Nane Copin

Assessment of the ecological bias of seven aggregate social deprivation indices

BackgroundIn aggregate studies, ecological indices are used to study the influence of socioeconomic status on health. Their main limitation is ecological bias. This study assesses the misclassification of individual socioeconomic status in seven ecological indices.MethodsIndividual socioeconomic data for a random sample of 10,000 persons came from periodic health examinations conducted in 2006 in 11 French departments. Geographical data came from the 2007 census at the lowest geographical level available in France. The Receiver Operating Characteristics (ROC) curves, the areas under the curves (AUC) for each individual variable, and the distribution of deprived and non-deprived persons in quintiles of each aggregate score were analyzed.ResultsThe aggregate indices studied are quite good “proxies” for individual deprivation (AUC close to 0.7), and they have similar performance. The indices are more efficient at measuring individual income than education or occupational category and are suitable for measuring of deprivation but not affluence.ConclusionsThe study inventoried the aggregate indices available in France and evaluated their assessment of individual SES.

Body Mass Index, Fatty Liver Index and Other Metabolic Disturbances Differentially Affect Albuminuria and Glomerular Filtration Rate in the General Population

Objective: Obesity and diabetes mellitus increase the risk of chronic renal disease. However, whether body mass index (BMI) and metabolic disturbances are associated with renal dysfunction and affect similarly albuminuria and estimated glomerular filtration rate (eGFR) are less clear. Hence, the aim of this study was to describe these associations in the general French population. Methods: We realised a large cross-sectional study of 118,314 subjects aged ≥ 40 years undergoing a medical examination in 11 French regional health centers. Results: Renal dysfunction ((abnormal albuminuria (≥ 30 mg/g) and/or low eGFR ( 40: 7.35 [5.89-9.15]) had a greater risk of abnormal albuminuria than subjects with normal weight. In contrast, the relationship between BMI - or other metabolic disturbances- and low eGFR was continuous. Metabolic disturbances increased the risk of abnormal albuminuria to a greater extent than the risk of abnormal eGFR. High fatty liver index and high calculated risk of developing diabetes were risk factors for both abnormal albuminuria and low eGFR. Conclusion: There is a J-curve relationship between BMI and abnormal albuminuria, in contrast to the continuous association between other metabolic disturbances and abnormal eGFR. All metabolic disturbances are associated with abnormal albuminuria, but the association with abnormal eGFR is less clear, suggesting a stronger relationship with endothelial than renal dysfunction. Abnormal albuminuria and eGFR may precede the onset of diabetes.

Perturbation du métabolisme lipidique chez des travailleurs postés consultants de centres d’examens de santé

AIMS To describe cardiovascular risk factors and metabolic disturbances in a French population including shift workers and study whether possible changes were noticeable after non-shift to shift work transition within the last five years. METHODS The study population included 4764 attendees of two health examinations (5 years apart), between January 1996 and October 2008, in 11 health examination centres. Clinical, biological and metabolic factors together with their changes over a five-year period were compared between attendees who kept a non-shift daytime job, those who kept working shift and those who switched from non-shift daytime to shift work over the last 5 years. RESULTS At baseline, working shift was, independently of lifestyle or BMI, significantly related to more elevated plasma triglycerides (β=0.04, P=0.05) and rate of hypertriglyceridemia (β=0.27, P=0.01), lower plasma HDL-C levels (β=-2.03, P=0.006) and less hypertension (β=-0.25, P=0.01) compared to non-shift daytime work. In men, a slightly more elevated yet non significant proportion of hypertriglyceridemia was observed with the transition from non-shift daytime to shift work within the last 5 years in comparison to men who kept a non-shift daytime job (13.9% vs. 11.0% P=0.17). CONCLUSION Our results are in agreement with previous studies showing a deleterious effect of shift work on lipid metabolism. In our population, triglycerides and HDL-C levels were the main parameters negatively influenced by shift work. Consequently, a regular biological monitoring together with the promotion of healthy behaviours should be provided to shift workers before negative consequences of working shift become noticeable.

Article originalPromouvoir un meilleur comportement nutritionnel chez les travailleurs postés avec horaires de nuitPromote better nutritional behaviours among shift workers with night shift

AIM Shift work, especially including a night shift, is associated with degradation of physical, social and psychosocial health as well as poor well-being. Food imbalance and low physical activity contributed to the negative effects on health. Our objective was to promote a healthier nutritional behaviour according to the French national nutrition and health program recommendations (PNNS). METHODS A one-year nutritional intervention with personalised dietetic counselling was proposed to 235 shift workers with night shift who came for a health prevention exam in one of the centres of the Institut Inter-Régional pour la Santé between 2009 and 2011. The intervention was three dietary interviews: at baseline with definition of goal setting, at 3 months for advice and support and at one-year for the evaluation. At 6 months, a personalised reminder letter was send. Compliance with the PNNS recommendations and level of physical activity were evaluated at baseline and at one-year by a self-administered questionnaire. Changes between baseline and follow-up were compared by paired t-tests or McNemar-tests. RESULTS The rate of follow-up was 57.4%. At the end of the study, subjects improved their compliance with PNNS guidelines concerning sweetened products (P<0.001), water (P=0.02) and salt (P=0.05), increased their leisure physical activity (P=0.001) and decreased their daily energy intakes (P<0.001). CONCLUSION A structured intervention can improve nutritional behaviours of shift workers. This intervention enabled to inform and alert on the risk related to this work schedule and promote better nutritional behaviours.

Promote better nutritional behaviours among shift workers with night shift.

AIM Shift work, especially including a night shift, is associated with degradation of physical, social and psychosocial health as well as poor well-being. Food imbalance and low physical activity contributed to the negative effects on health. Our objective was to promote a healthier nutritional behaviour according to the French national nutrition and health program recommendations (PNNS). METHODS A one-year nutritional intervention with personalised dietetic counselling was proposed to 235 shift workers with night shift who came for a health prevention exam in one of the centres of the Institut Inter-Régional pour la Santé between 2009 and 2011. The intervention was three dietary interviews: at baseline with definition of goal setting, at 3 months for advice and support and at one-year for the evaluation. At 6 months, a personalised reminder letter was send. Compliance with the PNNS recommendations and level of physical activity were evaluated at baseline and at one-year by a self-administered questionnaire. Changes between baseline and follow-up were compared by paired t-tests or McNemar-tests. RESULTS The rate of follow-up was 57.4%. At the end of the study, subjects improved their compliance with PNNS guidelines concerning sweetened products (P<0.001), water (P=0.02) and salt (P=0.05), increased their leisure physical activity (P=0.001) and decreased their daily energy intakes (P<0.001). CONCLUSION A structured intervention can improve nutritional behaviours of shift workers. This intervention enabled to inform and alert on the risk related to this work schedule and promote better nutritional behaviours.

Promouvoir un meilleur comportement nutritionnel chez les travailleurs postés avec horaires de nuit

AIM Shift work, especially including a night shift, is associated with degradation of physical, social and psychosocial health as well as poor well-being. Food imbalance and low physical activity contributed to the negative effects on health. Our objective was to promote a healthier nutritional behaviour according to the French national nutrition and health program recommendations (PNNS). METHODS A one-year nutritional intervention with personalised dietetic counselling was proposed to 235 shift workers with night shift who came for a health prevention exam in one of the centres of the Institut Inter-Régional pour la Santé between 2009 and 2011. The intervention was three dietary interviews: at baseline with definition of goal setting, at 3 months for advice and support and at one-year for the evaluation. At 6 months, a personalised reminder letter was send. Compliance with the PNNS recommendations and level of physical activity were evaluated at baseline and at one-year by a self-administered questionnaire. Changes between baseline and follow-up were compared by paired t-tests or McNemar-tests. RESULTS The rate of follow-up was 57.4%. At the end of the study, subjects improved their compliance with PNNS guidelines concerning sweetened products (P<0.001), water (P=0.02) and salt (P=0.05), increased their leisure physical activity (P=0.001) and decreased their daily energy intakes (P<0.001). CONCLUSION A structured intervention can improve nutritional behaviours of shift workers. This intervention enabled to inform and alert on the risk related to this work schedule and promote better nutritional behaviours.