Psycho-Social Factors, Lifestyle Practices & the Metabolic Syndrome BNF Workshop: London 2006

Transcription

1 FCNAUP Psycho-Social Factors, Lifestyle Practices & the Metabolic Syndrome BNF Workshop: London 26 Barbara Stewart Northern Ireland Centre for Food & Health (NICHE)

2 LIPGENE Workpackage 5 Demonstration 5.3: 5.3: Survey in in six six EU EU countries (Years (Years 2-3) 2-3) WP WP 5.1: 5.1: Qualitative consultationwith consumers and and stakeholders (Year (Year 1) 1) 5.2: 5.2: Model Metabolic Metabolic syndrome syndrome & Psychological Psychological factors factors (Years (Years 2-3) 2-3) Dissemination

3 Background Metabolic syndrome a consequence of: Inherited disposition Social circumstances Detrimental lifestyle practices Negative emotions Chronic stress (Fan et al.., 23) Type A behaviour (Ravaja et al., 1996) Lack of research exploring positive psychological factors that may protect against metabolic syndrome

4 Survey Aim & Objectives Determine the relative contribution of demographic, lifestyle, social and psychological factors to the development of metabolic syndrome Define societal segments according to reported signs of metabolic syndrome Identify demographic, social, lifestyle and psychological factors that predict membership of these segments Consider specific health promotion requirements in these groups

5 Method Ethical approval granted by the Office of Research Ethics Committee (OREC) Fieldwork sub-contracted to Ipsos MORI (GB) took place during January 26 Multi-stage stratified cluster sampling Omnibus survey in Portugal (n=54) and Great Britain (n=1182) Data analysis conducted by the partners using Microsoft EXCEL, SSPS for Windows Version 13 and Mplus (Muthén & Muthén) Version 4 Software

6 Questionnaire Questionnaire designed by the partners in consultation with MORI with reference to the qualitative findings Demographic information Lifestyle Diet (FFQ) Physical activity Anthropometric measures BMI Waist circumference Indicators of MS: High Blood Pressure High Cholesterol High/Low Blood Sugar Abdominal obesity Resilience Scale (RS11) (Wagnild & Young, 1993) Mood Survey (Underwood & Froming,198) Hopelessness Scale derived from the BDI (Beck et al., 1974) Perceived Stress Scale (PSS4) (Cohen et al., 1983) Life Events Scale (LES) (Mooy et al., 2)

7 The Sample % of Country Age groups, Country by Sex GB Male GB Female PT Male PT Female Age Groups (Years)

8 The Sample BMI by country and sex Mean BMI GB Male GB Female PT Male PT Female Country and Sex

9 The Sample 9 Weight (kg) by country and sex Mean Q1A (Kgs) - Approximate Weight GB Male GB Female PT Male PT Female Country X Sex

10 1.8 The Sample Height (m) by country and sex 1.7 Approximate Height (m) GB Male GB Female PT Male PT Female Country by Sex

11 BMI (self-reported height and weight) Morbid obesity (>4kg/m 2 ) Obesity grade II (35-39,9kg/m 2 ) Obesity grade I (3-34,5kg/m 2 ) Overweight (25-29,9kg/m 2 ) Normal weight (18,5-24,9kg/m 2 ) n = 959 n = Underweight (<18,5kg/m 2 ) % GB PT

12 Reported Indicators of Metabolic Syndrome GB (%) PORTUGAL (%) Male Female Male Female High Bl Chol ** High B/P ** Mid Obesity * High Bl Sugar ** Low Bl Sugar * Significant differences at 5% level ** Significant differences at 1% level

13 Low blood sugar High blood sugar Stress Self-Reported Indicators of Metabolic Syndrome By Country Central Obesity High blood pressure High cholesterol % n = n = 1182 WAIST CIRCUMFERENCE 89cm (58-147cm) 94cm (±1,4cm) WAIST CIRCUMFERENCE 96cm (58-172cm) 99cm (±13,9cm) 28 94cm (±15,1cm) 83cm (±13,7cm) GB PT

14 Reported Indicators of Metabolic Syndrome: Latent Class Analysis Metabolic syndrome (MS) Latent class probabilities Probability of endorsing MS indicator High Cholesterol High Blood pressure Mid obesity High blood sugar Self reported MS indicators Low Blood sugar Class 1 Class 2 Class 3 Class 4 1: healthy 2: overweight 3: obese 4: metabolic syndrome (Entropy.76)

15 Anthropometric Measures: Latent Class Analysis Latent class by BMI and waist girth BMI Waist girth (cm) BMI Waist circumference Class 1 Class 2 Class 3 Class 4 Latent Class 75 1: healthy 2: overweight 3: obese 4: metabolic syndrome (Entropy.76)

16 Reported Indicators of Metabolic Syndrome & Latent Class Estimated Posterior Possibilities N % Healthy Overweight Obese Metabolic Syndrome

17 Reported Indicators of Metabolic Syndrome: Probability of being Assigned to Latent Class High Bl Chol High B/P Central Obesity High Bl Sugar Low Bl Sugar Healthy No Yes Overweight No Yes Obese No Yes Metab. Synd. No Yes

18 Reported Indicators of Metabolic Syndrome: Response Patterns, Observed Frequencies & Latent Class Response High Chol High B/P Central Obesity High Bl Sugar Low Bl Sugar Frequency

19 Demographic Characteristics & Latent LIP ClassGENE Nationality Gender Age GB % P % F % M % Mean (SD) Metab. Syn (1.4) Obese (9.9) Overweight (1.6) Healthy (11.7) Total (11.4)

20 Anthropometric Measures & Latent Class MS Score BMI Waist Cms Mean (SD) Mean (SD) Mean (SD) Metabolic Synd (4.) 1.1 (11.1) Obese (7.7) 14.9 (22.5) Overweight (3.8) 93.2 (1.6) Healthy (3.2) 86.4 (11.) Total (4.6) 91.2 (13.2)

21 Lifestyle & Latent Class Smoking % Phys Activity (Factor Loadings) Dietary Habits (Factor Loadings) No Sm Quit Smoke W Day W End H Alcoh Unhealth Healthy Metab. Syn Obese Overweight Healthy Total

22 Self-Reported Stress, Major Life Events & Latent Class Stress % Personal Probs. % Bereavement % No Events % Metab. Syn Obese Overweight Healthy Total

23 Psychological Factors & Latent Class Perceived Stress (PSS) Resilience (RS1) Mood Survey Hopelessness (BDI) F 1 Emotion F 2 Control General Lability Intensity Metab. Syn Obese Overwt Healthy Total

24 Multinomial Logistic Regression Analysis comparator group = healthy - no signs of metabolic syndrome Demographic information Lifestyle FFQ (3 Factors: healthy; unhealthy; alcohol) Anthropometric measures Self reported stress Indicators of MS Resilience Scale (RS11) Mood Survey Hopelessness Scale (BDI) Perceived Stress Scale (PSS4)(2 factors: emotional; control) Life Events Scale (LES) (3 Factors: bereavement; personal problems; no events)

25 Group metabolic syndrome Report multiple signs of metabolic syndrome (high MS score) Typically: High BMI and waist circumference Portugese Older Inactive (especially weekdays) Experienced negative life events (especially bereavement) Less resilient

26 Group obese One third (approx) report high BP Typically: Very high BMI and waist circumference Female Inactive (especially weekdays) Less likely to feel emotional stress (PSS) More likely to experience labile mood

27 Group overweight Report central obesity Typically: Moderately high BMI and waist circumference British Younger Inactive (especially weekdays) Quit smoking/not current smokers Less likely to experience (perceived control related) stress (PSS)

28 Conclusions Four societal segments report various degrees of metabolic syndrome: Demographically distinct Typified by differing: Lifestyle Life experiences Propensity for psychological well-being These groups could be assumed to have different health intervention requirements

29 References Beck AT, Steer RA, Kovacs M & Garrison B (1985) Hopelessness and eventual suicide: a 1-year perspective study of patients hospitalized with suicidal ideation. Am J Psychiatry, 142, Cohen S, Kamarck T & Mermelstein R (1983) A global measure of perceived stress. J Health & Social Behaviour, 24, Fan A, Dwyer K & Dwyer J (23) Chronic stress is related to susceptibility of metabolic syndrome through elevating sympathetic activity in middle-aged adults. Ravaja N, Keltikangas Jarvinen L & Viikari J (1996) Type A behavior and metabolic syndrome precursors in young adults. J Clinical Epidemiology, 49, Mooy JM, Bouter LM, de Vries H, Heine RJ & Grootenhuis PA (2) Major stressful life events in relation to prevalence of undetected Type 2 Diabetes. Diabetes Care, 23, Underwood B & Froming WJ (198) The mood survey A personality measure of happy and sad moods. J Personality & Assessment, 44, Wagnild GM & Young HM (1993) Development and psychometric evaluation of the resilience scale. J Nursing Measurement, 1,

30 LIPGENE Workpackage 5 Consumer research led by Professor Daniel Almeida at the University of Porto, Portugal with Dr. Barbara Stewart-Knox University of Ulster, Coleraine. Survey fieldwork subcontracted to MORI Social Research Unit mdvalmeida@fcna.up.pt b.knox@ulster.ac.uk bp.bunting@ulster.ac.uk hj.parr@ulster.ac.uk Se.gilpin@ulster.ac.uk Hodge-s@ulster.ac.uk silviapinhao@fcna.up.pt Michele.Corrado@mori.com

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