Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population-based study in 161 269 employees.

BACKGROUND: Seborrhoeic dermatitis is a common but epidemiologically poorly researched chronic skin disease. OBJECTIVES: To characterize the prevalence and dermatological comorbidity of seborrhoeic dermatitis in Germany. METHODS: In the course of voluntary company skin checks, full-body examinations were carried out in more than 500 companies by experienced dermatologists and documented electronically. RESULTS: In total, 161 269 participants were included (men 55·5%, mean age 43·2 ± 10·9 years). Seborrhoeic dermatitis was identified in 3·2% (men 4·6%, women 1·4%). A significant difference was found between age groups (2·0% in < 35; 3·6% in 35-64; 4·4% ≥ 65 years). The most frequent concomitant skin conditions were: folliculitis [17·0%, 95% confidence interval (CI) 15·9-18·1], onychomycosis (9·1%, 95% CI 8·3-10·0), tinea pedis (7·1%, 95% CI 6·3-7·8), rosacea (4·1%, 95% CI 3·6-4·7), acne (4·0%, 95% CI 3·4-4·5) and psoriasis (2·7%, 95% CI 2·3-3·2). Regression analysis revealed the following relative dermatological comorbidities when controlling for age and sex: folliculitis [odds ratio (OR) 2·1, 95% CI 2·0-2·3], contact dermatitis (OR 1·8, 95% CI 1·1-2·8), intertriginous dermatitis (OR 1·8, 95% CI 1·4-2·2), rosacea (OR 1·6, 95% CI 1·4-1·8), acne (OR 1·4, 95% CI 1·2-1·7), pyoderma (OR 1·4, 95% CI 1·1-1·8), tinea corporis (OR 1·4, 95% CI 1·0-2·0), pityriasis versicolor (OR 1·3, 95% CI 1·0-1·7) and psoriasis (OR 1·2, 95% CI 1·0-1·5). CONCLUSIONS: Seborrhoeic dermatitis is a common disease, which is more prevalent in men and older people, and it has an increased rate of dermatological comorbidity. However, absolute differences in the prevalence of comorbidities are small and negligible. Nevertheless, the findings underline the need for integrated, complete dermatological diagnostics and therapy.

Lifestyle behaviour and prevalence of cardiovascular risk factors - a pilot study comparing Kiribati and European seafarers.

BACKGROUND: According to internal observations within a German shipping company, obvious risk-behaviour persists among the crew members coming from the Pacific Island State of Kiribati and representing a large part of the crew aboard merchant vessels of this company. These observations were related to excessive eating habits. This study aims to assess the cardiovascular risk among seafarers and to compare lifestyle factors between Kiribati and European crew members. METHODS: In the present maritime field study 81 sailors (48 Kiribati, 33 European, average age at 38.9 and 36.8 years respectively) were examined from April until August 2014 aboard four container ships crossing the Atlantic Ocean (participation rate of 90.9%). RESULTS: Based on the number of established risk factors, 35.4% of the Kiribati and 16.7% of the European crew members were regarded as a high risk group for cardiovascular diseases. The HDL-values of Kiribati were found to be considerably lower (34.9 mg/dl) than the references values given by the WHO and in comparison to the European crew members (44.8 mg/dl) (p = 0.002). 91.7% of Kiribati and 51.5% of European participants were found to be overweight according to WHO-criteria - with a mean Body Mass Index (BMI) of 30.3 kg/m2 and 25.6 kg/m2 (p <  0.001). Regarding lifestyle factors Kiribati often claimed to eat significantly larger amounts of food aboard while most European sailors stated to eat less or about the same during their shipboard stay (p = 0.017). Daily sleeping hours were slight on both sides; however with a mean of 5.2 h a day Kiribati crew members had significant fewer sleep (p = 0.038). The examined Kiribati sailors had a mean increase in weight of 6 kg over a 12 months period of observation. CONCLUSIONS: In total the compiled data points towards a higher risk of cardiovascular diseases particularly due to alimentary habits within the Kiribati crew members. The distinct weight-gain measured among the Kiribati in spite of higher energy consumption levels at sea is alarming. Thus, the results of this study confirm the necessity of health-improving interventions aboard cargo vessels.

Nutrition is a powerful independent risk factor for coronary heart disease in women--The CORA study: a population-based case-control study.

BACKGROUND: It is still common practice to rely mostly on drug treatment for preventing cardiovascular disease, although a healthy nutrition has been defined that may prevent most premature cardiovascular events. OBJECTIVES: This research raises the question of the magnitude of the effect of nutrition on cardiovascular disease independent of that of clinical risk factors, which are the targets of drug therapy. DESIGN: The study of coronary risk factors for atherosclerosis in women compares clinical, biochemical, and lifestyle factors in 200 consecutive pre- and postmenopausal women with incident coronary heart disease (CHD) to those in 255 age-matched population-based controls. RESULTS: Cases reported a higher intake of energy, predominantly through animal fat and protein reflected by a higher consumption of meat and sausage, while controls ate more fruit and vegetables. Multivariate analysis adjusted for clinical risk factors depicted a high intake of meat and sausage and a low consumption of fruit and vegetables as independent risk factors with an odds ratio of 2.5 (95% confidence interval 1.1-5.7) and 0.7 (95% confidence interval 0.5-1.0) for each 100 g per day, respectively. These dietary factors were found to be significantly more pronounced in cases with any clinical risk factor identified in this population as compared to controls with the same risk factors. CONCLUSIONS: The CORA-study clearly indicates a major impact of dietary habits on CHD in women independent of, and additive to, that of conventional risk factors. Thus, in clinical practice, the potential of nutrition as part of a healthy lifestyle is commonly greatly underestimated in favour of drug treatment.

DELIGHT (delay of impaired glucose tolerance by a healthy lifestyle trial) - a feasibility study on implementing a program of sustainable diabetes prevention in German companies.

BACKGROUND: Ca. 50% of Germans develop prediabetes in their lifetime. Though diabetes type 2 has been proven preventable, no screening for prediabetes has been implemented. DELIGHT was designed to assess if screening for individuals at risk and long-standing diabetes prevention is feasible in the setting of companies within the scope of the German legal health system. MATERIALS AND METHODS: In 5 companies employees with a waist circumference of ≥ 94 (men) and ≥ 80 cm (women) were offered a check-up. Those with fasting plasma glucose ≥ 100 mg/dl (IFG) or ≥ 140 mg/dl 2 h after oral glucose load (IGT) were followed for 3 years with an optional moderate lifestyle program during the first year and quarterly assistance for another 2 years. RESULTS: In 241 of 300 participants the self-measured waist circumference was confirmed as elevated. 3% had type 2 diabetes, while 37% had IFG (isolated in 96%) or IGT, of whom 91.4% (men) and 76.1% (women) had a metabolic syndrome. Within 3 years in those who had lost ≥ 1 kg, weight was reduced by 3.9 kg, risk factors were improved, and no case of diabetes had developed, while among those with weight loss of < 1 kg or weight gain, 10% of men and 5% of women had developed diabetes type 2. Screening for prediabetes did not increase the number or costs of drug prescriptions. CONCLUSIONS: Companies provide a suitable setting for screening for prediabetes. Long-term diabetes prevention is successfully feasible within the narrow financial frame of a legal insurance system without rise of costs.

Association between alcohol consumption and carotid intima-media thickness in a healthy population: data of the STRATEGY study (Stress, Atherosclerosis and ECG Study).

BACKGROUND/OBJECTIVES: Epidemiological evidence suggests a protective effect of moderate alcohol consumption on cardiovascular events. However, studies assessing the association between alcohol intake and intima-media thickness (IMT) as a marker of subclinical atherosclerosis have provided inconsistent results. The aim of this analysis of the Stress Atherosclerosis and ECG Study (STRATEGY study) was to investigate the relation between alcohol intake and IMT in a selectively healthy population. SUBJECTS/METHODS: In a cross-sectional study, laboratory values, anthropometric data, nutrition habits and physical activity were assessed in 106 men and 107 women, evenly distributed between 30 and 70 years. Carotid IMT was determined by B-mode ultrasonography according to the standardized protocol of the Study of Health in Pomerania. RESULTS: In men, a significant positive correlation between daily alcohol consumption and IMT was observed (P<0.0001), whereas in women the positive correlation was not significant. The type of beverage consumed did not affect this finding. The mean IMT was significantly higher in men with an alcohol intake above the upper limit of 20 g/day than in men with an alcohol intake <20 g/day (P<0.001). According to a stepwise linear regression model adjusted for age, conventional risk factors, nutrition and physical activity, the IMT increases by 0.0253 mm per 21.4 g/day intake of alcohol in men (P<0.05). CONCLUSIONS: The STRATEGY study revealed a positive association between alcohol consumption and carotid IMT in healthy men aged 30-70 years. This relationship remained significant after adjustment for nutrition, physical activity, anthropometry and conventional cardiovascular risk factors.

[Life style changes for prevention of coronary heart disease]. / Lebensstiländerungen zur Prävention koronarer Herzkrankheit.

BACKGROUND: In developed countries arteriosclerosis is responsible for the majority of all deaths. With growing prosperity the life expectancy is increasing, and cardiovascular disease is becoming the primary cause of premature death. Most complications of arteriosclerosis occur unexpectedly. Because of the severe morbidity and high mortality prevention is the only true solution. CHANGES OF LIFESTYLE: Unhealthy nutrition, physical inactivity, overweight and smoking have been identified as the primary causes of arteriosclerotic vascular disease. Central obesity is responsible for the risk factors characterizing the metabolic syndrome. This is the result of inappropriate caloric intake and expenditure. In addition, the nutrients themselves can bear harmful consequences either indirectly by deteriorating risk factors like lipid parameters or by affecting directly the vessel wall. This can add to the deleterious effects of smoking. Evidently saturated fat is the single most decisive nutrient for atherosclerotic vascular disease. Cholesterol and trans fatty acids act additive, while unsaturated fatty acids appear to be beneficial. However, total fat intake is an important determinant of the energy supply, which again influences body weight and composite. Physical activity can counteract, but appears to be beneficial by several additional ways. Quitting smoking is highly effective already within few years. Together with physical activity and healthy nutrition more than 80% of all cardiovascular events can be prevented. CONCLUSION: Preventive medicine needs to focus on lifestyle changes because they are feasible and highly effective. A nutrition low in total fat primarily by avoiding saturated and trans fatty acids, but rich in carbohydrates and fiber is recommended. Daily physical activity in any preferred way should be encouraged, and quitting smoking needs to be strongly emphasized.