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Crispin CN, Afsharian A, Loh MY, Dollard MF, Dormann C, Glozier N, Gill T, Taylor AW. Psychosocial safety climate (PSC) and working conditions, predictors of mental health and antidepressant and opioid use in Australia: a study protocol for longitudinal data linkage. BMJ Open 2023; 13:e074235. [PMID: 38097242 PMCID: PMC10729104 DOI: 10.1136/bmjopen-2023-074235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Work-related stress is a social determinant of global health that represents a huge cost to workers' health and reduces work performance. In Australia, mental well-being is a pressing national issue-with one in five Australians experiencing mental disorders. Antidepressants are a first-line medication commonly used to treat mental disorders. Recently, Australia has seen a dramatic increase in the use of prescribed antidepressant medications to treat mental health related illnesses. Australia has also seen a dramatic increase in the use of prescribed opioid analgesics for non-cancer pain including opioid use for psychological distress and social stressors. It is plausible a rise in mental health problems and antidepressant and opioid medication use is partly attributable to the corporate climate for worker mental health (ie, the psychosocial safety climate, PSC). This research aims to identify how PSC and workplace conditions contribute to employee well-being and distress that culminate in antidepressant and opioid medication use. METHODS/ANALYSIS Data will be collected through creative data linkage from the Australian Workplace Barometer (AWB), to medication data (via the Pharmaceutical Benefits Scheme, PBS). The participant sample will include 1372 working Australians from the AWB project from 2009 to 2021. Four waves of longitudinal data from 2009 to 2021 will be used to investigate the plausible link between Australia's high levels of antidepressant and opioid use and distress at work. The project advances theory by probing the role corporate climate plays in work design, distress, mental health problems and antidepressant and opioid use. It will determine if antidepressant and opioid use has led to an underestimation of work stress effects. Proposed theoretical models will be analysed through linked data, using continuous time structural equation modelling, hierarchical linear modelling, logistic regression and cost estimation. ETHICS AND DISSEMINATION The study has been approved by the Human Research Ethics Committee of the University of South Australia (Ethics Protocol: 203003). Further, approval from the Australian Institute of Health and Welfare Ethics Committee was also granted for linkage of AWB data and PBS data (EthOS Application EO2022/1/1190).Results of the study will be disseminated through worldwide keynotes, key international settings, high-impact peer-reviewed journals, industry conference presentations and media outlets to reach managers, workers, and industry partners. Further, UniSA requires publications from public projects to be held in an institutional repository which fulfils the Australian Research Council's Open Access Policy.
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Affiliation(s)
| | - Ali Afsharian
- Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - May Young Loh
- Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Maureen F Dollard
- Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Christian Dormann
- Johannes Gutenberg Universitat Mainz, Mainz, Rheinland-Pfalz, Germany
| | - Nick Glozier
- University of Sydney Brain and Mind Research Institute, Sydney, New South Wales, Australia
| | - Tiffany Gill
- Medical Specialities, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W Taylor
- School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Carroll SJ, Dale MJ, Niyonsenga T, Taylor AW, Daniel M. Associations between area socioeconomic status, individual mental health, physical activity, diet and change in cardiometabolic risk amongst a cohort of Australian adults: A longitudinal path analysis. PLoS One 2020; 15:e0233793. [PMID: 32470027 PMCID: PMC7259701 DOI: 10.1371/journal.pone.0233793] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/12/2020] [Indexed: 12/21/2022] Open
Abstract
Presumed pathways from environments to cardiometabolic risk largely implicate health behaviour although mental health may play a role. Few studies assess relationships between these factors. This study estimated associations between area socioeconomic status (SES), mental health, diet, physical activity, and 10-year change in glycosylated haemoglobin (HbA1c), comparing two proposed path structures: 1) mental health and behaviour functioning as parallel mediators between area SES and HbA1c; and 2) a sequential structure where mental health influences behaviour and consequently HbA1c. Three waves (10 years) of population-based biomedical cohort data were spatially linked to census data based on participant residential address. Area SES was expressed at baseline using an established index (SEIFA-IEO). Individual behavioural and mental health information (Wave 2) included diet (fruit and vegetable servings per day), physical activity (meets/does not meet recommendations), and the mental health component score of the 36-item Short Form Health Survey. HbA1c was measured at each wave. Latent variable growth models with a structural equation modelling approach estimated associations within both parallel and sequential path structures. Models were adjusted for age, sex, employment status, marital status, education, and smoking. The sequential path model best fit the data. HbA1c worsened over time. Greater area SES was statistically significantly associated with greater fruit intake, meeting physical activity recommendations, and had a protective effect against increasing HbA1c directly and indirectly through physical activity behaviour. Positive mental health was statistically significantly associated with greater fruit and vegetable intakes and was indirectly protective against increasing HbA1c through physical activity. Greater SES was protective against increasing HbA1c. This relationship was partially mediated by physical activity but not diet. A protective effect of mental health was exerted through physical activity. Public health interventions should ensure individuals residing in low SES areas, and those with poorer mental health are supported in meeting physical activity recommendations.
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Affiliation(s)
- Suzanne J. Carroll
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, Australian Capital Territory, Canberra, Australia
- * E-mail:
| | - Michael J. Dale
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, Australian Capital Territory, Canberra, Australia
| | - Theophile Niyonsenga
- Health Research Institute, University of Canberra, Australian Capital Territory, Canberra, Australia
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mark Daniel
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, Australian Capital Territory, Canberra, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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Carroll SJ, Dale MJ, Taylor AW, Daniel M. Contributions of Multiple Built Environment Features to 10-Year Change in Body Mass Index and Waist Circumference in a South Australian Middle-Aged Cohort. Int J Environ Res Public Health 2020; 17:ijerph17030870. [PMID: 32019246 PMCID: PMC7038103 DOI: 10.3390/ijerph17030870] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/24/2022]
Abstract
Residential areas may shape health, yet few studies are longitudinal or concurrently test relationships between multiple residential features and health. This longitudinal study concurrently assessed the contributions of multiple environmental features to 10-year change in clinically measured body mass index (BMI) and waist circumference (WC). Longitudinal data for adults (18+ years of age, n = 2253) from the north-west of Adelaide, Australia were linked to built environment measures representing the physical activity and food environment (expressed for residence-based 1600 m road-network buffers) and area education. Associations were concurrently estimated using latent growth models. In models including all environmental exposure measures, area education was associated with change in BMI and WC (protective effects). Dwelling density was associated with worsening BMI and WC but also highly correlated with area education and moderately correlated with count of fast food outlets. Public open space (POS) area was associated with worsening WC. Intersection density, land use mix, greenness, and a retail food environment index were not associated with change in BMI or WC. This study found greater dwelling density and POS area exacerbated increases in BMI and WC. Greater area education was protective against worsening body size. Interventions should consider dwelling density and POS, and target areas with low SES.
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Affiliation(s)
- Suzanne J. Carroll
- Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia; (M.J.D.); (M.D.)
- Correspondence: ; Tel.: +61-2-6201-2851
| | - Michael J. Dale
- Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia; (M.J.D.); (M.D.)
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, SA 5000, Australia;
| | - Mark Daniel
- Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia; (M.J.D.); (M.D.)
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia
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Niyonsenga T, Carroll SJ, Coffee NT, Taylor AW, Daniel M. Are changes in depressive symptoms, general health and residential area socio-economic status associated with trajectories of waist circumference and body mass index? PLoS One 2020; 15:e0227029. [PMID: 31914169 PMCID: PMC6948738 DOI: 10.1371/journal.pone.0227029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study sought to assess whether changes in depressive symptoms, general health, and area-level socio-economic status (SES) were associated to changes over time in waist circumference and body mass index (BMI). Methods A total of 2871 adults (18 years or older), living in Adelaide (South Australia), were observed across three waves of data collection spanning ten years, with clinical measures of waist circumference, height and weight. Participants completed the Centre for Epidemiologic Studies Depression (CES-D) and Short Form 36 health questionnaires (SF-36 general health domain). An area-level SES measure, relative location factor, was derived from hedonic regression models using residential property features but blind to location. Growth curve models with latent variables were fitted to data. Results Waist circumference, BMI and depressive symptoms increased over time. General health and relative location factor decreased. Worsening general health and depressive symptoms predicted worsening waist circumference and BMI trajectories in covariate-adjusted models. Diminishing relative location factor was negatively associated with waist circumference and BMI trajectories in unadjusted models only. Conclusions Worsening depressive symptoms and general health predict increasing adiposity and suggest the development of unhealthful adiposity might be prevented by attention to negative changes in mental health and overall general health.
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Affiliation(s)
- Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- * E-mail:
| | - Suzanne J. Carroll
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Neil T. Coffee
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- School of Architecture and Built Environment, Healthy Cities Research Group, The University of Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Mark Daniel
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Fitzroy, Australia
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Arriaga ME, Vajdic CM, Canfell K, MacInnis RJ, Banks E, Byles JE, Magliano DJ, Taylor AW, Mitchell P, Giles GG, Shaw JE, Gill TK, Klaes E, Velentzis LS, Cumming RG, Hirani V, Laaksonen MA. The preventable burden of breast cancers for premenopausal and postmenopausal women in Australia: A pooled cohort study. Int J Cancer 2019; 145:2383-2394. [DOI: 10.1002/ijc.32231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/07/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Maria E. Arriaga
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney Australia
| | - Claire M. Vajdic
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney Australia
| | - Karen Canfell
- Cancer Research DivisionCancer Council New South Wales Sydney Australia
- Faculty of Medicine and Health, School of Public HealthUniversity of Sydney Sydney Australia
- Prince of Wales Clinical SchoolUniversity of New South Wales Sydney Australia
| | - Robert J. MacInnis
- Cancer Epidemiology and Intelligence DivisionCancer Council Victoria Melbourne Australia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of Melbourne Melbourne Australia
| | - Emily Banks
- ANU College of MedicineBiology and Environment, Australian National University Canberra Australia
| | - Julie E. Byles
- Research Centre for Gender, Health and AgeingUniversity of Newcastle Newcastle Australia
| | - Dianna J. Magliano
- Diabetes and Population Health LaboratoryBaker Heart and Diabetes Institute Melbourne Australia
| | - Anne W. Taylor
- Adelaide Medical SchoolUniversity of Adelaide Adelaide Australia
| | - Paul Mitchell
- Centre for Vision ResearchWestmead Institute for Medical research, University of Sydney Sydney Australia
| | - Graham G. Giles
- Cancer Epidemiology and Intelligence DivisionCancer Council Victoria Melbourne Australia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of Melbourne Melbourne Australia
| | - Jonathan E. Shaw
- Clinical Diabetes LaboratoryBaker Heart and Diabetes Institute Melbourne Australia
| | - Tiffany K. Gill
- Adelaide Medical SchoolUniversity of Adelaide Adelaide Australia
| | | | - Louiza S. Velentzis
- Cancer Research DivisionCancer Council New South Wales Sydney Australia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of Melbourne Melbourne Australia
| | - Robert G. Cumming
- Faculty of Medicine and Health, School of Public HealthUniversity of Sydney Sydney Australia
- ANZAC Research InstituteUniversity of Sydney and Concord Hospital Sydney Australia
| | - Vasant Hirani
- Faculty of Medicine and Health, School of Public HealthUniversity of Sydney Sydney Australia
- School of Life and Environmental Sciences Charles Perkins CentreUniversity of Sydney Sydney Australia
| | - Maarit A. Laaksonen
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney Australia
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Per BL, Taylor AW, Gill TK. Prescription medicines, over-the-counter medicines and complementary and alternative medicines use: a comparison between baby boomers and older South Australians. AIMS Public Health 2019; 6:380-395. [PMID: 31909061 PMCID: PMC6940579 DOI: 10.3934/publichealth.2019.4.380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study examines the difference in medication use between baby boomers (born between 1946–1965) and older people (born before 1946) to determine the proportion of people combining over-the-counter (OTC) medicines and complementary and alternative medicines (CAM) use with prescription medicine use. Design A clustered, multistage, systematic, random, self-weighting area sample was obtained and a face-to-face interview was conducted to examine the difference in use in prescription medicines, OTC, and CAM and factors associated with the use between baby boomers and older people. Setting South Australia. Participants Respondents aged 15 years and over participated in surveys conducted in autumn (March to May) of 2004 (n = 3015) and 2008 (n = 3,034) in which all respondents were asked to list their current medications. This study focuses on those participants whose age was in the range defined by baby boomers and older people. Main outcome measures Proportion in each age group taking prescription medicine, OTC medicine, and CAM were determined. Multivariable logistic regression analyses were performed to investigate the relationships between medication use and demographic variables. Results The results showed that older people were not only the higher users of prescriptions medicines but also OTC medicines and CAM. Gender and education were associated with the use of CAM. Conclusions Due to the high use of CAM and OTC, it is important for the prescriber to take a full history of medication use before prescribing to reduce potential problems associated with drug interactions.
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Affiliation(s)
- Bee Leng Per
- SA Pharmacy, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Anne W Taylor
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Cao Y, Taylor AW, Wittert G, Adams R, Shi Z. Dietary patterns and sleep parameters in a cohort of community dwelling Australian men. Asia Pac J Clin Nutr 2019; 26:1158-1169. [PMID: 28917244 DOI: 10.6133/apjcn.122016.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Emerging evidence suggests potential effects of nutrients/foods on sleep parameters. However, no studies have addressed the complex interactions among nutrients/foods and relate them to sleep outcomes. To investigate the associations between dietary patterns and sleep parameters (polysomnography (PSG) measured and self-reported sleep symptoms) in a large sample of community dwelling men in South Australia. METHODS AND STUDY DESIGN Cross-sectional analysis was conducted of participants in the Men Androgen Inflammation Lifestyle Environment and Stress cohort enrolled in a sleep sub-study (n=784, age 35-80 years). Dietary intake was measured by a validated food frequency questionnaire. Dietary patterns were identified by factor analysis. Sleep was assessed by an overnight home PSG and self-reported questionnaires. RESULTS Two factors were obtained by factor analysis: Factor 1 was characterised by high intakes of vegetables, fruits, and legumes and factor 2 was characterised by processed meat, snacks, red meat and take-away foods. Three categories of the dietary patterns were defined (prudent, mixed and western) through classification of the sample according to the actual consumption higher or lower of each factor. The prudent (factor 1 dominant) and mixed dietary patterns were inversely associated with sleep onset, compared with the western dietary pattern (factor 2 dominant) (β=-6.34 (95% CI-1.11, -11.57), β=-4.34 (95% CI-8.34, -0.34) respectively)). The association was only significant with the prudent dietary pattern after multiple comparison adjustment. No associations were found with between dietary patterns and other sleep outcomes. CONCLUSIONS The prudent dietary pattern was associated with a faster sleep onset, which may provide a solution for sleep management.
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Affiliation(s)
- Yingting Cao
- Population Research and Outcome Studies, School of Medicine, University of Adelaide, South Australia, Australia. .,Freemasons Foundation Centre for Men's Health, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Population Research and Outcome Studies, School of Medicine, University of Adelaide, South Australia, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, Adelaide, South Australia, Australia.,Discipline of Medicine, School of Medicine, the University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Adams
- The Health Observatory, University of Adelaide, Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
| | - Zumin Shi
- Population Research and Outcome Studies, School of Medicine, University of Adelaide, South Australia, Australia.,Freemasons Foundation Centre for Men's Health, Adelaide, South Australia, Australia
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Ferguson SA, Appleton SL, Reynolds AC, Gill TK, Taylor AW, McEvoy RD, Adams RJ. Making errors at work due to sleepiness or sleep problems is not confined to non-standard work hours: results of the 2016 Sleep Health Foundation national survey. Chronobiol Int 2019; 36:758-769. [PMID: 31017005 DOI: 10.1080/07420528.2019.1578969] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Almost one-third of Australians report having made errors at work that are related to sleep issues. While there is significant literature investigating the role of sleep in workplace health and safety in shiftworking and nightwork operations, long working hours, work-family conflict, and commute times getting longer also impact day workers' sleep behaviors and opportunities. The aim of this study was to examine the relationship between sleep duration and disorders, sleep health and hygiene factors, work-related factors and errors at work in Australian workers. From a sample of 1011 Australian adults, age-adjusted binary logistic regression analyses were conducted in 512 workers who provided responses to the question "Thinking about the past three months, how many days did you make errors at work because you were too sleepy or you had a sleep problem?" A number of sleep behaviors and poor sleep hygiene factors were linked with work errors related to sleepiness or sleep problems, with age-adjusted odds of errors (confidence intervals) up to 11.6 times higher (5.4-25.1, p < 0.001) in those that snored, 7.7 (4.6-12.9) times higher in those reporting more than three sleep issues (p < 0.001), 7.0 times higher (3.4-14.8) in short (≤5 hours/night) sleepers (p < 0.021), 6.1 times higher (2.9-12.7) in those staying up later than planned most nights of the week (p< 0.001) and 2.4 times higher (1.6-3.7) in those drinking alcohol ≥3 nights/week before bed (p < 0.001). More than 40% of participants working non-standard hours reported making errors at work, and they were more likely to be young (compared to the main sample of workers) and more likely to engage in work activities in the hour before bed. Sleep factors (other than clinical sleep disorders) were associated with an increased likelihood of sleep-related work errors. Both day workers and those working non-standard hours engage in work, sleep and health behaviors that do not support good sleep health, which may be impacting safety and productivity in the workplace through increased sleepiness-related errors.
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Affiliation(s)
- Sally A Ferguson
- a Appleton Institute, School of Health, Medical and Applied Sciences , CQUniversity , Adelaide , Australia.,b Deakin University , Burwood , Australia
| | - Sarah L Appleton
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia.,d University of Adelaide , Freemasons Foundation Centre for Men's Health , Adelaide , Australia
| | - Amy C Reynolds
- a Appleton Institute, School of Health, Medical and Applied Sciences , CQUniversity , Adelaide , Australia
| | - Tiffany K Gill
- e Population Research & Outcome Studies, Discipline of Medicine , University of Adelaide , Adelaide , Australia
| | - Anne W Taylor
- e Population Research & Outcome Studies, Discipline of Medicine , University of Adelaide , Adelaide , Australia
| | - R Douglas McEvoy
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia
| | - Robert J Adams
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia.,f Southern Adelaide Local Health Network , SA Health , Adelaide , Australia.,g Adelaide Medical School , University of Adelaide , Adelaide , Australia
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Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Correlates of Discordance between Perceived and Objective Distances to Local Fruit and Vegetable Retailers. Int J Environ Res Public Health 2019; 16:ijerph16071262. [PMID: 30970565 PMCID: PMC6480361 DOI: 10.3390/ijerph16071262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 11/26/2022]
Abstract
Background: Perceptions of neighbourhood attributes such as proximity of food retailers that are discordant with objective measures of the same are associated with poor health behaviours and weight gain. Factors associated with discordant perceptions are likely relevant to planning more effective interventions to improve health. Purpose: Analysis of cross-sectional relationships between individual and neighbourhood factors and overestimations of walking distances to local fruit/vegetable retailers (FVR). Methods: Perceived walking times, converted to distances, between participant residences and FVR were compared with objectively-assessed road network distances calculated with a Geographic Information System for n = 1305 adults residing in Adelaide, South Australia. Differences between perceived and objective distances were expressed as ‘overestimated’ distances and were analysed relative to perceptions consistent with objective distances. Cross-sectional associations were evaluated between individual socio-demographic, health, and area-level characteristics and overestimated distances to FVR using multilevel logistic regression. Results: Agreement between objective and perceived distances between participants’ residence and the nearest FVR was only fair (weighted kappa = 0.22). Overestimated distances to FVR were positively associated with mental well-being, and were negatively associated with household income, physical functioning, sense of community, and objective distances to greengrocers. Conclusions: Individual characteristics and features of neighbourhoods were related to overestimated distances to FVR. Sense of connectivity and shared identity may shape more accurate understandings of local resource access, and offer a focal point for tailored public health initiatives that bring people together to achieve improved health behaviour.
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Affiliation(s)
- Katherine L Baldock
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Catherine Paquet
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Natasha J Howard
- Division of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
| | - Neil T Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, ATC 2601, Australia.
| | - Anne W Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, SA 5001, Australia.
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, ATC 2601, Australia.
- South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, VIC 3065, Australia.
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Taylor AW, Bewick BM, Ling Q, Kirzhanova VV, Alterwain P, Dal Grande E, Tucker G, Makanjuola AB. Clusters of alcohol abstainers and drinkers incorporating motives against drinking: a random survey of 18 to 30 year olds in four cities in four different continents. AIMS Public Health 2019; 6:15-33. [PMID: 30931340 PMCID: PMC6433617 DOI: 10.3934/publichealth.2019.1.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/17/2018] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of this analysis was to identify alcohol consumption clusters for adolescents and early adults according to attitudes to drinking, motivations against drinking and perceptions associated with alcohol. Method Interviews were undertaken with people aged 18–34 years old living in four cities in different regions of the world. Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward and back translated into relevant languages and face-to-face interviewing undertaken. The data were weighted to the population of each city. In total 6235 structured interviews were undertaken (1391 in Ilorin, 1600 in Montevideo, 1604 in Moscow and 1640 in Wuhan). Questions regarding motivation against alcohol consumption (14 items), assessing perceptions (3 items) and attitudes to drinking in certain situations (8 items) were asked of all respondents including abstainers. Factor analysis was initially undertaken to identify highly related correlated variables. Results Cluster analysis provided a variety of clusters (Ilorin (3 clusters), Montevideo (5), Moscow (4) and Wuhan (4)). At least one cluster in each city was dominated by abstainers and another by heavy episodic drinkers. Variations by city and alcohol consumption patterns existed in regards to variables included. Conclusion This analysis detailed the city specific motivations against drinking alcohol, and the attitudes towards alcohol consumption. Differences highlight the influence of country/city specific culture, customs, laws, societal norms and traditions.
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Affiliation(s)
- Anne W Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | | | - Qing Ling
- Center for Health Education, PR Ministry of Health, China
| | - Valentina V Kirzhanova
- Department of Epidemiology, Federal Medical Research Centre for Psychiatry and Narcology, Ministry of Health of the Russian Federation, Russia
| | | | - Eleonora Dal Grande
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Graeme Tucker
- Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Alfred B Makanjuola
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin-Nigeria
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Stacey AF, Gill TK, Price K, Taylor AW. Biomedical health profiles of unpaid family carers in an urban population in South Australia. PLoS One 2019; 14:e0208434. [PMID: 30921333 PMCID: PMC6438668 DOI: 10.1371/journal.pone.0208434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 03/14/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To compare the biomedical health profile and morbidity of adult carers with non-carers. METHODS The North West Adelaide Health Study (NWAHS) is a representative population-based longitudinal biomedical cohort study of 4056 participants aged 18 years and over at Stage One. Informal (unpaid) carers were identified in Stage 3 of the project (2008-2010). Risk factors, chronic medical conditions and biomedical, health and demographic characteristics using self-report and blood measured variables were assessed. Data were collected through clinic visits, telephone interviews and self-completed questionnaires. Risk factors included blood pressure, cholesterol/lipids, body mass index (BMI), smoking and alcohol intake. Chronic medical conditions included cardiovascular and respiratory diseases, diabetes, and musculoskeletal conditions. Blood measured variables were routine haematology, biochemistry, Vitamin D, and the inflammatory biomarkers high sensitivity C-Reactive Protein (hs-CRP), Tumor Necrosis Factor alpha (TNFα) and Interleukin-6 (Il-6). RESULTS The prevalence of carers aged 40 years and over was 10.7%, n = 191. Carers aged 40 years and over were more likely to assess their health status as fair/poor and report having diabetes, arthritis, anxiety and depression. They also reported insufficient exercise and were found to have higher BMI compared with non-carers. Significant findings from blood measured variables were lower serum Vitamin D and haemoglobin. Male carers had raised diastolic blood pressure, higher blood glucose, lower haemoglobin and albumin levels and slightly elevated levels of the inflammatory biomarkers TNFα and hs-CRP. DISCUSSION AND CONCLUSIONS This study confirms informal carers had different biomedical profiles to non-carers that included some chronic physical illnesses. It identifies that both female and male carers showed a number of risk factors which need to be considered in future caregiver research, clinical guidelines and policy development regarding carer morbidity.
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Affiliation(s)
- Anne F. Stacey
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tiffany K. Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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12
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Taylor AW, Bewick BM, Ling Q, Kirzhanova V, Alterwain P, Dal Grande E, Tucker G, Makanjuola AB. Assessing Heavy Episodic Drinking: A Random Survey of 18 to 34-Year-Olds in Four Cities in Four Different Continents. Int J Environ Res Public Health 2019; 16:ijerph16050706. [PMID: 30818783 PMCID: PMC6427135 DOI: 10.3390/ijerph16050706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 01/26/2023]
Abstract
Background: Heavy episodic drinking (HED) can have health and social consequences. This study assesses the associations between HED and demographic, socioeconomic, motivation and effects indicators for people aged 18–34 years old living in four cities in different regions of the world. Method: Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward/back translated and face-to-face interviewing was undertaken. A total of 6235 interviews were undertaken in 2014. Separate univariable and multivariable modelling was undertaken to determine the best predictors of HED. Results: HED prevalence was 9.0%. The best predictors differed for each city. The higher probability of HED in the final models included beliefs that they have reached adulthood, feeling relaxed as an effect of drinking alcohol, and forgetting problems as an effect of drinking alcohol. Lower probability of HED was associated with not being interested in alcohol as a reason for limiting alcohol, and the belief that drinking alcohol is too expensive or a waste of money. Conclusion: Although some indicators were common across the four cities, the variables included in the final models predominantly differed from city to city. The need for country-specific prevention and early intervention programs are warranted.
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Affiliation(s)
- Anne W Taylor
- Population Research & Outcome Studies, School of Medicine, The University of Adelaide, South Australia 5000, Australia.
| | | | - Qian Ling
- Chinese Center for Health Education, Beijing 100011, China.
| | - Valentina Kirzhanova
- Department of Epidemiology, Federal Medical Research Centre for Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow 101000, Russia.
| | | | - Eleonora Dal Grande
- Population Research & Outcome Studies, School of Medicine, The University of Adelaide, South Australia 5000, Australia.
| | - Graeme Tucker
- Population Research & Outcome Studies, School of Medicine, The University of Adelaide, South Australia 5000, Australia.
| | - Alfred B Makanjuola
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin 240242, Nigeria.
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13
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Arriaga ME, Vajdic CM, MacInnis RJ, Canfell K, Magliano DJ, Shaw JE, Byles JE, Giles GG, Taylor AW, Gill TK, Hirani V, Cumming RG, Mitchell RP, Banks E, Marker J, Adelstein BA, Laaksonen MA. The burden of pancreatic cancer in Australia attributable to smoking. Med J Aust 2019; 210:213-220. [PMID: 30656698 DOI: 10.5694/mja2.12108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To estimate the burden of pancreatic cancer in Australia attributable to modifiable exposures, particularly smoking. DESIGN Prospective pooled cohort study. SETTING, PARTICIPANTS Seven prospective Australian study cohorts (total sample size, 365 084 adults); participant data linked to national registries to identify cases of pancreatic cancer and deaths. MAIN OUTCOME MEASURES Associations between exposures and incidence of pancreatic cancer, estimated in a proportional hazards model, adjusted for age, sex, study, and other exposures; future burden of pancreatic cancer avoidable by changes in exposure estimated as population attributable fractions (PAFs) for whole population and for specific population subgroups with a method accounting for competing risk of death. RESULTS There were 604 incident cases of pancreatic cancer during the first 10 years of follow-up. Current and recent smoking explained 21.7% (95% CI, 13.8-28.9%) and current smoking alone explained 15.3% (95% CI, 8.6-22.6%) of future pancreatic cancer burden. This proportion of the burden would be avoidable over 25 years were current smokers to quit and there were no new smokers. The burden attributable to current smoking is greater for men (23.9%; 95% CI, 13.3-33.3%) than for women (7.2%; 95% CI, -0.4% to 14.2%; P = 0.007) and for those under 65 (19.0%; 95% CI, 8.1-28.6%) than for older people (6.6%; 95% CI, 1.9-11.1%; P = 0.030). There were no independent relationships between body mass index or alcohol consumption and pancreatic cancer. CONCLUSIONS Strategies that reduce the uptake of smoking and encourage current smokers to quit could substantially reduce the future incidence of pancreatic cancer in Australia, particularly among men.
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Affiliation(s)
- Maria E Arriaga
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
| | - Robert J MacInnis
- Cancer Council Victoria, Melbourne, VIC.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Karen Canfell
- Cancer Council NSW, Sydney, NSW.,University of Sydney, Sydney, NSW.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW
| | | | | | - Julie E Byles
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, VIC.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Anne W Taylor
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Vasant Hirani
- University of Sydney, Sydney, NSW.,Charles Perkins Centre, University of Sydney, Sydney, NSW
| | - Robert G Cumming
- University of Sydney, Sydney, NSW.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW
| | - R Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW
| | - Emily Banks
- Australian National University, Canberra, ACT
| | | | | | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
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14
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Campostrini S, Dal Grande E, Taylor AW. Increasing gaps in health inequalities related to non-communicable diseases in South Australia; implications towards behavioural risk factor surveillance systems to provide evidence for action. BMC Public Health 2019; 19:37. [PMID: 30621648 PMCID: PMC6325833 DOI: 10.1186/s12889-018-6323-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/14/2018] [Indexed: 11/14/2022] Open
Abstract
Background Although Australia is a country cited as having generally low health inequalities among different socioeconomic groups, inequalities have persisted. The aim of this analysis was to highlight how inequalities have evolved over a 13 years period in South Australia (SA). Methods Since 2002, over 600 interviews per month have been undertaken with SA residents through a computer assisted telephone survey method (total 77,000+). Major risk factors and chronic diseases have been analyzed providing trends by two socio-economic variables: education and a proxy of income (ability to save). Results While income and educational gaps are reducing over time in SA, those that remain in the lower socio-economic groups have a generally higher prevalence of risk factors and chronic diseases. The health disparity gap is still relevant, although at a different extent, for all the variables considered in our study, with most appearing to be stable if not increasing over time. Conclusions Surveillance can be a good source of information both to show the evolution of problems and to evaluate possible future interventions. Extensive effort is still required to “close the gap” of health inequalities in SA. More precisely targeted and properly implemented interventions are needed. Electronic supplementary material The online version of this article (10.1186/s12889-018-6323-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefano Campostrini
- Department of Economics, Ca' Foscari University of Venice, San Giobbe 873, 30121, Venice, Italy. .,School of Medicine, The University of Adelaide, Adelaide, South Australia.
| | - Eleonora Dal Grande
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
| | - Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
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15
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Grant JF, Chittleborough CR, Taylor AW. Parental body shape at midlife and its association with adult offspring weight measures. Obes Res Clin Pract 2019. [DOI: 10.1016/j.orcp.2016.10.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Laaksonen MA, Canfell K, MacInnis R, Arriaga ME, Banks E, Magliano DJ, Giles GG, Cumming RG, Byles JE, Mitchell P, Gill TK, Hirani V, McCullough S, Shaw JE, Taylor AW, Adelstein BA, Vajdic CM. The future burden of lung cancer attributable to current modifiable behaviours: a pooled study of seven Australian cohorts. Int J Epidemiol 2018; 47:1772-1783. [PMID: 29982519 DOI: 10.1093/ije/dyy136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 01/10/2023] Open
Abstract
Background Knowledge of preventable disease and differences in disease burden can inform public health action to improve health and health equity. We quantified the future lung cancer burden preventable by behavioural modifications across Australia. Methods We pooled seven Australian cohort studies (n = 367 058) and linked them to national registries to identify lung cancers and deaths. We estimated population attributable fractions and their 95% confidence intervals (CIs) for modifiable risk factors, using risk estimates from the cohort data and risk factor exposure distribution from contemporary national health surveys. Results During the first 10-year follow-up, there were 2025 incident lung cancers and 20 349 deaths. Stopping current smoking could prevent 53.7% (95% CI, 50.0-57.2%) of lung cancers over 40 years and 18.3% (11.0-25.1%) in 10 years. The smoking-attributable burden is highest in males, those who smoke <20 cigarettes per day, are <75 years of age, unmarried, of lower educational attainment, live in remote areas or are healthy weight. Increasing physical activity and fruit consumption, if causal, could prevent 15.6% (6.9-23.4%) and 7.5% (1.3-13.3%) of the lung cancer burden, respectively. Jointly, the three behaviour modifications could prevent up to 63.0% (58.0-67.5%) of lung cancers in 40 years, and 31.2% (20.9-40.1%) or 43 300 cancers in 10 years. The preventable burden is highest among those with multiple risk factors. Conclusions Smoking remains responsible for the highest burden of lung cancer in Australia. The uneven burden distribution distinguishes subgroups that could benefit the most from activities to control the world's deadliest cancer.
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Affiliation(s)
- Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Robert MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Maria E Arriaga
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia
| | - Dianna J Magliano
- Diabetes and Population Health Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Julie E Byles
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical research, University of Sydney, Sydney, NSW, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, Sydney, NSW, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | | | - Jonathan E Shaw
- Clinical Diabetes Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Anne W Taylor
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Barbara-Ann Adelstein
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
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17
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Shi Z, Taylor AW, Riley M, Byles J, Liu J, Noakes M. Cadmium intake and chronic kidney disease: Response to Kawada T. Clin Nutr 2018; 37:1774. [DOI: 10.1016/j.clnu.2018.06.976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
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18
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Gyawali P, Martin SA, Heilbronn LK, Vincent AD, Taylor AW, Adams RJT, O'Loughlin PD, Wittert GA. The role of sex hormone-binding globulin (SHBG), testosterone, and other sex steroids, on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men. Acta Diabetol 2018; 55:861-872. [PMID: 29845345 DOI: 10.1007/s00592-018-1163-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/18/2018] [Indexed: 12/27/2022]
Abstract
AIMS Contrasting findings exist regarding the association between circulating sex hormone-binding globulin (SHBG) and testosterone levels and type 2 diabetes (T2D) in men. We examined prospective associations of SHBG and sex steroids with incident T2D in a cohort of community-dwelling men. METHODS Participants were from a cohort study of community-dwelling (n = 2563), middle-aged to elderly men (35-80 years) from Adelaide, Australia (the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study). The current study included men who were followed for 5 years and with complete SHBG and sex steroid levels (total testosterone (TT), dihydrotestosterone (DHT) and oestradiol (E2)), but without T2D at baseline (n = 1597). T2D was identified by either self-report, fasting glucose (≥ 7.0 mmol/L), HbA1c (≥ 6.5%/48.0 mmol/mol), and/or prescriptions for diabetes medications. Logistic binomial regression was used to assess associations between SHBG, sex steroids and incident T2D, adjusting for confounders including age, smoking status, physical activity, adiposity, glucose, triglycerides, symptomatic depression, SHBG and sex steroid levels. RESULTS During an average follow-up of 4.95 years, 14.5% (n = 232) of men developed new T2D. Multi-adjusted models revealed an inverse association between baseline SHBG, TT, and DHT levels, and incident T2D (odds ratio (OR) = 0.77, 95% CI [0.62, 0.95], p = 0.02; OR 0.70 [0.57, 0.85], p < 0.001 and OR 0.78 [0.63, 0.96], p = 0.02), respectively. However, SHBG was no longer associated with incident T2D after additional adjustment for TT (OR 0.92 [0.71, 1.17], p = 0.48; TT in incident T2D: OR 0.73 [0.57, 0.92], p = 0.01) and after separate adjustment for DHT (OR 0.83 [0.64, 1.08], p = 0.16; DHT in incident T2D: OR 0.83 [0.65, 1.05], p = 0.13). There was no observed effect of E2 in all models of incident T2D. CONCLUSIONS In men, low TT, but not SHBG and other sex steroids, best predicts the development of T2D after adjustment for confounders.
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Affiliation(s)
- Prabin Gyawali
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Sean A Martin
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Leonie K Heilbronn
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Andrew D Vincent
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Anne W Taylor
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Population Research and Outcomes Studies, University of Adelaide, Adelaide, SA, Australia
| | - Robert J T Adams
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- The Health Observatory, University of Adelaide, Queen Elizabeth Hospital, Woodville, SA, Australia
| | | | - Gary A Wittert
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia.
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
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19
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Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Gender-specific associations between perceived and objective neighbourhood crime and metabolic syndrome. PLoS One 2018; 13:e0201336. [PMID: 30048521 PMCID: PMC6062143 DOI: 10.1371/journal.pone.0201336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Much research has considered the relationship between neighbourhood crime and physical activity, but few studies have assessed clinical outcomes consequent to behaviour, such as cardiometabolic risk. Fewer still have simultaneously assessed perceived and objective measures of crime. Perceptions of crime and actual victimisation vary according to gender; thus, this study sought to assess: 1) correspondence between perceived and objective neighbourhood crime; and 2) gender-specific associations between perceived and reported crime and metabolic syndrome, representing cardiometabolic risk. The indirect effect of neighbourhood crime on metabolic syndrome via walking was additionally evaluated. An Australian population-based biomedical cohort study (2004–2007) collected biomedical, socio-demographic, and neighbourhood perceptions data from n = 1,172 urban-dwelling, adults. Area-level reported crime rates were standardised and linked to individual data based on participants' residential location. Correspondence between actual and perceived crime measures was assessed using Pearson correlation coefficients. Cross-sectional associations between crime and metabolic syndrome were analysed using generalised estimating equations regression models accounting for socio-demographic factors and area-level income. Correspondence between perceived and objective crime was small to medium among men and women (r = 0.17 to 0.33). Among men, metabolic syndrome was related to rates of violent (OR = 1.21, 95% CI 1.08–1.35) and total crime (OR = 1.17, 95% CI 1.04–1.32), after accounting for perceived crime. Among women, metabolic syndrome was related to perceived crime (OR = 1.35, 95% CI 1.14–1.60) after accounting for total reported crime. Among women, there were indirect effects of perceived crime and property crime on metabolic syndrome through walking. Results indicate that crime, an adverse social exposure, is linked to clinical health status. Crime rates, and perceptions of crime and safety, differentially impact upon cardiometabolic health according to gender. Social policy and public health strategies targeting crime reduction, as well as strategies to increase perceptions of safety, have potential to contribute to improved cardiometabolic outcomes.
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Affiliation(s)
- Katherine L. Baldock
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
- * E-mail:
| | - Catherine Paquet
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Natasha J. Howard
- Wardliparingga Aboriginal Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Neil T. Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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20
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Stacey AF, Gill TK, Price K, Taylor AW. Differences in risk factors and chronic conditions between informal (family) carers and non-carers using a population-based cross-sectional survey in South Australia. BMJ Open 2018; 8:e020173. [PMID: 30037861 PMCID: PMC6059288 DOI: 10.1136/bmjopen-2017-020173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is growing discussion on the impact of informal caregiving on the health status and morbidity of family carers. Evidence suggests a proportion of carers may be at risk of poor health outcomes. However, there are limited population-based studies that provide representative data on specific risk factors among carers (eg, blood pressure, cholesterol, smoking status, activity and body mass index) and major chronic conditions (eg, asthma, diabetes and arthritis). This study aimed to redress that imbalance. METHOD Self-reported data were from the South Australian Monitoring and Surveillance System (SAMSS), a representative cross-sectional state-wide population-based survey of 600 randomly selected persons per month. SAMSS uses computer-assisted telephone interviewing (CATI) to monitor chronic health-related problems and risk factors and to assess health outcomes. In total, 2247 family carers were identified from 35 195 participants aged 16 years and older for the 5-year period from 2010 to 2015. Logistic regression analyses examined associations of being a carer with self-reported chronic diseases and health risk factors. In addition, the population attributable risk (PAR) of being a carer was examined for selected chronic conditions. RESULTS The prevalence of carers was 6.4%, and peak age group for carers was 50-59 years. Adjusted ORs for chronic conditions in carers were significant for all chronic conditions examined. Although there is a high prevalence of self-reported risk factors and chronic conditions among carers compared with non-carers at the population level, PAR findings suggest that caregiving is associated with a small to moderate increased risk of having these chronic conditions. CONCLUSIONS Monitoring of carer health and morbidity particularly 'at risk' individuals such as female carers with asthma or diabetes remains important and provides an ongoing baseline for future surveys. To achieve this, caregiver-based studies need to become part of mainstream biomedical research at both epidemiological and clinical levels.
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Affiliation(s)
- Anne F Stacey
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tiffany K Gill
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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21
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Gyawali P, Martin SA, Heilbronn LK, Vincent AD, Jenkins AJ, Januszewski AS, Taylor AW, Adams RJT, O’Loughlin PD, Wittert GA. Cross-sectional and longitudinal determinants of serum sex hormone binding globulin (SHBG) in a cohort of community-dwelling men. PLoS One 2018; 13:e0200078. [PMID: 29995902 PMCID: PMC6040731 DOI: 10.1371/journal.pone.0200078] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 06/19/2018] [Indexed: 12/31/2022] Open
Abstract
Despite its widespread clinical use, there is little data available from population-based studies on the determinants of serum sex hormone binding globulin (SHBG). We aimed to examine multifactorial determinants of circulating SHBG levels in community-dwelling men. Study participants comprised randomly selected 35–80 y.o. men (n = 2563) prospectively-followed for 5 years (n = 2038) in the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. After excluding men with illness or medications known to affect SHBG (n = 172), data from 1786 men were available at baseline, and 1476 at follow-up. The relationship between baseline body composition (DXA), serum glucose, insulin, triglycerides, thyroxine (fT4), sex steroids (total testosterone (TT), oestradiol (E2)), and pro-inflammatory cytokines and serum SHBG level at both baseline & follow-up was determined by linear and penalized logistic regression models adjusting for age, lifestyle & demographic, body composition, metabolic, and hormonal factors. Restricted cubic spline analyses was also conducted to capture possible non-linear relationships. At baseline there were positive cross-sectional associations between age (β = 0.409, p<0.001), TT (β = 0.560, p<0.001), fT4 (β = 0.067, p = 0.019) and SHBG, and negative associations between triglycerides (β = -0.112, p<0.001), abdominal fat mass (β = -0.068, p = 0.032) and E2 (β = -0.058, p = 0.050) and SHBG. In longitudinal analysis the positive determinants of SHBG at 4.9 years were age (β = 0.406, p = <0.001), TT (β = 0.461, p = <0.001), and fT4 (β = 0.040, p = 0.034) and negative determinants were triglycerides (β = -0.065, p = 0.027) and abdominal fat mass (β = -0.078, p = 0.032). Taken together these data suggest low SHBG is a marker of abdominal obesity and increased serum triglycerides, conditions which are known to have been associated with low testosterone and low T4.
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Affiliation(s)
- Prabin Gyawali
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- * E-mail: (PG); (GW)
| | - Sean A. Martin
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Leonie K. Heilbronn
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Andrew D. Vincent
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Alicia J. Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Andrzej S. Januszewski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Anne W. Taylor
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- Population Research and Outcomes Studies, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J. T. Adams
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The Health Observatory, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | | | - Gary A. Wittert
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- * E-mail: (PG); (GW)
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Vajdic CM, MacInnis RJ, Canfell K, Hull P, Arriaga ME, Hirani V, Cumming RG, Mitchell P, Byles JE, Giles GG, Banks E, Taylor AW, Shaw JE, Magliano DJ, Marker J, Adelstein BA, Gill TK, Laaksonen MA. The Future Colorectal Cancer Burden Attributable to Modifiable Behaviors: A Pooled Cohort Study. JNCI Cancer Spectr 2018; 2:pky033. [PMID: 31360860 PMCID: PMC6649699 DOI: 10.1093/jncics/pky033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/04/2018] [Accepted: 06/08/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Previous estimates of the colorectal cancer (CRC) burden attributed to behaviors have not considered joint effects, competing risk, or population subgroup differences. METHODS We pooled data from seven prospective Australian cohort studies (n = 367 058) and linked them to national registries to identify CRCs and deaths. We estimated the strength of the associations between behaviors and CRC risk using a parametric piecewise constant hazards model, adjusting for age, sex, study, and other behaviors. Exposure prevalence was estimated from contemporary National Health Surveys. We calculated population attributable fractions for CRC preventable by changes to current behaviors, accounting for competing risk of death and risk factor interdependence. Statistical tests were two-sided. RESULTS During the first 10 years of follow-up, there were 3471 incident CRCs. Overweight or obesity explained 11.1%, ever smoking explained 10.7% (current smoking 3.9%), and drinking more than two compared with two or fewer alcoholic drinks per day explained 5.8% of the CRC burden. Jointly, these factors were responsible for 24.9% (95% confidence interval [CI] = 19.7% to 29.9%) of the burden, higher for men (36.7%) than women (13.2%, P difference < .001). The burden attributed to these factors was also higher for those born in Australia (28.7%) than elsewhere (16.8%, P difference = .047). We observed modification of the smoking-attributable burden by alcohol consumption and educational attainment, and modification of the obesity-attributable burden by age group and birthplace. CONCLUSIONS We produced up-to-date estimates of the future CRC burden attributed to modifiable behaviors. We revealed novel differences between men and women, and other high-CRC burden subgroups that could potentially benefit most from programs that support behavioral change and early detection.
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Affiliation(s)
- Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Karen Canfell
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Peter Hull
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Maria E Arriaga
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, Sydney, Australia
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Julie E Byles
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - Anne W Taylor
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Jonathan E Shaw
- Clinical Diabetes Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Dianna J Magliano
- Diabetes and Population Health Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | | | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
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Carroll SJ, Niyonsenga T, Coffee NT, Taylor AW, Daniel M. Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort. Int J Behav Nutr Phys Act 2018; 15:44. [PMID: 29776358 PMCID: PMC5960151 DOI: 10.1186/s12966-018-0675-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/06/2018] [Indexed: 01/09/2023] Open
Abstract
Background Descriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c). Methods HbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income). Results Local descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI. Conclusion Adverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.
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Affiliation(s)
- Suzanne J Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.
| | - Theo Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Neil T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Anne W Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia.,Department of Medicine, The University of Melbourne, St Vincent's Hospital, Melbourne, VIC, Australia
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24
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Melaku YA, Renzaho A, Gill TK, Taylor AW, Dal Grande E, de Courten B, Baye E, Gonzalez-Chica D, Hyppӧnen E, Shi Z, Riley M, Adams R, Kinfu Y. Burden and trend of diet-related non-communicable diseases in Australia and comparison with 34 OECD countries, 1990-2015: findings from the Global Burden of Disease Study 2015. Eur J Nutr 2018. [PMID: 29516222 DOI: 10.1007/s00394-018-1656-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Diet is a major determining factor for many non-communicable chronic diseases (NCDs). However, evidence on diet-related NCD burden remains limited. We assessed the trends in diet-related NCDs in Australia from 1990 to 2015 and compared the results with other countries of the Organization for Economic Co-operation and Development (OECD). METHODS We used data and methods from the Global Burden of Disease (GBD) 2015 study to estimate the NCD mortality and disability-adjusted life years (DALYs) attributable to 14 dietary risk factors in Australia and 34 OECD nations. Countries were further ranked from the lowest (first) to highest (35th) burden using an age-standardized population attributable fraction (PAF). RESULTS In 2015, the estimated number of deaths attributable to dietary risks was 29,414 deaths [95% uncertainty interval (UI) 24,697 - 34,058 or 19.7% of NCD deaths] and 443,385 DALYs (95% UI 377,680-511,388 or 9.5% of NCD DALYs) in Australia. Young (25-49 years) and middle-age (50-69 years) male adults had a higher PAF of diet-related NCD deaths and DALYs than their female counterparts. Diets low in fruits, vegetables, nuts and seeds and whole grains, but high in sodium, were the major contributors to both NCD deaths and DALYs. Overall, 42.3% of cardiovascular deaths were attributable to dietary risk factors. The age-standardized PAF of diet-related NCD mortality and DALYs decreased over the study period by 28.2% (from 27.0% in 1990 to 19.4% in 2015) and 41.0% (from 14.3% in 1990 to 8.4% in 2015), respectively. In 2015, Australia ranked 12th of 35 examined countries in diet-related mortality. A small improvement of rank was recorded compared to the previous 25 years. CONCLUSIONS Despite a reduction in diet-related NCD burden over 25 years, dietary risks are still the major contributors to a high burden of NCDs in Australia. Interventions targeting NCDs should focus on dietary behaviours of individuals and population groups.
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Affiliation(s)
- Yohannes Adama Melaku
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
- Department of Human Nutrition, Institute of Public Health, The University of Gondar, Gondar, Ethiopia.
| | - Andre Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Tiffany K Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Anne W Taylor
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | | | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Estifanos Baye
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | | | - Elina Hyppӧnen
- Centre for Population Health Research, Sansom Institute, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - Zumin Shi
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | - Malcolm Riley
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, SA, Australia
| | - Robert Adams
- Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, The University of Adelaide, Adelaide, Australia
| | - Yohannes Kinfu
- Faculty of Health, University of Canberra, Canberra, Australia
- School of Demography, Australian National University, Canberra, Australia
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25
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Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Are Perceived and Objective Distances to Fresh Food and Physical Activity Resources Associated with Cardiometabolic Risk? Int J Environ Res Public Health 2018; 15:ijerph15020224. [PMID: 29382169 PMCID: PMC5858293 DOI: 10.3390/ijerph15020224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/19/2018] [Accepted: 01/25/2018] [Indexed: 12/13/2022]
Abstract
Perceived and objective measures of neighbourhood features have shown limited correspondence. Few studies have examined whether discordance between objective measures and individual perceptions of neighbourhood environments relates to individual health. Individuals with mismatched perceptions may benefit from initiatives to improve understandings of resource availability. This study utilised data from n = 1491 adult participants in a biomedical cohort to evaluate cross-sectional associations between measures of access (perceived, objective, and perceived-objective mismatch) to fruit and vegetable retailers (FVR) and public open space (POS), and clinically-measured metabolic syndrome and its component risk factors: central obesity, dyslipidaemia, hypertension and pre-diabetes/diabetes. Access measures included perceived distances from home to the nearest FVR and POS, corresponding objectively-assessed road network distances, and the discordance between perceived and objective distances (overestimated (i.e., mismatched) distances versus matched perceived-objective distances). Individual and neighbourhood measures were spatially joined using a geographic information system. Associations were evaluated using multilevel logistic regression, accounting for individual and area-level covariates. Hypertension was positively associated with perceived distances to FVR (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.02, 1.28) and POS (OR = 1.19, 95% CI = 1.05, 1.34), after accounting for covariates and objective distances. Hypertension was positively associated with overestimating distances to FVR (OR = 1.36, 95% CI = 1.02, 1.80). Overestimating distances to POS was positively associated with both hypertension (OR = 1.42, 95% CI = 1.11, 1.83) and dyslipidaemia (OR = 1.25, 95% CI = 1.00, 1.57). Results provide new evidence for specific associations between perceived and overestimated distances from home to nearby resources and cardiometabolic risk factors.
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Affiliation(s)
- Katherine L Baldock
- Centre for Population Health Research, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Catherine Paquet
- Centre for Population Health Research, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Natasha J Howard
- Wardliparingga Aboriginal Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5001, Australia.
| | - Neil T Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra 2617, Australia.
| | - Anne W Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, SA 5001, Australia.
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra 2617, Australia.
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne 3065, Australia.
- South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
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26
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Melaku YA, Gill TK, Taylor AW, Adams R, Shi Z, Worku A. Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores. Nutr J 2018; 17:14. [PMID: 29378583 PMCID: PMC5789646 DOI: 10.1186/s12937-018-0316-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/03/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Identifying dietary patterns that consider the overall eating habits, rather than focusing on individual foods or simple counts of consumed foods, better helps to understand the combined effects of dietary components. Therefore, this study aimed to use dietary patterns, as an alternative method to dietary diversity scores (DDSs), and investigate their associations with childhood stunting in Ethiopia. METHODS Mothers and their children aged under 5 years (n = 3788) were recruited using a two-stage random cluster sampling technique in two regions of Ethiopia. Socio-demographic, dietary and anthropometric data were collected. Dietary intake was assessed using standardized dietary diversity tools. Household, maternal and child DDSs were calculated and dietary patterns were identified by tetrachoric (factor) analysis. Multilevel linear and Poisson regression analyses were applied to assess the association of DDSs and dietary patterns with height-for-age z score (HAZ) and stunting, respectively. RESULTS The overall prevalence of stunting among children under-five was 38.5% (n = 1459). We identified three dietary patterns each, for households ("fish, meat and miscellaneous", "egg, meat, poultry and legume" and "dairy, vegetable and fruit"), mothers ("plant-based", "egg, meat, poultry and legume" and "dairy, vegetable and fruit" and children ("grain based", "egg, meat, poultry and legume" and "dairy, vegetable and fruit"). Children in the third tertile of the household "dairy, vegetable and fruit" pattern had a 0.16 (β = 0.16; 95% CI: 0.02, 0.30) increase in HAZ compared to those in the first tertile. A 0.22 (β = 0.22; 95% CI: 0.06, 0.39) and 0.19 (β = 0.19; 0.04, 0.33) increase in HAZ was found for those in the third tertiles of "dairy, vegetable and fruit" patterns of children 24-59 months and 6-59 months, respectively. Those children in the second (β = -0.17; 95% CI: -0.31, -0.04) and third (β = -0.16; 95% CI: -0.30, -0.02) tertiles of maternal "egg, meat, poultry and legume" pattern had a significantly lower HAZ compared to those in the first tertile. No significant associations between the household and child "egg, meat, poultry and legume" dietary patterns with HAZ and stunting were found. Statistically non-significant associations were found between household, maternal and child DDSs, and HAZ and stunting. CONCLUSION A higher adherence to a "dairy, vegetable and fruit" dietary pattern is associated with increased HAZ and reduced risk of stunting. Dietary pattern analysis methods, using routinely collected dietary data, can be an alternative approach to DDSs in low resource settings, to measure dietary quality and in determining associations of overall dietary intake with stunting.
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Affiliation(s)
- Yohannes Adama Melaku
- Department of Public Health Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia. .,Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
| | - Tiffany K Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Anne W Taylor
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Robert Adams
- Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, The University of Adelaide, Adelaide, Australia
| | - Zumin Shi
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Amare Worku
- Department of Public Health Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Abstract
OBJECTIVES To examine the association between BMI and all-cause mortality in the oldest old (≥80 years). DESIGN The study used a prospective cohort study design. SETTING Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011. POPULATION 8026 participants aged 80 years and older were followed every two to three years. MEASUREMENTS Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up. RESULTS The mean BMI was 19.8 (SD 4.5) kg/m2. The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality. CONCLUSION Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese.
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Affiliation(s)
- J Wang
- Zumin Shi, Discipline of Medicine, University of Adelaide, Level 7, SAHMRI, North Terrace, Adelaide, Australia, 5005. Phone: +61 8 8313 1188; Fax: +61 8 8313 1228;
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28
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Bobridge A, Price K, Gill TK, Taylor AW. Influencing Cancer Screening Participation Rates-Providing a Combined Cancer Screening Program (a 'One Stop' Shop) Could Be a Potential Answer. Front Oncol 2017; 7:308. [PMID: 29322029 PMCID: PMC5733549 DOI: 10.3389/fonc.2017.00308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Participation in established cancer screening programs remains variable. Therefore, a renewed focus on how to increase screening uptake, including addressing structural barriers such as time, travel, and cost is needed. One approach could be the provision of combined cancer screening, where multiple screening tests are provided at the same time and location (essentially a ‘One Stop’ screening shop). This cohort study explored both cancer screening behavior and the acceptability of a combined screening approach. Methods Participants of the North Western Adelaide Health Study (NWAHS), South Australia were invited to participate in a questionnaire about cancer screening behaviors and the acceptability of a proposed ‘One Stop’ cancer screening shop. Data were collected from 10th August 2015 to 18th January 2016, weighted for selection probability, age, and sex and analyzed using descriptive and multivariable logistic regression analysis. Results 1,562 people, 52% female (mean age 54.1 years ± 15.2) participated. Reported screening participation was low, the highest being for Pap Smear (34.4%). Common reasons for screening participation were preventing sickness (56.1%, CI 53.2–59.0%), maintaining health (51%, CI 48–53.9%), and free program provision (30.9%, CI 28.2–33.6%). Females were less likely to state that screening is not beneficial [OR 0.37 (CI 0.21–0.66), p < 0.001] and to cite sickness prevention [OR 2.10 (CI 1.46–3.00), p < 0.001] and free program [OR 1.75 (CI 1.22–2.51), p < 0.003] as reasons for screening participation. Of those who did not participate, 34.6% (CI 30.3–39.1%) stated that there was nothing that discouraged them from participation, with 55- to 64-year olds [OR 0.24 (CI 0.07–0.74), p < 0.04] being less likely to cite this reason. 21% (CI 17.2–24.8%) thought they did not need screening, while a smaller proportion stated not having time (6.9%, CI 4.9–9.7%) and the costs associated with screening (5.2%, CI 3.5–7.7%). The majority of participants (85.3%, CI 81.9–88.2%) supported multiple screening being offered at the same time and location. Conclusion Identified screening behaviors in this study are similar to those reported in the literature. The high support for the concept of combined cancer screening demonstrates that this type of approach is acceptable to potential end users and warrants further investigation.
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Affiliation(s)
| | - Kay Price
- University of South Australia, Adelaide, SA, Australia
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29
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Appleton SL, Gill TK, Lang CJ, Taylor AW, McEvoy RD, Stocks NP, González-Chica DA, Adams RJ. Prevalence and comorbidity of sleep conditions in Australian adults: 2016 Sleep Health Foundation national survey. Sleep Health 2017; 4:13-19. [PMID: 29332673 DOI: 10.1016/j.sleh.2017.10.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 10/11/2017] [Accepted: 10/20/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the prevalence of sleep conditions (obstructive sleep apnea [OSA], insomnia symptoms, simple snoring, and restless legs) and their associated burden of chronic conditions in a community sample. DESIGN Cross-sectional national adult online survey. SETTING Community-based sample. PARTICIPANTS Australian adults ≥18 years, N = 1011. MEASUREMENTS A cross-sectional national online survey assessed diagnosed OSA, OSA symptoms, insomnia symptoms, sleep problems, excessive daytime sleepiness (Epworth Sleepiness Scale ≥11), and physician-diagnosed health conditions (heart disease, diabetes, hypertension, reflux disease, lung disease, depression, anxiety/panic disorder, arthritis). Possible undiagnosed OSA was estimated using self-reported frequent loud snoring and witness apneas. International Criteria for Sleep Disorders-3 criteria identified insomnia symptoms. Logistic regression models adjusted for age, sex, obesity, and smoking determined correlates of sleep disorders. RESULTS Comorbid sleep conditions were common, with 56% of participants demonstrating ≥1 condition. Reporting ≥1 mental health condition (depression and/or anxiety) was independently associated with diagnosed OSA (odds ratio [95% confidence interval {CI}]: 6.6 [3.2-13.6]), undiagnosed OSA (3.2 [1.8-5.8]), simple snoring (2.4 [1.2-4.5]), insomnia symptoms (4.3 [2.5-7.3]), and restless legs (1.9 [1.2-3.1]). Diagnosed OSA was significantly associated with ≥1 cardiometabolic condition (2.9 [1.4-6.0]) and arthritis (3.6 [1.8-7.2]). ESS ≥11 was associated with diagnosed (3.1 [1.4-6.8]) and undiagnosed OSA (6.2 [3.4-11.4]), insomnia symptoms (2.6 [1.4-4.9]), and restless legs (2.3 [1.4-4.0]), and these sleep conditions were also significantly associated with ≥2 diagnosed medical problems. CONCLUSION Strategies to facilitate the diagnosis and management of often comorbid sleep disorders in primary care are required to reduce the significant sleep-related disparities in cardiometabolic and mental health.
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Affiliation(s)
- Sarah L Appleton
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia; Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
| | - Tiffany K Gill
- Population Research & Outcomes Studies, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Carol J Lang
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
| | - Anne W Taylor
- Population Research & Outcomes Studies, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - R Douglas McEvoy
- Adelaide Institute of Sleep Health, A Flinders Centre of Excellence, Flinders University, Bedford Park, South Australia, Australia; Department of Medicine, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Nigel P Stocks
- Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - David A González-Chica
- Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J Adams
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
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Taylor AW, Bewick BM, Makanjuola AB, Qian L, Kirzhanova VV, Alterwain P. Context and culture associated with alcohol use amongst youth in major urban cities: A cross-country population based survey. PLoS One 2017; 12:e0187812. [PMID: 29155847 PMCID: PMC5695777 DOI: 10.1371/journal.pone.0187812] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 10/26/2017] [Indexed: 12/25/2022] Open
Abstract
Background Alcohol consumption patterns are dependent upon culture and context. The aim of this study was to interview people aged 18–34 year old living in four cities in different regions of the world to explore differences in a range of alcohol measures to assist in determining culturally appropriate alcohol initiatives for this age group. Method Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward and back translated into relevant languages and face-to-face interviewing undertaken. The data were weighted to the population of each city. Uni-variable analysis (ever consumed, first time consumed, age when drunk for first time, number of days consumed, type consumed) and logistic regression modeling were undertaken. The final model for each city was adjusted for age, sex, marital status, highest education and employment status. In total 6235 interviews were undertaken (1391 in Ilorin, 1600 in Montevideo, 1604 in Moscow and 1640 in Wuhan). Results Alcohol was consumed by 96.4% in Montevideo, 86.1% in Moscow, 53.4% in Wuhan and 33.3% in Ilorin. There was very little difference by gender except Ilorin males were more likely to consume alcohol than females. Alcohol was consumed on more days for Ilorin males; Wuhan females consumed alcohol on the least number of days; Ilorin had the most abstainers; Montevideo and Moscow the highest proportion of light drinkers; Ilorin and Montevideo the highest proportion of heavy drinkers. Differences by type of alcohol were also apparent. The final logistic regression model provided different models including higher alcohol consumption rates for males, 25–34 years of age, divorced/separated marital status and employed part time for Ilorin respondents; males and higher educated for Montevideo; males, 25 to 29 years of age and higher educated for Moscow; and 25–29 years of age, non-married and vocationally trained for those in Wuhan. Conclusion Alcohol consumption in these four cities does not increase with age as found in most high income countries. The alcohol consumption patterns during this stage of the life cycle are important to assess so that high level, as well as country-specific, planning and interventions can be implemented.
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Affiliation(s)
- Anne W. Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| | - Bridgette M. Bewick
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Alfred B. Makanjuola
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Ling Qian
- Center for Health Education, PR Ministry of Health, Beijing, China
| | - Valentina V. Kirzhanova
- Department of Epidemiology, Federal Medical Research Centre for Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow, Russia
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Melaku YA, Gill TK, Appleton SL, Taylor AW, Adams R, Shi Z. Prospective Associations of Dietary and Nutrient Patterns with Fracture Risk: A 20-Year Follow-Up Study. Nutrients 2017; 9:nu9111198. [PMID: 29088104 PMCID: PMC5707670 DOI: 10.3390/nu9111198] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/10/2017] [Accepted: 10/26/2017] [Indexed: 11/21/2022] Open
Abstract
Studies on long-term exposure to foods/nutrients and its associations with fracture risk are scarce. Using data from the China Health and Nutrition Survey (CHNS), we determined the prospective association of dietary and nutrient patterns with fractures. Data from 15,572 adults aged ≥18 years were analyzed. Fracture occurrence was self-reported and dietary intake data were collected using a 24-h recall method for three consecutive days, for each individual across nine waves (1989–2011). We used cumulative and overall mean, recent and baseline dietary and nutrient exposures. Hazard ratios (HR) were used to determine the associations. Two dietary (traditional and modern) and two nutrient (plant- and animal-sourced) patterns were identified. After adjusting for potential confounders, study participants in the third tertiles (highest intake) of the modern dietary and animal-sourced nutrient patterns’ cumulative scores had a 34% (HR = 1.34; 95% CI: 1.06–1.71) and 37% (HR = 1.37; 95% CI: 1.08–1.72) increase in fracture risks compared to those in the first tertiles, respectively. While the overall mean factor scores of dietary and nutrient patterns had a similar (or stronger) pattern of association as the cumulative scores, no association between recent and baseline scores and fracture was found. Greater adherence to a modern dietary and/or an animal-sourced nutrient pattern is associated with a higher risk of total fractures. This suggests that a modern animal based diet is related to bone fragility. A repeated three-day 24-h recall dietary assessment provides a stronger association with fracture compared to a recent or baseline exposure.
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Affiliation(s)
- Yohannes Adama Melaku
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar 196, Ethiopia.
| | - Tiffany K Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Sarah L Appleton
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Woodville, SA 5011, Australia.
- Freemason's Centre for Men's Health, Discipline of Medicine, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Anne W Taylor
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Robert Adams
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Woodville, SA 5011, Australia.
| | - Zumin Shi
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
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Adams RJ, Appleton SL, Vakulin A, Hanly PJ, McDonald SP, Martin SA, Lang CJ, Taylor AW, McEvoy RD, Antic NA, Catcheside PG, Vincent AD, Wittert GA. Chronic Kidney Disease and Sleep Apnea Association of Kidney Disease With Obstructive Sleep Apnea in a Population Study of Men. Sleep 2017; 40:2739499. [PMID: 28364466 DOI: 10.1093/sleep/zsw015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 11/13/2022] Open
Abstract
Study Objectives To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 or eGFR≥60 and albuminuria (albumin-creatinine ratio ≥3.0 mg/mmol). Results CKD (10.5%, n = 85 [Stage 1-3, 9.7%; Stage 4-5, 0.7%]) of predominantly mild severity showed significant associations with OSA (apnea-hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.02-3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95% CI: 1.1-6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95%CI: 1.1-4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.
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Affiliation(s)
- Robert J Adams
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
| | - Sarah L Appleton
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Sleep and Respiratory Medicine, Repatriation General Hospital, Southern Adelaide Local Health Network, Daw Park, South Australia, Australia.,The NHMRC Centres of Research Excellence, CIRUS and NEUROSLEEP, Woolcock Institute of Medical Research, Central Clinical School, University of Sydney, New South Wales, Australia
| | - Patrick J Hanly
- Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
| | - Stephen P McDonald
- The Central Northern Renal and Transplantation Service, Central Adelaide Local Health Network, SA Department of Health, SA Health, Adelaide, South Australia, Australia
| | - Sean A Martin
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Carol J Lang
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
| | - Anne W Taylor
- Population Research & Outcomes Studies, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - R Doug McEvoy
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Sleep and Respiratory Medicine, Repatriation General Hospital, Southern Adelaide Local Health Network, Daw Park, South Australia, Australia
| | - Nick A Antic
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Sleep and Respiratory Medicine, Repatriation General Hospital, Southern Adelaide Local Health Network, Daw Park, South Australia, Australia
| | - Peter G Catcheside
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Andrew D Vincent
- Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Gary A Wittert
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Bai PY, Wittert G, Taylor AW, Martin SA, Milne RW, Jenkins AJ, Januszewski AS, Shi Z. The association between total phthalate concentration and non-communicable diseases and chronic inflammation in South Australian urban dwelling men. Environ Res 2017; 158:366-372. [PMID: 28686951 DOI: 10.1016/j.envres.2017.06.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/19/2017] [Accepted: 06/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate associations between urinary total phthalate concentration, chronic low-grade inflammation and non-communicable diseases in a cohort of South Australian men. METHODS 1504 men aged 39-84 years who provided a urinary sample at the follow-up visit of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a randomly-selected group of urban-dwelling, community-based men from Adelaide, Australia (n = 2038; study participation rate: 78.1%). Total phthalate concentration was quantified in fasting morning urine samples. Chronic diseases were assessed through self-report questionnaire or directly measured using standardised clinical and laboratory procedures. Inflammatory biomarkers were assayed by ELISA or spectroscopy. Multivariable linear and logistic regression models were applied to determine associations of log-transformed urinary phthalate concentration with inflammation and chronic disease. RESULTS Total phthalates were detected in 99.6% of urinary samples; geometric mean (95% CI) was 114.1 (109.5-118.9)µg/g creatinine. Higher total phthalate levels were associated with higher levels of hs-CRP, IL-6 (all p < 0.05) and TNF-α but not MPO. Urinary total phthalate concentrations were positively associated with cardiovascular disease, type-2-diabetes and hypertension. Comparing extreme quartiles of total phthalate, prevalence ratios were 1.78 (95% CI 1.17 - 2.71, p-trend = 0.001) for cardiovascular disease and 1.84 (95%CI 1.34 - 2.51, p-trend = 0.001) for type-2-diabetes and 1.14 (95%CI 1.01 - 1.29, p-trend = 0.013) for hypertension. Total phthalates and asthma and depression were not significantly associated. CONCLUSION A positive association between total phthalates and cardiovascular disease, type-2-diabetes, hypertension and increased levels of chronic low-grade inflammatory biomarkers was observed in urban-dwelling Australian men.
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Affiliation(s)
- Peter Y Bai
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Australia
| | - Anne W Taylor
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Australia
| | - Sean A Martin
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Australia
| | - Robert W Milne
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Alicia J Jenkins
- NHMRC Clinical Trials Centre, Faculty of Medicine, University of Sydney, Australia
| | | | - Zumin Shi
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Australia.
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Shi Z, Zhen S, Qi L, Zhou Y, Taylor AW. Association between rice intake and all-cause mortality among Chinese adults: findings from the Jiangsu Nutrition Study. Asia Pac J Clin Nutr 2017; 26:1152-1157. [PMID: 28917243 DOI: 10.6133/apjcn.012017.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES The few studies that have assessed the association between rice intake and mortality have generated inconsistent results. We assessed whether rice intake was associated with cardiovascular disease (CVD) mortality, cancer mortality and all-cause mortality in a prospective cohort of the Chinese population. METHODS AND STUDY DESIGN We prospectively studied 2,832 adults aged 20 years and above with a mean follow up of 10 years. Rice intake was measured by a 3-day weighed food record (WFR) in 2002. Hazard ratios (HRs) and 95% CI were calculated by competing risks regression (CVD and cancer mortality) and Cox proportional hazards analysis (all-cause mortality). RESULTS We documented 184 deaths (including 70 CVD deaths and 63 cancer deaths) during 27,742 person-years of follow-up. No association between rice intake and all-cause mortality was found. After adjusting for sociodemographic and lifestyle factors as well as energy and fat intake, HRs for CVD mortality across tertiles of rice intake were 1.00,0.47 (95% CI 0.25-0.87), and 0.49 (95% CI 0.21-1.13) (p for trend 0.049). CONCLUSIONS There was no association between rice intake and all-cause mortality.
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Affiliation(s)
- Zumin Shi
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.,Discipline of Medicine, University of Adelaide, Adelaide, Australia.
| | - Shiqi Zhen
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Lu Qi
- School of Public Health and Tropical Medicine, Tulane University, USA
| | - Yijing Zhou
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Anne W Taylor
- Discipline of Medicine, University of Adelaide, Adelaide, Australia
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Carroll SJ, Niyonsenga T, Coffee NT, Taylor AW, Daniel M. Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin? Int J Environ Res Public Health 2017; 14:ijerph14090953. [PMID: 28832552 PMCID: PMC5615490 DOI: 10.3390/ijerph14090953] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/15/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.
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Affiliation(s)
- Suzanne J Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Theo Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Neil T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Anne W Taylor
- Discipline of Medicine, University of Adelaide, North Terrace, Adelaide 5005, Australia.
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Parkville, Melbourne 3010, Australia.
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Shi Z, Atlantis E, Taylor AW, Gill TK, Price K, Appleton S, Wong ML, Licinio J. SSRI antidepressant use potentiates weight gain in the context of unhealthy lifestyles: results from a 4-year Australian follow-up study. BMJ Open 2017; 7:e016224. [PMID: 28801419 PMCID: PMC5629701 DOI: 10.1136/bmjopen-2017-016224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine the association between antidepressant use and weight gain, as well as the interaction with lifestyle factors. DESIGN Longitudinal study. SETTING AND PARTICIPANTS We used data from 2334 adults from two stages (4.4 years apart) of the North West Adelaide Health Study, including validated diet and lifestyle questionnaires, measured body weight and linked pharmaceutical prescription data. MAIN OUTCOME MEASURES Body weight change. RESULTS 188 (8.1%) participants had a mean annual number of 1-2 antidepressant prescriptions, and 212 (9.1%) had over two prescriptions. The mean annual weight gain was 0.12, 0.18 and 0.28 kg in non-users, low (1-2 prescriptions/year) and high (>2 prescriptions/year) antidepressant users, respectively. In multivariable regression models, antidepressant use was positively associated with weight gain: high antidepressant users gained an extra 0.22 (95% CI 0.00 to 0.44) kg per year. This association was mainly due to selective serotonin reuptake inhibitor (SSRI) use. High SSRI users gained 0.48 (95% CI 0.20 to 0.76) kg more than non-users. There was no association between tricyclic or other antidepressant use and weight gain. The association between SSRI use and weight gain was stronger among those with high intake of Western diet, greater sedentary activity, and who smoked. CONCLUSIONS SSRIs use was associated with weight gain in the presence of unhealthy behaviours including Western diet, sedentarism and smoking.
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Affiliation(s)
- Zumin Shi
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Evan Atlantis
- School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
| | - Anne W Taylor
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia
| | - Sarah Appleton
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Ma-Li Wong
- Mind & Brain Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Julio Licinio
- Mind & Brain Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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Grant JF, Chittleborough CR, Shi Z, Taylor AW. The association between A Body Shape Index and mortality: Results from an Australian cohort. PLoS One 2017; 12:e0181244. [PMID: 28759582 PMCID: PMC5536270 DOI: 10.1371/journal.pone.0181244] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/28/2017] [Indexed: 12/27/2022] Open
Abstract
It is well recognised that obesity increases the risk of premature death. A Body Shape Index (ABSI) is a formula that uses waist circumference (WC), body mass index (BMI) and height to predict risk of premature mortality, where a high score (Quartile 4) indicates that a person's WC is more than expected given their height and weight. Our study examines the association between ABSI quartiles and all-cause-, cardiovascular- and cancer-related mortality, and primary cause of death. Self-reported demographic and biomedically measured health-related risk factor and weight data was from the baseline stage of the North West Adelaide Health Study (1999-2003, n = 4056), a longitudinal cohort of Australian adults. Death-related information was obtained from the National Death Index. Primary cause of death across ABSI quartiles was examined. The association between mortality and ABSI (quartile and continuous scores) was investigated using a Cox proportional hazards survival model and adjusting for socioeconomic, and self-reported and biomedical risk factors. The proportion of all three types of mortality steadily increased from ABSI Quartile 1 through to Quartile 4. After adjusting for demographic and health-related risk factors, the risk of all-cause mortality was higher for people in ABSI Quartile 4 (HR 2.64, 95% CI 01.56-4.47), and ABSI Quartile 3 (HR 1.95, 95% CI 1.15-3.33), with a moderate association for the continuous ABSI score (HR 1.32, 95% CI 1.18-1.48). ABSI is therefore positively associated with mortality in Australian adults. Different combined measures of obesity such as the ABSI are useful in examining mortality risk.
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Affiliation(s)
- Janet F. Grant
- School of Public Health and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Catherine R. Chittleborough
- School of Public Health and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zumin Shi
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Dent E, Dal Grande E, Price K, Taylor AW. Frailty and usage of health care systems: Results from the South Australian Monitoring and Surveillance System (SAMSS). Maturitas 2017; 104:36-43. [PMID: 28923175 DOI: 10.1016/j.maturitas.2017.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/13/2017] [Accepted: 07/12/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Little is known about frailty and its impact on health-care systems. Using large-scale population health surveillance data, this study determined the prevalence of frailty, its associated factors, and the impact it places on health care services. STUDY DESIGN A cross-sectional snapshot of the 2013-2015 South Australian Monitoring and Surveillance System (SAMSS) database was used, focusing on individuals aged ≥65years. Frailty was assessed by the Frailty Index (FI), and classified as robust (scores≤0.1), pre-frail (>0.1 to ≤0.25), and frail (>0.25). RESULTS 7207 people (53.7% female) were included; mean (SD) age was 74.8 (7.17) years. The mean (SD) FI score was 0.23 (0.11), with a 99% upper limit of 0.53. Over a third (36.3% (95% CI 34.8-37.9)) were classified as frail and over half (53.6% (95% CI 52.0-55.1)) as pre-frail. Frailty was less common in rural areas, and was associated with age, lower education level, and higher socioeconomic disadvantage. After adjustment for confounders, multivariable analyses showed a gradient effect by frailty classification with regard to both hospital- and non-hospital-based services. Frail older adults were more likely to present to hospital Emergency Departments (EDs) than their pre-frail or robust counterparts, yet visited the GP at the same rate as older adults with pre-frailty. CONCLUSION Frail older adults were higher users of health care services, with the exception of GPs. Knowledge of the health service usage patterns of frail older adults can be used to direct public health policy and plan future GP provision.
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Affiliation(s)
- Elsa Dent
- Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia; School of Public Health, The University of Adelaide, Adelaide, Australia.
| | | | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia.
| | - Anne W Taylor
- School of Medicine, The University of Adelaide, Adelaide, Australia.
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Reynolds AC, Appleton SL, Gill TK, Taylor AW, McEvoy RD, Ferguson SA, Adams RJ. Sickness absenteeism is associated with sleep problems independent of sleep disorders: results of the 2016 Sleep Health Foundation national survey. Sleep Health 2017; 3:357-361. [PMID: 28923192 DOI: 10.1016/j.sleh.2017.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/24/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Sleep disorders are associated with sickness absenteeism (SA), at significant economic cost. Correlates of absenteeism are less well described in nonclinical samples. PARTICIPANTS AND METHODS We determined the relationship between markers of inadequate sleep and SA in a sample of 551 working adults aged ≥18 years across Australia. We considered diagnosed obstructive sleep apnea (OSA) and insomnia symptoms, daytime symptoms, and sleepiness with respect to sickness absenteeism (missing ≥1 day of work in the past 28 days because of problems with physical or mental health). RESULTS Sickness absenteeism was reported by 27.0% of participants and was more frequent in younger participants, university graduates, and those experiencing financial stress. Sickness absenteeism was independently associated with insomnia (odds ratio [OR]=2.5, confidence interval [CI]=1.5-4.0], OSA (OR=9.8, CI=4.7-20.7), sleep aid use (OR=3.0, CI=1.9-4.7), and daytime symptoms (OR=3.0, CI=2.0-4.6) and inversely associated with perception of getting adequate sleep (OR=0.6, CI=0.4-0.9). Associations persisted in the population free of insomnia and/or OSA. CONCLUSIONS In adults without clinical sleep disorders, sleep behaviors are contributing to sickness absenteeism. An increased focus at an organizational level on improvement of sleep hygiene is important to reduce lost work performance.
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Affiliation(s)
- Amy C Reynolds
- The Appleton Institute, CQUniversity Australia, 44 Greenhill Rd, Wayville SA 5034, South Australia, Australia.
| | - Sarah L Appleton
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Rd, Woodville, SA 5011, Australia; Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, North Terrace SA 5000, Australia
| | - Tiffany K Gill
- Population Research & Outcome Studies, Discipline of Medicine, University of Adelaide, Adelaide, SAHMRI, North Terrace SA 5000, Australia
| | - Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, University of Adelaide, Adelaide, SAHMRI, North Terrace SA 5000, Australia
| | - R Douglas McEvoy
- Adelaide Institute for Sleep Health, A Flinders Centre of Excellence, Flinders University, Repatriation General Hospital, Daw Park, SA 5041, Australia; Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Repatriation General Hospital, Daw Park, SA 5041, Australia
| | - Sally A Ferguson
- The Appleton Institute, CQUniversity Australia, 44 Greenhill Rd, Wayville SA 5034, South Australia, Australia
| | - Robert J Adams
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Rd, Woodville, SA 5011, Australia
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Taylor AW, Kelly G, Dal Grande E, Kelly D, Marin T, Hey N, Burke KJ, Licinio J. Population levels of wellbeing and the association with social capital. BMC Psychol 2017; 5:23. [PMID: 28673334 PMCID: PMC5496434 DOI: 10.1186/s40359-017-0193-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/22/2017] [Indexed: 11/23/2022] Open
Abstract
Background This research investigates wellbeing at the population level across demographic, social and health indicators and assesses the association between wellbeing and social capital. Method Data from a South Australian monthly chronic disease/risk factor surveillance system of randomly selected adults (mean age 48.7 years; range 16–99) from 2014/5 (n = 5551) were used. Univariable analyses compared wellbeing/social capital indicators, socio-demographic, risk factors and chronic conditions. Multi-nominal logistic regression modelling, adjusting for multiple covariates was used to simultaneously estimate odds ratios for good wellbeing (reference category) versus neither good nor poor, and good wellbeing versus poor wellbeing. Results 48.6% were male, mean age 48.7 (sd 18.3), 54.3% scored well on all four of the wellbeing indicators, and positive social capital indicators ranged from 93.1% for safety to 50.8% for control over decisions. The higher level of social capital corresponded with the good wellbeing category. Modeling showed higher odds ratios for all social capital variables for the lowest level of wellbeing. These higher odds ratios remained after adjusting for confounders. Conclusions The relationship between wellbeing, resilience and social capital highlights areas for increased policy focus.
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Affiliation(s)
- A W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
| | - G Kelly
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - E Dal Grande
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - D Kelly
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - T Marin
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - N Hey
- What Works Centre for Wellbeing, London, UK
| | - K J Burke
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,CQUniversity, Appleton Institute, School of Human, Health & Social Sciences, Wayville, South Australia, Australia
| | - J Licinio
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
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Arriaga ME, Vajdic CM, Canfell K, MacInnis R, Hull P, Magliano DJ, Banks E, Giles GG, Cumming RG, Byles JE, Taylor AW, Shaw JE, Price K, Hirani V, Mitchell P, Adelstein BA, Laaksonen MA. The burden of cancer attributable to modifiable risk factors: the Australian cancer-PAF cohort consortium. BMJ Open 2017; 7:e016178. [PMID: 28615275 PMCID: PMC5726120 DOI: 10.1136/bmjopen-2017-016178] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/28/2017] [Accepted: 04/11/2017] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To estimate the Australian cancer burden attributable to lifestyle-related risk factors and their combinations using a novel population attributable fraction (PAF) method that accounts for competing risk of death, risk factor interdependence and statistical uncertainty. PARTICIPANTS 365 173 adults from seven Australian cohort studies. We linked pooled harmonised individual participant cohort data with population-based cancer and death registries to estimate exposure-cancer and exposure-death associations. Current Australian exposure prevalence was estimated from representative external sources. To illustrate the utility of the new PAF method, we calculated fractions of cancers causally related to body fatness or both tobacco and alcohol consumption avoidable in the next 10 years by risk factor modifications, comparing them with fractions produced by traditional PAF methods. FINDINGS TO DATE Over 10 years of follow-up, we observed 27 483 incident cancers and 22 078 deaths. Of cancers related to body fatness (n=9258), 13% (95% CI 11% to 16%) could be avoided if those currently overweight or obese had body mass index of 18.5-24.9 kg/m2. Of cancers causally related to both tobacco and alcohol (n=4283), current or former smoking explains 13% (11% to 16%) and consuming more than two alcoholic drinks per day explains 6% (5% to 8%). The two factors combined explain 16% (13% to 19%): 26% (21% to 30%) in men and 8% (4% to 11%) in women. Corresponding estimates using the traditional PAF method were 20%, 31% and 10%. Our PAF estimates translate to 74 000 avoidable body fatness-related cancers and 40 000 avoidable tobacco- and alcohol-related cancers in Australia over the next 10 years (2017-2026). Traditional PAF methods not accounting for competing risk of death and interdependence of risk factors may overestimate PAFs and avoidable cancers. FUTURE PLANS We will rank the most important causal factors and their combinations for a spectrum of cancers and inform cancer control activities.
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Affiliation(s)
- Maria E Arriaga
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Robert MacInnis
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - Peter Hull
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Dianna J Magliano
- Diabetes and Population Health Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Julie E Byles
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, Australia
| | - Anne W Taylor
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Jonathan E Shaw
- Clinical Diabetes Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, Sydney, Australia
- School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | | | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
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On ZX, Grant J, Shi Z, Taylor AW, Wittert GA, Tully PJ, Hayley AC, Martin S. The association between gastroesophageal reflux disease with sleep quality, depression, and anxiety in a cohort study of Australian men. J Gastroenterol Hepatol 2017; 32:1170-1177. [PMID: 27862259 DOI: 10.1111/jgh.13650] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 08/01/2016] [Accepted: 11/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Previous clinical studies have demonstrated a relationship between gastroesophageal reflux disease (GERD) with anxiety and depression; however, few population-based studies have controlled for sleep disorders. The current study aimed to assess the relationship between GERD and anxiety, depression, and sleep disorders in a community-based sample of Australian men. METHODS Participants comprised a subset of 1612 men (mean age: 60.7 years, range: 35-80) who participated in the Men Androgen Inflammation Lifestyle Environment and Stress Study during the years 2001-2012, who had complete GERD measures (Gastresophageal Reflux Disease Questionnaire), and were not taking medications known to impact gastrointestinal function (excluding drugs taken for acid-related disorders). Current depression and anxiety were defined by (i) physician diagnosis, (ii) symptoms of depression (Beck Depression Inventory and Centre for Epidemiological Studies Depression Scale) or anxiety (Generalized Anxiety Disorder-7), and/or current depressive or anxiolytic medication use. Previous depression was indicated by past depressive diagnoses/medication use. Data on sleep quality, daytime sleepiness, and obstructive sleep apnea were collected along with several health, lifestyle, and medical factors, and these were systematically evaluated in both univariate and multivariable analyses. RESULTS Overall, 13.7% (n = 221) men had clinically significant GERD symptoms. In the adjusted models, an association between GERD and anxiety (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.0-6.8) and poor sleep quality (OR 1.8; 95% CI 1.2-2.9) was observed; however, no effect was observed for current depression (OR 1.5; 95% CI 0.8-2.7). After removing poor sleep quality from the model, an independent association between current depression (OR 2.6; 95% CI 1.7-3.8) and current anxiety (OR 3.2; 95% CI 1.8-6.0) and GERD was observed, but not for previous depression (OR 1.4; 95% CI 0.7-2.8). CONCLUSION In this sample of urban-dwelling men, we observed a strong independent association between GERD, anxiety, and current depression, the latter appearing to be partly mediated by poor sleep quality. Patients presenting with GERD should have concurrent mental health assessments in order to identify potential confounders to the successful management of their symptoms.
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Affiliation(s)
- Zhi Xiang On
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Population Research and Outcome Studies, The University of Adelaide, Adelaide, South Australia, Australia
| | - Janet Grant
- Population Research and Outcome Studies, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zumin Shi
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Population Research and Outcome Studies, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Population Research and Outcome Studies, The University of Adelaide, Adelaide, South Australia, Australia
| | - Gary A Wittert
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Phillip J Tully
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Amie C Hayley
- IMPACT SRC, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Sean Martin
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Shi Z, Zhen S, Orsini N, Zhou Y, Zhou Y, Liu J, Taylor AW. Association between dietary lead intake and 10-year mortality among Chinese adults. Environ Sci Pollut Res Int 2017; 24:12273-12280. [PMID: 28357790 DOI: 10.1007/s11356-017-8871-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 03/20/2017] [Indexed: 06/06/2023]
Abstract
Blood lead level is associated with increased risk of mortality, but dietary lead exposure and mortality, particularly with cancer, has not been studied in the general population. The objective of the study was to assess the association between lead intake and 10-year mortality among 2832 Chinese adults. Food intake was measured by 3-day weighed food record in 2002. We documented 184 deaths (63 cancer deaths and 70 cardiovascular disease (CVD) deaths) during 27,742 person-years of follow-up. Dietary lead intake was positively associated with cancer and all-cause mortality. Across quartiles of lead intake, hazard ratios (HRs) for cancer mortality were 1.00, 0.80 (0.33-1.92), 1.52 (0.65-3.56), and 3.00 (1.06-8.44) (p for trend 0.028). HRs for all-cause mortality were 1.00, 1.28 (0.83-1.98), 1.24 (0.78-1.97), and 2.24 (1.28-3.94) (p for trend 0.011). Each 30 μg/day increase of lead intake was associated with 25% (95% CI 3-52%) increase of all-cause mortality. There was an interaction between lead intake and hypertension in relation to CVD mortality (p for interaction 0.003): HRs conferred by every 30 μg/day of lead intake were 1.57 (0.98-2.52) and 1.06 (0.81-1.39) among those with or without hypertension. Dietary lead intake was positively related to cancer and all-cause mortality.
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Affiliation(s)
- Zumin Shi
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.
- Discipline of Medicine, University of Adelaide, L7 SAHMRI, North Terrace, Adelaide, 5000, Australia.
- Discipline of Medicine, University of Adelaide, 122 Frome Street, Adelaide, 5005, Australia.
| | - Shiqi Zhen
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Nicola Orsini
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yonglin Zhou
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Yijing Zhou
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Anne W Taylor
- Discipline of Medicine, University of Adelaide, L7 SAHMRI, North Terrace, Adelaide, 5000, Australia
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Li JJ, Appleton SL, Gill TK, Vakulin A, Wittert GA, Antic NA, Taylor AW, Adams RJ, Hill CL. Association of Musculoskeletal Joint Pain With Obstructive Sleep Apnea, Daytime Sleepiness, and Poor Sleep Quality in Men. Arthritis Care Res (Hoboken) 2017; 69:742-747. [DOI: 10.1002/acr.22994] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 06/22/2016] [Accepted: 07/12/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Joule J. Li
- University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia, Australia, and the Freemasons Foundation Centre for Men's Health, University of Adelaide; Adelaide South Australia Australia
| | - Sarah L. Appleton
- University of Adelaide, Queen Elizabeth Hospital; Woodville South Australia Australia
| | - Tiffany K. Gill
- School of Medicine, University of Adelaide; Adelaide South Australia Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, South Australia, Australia, and the National Health and Medical Research Council, Centres of Research Excellence, CIRUS and NeuroSleep Clinic, University of Sydney; Sydney New South Wales Australia
| | - Gary A. Wittert
- Freemasons Foundation Centre for Men's Health, University of Adelaide; Adelaide South Australia Australia
| | - Nick A. Antic
- Adelaide Institute for Sleep Health, Flinders University; Bedford Park South Australia Australia
| | - Anne W. Taylor
- University of Adelaide; Adelaide South Australia Australia
| | - Robert J. Adams
- University of Adelaide, Queen Elizabeth Hospital; Woodville South Australia Australia
| | - Catherine L. Hill
- University of Adelaide, Queen Elizabeth Hospital; Woodville South Australia Australia
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Lang CJ, Appleton SL, Vakulin A, McEvoy RD, Vincent AD, Wittert GA, Martin SA, Grant JF, Taylor AW, Antic N, Catcheside PG, Adams RJ. Associations of Undiagnosed Obstructive Sleep Apnea and Excessive Daytime Sleepiness With Depression: An Australian Population Study. J Clin Sleep Med 2017; 13:575-582. [PMID: 28095971 DOI: 10.5664/jcsm.6546] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/27/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To determine whether undiagnosed obstructive sleep apnea (OSA) and/or excessive daytime sleepiness are associated with symptomatic depression in Australian men. METHODS Participants were randomly selected, urban community dwelling men aged 40 to 88 years without a prior diagnosis of OSA. Clinically significant depressive symptoms were assessed using the Beck Depression Inventory-1A or Centre for Epidemiological Studies Depression Scale (2007-2010). A random sample of men (n = 788) undertook full at-home unattended polysomnography (Embletta X100, Broomfield, Colorado, United States) and completed the Epworth Sleepiness Scale questionnaire (2010-2012). RESULTS Undiagnosed severe obstructive sleep apnea (apnea-hypopnea index ≥ 30 events/h) was associated with depressive symptoms (adjusted odds ratio = 1.98; 95% confidence interval [CI] 1.05-3.73; P = .036). However, a significant interaction was observed between obstructive sleep apnea and excessive daytime sleepiness (P = .03) such that individuals with OSA and excessive daytime sleepiness (Epworth Sleepiness Scale score of 10 or higher) exhibited the strongest associations with depression (mild-moderate apnea: adjusted odd ratio = 3.86; 95% CI 1.87-7.95; severe apnea: adjusted odd ratio = 4.82; 95% CI 1.42-16.35) when compared to individuals without apnea. CONCLUSIONS Depressive symptoms in men were associated with undiagnosed OSA in the community. It is important that clinicians and primary care practitioners consider screening for depression in men with severe OSA and for OSA in men with depression. Screening for depression should also be considered in men with excessive daytime sleepiness regardless of OSA severity.
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Affiliation(s)
- Carol J Lang
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Sarah L Appleton
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Andrew Vakulin
- Adelaide Institute of Sleep Health, Flinders University of South Australia, c/o Repatriation General Hospital, Daw Park, South Australia, Australia.,NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Central Clinical School, University of Sydney, New South Wales, Australia
| | - R Doug McEvoy
- Adelaide Institute of Sleep Health, Flinders University of South Australia, c/o Repatriation General Hospital, Daw Park, South Australia, Australia.,School of Medicine, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Andrew D Vincent
- Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Gary A Wittert
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.,Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Sean A Martin
- Freemason's Centre for Men's Health, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Janet F Grant
- Population Research and Outcomes Studies, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Population Research and Outcomes Studies, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicholas Antic
- Adelaide Institute of Sleep Health, Flinders University of South Australia, c/o Repatriation General Hospital, Daw Park, South Australia, Australia.,School of Medicine, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Peter G Catcheside
- Adelaide Institute of Sleep Health, Flinders University of South Australia, c/o Repatriation General Hospital, Daw Park, South Australia, Australia.,School of Medicine, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Robert J Adams
- The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia
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Cao Y, Taylor AW, Zhen S, Adams R, Appleton S, Shi Z. Soy Isoflavone Intake and Sleep Parameters over 5 Years among Chinese Adults: Longitudinal Analysis from the Jiangsu Nutrition Study. J Acad Nutr Diet 2017; 117:536-544.e2. [PMID: 27956174 DOI: 10.1016/j.jand.2016.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Soy isoflavone is beneficial for menopausal/postmenopausal symptoms, including sleep complaints. However, little is known about its longitudinal association with sleep in the general population. OBJECTIVE Our aim was to investigate the association between soy isoflavone intake and sleep duration and daytime falling asleep among Chinese adults. DESIGN A longitudinal analysis was performed. Soy isoflavone intake was assessed by food frequency questionnaire. Sleep duration was self-reported at two time points. Occurrence of daytime falling asleep was determined at follow-up. Short and long sleep were defined as sleep <7 h/day or ≥9 h/day, respectively. PARTICIPANTS/SETTING Adults aged 20 years and older from the Jiangsu Nutrition Study (2002-2007) with complete isoflavone intake and sleep duration data at both time points (n=1,474) were analyzed (follow-up, n=1,492). MAIN OUTCOME MEASURES We measured sleep duration in 2002 and 2007 and daytime falling asleep occurrence in 2007. STATISTICAL ANALYSES PERFORMED Mixed-effects logistic regression was performed for repeated measures between isoflavone intake and sleep duration. Logistic regression was performed for daytime falling asleep at follow-up. Demographic, anthropometric, and social factors were adjusted in the analyses. RESULTS The prevalence of long sleep duration was 18.9% in 2002 and 12.6% in 2007, and the prevalence of daytime falling asleep was 5.3%. Compared with the lowest quartile of isoflavone intake, the highest quartile was associated with a lower risk of long sleep duration (odds ratio=0.66; 95% CI 0.48 to 0.90; P for trend=0.018) over 5 years. Compared with persistent low intake of isoflavone (less than median intake of isoflavone at two time points), persistent high intake was associated with a reduced risk of daytime falling asleep in women (odds ratio=0.20; 95% CI 0.06 to 0.68), but not men. No consistent association between soy isoflavone intake and short sleep duration was found. CONCLUSIONS Soy isoflavone intake was associated with a low risk of long sleep duration in both sexes and a low risk of daytime falling asleep in women but not men.
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Stockley C, Taylor AW, Montgomerie A, Dal Grande E. Changes in wine consumption are influenced most by health: results from a population survey of South Australians in 2013. IJWR 2017. [DOI: 10.2147/ijwr.s126417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gill TK, Menz HB, Landorf KB, Arnold JB, Taylor AW, Hill CL. Identification of Clusters of Foot Pain Location in a Community Sample. Arthritis Care Res (Hoboken) 2017; 69:1903-1908. [PMID: 28229556 DOI: 10.1002/acr.23212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/24/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify foot pain clusters according to pain location in a community-based sample of the general population. METHODS This study analyzed data from the North West Adelaide Health Study. Data were obtained between 2004 and 2006, using computer-assisted telephone interviewing, clinical assessment, and self-completed questionnaire. The location of foot pain was assessed using a diagram during the clinical assessment. Hierarchical cluster analysis was undertaken to identify foot pain location clusters, which were then compared in relation to demographics, comorbidities, and podiatry services utilization. RESULTS There were 558 participants with foot pain (mean age 54.4 years, 57.5% female). Five clusters were identified: 1 with predominantly arch and ball pain (26.8%), 1 with rearfoot pain (20.9%), 1 with heel pain (13.3%), and 2 with predominantly forefoot, toe, and nail pain (28.3% and 10.7%). Each cluster was distinct in age, sex, and comorbidity profile. Of the two clusters with predominantly forefoot, toe, and nail pain, one of them had a higher proportion of men and those classified as obese, had diabetes mellitus, and used podiatry services (30%), while the other was comprised of a higher proportion of women who were overweight and reported less use of podiatry services (17.5%). CONCLUSION Five clusters of foot pain according to pain location were identified, all with distinct age, sex, and comorbidity profiles. These findings may assist in the identification of individuals at risk for developing foot pain and in the development of targeted preventive strategies and treatments.
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Affiliation(s)
- Tiffany K Gill
- University of Adelaide, Adelaide, South Australia, Australia
| | | | - Karl B Landorf
- La Trobe University, Bundoora, Victoria, Australia, and Melbourne Health, Parkville, Victoria, Australia
| | - John B Arnold
- University of South Australia, Adelaide, South Australia, Australia
| | - Anne W Taylor
- University of Adelaide, Adelaide, South Australia, Australia
| | - Catherine L Hill
- The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Carroll SJ, Paquet C, Howard NJ, Coffee NT, Adams RJ, Taylor AW, Niyonsenga T, Daniel M. Local descriptive body weight and dietary norms, food availability, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort. BMC Public Health 2017; 17:149. [PMID: 28148239 PMCID: PMC5289014 DOI: 10.1186/s12889-017-4068-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/24/2017] [Indexed: 02/04/2023] Open
Abstract
Background Individual-level health outcomes are shaped by environmental risk conditions. Norms figure prominently in socio-behavioural theories yet spatial variations in health-related norms have rarely been investigated as environmental risk conditions. This study assessed: 1) the contributions of local descriptive norms for overweight/obesity and dietary behaviour to 10-year change in glycosylated haemoglobin (HbA1c), accounting for food resource availability; and 2) whether associations between local descriptive norms and HbA1c were moderated by food resource availability. Methods HbA1c, representing cardiometabolic risk, was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Residential environmental exposures were defined using 1600 m participant-centred road-network buffers. Local descriptive norms for overweight/obesity and insufficient fruit intake (proportion of residents with BMI ≥ 25 kg/m2 [n = 1890] or fruit intake of <2 serves/day [n = 1945], respectively) were aggregated from responses to a separate geocoded population survey. Fast-food and healthful food resource availability (counts) were extracted from a retail database. Separate sets of multilevel models included different predictors, one local descriptive norm and either fast-food or healthful food resource availability, with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and food resource availability were tested. Results HbA1c concentration rose over time. Local descriptive norms for overweight/obesity and insufficient fruit intake predicted greater rates of increase in HbA1c. Neither fast-food nor healthful food resource availability were associated with change in HbA1c. Greater healthful food resource availability reduced the rate of increase in HbA1c concentration attributed to the overweight/obesity norm. Conclusions Local descriptive health-related norms, not food resource availability, predicted 10-year change in HbA1c. Null findings for food resource availability may reflect a sufficiency or minimum threshold level of resources such that availability poses no barrier to obtaining healthful or unhealthful foods for this region. However, the influence of local descriptive norms varied according to food resource availability in effects on HbA1c. Local descriptive health-related norms have received little attention thus far but are important influences on individual cardiometabolic risk. Further research is needed to explore how local descriptive norms contribute to chronic disease risk and outcomes.
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Affiliation(s)
- Suzanne J Carroll
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Catherine Paquet
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia.,Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada
| | - Natasha J Howard
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Neil T Coffee
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Robert J Adams
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Theo Niyonsenga
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Mark Daniel
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia, 5001, Australia.,Department of Medicine, The University of Melbourne, St. Vincent's Hospital, Melbourne, VIC, Australia.,South Australian Health & Medical Research Institute, Adelaide, South Australia, Australia
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Adams RJ, Appleton SL, Taylor AW, Gill TK, Lang C, McEvoy RD, Antic NA. Sleep health of Australian adults in 2016: results of the 2016 Sleep Health Foundation national survey. Sleep Health 2017; 3:35-42. [DOI: 10.1016/j.sleh.2016.11.005] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/06/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
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