Gender related differences in dietary behaviors, cardiometabolic risks, unhealthy lifestyle factors, and their effect on cardiovascular morbidity in primary care

Yıl 2022, Cilt: 47 Sayı: 2, 535 - 547, 30.06.2022

Ayfer Bayındır Çevik Serap Baydur Şahin Sema Koçan Mehtap Metin Karaaslan Hilal Pekmezci Purut Aynur Kırbaş Teslime Ayaz

Öz

Purpose: This study aims to evaluate gender differences in dietary behaviors, cardiometabolic risks, related lifestyle factors, and their effect on cardiovascular morbidity in primary health care services.
Materials and Methods: The sample size of this population-based cross-sectional study was 930 adult individuals chosen by population-proportional cluster sampling. The researchers administered the questionnaires, anthropometric measurements, and blood drawing procedures. The effect of diet and lifestyle habits on the presence of cardiovascular diseases by gender was examined.
Results: The prevalence of cardiovascular diseases was 11.7% in men and 9.0% in women. Being over 50 years old, MetS contributed to the presence of heart disease while tea had a protective effect on both genders. Smoking and butter use were associated with heart disease in men.
Conclusion: This study showed that there is a relationship between gender and various risk factors for cardiovascular morbidity in primary care. These findings suggest that health care professionals should design gender-specific strategic programs for CVD prevention.

Anahtar Kelimeler

Cardiovascular morbidity, dietary behaviors, gender-related differences, primary care

Destekleyen Kurum

Recep Tayyip Erdoğan Üniversitesi

Proje Numarası

12.110.01.1.

Teşekkür

Authors offer their thanks to the Provincial Health Director Dr. Mustafa Tepe who provided permit and support on conducting the survey part of the study, to the laboratory supervisor Köksal Karaca for his assistance on conducting biochemical analyses, to Public Health specialist Professor Dr Leyla Kara, PhD for her assistance in statistical analyses, to the Family Health Center staff and to all participants of the study.

Beslenme davranışları, kardiyometabolik riskler ve sağlıksız yaşam tarzı faktörlerinde cinsiyete bağlı farklılıklar ve birinci basamakta kardiyovasküler morbidite üzerine etkileri

Öz

Amaç: Bu çalışmanın amacı, diyet davranışları, kardiyometabolik riskler, yaşam tarzı faktörleri ve bunların kardiyovasküler morbidite üzerindeki etkilerinde cinsiyet farklılıklarını birinci basamak sağlık hizmetlerinde değerlendirmektir.
Gereç ve Yöntem: Bu toplum temelli kesitsel çalışmanın örneklem büyüklüğü Nüfus orantılı küme örnekleme yöntemi ile 930 yetişkin birey seçildi. Anketlerin, antropometrik ölçümlerin ve kan alma prosedürlerinin uygulanması araştırmacılar tarafından gerçekleştirildi. Beslenme ve yaşam tarzı alışkanlıklarının cinsiyete göre kardiyovasküler hastalık varlığı üzerindeki etkisi incelendi.
Bulgular: Kardiyovasküler hastalık prevalansı erkeklerde %11.7 ve kadınlarda %9.0 idi. Her iki cinsiyette de 50 yaşın üzerinde olmak kardiyovasküler hastalık prevalansı ile iyi ilişkili iken, çay tüketimi koruyucu etkiye sahiptir. Ayrıca sigara ve tereyağı kullanımı erkeklerde kalp hastalığı ile iyi ilişkilidir.
Sonuç: Bu çalışma, birinci basamakta kardiyovasküler morbidite için cinsiyet ve çeşitli risk faktörleri arasındaki ilişkiye dair kanıtlar sağlamıştır. Bulgular, sağlık profesyonellerinin kardiyovasküler hastalık önleme için cinsiyete özel stratejik programlar tasarlaması gerektiğini göstermektedir.

Anahtar Kelimeler

Cardiovascular morbidity, dietary behaviors, unhealthy lifestyle factors, gender-related differences, primary care

Proje Numarası

12.110.01.1.

Kaynakça

• 1. WHO. Health Topic: Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) 07.12.2020.
• 2. Kayikcioglu M, Oto A. Control and Management of cardiovascular disease in Turkey. Circulation. 2020;141(1): 7-9. https://doi.org/10.1161/CIRCULATIONAHA.119.037606.
• 3. Li Y, Schoufour J, Wang DD, Dhana K, Pan A, Liu X, Song M. et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ. 2020; 368:l6669. https://doi.org/10.1136/bmj.l6669
• 4. Franklin, BF, Myers, J, Kokkinos, P. Importance of lifestyle modification on cardiovascular risk reduction counseling strategies to maximize patient outcomes. Journal of Cardiopulmonary Rehabilitation and Prevention. 2020; 40: 138-143. https://doi.org/10.1097/HCR.0000000000000496.
• 5. Timmis A, Townsend N, Gale C, Grobbee R, Maniadakis N, Flather M, Wilkins E, et al. ESC Scientific Document Group. European Society of Cardiology: cardiovascular disease statistics 2017. Eur Heart J. 2018; 39:508–579. https://doi.org/10.1093/eurheartj/ehx628.
• 6. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation.2019;140(11):e596–e646. https://doi.org/10.1161/CIR.0000000000000678
• 7. Bayındır Çevik A, Metin Karaaslan M, Koçan S, et al. Prevalence and screening for risk factors of type 2 diabetes in Rize, Nourtheast Turkey: findings from a population-based study. Primary Care Diabetes. 2016; 10(1): 10-8. http://dx.doi.org/10.1016/j.pcd.2015.06.002
• 8. Hoes AW, Agewall S, Albus C, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal. 2016; 37: 2315–2381.
• 9. Dinç G, Sözmen K, Gerçeklioğlu G, Arık H, Critchley J, Unal B, et al. Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008. BMC Public Health. 2013; 13: 896 https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-896
• 10. Humphries KH, Izadnegadar M, Sedlak T, Saw J, Johnston N, Schenck-Gustafsson K, Shah RU,Regitz-Zagrosek V, Grewal J, Vaccarino V, Wei J, and Bairey Merz CN. Sex Differences in cardiovascular disease – ımpact on care and outcomes. Front Neuroendocrinol. 2017; 46: 46–70.
• 11. Canadian Institutes of Health Research. Science is better with sex and gender strategic plan 2018-2023. https://cihr-irsc.gc.ca/e/51310.html., 07.12.2020.
• 12. Mosca L, Barrett-Connor E, Kass Wenger N. Gender/gender differences in cardiovascular disease prevention what a difference a decade makes. Circulation. 2011, 8; 124: 2145–2154. https://doi.org/10.1093/eurheartj/ehw106.
• 13. Puddu PE, Menotti A. The impact of basic lifestyle behaviour on health: how to lower the risk of coronary heart disease, other cardiovascular diseases, cancer and all-cause mortality. Lifestyle adaptation: a global approach. e-Journal of Cardiology Practice.2015; 13(32 – 29).
• 14. McKenzie BL, Santos JA, Geldsetzer P, Davies J, Manne-Goehler J, Gurung MS, Sturua L. et al. Evaluation of gender differences in dietary behaviors and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries. Nutrition Journal. 2020; 19:1-15. https://doi.org/10.1186/s12937-019-0517-4.
• 15. Huang L, Trieu K, Yoshimura Y, Neal B, Woodward M, Campbell NRC, Li Q, et al. Effect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials. BMJ. 2020;368:m315 https://doi.org/10.1136/bmj.m315.
• 16. Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017; 46: 1029–1056. https://doi.org/10.1093/ije/dyw319
• 17. Fung TT, Van Dam RB, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low-carbohydrate diets and all-cause and cause-specific mortality. Ann. Intern. Med. 2010; 153: 289-298. https://doi.org/10.7326/0003-4819-153-5-201009070-00003.
• 18. Katano S, Nakamura Y, Okuda N, Murakami Y, Chiba N, Yoshita K, et al. Relationship between dietary and other lifestyle habits and cardiometabolic risk factors in men. Diabetology & Metabolic Syndrome 2011; 3: 1-7. https://doi.org/10.1186/1758-5996-3-30.
• 19. Erdogan, S, Nahçıvan, N, Esin, N. Research process, practice and critic in nursing. Nobel Publishing 2014, İstanbul.
• 20. Kalaycı S. SPSS applied multivariate statistics techniques. 5.Ed, Asil Publishing, 2018; Ankara.
• 21. Flack JM, Adekol B. Blood pressure and the new ACC/AHA hypertension guidelines 2020; 30: 160-164. https://doi.org/10.1016/j.tcm.2019.05.003.
• 22. BMI (Body Mass Index). National heart, lung, and blood institute. (2020). https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
• 23. Türkiye Endokrinoloji ve Metabolizma Derneği. Diyabetes Mellitus Tanı, Tedavi ve İzlem Kılavuzu, ISBN: 978-605-4011-40-7, Haziran 2020, Ankara.
• 24. American Diabetes Association. 2. Classification and Diagnosis of diabetes: standards of medical care in diabetes 2019. Diabetes Care 2019;42(Suppl 1):S13–S28.
• 25. Williams B, Mancia G, Spiering W, Rosei E.A., Azizi M, Burnier M, Clement DL, et al. ESC Scientific Document Group, 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal. 2018, 39:3021–3104. https://doi.org/10.1093/eurheartj/ehy339
• 26. International Diabetes Federation (IDF). The IDF consensus worldwide definition of the Metabolic Syndrome. 2021. https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html 7.12.2020
• 27. Grundy SM, Stone NJ, Bailey AL, et al. AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2019;139:e1082–143.
• 28. Medical Association. Declaration of Helsinki. Br Med J. 1964;2:177. https://doi.org/10.1136/bmj.2.5402.177.
• 29. Miller V, Mente A, Dehghan M, Rangarajan S, Zhang X, Swaminathan S, Dagenais G, Gupta R, Mohan V, Lear S. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet. 2017;390:2037–49. https://doi.org/10.1016/S0140-6736(17)32253-5. 30. Forouhi NG, Krauss RM, Taubes G, Willett W. Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance. BMJ. 2018; 361: k2139. https://doi.org/10.1136/bmj.k2139
• 31. Nestel PJ, Mellett N, Pally S, Wong G, Barlow CK, Croft K, et al. Effects of low-fat or full-fat fermented and non-fermented dairy foods on selected cardiovascular biomarkers in overweight adults. British Journal of Nutrition 2013; 110:2242-9. https://doi.org/10.1017/S0007114513001621.
• 32. Patterson E, Larsson SC, Wolk A, Akesson A. Association between dairy food consumption and risk of myocardial infarction in women differs by type of dairy food. The Journal of Nutrition 2013; 143: 74-9. https://doi.org/10.3945/jn.112.166330.
• 33. Song X, Jousilahti P, Stehouwer CDA, Söderberg S, Onat A, Laatikainen T, et al. Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans. Nutrition, Metabolism & Cardiovascular Diseases 2015; 25: 295- 304. https://doi.org/10.1016/j.numecd.2014.09.004.
• 34. Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women. Archives of Internal Medicine 2010; 170:711-8. https://doi.org/10.1001/archinternmed.2010.76.
• 35. Mikkola TS, Gissler M, Merikukka M, Tuomikoski P, Ylikorkala O. Gender differences in age-related cardiovascular mortality. PLoS One 2013; 8: 2-13. https://doi.org/10.1371/journal.pone.0063347
• 36. Amiri P, Mohammadzadeh-Naziri K, Abbasi B, Cheraghi L, Jalali-Farahani S, Abbasi B, et al. Smoking habits and incidence of cardiovascular diseases in men and women: findings of a 12 year follow up among an urban Eastern-Mediterranean population. BMC Public Health. 2019; 19:1042-52. https://doi.org/10.1186/s12889-019-7390-0.
• 37. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemia: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). European Heart Journal. 2020; 41:111–188. https://doi.org/10.1093/eurheartj/ehz455
• 38. Shohaimi S, Boekholdt MS, Luben R, et al. Distribution of lipid parameters according to different socio-economic indicators- the EPIC-Norfolk prospective population study. BMC Public Health. 2014, 14:782. https://doi.org/10.1186/1471-2458-14-782
• 39. Danzi, S, Klein, I. Thyroid disease and the cardiovascular system. The Journal of Clinical Endocrinology & Metabolism. 2014; 43:517-28. https://doi.org/0.1016/j.ecl.2014.02.005
• 40. O'Keefe EL, DiNicolantonio JJ, Patil H, Helzberg JH, Lavie CJ. Epidemics of diabetes and cardiovascular disease among Asian Indians. Progress in Cardiovascular Diseases 2016;58:505-13. https://doi.org/10.1016/j.pcad.2015.08.010
• 41. Khayyam-Nekouei Z, Neshatdoost H, Yousefy A, Sadeghi A, and Manshaee G. Psychological factors and coronary heart disease. ARYA Atheroscler. 2013; 9(1): 102–111.
• 42. Zhang C, Qin YY, Wei X, Yu FF, Zhou YH, He J. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies. European Journal of Epidemiology 2015; 30: 103-13. https://doi.org/10.1007/s10654-014-9960-x.
• 43. Santesso N, Manheimer E. A summary of a Cochrane review: green and black tea for the primary prevention of cardiovascular disease. Global Advances in Health and Medicine. 2014; 3: 66-7. https://doi.org/10.7453/gahmj.2014.003