The Effect of Body Adiposity and Alcohol Consumption on Serum Uric Acid: A Quantile Regression Analysis Based on the China National Health Survey

Adiposity and alcohol consumption are reported to be associated with a higher level of serum uric acid (SUA), but whether their effect differs on SUA percentile distribution is still unclear. In this study, we aimed to investigate how alcohol intake and body fat percentage (%BF) integrated with body mass index (BMI) influence the distribution of SUA in Chinese adults. Data from the China National Health Survey (CNHS) which included adults from 10 provinces of China were used (n = 31,746, aged 20–80 years, 40% male). %BF and BMI were integrated into eight expanded body composition groups to understand how excess body adiposity affects the distribution of SUA in the populational level. Self-report alcohol intake information was collected by face-to-face questionnaire interview. Quantile regression (QR) was used to analyze the data. We found that adiposity and alcohol consumption were associated with SUA, especially at the upper percentile in both sexes. In obese men, the QR coefficients at the 75th and 95th percentiles were 74.0 (63.1–84.9) and 80.9 (52.5–109.3) μmol/L, respectively. The highest quartile of %BF in men had a 92.6 (79.3–105.9) μmol/L higher SUA levels at its 95th percentile than the 5th quartile (p < 0.001). Compared with normal or underweight with the lowest %BF group (NWBF1), the obesity-highest %BF group (OBBF4) had the strongest positive effect on SUA, especially at the higher percentile of SUA. In BMI-defined normal or underweight participants, a higher quartile of %BF had greater effect size in all SUA percentiles. In men, current alcohol drinking had the strongest effect at the 95th percentile of SUA (QR coefficient: 31.8, with 95% CI: 22.6–41.0) comparing with 14.5, 95% CI of 8.4 to 20.6 in the 5th SUA percentile. High risk of alcohol consumption had a greater effect on SUA, especially in the higher SUA percentile. The observation of stronger association at the higher percentile of SUA suggests that decreasing body adiposity and alcohol intake at the populational level may shift the upper tails of the SUA distributions to lower values, thereby reducing the incidence of hyperuricemia.

Working Conditions and Health Among Italian Ageing Workers

In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Italian surveys, as well as comparing them with those observed in the same surveys conducted before the 2011 Italian pension reform tightening the normal retirement age. The 2013 National Health Survey (NHS) and Labour Force Survey (LFS) were employed to assess the prevalence of poor perceived health, health conditions and functional limitations, and of exposure to physical, psychosocial and organization factors at work, among 60–64 years workers. Poisson regression models were used to estimate Prevalence Ratios of health outcomes and unfavorable working conditions in the two surveys, compared to data from the 2005 (NHS) and 2007 (LFS) corresponding surveys, respectively. Among both men and women, approximately one quarter had at least one physical disorder or functional limitations and 15% poor mental health. Exposure to different ergonomic factors (15–30%) and working during unsocial hours (19%) were particularly diffused. A significant increase in the prevalence of functional limitations and of working at night or during unsocial hours was found in 2013, compared to corresponding data from 2005 and 2007, respectively. Our results indicate that exposure to ergonomic and organizational hazards should be reduced among ageing workers, to avoid decreased work ability, health damage or early exit from the labour market.

Factors associated with use of assistive walking devices among older adults in Brazil

Background Walking devices and other forms of assistive technology (AT) can benefit older adults by supporting mobility and social interactions, but usage outside of high-income countries is generally low. Objective To examine the factors associated with AT use and whether AT use is associated with higher levels of social participation among older adults in Brazil. Method The 2013 Brazilian National Health Survey interviewed 23,815 individuals 60 years or older. Descriptive and logistic regression analyses were used to examine AT use, including canes and walkers, to assist with walking and social participation. Results Among older adults with mobility difficulty, 34.0% (95% CI 31.2- 36.9) reported using AT. Prevalence of the use of AT for walking increases with age: 21.4% of those 60-69 years reported using AT while 58.5% of those 90 years or older did. AT was negatively associated with participation in social activities. Conclusion Our analyses focused on older adults with mobility limitations who need appropriate transportation and environment adaptations to engage socially. Contrary to studies in more developed countries, among Brazilians, AT use is negatively associated with social interactions. The resulting confinement seems to lead to social isolation.

Emotional Regulation Activities Moderates the Risk of Depression in People With Sleep Disturbance: Evidence From a Community Health Survey

Background and Objective It is widely known that poor sleep quality is closely related to depression, but there are limited studies on the mediating factors.Methods Based on national health survey data, the relationship between sleep quality and depressive symptoms was explored, and structural equations were drawn to determine whether emotional regulation activities, such as regular breakfast, regular exercise, smoking, and drinking contribute to poor sleep quality-induced depression.Results There was a significant correlation between poor sleep quality and depressive symptoms. Regular breakfast tended to mediate between poor sleep quality and depression the most, followed by smoking, drinking, and regular exercise.Conclusions Several emotional regulation activities including regular breakfast, can play a protective role in the process leading to poor sleep quality-induced depression. A follow-up study is required to examine the clinical aspect of how regular breakfast can prevent the process of poor sleep quality to depression.

Association between Estimated Cardiorespiratory Fitness and Depression among Middle-income Country Adults: Evidence from National Health Survey

Objective: This study assessed the relationship between cardiorespiratory fitness (CRF) and depression in adults. Methods: A total of 52,611 individuals aged between 18-59 years old were evaluated for symptoms of depression and CRF. The presence of depressive symptoms was self-report through the Patient Health Questionnaire (PHQ-9), and the CRF was predicted from a non-exercise equation. The association between CRF and the presence of depression was determined by crude and multivariable-adjusted logistic regressions. Results: The associations were identified between symptoms of depression and CRF in both unadjusted and adjusted models. After adjusting for age categories, sex, body mass index categories, educational level, marital status, smoking, and alcohol use, the individuals with moderate CRF had 18% lower odds of depression (OR: 0.82, CI 95%: 0.71 – 0.95) compared to individuals with low CRF. Conclusion: Depressive symptoms are inversely related to CRF levels in adults.

Limitations in Activities of Daily Living in Individuals With Chronic Kidney Disease: Biopsychosocial Factors of the Brazilian Population

This study assesses the relationship between biopsychosocial factors and limitations in activities of daily living (ADL) in individuals with chronic kidney disease (CKD). Individual data from the National Health Survey were analyzed, with a sample size of 839 participants. The outcome was dichotomous, presenting limitations in ADL, and the factors considered were clinical and health characteristics, self-perceived behavior, contextual social support, and housing. Cox regression was applied to control the interaction between factors, using the prevalence ratio as a measure of effect and a significance level of 5%. A total of 839 individuals with CKD were reported, of which 373 (40.7%: 35.4 - 46.1%) reported having limitations in ADL. The presence of limitations in ADL was related to residing in a rural area, as well as to the absence of private health insurance, worse self-perceived health, presence of depressive symptoms, and disabilities, in addition to the use of medications and hemodialysis. Limitations in ADL in individuals with CKD are associated with biopsychosocial factors in the Brazilian population, requiring public policies that enable better therapeutic management and support for behavioral health and contextual needs.

Health perception, health conditions, and smoking cessation in Brazil

Background Smoking cessation is strongly associated with motivational factors. It is possible that individuals who have successfully stopped smoking have different conditions and judgments about their own health. Objective To evaluate the relationship between tobacco-related diseases, health perception, and successful smoking cessation in Brazil. Method Cross-sectional observational study using data from the 2013 National Health Survey (PNS - 2013). Sociodemographic and health-related variables were considered in this study. Logistic regression modeling was carried out considering smoking cessation as outcome. Results Successful smoking cessation attempt was associated with age (OR=2.9, p=0.004), marital status (OR=1.69, p<0.001), level of education (OR=1.34, p<0.001), socioeconomic status (OR=1.58, p<0.001), census status (OR=1.07; p<0.001), access to pro-tobacco advertising (OR=1.74, p<0.001), anti-tobacco campaigns (OR=3.30; p<0.001) and, in particular, living with other smokers (OR=9.65; p<0.001). Conclusion Knowledge about sociodemographic and census status variables is relevant to the assessment of future specific health promotion policies.

A healthy eating score is inversely associated with depression in older adults: Results from the Chilean National Health Survey 2016-2017

Objective: To investigate the relationship of a healthy eating score with depression in Chilean older adults. Design: Cross-sectional study. Setting: Chilean older adults from the Chilean National Health Survey 2016-2017. Associations were analyzed using complex samples multivariable logistic regressions adjusted for: age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption, and sleep duration), body mass index, and clinical conditions (hypertension, diabetes, hypercholesterolemia, and cardiovascular diseases). Participants: The number of participants were 2,031(≥60y). The Composite International Diagnostic Interview-Short Form (CIDI-SF) was applied to establish the diagnosis of major depressive episode (MDE). Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables, and legumes. Participants were categorized according to their final scores as healthy (≥9), average (5 to 8), and unhealthy (≤4). Results: Participants with a healthy score had a higher educational level, physical activity, and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0.28, 95%CI: 0.10-0.74). Food items that contributed the most to this association were legumes (15.2%) and seafood (12.7%). Conclusion: Participants classified in the healthiest healthy eating score, characterized by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.

Gender Differences in the Association Between Cataract and Mental Health in Adults With Diabetes: A Cross-Sectional Analysis From the Spanish National Health Survey 2017

Objective: This study aimed to explore gender differences in the associations between cataracts and self-reported depression and chronic anxiety in Spanish adults with diabetes.Methods: Cross-sectional data from the Spanish Health Survey 2017 were analyzed. Inclusion criterion was a positive response to the question “Have you ever been diagnosed with diabetes?” Diabetes, cataracts, depression and chronic anxiety were based on self-reported lifetime diagnosis. Multivariable logistic regression was conducted to assess the association between cataracts and depression or anxiety among respondents with diabetes, stratifying by gender.Results: Out of a total 23,089 respondents, 2,266 people self-reported suffering from diabetes (50.2% women; average age 69.7 ± 12.7 years; age range 15-98 years). In people with diabetes, the presence of cataracts was associated with significantly higher odds for depression (OR = 1.655; 95% CI = 1.295-2.115). Gender-stratified analyses showed that only women with cataracts were significantly associated with higher odds for depression (OR = 1.762; 95% CI = 1.307-2.374) and chronic anxiety (OR = 1.519; 95% CI = 1.067-2.163).Conclusion: Cataracts are a significant risk factor for depression and chronic anxiety in Spanish women with diabetes, but not in men. Women with both diabetes and cataracts require assessment for depression and chronic anxiety, and possibly earlier interventions in order to reduce the potential risk of further mental health complications.