Twenty-four-year trends and determinants of change in compliance with Swiss dietary guidelines

How prevalent is a cancer-protective lifestyle? Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in Switzerland

Population monitoring of lifestyle behaviours that are crucial as risk and protective factors for major chronic diseases is vital for the identification of priority areas for public health. In this study, we aimed to investigate the prevalence of adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations in Switzerland, overall and by selected sociodemographic and lifestyle characteristics. Data from the population-based, cross-sectional survey menuCH were used. We constructed a score reflecting adherence to the 2018 WCRF/AICR cancer prevention recommendations. Multinomial logistic regression models were fitted to investigate the association of sociodemographic and lifestyle characteristics with the level of adherence to the WCRF/AICR cancer prevention recommendations. The least frequently met cancer prevention recommendations were the ones on fibre intake (met by 13·7 %), red and processed meat (25·4 %), and ultra-processed food (33·3 %) consumption, while the recommendation on physical activity was met by almost 80 %. Women and individuals with tertiary education were more likely to have a score of ≥ 5 (as a reflection of adherence to the cancer prevention recommendations), compared with men or those who completed secondary education, respectively. Current smokers were less likely to have a score of ≥ 5, compared with never smokers. A high proportion of the population in Switzerland was found to not adhere closely to the WCRF/AICR cancer prevention recommendations. Differences were detected based on sociodemographic characteristics. Education and policy actions are needed to facilitate the adoption of a cancer-protective lifestyle.

Different dietary assessment methods, similar conclusions? Comparison of a country's adherence to food-based dietary guidelines as depicted in two population-based surveys using different dietary assessment methods

OBJECTIVE

Different methods of dietary intake assessment are frequently used to assess a population's diet. In this study, we aimed to compare the adherence to Swiss food-based dietary guidelines as depicted in two Swiss population-based surveys using different methods of dietary assessment.

DESIGN

Two population-based, cross-sectional surveys were compared. In the Swiss Health Survey (SHS), diet was assessed via a short set of questions on specific food groups, while in menuCH by two non-consecutive 24-h dietary recall interviews.

SETTING

To compare the diet depicted in these surveys, we used the Swiss food-based dietary guidelines on vegetable, fruit, dairy product, meat and meat product, fish and alcohol. The weighted proportion of responders meeting these guidelines was calculated for both surveys and was compared overall and by selected characteristics.

PARTICIPANTS

Residents of Switzerland, selected from a stratified random sample of the non-institutionalised residents, who agreed to participate in the respective survey. To ensure comparability between the surveys, the age of the study populations was restricted to 18-75 years.

RESULTS

In menuCH, approximately 2 % of responders met ≥4 of the selected Swiss food-based dietary guidelines. In the SHS, using a cruder dietary assessment, the corresponding percentage was 20 %. In both surveys, more women and never smokers were meeting ≥4 food-based dietary guidelines compared to men and current or former smokers, respectively.

CONCLUSIONS

Our study comparing the diet in two population-based, representative surveys detected large variations in guideline adherence depending on the dietary assessment method used.

Body height in adult women and men in a cross-sectional population-based survey in Geneva: temporal trends, association with general health status and height loss after age 50

OBJECTIVE

On the one hand, trends in average height in adulthood mirror changes in living standard and health status of a population and its subgroups; on the other hand, height in general, as well as the loss of height in older age in particular, are associated in different ways with outcomes for health. For these aspects, there is hardly any information for Switzerland based on representative and measured body height data.

DESIGN

Repeated cross-sectional survey study.

SETTING

Fully anonymised data from the representative population-based Geneva Bus Santé Study between 2005 and 2017 were analysed.

METHODS

Data from N=8686 study participants were used in the trend analysis. Height was measured and sociodemographic information and self-rated health was collected via questionnaires. Follow-up (mean: 7.1 years) measurements from N=2112 participants were available to assess height loss after age 50.

RESULTS

Women were, on average, 166.2 cm (SD 6.5) tall and men 179.2 cm (SD 6.5). Among men and women, higher socioeconomic status was associated with taller average height. The flattening of the increase in height from the 1970s birth years appears to begin earlier in the subgroup with the highest education level. The tallest average height was measured for men and women from Central and Northern Europe, the shortest for South America and Asia. The likelihood that participants rated their health as 'very good' increased with greater body height. The follow-up data show that men lost -0.11 cm per follow-up year (95% CI -0.12 to -0.10), women -0.17 cm (95% CI -0.18 to 0.15).

CONCLUSIONS

The association of height and health status is currently understudied. Monitoring changes in average body height may indicate disparities in different subgroups of populations. Based on our study and a growing literature, we think that the multifaceted role of body height should be better considered in clinical practice.

Retirement is associated with a decrease in dietary quality

BACKGROUND AND AIM

Retirement has been associated with changes in dietary intake. We evaluated dietary intake and compliance to dietary guidelines after retirement in a population-based survey.

METHODS

Data from a prospective study conducted in Lausanne, Switzerland. Dietary intake was assessed using a validated food frequency questionnaire in 2009-2012 (first survey) and 2014-2017 (second survey). Total energy intake (TEI), macro and micronutrients, foods, dietary scores and compliance to dietary guidelines were assessed. Three approaches were used comparing changes in dietary intake: 1) before and after retiring (paired analysis); 2) in participants who retired with gender- and age-matched participants who did not retire (two-group comparison), and 3) in participants who retired, who did not retire or who were retired at both surveys (analysis of variance).

RESULTS

Using the first approach, newly retired participants (n = 215) increased their intake of total (median and [interquartile range]: 15.2 [13.7-17.5] vs. 14.9 [13.3-17.1] % of TEI) and animal (11.1 [9.1-13.0] vs. 10.0 [8.5-12.6] %TEI) protein; total (35.8 [32.1-40.7] vs. 34.6 [30.0-39.1] %TEI), saturated and monounsaturated fat; alcohol; cholesterol; vitamin D and fish, and decreased their intake of vegetable protein; total carbohydrates and monosaccharides, and of the Mediterranean diet score. Those findings were confirmed for total and saturated fat, alcohol, total carbohydrates and monosaccharides; vitamin D and fish intake, and of the Mediterranean diet score in the other two approaches.

CONCLUSION

Retirement was associated with an unhealthier dietary intake.

Policy and Food Consumption: What Nutrition Guidelines Are Swiss Children Meeting and What Determines Adherence?

Objectives: To describe the adherence of the children to the Swiss Society for Nutrition (SSN) dietary guidelines, assess determinants of adherence, and compare these findings with a previous study in the same population.

Methods: Data from 312 children ages 5–12 were collected through a survey and a 2-day food record. The associations of children- and parent-related factors with adherence of the children to guidelines were assessed by logistic regression analyses.

Results: SSN guidelines were not met for any food category, although there were improvements: vegetables (4.5% in this study vs. 0% in the previous study), sweets, snacks, and soft drinks (SSD) (12.5 vs. 9.5%), and fruit (45.5 vs. 10.4%). Higher Body Mass Index (BMI) in children was associated with higher adherence to guidelines for protein intake. Higher parental BMI was associated with higher adherence to vegetables. Parental lower educational level was associated with higher adherence for cereal.

Conclusion: Despite improvements since the last eating behavior assessment in this population, children consume too little fruit, vegetables, cereal, and milk and dairy products, and too much SSD and proteins. Further efforts are needed to promote healthy eating to children and achieve adherence to guidelines.

Effect of dairy intake with or without energy restriction on body composition of adults: overview of systematic reviews and meta-analyses of randomized controlled trials

CONTEXT

Some studies suggest that consumption of dairy products can aid in weight loss, while others suggest a negative effect or no effect.

OBJECTIVE

An overview of systematic reviews and meta-analyses was conducted to examine the effect of dairy product consumption on changes in body composition.

DATA SOURCES

PRISMA guidelines were followed to ensure transparent reporting of evidence. The MEDLINE, Embase, Cochrane Central Database of Systematic Reviews, and Web of Science databases were searched from inception to April 2018.

STUDY SELECTION

Six systematic reviews and 47 associated meta-analyses (which included the results of 58 different randomized controlled trials) published in English or Spanish and reporting data on dairy intake and changes in weight, fat mass, lean mass, or waist circumference were included.

DATA EXTRACTION

Two authors independently extracted the data and assessed the risk of bias using the AMSTAR2 tool.

RESULTS

Dairy consumption interventions without dietary energy restriction had no significant effects on weight, fat mass, lean mass, or waist circumference. Interventions in energy-restricted settings had significant effects on fat mass and body weight.

CONCLUSIONS

Increasing total dairy intake without energy restriction in adults does not affect body composition. In the context of an energy-restricted diet, however, increased dairy intake results in lower fat mass and body weight but has no conclusive effects on waist circumference or lean mass.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number CRD42018094672.

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

Thirteen-year trends in the prevalence of diabetes in an urban region of Switzerland: a population-based study

AIM

To assess trends in prevalence of total and diagnosed diabetes, and in the probability of detecting undiagnosed diabetes in the Swiss population.

METHODS

The Bus Santé study is an annual cross-sectional study of adults residing in Geneva state, Switzerland. We included 8532 participants (51% women) from the years 2005 to 2017, when fasting plasma glucose data became available. Total diabetes was defined as the sum of diagnosed and undiagnosed diabetes, while diagnosed diabetes was defined as having a previous diagnosis, and undiagnosed diabetes as having fasting plasma glucose level of ≥7 mmol/l and no previous diagnosis. We calculated the probability of finding undiagnosed diabetes among participants without a diagnosis. We examined for linear and quadratic trends, grouping survey years into five survey periods.

RESULTS

In total, 711 diabetes cases were identified over 13 years. The age- and gender-standardized prevalence of total diabetes decreased between the periods 2005-2009 and 2012-2013 from 9.6% (95% CI 8.3, 10.9) to 7.1% (95% CI 5.8, 8.4), but increased to 8.6% (95% CI 7.3%, 9.9%) by 2016-2017 (P-quadratic <0.01). For diagnosed diabetes, the prevalence decreased between 2005-2009 and 2014-2015 from 8.3% (95% CI 7.0%, 9.5%) to 6.1% (95% CI 5.0%, 7.2%), but increased slightly again to 7.0% (95% CI 5.8%, 8.2%) by 2016-2017 (P-quadratic = 0.01). Men generally had a higher prevalence of total and diagnosed diabetes than women, except in 2016-2017, when the prevalence of total diabetes was 9.5% (95% CI 7.6, 11.5) among men and 7.7% (95% CI 6.0, 9.5) among women (P >0.05). The probability of finding undetected diabetes among participants without a diabetes diagnosis decreased slightly between 2005-2009 and 2012-2013 from 1.5% (95% CI 0.9, 2.0) to 1.0% (95% CI 0.5, 1.5), but increased afterwards to 1.7% (95% CI 1.0, 2.3) by 2016-2017 (P-quadratic = 0.06); in 2016-2017, it was 2.6% (95% CI 1.5, 3.7) among men and 0.7% (95% CI 0.1, 1.3) among women (P <0.01).

CONCLUSION

The prevalence of diabetes has remained relatively constant over time. However, the probability of finding undetected cases of diabetes in the population without diabetes may be increasing among men.

Trends in lawyer use in road traffic injury compensation claims

Injury compensation claimants use legal services to help them navigate compensation schemes, including accessing benefits and resolving disputes. Little is known, however, about the extent of lawyer use by compensation claimants, including changes over time. This paper presents findings from one of the largest empirical investigations of lawyer use in an injury compensation setting to date. Using evidence from more than 275,000 claims in the road traffic injury scheme in the state of Victoria, Australia, this study examines the prevalence of, and changes in, lawyer use between 2000 and 2015. The analysis identifies a significant increase in the use of lawyers in the scheme, and explores possible explanations. This study provides critical insights into lawyer use in compensation settings: the steep increase in lawyer involvement has both access to justice and financial implications for compensation schemes, given the associations between lawyer use, claimant outcomes, and long-term scheme viability.

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CoLaus: Diet, the Forgotten Key to Preventing Cardiovascular Diseases Abstract. Healthy eating is paramount for the prevention and management of cardiovascular diseases. Still, data from the CoLaus study show that dietary management of cardiovascular risk factors and cardiovascular disease is little implemented. Less than one fifth of participants with dyslipidemia reported being on a hypolipidemic diet, and only half of participants with diabetes reported being on an antidiabetic diet. Further, the occurrence of a myocardial infarction was not associated with an improvement in dietary quality.