorphism with overweight and obesity in Polish adults. Results from the representative population-based WOBASZ study.

Genetic factors play an important role in the origin of obesity. We investigated the association between the FTO rs9939609 genotype and overweight and obesity, along with additional anthropometric variables in the representative sample of adult Polish population. We genotyped a random sample of 3369 adult individuals examined in a cross-sectional population survey (WOBASZ 2003-2005). More than 40% of men and women had at least one A allele. The AA genotype was found in approximately one fifth of both men and women. The frequency of the AA genotype increased with higher BMI in both sexes and was associated with higher anthropometric obesity indicators in both men and women. The FTO rs9939609 AA genotype was significantly related to abnormal BMI [OR=1.55 (1.14-2.11)] and overweight [OR=1.55 (1.11-2.16)] or obesity [OR=1.56 (1.04-235)] in men regardless of age, tobacco smoking, physical activity, diet and diabetes, while in women it was related to abnormal BMI [OR=1.45 (1.05-2.01)] and overweight [OR=1.59 (1.11-2.29)] after adjustment in addition for menopause. The frequency of the A allele in the Polish population was the same as in other European countries. About one fifth of both men and women have the FTO rs9939609 AA variant. A significant relationship was found between the FTO genotype and anthropometric obesity indicators. The AA genotype was significantly associated with abnormal BMI and overweight in both sexes, but the relation to the obesity phenotype was observed only in men.

Prevalence of diabetes and impaired fasting glucose in Poland in 2005-2014: results of the WOBASZ surveys.

AIMS: To evaluate the prevalence of diabetes and impaired fasting glucose in Poland in 2013-2014 and to determine the temporal trends between 2003-2005 and 2013-2014. METHODS: A questionnaire survey was conducted in a representative sample of Polish adults, complemented by anthropometric and fasting plasma glucose measurements. The research was part of the national cross-sectional WOBASZ study. Diabetes was assessed as self-reported or screened (fasting plasma glucose level ≥ 7 mmol/l, based on one blood sample). RESULTS: In the years 2013-2014 among 5694 participants aged 20-74 years, 6.0% (95% CI 5.4-6.6) reported a previous diagnosis of diabetes (5.8% in women and 6.2% in men). In addition, 2.4% of the participants (95% CI 2.0-2.8) without a previous diagnosis of diabetes (1.8% of women and 3.1% of men) had a fasting blood glucose level ≥7.0 mmol/l in a single measurement. In a single measurement, 18.4% of the participants (95% CI 17.4-19.4; 13.2% of women and 23.8% of men) had impaired fasting glucose. The prevalence of dysglycaemia in the WOBASZ II study was significantly higher compared to the WOBASZ I study findings from 2003-2005, increased from 6.6% to 8.4% for diabetes and from 9.3% to 18.4% for impaired fasting glucose (after age and sex standardization to the 2013 Polish population). CONCLUSIONS: The prevalence of diabetes in Poland is similar to that observed in other European populations and has increased significantly over the last decade.

Are heart rate monitors valuable tools for diagnosing arrhythmias in endurance athletes?

Millions of physically active individuals worldwide use heart rate monitors (HRMs) to control their exercise intensity. In many cases, the HRM indicates an unusually high heart rate (HR) or even arrhythmias during training. Unfortunately, studies assessing the reliability of these devices to help control HR disturbances during exercise do not exist. We examined 142 regularly training endurance runners and cyclists, aged 18-51 years, with unexplained HR abnormalities indicated by various HRMs to assess the utility of HRMs in diagnosing exertion-induced arrhythmias. Each athlete simultaneously wore a Holter electrocardiogram (ECG) recorder and an HRM during typical endurance training in which they had previously detected "arrhythmias" to verify the diagnosis. Average HRs during exercise were precisely recorded by all types of HRMs. No signs of arrhythmia were detected during exercise in approximately 39% of athletes, and concordant HRs were recorded by the HRMs and Holter ECG. HRMs indicated surprisingly high short-term HRs in 45% of athletes that were not detected by the Holter ECG and were artifacts. In 15% of athletes, single ventricular/supraventricular beats were detected by the Holter ECG but not by the HRM. We detected a serious tachyarrhythmia in the HRM and Holter ECG data with concomitant clinical symptoms in only one athlete, who was forced to cease exercising. We conclude that the HRM is not a suitable tool for monitoring heart arrhythmias in athletes and propose an algorithm to exclude the suspicion of exercise-induced arrhythmia detected by HRMs in asymptomatic, physically active individuals.

Alcoholic beverage preference and diabetes incidence across Europe: the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES) project.

BACKGROUND/OBJECTIVES: It is unknown if wine, beer and spirit intake lead to a similar association with diabetes. We studied the association between alcoholic beverage preference and type 2 diabetes incidence in persons who reported to consume alcohol. SUBJECTS/METHODS: Ten European cohort studies from the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States were included, comprising participant data of 62 458 adults who reported alcohol consumption at baseline. Diabetes incidence was based on documented and/or self-reported diagnosis during follow-up. Preference was defined when ⩾70% of total alcohol consumed was either beer, wine or spirits. Adjusted hazard ratios (HRs) were computed using Cox proportional hazard regression. Single-cohort HRs were pooled by random-effects meta-analysis. RESULTS: Beer, wine or spirit preference was not related to diabetes risk compared with having no preference. The pooled HRs were HR 1.06 (95% confidence interval (CI) 0.93, 1.20) for beer, HR 0.99 (95% CI 0.88, 1.11) for wine, and HR 1.19 (95% CI 0.97, 1.46) for spirit preference. Absolute wine intake, adjusted for total alcohol, was associated with a lower diabetes risk: pooled HR per 6 g/day was 0.96 (95% CI 0.93, 0.99). A spirit preference was related to a higher diabetes risk in those with a higher body mass index, in men and women separately, but not after excluding persons with prevalent diseases. CONCLUSIONS: This large individual-level meta-analysis among persons who reported alcohol consumption revealed that the preference for beer, wine, and spirits was similarly associated with diabetes incidence compared with having no preference.

Process evaluation of European 'Healthy Stadia' program.

Healthy Stadia (HS) is a European public health pilot-program started in 2007 to support sports stadia in promoting the health of people who work and visit sports stadia, as well as inhabitants of the surrounding communities. The aim of this study is to describe the process evaluation of the program, from its beginning in July 2007 to December 2009, in order to assess the feasibility and sustainability of an HS network across Europe. The program involved nine associate partners involved in the coordination of activities at a local level, in the recruitment of stadia, in the development of specific program tasks and in the dissemination of the program at a national level. The activities of associate partners were evaluated through structured questionnaires administered every 6 months. The questionnaire response rate from associate partners was 77.8% for the first and third evaluations and 88.9% for the second and fourth evaluations. According to the evaluation's results, several good practices such as alcohol prevention policies and those supporting people with disabilities were implemented in stadia over the course of the program. Conversely, practices supporting mental health and green transport were generally not achieved. The implemented activities mainly involved staff and visitors. Lack of human and economic resources, especially toward the end of the program, was considered the principal challenge for program development. In conclusion, the process evaluation presented the feasibility of the HS program and the development of health promoting practices in sport stadia over time.

Socio-demographic and lifestyle correlates of commuting activity in Poland.

OBJECTIVES: The aim of this study is to analyse the epidemiology of active transportation and to investigate the relationship between commuting physical activity (PA) and socio-demographic and lifestyle characteristics in Poland. METHODS: A cross sectional analysis was conducted among 7280 randomly selected individuals (3747 men and 3533 women) aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2002-2005). Socio-demographic, smoking and physical activity details were assessed by an interviewer-administered questionnaire. RESULTS: Only 36% of the participants (30% men and 42% of women) are active commuters. Moreover, 55.4% of them spend less than 15 min/day on walking or cycling. The highest risk of commuting inactivity was noticed among residents of large urban settings, with university education, the highest income and low occupational PA in both genders. Smoking and leisure-time PA were not significantly associated with commuting activity. CONCLUSIONS: Active commuting is not common in Poland. There are several differences in commuting patterns as compared with the US or Western European populations. Due to important differences between various socio-demographic groups, future interventions should be specific for the targeted subpopulations.

Epidemiology of physical inactivity in Poland: prevalence and determinants in a former communist country in socioeconomic transition.

OBJECTIVES: The aim of this study was to identify physical activity patterns and determinants of physical inactivity in a representative sample of Polish adults. STUDY DESIGN: A cross-sectional analysis of 14 769 randomly selected individuals (52.7% women and 47.3% men) aged 20-74 years participating in the National Polish Health Survey, WOBASZ (2002-2005). METHODS: Sociodemographic and lifestyle details were collected. Assessment of physical activity was based on selected questions from the CINDI Health Monitor Questionnaire. RESULTS: Approximately 35% of Polish adults are not physically active in leisure time, whilst 39.5% declare sufficient level of leisure-time physical activity. Leisure-time inactivity is significantly less likely in persons aged <35 years, those with university education and those living in rural areas. Almost 48% of men and 28.4% of women employed full- or part-time report highly active work, whilst sedentary work is reported by 42.7% of women and 30.2% of men. Low occupational activity is more prevalent in young adults, persons with university education and those living in large urban areas. Nearly 67% of the entire working population report no active commuting. CONCLUSIONS: There is a need to promote various forms of physical activity, with special attention on active commuting and leisure-time activities across both genders and all age groups. Public health policies and programmes should focus on substantial differences between various sociodemographic groups.

Aerobic and anaerobic power in relation to age and physical activity in 354 men aged 20-88 years.

We examined simultaneously the influence of age as well as both current and historical habitual physical activity (PA) on aerobic (physical working capacity - PWC) and anaerobic (Pmax) power in 354 men aged 20.2-87.6 yrs. All the participants performed the graded aerobic exercise test and 8-second explosive power tests on a bicycle ergometer. Current leisure time physical activity (LTPA) and lifetime historical LTPA were assessed. The decline in Pmax/kg (10.3% per decade) was higher than in PWC/kg (7.5% per decade). Correlation coefficients for current LTPA and aerobic indices were higher than for current LTPA and anaerobic indices. In a multiple stepwise regression, current LTPA had the main effect on PWC/kg, whereas age had the main effect on Pmax/kg. Aerobic power was related to all measures of historical PA questionnaire, while anaerobic power - only to those historical measures which pertained to adolescence and younger years of adulthood. We conclude that the age-associated decline in anaerobic power is steeper than that of aerobic power. Habitual endurance-type LTPA increases aerobic but not anaerobic fitness throughout the adult lifespan. Anaerobic fitness indices are higher in young active vs sedentary men but this difference is not discernible as early as in the middle age.

Physical activity and upper respiratory tract infections.

We explored the relationship of current and lifetime physical activity (PA) with upper respiratory tract infections (URTI) symptomatology in 142 male volunteers aged 33 to 90. They participated in baseline and one-year follow-up examinations and fulfilled the log books for daily recording of URTI symptomatology during the whole year. PA was assessed by the Seven Day Recall PA Questionnaire and the Historical Leisure Activity Questionnaire. Number of URTI episodes per year and the number of days with URTI per year were significantly inversely associated with the follow-up 7-Day Recall Hard score (rho = - 0.21; p = 0.013 and rho = - 0.18; p = 0.032, respectively). In logistic regression model, after adjustment for age and anthropometric data, the subjects with high follow-up 7-Day Recall Hard score (dichotomised as high vs. low) had a lower probability of having at least 2 URTI episodes per year (OR = 0.38; CI = 0.18 - 0.78), lower probability of having at least 3 URTI episodes per year (OR = 0.42; CI = 0.20 - 0.87), and lower probability of having at least 15 days with URTI (OR = 0.36; CI = 0.15 - 0.88). URTI symptomatology was not related to cardiorespiratory fitness or any measures of the historical PA questionnaire. We conclude that in middle-aged and older men the symptomatology of URTI over long periods of time is inversely related to current but not to lifetime PA.

The prevalence of tobacco smoking among public health students at Medical University of Bialystok.

The rate of cigarettes' consumption in the world is regularly decreasing, although it remains high. In spite of the fashion for non-smoking, younger and younger people start to smoke. It is important that health related major students' behaviour is a social example. The aim of this study was to determine the number of smokers among public health major students at Medical University of Bialystok, and to present the influence of socio-demographic features of respondents on their behaviour related to smoking. The results showed that among the examined students the prevalence of smoking was high--almost one-third of respondents smoked. The prevalence of smoking was significantly higher in men than in women students.

How education, income, control over life and life style contribute to risk factors for cardiovascular disease among adults in a post-communist country.

OBJECTIVES: To examine the effect of education, income, food habits and control over life on risk factors for cardiovascular diseases in Poland, a former communist country with ongoing transformations of the political and economic system, where cardiovascular disease is an important health problem. METHODS: The data were collected by questionnaire, as part of the CINDI Programme, from 2001 to 2002 in Lodz, an industrial city in Poland. The surveys were directed at random samples of 2000 men and 2000 women; 1847 participants aged 18-64 years responded. As detailed in the ATP III report, participants with three or more of abdominal obesity, hypertriglyceridaemia, low high-density-lipoprotein cholesterol, high blood pressure or high fasting glucose were defined as having the metabolic syndrome. RESULTS: We have found that education is more strongly associated with the metabolic syndrome. Our study suggests that higher education may be a strong and consistent predictor of good health. Also, low control over life (unfulfilled daily needs, unfulfilling work, little or no reward for effort at work) and lack of physical activity have been shown to be predictors for the metabolic syndrome. CONCLUSIONS: Our findings suggest that interventions to improve the health of the Polish population need to be specific for the social environment.

Sociodemographic and clinical determinants of quality of life in urban population of Poland.

The aim of the study was to assess quality of life (QL) of residents of Polish urban area and analyze the influence of selected sociodemographic and clinical variables on their QL. The study revealed a very high level of reported problems, especially regarding pain and anxiety. The mean subjective assessment of health state was poor in comparison with results obtained in other (usually western) countries. Presence of major risk factors of cardiovascular diseases had an important impact on QL. Elevated blood pressure and unsatisfactory level of physical activity were the strongest factors deteriorating QL in the studied population. There is a need for implementing effective interventions in the society, especially in the area of prevention and management of hypertension and sedentary lifestyle.

Do health behaviour and psychosocial risk factors explain the European east-west gap in health status?

BACKGROUND: Mortality rates are much more favourable in Western European countries than in those of Eastern Europe. Health behaviour and psychosocial factors have been suggested to be important contributors to East-West differences in mortality and health status. METHODS: To compare reported health status as well as health behaviours and psychosocial factors which may be related to unequal health status in different parts of Europe, standardised postal surveys of representative populations samples were conducted in six Eastern and Western European areas. RESULTS: Higher mortality in the eastern populations was associated with more reported morbidity and generally more negative health ratings. Health behaviours and psychosocial factors were also more negative in the East. Multivariate analyses suggested that the East-West difference in health status may be partly explained by differences in health behaviours and psychosocial factors. CONCLUSION: Efforts to promote health in Eastern Europe should concentrate both on the promotion of healthier lifestyles and on improvement of social and economic conditions.

East-west differences in reported preventive practices. A comparative study of six European areas of the WHO-CINDI programme.

BACKGROUND: Differences have been reported in life expectancy and mortality between Eastern and Western European countries. Also, disparities have been found among different European countries or populations concerning the implementation of preventive practices by health professionals. This study analysed the patterns of reported preventive practices in three Eastern European areas and three Western ones. METHODS: Health surveys were carried out in particular geographical area of six countries participating in the project (three Eastern European countries; Russia, Poland and Hungary and three Western European countries; Finland, Germany and Spain). All of them are partners in the WHO-CINDI (Countrywide Integration Non-communicable Diseases Intervention) Programme. Three preventive practices are analysed: reported blood pressure and blood cholesterol measurements and reported antismoking counseling during the last year. Data are presented separately for the general population and for people reporting specific chronic conditions (cardiovascular disease, respiratory disease and/or diabetes mellitus). RESULTS: Blood pressure measurement and antismoking counseling are more frequently reported to be carried out by primary health care physicians in the Eastern European areas while blood cholesterol measurement is more frequently reported in Western European countries. All these preventive activities are more frequently reported to be done among people with chronic conditions than in the population as a whole. CONCLUSIONS: Major differences have been found in reported preventive practices between Eastern and Western European countries. Great potential exists for chronic disease prevention among them.

[Red wine in medicine: panacea, fashion or ... risk factor?]. / Czerwone wino w medycynie: panaceum, moda czy ... czynnik ryzyka?

Red wine has been a subject of much interest of professionals representing different fields of medicine. However, most of scientific studies have been searching for the reason of so called French paradox, which means that in France and other mediterranean countries the morbidity and mortality due to ischaemic heart disease is significantly lower than in other developed countries, in spite of relatively high consumption of fat and saturated fatty acids. The cardio-protective mechanism of red wine, although incompletely understood, is connected on one hand with the presence of ethanol which increases high-density lipoprotein cholesterol (HDL) and inhibits platelet aggregation, and on the other hand with the presence of polyphenols that have desirable biological properties. These include flavonoids, phenolic acids and stilbenes which are reputed to have antioxidant, vasorelaxing and antiplatelet properties. There is a considerable body of evidence indicating that regular consumption of red wine at moderate doses (200-400 ml a day) exerts a protective effect against ischaemic heart disease, other cardiovascular diseases, and perhaps diabetes, osteoporosis or some cancers. But, since alcohol intake involves a potential danger (risk of dependence, alcoholism, many organic diseases, migraine, allergies) medical recommendations of red wine consumption should be formulated very carefully.

Long-term effects of different physical activity levels on coronary heart disease risk factors in middle-aged men.

In order to define the amount of physical activity appropriate in primary prevention of coronary heart disease (CHD), we have compared the effects during 5 years of physical activity in four groups of middle-aged men with different but stable approximate metabolic costs of leisure time sports activities (AMCSA): sedentary (n = 40; 0 kcal per week), low activity (n = 31; 1-999 kcal per week), moderate activity (n = 56; 1,000-1,999 kcal per week), and high activity (n = 71; > or = 2,000 kcal per week). Time related increase of body mass and BMI was more pronounced in lower activity groups. Changes in HDL cholesterol were more favourable in the high activity group as compared to sedentary and low activity groups. The increase of diastolic blood pressure (DBP) in the sedentary group was statistically significantly different from the decrease of DBP observed in both moderate and high activity groups. We conclude that favourable long-term stabilization of most coronary risk factors is achievable with physical activity energy expenditure above 1,000 kcal per week. Physical activity-related energy expenditure > or = 2,000 kcal per week is associated with some additional benefits, especially with a favourable modification of HDL cholesterol level.

[Pharmacotherapy of arterial hypertension and pharmacoeconomic aspects of hypotensive therapy in elderly patients in Poland]. / Leczenie farmakologiczne nadcisnienia tetniczego oraz wybrane aspekty farmakoekonomiczne terapii hipotensyjnej u chorych w starszym wieku w Polsce.

The aim of our study was to examine the use of pharmacological therapy and to evaluate the economical aspects of treating hypertension (HT) in elderly patients in Poland. Two hundred and sixty eight elderly persons (147 females, 121 males; mean age: 72.2 +/- 6.0 years) were selected from Polish population by stratified and cluster random sampling with quotas. BP measurement was performed 3 times every 2 minutes at respondents home. In the questionnaire, awareness of HT was assessed. Prevalence of hypertension among subjects aged 65 years and over by JNC VI criteria (SAP > or = 140 mm Hg, DAP > or = 90 mm Hg or hypotensive therapy) was 74%. Awareness of HT was equal to 61%. Eleven percent of all hypertensives were well controlled. Among hypertensives, 71% took prescribed antihypertensive drugs on a regular basis. Patients with HT were taking the following antihypertensive drugs: diuretics 16%, diuretics and reserpine 20%, beta-blockers 19%, ACE inhibitors 53%, calcium antagonists 30%, and other 3%. Newer drugs were prescribed in 7%, and multi-source (generic) products in 93%. The average cost of treatment with one drug was 147 PLN (37.5 USD) per year (newer drugs: 413 PLN; multi-source product 126 PLN). Assuming those data and number of elderly people in Poland (4.335 mln), we estimated that 3.208 mln of subjects have had hypertension according to JNC VI criteria. Only 1.957 mln of patients with HT have been detected and only 0.353 mln of hypertensives have been well controlled. The approximate global cost of antihypertensive drugs per year in elderly patients in Poland has been equal to 285 mln PLN (72.8 mln USD). In hypothetical situation with optimal (100%) detection and control of HT the global cost by the actual rate of regularity in taking drugs would increase to 569 mln PLN (145.3 mln USD). The prevalence of HT in elderly people in Poland is very high. In elderly hypertensives ACE inhibitors are used most often. More than 90% of prescribed drugs are multi-source products. An optimal improvement of HT detection and control would cause a two-fold augmentation of the costs of pharmacological therapy.

[Methods of evaluating physical activity in the elderly]. / Metody oceny aktywnosci ruchowej u osób w podeszlym wieku.

Various methods measuring physical activity (PA) that have been used so far in older population are described. Different PA questionnaires and their potential application in routine PA assessment in that age group are discussed.