Gradual reduction of free sugars in beverages on sale by implementing the beverage checklist as a public health strategy.

Background: Sugar-sweetened beverages (SSBs) are a major source of free sugar intake and contribute to obesity and obesity-related diseases. Therefore, we analyzed the effect of a gradual sugar reduction strategy within the so-called 'beverage checklist' on free sugar content in beverages on sale in Austria. Methods: From 2010 until 2017, data on the amount of free sugar of sweetened beverages (sweetened with sugars, fruit juice and artificial sweeteners) with 0.20-0.75l serving sizes in all main supermarkets and from industry was collected. These data were published annually as the beverage checklist, which displays beverages on sale in Austria. The checklist aims to encourage beverage production with a free sugar content of ≤7.4 g/100 ml and no artificial sweeteners. Results: Free sugar content in the total supply decreased significantly [7.53 (2.86) vs. 6.75 (2.79) g/100 ml; 10.4%; P < 0.001] over time and also in those for which follow-up data were available until 2017 (n = 100) [7.55 (2.46) vs. 7.28 (2.44) g/100 ml; 3.5%; P < 0.001]. The percentage of beverages fulfilling the guiding criteria increased by 12.8% (P < 0.001) and of those containing sweeteners decreased by 13.3% (after 2012; P = 0.034). Conclusions: This public health strategy, conducted by a small non-profit organization, showed a reduction in the mean free sugar content by working with the industry to voluntarily reformulate beverages. More beverages with less added sugar were brought to the market, which implies healthier choices. The challenge now is to further engage the industry and also policy makers to achieve a greater reduction in the future.

Treatment Duration With Long-Acting Injectable Antipsychotics After In-hospital Initiation: A Retrospective Cohort Study.

PURPOSE: Long-acting injectable (LAI) antipsychotics are recommended especially for patients with multiple admissions and poor adherence. The empirical basis of this strategy is a matter of debate. METHODS: In a retrospective cohort study extending over 6 years, all patients admitted for inpatient treatment with a diagnosis of psychotic disorders according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision (F2) were screened for treatment episodes with a new start of an LAI. Indication for LAI treatment was based primarily on previous medication default. All-cause discontinuation was used as a measure of treatment efficiency. Patients with early dropout (termination of LAI treatment within 6 months) were compared with patients with longer treatment (treatment >6 months) for sociodemographic and treatment variables using bivariate and multivariate analyses. RESULTS: A total of 194 treatment episodes with new start of LAIs were identified. Almost one half dropped out within 6 months (early dropout: n = 95 [49%]; mean duration, 2.2 months). Termination of treatment was mainly due to patients' refusal to continue. However, almost a third of patients (61; 31.4%) had a treatment duration of more than 2 years. In a multivariate Cox regression model, longer treatment duration was associated with older age (P = 0.05), not being single (P = 0.04), fewer admissions during the year preceding the index episode (P = 0.02), and better ratings for adherence at the index episode (P = 0.03). CONCLUSIONS: There are both more patients than expected leaving the treatment early and more patients than expected staying for long periods, even among patients with a history of poor adherence.

[Nutrition in overweight and obesity with a specific focus on gender aspects]. / Ernährung bei Übergewicht und Adipositas unter besonderer Berücksichtigung von Genderaspekten.

Efforts to optimize the diet in terms of prevention and treatment of obesity aim at long-term adaptation and reduction of energy intake according to age and physiological requirements while preserving the nutrient density with consideration of individual food preferences.As the nutritional habits of the average Austrian people are unfavorable for obesity prevention there is a clear need for action. Women are "disadvantaged" in weight control compared to men in terms of physiological conditions-and are confronted with specific needs during life course (e.g. pregnancy), whereas the average man or male adolescents present "unhealthier" behaviors and attitudes and are (still) less interested on nutrition or weight control.To achieve better nutrition a target-group specific, gender-sensitive guidance of the individual is needed, starting with pregnant women, but also habitat-oriented interventions for improved nutrition offers, which have to be sustainably assured through the support of a relevant legal and social framework.

Worksite Prevalence of (un)Diagnosed Cardiovascular Risk Factors From a Health-Check-Program in An Austrian Company.

OBJECTIVE: This investigation aims to determine cardiovascular disease risk profile in a cohort of employees. METHODS: In 704 participants, within the Special Institute for Preventive Cardiology And Nutrition health-check-program, body mass index, waist circumference, blood pressure (BP), lipids, glucose, and 10-year cardiovascular disease risk were assessed. RESULTS: Mean age was 37 (10) years (20% women) with 25.5 (3.9)  kg/m. A total of 38% demonstrated overweight, 44% abdominal obesity, 12% obesity, and 19% metabolic syndrome. We found a significant difference in increased BP versus diagnosed hypertension (47% vs. 14%; P < 0.001). Increasing age was a significant predictor of metabolic syndrome (odds ratio [95% confidence interval] = 1.08 [1.06 to 1.10]; P < 0.001). Ten percent had intermediate and 8% high cardiovascular disease risk. A total of 79% demonstrated at least one risk factor. CONCLUSIONS: We detected high prevalence of risk factors particularly increased BP and abdominal obesity. Workplace prevention programs should aim in initially identifying risk factors and subsequently improving lifestyle.

Anti-genotoxic potential of bilirubin in vivo: damage to DNA in hyperbilirubinemic human and animal models.

The bile pigment bilirubin is a known antioxidant and is associated with protection from cancer and cardiovascular disease (CVD) when present in too strong concentrations. Unconjugated bilirubin (UCB) might also possess anti-genotoxic potential by preventing oxidative damage to DNA. Moderately elevated bilirubin levels are found in individuals with Gilbert syndrome and more severe in the hyperbilirubinemic Gunn rat model. This study was therefore aimed to assess the levels of oxidative damage to DNA in Gilbert syndrome subjects and Gunn rats compared to matched controls. Seventy-six individuals (age- and sex-matched) were allocated into Gilbert syndrome (UCB ≥17.1 µmol/L; n = 38) or control groups (UCB < 17.1 µmol/L; n = 38). In addition, 40 Gunn rats were used to support the results of the human trial. Single-cell gel electrophoresis (SCGE) assay measuring standard conditions (strand breaks, apurinic/apyrimidinic sites) and formamidopyrimidine glycosylase (FPG)-sensitive sites was conducted in human peripheral blood mononuclear cells (PBMC) and rat PBMCs, colon, and hepatocytes. Furthermore, urinary 8-oxo-2'-deoxyguanosine (8oxodGuo, DNA oxidation) and 8-oxo-guanosine (8oxoGuo, RNA oxidation) were measured in humans. The Gilbert syndrome and Gunn rat groups had significantly higher UCB levels (P < 0.001) than the corresponding controls. No further differences in damage to DNA or RNA were detected between the two groups, except higher strand breaks (PBMCs) in Gunn rats when compared with controls. However, when demographic effects were analyzed, lower 8oxodGuo concentrations were detected in the human group with a BMI ≥25 kg/m(2) (1.70 ± 0.67 vs. 1.38 ± 0.43 nmol/mmol creatinine, P < 0.05), although this group showed lower UCB levels than normal weight subjects. This study suggests that the disease preventative effect of UCB is unrelated to DNA oxidation/strand breaks in human and animal models of hyperbilirubinaemia.