Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean dia…

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia…

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions…

Postural Balance in a Random Sample of 7,979 Subjects Aged 30 Years and Over

<i>Background:</i> Reliable normative data for force platform measurements of postural balance have not been available. <i>Methods:</i> Data on postural balance were collected from a representative nationwide sample of a Finnish population aged ≧30 years (n = 7,979). As part of a comprehensive health survey <i>(Health 2000)</i>, postural balance was measured with the help of a force platform system in four test conditions: normal standing with eyes open and closed (both for 30 s), semi-tandem (20 s) and tandem stand with eyes open (20 s). In addition, balance abilities were also evaluated by a non-instrumented field test. <i>Results:</i> The m…

Additional file 3: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on the associations between self-reported hearing difficulty and health service use in older adults when accounting for missing data with maximum likelihood. Multivariable adjusted odds ratios (OR) for self-reported hearing difficulty explaining use of health services when accounting for missing data with maximum likelihood method (N = 2144). (PDF 6 kb)

Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Additional file 2: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on health service use in older adults with (pure-tone hearing level > 25 dB) and without hearing loss. Age-sex adjusted proportions person with (N = 787) and without hearing loss (better-ear hearing level at frequencies 0.5–2 kHz >25 dB, N = 893) and multivariable-adjusted odds ratios for hearing loss explaining use of health services. (PDF 234 kb)

Obesity History as a Predictor of Walking Limitation at Old Age*

Objective: To study whether walking limitation at old age is determined by obesity history. Research Methods and Procedures: In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed <1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded. Results: Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4-fold higher risk of walking limitation compared to non-obe…

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

BACKGROUND: Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults

© 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model …

National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio : a pooled analysis of 458 population-based studies in Asian and Western countries

Artículo con numerosos autores. Sólo quedan reflejados el primero, los pertenecientes a la UAM y el colectivo

Sleep-Related Factors and Mobility in Older Men and Women

SHORT and long sleep duration, sleep-related disturbances, and their daytime consequences are common in older adults, and they are associated with decreased health and increased mortality (1–4). Because aging is associated with decline in physical performance often leading to physical disability and loss of independence, concomitant sleep problems may exacerbate the age-related decline in physical function. Previous studies suggest that self-reported and measured insomnia and sleep-related problems are associated with decline in psychomotor performance (5) as well as with poor balance and increased risk of falls (6–8). In addition, Goldman and coworkers (2007) (9) reported that short (<6 ho…

Standardized Map of Iodine Status in Europe

Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the wh…

Participation rates by educational levels have diverged during 25 years in Finnish health examination surveys

Background Declining participation rates in health examination surveys may impair the representativeness of surveys and introduce bias into the comparison of results between population groups if participation rates differ between them. Changes in the characteristics of non-participants over time may also limit comparability with earlier surveys. Methods We studied the association of socio-economic position with participation, and its changes over the past 25 years. Occupational class and educational level are used as indicators of socio-economic position. Data from six cross-sectional FINRISK surveys conducted between 1987 and 2012 in Finland were linked to national administrative registers…

Additional file 1: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on the associations between hearing loss and health service use in older adults when accounting for missing data with maximum likelihood. Multivariable adjusted odds ratios (OR) for hearing loss explaining use of health services when accounting for missing data with maximum likelihood method (N = 2144). (PDF 211 kb)

The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI study.

Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength.Community-dwelling adults agedor = 65 years (n = 930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study.On the basis of baseline measurements (1998-2000), obesity was defined as b…

Effect of co-morbidity on the association of high body mass index with walking limitation among men and women aged 55 years and older.

Background and aims: Obesity among older persons is rapidly increasing, thus affecting their mobility negatively. The aim of this study was to examine the association of high body mass index (BMI) with walking limitation, and the effect of obesity-related diseases on this association. Methods: In a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, chronic diseases, and BMI were ascertained in a health examination. Walking limitation was defined as maximal walking speed of less than 1.2 m/s or difficulty in walking 500 meters. To analyze the effects of chronic conditions, smoking, marital status, and education on BMI class…

ARIA���EAACI statement on asthma and COVID���19 (June 2, 2020)

Artículo con numerosos autores sólo se mencionan el primero y el de la UAM

Repositioning of the global epicentre of non-optimal cholesterol

Publisher's version (útgefin grein)

A century of trends in adult human height

Article

The effect of obesity combined with low muscle strengthon decline in mobility in older persons - Results from the InCHIANTI Study

Objective: Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength. Design: Community-dwelling adults aged ⩾65 years (n=930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study. Measurements: On the basis of baseline measurements (1998–2…

Systematic handling of missing data in complex study designs : experiences from the Health 2000 and 2011 Surveys

We present a systematic approach to the practical and comprehensive handling of missing data motivated by our experiences of analyzing longitudinal survey data. We consider the Health 2000 and 2011 Surveys (BRIF8901) where increased non-response and non-participation from 2000 to 2011 was a major issue. The model assumptions involved in the complex sampling design, repeated measurements design, non-participation mechanisms and associations are presented graphically using methodology previously defined as a causal model with design, i.e. a functional causal model extended with the study design. This tool forces the statistician to make the study design and the missing-data mechanism explicit…

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants

Copyright © NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.

Long-Term Determinants of Muscle Strength Decline: Prospective Evidence from the 22-Year Mini-Finland Follow-Up Survey

Objectives: To examine long-term changes in handgrip strength and the factors predicting handgrip strength decline. Design: Longitudinal cohort study with 22 years of follow-up. Setting: Population-based Mini-Finland Health Examination Survey in Finland. Participants: Nine hundred sixty-three men and women aged 30 to 73 at baseline. Measurements: Handgrip strength was measured using a handheld dynamometer at baseline and follow-up. Information on potential risk factors, namely lifestyle and chronic conditions, and their changes throughout the follow-up were based on health interviews. Results: Based on linear mixed-effect models, midlife physically strenuous work, excess body weight, smokin…

Psychomotor speed in a random sample of 7,979 subjects aged 30 years and over.

Background and aims: Slowing of psychomotor speed among older individuals has been shown in numerous studies. However, in most cases these studies were based on small and selected groups of people and, in some cases, the test procedures did not allow separation of decision time and motor components of the overall performance. The purpose of the present study was to analyse in a large, randomly selected population sample the differences in decision and movement times in simple and multiple-choice test conditions. The association of educational background with psychomotor speed was also examined. Methods: Data on psychomotor speed were collected from a representative nation-wide sample of the…

Hearing loss and use of health services : a population-based cross-sectional study among Finnish older adults

Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, he…

Moving to become healthier?

This paper examines individuals’ health and whether it improves when individuals move from a region with poorer health on average to a region with better health on average. We used data from Finland, which is a country with large regional differences in health behaviours and outcomes. We found no evidence that moving from a less healthy region to a healthier region would have any significant effect on the health of individuals who move compared with the health of other individuals. We also examined the potential heterogeneity in the analysed relationships. We found evidence of a relationship between moving itself and health improvements, but this generally true only for our subsample of ind…

The Mediating Role of C-Reactive Protein and Handgrip Strength Between Obesity and Walking Limitation

OBJECTIVES: To study the association between different obesity indicators and walking limitation and to examine the role of C-reactive protein (CRP) and handgrip strength in that association. DESIGN: A cross-sectional, population-based study. SETTING: The Health 2000 Survey with a representative sample of the Finnish population. PARTICIPANTS: Subjects aged 55 and older with complete data on body composition, CRP, handgrip strength, and walking limitation (N=2,208). MEASUREMENTS: Body composition, anthropometrics, CRP, medical conditions, handgrip strength, and maximal walking speed were measured in the health examination. Walking limitation was defined as maximal walking speed less than 1.2…

Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants.

Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions.

Association between Obesity History and Hand Grip Strength in Older Adults-Exploring the Roles of Inflammation and Insulin Resistance as Mediating Factors

Background: To examine the association between obesity history and hand grip strength, and whether the association is partly explained by subclinical inflammation and insulin resistance. Methods:Data are from 2,021 men and women aged 55 years and older participating in the representative population-based Health 2000 Survey in Finland. Body mass and body height, maximal hand grip strength, C-reactive protein, and insulin resistance based on homeostasis model assessment (HOMA-IR) were measured in a health examination. Recalled weight at 20, 30, 40, and 50 years of age were recorded to obtain a hierarchical classification of obesity history. Obesity was defined as body mass index ≥ 30 kg/m2. R…

Hand-Grip Strength Cut Points to Screen Older Persons at Risk for Mobility Limitation

Objectives To determine optimal hand-grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI). Design Cross-sectional analysis of data. Setting Data collected in the Finnish population-based Health 2000 Survey. Participants One thousand eighty-four men and 1,562 women aged 55 and older with complete data on anthropometry, hand-grip strength and self-reported mobility. Measurements Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand-grip strength cut points for likelihood of mobility limitation.…

The Long-Term Effects of Physical Loading and Exercise Lifestyles on Back-Related Symptoms, Disability, and Spinal Pathology Among Men

Study design Historical cohort, including selected subgroups. Objectives To understand the long-term effects of exercise on back-related outcomes, back pain, sciatica, back-related hospitalizations, pensions, and magnetic resonance imaging findings were studied among former elite athletes. Summary of background data Exercise and sports participation have become increasingly popular, as have recommendations of exercises for back problems, but little is known about their long-term effects. Methods Questionnaires were returned by 937 former elite athletes and 620 control subjects (83% response rate). Identification codes allowed record linkage to hospital discharge and pension registers. Magne…

Cabbage and fermented vegetables: from death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

International audience; Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1 R) axis associated with oxidative stress. This leads to insulin resistance …