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ABSTRACT: To evaluate the association between current and lifetime alcohol consumption, and overall and central obesity in adults of an urban Portuguese population.
Participants were randomly selected from the non-institutionalized Porto inhabitants, aged ≥18 years (EPIPorto Study: 1999-2003). The study included 2366 participants for evaluating current alcohol consumption and overall obesity, and 2377 participants for central obesity. A trained interviewer applied a questionnaire and anthropometrics were measured. Data on alcohol intake were obtained by using a food frequency questionnaire. Overall obesity was considered when body mass index was ≥30.0 kg/m(2), and central obesity when waist circumference (WC) was ≥88 cm in women and ≥102 cm in men. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated, separately by sex, using unconditional logistic regression models.
After adjustment for age, education, smoking, energy intake and regular physical exercise, men who consumed >60g/day of alcohol were more frequently obese compared with non-drinkers (OR=2.26, 95% CI: 1.17-4.35). When considering lifetime alcohol consumption, the magnitude of the association was stronger in both women (OR=2.41, 95% CI: 1.28-4.56) and men (OR=4.22, 95% CI: 1.93-9.24). For central obesity, women consuming 15.1-30 g/day and >30 g/day had higher probability of being obese, considering both current and lifetime alcohol consumption. In men, the same positive associations were observed, which were particularly stronger between lifetime alcohol consumption and central obesity (>60g/day vs non-drinkers: OR=4.02, 95% CI: 1.80-8.98).
Independently of social and behavioural features, current and lifetime alcohol consumption were positively associated with overall and central obesity, in both women and men.
European journal of clinical nutrition 02/2012; 66(7):813-8. · 3.07 Impact Factor
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ABSTRACT: Research on the importance of serum uric acid (SUA) as a contributing metabolic factor to cardiovascular diseases has conducted to conflicting results, with most studies assuming a cross-sectional design. The aim of this study was to evaluate the association of SUA and metabolic syndrome (MetS) and its features. A representative sample of 2,485 individuals aged ≥18 years was randomly selected from the non-institutionalized resident population of Porto, Portugal. A total of 1,054 eligible subjects were included for the longitudinal analyses. Hyperuricemia was defined as SUA ≥70 mg/L in men and ≥60 mg/L in women. MetS was defined according the Joint Interim (2009) criteria. Associations were estimated using Poison regression and binomial models. In the cross-sectional analysis, subjects with hyperuricemia had a 2.10-fold increased risk of MetS as compared with normouricemic subjects (PR = 2.10, 95% CI: 1.68-2.63). Among MetS features, high triglycerides presented the strongest association with hyperuricemia (PR = 2.32, 95% CI: 1.84-2.91). The MetS crude incidence rate was 4.5/100 person-year (95% CI: 3.9-5.2) in normal uricemic and 13.0/100 person-year (95% CI: 8.5-20.0) in hyperuricemic participants. Using a multivariate longitudinal approach, hyperuricemia was positively associated with MetS incidence rate ratios (IRR = 1.73, 95% CI: 1.08-2.76). One standard deviation increase of SUA concentration was associated with a 1.22-fold increase in MetS risk (IRR = 1.22, 95% CI: 1.05-1.42). Elevated SUA presented the strongest association with high-triglycerides concentration (IRR = 1.44, 95%: 1.22-1.71) and waist circumference (IRR = 1.25, 95%: 1.05-1.49). The independent positive association between SUA and MetS suggested by this longitudinal study supports that SUA might be a risk factor for MetS.
Endocrine 02/2012; 41(3):450-7. · 1.42 Impact Factor
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ABSTRACT: To evaluate longitudinally the role of physical activity (PA) (type and intensity) and diet (measured using DASH score, nutrients and food intake) in hypertension incidence.
As part of the EPIPorto study, 549 participants (≥40 years), resident in Porto, Portugal, at risk of developing hypertension, were evaluated. Blood pressure (BP) measurements were obtained twice (1999-2003 and 2005-2008), with a median interval of 3.8 years. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, and/or if the subjects were under anti-hypertensive therapy. Validated questionnaires were used to assess usual PA and dietary intake during the previous year. Poisson regression was used to calculate the incident rate ratios (IRRs) and respective 95% confidence intervals (95% CIs).
In our population, the crude incidence rate (95% confidence interval (CI)) per 100 person-years of hypertension was 6.23 (5.26-7.20). After adjustment for several confounders, an inverse, though not significant, association was found across increasing tertiles of leisure-time PA and IRR (95% CI): 1 (reference); 0.77 (0.51-1.16); and 0.74 (0.48-1.11). No significant associations between the DASH score and hypertension incidence were observed. However, potassium intake (mg/1000 kcal) was shown to be inversely associated with hypertension development (upper tertile: >1863.0 for women and >1657.2 for men) vs first tertile (IRR=0.65 (0.44-0.96), P for trend=0.025). Additionally, in multivariate analysis, a significantly inverse association between the consumption of fruits/vegetables/pulses and hypertension incidence was found (upper vs first tertile: IRR=0.61 (0.40-0.93), P for trend=0.024).
In Portuguese adults, after adjustment for several confounders, the development of hypertension was inversely associated with potassium and fruits/vegetables/pulses intake. A dose-response is inherent to these inverse associations.
European journal of clinical nutrition 12/2010; 64(12):1441-9. · 3.07 Impact Factor
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ABSTRACT: The majority of the studies have focused on the effect of general and central fat on coronary risk, neglecting the potential role of peripheral body fat.
To assess the effect of surrogate measures for general, central and peripheral body fat on the occurrence of non-fatal acute myocardial infarction (AMI).
Population-based case-control study; cases were patients aged >or=40 years consecutively hospitalized with an incident AMI (n=653), and controls were community participants without previous AMI, selected randomly from the hospitals' catchment area population (n=1713). Body mass index (BMI), waist circumference (WC), hip circumference and a skinfolds composite index to estimate the proportion of peripheral subcutaneous fat in the arms were ascertained. Associations were summarized with odds ratios (OR) and 95% confidence intervals (95% CI), obtained from unconditional logistic regression with adjustment for the main confounders.
WC, and in particular waist-to-hip ratio (WHR), had strong direct associations with AMI risk. Peripheral subcutaneous fat was inversely associated with AMI in women, but directly in men. Using principal component analysis, three uncorrelated factors were identified representing different patterns of fat distribution: (1) generalized fat, with high BMI and high WC; (2) central fat, with high WC and WHR; and (3) peripheral subcutaneous fat. The first factor showed no significant association with AMI, but the second factor increased AMI risk in each sex (upper vs lower fourth: OR 12.2, 95% CI 5.34-27.9 in women; OR 25.0, 95% CI 14.0-44.7 in men). In contrast, the third factor was inversely associated with AMI in women (upper vs lower fourth: OR 0.59, 95% CI 0.36-0.96) and directly associated in men (OR 2.45, 95% CI 1.69-3.55; P-value for sex interaction<0.001).
Central fat was associated with increased risk of AMI in women and men, while the peripheral subcutaneous fat index predicted a lower risk of AMI in women and a higher risk in men.
International journal of obesity (2005) 04/2010; 34(4):733-41. · 4.34 Impact Factor
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ABSTRACT: To assess, using principal component analysis, the independent associations of general, central and peripheral subcutaneous fat with high-sensitivity C-reactive protein (hs-CRP), in men and women from the general population.
We studied 833 women and 486 men, randomly selected from the non-institutionalized population of Porto, Portugal, with information on hs-CRP (≤10 mg/l) and anthropometrics (1999-2003). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a skinfold composite index to estimate the proportion of arm subcutaneous fat (PSFA), were ascertained by trained personnel. Beta regression coefficients were obtained from generalized linear models with adjustment for the main confounders. Direct associations were found between BMI, WC, WHR and hs-CRP. PSFA was inversely associated with hs-CRP in women (β=-0.080, p-trend=0.010). Since the anthropometric measures were strongly correlated, we used principal component analysis to identify new independent anthropometric factors. The first one, representing a generalized fat distribution (high BMI and WC), was directly associated with hs-CRP (β=0.226, p-trend<0.001 in women; β=0.138, p-trend=0.002 in men). The second factor, characterized by a high PSFA, showed an inverse association with hs-CRP in women (β=-0.071, p-trend=0.048). The third factor, representing a central pattern of fat distribution (low BMI, but high WC and high WHR), was directly associated with hs-CRP in men (β=0.090, p-trend=0.005).
A central pattern of fat distribution is directly associated with hs-CRP levels in men, while a high proportion of peripheral subcutaneous fat seems to be inversely associated with hs-CRP, but only in women.
Nutrition, metabolism, and cardiovascular diseases: NMCD 02/2010; 21(5):347-54. · 3.52 Impact Factor
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ABSTRACT: To study the associations of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein (hs-CRP). Existing literature on these associations is scarce and has rendered conflicting results.
Cross-sectional study of 1060 individuals (675 women, 385 men), representative of the non-institutionalized population, aged >or=18 years, in Porto, Portugal (70% participation rate). Diet over the previous year was assessed with a validated food frequency questionnaire. Associations between diet and hs-CRP (categorized into <1, 1-3, >3 to <or=10 mg/l) were obtained from ordinal logistic regression models (odds ratio, 95% confidence intervals-OR, 95% CI) adjusted for sociodemographic and behavioural variables.
In normal weight men (body mass index (BMI) <25.0 kg/m(2)), for each 100 g increase in fruit and vegetable intake, there was 30% less probability of changing of hs-CRP category (no risk to moderate risk, or moderate to high risk). Protective associations were also observed between hs-CRP and fruits (OR=0.73, 95% CI 0.56-0.96 per 100 g/day), vegetables (OR=0.55, 95% CI 0.35-0.86 per 100 g/day), vitamin C (OR=0.34, 95% CI 0.14-0.80 per 10 mg/day) and vitamin E (OR=0.14, 95% CI 0.02-0.88 per 1000 retinol equivalents per day). Overall, associations tended to be weaker in overweight participants. In men (BMI >or=25.0 kg/m(2)), fibre was also negatively associated with hs-CRP. In women, no significant associations were found between dietary variables and hs-CRP. A significant modification effect of the evaluated associations was found by sex for fruits and vegetables, vitamin C and fibre, but not by BMI.
Intake of fruits and vegetables, vitamin C, E and fibre were negatively associated with hs-CRP in men.
European journal of clinical nutrition 08/2009; 63(11):1345-52. · 3.07 Impact Factor
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ABSTRACT: Self-reported height and weight are commonly used to estimate body mass index. The present study aims to identify the characteristics of participants who reported not to know their height or weight and to evaluate the consequence of these missing data on the estimates of the prevalence of body mass index categories.
We evaluated 1492 adults, aged 18-92 years, who were selected using random digit dialing. During a general interview, participants were asked to report their current height and weight and actual anthropometrical measurements were obtained as part of a subsequent physical examination. We classified as unaware subjects who reported not to know their height or weight.
In this sample, 185 (12.4%) subjects reported not to know their height or weight (19.6% of females and 6.3% of males, p < 0.001). Women unaware of their weight or height were older, less educated, overweight or obese, never smoker and more frequently reported no regular physical exercise practice. In men, only ex-smokers were significantly less aware of their weight or height. In women, the prevalence of obesity using measured data was 25.3%, decreasing to 22.2% when considering only participants aware of their weight and height. Using self-reported data the obesity prevalence, in females, was 15.0%.
A large proportion of adults, mainly women and older persons, reported not to know their weight and height and the exclusion of those participants results in differential errors depending on the actual values. The exclusion of participants unaware of their weight or height is an additional source of bias that decreases the sensitivity in detecting obesity and underestimates the real problem, namely in the older population.
The Journal of Nutrition Health and Aging 04/2009; 13(4):310-4. · 2.69 Impact Factor
