Abstract P220: Obesity in the Italian Adult Population: Preliminary Results of the 2018-2019 Cuore Project-health Examination Survey

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Cinzia Lo Noce ◽  
Elisabetta Profumo ◽  
Brigitta Buttari ◽  
Daniela Minutoli ◽  
...  

Introduction: Obesity is associated to an increased risk of hypertension, non-communicable diseases (NCDs), such as diabetes, coronary heart disease, stroke, and cancers, and conditions including obstructive sleep apnoea and osteoarthritis. Obesity is largely preventable and one of the WHO Global Action Plan for the Prevention of NCDs targets is to halt its rise. Hypothesis: Between 2000 and 2016, obesity trends showed a steady increase in all WHO regions and income groups. This preliminary analysis aims to assess mean level of BMI and prevalence of obesity in the Italian general adult population using the data collected within the CUORE Project-health examination survey. Methods: Within the ongoing survey started in 2018, mean of BMI and prevalence of obesity (BMI>=30 kg/m 2 ) and overweight (25<=BMI<30 kg/m 2 ) were assessed in random samples of resident population, aged 35-74 years, stratified by age and sex (men 822 and women 869), from 8 Italian Regions in Northern, Central and Southern Italy. Weight and height were measured using standardized methodologies. A standardized questionnaire was used to collect data on education and physical inactivity. The survey is funded by the Italian Ministry of Health-CCM. Results: Mean values of BMI resulted 26.8 kg/m 2 (95% C.I. 26.5-27.1) in men and 25.9 kg/m 2 (25.6-26.3) in women. Prevalence of obesity was 19.0% (16.3-21.7) in men and 21.7% (19.0-24.5) in women; prevalence of overweight was 44.5% (41.1-47.9) in men and 28.4% (25.4-31.4) in women. Obesity levels resulted significantly higher in persons with lower education (primary or high school) vs those with higher level of education: 25.6% (20.0-31.1) vs 16.0% (13.0-19.0) in men and 32.5% (27.0-37.9) vs 16.7% (13.6-19.7) in women. Prevalence of physical inactivity during leisure time was 31.9 % (28.7-35.1) in men and 41.4% (38.2-44.7) in women. Both in men and women the prevalence of obesity was significantly higher in the Southern regions, likewise physical inactivity. Conclusions: Preliminary data of the first 8 Regions (out of 10 to be examined in the on-going survey) underline that more than half of Italian adults are in excess of weight. In comparison to data measured within the CUORE Project 10 years earlier, a slight increasing of normal weight men seems to occur moving in the direction of the WHO-NCDs obesity target.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Donfrancesco ◽  
E Profumo ◽  
B Buttari ◽  
C Lo Noce ◽  
D Minutoli ◽  
...  

Abstract Background The WHO Global Action Plan for the Prevention of Non-Communicable Disease (WHO-NCD) recommends to halt the rise of obesity by 2025. Obesity is largely preventable. This preliminary analysis aims to assess mean level of BMI and prevalence of obesity in the Italian general adult population using the data collected within the CUORE Project to investigate if Italy can meet the WHO-NCD target. Methods Within the health examination survey conducted in 2018-2019, mean level of BMI and prevalence of obesity (BMI &gt; =30 kg/m2) and overweight (25 &lt; =BMI&lt;30 kg/m2) were assessed in representative random samples of resident population, aged 35-74 years, stratified by age and sex (822 men and 869 women), from 8 Italian Regions in Northern, Central and Southern Italy. Weight and height were measured using standardized methods. A standardized questionnaire was used to collect data on educational level that was used as a proxy of socio-economic status. The survey is funded by the Italian Ministry of Health-CCM. Results In this preliminary analysis, mean level of BMI was 26.8 kg/m2 (95% C.I. 26.5-27.1) in men and 25.9 kg/m2 (25.6-26.3) in women. Prevalence of obesity was 19% (16-22) in men and 22% (19-25) in women; prevalence of overweight was 45% (41-48) in men and 28% (25-31) in women. Obesity resulted significantly higher in persons with lower educational level (primary or middle school) vs those with higher education: 26% (20-31) vs 16% (13-19) in men and 33% (27-38) vs 17% (14-20) in women. Both in men and women prevalence of obesity was significantly higher in the Southern regions. Conclusions Preliminary data show that more than half of Italian adults are overweight/obese. However, in comparison to BMI measured in the CUORE Project 10 years earlier, the prevalence of people at normal weight is increasing, moving in the direction of the WHO-NCDs obesity target. Preventive actions at community level should be more incisive in the population at low socio-economic level. Key messages Mean BMI and prevalence of obesity in the Italian general adult population are still high. If confirmed, in the last ten years an increase of normal weight prevalence in the Italian general adult population seems to be occurred.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Cinzia Lo Noce ◽  
Anna Di Lonardo ◽  
Daniela Minutoli ◽  
Brigitta Buttari ◽  
...  

Introduction: Hypertension is a major risk factor for coronary heart disease, chronic kidney disease, ischaemic and haemorrhagic stroke. The WHO Global Action Plan for the Prevention of non-communicable diseases (NCDs) target by 2025 for hypertension is a 25% relative reduction in the prevalence of raised blood pressure. Hypothesis: Prevalence of raised blood pressure in adults has declined in high-income countries over the past few decades; the CUORE project surveys have shown this trend also in Italy from the 1980s to the 2010s. This preliminary analysis aims to assess mean level of blood pressure and prevalence of raised blood pressure in the Italian general adult population using the data collected within the CUORE Project-health examination survey. Methods: Within the ongoing survey, started in 2018, mean of blood pressure and prevalence of raised blood pressure are assessed in random samples of resident population, aged 35-74 years, stratified by age and sex (men 822 and women 869), from 8 Italian Regions from the Northern, Central and Southern Italy. Blood pressure is measured three times consecutively by automated oscillometric device using standardized procedures and methods. Mean level of first two measurements are here considered. Raised blood pressure is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg or under specific drug treatment. The survey is funded by the Italian Ministry of Health-CCM. Results: Preliminary analysis shows a mean value of systolic blood pressure of 131 mmHg (95% C.I.130-132) in men and 122 mmHg (121-123) in women. Mean value of diastolic blood pressure is 77 mmHg (76-78) in men and 73 mmHg (72-74) in women. Prevalence of raised blood pressure is 43.3% (39.9-46.7) in men and 32.4% (29.2-35.5) in women. In men prevalence of persons with raised blood pressure and untreated is 18.5% (14.6-22.3) and 8.6% (5.4-11.7) in women. In men and women prevalence of raised blood pressure is significantly higher in the Southern regions. Conclusions: Preliminary data of first 8 Regions (out of 10 which should be examined) underline that raised blood pressure is widely present in the Italian adult population. In comparison to data measured within the CUORE Project 10 years earlier, a decrease of mean level of blood pressure and prevalence of raised blood pressure seems to occur facilitating the meeting of WHO-NCDs target.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Luigi Palmieri ◽  
Chiara Donfrancesco ◽  
Cinzia Lo Noce ◽  
Francesco Dima ◽  
Lidia Gargiulo ◽  
...  

Background: Health Interview Survey (HIS) collects only self-reported height and weight to estimate obesity prevalence. Because of self-reporting, estimated obesity prevalence could be too low. From 2008 to 2012 an Health Examination Survey/Osservatorio Epidemiologico Cardiovascolare (HES/OEC) has been implemented in Italy with the aim of assessing cardiovascular (CV) risk factors, prevalence of risk conditions and CV diseases for the Italian adult population. Differences in measured and self-reported main anthropometric measures are described. Methods: Random samples of general population stratified by age and sex were examined in all Italian regions (participation rate 56%). Self-reported height and weight were requested to participants just after the welcome at the screening center. Height and weight were then measured using standardized procedures and methods. BMI was categorized in 3 groups: normal (BMI<25 kg/m2), overweight (25<=BMI<30 kg/m2), obesity (BMI>=30 kg/m2). Comparisons between measured and reported height, weight, and calculated BMI in men and women were assessed using t-test for means and chi-squared test for prevalence for paired samples. Results: Data from 2,583 men and 2,575 women aged 35-79 years were analysed. In men, measured height was lower than self-reported (-2.1 cm.), measured weight resulted higher than self-reported (+0.3 kg.); as a consequence BMI calculated on measured data resulted higher than that based on self-reported data (+0.8 kg/m2). Prevalence of obesity was higher for measured data than for self-reported (+7.1%). In men, difference between measured and self-reported height resulted higher in obese category than in the overweight or normal groups (-2.6 cm.), as well as for weight (+1.6 kg.). Similar results were registered in women: measured height was lower than self-reported (-3.6 cm.), measured weight resulted higher than self-reported (+0.8 kg.); as a consequence BMI calculated on measured data resulted higher than that based on self-reported data (+1.6 kg/m2). Prevalence of obesity was higher for measured data than for self-reported (+9.2%). Difference between measured and self-reported height resulted higher in obese category than in the overweight or normal groups (-5.0 cm.), as well as for weight (1.8 kg.). Both in men and women differences increased by age-group. Conclusions: Our results confirm how important is to produce standardised measures, also to adjust and correct self-reported height and weight, in order to have a reliable picture of obesity in the population. At present obesity is still a priority in public health and is one of the main indicator to plan community actions for cardiovascular disease prevention in the population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Donfrancesco ◽  
A Di Lonardo ◽  
D Minutoli ◽  
C Lo Noce ◽  
B Buttari ◽  
...  

Abstract Background The WHO Global Action Plan for the Prevention of Non-Communicable Disease (WHO-NCD) recommends a 25% relative reduction in the prevalence of raised blood pressure (RBP) by 2025. Prevalence of RBP and mean blood pressure in the Italian general adult population measured in the 2018 CUORE Project-Health Examination Survey are presented to investigate if Italy can reach this target. Methods Within the health examination survey conducted in 2018-2019, representative random samples of resident population, aged 35-74 years, stratified by age and sex (822 men and 869 women) were examined in 8 Italian Regions from the Northern, Central and Southern Italy. Blood pressure was measured by automated oscillometric device using standardized procedures and methods; mean level of two measurements are here considered. RBP is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg or being under specific drug treatment. The survey is funded by the Italian Ministry of Health-CCM. Results Preliminary analysis shows that prevalence of RBP is 43% (95% C.I. 40-47) in men and 32% (29-36) in women. Prevalence of persons with raised blood pressure and not receiving pharmacological treatment is 19% (15-22) in men and 9% (5-12) in women. In men and women prevalence of raised blood pressure is significantly higher in the Southern Regions. Mean value of systolic blood pressure is 131 mmHg (130-132) in men and 122 mmHg (121-123) in women. Mean value of diastolic blood pressure is 77 mmHg (76-78) in men and 73 mmHg (72-74) in women. Conclusions Preliminary data underline that RBP is commonly observed in the Italian adult population. However, in comparison to data measured within the CUORE Project 10 years earlier, prevalence of RBP and mean blood pressure are declining, facilitating the meeting of WHO-NCDs target. Key messages Raised blood pressure is commonly observed in the Italian general adult population. If confirmed, in the last ten years prevalence of raised blood pressure and mean blood pressure are declining in the Italian general adult population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Donfrancesco ◽  
C Lo Noce ◽  
O Russo ◽  
P Bellisario ◽  
D Galeone ◽  
...  

Abstract Background The WHO Global Action Plan for the Prevention of NCDs recommends a 30% relative reduction in mean population intake of salt/sodium. To this end, the Italian Ministry of Health (MoH) has strengthened prevention and health promotion through the “Gaining health: making healthy choices easy” Programme and the National Preventive Plan 2014-2019, in collaboration with the Interdisciplinary Working group for Salt Reduction in Italy. To estimate the habitual salt intake and its trend in the general adult population, national surveys, funded by the MoH-CCM, are conducted within the CUORE Project. Methods Baseline salt intake by the use of 24h urine collections was assessed in 2008-2012 from representative random samples of residents in all Italian Regions. A new survey was conducted in 2018-2019 involving random samples of residents in 10 Regions. Urinary sodium excretion is assayed by a central lab at Federico II University of Naples, subjected to strict quality controls. Comparisons are made considering, for both periods, the first seven regions examined in the 2018-2019 survey and the age range of 35-74 years. Results Within the 2008-2012 survey, mean level of sodium chloride per day in 642 men and 627 women were 10.6 g (10.3-11.0 g) and 8.0 g (7.7-8.3 g) respectively, whereas in the 2018-2019 survey the corresponding mean levels in 673 men and 709 women were 9.3 g (95% C.I.: 9.1-9.6 g) and 7.1 g (6.9-7.3 g), respectively. A sodium chloride intake level lower than the WHO recommended target of 5g/day (or 85 mmol/day) was detected in 5% (3-6%) of men and 16% (13-19%) of women examined in 2008-2012 vs 9% (6-11%) of men and 24% (20-27%) of women examined in 2018-2019. Conclusions These preliminary data show that the average habitual sodium intake in Italy is still higher than recommended but a significant reduction seems to occur. These results fully justify and encourage the ongoing preventive initiatives of MoH, facilitating the meeting of the WHO-NCD target. Key messages Habitual salt intake in the Italian general adult population is still higher than the recommended by the WHO. If confirmed, in the last ten years a reduction of habitual salt intake in Italian general adult population seems to be occurred.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Luigi Palmieri ◽  
Francesco Dima ◽  
Cinzia Lo Noce ◽  
Patrizia De Sanctis Caiola ◽  
...  

Background: Despite cardiovascular diseases (CVD) are the leading causes of death and hospitalization in nearly all countries in Europe, there are paucity, weak quality and comparability of data. The periodic Health Examination Survey (HES) represents in Italy the major source of information on CVD at national level thanks to the adoption of standardized methodologies throughout the country. The aim is to present differences in trends of CVD prevalence by gender in the Italian adult population from 1998 to 2008. Methods: Randomized population samples stratified by age and sex were examined. In 1998, 9,712 men and women aged 35–74 years were enrolled in all Italian regions; ongoing screening started in 2008 is enrolling 9,020 persons. A standardized questionnaire investigates cardiovascular disease and pharmacological treatments. The anamnesis is positive when clinical diagnosis has been made by a physician. Electrocardiograms read in Minnesota code are also performed and used to define previous myocardial infarction. Results: Data are from 12 regions in the North, Center, and South of Italy: 3,704 men and women in 1998 and 3,479 persons in 2008 are compared. In men, prevalence of cerebrovascular events decreases from 1.5% (95% confidence interval: 1.0-1.9%) in 1998 to 0.6 (0.3–0.9%) in 2008; in women, prevalence results stable: 0.9% in 1998 (0.5–1.3%) and 0.7% in 2008 (0.4–1.1%). Prevalence of myocardial infarction results stable both in men and women: in 1998, 1.9% in men (1.4–2.4%) and 0.6% in women (0.3–0.9%), and in 2008, 2.0% (1.4-2.7%) and 0.6% (0.3-0.9%) respectively; angina pectoris results stable as well: in 1998, 2.2% in men (1.7-2.8%) and 3.9% in women (3.1-4.6%), and in 2008, 3.2% (2.5-4.0%) and 4.5% (3.6-5.4%) respectively. Prevalence of by-pass or angioplasty surgery increases in men: 2.4% (1.8-3.0%) in 1998, and 4.5% (3.6-5.4%) in 2008; in women increasing is not significant: from 0.2% (0.0-0.4%) in 1998 to 0.7% (0.3-1.1%) in 2008. Stratifying data by geographical area (North, Center, South and Island) all comparisons become not significant; in men only, cerebrovascular decreasing and by-pass or angioplasty surgery increasing trends tend to be confirmed in all three areas. Conclusions: Trends between 1998 and 2008 decrease in cerebrovascular events and increase in prevalence of by-pass or angioplasty surgery, especially in men. Stable prevalence resulted for myocardial infarction and angina pectoris. Cerebrovascular decreasing trend is in line with smoking prevalence and mean of blood pressure decreasing in the country. Further analyses considering data from all Italian regions are needed to confirm results.


2003 ◽  
Vol 19 (suppl 1) ◽  
pp. S77-S86 ◽  
Author(s):  
Juliana Kain ◽  
Fernando Vio ◽  
Cecilia Albala

Obesity rates have increased markedly in Latin America, especially during the last 10-15 years, becoming a public health problem in most countries. Prevalence of obesity among preschool children remains low, while among schoolchildren it has increased considerably. Prevalence is high in the adult population, especially among women with less schooling. In developed populations, obesity occurs more frequently among the poor; the opposite occurs in less developed societies, where in households undergoing nutritional transition, underweight can coexist with obesity. The most important determinant factors involved in the increasing obesity prevalence are fetal and infant nutritional conditions (stunting), education and socioeconomic conditions, dietary changes (especially increased total energy intake), and physical inactivity. Because chronic diseases are the main causes of death in the Region and obesity is one of the main risk factors for these diseases, policies to improve economic and educational levels with the implementation of health promotion and prevention should be a priority in every country.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Igidbashian ◽  
F Caracci ◽  
P Bonanni ◽  
P Castiglia ◽  
M Conversano ◽  
...  

Abstract Introduction Invasive Meningococcal Disease (IMD) is one of the most severe vaccine-preventable disease, with high fatality rate and severe sequelae in up to 20% of survivors. MenB, MenC and MenACWY vaccines are available in Italy, but recommendations vary among Italian regions in terms of type of vaccines and targeted age groups. The aim of the study is to describe epidemiology of IMDs in order to provide the best vaccination strategy. Methods IMDs surveillance data in the period 2011-2017 from the Italian National Health Institute were explored. Excel was used to present trend analysis, stratifying by age and serogroups. Results In Italy, during the period 2011-2017, IMDs overall incidence increased from 0.25 cases/100,000 inhabitants in 2011 to 0.33 in 2017. Most cases after 2013 were caused by non-B serogroups (52%, 52%, 66%, 64%, 59% from 2013 to 2017). Although incidence is highest in 1 years old children, the number of cases is highest in the age range 25-64. The number of cases in this age-range had a steady increase after 2013 (36 cases in 2011, 79 in 2017), with serogroups C, W and Y present in more than 65% of cases in 25+ age ranges after 2012. Conclusions IMD is a rare but severe vaccine-preventable disease. The key role of public health is to monitor disease serogroups, trends and outbreaks and strengthen methodological evidence-based tools for decision-making processes, public health policies, planning of healthcare services and intervention measures, including immunization. The increase in incidence shown in the period 2011-2017 in Italy, although probably due to better surveillance, highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population. Based on our analysis we believe that anti-meningococcal vaccination plan in Italy should include the highest number of preventable serogroups and be aimed to the whole population through a multicohort strategy, including boosters in children and in adults. Key messages Anti-meningococcal vaccination plan in Italy should include all the preventable serogroups and be aimed to the whole population with a multicohort strategy including boosters in children and in adults. The increase in incidence of IMD in the period 2011-2017 in Italy highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Luigi Palmieri ◽  
Cinzia Lo Noce ◽  
Francesco Dima ◽  
Amalia De Curtis ◽  
...  

Background: From 2008 to 2012 an Health Examination Survey (HES)-Osservatorio Epidemiologico Cardiovascolare (OEC) has been implemented in Italy with the aim of assessing cardiovascular (CV) risk factors, prevalence of risk conditions and CV diseases for the Italian adult population. Methods: Random samples of general population stratified by age and sex were examined in all Italian regions (participation rate 56%). Risk factor were collected using standardized procedures and methods; biochemical tests were assayed in a central laboratory; a questionnaire investigates behaviours and CVD history; a ECG read in Minnesota code was used to define previous myocardial infarction. Comparisons between men and women were assessed using t-test for means and chi-squared test for prevalence. Results: Data of 4371 men and 4339 women ages 35-79 years were analysed. Majority of risk factors mean levels resulted higher in men than in women: systolic blood pressure (SBP) was 134 mmHg and 129 mmHg (p<0.0001), diastolic (DBP) was 84 mmHg and 79 mmHg (p<0.0001), fasting plasma glucose was 103 mg/dl and 95 mg/dl (p<0.0001), triglycerides was 135 mg/dl and 108 mg/dl (p<0.0001), respectively; as well as many CV risk conditions: smoking habit was 21% in men and 18% in women (p<0.0001), diabetes was 14% in men and 9% in women (p<0.0001) (28% of diabetic unaware both in men and women), 56% of men and 43% of women have SBP>=140 mmHg or DBP>=90 mmHg or in treatment (p<0.0001), 65% of men and 70% of women have total cholesterol (TC) >=200 mg/dl or in treatment for (p<0.0001), 48% of men and 33% of women are in overweight (BMI 25-29 kg/m 2 ) (p<0.0001). TC, LDL and HDL cholesterol resulted lower in men than in women: 209 mg/dl and 218 (44) (p<0.0001), 131 (38) mg/dl and 134 mg/dl (p<0.0001), 51 mg/dl and 62 mg/dl (p<0.0001), respectively. As well as prevalence of physical inactivity during leisure time: 31% in men and 43% in women (p<0.0001). Prevalence of obesity (BMI>=30 kg/m 2 ) resulted similar in men and women: 25% and 27% respectively (p=0.0818). Prevalence of myocardial infarction was 2.1% in men and 0.7% in women (p<0.0001), prevalence of by-pass or angioplasty surgery was 5.1% and 1.0% (p<0.0001), prevalence of angina pectoris was 3.2% and in 4.8% (p<0.0001), respectively. Conclusions: At present obesity and smoking are still a priority in public health. In combination with other information sources, the OEC can contribute greatly to plan community actions and health services at national and regional level.


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