Arthur Eumann Mesas

The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis

BACKGROUND The effect of coffee and caffeine on blood pressure (BP) and cardiovascular disease (CVD) in hypertensive persons is uncertain. OBJECTIVE The objective was to summarize the evidence on the acute and longer-term effects of caffeine and coffee intake on BP and on the association between habitual coffee consumption and risk of CVD in hypertensive individuals. DESIGN A systematic review and meta-analysis of publications identified in a PubMed and EMBASE search up to 30 April 2011 was undertaken. Data were extracted from controlled trials on the effect of caffeine or coffee intake on BP change and from cohort studies on the association between habitual coffee consumption and CVD. RESULTS In 5 trials, the administration of 200-300 mg caffeine produced a mean increase of 8.1 mm Hg (95% CI: 5.7, 10.6 mm Hg) in systolic BP and of 5.7 mm Hg (95% CI: 4.1, 7.4 mm Hg) in diastolic BP. The increase in BP was observed in the first hour after caffeine intake and lasted ≥3 h. In 3 studies of the longer-term effect (2 wk) of coffee, no increase in BP was observed after coffee was compared with a caffeine-free diet or was compared with decaffeinated coffee. Last, 7 cohort studies found no evidence of an association between habitual coffee consumption and a higher risk of CVD. CONCLUSIONS In hypertensive individuals, caffeine intake produces an acute increase in BP for ≥3 h. However, current evidence does not support an association between longer-term coffee consumption and increased BP or between habitual coffee consumption and an increased risk of CVD in hypertensive subjects.

Selected eating behaviours and excess body weight: a systematic review.

The relationship between obesity and the intake of macronutrients and specific foods is uncertain. Thus, there is growing interest in some eating behaviours because they may reflect the joint effect of several foods and nutrients and, thus, increase the likelihood of finding a link to obesity. This study examined the association between selected eating behaviours and excess weight in the general population throughout a systematic review of publications written in English, Spanish or Portuguese identified in a PubMed search up to 31 December 2010. We included 153 articles, 73 of which have been published since 2008. Only 30 studies had a prospective design; of these, 15 adjusted for sociodemographic variables, physical activity and energy or food intake. Moreover, definitions of eating behaviours varied substantially across studies. We found only small or inconsistent evidence of a relationship between excess weight and skipping breakfast, daily eating frequency, snacking, irregular meals, eating away from home, consumption of fast food, takeaway food intake, consumption of large food portions, eating until full and eating quickly. In conclusion, this review highlights the difficulty in measuring human behaviour, and suggests that a more systematic approach is needed for capturing the effects of eating behaviours on body weight.

Sleep Duration and Mortality According to Health Status in Older Adults

OBJECTIVES: To examine the association between usual sleep duration and mortality according to physical and mental health status in older adults.

Condições de saúde bucal de idosos de comunidade urbana de Londrina, Paraná

OBJETIVO: Verificar a condicao dentaria e periodontal, o uso e necessidade de protese, e a presenca de lesoes associadas ao uso de protese em idosos residentes em uma area urbana do municipio de Londrina, Parana. METODO: Estudo transversal, com coleta dos dados por meio de visitas domiciliares que incluiram entrevista e exame odontologico em idosos de 60 a 74 anos e funcionalmente independentes. RESULTADOS: A media de idade dos 267 idosos examinados foi de 66,5 anos, 59,2% nunca estudaram ou tinham escolaridade inferior a 4 anos de estudo e 59,9% eram mulheres. O indice de dentes cariados, perdidos e obturados encontrado foi de 27,9, com maior participacao dos dentes perdidos (85,9%). A media de dentes presentes entre as mulheres (5,7 dentes) foi menor do que entre os homens (11,6 dentes) (p<0,01). O edentulismo foi detectado em 43,1% dos idosos, e a presenca de 20 dentes naturais ou mais em 8,8% das mulheres e 28% dos homens (p<0,01). Dos 408 sextantes que possibilitaram avaliacao periodontal, 49,2% apresentavam bolsa periodontal. A necessidade de protese foi de 45,7% na arcada inferior e 19,1% na superior, com maior frequencia no sexo masculino. Dos 204 individuos que usavam protese, 40,7% apresentavam lesoes de mucosa. CONCLUSAO: Os resultados obtidos indicam que os idosos da comunidade avaliada apresentam elevadas prevalencias de problemas bucais, com necessidade de tratamento odontologico, com diferencas entre homens e mulheres, e que ha necessidade de programas de saude bucal que atendam as necessidades especificas da populacao idosa.

Factors associated with negative self‐perception of oral health among elderly people in a Brazilian community

OBJECTIVE Self-perception of oral health is an important measurement for assessing the health and quality of life of elderly people. The aim of this study was to analyse associations between negative self-perception of oral health and poor oral state, socio-demographic variables, depression and use of medications. METHOD In this cross-sectional study, elderly people aged 60 to 74 years living in the urban zone of a city in southern Brazil were interviewed and examined. Functionally dependent individuals were excluded. Self-perception was measured using the General Oral Health Assessment Index, and scores of 30 points or less were considered to represent negative perception. The physical, social and worry dimensions of this indicator were also analysed. RESULTS Two hundred and sixty-seven elderly people (mean age 66.5 years, 59.9% female) were included in the study. Most of them had had little schooling. Negative self-perception was identified in 18.7%, although none of the poor oral state was associated with this variable. In multivariate analysis, negative self-perception was associated with female gender and depression. The women presented significantly lower means in the three dimensions analysed and individuals with depression, in the physical and social dimensions. Poor oral health (edentulism and absence of posterior occlusion) were associated with the physical dimension. CONCLUSION Negative self-perception of oral health was associated with gender and depression, but not with poor oral health. Therefore, gender and the presence of depression are factors to be taken into account in assessments involving this age group.

Self‐reported sleep duration and falls in older adults

Whether the association between sleep duration and accidental falls is independent of sleep quality is uncertain. It is also unclear if this association varies with age and sex among older adults. Data were collected through telephone interviews of 1542 community‐dwelling individuals aged ≥68 years in Spain. Analyses were performed with logistic regression and adjusted for the main confounders, including lifestyle, health status, comorbidity and sleep quality, as measured by nighttime and daytime sleep complaints. Analyses were also stratified by age and sex. In total, 449 (29.1%) participants fell in the previous year; of these, 57.7% had one fall and 42.3% had recurrent (≥2) falls. As compared with those who usually slept 7–8 h, those sleeping ≥11 h were more likely to suffer recurrent falls [odds ratios (OR) 2.75; 95% confidence intervals (CI) 1.32–5.62]. In the stratified analysis, there was no association between sleep duration and falls in those aged ≤75 years and in men. In contrast, among those aged >75 years, the percentage of individuals with ≥1 falls was higher in those sleeping ≤5 h (OR 2.15; 95% CI 1.20–3.87) and ≥11 h (OR 2.34; 95% CI 1.17–4.68) than in those sleeping 7–8 h; also, women who slept ≥11 h were more likely to fall ≥1 times (OR 3.89; 95% CI 1.74–8.69). In conclusion, long sleep duration was associated with higher frequency of falls in older adults, even after adjustment for a wide range of sleep quality indicators. The association is clearer in women and the oldest adults. Assessment of sleep duration can help identify older adults who might benefit from interventions aimed at fall prevention.

Psychoactive Substance Use by Truck Drivers: A Systematic Review

The aim of this study was to summarise the scientific evidence on the prevalence of psychoactive substance use and on the factors associated with their intake among truck drivers. A systematic review was performed in the databases PubMed, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, and Cochrane and 36 cross-sectional studies were identified with quantitative results about the use of psychoactive substances by truck drivers. Out of these, 28 were carried out in countries with large land areas and 23 obtained their information through self-reporting. The most frequently studied substances were alcohol (n=25), amphetamines (n=17), marijuana (n=16) and cocaine (n=13). The prevalence of the use of these substances greatly varied: alcohol (0.1–91.0%); amphetamines (0.2–82.5%), marijuana (0.2–29.9%), cocaine (0.1–8.3%). The frequency of substance use was lower in studies that investigated the presence of these substances in biological samples than in those based on self-reported use. In 12 studies that evaluated factors associated with the intake of psychoactive substances, the following stood out: younger age, higher income, longer trips, alcohol consumption, driving in the night shift, travelling interstate routes, long or short sleep, fewer hours of rest, little experience of the driver, connection with small and medium sized companies, income below levels determined by labour agreements, productivity-based earnings and prior involvement in accidents. The frequency of psychoactive substance use by truck drivers seems to be high, although that greatly varies according to the type of substance and the method of collecting the information. The use of these substances was mainly associated with indicators of poor working conditions.

Lead Exposure and Oxidative Stress: A Systematic Review

Lead is an environmental toxicant that can induce oxidative stress (OS) via reactive oxygen species (ROS) generation, which has been reported as an important mechanism underlying lead toxicity (Gurer and Ercal 2000; Pande and Flora 2002; Kasperczyk et al. 2004a; Farmand et al. 2005; Verstraeten et al. 2008; Wang et al. 2009; Martinez-Haro et al. 2011). OS occurs when the generation of ROS exceeds the antioxidant systems ability to defend cells against oxidized molecules. ROS is a term generally used to refer to free radicals derived from O2 (e.g., superoxide anions [O2-] and hydroxyl radicals [OH-]) or to non-radical species (e.g. hydrogen peroxide [H2O2]) (Halliwell and Cross 1994).

Obesity-Related Eating Behaviors Are Associated with Low Physical Activity and Poor Diet Quality in Spain

This study examined the association of obesity-related eating behaviors (OREB) with physical activity, sedentariness, and diet quality. Data were taken from a cross-sectional study in 10,791 persons representative of the Spanish population who were ≥18 y of age in 2008-2010. The following self-reported information was collected on 12 OREB: not planning how much to eat before sitting down, not deciding the amount of food on the plate, skipping breakfast, eating precooked/canned food or snacks bought at vending machines or at fast-food restaurants, not choosing low-energy foods, not removing visible fat from meat or skin from chicken, eating while watching television or seated on a sofa or an armchair, and taking a short time for meals. Analyses were performed with linear or logistic regression, as appropriate, and adjusted for the main confounders. In comparison to participants with ≤1 OREB, those with ≥5 OREB performed less physical activity [β: -2.61 (95% CI: -4.44, -0.78); P-trend < 0.001] and spent more time watching television [β: 2.17 (95% CI: 1.39, 2.95); P-trend < 0.001]; furthermore, they had greater total energy intake [β: 160 (95% CI: 115, 210); P-trend < 0.001] and were less likely to follow a Mediterranean diet [OR: 0.55 (95% CI: 0.41, 0.73); P-trend < 0.001]. In conclusion, the association between OREB and obesity is biologically plausible because OREB are associated with energy intake and poor accordance with the Mediterranean diet. Studies on the association between OREB and obesity should control for the confounding effect of physical activity and sedentariness.

Sleep quality and the metabolic syndrome: the role of sleep duration and lifestyle.

This study examined the association between sleep quality and the metabolic syndrome and whether if it is independent of sleep duration and if it can be explained by lifestyles linked to sleep quality.