Consumption of Alcoholic Beverages and the Prevalence of Metabolic Syndrome and Its Components

High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study

INTRODUCTION

Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB).

METHODS

A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD.

RESULTS

The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not.

CONCLUSION

This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Is evening chronotype associated with higher alcohol consumption? A systematic review and meta-analysis

A broader understanding of whether and to what extent chronotype should be considered a risk factor for alcohol consumption is needed. The aim of this systematic review was to summarize the evidence on the association between evening chronotype and alcohol consumption. A systematic search of observational studies on this association was conducted in the PubMed, Scopus, Web of Science, Cochrane Library and PsycINFO databases up to April 30th, 2023. Random-effect models estimated the pooled odds ratio (OR) of alcohol consumption according to chronotype. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment tool for Observational Cohorts and Cross-sectional Studies from the National Heart, Lung and Blood Institute were followed. A total of 33 studies involving 28 207 individuals (age range: 18-93 years) were included in this review. Overall, most studies indicated a higher volume and frequency of alcohol consumption in evening-type individuals than in individuals with different chronotypes. Additionally, a meta-analysis including 13 studies showed that evening-type individuals were 41% more likely to consume alcohol than those with other chronotypes (OR = 1.41, 95% confidence interval: 1.16-1.66; I2 = 38.0%). Limitations of the present findings are the predominance of cross-sectional studies and varied definitions of alcohol consumption. The available evidence supports an association between the evening chronotype and alcohol consumption. The evening-type population, especially young adults, is a specific target for educational interventions for preventing or reducing alcohol consumption.PROSPERO number: CRD42022343778.

Association between Shift Work and Metabolic Syndrome: A 4-Year Retrospective Cohort Study

(1) Background: Previous studies on the association between shift work and metabolic syndrome have had inconsistent results. This may be due to the cross-sectional study design and non-objective data used in those studies. Hence, this study aimed to identify risk factors for Metabolic syndrome using objective information provided by the relevant companies and longitudinal data provided in health examinations. (2) Methods: In total, 1211 male workers of three manufacturing companies, including shift workers, were surveyed annually for 4 years. Data on age, smoking, drinking, physical activity, length of shift work, type of shift, past history, waist circumference, blood pressure, blood sugar, triglyceride, and high-density cholesterol (HDL) were collected and analyzed using generalized estimating equations (GEE) to identify the risk factors for Metabolic syndrome. (3) Results: In the multivariate analysis of Metabolic syndrome risk factors, age (OR = 1.078, 95% CI: 1.045–1.112), current smoking (OR = 1.428, 95% CI: 1.815–5.325), and BMI (OR = 1.498, 95% CI: 1.338–1.676) were statistically significant for day workers (n= 510). Additionally, for shift workers (N = 701), age (OR = 1.064, 95% CI: 1.008–1.174), current smoking (OR = 2.092, 95% CI: 1.854–8.439), BMI (OR = 1.471, 95% CI: 1.253–1.727) and length of shift work (OR = 1.115, 95% CI: 1.010-1.320) were statistically significant. Shift work was associated with a higher risk of Metabolic syndrome (OR = 1.093, 95% CI: 1.137–2.233) compared to day workers. For shift workers, shift work for more than 20 years was associated with Metabolic syndrome (OR = 2.080, 95% CI: 1.911–9.103), but the dose–response relationship was not statistically significant. (4) Conclusions: This study revealed that age, current smoking, BMI, and shift work are potential risk factors for Metabolic syndrome. In particular, the length of shift work (>20 years) is a potential risk factor for Metabolic syndrome in shift workers. To prevent metabolic syndrome in shift workers, health managers need to actively accommodate shift workers (especially those who have worked for more than 20 years), current smokers, and obese people. A long-term cohort study based on objective data is needed to identify the chronic health impact and the risk factors of shift work.

Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Alcohol intake and dyslipidemia in male patients with hypertension and diabetes enrolled in a China multicenter registry

Alcohol consumption is a proven risk factor of dyslipidemia. In the present analysis, we investigated the association of alcohol intake with dyslipidemia, an emerging epidemic in China, in male patients with hypertension and diabetes mellitus. Our study participants were from a nationwide registry (n = 1181). A questionnaire was administered to collect information on alcohol intake. Dyslipidemia was defined as an elevated concentration of serum triglycerides (≥2.3 mmol/L), total (≥6.2 mmol/L) or low-density lipoprotein (LDL) cholesterol (≥4.1 mmol/L), or a reduced high-density lipoprotein (HDL) cholesterol (< 1.0 mmol/L). Serum concentrations of triglycerides (1.60 mmol/L) and total (4.93 mmol/L) and LDL cholesterol (2.95 mmol/L) were highest with current usual drinking, with a significant P value for trend from never (n = 679) to ever (n = 107) and to rare (n = 187) and usual drinkers (n = 208, P ≤ .002). Serum HDL cholesterol (1.13 mmol/L) was lowest in ever drinkers, with a nonsignificant P value for trend (P = .22). The prevalence was highest in usual drinkers for hypertriglyceridemia (27.4%) and total (12.5%) and LDL hypercholesterolemia (8.7%), and in ever drinkers for low HDL cholesterol (34.6%). The P value for trend was significant for hypertriglyceridemia and total hypercholesterolemia (P ≤ .01), but not for LDL hypercholesterolemia or low HDL cholesterol (P ≥ .26). The between-province ecological analysis showed that the proportion of usual drinking was significantly associated with the prevalence of any dyslipidemia across 10 China provinces (r = .42, P < .0001). In conclusion, alcohol drinkers showed a worse lipid profile in patients with hypertension and diabetes mellitus. Usual drinking ecologically explained the between-province variation in the prevalence of dyslipidemia.

Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Eleocharis dulcis corm: phytochemicals, health benefits, processing and food products

Eleocharis dulcis, an aquatic plant belonging to Cyperaceae family, is indigenous to Asia, and also occurs in tropical Africa and Australia. The edible corm part of E. dulcis is a commonly consumed aquatic vegetable with a planting area of 44.46 × 10³ hm² in China. This work aims to explore the potential of E. dulcis corm for use as a new food source for sufficient nutrients and health benefits by reviewing its nutrients, phytochemicals, functions, processing and food products. Eleocharis dulcis corm contains starches, dietary fibers, non-starch polysaccharides, proteins, amino acids, phenolics, sterols, puchiin, saponins, minerals and vitamins. Among them, phenolics including flavonoids and quinones could be the major bioconstituents that largely contribute to antioxidant, anti-inflammatory, antibacterial, antitumor, hepatoprotective, neuroprotective and hypolipidemic functions. Peel wastes of E. dulcis corm tend to be enriched in phenolics to a much higher extent than the edible pulp. Fresh-cut E. dulcis corm can be consumed as a ready-to-eat food or processed into juice for beverage production, and anti-browning processing is a key to prolonging shelf life. Present food products of E. dulcis corm are centered on various fruit and vegetable beverages, and suffer from single categories and inadequate development. In brief, underutilized E. dulcis corm possesses great potential for use as a new food source for sufficient nutrients and health benefits. © 2021 Society of Chemical Industry.

Magnitude of metabolic syndrome in Gondar town, Northwest Ethiopia: A community-based cross-sectional study

Background

Metabolic syndrome (MetS) is becoming a major public health problem globally; it is clear that the burden of MetS is rapidly increasing the rates of non-communicable diseases (NCD). In Ethiopia studies done so far have shown a large disparity in magnitude of the prevalence of MetS and were mainly institution-based studies. Therefore, this study assess the prevalence of MetS among adults who are residing in Gondar city using Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) assessment tool. The findings are imperative to developing and strengthening national NCD prevention and control programs.

Methods

This study was conducted in Gondar city Northwest Ethiopia in 2018. It employs a community-based cross-sectional study design among 3,227 individuals 18 years of age or older. Data was collected using the WHO stepwise tool, lipid profile, blood pressure (BP), waist circumference (WC) body mass index (BMI), fasting blood glucose levels (FG), and anthropometric measurements. The prevalence estimation was made along with a 95% confidence interval (CI). The Kappa statistic was used to analyze the statistical agreement between ATP III and IDF definitions of the MetS. Stratified analysis was also performed for description and analysis components using ATP III and IDF as an outcome.

Result

Of the total study participants (3227), 3059 (94.8%) were included in the final analysis and 52.5% were female. The mean (±SD) age of the study participant was 40.8 years (16.2 ±SD). The overall prevalence of MetS using ATP III was 11.2% [95%CI: 10.1, 12.3] and using IDF was 11.9% [95%CI: 10.8, 13.2]. The sex-specific proportion was high in females rather than males irrespective of the criteria. The overall level of agreement between ATP III and IDF prevalence was 91.7% and the Kappa statistics was 0.594. Older age, low-density lipoprotein cholesterol, body mass index, being female, born in an urban area, consumption of an alcoholic drink in the preceding 30 days, and non-fasting practice was significantly associated with MetS.

Conclusion and recommendation

There was a higher prevalence of metabolic syndrome among females than males irrespective of metabolic syndrome diagnostic criteria. This also shows good agreement between ATP III and IDF. Being female, urban birthplace, frequent alcohol consumption in the last 30 days, and non-fasting practice are factors associated with higher rates of metabolic syndrome. Hence, awareness campaigns, physical exercise, and nutrition education intervention should be undertaken to promote health behavioral practice.

Depressive symptoms and 5-year incident metabolic syndrome among older adults

Little is known regarding the association between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. This study aimed to examine the association of depressive symptoms with MetS and its components among Chinese elderly. Based on whether they showed depressive symptoms at baseline, 262 age-gender-matched participants from a community-based cohort study were included. The presence of depressive symptoms was measured using the nine-item Patient Health Questionnaire (PHQ-9). MetS was defined according to the Adult Treatment Panel III of the National Cholesterol Education Program. Linear regression and logistic regression analyses were performed to assess associations of depressive symptoms with MetS and its components. The incidence of MetS among the participants with depressive symptoms at baseline was 15.27% (20/131). The association of the presence of depressive symptoms with MetS was significant (odds ratio [OR] = 2.53, 95% confidence intervals [CI] = 1.07, 5.95). There was a negative association between depressive symptoms and hypertension (OR = 0.04, 95% CI = 0.002, 0.98). The change in mean arterial pressure varies approximately 1.03 mmHg with a 1-point change in PHQ-9 score. In this study, baseline depressive symptoms were associated with subsequent MetS. The presence of depressive symptoms was negatively associated with elevated mean arterial pressure.

Factores asociados con síndrome metabólico y calidad de vida de adultos en un municipio noreste de brasileño

Introducción: El Síndrome Metabólico (SM) se considera actualmente una enfermedad multifactorial relacionada con la inflamación asintomática, insidiosa y deletérea que predispone al individuo a la vulnerabilidad al agregar marcadores de riesgo cardiovascular. Objetivo: analizar los factores asociados al síndrome metabólico y calidad de vida en adultos usuarios de una unidad de salud. Materiales y Métodos: estudio transversal realizado con 108 usuarios adultos. La recogida de datos se realizó mediante un cuestionario sociodemográfico, clínico y metabólico, estructurado y mediante el cuestionario The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Para el diagnóstico de Síndrome Metabólico se utilizaron los siguientes criterios: aumento de la circunferencia abdominal e hipertensión arterial, diabetes, hipertrigliceridemia y colesterol HDL bajo. El análisis estadístico se realizó utilizando el software Statistical Package for Social Sciences (SPSS) 21.0. Resultados: Se identificó síndrome metabólico en el 88,0% de los adultos. De este total de usuarios evaluados con el síndrome, el 87,4% de los individuos eran mujeres; 71,7% con diabetes; 87,0% tenía hipertensión arterial; Se identificó sedentarismo en 53,7%. En la valoración del IMC, predominaron el sobrepeso y la obesidad en 68,4% y 24,9%, respectivamente. Los dominios con las puntuaciones más bajas de calidad de vida fueron Salud general y Vitalidad. Conclusiones: el estudio permitió identificar el Síndrome Metabólico en la mayoría de los adultos evaluados. Hubo una baja percepción de la calidad de vida entre los adultos en todos los dominios, excepto en los aspectos físicos y vitalidad. Por tanto, es necesaria la vigilancia y educación sanitaria de la población estudiada y la mejora de su calidad de vida. Como citar este artículo: Santos, Isleide Santana Cardoso; Boery, Rita Narriman Silva de Oliveira; Fernandes, Josicélia Dumêt; Rosa, Randson Souza; Ribeiro, Ícaro José dos Santos; Souza, Andréa dos Santos.  Factors associated with metabolic syndrome and quality of life of adults in a northeast brazilian municipality.   Revista Cuidarte. 2021;12(2):e.1678 http://dx.doi.org/10.15649/cuidarte1678    

Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies

Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.

Sex-based differences in and risk factors for metabolic syndrome in adults aged 40 years and above in Northeast China: Results from the cross-sectional China national stroke screening survey

OBJECTIVES

Low levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This study aimed to determine sex-based differences associated with the prevalence of and risk factors for metabolic syndrome among people older than 40 years in Northeast China; this has not been previously investigated.

DESIGN

This study analysed a portion of the large sample data of the national cross-sectional screening of China from 2016. Metabolic syndrome was defined as the presence of any three of the following five risk factors: abnormal waist circumference; high levels of triglycerides, high-density lipoprotein cholesterol or fasting plasma glucose; and elevated blood pressure. Multiple regression analysis was used to investigate sex-based differences in the prevalence of, and risk factors for metabolic syndrome.

SETTING

The study was conducted in Dehui City, Jilin Province, China.

PARTICIPANTS

A total of 4052 participants with complete questionnaire information and laboratory examination results were included.

RESULTS

The prevalence of metabolic syndrome was 50.1% overall (38.4% in men and 57.9% in women; p<0.001). High body mass index and hip circumference were associated with metabolic syndrome in both sexes. In addition, physical inactivity (OR and 95% CI 1.44 (1.06 to 1.97); p=0.022) in men and advanced age (OR and 95% CI 1.54 (1.15 to 2.04); p=0.003) in women were factors associated with metabolic syndrome. Women with junior high school education or above and living in rural areas were less likely to have metabolic syndrome. For men, education and rural or urban living had no association with metabolic syndrome.

CONCLUSIONS

The risk factors for metabolic syndrome have similarities and differences in different sexes; thus, the prevention and treatment of metabolic syndrome should be based on these sex differences.

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease.

RESULTS

Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Association between alcohol intake pattern and metabolic syndrome components and simulated change by alcohol intake reduction: A cross-sectional study from the Japan Multi-Institutional Collaborative Cohort Study

To investigate the association between alcohol intake pattern in amount and frequency and metabolic syndrome (Mets) components, we simulated the change in the prevalence of Mets components by intake reduction. In order to manage Mets, alcohol intake reduction with moderation of intake pattern is required. However, evidence investigating the comparative impact of alcohol intake reduction in amount and frequency for Mets components is limited. We conducted a large-scale cross-sectional study in the general Japanese population. The study subjects included 37,371 non-drinkers and current drinkers recruited in the Japan Multi-Institutional Collaborative Cohort Study. Odds ratios (ORs) for Mets components according to alcohol intake amount and frequency were estimated using a multiple logistic regression model. The prevalence of Mets components was estimated after assumed alcohol intake reduction of a) none, b) 10 g/day (men) or 5 g/day (women), c) 20 g/day (men) or 10 g/day (women), d) less than 20 g/day (men) or 10 g/day (women) for moderate-to-heavy drinkers, e) 1-2 times/week, and f) 3-4 times/week. The ORs with alcohol intake amount and frequency increased with high blood pressure while decreasing with dyslipidemia. A J-shaped association was observed between intake amount and Mets. The estimated prevalence (%) of high blood pressure and dyslipidemia in men were a) 45.2, b) 43.0, c) 41.4, d) 40.4, e) 42.9, and f) 42.0; and a) 50.3, b) 51.8, c) 52.9, d) 50.2, e) 52.7, and f) 53.4 in women. The estimated prevalence of high blood pressure in women did not evidently decrease. Simulated alcohol intake reduction showed decreased prevalence for high blood pressure and increased prevalence for dyslipidemia in men after reduced intake amount and frequency. The largest decreased prevalence for high blood pressure was observed in men when all moderate-to-heavy drinkers reduced their alcohol intake amount to less than 20 g/day.

Prevalence of and lifestyle factors associated with metabolic syndrome determined using multi-level models in Chinese adults from a cross-sectional survey

People living in the same area are more likely to experience similar socioeconomic characteristics, which leads to cluster effect and influences the generalizability of data regarding metabolic syndrome (MetS). However, previous studies did not consider or adjust for the cluster effect of living circumstances. The aim of this study was to determine the prevalence of MetS and associated lifestyle factors in Chinese adults 18 to 80 years of age, using multi-level generalized estimation equation (GEE).The participants came from a large-scale cross-sectional population survey. A total of 28,062 participants underwent all the blood tests. Participants meeting at least 3 of the 5 diagnostic criteria were defined as having MetS. Multi-level GEE was used to evaluate the relationship between MetS and lifestyle covariates to control the cluster effect of living circumstances. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used to assess the strength of each relationship.A total of 65.70% of the participants had at least 1 clinical feature of MetS, and 2926 were diagnosed with MetS (prevalence 14.03%). 32.74%, 18.93%, 10.25%, 3.25%, and 0.53% of the participants had 1, 2, 3, 4, and 5 components, respectively. The prevalence of MetS in men (12.31%) was lower than in women (15.57%). After controlling for the cluster effect of living circumstances, many demographic and lifestyle characteristics were associated with MetS. Overweight (OR = 1.670, 95%CI: 1.600-1.743), obesity (OR = 2.287, 95% CI: 2.136-2.449), current alcohol consumption (OR = 1.053, 95% CI: 1.020-1.086), physical labor (OR=1.070, 95% CI: 1.040-1.101), a high-salt diet (OR=1.040, 95% CI: 1.009-1.071), hyperuricemia (OR=1.264, 95% CI: 1.215-1.316), short sleep duration (OR=1.032, 95% CI: 1.009-1.055), and a family history of cardiovascular disease (OR=1.065, 95% CI: 1.019-1.113), or cerebrovascular disease (OR=1.055, 95% CI: 1.007-1.104) increased the risk of MetS. The risk of MetS increased 6.9% (OR = 1.069, 95% CI: 1.053-1.085) with each 5% increase in body fat percentage.MetS has become a serious public health challenge in China. Many lifestyle factors have been found to be closely associated with MetS, including obesity, a high-salt diet, alcohol consumption, and short sleep duration. Therefore, changes in lifestyle are very important for adults to reduce the prevalence of MetS.

Alcohol-Induced Neuropathy in Chronic Alcoholism: Causes, Pathophysiology, Diagnosis, and Treatment Options

Purpose of the Review

Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology.

Recent Findings

Coasting is a major feature of alcoholic neuropathy, largely due to chronic alcohol abuse. Its major features are hyperalgesia, allodynia, and burning pain. Even though much research was done in this area, still we do not have a full understanding of the mechanism of alcoholic neuropathy. However, some theories have been proposed. These include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters. Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis also seem to be implicated in the pathophysiology of this alcoholic neuropathy. The goal of treatment is to impede further damage to the peripheral nerves while also restoring their normal physiology. Alcohol abstinence, intake of balanced diets, and treatment with medications are suggested including benfotiamine, alpha-lipoic acid, acetyl-l-carnitine, vitamin E, methylcobalamin, myo-inositol, N-acetylcysteine, capsaicin, tricyclic antidepressants, or antiepileptic drugs.

Summary

This review focuses on the many pathways that play a role in the onset and development of alcohol-induced neuropathy, as well as present the possible treatment strategies of this disorder, providing insights into a further search of new treatment modalities.

Association between Dietary Habits, Shift Work, and the Metabolic Syndrome: The Korea Nurses' Health Study

Metabolic syndrome (MetS) is an important public health problem, and unhealthy dietary habits and shift work are considered major factors that increase the prevalence of MetS. The purpose of this study was to examine whether dietary habits, alcohol drinking, and shift-working were associated with development of MetS in shift-working female nurses. This study analyzed cross-sectional survey data from the Korea Nurses’ Health Study (KNHS). Of the 1638 nurses, 403 participants were selected based on the propensity score matching method (PSM). These participants had either no or more than three MetS determinant factors. Analysis was conducted by using multivariable logistic regression to confirm the factors influencing MetS. The prevalence of MetS in this group (1638 participants) was 5.6% (92 participants). Consumption of over 50% of daily calorie intake after 7 p.m., consumption of carbonated drinks, family history of diabetes, and non-shift work were significant factors influencing MetS. Nurses are one of the at-risk groups for unhealthy dietary habits due to the nature of their work. Therefore, nurse managers should include regular dietary education for nurses and continue their policy efforts to resolve health problems that may arise in connection with nurses’ work.

Breastfeeding and Prevalence of Metabolic Syndrome among Perimenopausal Women

Little is known about the long-term benefits of breastfeeding for mother's metabolic health. This study aimed to investigate the links between breastfeeding duration and the prevalence of metabolic syndrome (MetS) and its components in perimenopausal women. The analysis included a group of 7621 women aged 55.4 ± 5.4 years. MetS and its components were defined according to the International Diabetes Federation guidelines. Women who breastfed for 13-18 months and beyond 18 months were at lower risk of MetS (odds ratio OR) = 0.76, 95% CI 0.60-0.95; p = 0.017 and OR = 0.79, 95% CI 0.64-0.98; p = 0.030, respectively) than those who never breastfed. Meanwhile, women who breastfed for 7-12 months showed increased glucose concentration (OR = 0.77, 95% CI 0.63-0.94; p = 0.012) compared with those who had never breastfed. The additional analysis involving parity showed that women who had given birth to two babies and breastfed them had lower odds of MetS than those who never breastfed (p < 0.05), although there was no significant difference among women who breastfed for >18 months. Women who had given birth to at least three children and breastfed for 1-6 and 13-18 months had lower odds of MetS and increased triglyceride concentration (p < 0.05). Moreover, participants having breastfed for 1-6 months were found to have a reduced risk of abdominal obesity compared with those who had not breastfed (p < 0.05). Breastfeeding is associated with lower prevalence of MetS in perimenopausal women and can be recommended as a way of reducing the risk of MetS and its components.

Anthropometric indices and cut-off points in the diagnosis of metabolic disorders

OBJECTIVE

Identifying metabolic disorders at the earliest phase of their development allows for an early intervention and the prevention of serious consequences of diseases. However, it is difficult to determine which of the anthropometric indices of obesity is the best tool for diagnosing metabolic disorders. The aims of this study were to evaluate the usefulness of selected anthropometric indices and to determine optimal cut-off points for the identification of single metabolic disorders that are components of metabolic syndrome (MetS).

DESIGN

Cross-sectional study.

PARTICIPANTS

We analyzed the data of 12,328 participants aged 55.7±5.4 years. All participants were of European descent.

PRIMARY OUTCOME MEASURE

Four MetS components were included: high glucose concentration, high blood triglyceride concentration, low high-density lipoprotein cholesterol concentration, and elevated blood pressure. The following obesity indices were considered: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body fat percentage (%BF), Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), body roundness index (BRI), and a body shape index (ABSI).

RESULTS

The following indices had the highest discriminatory power for the identification of at least one MetS component: CUN-BAE, BMI, and WC in men (AUC = 0.734, 0.728, and 0.728, respectively) and WHtR, CUN-BAE, and WC in women (AUC = 0.715, 0.714, and 0.712, respectively) (p<0.001 for all). The other indices were similarly useful, except for the ABSI.

CONCLUSIONS

For the BMI, the optimal cut-off point for the identification of metabolic abnormalities was 27.2 kg/m2 for both sexes. For the WC, the optimal cut-off point was of 94 cm for men and 87 cm for women. Prospective studies are needed to identify those indices in which changes in value predict the occurrence of metabolic disorders best.

The Prevalence of Metabolic Syndrome and Health-Related Behavior Changes: The Korea National Health Examination Survey

This study was conducted to investigate the effect of health-related behavior changes on the prevalence of metabolic syndrome (MetS). This study utilized data from the Korea National Health Examination Survey of adults aged 40 or older who underwent health screening in 2011, 2013, and 2015. The prevalence of MetS was analyzed according to sex, age, income, residence location, and health-related behaviors by conducting multiple logistic regression analysis. For health-related behaviors, smoking, drinking, and physical activity were examined, and changes in health-related behaviors over five years from 2011 to 2015 were included in the analysis. The prevalence of MetS in Korea in 2015 was 31.7%. The prevalence showed statistically significant differences according to sex, age, income, location, and health-related behaviors. The prevalence was higher in men than in women and increased with aging. Regarding income, MetS prevalence was slightly higher in the middle-income groups compared with the lowest or the highest. Regarding location, MetS prevalence was lower in metropolitan areas compared to small- to medium-sized cities and farming/fishery rural areas. Regarding health-related behavior, MetS prevalence increased in the smoking, heavy drinking, and passive activity groups compared with the nonsmoking, moderate drinking, and active activity groups. Regarding health-related behavior change, MetS prevalence was higher by 22% in the short-term nonsmoking group (subjects who smoked in the past but not currently) compared to the continuous nonsmoking group. The risk for MetS also increased by 84.9% in the continuous heavy drinking group compared to the continuous moderate drinking group. Finally, the risk for MetS increased by 30.3% in the continuous passive physical activity group compared to the continuous active physical activity group. This study’s findings indicate the importance of maintaining healthy lifestyle habits to prevent MetS. In particular, the focus for change should be concentrated on short-term nonsmoking, continuous heavy drinking, and continuous passive physical activities to improve health-related behaviors.