Lifestile And Socio-Demographic Factors Determining The Coronary-Arterial Disease Risks In Brazilian Free-Living Adults

Abstract

PURPOSE: Coronary heart disease(CHD) continues to be a leading cause of morbidity and mortality among adults worldwide. The risk factors include complications of Metabolic Syndrome(MetS) and environmental factors. The Framingham score(FS) is a predictive algorithm developed using categorical variables, allowing the 10-yr prediction of multivariate CHD risk in patients without overt CHD. The purpose is to determine the intrinsic and the involved environmental factors of CHD in free-living adults. METHODS: A lifestyle modification program(LSM) involving dietary counseling and regularly supervised physical activity(“Move for Health”) has been used here, since 1991 for NCDs primary care. In a cross-sectional study we used the baseline data from 709 subjects(2005-2016), older than 35 yrs.The FS distribution was used as main variable and, as co-variablessocio-demographic, behavioral(dietetic and physical fitness)anthropometric and clinical-biochemistry.For these accomplishments, were used IPAQ(long-version), Healthy Eating Index(through 24h food intake recall), body weight, height and electrical bio-impedance, clinical signs and fasting plasma markers of insulin resistance(HOMA-IR), inflammatory(hs-CRP) and oxidative(MDA and uric acid) states. Statistical comparisons were defined by p=0.05. RESULTS: The top quartile of FS was found as ≥10% for females(F) and ≥15% for males(M) and, they differed from the lower quartile (≤3% and ≤5%, respectively), by presenting 1.81x higher either HOMA-IR, 1.61x hs-CRP and 1.6x MDA values. Prevalence of MetS was 2.6x higher in p75(71.9% F and 73.1%M) than p25(28.1%F and 26.9%M) with p75 being fatter(higher BMI, total body and abdominal fatness) with lower physical activity, lower aerobic capacity, lower either muscle mass and hand grip force.The p75 FS subjects presented also lower schooling and lower income.Their poor diet quality(HEI) was characterized by being more processed foods(higher CHO/fibers and sodium/potassium ratio), higher daily consumption of oils(and PUFAs) and cholesterol and, less amounts of MUFA, fruits and vegetables(and fibers). CONCLUSIONS: The higher FS(moderate CHD risk) of this community followed markers of the MetS aggravation, having inadequate- dietary quality and physical unfitness as environmental factors.