The use of vitamin supplements among adults in Warsaw: is there any nutritional benefit?

BACKGROUND: The use of dietary supplements is widespread and can contribute substantially to total nutrient intake. However, it also generates some potential risks in the case of unreasonable and excessive use of such products. OBJECTIVE: To estimate the prevalence of supplementation and the vitamin supplement contribution to total intake among Warsaw population aged 20-74 years. MATERIAL AND METHODS: Nutrient intake and supplement use were studied in a representative sample of Warsaw population in years 2011/12 (486 men and 421 women) and in 2001 (658 and 671 respectively). The vitamin levels were analyzed in reference to the Recommended Dietary Allowance (RDA) and the tolerable upper intake level (UL). RESULTS: In the years 2011/12 the use of dietary supplements (vitamins and minerals) was reported by 31% men and 40% women. Vitamin intake from food showed the deficiency of vitamins D, B1 and folates and adequate intake of vitamins A, C, E, B2, B6, B12. Supplementing with vitamins D and B1 as well as folic acid contributed to better RDA fulfillment. Supplementing with vitamins A, C, E, B2, B6 and B12 was not justified because these vitamins were taken in sufficient amounts with food. In 1.3%-14.9% supplement users, the total intake of vitamins A, C, E and B6 exceeded the UL. The prevalence of supplementation of vitamins A, C and E did not change between 2001 and 201 1/12, but the total intake of vitamin A in both sexes and vitamins C, E in women was significantly higher in 2001. CONCLUSIONS: The use of dietary supplements in Warsaw population was widespread and in case of some vitamins- unreasonable.

Do depressive symptoms adversely affect the lifestyle? Results of the WOBASZ study.

BACKGROUND: The negative psychosocial risk factors for cardiovascular (CV) disease, such as low social support or depression, may adversely affect the lifestyle. AIM: To evaluate the lifestyle in terms of anti-health behaviours in patients with depressive symptoms (DS) compared to individuals without DS. METHODS: A total of 6392 men and 7153 women aged 20-74 years were evaluated in the WOBASZ study [a multicentre nationwide study of the Polish population's health]). The presence of DS was assessed with Beck's Depression Inventory (BDI). Depressive symptoms were considered to be present if the patient scored at least 10 points on the BDI scale. RESULTS: The DS were present in 24% of men and 34% of women. In both groups, the mean age of subjects with DS was significantly higher compared to healthy individuals. Compared to healthy individuals, subjects with DS had a more unfavourable CV risk profile (hypertension, diabetes mellitus, obesity and hyperlipidaemia were significantly more prevalent among the subjects with DS), were characterised by a lower socioeconomic status and inhabited small administrative districts. Subjects with DS were also characterised by more anti-health lifestyles than healthy individuals. Of the 6 elements of anti-healthy lifestyle, 3 or more were observed in 18.8% of men with DS and 14.6% of men without DS (p < 0.0001) and in 17.5% of women with DS and 11.3% of women without DS (p < 0.0001). Significantly more men and women with DS than men and women without DS were regular smokers (men [M]: 42.3% vs 37.4%, p < 0.0007; women [W]: 25.6% vs 23.3%, p < 0.0346), were not physically active (M: 37.4% vs 30.2%, p < 0.0001; W: 43.4% vs 34.9%, p < 0.0001), consumed alcohol at least three times a week (M: 3.8% vs 1.7%, p < 0.0097; W: 0.3% vs 0.1%, p = 0.0349), were incompliant with their doctor's recommendations (M: 17.9% vs 12.3%, p < 0.0001; W: 22.2% vs 13.9%, p < 0.0001) and failed to have their blood pressure measured within the past year (M: 19.4% vs 15.0%, p < 0.0003; W: 15.1% vs 11.4%, p < 0.0001). The lack of physical activity and smoking, and - in women - regular consumption of alcohol, were demonstrated to be the lifestyle factors which were significantly and independently related to DS. CONCLUSIONS: A high prevalence of DS, especially among women, has been observed in the Polish population. The DS were found in every fourth man and every third woman. In both groups, subjects with DS were characterised by more anti-health lifestyle compared to healthy individuals. Of all the analysed factors of anti-health lifestyle the following were significantly and independently associated with DS - lack of physical activity and smoking in both sexes and, additionally, regular alcohol consumption in women.

Dietary intake of vitamins B6, B12 and folate in relation to homocysteine serum concentration in the adult Polish population - WOBASZ Project.

BACKGROUND: Increased homocysteine (Hcy) levels predispose to atherosclerosis. Vitamin B6, B12 and folate play an important role in Hcy metabolism. AIM: To assess vitamin B6, B12 and folate intake and describe the relationship between these vitamins intake and Hcy level in the Polish population. METHODS: Within the framework of the National Multicentre Health Survey (WOBASZ), a representative sample of the whole Polish population aged 20-74 was screened in the years 2003-2005. In each province of Poland 6 communities were randomly selected and in each of them a sample of 100 men and 100 women was randomly selected from the personal identification number (PESEL) database. In a sample of 50% of subjects (3004 men and 3401 women) Hcy level and nutrients were assessed according to the study protocol. RESULTS: Average intake of vitamin B6 was 2.26 mg/day in men and 2.03 mg/day in women, of vitamin B12 - 5.85 microg/day and 3.69 microg/day, and folate 258 microg/day and 211 microg/day, respectively. The recommended levels of intake were not achieved by 16% of men and 36% of women for vitamin B6, 32% and 51% for vitamin B12, and 78% and 90% for folate, respectively. The Hcy level (after adjustment for age, smoking, coffee and alcohol consumption) and prevalence of hyper-Hcy (> or = 12 micromol/l) decreased with increasing number of quartile of vitamins B6 and B12 in both genders and folate in men. In multivariable linear regression analysis an inverse association between the Hcy level and intake of vitamin B6 and folate in both genders, and vitamin B12 in men, was demonstrated. CONCLUSIONS: In the Polish population insufficient folate intake was common (deficiency was noted in nearly 80-90% of the population) and despite the correct average, a high proportion of subjects did not fulfil B6 and B12 intake recommendations; an inverse association between vitamins B6, B12 and folate consumption and Hcy concentration and prevalence of hyper-Hcy was observed

[Evaluation of prevalence and magnitude of vitamins and minerals supplementation in Polish population]. / Ocena rozpowszechnienia i wielkosci suplementacji witaminami i skladnikami mineralnymi w populacji polskiej.

The aim of this paper was evaluation of prevalence of supplementation according to demographic, economic and healthy factors and assessment of vitamins and minerals intake from supplements in Polish population aged 20-74 years. Data of 3132 men and 3529 women, from whom data about use of vitamins and minerals supplements on the day before examination was obtained, was used. Prevalence of supplement use in the study group was rather small and depended on gender, place of residence, education level and income. Mean intake from supplements of the majority of vitamins was higher than recommended daily allowance (RDA). Only iron intake from supplements was higher than RDA, however calcium and magnesium intake from supplements was 25% of RDA. High vitamin A, niacin and iron intake from supplements can display risk of adverse effect on health.

[Vitamins and minerals intake from diet and supplements among subjects with a history of cardiovascular events in Polish population]. / Spozycie witamin i skladników mineralnych z uwzglednieniem suplementacji u osób po przebytych incydentach sercowo-naczyniowych w populacji polskiej.

Some vitamins and minerals play an important role in the secondary prevention of cardiovascular diseases (CVD). The aim of this study was the assessment of dietary vitamins and minerals intake and patterns of supplement use among subjects with diagnosed CVD in Polish population. Within the frame of the WOBASZ study, a representative sample of whole Polish population aged 20-74 (7257 subjects) was screened in 2003-2005. A subsample of 803 persons with a clinical history of cardiovascular events was analyzed. It was found, that the average diet of adult Polish citizens with established CVD was not balanced concerning the intake of vitamins and minerals. Daily intake of antioxidant vitamins (A, C and E) and vitamin B12 was satisfactory the realization degree of recommended dietary allowances (RDA) was about 126-310%. The insufficient amounts of vitamins B1, B2, folates, as well as potassium, calcium, magnesium in diet of both genders and vitamin B6 in men and iron in women were noted. The highest deficiency has been noticed in vitamins B1, B2 and calcium and magnesium intake--the realization degree of RDA has stayed on 54-82% level. Around 1% of potassium, calcium and magnesium intake in both genders and more than 25% of vitamins E and B6 consumption in women derived from the supplementation.

Quality of nutrition and health knowledge in subjects with diagnosed cardio-vascular diseases in the Polish population--National Multicentre Health Survey (WOBASZ).

BACKGROUND: Dietary treatment plays an important role in prevention of cardiovascular diseases (CVD). A significant factor that influences the fulfilment of dietary recommendations is also the knowledge of non-pharmacological methods of CVD prevention. AIM: To evaluate the health knowledge and the dietary behaviours among subjects with established CVD and to assess how many of them meet recommended dietary allowances (RDA) for secondary prevention. METHODS: Within the framework of the National Multicentre Health Survey (WOBASZ), a representative sample of 7257 persons of the whole Polish population aged 20-74 was screened in years 2003-2005. A subsample of 803 persons (males--430, females--373) with a clinical history of myocardial infarction and/or coronary artery disease and/or heart failure and/or stroke and/or arrhythmia and/or PCI and/or coronary bypass surgery was analysed. Nutrients intake and health knowledge were assessed according to the study protocol. RESULTS: The evaluated group was characterised by a high prevalence of persons with obesity (70%), ex-smokers (49% in males and 22% in females) and smokers (27% and 13%, respectively). The proportion of patients with knowledge of the following CVD prevention methods was very low: weight reduction (33 vs. 35% males vs. females), increase of physical activity (54 vs. 52% respectively), salt reduction (23 vs. 21%), reducing fat intake (37 vs. 36%), and regular consumption of fruits and vegetables (23 vs. 23%). The low level of dietary knowledge was reflected by dietary behaviours. A low fat and low cholesterol diet was reported only by every 5th patient and a low calorie diet by every 100th. Adding salt to previously seasoned dishes was reported by 25% of males and 19% of females. Respectively, 49 and 32% consumed meat products with visible fat. The prevalence of persons whose diet met RDA was unsatisfactory. The degree of fulfilment of recommendations as to anti-oxidant vitamins (A, C and E), proteins, cholesterol and fruits and vegetables was relatively the best; however, also in this case only 40-80% of respondents followed the recommendations. The intake of fats, fatty acids and carbohydrates was less satisfactory. The correct amount of those nutritional components was consumed only by 20-39% of assessed patients. The worst situation was noted as to the intake of B vitamins, calcium and magnesium. The recommendations for those vitamins and minerals was followed only by 11-37% of evaluated persons. CONCLUSIONS: In the Polish population subjects with established CVD are characterised by a low level of knowledge of non-pharmacological methods of preventing heart diseases and low quality of nutrition.

Did favourable trends in food consumption observed in the 1984-2001 period contribute to the decrease in cardiovascular mortality? - Pol-MONICA Warsaw Project.

AIM: To compare food consumption trends (1984-2001) with cardiovascular mortality trends (1984-2002) in an adult population of right-bank Warsaw residents and establish the delay between dietary changes and mortality reduction. METHODS: Cardiovascular mortality rates for the 1984-2002 period, calculated based on the Central Statistical Office data and the results of individual evaluation of nutrition patterns in 4 independent Pol-MONICA cross-sectional studies (1984, 1988, 1993 and 2001) were analysed. RESULTS: The cardiovascular mortality rate in right-bank Warsaw inhabitants tended to increase until 1991, and then a decline was observed -- in 2002 in comparison to 1991 the mortality rate in both genders decreased by over 50%. From 1984 to 2001 a significant decrease in the following dietary factors was found: total energy intake, dietary cholesterol, and Keys score reflecting atherogenicity of the diet and animal fats. In contrast trends of vegetable fats intake increased. The favourable changes in the dietary habits of Warsaw inhabitants were correlated with the reduction of cardiovascular mortality (R2 within the range of 0.35-0.95), and the strongest relationship between these facts occurred after 7 years. CONCLUSIONS: A positive tendency observed with respect to nutrition patterns of right-bank Warsaw inhabitants contributed to the reduction of cardiovascular mortality.

Body mass index and risk of death in middle-aged men and women in Poland. Results of POL-MONICA cohort study.

BACKGROUND: Overweight and obesity have been considered to be the causes of serious health consequences. So far, there have been no studies in Poland to analyse the relationship between Body Mass Index (BMI) and mortality. AIM: To determine the relationship between BMI and the mortality risk due to all causes and due to cardiovascular diseases (CVD) in the middle-aged population of Poland. METHODS: The study group consisted of men and women aged 35-64, residents of two districts of Warsaw (Praga Pólnoc and Praga Poludnie) and the former Tarnobrzeg Voivodship who were selected at random for POL-MONICA Project cross-sectional studies in 1983-1994. Risk assessment of death due to all causes and due to CVD was performed using the Cox proportional hazards method. Persons with BMI of 22-23.9 were adopted as reference group. RESULTS: Sample size consisted of 5,281 men and 5,691 women. Prospective observation was carried out from 5 to 15 years, mean duration 10.7 years. Overall, the observation comprised 117,839 person-years. During the study, 914 men died (including 448 due to CVD) as well as 430 women (including 160 due to CVD). After adjusting for age, place of residence (Warsaw vs. the Tarnobrzeg Voivodship), risk factors (hypercholesterolemia, arterial hypertension and smoking) and self-assessment of health, increased risk of all cause death was found in men with BMI lower than 20 kg/m(2) (relative risk 2.27), with BMI of 32-34.9 kg/m(2) (relative risk 1.41), with BMI > or =35 kg/m(2) (relative risk 1.73), and in women whose BMI was lower than 20 kg/m(2) (relative risk 1.66). Increased risk of CVD death was found in men with BMI lower than 20 kg/m(2) (relative risk 1.97), with BMI of 32-34.9 kg/m(2) (relative risk 1.66), with BMI > or =35 kg/m(2) (relative risk 2.06), and in women with BMI > or =35.0 kg/m(2) (relative risk 2.02). CONCLUSIONS: The POL-MONICA study carried out in the middle-aged Polish population did not confirm a relationship between overweight (BMI from 25 to 29.9 kg/m(2)) and risk of death due to all causes or due to CVD.

[Homocysteine level, relationship with cardiovascular risk factors in selected Polish population]. / Stezenie homocysteiny, zwiazek z czynnikami ryzyka chorób ukladu krazenia w wybranych polskich populacjach.

The aim of the study was to evaluate the concentration and distribution of homocysteine in random samples of men and women aged 20-74 from two populations: urban (Warsaw) and industrial-rural (former Tarnobrzeg Province), and the estimation of relationship between selected cardiovascular risk factors and homocysteine concentration. In 2001 in 617 men and 657 women homocysteine level, lipids profile, glucose, folic acid, vitamin B12 concentration, blood pressure and alcohol intake were determined. The mean (geometric) homocysteine concentration was 10.9 micro mol/L in men and 9.6 micro mol/L in women. There were no differences in the homocysteine concentration and distribution between regions according to sex. The homocysteine level was connected with folic acid and vitamin B12 concentration in both genders. Moreover, in men was recorded relationship between homocysteine and body mass index, cholesterol level, alcohol intake, and in women between homocysteine and daily number of cigarettes smoked.

Relationship between alcohol consumption and cardiovascular mortality--the Warsaw Pol-MONICA Project.

BACKGROUND: Cardioprotective effects of alcohol recently gained wide spread interest and have been examined in several studies. AIM: To assess the effects of alcohol consumption on mortality due to cardiovascular diseases (CV) in the population of the Eastern part of Warsaw. METHODS: The study group consisted of representative, independent and randomly selected samples of the populations of two Warsaw districts (Praga Pólnoc and Praga Poludnie), aged between 35 and 64 years. The studied subjects were examined in 1984 (2570 subjects), in 1988 (1397 subjects) and in 1993 (1485 subjects). Their survival rates were followed up until 1998. The annual beer, wine and vodka intake was assessed using a standardised questionnaire and calculated for a daily pure ethanol intake. The studied subjects were divided into four groups: abstinents and three groups according to the tertile distribution of the alcohol intake (mean alcohol intake in the first tertile: males 1.1 g/day, females 0.2 g/day, in the second tertile: 3.9 and 0.4 g/day, respectively, and in the third tertile: 28.2 and 2.8 g/day, respectively). The relative risk of death in the analysed groups was assessed using the proportional hazard Cox analysis. RESULTS: In total, 471 males and 244 females died during the follow-up period. There were 221 CV deaths among males and 85 among females. The relative risk of CV death after adjustment for other parameters (age, screening, cigarette smoking, body mass index, education level, cholesterol level, anginal symptoms, systolic blood pressure and self-assessed health status) was approximately 40% lower among males who consumed alcohol compared with the abstinents. The lowest risk of CV death was noted in the first tertile group. Females who consumed alcohol, had a 40-70% lower CV risk of death than abstinents the lowest risk was documented for the third tertile group. CONCLUSIONS: Alcohol consumption independently lowers the risk of death due to cardio-vascular diseases.

Is there an association between depressive symptoms and coronary artery disease in the Polish adult population?

BACKGROUND: Evidence-based medicine has confirmed the role of psychosocial factors in the pathogenesis of many diseases, both cardiovascular (CVD) and metabolic. On the other hand, CVD patients often suffer from concomitant diseases. Depression was found to be an independent predictor of coronary artery disease (CAD) in many populations. AIM: To evaluate the association between depressive symptoms (DS) and CAD in the Polish adult population. METHODS: A random sample of the Polish population (6392 men and 7153 women), aged 20-74 years, was examined in 2003-2005 for the presence of DS using the Beck Depression Inventory. RESULTS: In the examined population, CAD was found in 12.1% of men and 11.0% of women. Persons with CAD were older, more often finished their education at the level of primary school and lived in large communes, and more often had obesity, hypertension, diabetes and hyperlipidaemia compared to those without CAD. DS were found twice more often in persons with CAD compared to those without CAD, both in men and women. Subjects with DS were twice more likely to have CAD (men: odds ratio [OR] 2.14, 95% confidence interval [CI] 1.78-2.56; women: OR 2.03, 95% CI 1.70-2.43) and arrhythmia (women), and 1.5-fold more likely to report myocardial infarction and arrhythmia. CONCLUSIONS: A significant association between DS and CAD, myocardial infarction and arrhythmia independent of CVD risk factors was found in the Polish adult population.

Does heart failure determine the nutrition of patients?

BACKGROUND: Studies of the diet of heart failure (HF) patients, available in the literature, indicate that this diet is highly inadequate in light of the existing recommendations. AIM: To assess the nutrition of middle-aged patients with HF compared to a control group representing the general population without HF. METHODS: The study group comprised 70 patients with diagnosed HF, below 65 years, with NYHA class I/II/III. For the control group, we selected members of the general population with identical sex, age, body mass index and cigarette smoking parameters as the tested persons. Diet was evaluated on the basis of a dietary questionnaire and a 24-h dietary recall. RESULTS: The energy/ideal body weight ratio was significantly lower in the study group than in the control group (p < 0.005). Patients with HF had lower % kcal from fat, SAFA, MUFA (p < 0.05), omega-3 (p < 0.05), folic acid (p < 0.001) and dietary fibre (p < 0.01) consumption compared to the control group. No intergroup differences were found in the consumption of vitamins B6, C, A or E. The lowest energy, dietary fibre and vitamins intake (except vitamin A) was found in patients in NYHA class III. CONCLUSIONS: The diet of patients with HF seems to differ from the diet of persons without HF. These differences are manifested in a lower energy content of diet, lower intake of total fat, omega-3 fatty acids, folic acid and dietary fibre. Most patients with HF have ischaemic aetiology, and therefore should apply the dietary recommendations for patients with dyslipidaemia and high cardiovascular risk. However, their diet for certain parameters was inconsistent with ESC/EAS guidelines (high intake of saturated fatty acids, low intake of dietary fibre).

Alcohol intake and cardiovascular risk factor profile in men participating in the WOBASZ study.

BACKGROUND: Studies showed that alcohol intake affects various biomarkers (lipids, blood pressure [BP], homocysteine, diabetes, haemostatic factors) associated with the risk of coronary heart disease. AIM: To determinate cardiovascular (CV) risk factor profile in a population Polish men stratified according to alcohol intake. METHODS: Within the frame of the National Multicentre Health Survey (WOBASZ), a sample of 6912 men aged 20-74 years representative for the general population in Poland was screened in 2003-2005. A wide range of CV risk factors was assessed in all participants on the basis of questionnaires, laboratory tests, anthropometric studies, and BP measurements. Annual beer, wine and vodka intake was assessed using a standardised questionnaire, and daily pure ethanol intake was calculated. The studied subjects were divided into 4 groups: abstainers (A), light drinkers (L; ≤ 15 g ethanol/day), moderate drinkers (M; 15-30 g ethanol/day), and heavy drinkers (H; > 30 g ethanol/day). RESULTS: A positive association between alcohol consumption and systolic BP (A: 134.0, L: 136.9, M: 139.7, H: 141.3 mm Hg), diastolic BP (81.1, 83.3, 85.9, 87.1 mm Hg, respectively), high-density lipoprotein cholesterol (HDL-C) level (1.25, 1.34, 1.45, 1.61 mmol/L, respectively), and triglyceride level (1.59, 1.63, 1.82, 2.00 mmol/L, respectively) was observed. After adjustment for confounding factors, moderate drinkers were found to have a 37% higher risk of hypertension, a 25% higher risk of elevated trigliceride level, a 40% lower risk of low HDL-C level and a 35% lower risk of diabetes compared to light drinkers. Heavy alcohol consumption increased the likelihood of hypertension by 52%, elevated triglycerides by 46% and hyperhomocysteinaemia by 95%, and decreased the likelihood of low HDL-C by 44%. CONCLUSIONS: In the Polish population, negative consequences of alcohol intake were seen among men who consumed more than 15 g of ethanol daily. A potential positive effect of alcohol consumption, as manifested by higher HDL-C level a lower likelihood of diabetes (only with moderate alcohol intake), was counterbalanced by a negative effect on BP, homocysteinaemia, and triglycerides.

Is level of social support associated with health behaviours modifying cardiovascular risk? Results of the WOBASZ study.

BACKGROUND: Psychosocial risk factors affected the human health both by autonomic, neuroendocrine and immunological mechanisms and by the influence on human lifestyle. Lack of social support can reflect the person's lifestyle to more unhealthy. AIM: To assess if low, compared to high social support level (SSL), contributes to the unhealthy lifestyle in Polish general population. METHODS: The random sample of Polish population of 6164 men and 6915 women, aged 20-74, filled-in the Berkman and Syme questionnaire in 2003-2005 in the frame of National Multicenter Health Survey (WOBASZ). RESULTS: 31% of men and 39% of women had low SSL and they more often had high cardiovascular risk, depressive symptoms and cardiovascular disease risk factors, especially women. Men and women with low SSL more often smoked cigarettes than those with high SSL, rarely try to quit smoking, made regular physical activity, and rarely self-measured their blood pressure. Additionally men more often drank alcohol ≥ 30.0 g/day. They also more often did not take the prescribed medication, although they bought them. Out of unhealthy elements, lack of regular physical activity and blood pressure self-measuring were significantly and independently associated with SSL in both genders and additionally smoking habit and lack of quit smoking in the past in women. CONCLUSIONS: Persons with low SSL had more unhealthy lifestyle than those without. In Polish population the low SSL played a greater role in creating the cardiovascular risk in women than in men.

Homocysteine concentration and the risk of death in the adult Polish population.

BACKGROUND: Although there is a considerable epidemiologic evidence for a relation between homocysteine (Hcy) level and cardiovascular disease (CVD). The role of Hcy as a causal risk factor remains controversial. AIM: To determine associations between Hcy level and all-cause and cardiovascular mortality in general population of Poland. METHODS: Within the frame of the National Multicenter Health Survey (WOBASZ), a representative sample of whole Polish population aged 20-74 was screened in years 2003-2005 and prospectively followed up until 2009. Baseline determinations, among other classical risk factors, included Hcy level in 7165 responders, performed by an immunoenzymatic method using IMMULITE 1 analyser and DPC reagents. Survival rates were followed up until 2009 and average follow up time was 5.4 years. RESULTS: During the 38,818.9 person-years of follow-up there were 270 deaths including 108 due to CVD, 37 due to coronary heart disease and 21 due to stroke. The relative risk of all-cause and CVD mortality was significantly higher in the highest (> 10.51 µmol/L) compared to the lowest (< 8.20 µmol/L) Hcy tercile in crude and multivariable proportional hazards models adjusted for sex, age, smoking status, hypertension, body mass index, total cholesterol, glucose and high sensitivity-C-reactive protein. Hazards ratios (95% confidence intervals) were as follows: all-cause mortality HR (95% CI): crude = 4.528 (2.947-6.154), multivariable-adjusted = 1.766 (1.197-2.605), CVD mortality crude = 4.322 (2.426-7.700), multivariable- -adjusted = 1.937 (1.051-3.569). CONCLUSIONS: In Polish adult population Hcy concentration is independently associated with all-cause and CVD mortality.

Socioeconomic factors and the risk of metabolic syndrome in the adult Polish population: the WOBASZ study.

BACKGROUND: Metabolic syndrome (MetS) increases the risk of cardiovascular disease and its development is determined by certain socioeconomic and lifestyle factors. AIM: To investigate the impact of socioeconomic and lifestyle factors on the risk of MetS and the underlying contributing factors in the Polish population aged 20-74 years. METHODS: Between 2003 and 2005, as part of the National Multicentre Health Survey (WOBASZ, Wieloosrodkowe Badanie Stanu Zdrowia Ludnosci), a random sample of Polish residents aged 20 to 74 years was investigated. Data on sociodemographic and anthropometric parameters, blood pressure, lipid and glucose levels and medical history were collected. MetS was defined according to the criteria proposed by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and by the International Diabetes Federation (IDF) in 2005. Data necessary to evaluate MetS and the socioeconomic characteristics were obtained for 5940 men and 6627 women. RESULTS: MetS was identified in 26.0% of men and 23.9% of women according to the AHA/NHLBI definition, and in 30.7% of men and 26.8% of women according to the IDF definition. In both genders older age, higher body mass index and current smoking increased the risk of developing MetS, whereas higher physical activity and good self-rated health decreased the risk. Moreover, women with higher education and in the higher quartile of alcohol intake were associated with a lower risk of having MetS. Household per-capita income did not affect the risk of having MetS in either gender. CONCLUSIONS: A relatively high percentage of individuals with MetS was observed in the Polish population aged 20 to 74 years. In both sexes, the risk of MetS and its contributing factors was significantly associated with age and the following lifestyle factors: body mass index, smoking, self-rated health and, additionally for women, higher education and alcohol intake.