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Little is known regarding intuitive eating (IE), diet quality and adherence. We investigated the associations between IE, diet quality and metabolic health after gestational diabetes (GDM), who have an increased diabetes risk. Data from 179 women with GDM from MySweetheart trial (NCT02872974) were analyzed. IE was assessed using the eating for physical rather than emotional reasons (EPR) and reliance on hunger and satiety cues (RHSC) subscales of the French Intuitive Eating Scale-2. Metabolic outcomes included weight, central body fat and insulin resistance. Diet quality was calculated using the Alternative Health Eating Index (AHEI) and compliance with national recommendations was evaluated. Both IE subscales were associated with lower BMI and fat mass (BIA) at 1-year postpartum (all p ≤ 0.034). The EPR subscale inversely correlated with fat mass (DXA) and visceral adipose tissue (both p ≤ 0.028), whereas RHSC with higher insulin sensitivity (Matsuda, p = 0.034). RHSC during pregnancy predicted increased AHEI (p = 0.043) at 1-year postpartum, whilst EPR predicted lower fat mass and insulin resistance (HOMA-IR) (all p ≤ 0.04). In longitudinal analyses, both subscales were associated with increased adherence to dairy and fiber intake recommendations (both p ≤ 0.023). These data suggest IE may be an interesting approach to improve diet quality and metabolic outcomes in women with GDM.

Little is known regarding intuitive eating (IE), diet quality and adherence. We investigated the associations between IE, diet quality and metabolic health after gestational diabetes (GDM), who have an increased diabetes risk. Data from 179 women with GDM from MySweetheart trial (NCT02872974) were analyzed. IE was assessed using the eating for physical rather than emotional reasons (EPR) and reliance on hunger and satiety cues (RHSC) subscales of the French Intuitive Eating Scale-2. Metabolic outcomes included weight, central body fat and insulin resistance. Diet quality was calculated using the Alternative Health Eating Index (AHEI) and compliance with national recommendations was evaluated. Both IE subscales were associated with lower BMI and fat mass (BIA) at 1-year postpartum (all p ≤ 0.034). The EPR subscale inversely correlated with fat mass (DXA) and visceral adipose tissue (both p ≤ 0.028), whereas RHSC with higher insulin sensitivity (Matsuda, p = 0.034). RHSC during pregnancy predicted increased AHEI (p = 0.043) at 1-year postpartum, whilst EPR predicted lower fat mass and insulin resistance (HOMA-IR) (all p ≤ 0.04). In longitudinal analyses, both subscales were associated with increased adherence to dairy and fiber intake recommendations (both p ≤ 0.023). These data suggest IE may be an interesting approach to improve diet quality and metabolic outcomes in women with GDM.

Studies showing that the management of dyslipidemia is suboptimal are hampered by their cross-sectional design or short follow-up. Using recent data from a population-based cohort with a 10-year follow-up, we assessed the use of statins, including their intensity. We used data from the CoLaus|PsyColaus study, involving 4,655 participants at baseline (2003 to 2006) and 3,587 at 10-year follow-up (2014 to 2017). We assessed the cardiovascular risk of participants according to established guidelines from the European Society of Cardiology (ESC) and from the American Heart Association/American College of Cardiology and estimated 10-year cardiovascular risk using corresponding risk scores, Systemic Coronary Risk Evaluation risk prediction model and Pooled Cohort Equations. We first determined eligibility for statins and adherence to recommendations at 2 time periods. Additionally, we assessed the prevalence of statin users from 2014 to 2017 in persons without atherosclerotic cardiovascular disease at baseline and who developed it during the follow-up (secondary prevention). A total of 219 participants developed a first atherosclerotic cardiovascular disease during follow-up. Statin use in eligible subjects was 25.9% and 24.0% from 2003 to 2006 and 35.9% and 26.3% from 2014 to 2017, according to ESC and American Heart Association/American College of Cardiology guidelines, respectively. Per ESC guidelines, only 28.2% of treated persons achieved low-density lipoproteins cholesterol target levels from 2014 to 2017 (15.8% from 2003 to 2006), and women less frequently attained goals. Only 18% of subjects used high-intensity statins from 2014 to 2017, with women less often receiving them (14% vs 22%). In secondary prevention, only 74% of eligible subjects were using statins. In conclusion, based on contemporaneous data, management of dyslipidemia is suboptimal, including in secondary prevention, especially in women who are less frequently treated and, if treated, less frequently receive high-intensity treatment.

Introduction: The importance of genetic factors in management of hypertension in a population setting is unclear. Hypothesis: To identify the clinical and genetic factors associated with poor control of hypertension in the Swiss population. Methods: Data from first (2009-2012) and second (2014-2017) follow-ups of a population-based, prospective study conducted in Lausanne, Switzerland. Management of hypertension was assessed according to the ESC guidelines based on the 140/90 or the 130/80 mm Hg thresholds. Two genetic risk scores for hypertension (18 and 28 SNPs) and 133 individual SNPs related to response to specific antihypertensive drugs were tested. Results: 1073 and 1157 participants of first and second follow-ups were included. The prevalence of controlled participants using the 140/90 threshold was 58.8% and 63.6% in first and second follow-ups, respectively. Using the 130/80 threshold, the prevalence rates were 31.4% and 34.0%, respectively. On multivariable analysis, using the 140/90 threshold, older age was negatively associated to hypertension control. Using the 130/80 threshold, older age and increased BMI were negatively associated while total number of drugs was positively associated with hypertension control. The associations with gender, education, alcohol drinking and antidiabetic drug treatment varied between surveys and thresholds. No consistent associations were found between genetic risk scores and hypertension control for both surveys and both thresholds. Finally, no significant association was found between individual SNPs and hypertension control according to antihypertensive drug used. Conclusions: Control of hypertension is poor in Switzerland, namely among older adults and possibly among overweight or obese subjects. No association between genetic scores or individual SNPs and hypertension control could be found.

To assess the agreement of commonly used skinfold thickness equations to estimate percentage of Fat Mass (FM%) in paediatric patients with IBD, in comparison with dual energy X-ray absorptiometry (DEXA).Twenty-one paediatric IBD patients were included: 11 females and 10 males; mean age for the entire group: 14.3 years, range 12-16 years, 16 with Crohn's disease, five with ulcerative colitis. The FM% was calculated using six established paediatric skinfold thickness equations and compared to the results obtained by DEXA. The statistical analysis was performed using Spearman's correlation, Lin's concordance correlation coefficient and corresponding 95% confidence interval, Bland-Altman's limits of agreement method and the Bradley-Blackwood test.Correlation between skinfold and DEXA values ranged between 0.85 (Deurenberg) and 0.92 (Durnin and Rahaman and Johnston), all P 0.001. Lin's concordance correlation coefficients and (95% confidence interval) ranged between 0.702 (0.512-0.891) for the Deurenberg equation and 0.876 (0.779-0.972) for the Brook equation. Average differences between skinfold and DEXA values ranged between -3.6% (Deurenberg) and 2.5% (Weststrate). Bland-Altman limits of agreement were wide, spanning over 10%. Finally, the Bradley-Blackwood test of equality of means and variances was significant in all but the Durnin and Rahaman equation.In adolescents with IBD, fat mass calculated from six skinfold thickness equations showed good correlation but poor agreement with reference values from DEXA. Assessment of body composition using skinfold thickness equations cannot be recommended in paediatric patients with IBD.

Current dietary salt (sodium chloride) intake largely exceeds physiological needs (about 1.5 g salt per day, or 550 mg sodium per day) in most countries (8 g salt per day). The main sources of dietar salt intake are breads, cheeses, products derived from meat and ready-to-eat meals. On average, a high-salt diet is associated with higher blood pressure levels. In Switzerland, one out of three adults suffers from arterial hypertension. Half of cerebrovascular events and ischaemic cardiac events are attributable to elevated blood pressure. The Swiss Federal Office of Public Health is currently running a strategy aiming at reducing dietary salt intake in the Swiss population to less than 5 g per day on the long run (Salz Strategie 2008-2012).

Primary prevention of cardiovascular disease by physicians is achieved by management of individual risk factors. The eligibility for treatment with statins is based on both an estimate of the risk of developing cardiovascular disease and the LDL-cholesterol. Three risk scores are commonly used: the PROCAM score, the Framingham score, and the European score. In Switzerland, the Swiss Group Lipids and Atherosclerosis (GSLA) recommends to use the PROCAM score with an adjustment of the level of risk for Switzerland. A survey also showed that PROCAM is the most used in Switzerland. In this article, the differences of these scores and their practical applications regarding the prescription of statins in primary prevention are discussed. The consequences and potential benefits of applying these scores in Switzerland are also discussed.

Background and PurposeCoronary heart disease (CHD) is one of the most pressing health problems of our time and a major cause of preventable death. CHD results from complex interactions between genetic and environmental factors. Using multiplex serological testing for persistent or frequently recurring infections and genome-wide analysis in a prospective population study, we delineate the respective and combined influences of genetic variation, infections, and low-grade inflammation on the risk of incident CHD.Participants and MethodsStudy participants are enrolled in the CoLaus|PsyCoLaus study, a longitudinal, population-based cohort with baseline assessments from 2003 through 2008 and follow-up visits every five years. We analyzed a subgroup of 3’459 individuals with available genome-wide genotyping data and immunoglobulin G levels for 22 persistent or frequently recurring pathogens. All reported CHD events were evaluated by a panel of specialists. We identified independent associations with incident CHD using univariable and multivariable stepwise Cox proportional hazards regression analyses.ResultsOf the 3’459 study participants, 210 (6.07%) had at least one CHD event during the 12 years of follow-up. Multivariable stepwise Cox regression analysis, adjusted for known cardiovascular risk factors, socioeconomic status and statin intake, revealed that high polygenic risk (hazard ratio (HR) 1.31, 95% CI 1.10–156, P = 2.64e-03) and infection with Fusobacterium nucleatum (HR 1.63, 95% CI 1.08–2.45, P = 1.99e-02) were independently associated with incident CHD.ConclusionIn a prospective, population-based cohort, high polygenic risk and infection with Fusobacterium nucleatum have a small, yet independent impact on CHD risk.