Sabine Brasche

Food and fatty acid intake and atopic disease in adults

The aim of the study was to assess the relationship between dietary intake of selected foods and fatty acids with atopic disease prevalence in adults. Data from the European Community Respiratory Health Survey in Erfurt, combined with a 3‐day weighed records dietary survey, was used. Complete data was available from 469 males and 333 females aged 20–64 yrs. Multiple logistic regression was applied comparing the highest with the lowest quartile of dietary exposures and linear trends were tested stratified by sex. In males, margarine intake and a high ratio of omega‐6 to omega‐3 fatty acids were positively associated with hay fever. In females, a high intake of total fat, palmitoleic and oleic acids were positively associated with sensitisation. A high total fat, high monounsaturated fatty acid and high oleic acid consumption were positively associated with hay fever. Whilst an excessive intake of fat or imbalance in fat intake, particular of monounsaturated fatty acids, increased the risk for hay fever and allergic sensitisation in females, mostly no significant associations were found for males. Dietary factors were mostly not related with prevalence rates of bronchial hyperresponsiveness and atopic eczema either in males or in females.

Trends in food intake in adults from the City of Erfurt before and after the German reunification

Three-day weighed dietary records from two surveys conducted in independent random population samples from Erfurt (East Germany) in 1987/88 (S1) and in 1991/92 (S2) were used to analyze trends in food intake before and after the German reunification. Structured records of 281 men and 256 women from S1 and open-ended records of 353 men and 252 women from S2, all aged 25-64, were included into the comparison. Distinct changes were found for most foods. For instance, for men mean daily intake of fruit and fruit products increased from 115 to 154 g, intake of bread and baked goods decreased from 286 to 249 g and intake of meat from 91 to 77 g. Respective figures for women were 137 vs. 180 g; 209 vs. 174 g and 62 vs. 53 g. Surprisingly similar changes in eating habits were observed with men and women. The majority of changes could be explained by the improved variety in food supply after the reunification.

Association of hormone replacement therapy with bronchial hyper-responsiveness

Postmenopausal hormone replacement therapy (HRT) has been linked to asthma in women, however, with inconsistent conclusions. This study examined the association of HRT with bronchial hyper-responsiveness (BHR). Eighty-five postmenopausal women completed a women-specific questionnaire and underwent methacholine challenge testing according to the protocol of the European community respiratory health survey. Associations of HRT use with BHR (based on a 20% fall in FEV1), mild BHR (10% fall in FEV1) or dichotomized dose-response slopes were analyzed by logistic regression, controlling for age, education, smoking and overweight. The 27 HRT users were less likely to show BHR compared to the 58 non-users (11% vs. 41%), multiply adjusted odds ratio (95% confidence interval) 0.12 (0.03, 0.55). Results for dose-response slopes were similar, while mild BHR showed no association with HRT use. These results point to a relaxing effect of estrogens on bronchial smooth muscle.

Explaining the individual processes leading to adaptive comfort: Exploring physiological, behavioural and psychological reactions to thermal stimuli

Behavioural, physiological and psychological adaptive processes are presumed reasons for the discrepancies between predicted mean vote and observed comfort votes during field studies. However, few are known about the individual portions of these processes. An experimental design was developed, which aims at identifying those portions and is meant for climate chambers with operable windows facing the exterior. This article looks in detail at behavioural and physiological reactions together with their effect on the perceived level of comfort. By means of multivariate regression analyses, these reactions are analysed in order to assess differences due to variations in indoor/outdoor conditions as well as the number of interactive opportunities. One of the results shows that the restriction to keep the window closed is counterbalanced by an increased amount of physiological reactions, such as an increased level of skin temperature, together with an increase of still permitted actions such as drinking. The results highlight the importance of detailed insights into single aspect of adaptive processes for a better understanding of the phenomenon called ‘adaptive comfort’. Such approach is novel and important because a detailed knowledge and quantification of the occupant’s comfort perception in naturally ventilated buildings permits a planning with less uncertainty.

Association between lung function, hypertension and blood pressure medication

BACKGROUND Several studies showed an association between lung function and hypertension. However, it must be considered that antihypertensive treatment might have an effect on lung function, too. So far, this potential effect of antihypertensive medication on lung function has been investigated mainly in patients with already existing pulmonary diseases. Thus, the aim of this analysis was to determine whether hypertension and its medical treatment are associated with lung function impairment in a general adult population. METHODS Within the cross-sectional study ECRHS-I Erfurt 1158 adults aged between 20 and 65 years performed lung function tests and blood pressure measurements. Additionally, information on anthropometric measurements, sociodemographic characteristics and medical history was available. Multivariate regression models were applied to study the association between lung function, blood pressure and antihypertensive treatment. RESULTS The combination of high blood pressure and the use of antihypertensive medication had the strongest negative effect on lung function. Thus, it was associated with a deterioration in FEV(1) of -150 ml (p=0.01) and in FVC of -190 ml (p<0.01). When using both high blood pressure and antihypertensive medication as individual variables in one regression model, only medication decreased FEV(1) and FVC significantly (each p<0.01). CONCLUSIONS We speculate that high blood pressure in combination with antihypertensive treatment and not HBP itself might be associated with reduced lung function in a general adult population. Nevertheless, it must be considered that antihypertensive medication might just be an indicator for very high blood pressure.

Specific risk factors for contracting Q fever: lessons from the outbreak Jena.

A Q fever outbreak with 331 reported cases in seven weeks occurred in a densely populated residential district in Jena (Germany) in 2005. Prompt identification of a stable infection source follow by an intense information policy, well defined and stable meteorological conditions and a large number of reported cases within one small community all allowed us to study promoting and protecting factors of Q fever. We conducted a cross-sectional study and investigated a part of the affected area for 100% sampling (in-home interviews). Out of 608 residents at home 460 (75.7%) participated in the study and 101 fulfilled our definition of an acute Q fever case. Our data revealed a critical zone for residency within 500 m of herds of gestating ewes in a typical urban dwelling area. We found an association between shift work and contracting Q fever. An association between outdoor activity and Q fever was only found after prolonged outdoor stays, on average more than 4h/day. Only open windows facing the putative source were associated with increased risk of Q fever. Therefore fully open windows of more than 6h/day is a significant parameter.

Ernährungserhebung bei Erwachsenen in Erfurt 1991/92: Nährstoffaufnahme

A dietary survey using weighted 3-day-records was carried out in the sample of the third MONICA risk-factor survey in the Thuringian city of Erfurt (eastern Germany) in 1991/92. The aim was to collect detailed intake data in a defined population after the first phase of consolidation on the food market after the German reunification. The dietary sample consisted of 1,118 men and 1,179 women aged 20-64 years; we received 469 acceptable records from men and 333 from women. The German national nutrient datafile BLS (version 2.1) was used to code the records and for the transformation into nutrients. Mean energy intake in men was 2,624 kcal per day, 15.3% came from protein, 40.0% from fat, 38.5% from carbohydrates and 6.0% from alcohol. Corresponding figures for women were 1,916 kcal per day, 15.8%, 40.5%, 41.5% and 2.1%. Only a small percentage of participants achieved the recommendations of the German Society for Nutrition for the intake of selected nutrients.ZusammenfassungBei der dritten MONICA Querschnittsstudie in der Stadt Erfurt wurde 1991/92 an einer Stichprobe von 1 118 Männern und 1 179 Frauen im Alter von 20 bis 64 Jahren eine Ernährungserhebung mit offenen 3-Tage-Wiegeprotokollen durchgeführt. Ziel war es u.a., Daten zur Nährstoffzufuhr einer definierten Bevölkerung nach der ersten Phase der Konsolidierung des Lebensmittelmarktes kurz nach der deutschen Wiedervereinigung zu erheben. Von 469 Männern und 333 Frauen konnten Protokolle ausgewertet werden. Zur Kodierung und Transformation in Nährstoffe wurde die Nährwertdatenbank BLS (Version 2.1) verwendet. Die Energiezufuhr beträgt bei den Männern 2 624 kcal pro Tag, davon stammen 15,3 % aus Protein, 40,0 % aus Fett, 38,5 % aus Kohlenhydraten und 6,0 % aus Alkohol. Die entsprechenden Werte für die Frauen sind 1 916 kcal pro Tag, 15,8 %, 40,5 %, 41,5 % und 2,1 %. Nur ein geringer Anteil der Teilnehmer und Teilnehmerinnen erfüllte die Empfehlungen der Deutschen Gesellschaft für Ernährung für die Zufuhr ausgewählter Nährstoffe.SummaryA dietary survey using weighted 3-day-records was carried out in the sample of the third MONICA risk-factor survey in the Thuringian city of Erfurt (eastern Germany) in 1991/92. The aim was to collect detailed intake data in a defined population after the first phase of consolidation on the food market after the German reunification. The dietary sample consisted of 1 118 men and 1 179 women aged 20–64 years; we received 469 acceptable records from men and 333 from women. The German national nutrient datafile BLS (version 2.1) was used to code the records and for the transformation into nutrients. Mean energy intake in men was 2 624 kcal per day, 15.3 % came from protein, 40.0 % from fat, 38.5 % from carbohydrates and 6.0 % from alcohol. Corresponding figures for women were 1 916 kcal per day, 15.8 %, 40.5 %, 41.5 % and 2.1 %. Only a small percentage of participants achieved the recommendations of the German Society for Nutrition for the intake of selected nutrients.

Entwicklung der Herz-Kreislauf-Morbidität und -Mortalität in Ostdeutschland nach der politisch-ökonomischen Wende

ZusammenfassungDie Herz-Kreislauf-Mortalität ist in der DDR zwischen 1980 und 1989 bei den Männern um 14 Prozent und bei den Frauen um 18 Prozent zurückgegangen. Im Jahre 1990 war jedoch sowohl bei Männern als auch bei Frauen, insbesondere bei den 25-44 jährigen (18 bzw. 17 Prozent), aber auch bei den 45-64jährigen (jeweils 7 Prozent), ein deutlicher Anstieg zu verzeichnen. Dadurch gab es in Ostdeutschland im Jahr der Wiedervereinigung in diesem Altersbereich etwa 1.120 Herz-Kreislauf-Todesfälle mehr als nach dem Stand von 1989 zu erwarten gewesen wären. Die Umstellung der Kodierung der Totenscheine im gleichen Jahr ist dafür offensichtlich keine Erklärung. Auffällig ist dagegen die weitgehende Parallelität der Entwicklung der Herz-Kreislauf-Mortalität und der Herzinfarkt- und Schlaganfallmorbidität in den Jahren vor und nach der Wiedervereinigung. Dabei verlief die Entwicklung der Hypertonie-Prävalenzraten und der Schlaganfallereignisraten weitgehend parallel. Kein Zusammenhang bestand jedoch zwischen der Entwicklung von Hypercholesterinämie und Zigarettenrauchen einerseits und der Entwicklung der Herzinfarktereignisraten andererseits. Dafür hatten jedoch ungünstige psychosoziale Faktoren (soziales Netzwerk, Arbeitsplatzbelastungen, kritische Lebensereignisse) deutlich zugenommen. Ihnen dürfte also insbesondere bei der Zunahme der Herzinfarkte nach der Wende eine wesentliche Bedeutung zukommen. Nach der Wiedervereinigung ist die Herz-Kreislauf-Mortalität, insbesondere bei den unter 65jährigen, zwar wieder verstärkt abgefallen, dennoch ist sie in Ostdeutschland noch deutlich höher als in Westdeutschland, so daß eine Angleichung der Mortalitätsraten wahrscheinlich noch einen längeren Zeitraum in Anspruch nehmen wird.AbstractCardiovascular mortality decreased in the GDR between 1980 and 1989 in men by 14 % and in women by 18 %. In 1990, however, among men as well as women the rates increased considerably, particularly for the age group 25-44 (18 % and 17 %, respectively), but also for the age group 45-64 (7 % for both sexes). Compared with the mortality rates of 1989 this increase resulted in an excess-mortality of approximately 1120 cardiovascular deaths in this age range in East Germany during the year of the reunification. The re-arrangement of the coding practice in this year is obviously not an explaination for this phenomenon. There were, on the other hand, very similar trends of the cardiovascular mortality and the myocardial infarction and stroke morbidity in the years before and after the reunification. The stroke morbidity developed quite parallel with the hypertension prevalence rates. But we observed no relationship between the trends in hypercholesterolemia and smoking, on the one hand, and the myocardial infarction attack rates, on the other hand. However, the prevalence of psychosocial risk factors (social network, job stress, life events) increased considerably. This fact seems to play an important role particularly in the increase of the incidence of myocardial infarctions after the political change. Cardiovascular mortality droped after the reunification to a faster rate than before the reunification especially in the age range below 65 years. Nevertheless, cardiovascular mortality is still currently much higher in East than in West Germany. Therefore, in order to bring the East German rates in line with the West German rates it will probably still take a long time.

Ernährungserhebung bei Erwachsenen in Erfurt 1991/92:

ZusammenfassungBei der dritten MONICA Querschnittsstudie in der Stadt Erfurt 1991/92 wurde an einer Stichprobe von 1 118 Männern und 1 179 Frauen im Alter von 20 bis 64 Jahren eine Ernährungserhebung mit offenen 3-Tage-Wiegeprotokollen durchgeführt. Hier wird der mittlere tägliche Lebensmittelverzehr, der Beitrag der Lebensmittel zur Nährstoffzufuhr und der Anteil der Personen, die Supplemente einnehmen, dargestellt. Beispielsweise verzehren Männer täglich im Mittel 199 g Fleisch und Fleischerzeugnisse, die 20,7 % der Energie, 31,8 % des Fettes und 42,7 % des Cholesterins liefern. Bei den Frauen stammen 18,6 % der Energie, 26,8 % des Fettes und 37,2 % des Cholesterins aus dem mittleren täglichen Verzehr von 130 g Fleisch und Fleischerzeugnissen. Ältere Frauen verzehren deutlich mehr Fleisch als jüngere Frauen. 0,4 % der Männer und 2,6 % der Frauen nehmen während der drei Protokolltage Supplemente ein.SummaryA dietary survey using 3-day weighed records was carried out in the sample of the third MONICA risk-factor-survey in the Thuringian city of Erfurt (former East Germany) in 1991/92 consisting of 1 118 men and 1 179 women aged 20–65 years. Mean daily food intake, the contribution of food groups to nutrient intake and the percentage of participants using supplements are shown here. For instance, men have a mean daily intake of meat and meat products of 199 g, delivering 20.7 % of energy, 31.8 % of fat and 42.7 % of cholesterol. In women 18.6 % of energy, 26.8 % of fat and 37.2 % of cholesterol origine from their mean daily intake of 130 g meat and meat products. Women in older age groups consume distinctly more meat than women in younger age groups. 0.4 % of men and 2.6 % of women use supplements during their three recording days.

Kindheit und Herzinfarkt: sozioökonomische und psychosoziale Kindheitseinflüsse auf das Herzinfarktrisiko

OBJECTIVES Compared to the established risk factors of myocardial infarction (MI) little is known about the impact of socio-economic and psycho-social risk factors during childhood. METHODS Based on the WHO MONICA infarction register of the Erfurt reporting unit (1990-1993), 129 male cases and 129 controls (patients of accident surgery without psychiatric or heart disease, matched by age groups) were surveyed by a qualitative interview. The MI risk was analysed for general conditions of childhood, stressful life events, serious changes during childhood, and dissatisfaction with childhood using univariate and multiple logistic regression models. RESULTS A significantly higher risk was found for worse (OR = 5.1; CI: 1.5-18.1) and mediocre (OR = 2.0; CI: 1.0-4.1) housing conditions as well as migration (OR = 3.0; CI: 1.1-8.3) during childhood. A significantly increased risk of MI is also found for individuals who reported three or more stressful life events (OR = 3.2; CI: 1.1-9.4) during childhood. In comparison, smoking habits (current or ex-smokers)--an established impact factor on MI--was associated with a slightly lower risk (OR = 2.6; CI: 1.3-5.3). CONCLUSIONS Both socio-economic determinants and psycho-social factors of childhood carry significant risk for myocardial infarction in later life. Our data support the hypothesis that risk factors of MI are affected and/or triggered by socio-economic living conditions during childhood in general, and by stressful life events during childhood in particular.