Emmanouil Smpokos

Prevalence of multiple behavioral risk factors for chronic diseases in adults aged 50+, from eleven European countries - the SHARE study (2004)

OBJECTIVE To estimate the prevalence and the associations between multiple behavioral risk factors (MBRFs) for chronic diseases in European adults. METHOD Data from 26,743 individuals, aged 50+years, participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) (2004/05) were used. MBRFs included physical inactivity, high body weight, smoking habits and risky alcohol consumption. Estimations were based on weights according to the complex sampling design. RESULTS In total, 71.2% of individuals were physically inactive, while 59.8% had high body weight. 53.4% had 2+ MBRFs, while males presented higher prevalence of MBRF clusters than females (P < 0.001). Females displayed lower odds of increased alcohol consumption (OR = 0.16, P < 0.001) and higher odds of physical inactivity (OR = 1.47, P < 0.001) than males. Individuals who lived alone, compared to living with a partner and those with more, compared to fewer education years, exhibited a significantly higher and lower, respectively, mean MBRF score (P < 0.001). CONCLUSION The prevalence of MBRFs was considerably high in this sample of European adults, while not living alone and having higher education may prove protective. These findings could be used for the design of primary healthcare programs by health professionals.

Secular trends in fitness, moderate-to-vigorous physical activity, and TV-viewing among first grade school children of Crete, Greece between 1992/93 and 2006/07.

OBJECTIVES To assess secular changes in physical fitness (PF), moderate-to-vigorous-physical activity (MVPA) and TV-viewing in 1st-grade children from Crete, Greece. DESIGN Cross-sectional cohorts examined in academic years 1992/93 and 2006/07. METHODS Two representative samples of children, aged 5.9-7.8 years, were studied during 1992/93 (N=606) and 2006/07 (N=361). PF (sit-and-reach, standing-broad-jump, sit-ups and 20 m-shuttle-run-test) was assessed by the European-PF test battery and MVPA by a physical activity (PA) questionnaire. Data on the frequency of TV-viewing was also collected. RESULTS Between 1992/93 and 2006/07, there was a significant increase in all fitness tests in both genders (P<0.001) and in MVPA in boys (76.5 min/week vs. 38.7 min/week, P<0.001). Time spent watching TV on weekdays was significantly more in both genders in 2006/07, compared to 1992/93 (P<0.001). In 2006/07, active boys and active girls spent more time in MVPA than active boys and girls in 1992/93 (P<0.001). Significantly higher proportions of boys and girls engaged in vigorous activities in 2006/07, than 1992/93 (P<0.001 and P=0.027, respectively). CONCLUSIONS A significant increase in physical and cardiorespiratory fitness in both genders and MVPA in boys was observed in children from Crete between 1992/93 and 2006/07. The increase in weekday TV-viewing, despite being parallel to an increase in leisure-time MVPA, could have an unfavorable effect on health and should be tackled in future interventions in this population. Dietary, anthropometric and biochemical indices should also be investigated to assess their impact on the secular changes in physical fitness and activity observed in this sample of children.

Secular changes in anthropometric measurements and blood pressure in children of Crete, Greece, during 1992/93 and 2006/07

OBJECTIVES To examine secular changes in anthropometric measurements and blood pressure (BP) in 1st-grade children in Crete, Greece, during 1992/93 and 2006/07. METHODS Children (aged 5.7-7.8 years) from two representative cross-sectional cohorts participated during 1992/93 (n=606) and 2006/07 (n=361). Body weight, body-mass-index (BMI), waist circumference (WC), waist-to-hip (WHpR) and waist-to-height (WHtR) ratios, BP, 20 m-shuttle-run test (20 mSRT), and moderate-to-vigorous-physical-activity (MVPA) were assessed. RESULTS There was a significant increase (P<0.01) in body weight (+10.2% and +6.7%), BMI (+6.9% and +4.0%), WC (+5.6% and +5.1%), WHpR (+3.0% and +3.4%), and WHtR (+4.2% and +3.8%), for boys and girls, respectively, and in the proportion of overweight/obese boys (19.4% vs. 33.7%; P<0.001) between 1992/93 and 2006/07. Both genders had decreased BP measurements in 2006/07 compared to 1992/93 (P<0.001). In both periods, BP was higher in obese compared to overweight and normal children (P<0.001), but there was no relationship between BP and physical activity (PA). CONCLUSIONS A substantial decrease in BP was observed in Cretan children over a 15-year period, despite a concurrent increase in obesity and anthropometric indices. This may be attributed to lifestyle and dietary changes and does not support the hypothesis that the obesity epidemic in children has resulted in proportionate increases in BP levels.

Association of Behavioral Risk Factors for Chronic Diseases With Physical and Mental Health in European Adults Aged 50 Years or Older, 2004–2005

Introduction Noncommunicable diseases are the leading cause of illness and death worldwide; behavioral risk factors (BRFs) contribute to these diseases. We assessed the presence of multiple BRFs among European adults according to their physical and mental health status. Methods We used data from 26,026 adults aged 50 years or older from 11 countries that participated in the Survey of Health, Ageing and Retirement in Europe (2004–2005). BRFs (overweight or obesity, smoking, physical inactivity, and risky alcohol consumption) were assessed according to physical health (ie, presence of chronic diseases, disease symptoms, or limitations in activities of daily living) and mental health (depression) through multiple regression estimations. Results Overweight or obesity in men and physical inactivity in women were the most prevalent BRFs. Compared with physically active adults, physically inactive adults had a higher mean number of chronic diseases (1.33 vs 1.26) and chronic disease symptoms (1.55 vs 1.47). Risky alcohol consumption (≥4 servings of an alcohol beverage ≥3 times a week) was associated with a higher mean depression score (2.84 vs 2.47). Compared with adults with 0 or 1 BRF, adults with 2 or more BRFs had significantly higher odds of having 1 or more chronic diseases (men: 1.52; women: 1.73) and functional limitations (men: 1.65; women: 1.79) and higher prevalence of high blood pressure (37.8% vs 28.2). Belgian adults with BRFs had the highest mean number of chronic diseases or functional limitations among those who were overweight or obese and the highest mean number of chronic diseases and disease symptoms among those who smoked and were physically inactive. Conclusion We found revealed significant positive associations between BRFs and poor health among middle-aged and older European adults. Primary health care intervention programs should focus on developing ways to reduce BRF prevalence in this population.

Relationship of behavioral risk factors for chronic diseases and preventive health services utilization among adults, aged 50+, from eleven European countries

AimThe current study aims to assess the relationship between behavioral risk factors (BRFs) for chronic diseases and preventive health services utilization among European adults.Subjects and MethodsWe used data from 16,125 adults, aged 50+ years, from 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Prevalence of BRFs (high body weight, smoking, physical inactivity and risky alcohol consumption) was examined in relation to preventive health services utilization, which was assessed via a 12-component score (PHSUs) (scale: 0–100). Estimations were based on the complex study design.ResultsOf the participants, 90.7% were seeing a general practitioner (GP) and 52.7% had 2+ BRFs. Adults with high body weight had lower odds of seeing a dentist (0.75, p < 0.05) or having sigmoidoscopy/colonoscopy (0.70, p < 0.05) and higher odds of receiving GP advice to exercise regularly (1.56, p < 0.05). Smokers had lower odds of having mammograms (0.76, p < 0.05), sigmoidoscopy/colonoscopy (0.72, p < 0.05) and being tested for hidden blood in stool (0.63, p < 0.05). Risky drinkers had lower odds of having mammograms (0.23, p < 0.05). Lower mean PHSUs were found for adults with high body weight (p = 0.001), smokers (p = 0.001) and risky drinkers (p = 0.008), while PHSUs did not differ by BRF clusters (p = 0.218). In adults with 2+ BRFs, Greece was the country with the lowest mean PHSUs (28.0, p < 0.05).ConclusionAdults with high body weight, those who smoked and were risky drinkers used fewer preventive health services. Primary prevention programs should be developed to reduce BRF prevalence and promote preventive health services use in this population.