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Background The American Heart Association recently released an updated algorithm for evaluating cardiovascular health—Life's Essential 8 (LE8). However, the associations between changes in LE8 score over time and risk of cardiovascular disease (CVD) remain unclear. Methods We investigated associations between 6-year changes (2006–12) in LE8 score and risk of subsequent CVD events (2012–20) among 53 363 Chinese men and women from the Kailuan Study, who were free from CVD in 2012. The LE8 score was calculated based on eight components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose and blood pressure. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results We documented 4281 incident CVD cases during a median of 7.7 years of follow-up. Compared with participants whose LE8 scores remained stable in a 6-year period, those with the large increases of LE8 score over the 6-year period had a lower risk of CVD, heart disease and stroke in the subsequent 8 years [HRs and 95% CIs: 0.67 (0.64, 0.70) for CVD, 0.65 (0.61, 0.69) for heart disease, 0.71 (0.67, 0.76) for stroke, all P trend < 0.001]. Conversely, those with the large decreases of LE8 score had 47%, 51% and 41% higher risk for CVD, heart disease and stroke, respectively. These associations were consistent across the subgroups stratified by risk factors. Conclusions Improving LE8 score in a short- and moderate-term was associated with a lower CVD risk, whereas decreased LE8 score over time was associated with a higher risk. [ABSTRACT FROM AUTHOR]

Background Blood lipids and glucose levels dysregulation represent potential mechanisms intermediating the adverse cardiovascular effects of ambient particulate matter (PM) exposure. This study aims to estimate the effect of long-term PM10 exposure on blood lipids and glucose levels and to assess the potential mediation and/or modification action of abdominal obesity (AO) (waist-to-height ratio). Methods Our study was based on 2,390 participants of the first Portuguese Health Examination Survey (INSEF, 2015) with available data on blood lipids and glucose parameters and living within a 30-km radius of an air quality monitoring station with available PM10 measurements. PM10 concentrations were acquired from the air quality monitoring network of the Portuguese Environment Agency. Generalized linear models were used to assess the effect of 1-year PM10 exposure on blood lipids and glucose levels. An interaction term was introduced in the models to test the modification action of AO. Results We found an association between PM10 and non-fasting blood triglycerides (TG) after adjustment for age, sex, education, occupation, lifestyles-related variables and temperature but only in participants with AO. Per each 1 µg/m3 PM10 increment, there was a 1.84% (95% confidence interval: 0.02–3.69) increase in TG. For the remaining blood lipid and glucose parameters, no associations were found. Conclusions Our study demonstrates that even at low levels of exposure, long-term PM10 exposure interacts with AO to increase blood TG. Our findings suggest that reducing both AO prevalence and PM10 below current standards would result in additional health benefits for the population. [ABSTRACT FROM AUTHOR]

Background Dietary recommendations regarding egg intake remain controversial topic for public health. We hypothesized that there was a positive association between egg consumption and all-cause mortality. Methods To test this hypothesis, we enrolled 9885 adults from a community-based cohort in Anhui Province, China during 2003–05. Egg consumption was assessed by food questionnaire. Stratified analyses were performed for age, sex, body mass index (BMI), blood pressure, smoking, drinking and laboratory tests. Results After an average follow-up of 14.1 years, 9444 participants were included for analysis. A total of 814 deaths were recorded. Participants' BMI and lipid profile had no significantly difference between three egg consumption groups. BMI was 21.6±2.7 of the whole population, especially BMI>24 was only 17.3%. A bivariate association of egg consumption >6/week with increased all-cause mortality was observed compared with ≤6/week (RR: 1.35, 95% CI: 1.05, 1.73, P  = 0.018). A significant interaction was observed for BMI ≥ 21.2 kg/m2 vs. BMI<21.2 kg/m2 (P for interaction: 0.001). No other significant interactions were found. Conclusions In this study, consuming >6 eggs/week increased risk of all-cause mortality, even among lean participants, especially who with BMI ≥ 21.2 kg/m2. Eggs are an easily accessible and constitute an affordable food source in underdeveloped regions. Consuming <6 eggs/week may be the most suitable intake mode. [ABSTRACT FROM AUTHOR]

Background The global prevalence of obesity in women keeps increasing. The preconception period may be a window of opportunity to improve lifestyle, reduce obesity and improve cardiometabolic health. This study assessed the effect of a preconception lifestyle intervention on long-term cardiometabolic health in two randomized controlled trials (RCTs). Methods Participants of the LIFEstyle and RADIEL preconception lifestyle intervention studies with a baseline body mass index (BMI) ≥29 kg/m2 were eligible for this follow-up study. Both studies randomized between a lifestyle intervention targeting physical activity, diet and behaviour modification or usual care. We assessed cardiometabolic health 6 years after randomization. Results In the LIFEstyle study (n = 111) and RADIEL study (n = 39), no statistically significant differences between the intervention and control groups were found for body composition, blood pressure, arterial stiffness, fasting glucose, homeostasis model assessment of insulin resistance, HbA1c, lipids and high sensitive C-reactive protein levels 6 years after randomization. Participants of the LIFEstyle study who successfully lost ≥5% bodyweight or reached a BMI <29 kg/m2 during the intervention (n = 22, [44%]) had lower weight (−8.1 kg; 99% CI [−16.6 to −0.9]), BMI (−3.3 kg/m2; [−6.5 to −0.8]), waist circumference (−8.2 cm; [−15.3 to −1.3]), fasting glucose (−0.5 mmol/L; [−1.1 to −0.0]), HbA1c (−4.1 mmol/mol; [−9.1 to −0.8]), and higher HDL-C (0.3 mmol/L; [0.1–0.5]) compared with controls. Conclusion We found no evidence of improved cardiometabolic health 6 years after a preconception lifestyle intervention among overweight and obese women in two RCTs. Women who successfully lost weight during the intervention had better cardiometabolic health 6 years later, emphasizing the potential of successful preconception lifestyle improvement. [ABSTRACT FROM AUTHOR]

Background The relation between shift work and a large variety of cardiometabolic risk factors is unclear. Also, the role of chronotype is understudied. We examined relations between shift work and cardiometabolic risk factors, and explored these relations in different chronotypes. Methods Cardiometabolic risk factors (anthropometry, blood pressure, lipids, diabetes, γ-glutamyltransferase, C-reactive protein, uric acid and estimated glomerular filtration rate) were assessed among 1334 adults in 1987–91, with repeated measurements every 5 years. Using shift work history data collected in 2013–15, we identified shift work status 1 year prior to all six waves. Linear mixed models and logistic generalized estimating equations were used to estimate the longitudinal relations between shift work and risk factors 1 year later. Results Shift work was not significantly related with cardiometabolic risk factors (P ≥ 0.05), except for overweight/body mass index. Shift workers had more often overweight (OR: 1.44, 95% CI 1.06–1.95) and a higher body mass index (BMI) (β : 0.56 kg m−2, 95% CI 0.10–1.03) than day workers. A significant difference in BMI between day and shift workers was observed among evening chronotypes (β : 0.97 kg m−2, 95% CI 0.21–1.73), but not among morning chronotypes (β : 0.04 kg m−2, 95% CI −0.85 to 0.93). No differences by frequency of night shifts and duration of shift work were observed. Conclusion Shift workers did not have an increased risk of cardiometabolic risk factors compared with day workers, but, in particular shift working evening chronotypes, had an increased risk of overweight. More research is needed to verify our results, and establish whether tailored interventions by chronotype are wanted. [ABSTRACT FROM AUTHOR]

Background: Evidence for an association of fasting plasma glucose (FPG) with cognitive function in adults free of diabetes is scarce and based on middle-aged and older adults. We examined the association of FPG, measured at age 30, and of change in FPG from age 30 to 43, with cognitive function at age 50. Methods: 505 nondiabetic participants of the population-based Jerusalem Lipid Research Clinic (LRC) cohort study had baseline FPG, 2-h postoral challenge plasma glucose (OGTT) and insulin determined at ages 28-32, and FPG and OGTT again at ages 41- 46. Subsequently at ages 48-52, global cognitive function and its five specific component domains were assessed with a NeuroTrax computerized test battery, using multiple linear regression and multivariable logistic models. Results: Hyperglycemia (FPG-5.6 mmol/l vs. <5.6 mmol/l) at baseline was associated with poorer global cognitive function in midlife (predominantly in the visual spatial and attention domains), independent of socio-demographic characteristics, life style variables, body mass index (BMI), and inflammatory and biochemical variables (standardized Beta = -0.121, P=0.002, plinear trend(FPG continuous) =0.016). Similarly, increased odds for low-ranked (lowest fifth) global cognition was evident (ORper mmol/l FPG=2.31, 95% CI = 1.30-4.13, P=0.005). Baseline OGTT, insulin resistance (HOMA-IR) and change in FPG and OGTT over 13 years were not associated with cognition. Conclusion: A higher FPG in young adults was associated with lower cognitive performance in midlife. Although we cannot dismiss the possibility of reverse causation, hyperglycemia at a young age may be a modifiable risk factor for low-ranked cognitive function in midlife. [ABSTRACT FROM AUTHOR]

Background: Blood lipids levels dysregulation represent potential mechanism intermediating the adverse cardiovascular effects of ambient particulate matter (PM) exposure. The present study aims to estimate the effect of particulate matter (PM10) exposure on blood lipid levels (TC, Total Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; LDL-C, Low-Density Lipoprotein Cholesterol; TG, Triglycerides) in the adult Portuguese mainland population and to assess the potential mediation and/or modification action of abdominal obesity on this effect. Methods: We used data from 2390 participants of the 1st Portuguese Health Examination Survey (INSEF, 2015) with available data on blood lipids parameters and living within a 30km radius of an air quality monitoring station with available PM10 measurements. PM10 concentrations were acquired from the air quality monitoring network of the Portuguese Environment Agency. Generalized linear models were used to assess the effect of 1-year PM10 exposure on blood lipids values. An interaction term was introduced in the models to test the modification action of abdominal obesity. Results: We found an association between long-term exposure to PM10 and non-fasting blood TG levels after adjustment for age, sex, education, occupation, lifestyles related variables and temperature but only in participants with abdominal obesity (1.84% TG increase per each 1 μg/m3 PM10 increment, 95% CI: 0.02%; 3.69%) which is well supported by the sensitivity analysis. Conclusions: Our study demonstrate that even at low levels of exposure, long-term PM10 exposure interacts with abdominal obesity to increase blood TG levels. To the best of our knowledge, this is the first study showing the modification action of abdominal obesity regarding the PM10 effect on a blood lipid parameter. Our findings suggest that reducing both abdominal obesity prevalence and PM10 below current standards would result in additional health benefits for the population. Key messages: Long-term PM10 exposure interacts with abdominal obesity to increase non-fasting blood triglycerides levels by about 2% per each 1 μg/m3 PM10 increase. Reducing both abdominal obesity prevalence and PM10 below current standards would result in additional health benefits for the population. [ABSTRACT FROM AUTHOR]

Background: The economic crisis in Sweden in the 1990s led to major reorganization at many workplaces, which appears to have had negative consequences for occupational and public health. Methods: Psychosocial questionnaires and medical screening data for 3,904 white-collar employees in 15 major companies plus a large number of small-scale entrepreneurs in Stockholm were used. Subjects were part of a study of working conditions and cardiovascular risk factors (WOLF). Workplaces were categorized using interview data from managers and union representatives. Categories were compared regarding job strain, blood pressure, serum cholesterol, triglycerides, and fibrinogen among employees. Results: The companies formed five categories: Stable', 'Changing/Growing', 'Threatened Private', 'Questioned Public', plus 'Small Firms'. Compared with the 'Stable' group, employees in 'Changing/Growing' companies had higher job strain (0.28 SD, p<0.001). In the 'Threatened Private' group, job strain (0.30 SD, p<0.001), cholesterol (0.18 mmol/l, p<0.05) and triglycerides (0.09 mmol/l, p<0.05) were elevated. The 'Questioned Public' group had higher cholesterol (0.22 mmol/l, p'(0.01), triglycerides (0.10 mmol/l, p<0.01) and fibrinogen (0.13 mmol/l, p<0.05). In 'Small Firms', job strain (0.30 SD, p<(0.001), cholesterol (0.28 mmol/l, p<(0.001), triglycerides (0.14 mmol/l, p<0.001) and fibrinogen (0.19 mmol/l, p'(0.001) were elevated. With the exception of lower systolic blood pressure (2.1 mmHg; p<(0.05) in the 'Changing/Growing' category, there were no significant differences in blood pressure between the groups. Conclusion: In addition to traditional measures of organizational instability, such as downsizing, expansion in a favourable economic climate, appears to be adversely correlated with job strain and psychophysiology. The study also raises concerns about employees in small firms. [ABSTRACT FROM AUTHOR]

The article presents abstracts of research related to epidemiology of chronic diseases. They include "Stroke Morbidity and Mortality Rates in Germany: A Population-Based Scenario-Analysis," "Socio and Early Life Determinants of Overweight and Obesity in 18-year-old Swedish Men: The Role of Intergenerational Effects and Developmental Origins" and "Serum Lipids in Relation to Sciatica in a Nationally Representative Sample."

Editorial. Discusses the role of impaired endothelial functions in the formation of ischaemic heart disease. Role of lipids in the formation of coronary thrombosis; Influence of statins on endothelial function; Effect of folate supplementation on endothelial function.