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Yang L, Juan A, Waldhoer T. Prevalence and trends in obesity among Austrian conscripts from 1983 to 2017. Wien Klin Wochenschr 2021:10.1007/s00508-021-01941-9. [PMID: 34533634 DOI: 10.1007/s00508-021-01941-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
This article describes the recent prevalence and trend in weight status in young men over three and half decades among Austrian conscripts overall and by subgroups defined by education and smoking behavior. We extracted medical record data from six medical examination stations across the country of all Austrian military conscripts (aged 17-19 years) recruited between 1983 and 2017 (n = 1.5 million). Weight and height were measured to calculate body mass index (BMI). Mean BMI increased from 22.7 to 24.3 kg/m2 between 1983 and 2017. Over time, the prevalence of obesity (BMI ≥ 30 kg/m2) increased from 1.6% (95% CI 1.6-1.7%) to 8.2% (95% CI 8.1-8.3%). The prevalence of obesity among Austrian young men increased remarkably in the past 35 years. Higher levels of education appeared to be associated with lower prevalence of obesity, particularly among the non-smokers.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210-2nd Street SW, ACB, T2S 3C3, Calgary, AB, Canada.,Preventive Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada.,Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria
| | | | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria.
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Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol 2021; 18:785-802. [PMID: 34050340 PMCID: PMC8162166 DOI: 10.1038/s41569-021-00559-8] [Citation(s) in RCA: 487] [Impact Index Per Article: 162.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
High blood pressure is one of the most important risk factors for ischaemic heart disease, stroke, other cardiovascular diseases, chronic kidney disease and dementia. Mean blood pressure and the prevalence of raised blood pressure have declined substantially in high-income regions since at least the 1970s. By contrast, blood pressure has risen in East, South and Southeast Asia, Oceania and sub-Saharan Africa. Given these trends, the prevalence of hypertension is now higher in low-income and middle-income countries than in high-income countries. In 2015, an estimated 8.5 million deaths were attributable to systolic blood pressure >115 mmHg, 88% of which were in low-income and middle-income countries. Measures such as increasing the availability and affordability of fresh fruits and vegetables, lowering the sodium content of packaged and prepared food and staples such as bread, and improving the availability of dietary salt substitutes can help lower blood pressure in the entire population. The use and effectiveness of hypertension treatment vary substantially across countries. Factors influencing this variation include a country's financial resources, the extent of health insurance and health facilities, how frequently people interact with physicians and non-physician health personnel, whether a clear and widely adopted clinical guideline exists and the availability of medicines. Scaling up treatment coverage and improving its community effectiveness can substantially reduce the health burden of hypertension.
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Yang L, Vass C, Smith L, Juan A, Waldhör T. Thirty-five-year trend in the prevalence of refractive error in Austrian conscripts based on 1.5 million participants. Br J Ophthalmol 2020; 104:1338-1344. [DOI: 10.1136/bjophthalmol-2019-315024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/16/2019] [Accepted: 12/19/2019] [Indexed: 01/25/2023]
Abstract
BackgroundTo quantify the current burden of myopia and hyperopia in Austrian young men and the time trend of myopia in the past 35 years by individual and social correlates.MethodWe included data on all Austrian military conscripts from 1983 to 2017 (n=1 507 063) from six medical investigation stations. Young men provided data on education, weight and height for calculating body mass index, blood pressure and resting heart rate. Non-cycloplegic refractions were measured by an autorefractometer. Spherical equivalent was calculated by standard formula (sphere+cylinder/2, unit dioptres (D)). Myopic refractive error was defined as <−0.5 D). Hyperopic refractive error was defined as >0.5 D.ResultsThe largest burden of refractive error in Austria is myopia, which rose from 13.8% to 24.4% over 35 years, with less than 5% hyperopic population. Over time, the prevalence of myopia was constantly lower yet increased more rapidly among those with low education levels (11.4%–21.7%) compared with those with higher education (24.5%–29.6%) in all medical investigation stations. We found consistent associations of some unfavourable health indicators (underweight: ORs 1.1–1.4, higher resting heart rate: all p trend <0.001) with higher myopia prevalence, which point towards lifestyle factors playing an important role in the development of myopia.ConclusionPrimary preventive measures are needed to curb the observed trend in myopia among Austrian young men. Future research should investigate the impact of modifiable factors on myopia development and progression, particularly lifestyle factors that are dramatically shifting.
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Binda P, Eldor R, Huerta C, Adams J, Lancaster J, Fox P, Del Prato S, DeFronzo R, Abdul-Ghani M, Daniele G. Exenatide modulates visual cortex responses. Diabetes Metab Res Rev 2019; 35:e3167. [PMID: 30974038 PMCID: PMC6718343 DOI: 10.1002/dmrr.3167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 03/25/2019] [Accepted: 04/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Increasing evidence suggests that metabolism affects brain physiology. Here, we examine the effect of GLP-1 on simple visual-evoked functional Magnetic Resonance Imaging (fMRI) responses in cortical areas. METHODS Lean (n = 10) and nondiabetic obese (n = 10) subjects received exenatide (a GLP-1 agonist) or saline infusion, and fMRI responses to visual stimuli (food and nonfood images) were recorded. We analysed the effect of exenatide on fMRI signals across the cortical surface with special reference to the visual areas. We evaluated the effects of exenatide on the raw fMRI signal and on the fMRI signal change during visual stimulation (vs rest). RESULTS In line with previous studies, we find that exenatide eliminates the preference for food (over nonfood) images present under saline infusion in high-level visual cortex (temporal pole). In addition, we find that exenatide (vs saline) also modulates the response of early visual areas, enhancing responses to both food and nonfood images in several extrastriate occipital areas, similarly in obese and lean participants. Unexpectedly, exenatide increased fMRI raw signals (signal intensity during rest periods without stimulation) in a large occipital region, which were negatively correlated to BMI. CONCLUSIONS In both lean and obese individuals, exenatide affects neural processing in visual cortex, both in early visual areas and in higher order areas. This effect may contribute to the known effect of GLP1 analogues on food-related behaviour.
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Affiliation(s)
- Paola Binda
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa. Pisa. Italy
| | - Roy Eldor
- Diabetes Unit-Institute of Endocrinology, Metabolism & Hypertension at The Tel Aviv Sourasky Medical Center. Tel-Aviv. Israel
| | - Claudia Huerta
- Imaging Research Center University of Texas Health Science Center at San Antonio. San Antonio, TX. US
| | - John Adams
- Imaging Research Center University of Texas Health Science Center at San Antonio. San Antonio, TX. US
| | - John Lancaster
- Division of Diabetes, University of Texas Health Science Center at San Antonio. San Antonio, TX. US
| | - Peter Fox
- Division of Diabetes, University of Texas Health Science Center at San Antonio. San Antonio, TX. US
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine. Section of Diabetes. University of Pisa. Pisa. Italy
| | - Ralph DeFronzo
- Division of Diabetes, University of Texas Health Science Center at San Antonio. San Antonio, TX. US
| | - Muhammad Abdul-Ghani
- Division of Diabetes, University of Texas Health Science Center at San Antonio. San Antonio, TX. US
- Diabetes and Obesity Clinical Research Center, Hamad General Hospital, Doha, Qatar
| | - Giuseppe Daniele
- Division of Diabetes, University of Texas Health Science Center at San Antonio. San Antonio, TX. US
- Diabetes and Obesity Clinical Research Center, Hamad General Hospital, Doha, Qatar
- Department of Clinical and Experimental Medicine. Section of Diabetes. University of Pisa. Pisa. Italy
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Staub K, Floris J, Koepke N, Trapp A, Nacht A, Schärli Maurer S, Rühli FJ, Bender N. Associations between anthropometric indices, blood pressure and physical fitness performance in young Swiss men: a cross-sectional study. BMJ Open 2018; 8:e018664. [PMID: 29886438 PMCID: PMC6009476 DOI: 10.1136/bmjopen-2017-018664] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To assess the benefit of waist circumference (WC) measurements during routine conscription medical examination in two military conscription centres in Switzerland. We compared the prevalence of overweight and obesity assessed by body mass index (BMI) with the prevalence of elevated disease risks assessed by WC and waist-to-height ratio (WHtR). We investigated how these measures were associated with systolic blood pressure, physical fitness performance and socioeconomic determinants. DESIGN Cross-sectional survey. SETTING Two Swiss conscription centres in 2016. PARTICIPANTS 1548 Swiss male conscripts, 18-22 years old. MAIN OUTCOME Prevalences of elevated WC, WHtR and BMI values according to WHO categories. Secondary outcomes include systolic blood pressure, physical fitness performance and endurance performance. RESULTS Using BMI cut-points, 25.0% of all conscripts were overweight or obese. When applying WC cut-points, 9.2% had an increased disease risk, while 14.8% of the conscripts were at risk using WHtR cut-points. In the BMI range of 25.0-27.4 kg/m2, 3.6% showed an increased disease risk when using WC and 24.6% when using WHtR cut-points. Of the conscripts with a BMI of 27.5-29.9 kg/m2, 72.4% had an increased disease risk using WHtR, and 42.5% when using WC cut-points. Determinants of elevated BMI, WC and WHtR were low occupational status, rural residential area, older age and location in central and Northwest Switzerland. Systolic blood pressure increased with increasing BMI, WC and WHtR. Physical fitness and endurance test performances decreased with increasing BMI, WC and WHtR. CONCLUSION In addition to BMI, WC and WHtR add relevant information to the health assessment of young men. However, the prevalence of overweight/increased health risk differed when using BMI, WC or WHtR. Further studies should include measures of body composition to test whether these differences arise from muscular young men within the overweight BMI range, who had a normal WC.
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Affiliation(s)
- Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Joël Floris
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
- Department of Economics, University of Zurich, Zürich, Switzerland
| | - Nikola Koepke
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Adrian Trapp
- Swiss Armed Forces, Recruiting Centre 2 Sumiswald and Army Medical Services, Sumiswald, Switzerland
| | - Andreas Nacht
- Swiss Armed Forces, Recruiting Centre 6 Mels and Army Medical Services, Mels, Switzerland
| | - Susanna Schärli Maurer
- Swiss Armed Forces, Recruiting Centre 4 Windisch and Army Medical Services, Windisch, Switzerland
| | - Frank J Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
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Roulet C, Bovet P, Brauchli T, Simeoni U, Xi B, Santschi V, Paradis G, Chiolero A. Secular trends in blood pressure in children: A systematic review. J Clin Hypertens (Greenwich) 2016; 19:488-497. [DOI: 10.1111/jch.12955] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/17/2016] [Accepted: 10/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Céline Roulet
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Thomas Brauchli
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Umberto Simeoni
- Department of Pediatrics; Lausanne University Hospital; Lausanne Switzerland
| | - Bo Xi
- Department of Epidemiology; School of Public Health; Shandong University; Jinan China
| | - Valérie Santschi
- La Source, School of Nursing Sciences; University of Applied Sciences Western Switzerland; Lausanne Switzerland
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health; McGill University; Montreal Canada
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
- Department of Epidemiology, Biostatistics, and Occupational Health; McGill University; Montreal Canada
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Bruggisser M, Burki D, Haeusler M, Rühli FJ, Staub K. Multivariable analysis of total cholesterol levels in male Swiss Armed Forces conscripts 2006-2012 (N = 174,872). BMC Cardiovasc Disord 2016; 16:43. [PMID: 26888218 PMCID: PMC4756510 DOI: 10.1186/s12872-016-0218-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/09/2016] [Indexed: 11/23/2022] Open
Abstract
Background Cholesterol is an important contributor to morbidity and mortality risks due to its association with obesity, cardiovascular disease, and cancer. A system of mandatory military conscription is a useful tool for disease-risk monitoring in a given male population. Swiss military conscription data are representative for more than 90 % of a given male birth cohort (with Swiss citizenship). The medical examination also includes voluntary laboratory testing, for which approximately 65 % of the young men present at conscription give consent. Methods Here we present the temporal and subgroup analyses of total serum cholesterol levels (TCL) among Swiss conscripts from 2006 to 2012 (N = 174,872; mean age = 19.75 years). The voluntary blood samples were tested by a central laboratory (Viollier AG) with identical measurement standards and strict quality control. To test differences in TCL by socioeconomic occupational status, sports test performance, Body Mass Index (BMI), age, and place of residence of the conscripts we used a multivariable regression model with TCL as dependent variable. Results Mean TCL decreased significantly, by 0.125 mmol/l (95 % CI 0.108–0.142, p < 0.001) from 4.225 mmol/l (95 % CI 4.210–4.240) in 2006 to 4.100 mmol/l (95 % CI 4.091–4.109) in 2012. Similarly, the prevalence of conscripts with an elevated TCL ≥ 5.17 mmol/l decreased from ≥10.2 % prior to 2011 to 6.9 % in 2011 and 8.2 % in 2012. Multivariate regression showed an association between elevated TCL and lower socioeconomic occupational status, lower sports test performance, higher BMI, higher age, and area of residence. There was no longer a significant increase in mean TCL among the three grades of obesity (BMI ≥ 30.0 kg/m2) as defined by the WHO. Within the BMI categories of normal weight and overweight, TCL was stratified by sports performance (better sports performance = lower TCL). Conclusion Decreasing TCL in 2011 and 2012 fits the known pattern of conscripted persons’ stabilizing BMI and sports test performance of the conscripts in recent years. However, small temporal drifts within the laboratory analyses cannot be ruled out as confounding factors. In conclusion, identifying subgroups with unfavorable lipid profiles will contribute to the continuing success of intensified public health programs.
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Affiliation(s)
- Marcel Bruggisser
- Swiss Armed Forces, Medical Service, Worblentalstrasse 36, Ittigen, CH-3063, Switzerland
| | - Dieter Burki
- Viollier AG, Hagmattstrasse 14, Allschwil, CH-4123, Switzerland
| | - Martin Haeusler
- Institute of Evolutionary Medicine, University of Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland.,Institute of Anatomy, University of Zürich, Winterthurerstrasse 190, Zürich, CH-8057, Switzerland
| | - Frank J Rühli
- Institute of Evolutionary Medicine, University of Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland.
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Prevalence of obesity and overweight in male 18-year-olds in Austria from 2006 to 2010: an update. Eur Surg 2011. [DOI: 10.1007/s10353-011-0009-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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