The Epidemiological Boehringer Ingelheim Employee Study—Part I: Impact of Overweight and Obesity on Cardiometabolic Risk

Objective.Obesity-dependent diseases cause economic burden to companies. Large-scale data for working populations are lacking. Prevalence of overweight and obesity in the Boehringer Ingelheim (BI) Employee cohort and the relationship between body mass index (BMI) and cardiometabolic risk factors and diseases were estimated.Design and Methods.Employees (≥38 years, employed in Ingelheim ≥2 years;n=3151) of BI Pharma GmbH & Co. KG were invited by the medical corporate department to participate in intensive health checkups. Cross-sectional analysis of baseline data collected through 2006–2011 was performed.Results.90% of eligible subjects participated (n=2849). Prevalences of overweight and obesity were 40% and 18% and significantly higher in men and participants ≥50 years. Cardiometabolic risk factor levels and prevalences of cardiometabolic diseases significantly increased with BMI and were higher in overweight and obese participants. Cut-points for increased risk estimated from ROC curves were≈25 kg/m2for hypertension, hypercholesterolemia, arteriosclerosis, and hypertriglyceridemia and 26.7–28.0 kg/m2for the metabolic syndrome, insulin resistance, hyperinsulinemia, increased intima media thickness, and type 2 diabetes.Conclusion.This is the first large-scale occupational health care cohort from a single company. Cardiometabolic risk factors and diseases accumulate with increasing BMI. Occupational weight reduction programs seem to be reasonable strategies.

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Meal irregularity and cardiometabolic consequences: results from observational and intervention studies

Proceedings of The Nutrition Society ◽

10.1017/s0029665116000239 ◽

2016 ◽

Vol 75 (4) ◽

pp. 475-486 ◽

Cited By ~ 25

Author(s):

Gerda K. Pot ◽

Suzana Almoosawi ◽

Alison M. Stephen

Keyword(s):

Risk Factors ◽

Large Scale ◽

Cardiometabolic Risk ◽

Intervention Studies ◽

Cardiometabolic Risk Factors ◽

Obese Women ◽

Cross Sectional ◽

Meal Patterns ◽

The Metabolic Syndrome ◽

The Impact

Studying irregular meal patterns fits in with the latest research focusing not only on what people eat but also when they eat, also called chrono-nutrition. Chrono-nutrition involves studying the impact of nutrition on metabolism via circadian patterns, including three aspects of time: (ir)regularity, frequency and clock time. The present paper aimed to narratively review research on irregular meal patterns and cardiometabolic consequences. Only few cross-sectional studies and prospective cohort studies were identified, and most of these suggested that eating meals irregularly is associated with a higher risk of the metabolic syndrome and cardiometabolic risk factors, including BMI and blood pressure. This was supported by two randomised controlled intervention studies showing that consuming meals regularly for 2 weeks v. an irregular meal pattern, led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women. In conclusion, the limited evidence on meal regularity and cardiometabolic consequences supports the hypothesis that consuming meals irregularly is adversely associated with cardiometabolic risk. However, it also highlights the need for more large-scale studies, including detailed dietary assessment to further advance the understanding of the impact of chrono-nutrition on public health.

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A stepwise approach to assess the impact of clustering cardiometabolic risk factors on carotid intima-media thickness: the metabolic syndrome no-more-than-additive

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1097/hjr.0b013e3282f17bc3 ◽

2008 ◽

Vol 15 (2) ◽

pp. 190-196 ◽

Cited By ~ 23

Author(s):

Gian Paolo Fadini ◽

Anna Coracina ◽

Sandro Inchiostro ◽

Antonio Tiengo ◽

Angelo Avogaro ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Cardiometabolic Risk ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cardiometabolic Risk Factors ◽

Stepwise Approach ◽

Media Thickness ◽

The Metabolic Syndrome ◽

The Impact

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Abstract MP67: Lactation Duration and Subsequent Intima Media Thickness in Women During Midlife Controlling for Pre-pregnancy Cardiometabolic Risk Factors: The CARDIA Study

Circulation ◽

10.1161/circ.129.suppl_1.mp67 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Erica P Gunderson ◽

Cora E. Lewis ◽

Xian Ning ◽

Mark Pletcher ◽

David Jacobs ◽

...

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Weight Gain ◽

Cardiometabolic Risk ◽

Intima Media Thickness ◽

Cardiometabolic Risk Factors ◽

Inverse Association ◽

Media Thickness ◽

The Metabolic Syndrome ◽

Lactation Duration

Background: Greater lactation duration has been associated with lower incidence of the metabolic syndrome, and self-reported type 2 diabetes and heart disease in women later in life. Two retrospective studies reported higher carotid artery intima-media thickness among parous women who never or inconsistently breastfed, but no clear association with duration. However, lactation history was recalled many years later and heart disease risk factors were not measured before pregnancy. We hypothesized that lactation duration has a graded inverse association with subclinical atherosclerosis in women during mid-life independent of pre-pregnancy cardiometabolic risk factors. Methods: We examined 846 women (46% Black), aged 18-30 years at enrollment in 1985-1986 (baseline) in the biracial Coronary Artery Risk Development in Young Adults (CARDIA) study. Women included delivered 1 or more live births from 1986-2005, had no history of heart disease or diabetes before pregnancies, and had maximum common carotid intima media thickness (ccIMT, mm) measured in 2005-2006 at ages 38-50 years. Lactation duration was recalled within 1 to 4 years of delivery. We categorized women into four lactation groups according to cumulative duration for all post-baseline births; 0-<1 month (n=262), 1-<6 months (n=210), 6-10 months (n=169) and >10 months (n=205). Multiple linear regression models estimated mean ccIMT (95% CI) among lactation categories adjusted for pre-pregnancy cardiometabolic risk factors [BMI, systolic blood pressure (SBP), HDL-C, HOMA-IR], parity, socio-demographics (age, race, education), and smoking. We also assessed weight gain and change in SBP as mediators of the lactation and ccIMT association. Results: Increasing lactation duration showed a graded inverse association with mean ccIMT; differences between >10 months vs. 0<1 month groups ranged from -0.062 from the unadjusted model (p<0.001) and -0.029 from adjusted models (p=0.046) that included pre-pregnancy risk factors and other covariates. Weight gain and SBP change during the 20-year follow up slightly attenuated (~10%) the ccIMT-association with increased lactation duration. Conclusions: Greater lactation duration is associated with lower mean ccIMT independent of cardiometabolic risk factors measured before pregnancy, parity, socio-demographics and smoking. Lactation may have lasting favorable effects on cardiometabolic risk factors for heart disease.

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Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

Public Health Nutrition ◽

10.1017/s1368980009991637 ◽

2009 ◽

Vol 13 (4) ◽

pp. 488-495 ◽

Cited By ~ 10

Author(s):

Ahmet Selçuk Can ◽

Emine Akal Yıldız ◽

Gülhan Samur ◽

Neslişah Rakıcıoğlu ◽

Gülden Pekcan ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Risk Factor ◽

Cardiometabolic Risk ◽

Roc Curves ◽

Cross Sectional Study ◽

Cardiometabolic Risk Factors ◽

Youden Index ◽

Cross Sectional ◽

Men And Women

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.

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Irregularity of energy intake at meals: prospective associations with the metabolic syndrome in adults of the 1946 British birth cohort

British Journal Of Nutrition ◽

10.1017/s0007114515004407 ◽

2015 ◽

Vol 115 (2) ◽

pp. 315-323 ◽

Cited By ~ 8

Author(s):

Gerda K. Pot ◽

Rebecca Hardy ◽

Alison M. Stephen

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Energy Intake ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Logistic Regression Models ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Health And Development

AbstractIrregularity in eating patterns could be a potential cardiometabolic risk factor. We aimed to study the associations of irregular intake of energy at meals in relation to cardiometabolic risk factors 10 and 17 years later. Variability of energy intake data – derived from 5-d estimated diet diaries of cohort members of the National Survey for Health and Development collected at ages 36 (n1416), 43 (n1505) and 53 years (n1381) – was used as a measure for irregularity. Associations between meal irregularity scores with cardiometabolic risk factors measured 10 and 17 years later were investigated using linear mixed models and logistic regression models. The results showed that irregularity scores changed significantly over the years (P<0·05). At age 36 years, subjects with a more irregular intake of energy at lunch (OR 1·42; 95 % CI 1·05, 1·91) and between meals (OR 1·35; 95 % CI 1·01, 1·82) had an increased risk for the metabolic syndrome 17 years later; at lunch was also associated with an increased waist circumference (OR 1·58; 95 % 1·27, 1·96) and TAG levels (OR 1·33; 95 % CI 1·02, 1·72). At age 43 years, subjects with a more irregular intake at breakfast had an increased risk of the metabolic syndrome 10 years later (OR 1·53; 95 % CI 1·15, 2·04), as well as an increased BMI (OR 1·66; 95 % CI 1·31, 2·10), waist circumference (OR 1·53; 95 % CI 1·23, 1·90) and diastolic blood pressure (OR 1·42; 95 % CI 1·13, 1·78). In conclusion, subjects with a more irregular intake of energy, mostly at breakfast and lunch, appeared to have an increased cardiometabolic risk 10 and 17 years later.

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Trends in known and undiagnosed diabetes, HbA1c levels, cardiometabolic risk factors and diabetes treatment target achievement in repeated cross-sectional surveys: the population-based Tromsø Study 1994–2016

BMJ Open ◽

10.1136/bmjopen-2020-041846 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041846

Author(s):

Petja Lyn Langholz ◽

Tom Wilsgaard ◽

Inger Njølstad ◽

Rolf Jorde ◽

Laila Arnesdatter Hopstock

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Cardiometabolic Risk ◽

Population Based ◽

Cardiometabolic Risk Factors ◽

Undiagnosed Diabetes ◽

Cross Sectional ◽

Treatment Target ◽

The Metabolic Syndrome ◽

Hba1c Levels

ObjectivesThe aim of this study was to investigate time trends in known and undiagnosed diabetes, glycated haemoglobin (HbA1c) levels and other cardiometabolic risk factors in the general population as well as treatment target achievement among those with diabetes.Design and settingRepeated cross-sectional surveys in the population-based Tromsø Study.MethodsWe used age-adjusted generalised estimating equation models to study trends in self-reported and undiagnosed (HbA1c ≥6.5%) diabetes, cardiometabolic risk factors and the metabolic syndrome in 27 281 women and men aged 40–84 years examined in up to four surveys of the Tromsø Study between 1994 and 2016. Further, we analysed trends in diabetes treatment target achievement.ResultsDuring 1994–2016, diabetes prevalence increased in women (2.3% to 4.6%) and men (2.4% to 5.8%) and in all age groups, while the proportion of undiagnosed diabetes in women (32% to 17%) and men (37% to 24%) decreased. Blood pressure and total cholesterol decreased, while waist circumference increased in participants with and without diabetes, leading to a relatively stable prevalence of the metabolic syndrome throughout the study period. There was a marginal increase in HbA1c levels among participants without diabetes. Only half of those with diabetes achieved the treatment target of HbA1c ≤7.0%.ConclusionIn the last two decades, diabetes prevalence increased, while the proportion of undiagnosed diabetes declined. The prevalence of the metabolic syndrome remained stable throughout, driven by opposing trends with an increase in obesity and a decrease in other cardiometabolic risk factors. HbA1c treatment target achievement did not improve.

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Daily eating frequency and cardiometabolic risk factors in young Australian adults: cross-sectional analyses

British Journal Of Nutrition ◽

10.1017/s0007114511006398 ◽

2011 ◽

Vol 108 (6) ◽

pp. 1086-1094 ◽

Cited By ~ 38

Author(s):

Kylie J. Smith ◽

Leigh Blizzard ◽

Sarah A. McNaughton ◽

Seana L. Gall ◽

Terence Dwyer ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Cardiometabolic Risk ◽

Overweight And Obesity ◽

Cardiometabolic Risk Factors ◽

Dietary Recommendations ◽

Cross Sectional ◽

Mean Values ◽

Eating Frequency ◽

Eating Occasions

Eating frequency may be important in the development of overweight and obesity and other cardiometabolic risk factors; however, the evidence is inconsistent. The aim of the present study was to examine the associations between the number of eating occasions and cardiometabolic risk factors in a national population-based sample of young adults. A cohort of 1273 men and 1502 women, aged 26–36 years, completed a meal pattern chart to record when they had eaten during the previous day (in hourly intervals). The total number of eating occasions was calculated. Diet quality was assessed, waist circumference was measured and a fasting blood sample was taken. Dietary intake was compared with the Australian Guide to Healthy Eating. The associations between the number of eating occasions and cardiometabolic risk factors were calculated using linear regression. Analyses were adjusted for age, education and physical activity. Most men ate three to five times per d and most women ate four to six times. The proportion of participants meeting dietary recommendations increased with the number of eating occasions. For men, an additional eating occasion was associated with reductions in mean values for waist circumference ( − 0·75 cm), fasting glucose ( − 0·02 mmol/l), fasting insulin ( − 0·34 mU/l; 2·04 pmol/l), TAG ( − 0·03 mmol/l), total cholesterol ( − 0·08 mmol/l) and LDL-cholesterol ( − 0·06 mmol/l). Adjustment for waist circumference attenuated the results. Significant trends were not observed for women. In conclusion, a higher number of eating occasions were associated with reduced cardiometabolic risk factors in men. Many associations were mediated by waist circumference.

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