No association between history of psychiatric treatment and postoperative weight reduction after bariatric surgery.

PURPOSE: The objective of the study was to assess whether the history of psychiatric treatment was associated with (1) body weight and BMI on admission for bariatric surgery, (2) weight loss > 5 kg prior to bariatric surgery, and (3) postoperative body weight reduction. METHODS: Data from medical records of all consecutive patients admitted for surgical treatment of obesity in the 2nd Department of General Surgery Jagiellonian University Medical College were obtained. There were 1452 records of patients who underwent bariatric surgery between 2009 and 2021 included in the study. RESULTS: History of psychiatric treatment was found in 177 (12%) of the sample and was inversely associated with body weight and BMI on admission for surgery in women. Men with history of psychiatric treatment were 54% less likely to lose > 5 kg before the surgery (OR = 0.46 95% CI = 0.24-0.88). Both in men and women %TWL did not differ significantly by history of psychiatric treatment (Me: 40.7 vs. 45.9; p = 0.130 and Me: 27.0 vs. 23.9; p = 0.383, respectively). After adjustment for covariates no association was found between history of psychiatric treatment and body weight reduction one year after surgery. CONCLUSION: Although men with preoperative history of psychiatric treatment had lower odds of losing weight before the surgery, psychiatric treatment did not differentiate the effectiveness of bariatric treatment in 1 year of observation. Bariatric surgery appears to be an effective obesity care for people treated for mental disorders. LEVEL OF EVIDENCE: III Evidence obtained from cohort or case-control analytic studies.

Determinants of body weight changes during COVID-19 pandemic in older urban residents.

INTRODUCTION: COVID­19 pandemic is associated with unfavorable body weight changes. However, little is known about these changes in older individuals, a particularly vulnerable group with limited representation in both direct and online research. OBJECTIVES: The aims of the study were to assess changes in body weight and determinants of thesechanges, and to evaluate the prevalence of COVID­19 history and its impact on the changes in body weight in older individuals. PATIENTS AND METHODS: The analysis included 2076 residents of Kraków, aged 60 to 84 years. Data on sociodemographic factors, lifestyle, history of COVID­19, and changes in body weight were collected in 2021 and 2022 by a postal survey. Multinomial logistic regression analysis was used. RESULTS: COVID­19 tests were performed in 29.3% of the participants, with one­third of them being positive. A total of 14.3% of the participants had any history of COVID­19. Almost two­thirds of the study participants declared no change in their body weight during the pandemic, while 26.2% gained weight. The weight gain was associated with unfavorable sociodemographic and lifestyle conditions. Weight loss was reported by 11.3% of the participants, and it was associated with poor perceived health and a history of COVID­19. After adjusting for covariates, the history of COVID­19 was associated with about 4 times higher odds of weight loss in any case (odds ratio [OR], 2.69; 95% CI, 1.59-4.57 for nonhospitalized, and OR, 18.96; 95% CI, 5.64-63.73 for hospitalized individuals). CONCLUSIONS: Most people with a change in their body weight gained weight due to unfavorable lifestyle modifications, but the history of COVID­19, especially hospitalization, was a strong determinant of body weight loss.

ATHLOS Healthy Aging Scale score as the predictor of all-cause mortality in Poland and Czechia.

Background: The ATHLOS consortium (Aging Trajectories of Health-Longitudinal Opportunities and Synergies) used data from several aging cohorts to develop a novel scale measuring healthy aging comprehensively and globally (ATHLOS Healthy Aging Scale). In the present study, we assessed the predictive performance of the ATHLOS Healthy Aging Scale for all-cause mortality in middle-aged and older adults. Methods: Data from the Polish and Czech HAPIEE (Health Alcohol and Psychosocial factors In Eastern Europe) prospective cohorts were used. There were 10,728 Poles and 8,857 Czechs recruited. The ATHLOS Healthy Aging Scale score was calculated for all participants using data from the baseline examination carried out from 2002 to 2005. The follow-up for all-cause mortality was completed over 14 years. The associations between quintiles of the ATHLOS Healthy Aging Scale and all-cause mortality were estimated using Cox proportional hazards models. Results: A total of 9,922 Polish and 8,518 Czech participants contributed ATHLOS Healthy Aging Scale and mortality data with 1,828 and 1,700 deaths, respectively. After controlling for age, the ATHLOS Healthy Aging Scale score was strongly associated with mortality in a graded fashion for both genders and countries (hazard ratios for lowest vs. highest quintile were 2.98 and 1.96 for Czech and Polish women and 2.83 and 2.66 for Czech and Polish men, respectively). The associations were only modestly attenuated by controlling for education, economic activity, and smoking, and there was further modest attenuation after additional adjustment for self-rated health. Conclusion: The novel ATHLOS Healthy Aging Scale is a good predictor of all-cause mortality in Central European urban populations, suggesting that this comprehensive measure is a useful tool for the assessment of the future health trajectories of older persons.

Dietary Antioxidants, Quality of Nutrition and Cardiovascular Characteristics among Omnivores, Flexitarians and Vegetarians in Poland-The Results of Multicenter National Representative Survey WOBASZ.

Several reports have shown that more plant-based dietary patterns provide a higher intake of antioxidants compared to diets rich in meat and animal products. Data on the intake of key nutrients in cardiovascular disease (CVD) prevention in relation to particular diets in countries of Central and Eastern Europe are scarce. The aim of this study was to assess quality of nutrition and CVD characteristics in a representative sample of Polish adults following different dietary patterns. Special regard was paid to the intake of natural antioxidants. The study comprised 13,318 (7159 females) randomly selected adults aged ≥ 20 years participating in the National Multicentre Health Surveys WOBASZ and WOBASZ II. The subjects were categorized into groups of omnivores (92.4%), flexitarians (7.4%) and vegetarians (0.16%) according to type of diet using the Food Frequency Questionnaire and 24 h dietary recall. The obtained results showed that neither flexitarians nor vegetarians represented better dietary habits or lifestyle behaviors compared to omnivores. Flexitarians had significantly lower daily energy intake than omnivores, but their diet was rich in total fat (above 30% of daily energy consumption) and low in fiber. Omnivores declared a higher consumption of fresh vegetables (p < 0.001), fresh fruit (p < 0.01), coffee (p < 0.01) and tea (p < 0.05, in women only) than flexitarians. Omnivores had significantly higher intake of natural antioxidants (vitamin C, E, zinc in both genders and vitamin A in men) as compared with flexitarians. Among women, the highest adherence to the intake of recommended amounts of antioxidant nutrients was noted among omnivores. Among men, vegetarians had the highest proportion of meeting the guidelines for vitamin A (77.8%), E (66.7%) and C (66.7%), while the lowest proportions were found in flexitarians (69.9%, 39.5% and 32.4%, respectively). The groups did not differ in terms of smoking and physical activity level. There were no significant differences in the analyzed CVD characteristics between omnivores and flexitarians. In women, vegetarians had substantially lower BMI than omnivores (p < 0.05) and flexitarians (p < 0.05) and a lower mean serum glucose compared with omnivores (p < 0.01) and flexitarians (p < 0.05). Vegetarians had lower prevalence of hypertension and obesity than meat eaters. In conclusion, the results of the current research showed an inappropriate intake of several nutrients, including highly potent antioxidants, irrespective of the dietary regimen. Flexitarians did not have a more favorable CVD profile than omnivores. Taking into account the growing popularity of diets with reduced animal products, there is a need to elaborate strategies providing Polish adults with guidance regarding properly balanced nutrition.

Changes in Socioeconomic Status as Predictors of Cardiovascular Disease Incidence and Mortality: A 10-Year Follow-Up of a Polish-Population-Based HAPIEE Cohort.

Although the inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) is well established, research on the effect of changes in the SES throughout life on CVD risk in populations with different social backgrounds remains scarce. This study aimed to assess the relationship between childhood SES, adulthood SES, and changes in SES over time, and CVD incidence and mortality in a Polish urban population. In addition, the predictive performance of the SES index was compared with education alone. A cohort study with a 10-year follow-up was conducted, in which a random sample of 10,728 residents in Kraków aged 45-69 years were examined. The SES was assessed at baseline using data on education, parents' education, housing standard at the age of 10 years, professional activity, household amenities, and difficulties in paying bills and buying food. SES categories (low, middle, and high) were extracted using cluster analyses. Information on new CVD cases was obtained from questionnaires in subsequent phases of the study and confirmed by reviewing clinical records. Data on deaths and causes were obtained from the residents' registry, Central Statistical Office, and the participants' families. The effect of the SES index on the risk of CVD was assessed using Cox proportional hazard models. In male and female participants, the CVD incidence and mortality were observed to be 27,703 and 32,956 person-years (384 and 175 new CVD cases) and 36,219 and 40,048 person-years (159 and 92 CVD deaths), respectively. Childhood SES was not associated with CVD incidence and mortality. A protective effect of high adulthood SES against CVD mortality was observed in men and women (HR = 0.59, 95% CI = 0.31-0.97; HR = 0.33, 95% CI = 0.14-0.75, respectively). In women, downward social mobility was related to 2.24 and 3.75 times higher CVD incidence and mortality, respectively. In men, a protective effect against mortality was observed in upward mobility (HR = 0.50, 95% CI = 0.29-0.84). Model discrimination was similar for the SES index and education alone for the association with CVD incidence. In women, the SES index was a slightly better predictor of CVD mortality than education alone (C-index = 0.759, SE = 0.0282 vs. C-index = 0.783, SE = 0.0272; p = 0.041). In conclusion, high adulthood SES, but not childhood SES, may be considered to be a protective factor against CVD in urban populations in high-CVD-risk regions. No effects of critical periods in early life were observed on CVD risk. In later life, social mobility was found to affect CVD mortality in both men and women. In men, a protective effect of upward mobility was confirmed, whereas in women, an increased CVD risk was related to downward mobility. It can be concluded that CVD prevention may be beneficial if socioeconomic potentials are strengthened in later life.

Relationship between Dietary Macronutrients Intake and the ATHLOS Healthy Ageing Scale: Results from the Polish Arm of the HAPIEE Study.

BACKGROUND: Despite extensive research, our knowledge on the relationship between nutrition and healthy ageing is limited. The aim of this study was to evaluate the associations between the intake of macronutrients and a single measure of healthy ageing (ATHLOS Healthy Ageing Scale). METHODS: A cross-sectional analysis was performed using data from 9906 randomly selected citizens of Krakow (Poland) who were 45-69 years of age and participants of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Macronutrient intake was evaluated using a food frequency questionnaire. ATHLOS Health Ageing Scale was estimated from 41 variables in pooled data from 16 cohorts. Standardized beta coefficients were estimated using multivariable linear regression models. RESULTS: In multivariable adjusted models, there were significant positive associations between the ATHLOS Healthy Ageing Scale score and intake of protein (b = 0.030, 95% CI 0.001; 0.059 in men; b = 0.056, 95% CI 0.027; 0.085 in women), monounsaturated fatty acids (MUFA) (b = 0.042, 95% CI 0.013; 0.071 in men; b = 0.035, 95% CI 0.006; 0.064 in women), polyunsaturated fatty acids (PUFA) (b = 0.053, 95% CI 0.024; 0.082 in men; b = 0.063, 95% CI 0.034; 0.092 in women), and omega-3 PUFA (b = 0.031, 95% CI 0.002;0.060 in men; b = 0.054, 95% CI 0.026; 0.082 in women). Carbohydrate intake was inversely associated with the ATHLOS Healthy Ageing Scale in women. Total fat intake was positively associated with the ATHLOS Healthy Ageing Scale in men. CONCLUSIONS: A number of nutrients were associated with the healthy ageing score, suggesting that dietary habits may play an important role in healthy ageing. Further research in other settings and with a prospective design is strongly warranted.

The Consumption of Nuts is Associated with Better Dietary and Lifestyle Patterns in Polish Adults: Results of WOBASZ and WOBASZ II Surveys.

In recent years, the concept of the health benefits of synergistic dietary patterns as opposed to individual foods or food constituents has been developed. The aim of this study was to determine whether nut consumption is associated with healthier nutrition and lifestyle. The research was based on complete data obtained during two Polish National Multi-Centre Health Examination Surveys-WOBASZ (2003-2005) and WOBASZ II (2013-2014). Of the 12,946 participants who completed dietary assessments, 299 subjects reported consuming any quantity of whole nuts. A control group of 1184 non-nut consumers from both surveys was randomly selected for the study, with age, gender, study (WOBASZ, WOBASZ II), educational level, and season-related interactions taken into account. In this study, nut consumption was associated with favorable food and lifestyle choices, excluding smoking. Better dietary quality consisted of having a higher Healthy Diet Indicator score, an increased intake of polyphenols and antioxidants, lower intake of red meat, but higher of poultry and fruit, more frequent consumption of antiatherogenic food products, and less frequent consumption of processed meats. There was also greater interest in special diets, such as weight-loss diet. In addition, nut eaters were more physically active in their leisure time. While limited by 24-h recall of nut intake and possible misclassification of nut/non-nut consumer status, this research supports the synergistic health-promoting attitudes of those who were classified as nut consumers.

Relationship between the dietary glycemic load of the adult Polish population and socio-demographic and lifestyle factors - results of the WOBASZ II study.

BACKGROUND: Cardiovascular disease (CVD) occurs more often among people with a low sociodemographic status, so it is worth knowing if any sociodemographic factor also has an impact on diet quality, defined by glycemic load (GL). OBJECTIVES: Assessment of the relationship between the sociodemographic and lifestyle factors, health status self-assessment and dietary GL of the adult Polish population based on WOBASZ II study results. MATERIAL AND METHODS: The study included a representative group of the Polish population aged ≥20 years (2,554 men and 3,136 women). A 24-hour dietary recall was collected to assess the dietary intake. The total GL was calculated by summing the GL values of the consumed food. RESULTS: The average GL/1,000 kcal was significantly higher in women's than in men's diets (74.0 ±15.9 vs 71.2 ±15.7). Dietary GL/1,000 kcal increased with age (men: aged <35 - 70.3 and aged ≥65 - 73.9, women: 73.5 and 76.5, respectively). The lowest dietary GL/1,000 kcal was found among people living in large population centers. Dietary GL/1,000 kcal decreased with education level (men with primary, secondary and higher education: 73.4, 69.5 and 68.9, respectively, and women: 76.7, 73.4 and 70.9, respectively). Dietary GL decreased as an income increased. The highest GL/1,000 kcal was observed in the diets of participants who performed less physical activity. The highest GL/1,000 kcal was observed in the participants who defined their health status as very poor/poor and the lowest among those who defined their health status as good/very good. CONCLUSIONS: Nutritional education about the proper selection of products that are sources of carbohydrates in the diet should be addressed mainly to people with low sociodemographic status, such as: people in the older age group, living in small population centers, and with lower levels of education and lower income. It should also be directed to people with a lower level of physical activity. Greater awareness of the choices of carbohydrate products is recommended to improve diet quality in these groups of people.

Dietary acid load and cardiometabolic risk in the Polish adult population.

BACKGROUND: The potential influence of disorders of acid/base homeostasis on cardiovascular risk factors has been suggested. OBJECTIVES: The aim of the study was to estimate the relationship between dietary acid load and the prevalence of cardiovascular disease and the prevalence and intensity of cardiovascular risk factors (i.e., hypertension, diabetes, overweight and obesity, dyslipidemia) in the Polish adult population. MATERIAL AND METHODS: Data was derived from a cross-sectional survey of a random sample of 6,170 Polish residents aged 20+ (Multi-Center National Population Health Examination Survey, WOBASZ II study), including anthropometric and laboratory measurements, and estimates of nutrient intakes by 24-h recall. Dietary acid/ base load was assessed as potential renal acid load (PRAL) and net endogenous acid production (NEAP). RESULTS: The median PRAL and NEAP values for the whole study population were: PRAL -3.85 mEq/day and NEAP 39.79 mEq/day. The prevalence of overweight and obesity, both in males and females, tended to decrease across tertiles of PRAL and to increase across tertiles of NEAP. In females, the values of several metabolic characteristics differed across tertiles of NEAP. After adjustment for age and waist circumference, these relationships did not persist, but the prevalence of diabetes was found to increase across tertiles of PRAL (p for trend <0.05) in females. CONCLUSIONS: The dietary acid load in the Polish adult population was relatively low. There was no independent relationship between dietary acid load and cardiovascular disease and its risk factors in the population under study, except for the positive association between the PRAL value and diabetes prevalence in females.

Are Total and Individual Dietary Lignans Related to Cardiovascular Disease and Its Risk Factors in Postmenopausal Women? A Nationwide Study.

The study objectives were to examine total and individual lignan intakes and their dietary sources in postmenopausal Polish women and to investigate the relationship between lignan intake and the prevalence of cardiovascular disease (CVD), hypertension, hypercholesterolemia and central obesity. A total of 2599 postmenopausal women, participants of the Multi-centre National Population Health Examination Surveys (WOBASZ and WOBASZ II) were selected. Of them, 916 had a history of CVD. Nutritional data were collected using a single 24-h dietary recall. Data on lignan content in food, i.e., lariciresinol (LARI), matairesinol (MAT), pinoresinol (PINO) and secoisolariciresinol (SECO), were collected from the available lignan databases. In postmenopausal women, total and individual lignan intakes (SECO, PINO, MAT) were not associated with the prevalence of CVD and its risk factors. The intake of LARI was linked by 30% to the reduced odds for hypercholestrolemia. This study reinforces the existing concept that dietary total lignans are not associated with the prevalence of CVD, and provides further evidence that they are not linked to CVD risk factors such as hypertension, hypercholesterolemia and central obesity. However, the intake of LARI should be taken into consideration in further studies with regard to its potentially beneficial effect in hypercholesterolemia.

Dietary polyphenol intake and risk of hypertension in the Polish arm of the HAPIEE study.

PURPOSE: Dietary polyphenols have been studied for their potential effects on metabolic disorders, but studies on risk of hypertension are scarce. This study aimed to test the association between total and individual classes of dietary polyphenols and incidence of hypertension in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study. METHODS: A total of 2725 participants free of hypertension at baseline were tested for blood pressure or taking hypertensive medication within the last 2 weeks at 2-4-year follow-up visit. A 148-item food frequency questionnaire and the Phenol-Explorer database were used to estimate dietary polyphenol intake. Odds ratios (ORs) and 95% confidence intervals (CIs) of hypertension comparing the various categories of exposure (total and individual classes of polyphenol intake) with the lowest one (reference category) were calculated by performing age- and energy-adjusted and multivariate-adjusted logistic regression models. RESULTS: During follow-up, 1735 incident cases of hypertension occurred. The highest quartile of total polyphenol intake was associated with 31% decreased risk of hypertension compared with the lowest intake (OR 0.69, 95% CI 0.48, 0.98) in women. There was no significant association in men. Among main classes of polyphenols, flavonoids and phenolic acids were independent contributors to this association. The analysis of individual subclasses of polyphenol revealed that, among phenolic acids, hydroxycynnamic acids were independently associated to lower odds of hypertension (OR 0.66, 95% CI 0.47, 0.93), while among flavonoids, most of the association was driven by flavanols (OR 0.56, 95% CI 0.36, 0.87). CONCLUSION: Certain classes of dietary polyphenols were associated with lower risk of hypertension, but potential differences between men and women should be further investigated.

Dietary polyphenol intake and risk of type 2 diabetes in the Polish arm of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study.

This study aimed to test the association between dietary content of total and individual classes of polyphenols and incident cases of type 2 diabetes in Polish adults participating to the Health, Alcohol and Psychosocial factors In Eastern Europe study. At baseline, diet by 148-item FFQ and health information were collected from 5806 participants free of diabetes. Self-reported incident type 2 diabetes was ascertained at 2-4-year follow-up visit. OR and 95 % CI of type 2 diabetes comparing the various categories of polyphenol intake to the lowest one (reference category) and as 1 sd increase modelled as continuous variable were calculated by performing age-, energy-, and multivariate-adjusted logistic regression models. During the follow-up, 456 incident cases of type 2 diabetes occurred. When comparing extreme quartiles, intake of total polyphenol was inversely associated with the risk of type 2 diabetes (OR 0·43; 95 % CI 0·30, 0·61); 1 sd increase was associated with a reduced risk of diabetes (OR 0·68; 95 % CI 0·59, 0·79). Among the main classes of polyphenols, flavonoids, phenolic acids, and stilbenes were independent contributors to this association. Both subclasses of phenolic acids were associated with decreased risk of type 2 diabetes, whereas among subclasses of flavonoids, high intake of flavanols, flavanones, flavones and anthocyanins was significantly associated with decreased risk of type 2 diabetes. Total dietary polyphenols and some classes of dietary polyphenols were associated with lower risk of type 2 diabetes.

Dietary Polyphenol Intake, but Not the Dietary Total Antioxidant Capacity, Is Inversely Related to Cardiovascular Disease in Postmenopausal Polish Women: Results of WOBASZ and WOBASZ II Studies.

The aim of the study was to assess the relationship between the dietary polyphenol intake (DPI) and the dietary total antioxidant capacity (DTAC) and the prevalence of cardiovascular disease (CVD) in postmenopausal women. Participants were 916 postmenopausal women diagnosed with CVD and 1683 postmenopausal women without history of CVD, who took part in the population-based studies carried out in Poland: WOBASZ (2003-2005) and WOBASZ II (2013-2014). Nutritional data were collected using a single 24-hour dietary recall. DPI and DTAC in the CVD women were significantly lower and accounted for 1766.39 mg/d and 10.84 mmol/d, respectively, versus 1920.57 mg/d and 11.85 mmol/d in the women without CVD, but these differences disappeared after the standardization for energy input. Also, in the multiple-adjustment model, higher DPI, but not DTAC, was associated with the reduced odds ratio for the prevalence of CVD. Beverages, mainly coffee and tea, contributed in more than 40% to DPI and in more than a half to DTAC. In this study, higher dietary polyphenol intake, but not the dietary total antioxidant capacity, was inversely associated with CVD in postmenopausal women, which points to the health benefits of increased polyphenol intake from food sources for these women.

Metabolic syndrome and its components in Polish women of childbearing age: a nationwide study.

BACKGROUND: Abnormal body mass and related metabolic disorders may affect female reproductive health. The purpose of the study was to determine the prevalence of underweight, overweight, obesity, lipid and glucose metabolism disorders, hypertension, and metabolic syndrome, among Polish women of childbearing age. METHODS: One thousand five hundred eighty-eight non-pregnant Polish women of childbearing age (20-49 years) who participated in the Multi-Centre National Population Health Examination Survey (WOBASZ II study) in 2013-2014, were assigned to 3 age groups: 20-29 years (n = 403), 30-39 years (n = 600) and 40-49 years (n = 585). Measurements of weight, height, waist circumference, blood pressure, blood lipids, and blood glucose were taken. For statistical analysis, the Kruskal-Wallis, Chi-Square, and Cohran-Armitage tests were used. RESULTS: Of the participants, 4.3% were determined to be underweight, 25.2% were overweight, 15% were obese, and 53.1% had abdominal obesity. With age, the prevalence of both excessive body mass and abdominal obesity tended to increase, and that of underweight to decrease. Frequency of hypercholesterolemia and hypertriglyceridemia found in the whole group were 50% and 12.6% respectively, and also tended to rise with age. Low serum HDL-cholesterol (high density lipoprotein cholesterol) levels were found in 15.1% of the participants. Prevalence of impaired fasting glucose in the whole group was 8.2% and tended to increase with age. Diabetes was found in 1.2% of the participants and its prevalence also tended to rise with age, at the borderline of significance. Frequency of arterial hypertension and metabolic syndrome in the whole group was 15.7% and 14.1% respectively and both tended to increase with age. CONCLUSIONS: Overweight and obesity, especially of abdominal type, and the related metabolic abnormalities are common in Polish women of childbearing age. Their prevalence tends to increase with age. Underweight is relatively common in the youngest age group.

Coffee consumption and mortality in three Eastern European countries: results from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study.

OBJECTIVE: To test the association between coffee consumption and risk of all-cause, CVD and cancer death in a European cohort. DESIGN: Prospective cohort study. Cox proportional hazards models with adjustment for potential confounders to estimate multivariable hazard ratios (HR) and 95 % CI were used. SETTING: Czech Republic, Russia and Poland. SUBJECTS: A total of 28561 individuals followed for 6·1 years. RESULTS: A total of 2121 deaths (43·1 % CVD and 35·7 % cancer mortality) occurred during the follow-up. Consumption of 3-4 cups coffee/d was associated with lower mortality risk in men (HR=0·83; 95 % CI 0·71, 0·99) and women (HR=0·63; 95 % CI 0·47, 0·84), while further intake showed non-significant reduced risk estimates (HR=0·71; 95 % CI 0·49, 1·04 and HR=0·51; 95 % CI 0·24, 1·10 in men and women, respectively). Decreased risk of CVD mortality was also found in men (HR=0·71; 95 % CI 0·54, 0·93) for consumption of 3-4 cups coffee/d. Stratified analysis revealed that consumption of a similar amount of coffee was associated with decreased risk of all-cause (HR=0·61; 95 % CI 0·43, 0·87) and cancer mortality (HR=0·59; 95 % CI 0·35, 0·99) in non-smoking women and decreased risk of all-cause mortality for >4 cups coffee/d in men with no/moderate alcohol intake. CONCLUSIONS: Coffee consumption was associated with decreased risk of mortality. The protective effect was even stronger when stratification by smoking status and alcohol intake was performed.

Dietary polyphenols are inversely associated with metabolic syndrome in Polish adults of the HAPIEE study.

PURPOSE: The aim of this study was to evaluate the association between total and individual classes and subclasses of dietary polyphenol intake and prevalence of metabolic syndrome (MetS) in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe cohort study. METHODS: A cross-sectional population-based survey including 8821 adults (51.4 % female) was conducted in Kraków, Poland. Dietary polyphenol intake was evaluated using food frequency questionnaires and matching food consumption data with the Phenol-Explorer database. MetS was defined according to the International Diabetes Federation definition. Linear and logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). RESULTS: Significant differences in age and energy intake among different categories of total dietary polyphenol intake were found. Body mass index (BMI), waist circumference (WC), blood pressure, and triglycerides were significantly lower among individuals in the higher quartiles of polyphenol intake, but a linear association was found only for BMI and WC. After adjusting for potential confounding factors, individuals in the highest quartile of polyphenol intake were less likely to have MetS (OR 0.80; 95 % CI 0.64, 0.98 and OR 0.70; 95 % CI 0.56, 0.86 for both men and women, respectively). High total polyphenol intake was negatively associated with WC, blood pressure, high lipoprotein cholesterol, and triglycerides in women, and fasting plasma glucose in both genders. Among individual classes of polyphenols, phenolic acids and stilbenes were significantly associated with MetS; lignans and stilbenes with WC; phenolic acids with blood pressure and triglycerides; and flavonoids with fasting plasma glucose. Among specific subclasses of polyphenols, hydroxycinnamic acids, flavanols, and dihydrochalcones had the most relevant role. CONCLUSIONS: Total and individual classes and subclasses of dietary polyphenols were inversely associated with MetS and some of its components.

Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005).

INTRODUCTION There are limited data on the current prevalence of overweight and obesity as well as its changes with time in Poland. OBJECTIVES The aim of the study was to assess the prevalence of general and abdominal obesity and overweight in Polish adults in the years 2013-2014, and to compare it with the prevalence in the years 2003-2005. PATIENTS AND METHODS The study was conducted in 2 independent, representative samples of the Polish population, comprising 14 537 persons (aged 20-74 years) examined in the years 2003-2005 and 6164 persons (aged ≥20 years) examined in the years 2013-2014. Anthropometric measurements were done by trained nurses. RESULTS In the years 2013-2014, the age-standardized prevalence of obesity (body mass index [BMI] ≥30 kg/m2) was 24.4% in men and 25.0% in women. The prevalence of overweight (BMI, 25.0-29.9 kg/m2) was 43.2% in men and 30.5% in women. Abdominal obesity (waist circumference ≥102 cm in men or ≥88 cm in women) was noted in 32.2% of men and 45.7% of women. Abdominal overweight (waist circumference, 94-101.9 cm in men or 80-87.9 cm in women) was present in 27.2% of men and 21.7% of women. Since the years 2003-2005, the distribution of body mass according to the BMI category had shifted to higher values, and an increase in the prevalence of obesity was observed in men. The percentage of adults with normal waist circumference decreased significantly in both sexes. CONCLUSIONS Every fourth inhabitant of Poland is obese, and during the last decade, the prevalence of obesity has increased, particularly in men. Abdominal obesity is observed in every third man and nearly every second woman, and an excess of abdominal fat has increased in both sexes.

Inequalities in mortality of infants under one year of age according to foetal causes and maternal age in rural and urban areas in Poland, 2004-2013.

INTRODUCTION: European countries are characterized by low mortality during the infancy period compared to other areas of the world. However, there are significant disparities in the state of infant health which are related to socio-economic conditions and place of residence. OBJECTIVE: Analysis of mortality in Poland from foetal and maternal causes (length of gestation, birth weight, maternal age) in the neonatal and post-neonatal period depending on place of residence (rural and urban areas) in 2004-2013. MATERIALS AND METHOD: Data on mortality during the neonatal and infancy period in 2004-2013 was obtained from the Central Statistical Office. Diagnosed cases of deaths in rural and urban areas were analyzed, taking into account the causes of death according to ICD-10, the duration of pregnancy in weeks, birth weight, and maternal age. Trend analysis and comparison of mortality between rural and urban areas were performed using the Poisson regression model. RESULTS: In rural areas, neonatal and post-neonatal death rates due to congenital malformations were siginificantly higher than in urban areas. The mortality rate was also higher in rural areas in children born to women aged 20-34 years, and children born after 37 weeks gestation with low birth weight. In the cities, higher post-neonatal mortality was due to respiratory diseases, and in children born after 37 weeks gestation to mothers under the age of 20 years. A decrease in the mortality of newborns and infants was observed, but in rural areas neonatal mortality decreased significantly more slowly. CONCLUSIONS: The results indicate the need to intensify programmes aimed at improving access to prenatal and maternity care, especially among women in rural areas.

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? - WOBASZ II project.

BACKGROUND: Diet is a modifiable risk factor for cardiovascular disease (CVD). AIM: To assess diet quality in the adult Polish population, taking into consideration consumption of various nutrients as well as the total diet quality. METHODS: Within the frame of the National Multicentre Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013-2014. Dietary habits were assessed in 5690 subjects (2554 men and 3136 women). Nutrient intakes were compared to the Dietary Reference Intakes. Total diet quality was measured using the Healthy Diet Indicator (HDI) score, based on the World Health Organisation recommendations for CVD prevention, that includes 7 nutrients (saturated and polyunsaturated fatty acids, cholesterol, protein, dietary fibre, fruits and vegetables, free sugars) and ranges from 0 (the least healthy diet) to 7 (the healthiest diet). RESULTS: The studied group was characterised by a high prevalence of overweight and obesity (69% in men vs. 59% in women), hypercholesterolaemia (56% vs. 55%, respectively), hypertension (50% vs. 42%), and diabetes (12% vs. 10%). At the same time, a significant percentage of Poles had improper dietary habits. A low fat and low cholesterol diet was reported by only 8% and a low calorie diet by 1% of the respondents. Adding salt to already seasoned dishes was reported by 27% of men and 18% of women, and 56% and 30% of them, respectively, consumed meat products with visible fat. The diet of most adult Polish citizens was found to be not balanced. Vitamins A, C, E, B1, B2, B6, and B12, protein, dietary cholesterol and fruits/vegetables were consumed in recommended doses only by 44-80% of the respondents. The recommended intake of fat, saturated and polyunsaturated fatty acids, which significantly affect lipid levels, was found in 18-37% of the respondents. Dietary intakes of folate and minerals important for the prevention of hypertension were insufficient. The desired level of folate intake was found only in 13-26% of the respondents, and that of magnesium, calcium and potassium in 5-36% of them. The average HDI value was about 3.2 (out of the maximum of 7). A healthy diet (5-7 points) was noted in 15% of adult Poles. Most subjects (60%) were characterised by a low quality diet (0-3 points). Nevertheless, about 55% of respondents believed that their diet was appropriate. CONCLUSIONS: The quality of dietary habits of the majority of the adult Polish population falls far short of the recommendations relevant for CVD prevention.

Fruit and vegetable consumption and mortality in Eastern Europe: Longitudinal results from the Health, Alcohol and Psychosocial Factors in Eastern Europe study.

BACKGROUND: It is estimated that disease burden due to low fruit and vegetable consumption is higher in Central and Eastern Europe (CEE) and the former Soviet Union (FSU) than any other parts of the world. However, no large scale studies have investigated the association between fruit and vegetable (F&V) intake and mortality in these regions yet. DESIGN: The Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) study is a prospective cohort study with participants recruited from the Czech Republic, Poland and Russia. METHODS: Dietary data was collected using food frequency questionnaire. Mortality data was ascertained through linkage with death registers. Multivariable adjusted hazard ratios were calculated by Cox regression models. RESULTS: Among 19,333 disease-free participants at baseline, 1314 died over the mean follow-up of 7.1 years. After multivariable adjustment, we found statistically significant inverse association between cohort-specific quartiles of F&V intake and stroke mortality: the highest vs lowest quartile hazard ratio (HR) was 0.52 (95% confidence interval (CI): 0.28-0.98). For total mortality, significant interaction (p = 0.008) between F&V intake and smoking was found. The associations were statistically significant in smokers, with HR 0.70 (0.53-0.91, p for trend: 0.011) for total mortality, and 0.62 (0.40-0.97, p for trend: 0.037) for cardiovascular disease (CVD) mortality. The association was appeared to be mediated by blood pressure, and F&V intake explained a considerable proportion of the mortality differences between the Czech and Russian cohorts. CONCLUSIONS: Our results suggest that increasing F&V intake may reduce CVD mortality in CEE and FSU, particularly among smokers and hypertensive individuals.