European Adult Population Research Articles

Exposure assessment of the European adult population to deoxynivalenol – Results from the HBM4EU Aligned Studies

Mycotoxins are natural toxins produced by fungi that may cause adverse health effects thus constituting a public health concern. Deoxynivalenol (DON), a mycotoxin affecting the immune system and causing intestinal disorders, was selected as a priority under the European Human Biomonitoring Initiative (HBM4EU). Urinary total DON levels (tDON) of 1270 participants from six countries were used to characterize the internal exposure of the adult European population and identify the most relevant determinants of exposure. tDON concentrations’ P50 and P95 were in the range of 0.41–10.16 µg/L (0.39–9.05 µg/g crt) and 3.25–46.58 µg/L (2.12–33.50 µg/g crt) respectively. Higher tDON levels were observed for (i) male participants from France and Germany, (ii) samples collected in spring and summer, (iii) participants with a lower educational level, (iv) participants living in rural areas, (v) individuals without a job in France and Luxembourg, while in Portugal higher exposure was observed in working individuals, (vi) individuals with higher consumption of cereals and bread. The proportion of individuals with exposure levels exceeding the HBM-GV of 23 µg/L was 12.3 %, ranging from 0.8 % to 20.7 % in the individual countries. This study on mycotoxins exposure has used post harmonized questionnaire data and validated analytical methodologies for analysis and covered countries representing the four geographical regions of Europe, having produced much needed knowledge on the exposure of the European adult population to deoxynivalenol.

Chronic pain in European adult populations: a systematic review of prevalence and associated clinical features

Abstract Chronic pain (CP) is a multifaceted and severely disabling persistent condition that affects individuals worldwide. A synthesis of epidemiological data is still lacking. The present systematic review aims at presenting point, period, and lifetime prevalence estimates of CP in the European adult population, as well as relevant features associated with it. Following PRISMA guidelines, a systematic search in PubMed, Web of Science, Embase, and Cochrane library was run from inception to May 2024, resulting in 39,832 hits. Among those, 132 full-text articles were assessed, and 23 studies comprising 862,013 participants with CP were included. The Joanna Biggs Institutes' Critical Appraisal Checklist for Studies Reporting Prevalence Data (JBI) was used for quality assessment. Findings showed a point prevalence ranging from 12% to 48%, a 6-month prevalence of 17.5% to 49.8%, a 12-month prevalence ranging from 8.1% to 44.6%, and a lifetime prevalence ranging from 12.7% to 33.7% independently from sex. Sociodemographic factors (eg, female sex, higher age, no partnership, lower education, unemployment) and clinical features (eg, medical diseases, mental disorders and burdens, healthcare utilization, functional impairment) were identified as being associated with CP. The variability in prevalence estimates can be reduced by applying consistent diagnostic criteria (eg, ICD-11) and by using standardized assessment tools (eg, scales, clinical interview). The high prevalence and the characteristics of the associated features support the need for adequate, multicomponent care paths to manage CP based on a comprehensive biopsychosocial model.

Reference equations for pulse wave velocity, augmentation index, amplitude of forward and backward wave in a European general adult population

Pulsatile hemodynamics have been shown to be independent predictors of cardiovascular events. The aim of the current study was to describe four pulsatile hemodynamic markers in a large, well-established, population-based cohort and to provide reference equations for sex- and age-based standardization of these measurements. 6828 adult participants from the Austrian LEAD (Lung, hEart, sociAl, boDy) cohort study, who were free from overt cardiovascular disease, non-diabetic based on blood test results, and had no history of pharmacological treatment for hypertension, dyslipidemia, and diabetes, comprised the “reference population”. Carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), amplitude of forward wave (Pf), and backward wave (Pb) were described in different age categories for both sexes. Sex-specific reference equations for cfPWV, AIx, Pf, and Pb with age as the predictive variable were created using the Lambda-Mu-Sigma (LMS) method. All four parameters increased with age. CfPWV and Pf were higher in males than females, especially in young and middle-age groups (P < 0.001). AIx was higher in females than males in all age categories (P < 0.001). Pb was also higher in females than males in age groups older than 40 years (P < 0.01). Reference equations for the skewness (Lambda), median (Mu), and coefficient of variation (Sigma) values were determined, enabling the calculation of sex- and age-standardized values (z-scores) for each individual’s pulsatile hemodynamic measurement, and an online application was developed. Reference equations derived from a large population-based dataset constitute a suitable tool for the standardization of pulsatile hemodynamics and for the accurate interpretation of vascular aging.

Problematic Internet use among adults: A longitudinal European study.

There are few cross-cultural studies utilizing longitudinal analysis to explore problematic internet use (PIU), and almost none among adults. The present follow-up study compared three waves across 12-month period every six months and observed the natural course and trajectory of PIU in a European multi-country sample of adults from 11 countries (Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Belgium). A total of 139 participants (45.5% females) provided data across all three waves with an average age of 26.14 years (SD = 5.92). There were longitudinal effects in PIU, with statistical differences between at-risk users compared to healthy users in Waves 1 and 2, and Waves 1 and 3. The analyses of variance showed a longitudinal effect of waves on the PIU symptoms. PIU was significantly affected by time and type of user, with those classed as at-risk having higher scores than healthy users, although PIU decreased over time. In addition, the type of PIU detected in adults contained mild addictive symptoms. In conclusion, this study demonstrated that PIU was generally low among European adult population and tended to decrease over the one-year period, what contrasts with adolescent population findings.

Lifestyle predictors of colorectal cancer in European populations: a systematic review

BackgroundColorectal cancer (CRC) is the second most prevalent cancer in Europe, with one-fifth of cases attributable to unhealthy lifestyles. Risk prediction models for quantifying CRC risk and identifying high-risk groups...

A bidirectional Mendelian randomisation study to evaluate the relationship between body constitution and hearing loss

Hearing loss and hearing disorders represent possible mediating pathways in the associations between noise exposures and non-auditory health outcomes. In this context, we assessed whether the noise-obesity associations should consider hearing functions as possible mediators and applied Mendelian randomisation (MR) to investigate causal relationships between body constitution and hearing impairments. We obtained genetic associations from publicly available summary statistics from genome-wide association studies in European ancestry adult populations (N= from 210,088 to 360,564) for (i) body constitution: body mass index (BMI), waist circumference (WC) and body fat percentage (BFP), and (ii) hearing loss: sensorineural hearing loss, noise-induced hearing loss, and age-related hearing impairment (ARHI). We employed colocalisation analysis to investigate the genetic associations for BMI and ARHI liability within an FTO locus. We conducted bi-directional MR for the ‘forward’ (from body constitution to hearing) and ‘reverse’ directions. We applied the random effects inverse variance-weighted method as the main MR method, with additional sensitivity analyses. Colocalisation analysis suggested that BMI and ARHI shared a causal variant at the FTO gene. We did not find robust evidence for causal associations from body constitution to hearing loss and suggested that some associations may be driven by FTO variants. In the reverse analyses, ARHI was negatively associated with BMI [effect size – 0.22 (95% CI – 0.44 to – 0.01)] and BFP [effect size – 0.23 (95% CI – 0.45 to 0.00)], supporting the notion that ARHI may diminish body constitution. Finally, our data suggest that there is no strong evidence that hearing explains the association between noise exposure and body constitution.

Urinary pesticide mixture patterns and exposure determinants in the adult population from the Netherlands and Switzerland: Application of a suspect screening approach

IntroductionNon-occupational sources of pesticide exposure may include domestic pesticide usage, diet, occupational exposure of household members, and agricultural activities in the residential area. We conducted a study with the ambition to characterize pesticide mixture patterns in a sample of the adult population of the Netherlands and Switzerland, using a suspect screening approach and to identify related exposure determinants. MethodsA total of 105 and 295 adults participated in the Dutch and Swiss studies, respectively. First morning void urine samples were collected and analyzed in the same laboratory. Harmonized questionnaires about personal characteristics, pesticide-related activities, and diet were administered. Detection rates and co-occurrence patterns were calculated to explore internal pesticide exposure patterns. Censored linear and logistic regression models were constructed to investigate the association between exposure and domestic pesticide usage, consumption of homegrown and organic foods, household members’ exposure, and distance to agricultural and forest areas. ResultsFrom the 37 detected biomarkers, 3 (acetamiprid (-CH2), chlorpropham (4-HSA), and flonicamid (-C2HN)) were detected in ≥40% of samples. The most frequent combination of biomarkers (acetamiprid-flonicamid) was detected in 22 (5.5%) samples. Regression models revealed an inverse association between high organic vegetable and fruit consumption and exposure to acetamiprid, chlorpropham, propamocarb (+O), and pyrimethanil (+O + SO3). Within-individual correlations in repeated samples (summer/winter) from the Netherlands were low (≤0.3), and no seasonal differences in average exposures were observed in Switzerland. ConclusionHigh consumption of organic fruit and vegetables was associated with lower pesticide exposure. In the two countries, detection rates and co-occurrence were typically low, and within-person variability was high. Our study results provide an indication for target biomarkers to include in future studies aimed at quantifying urinary exposure levels in European adult populations.

BMI and well-being in people of East Asian and European ancestry: a Mendelian randomisation study

Previous studies have linked higher body mass index (BMI) to lower subjective well-being in adult European ancestry populations. However, our understanding of these relationships across different populations is limited. Here, we investigated the association between BMI and well-being in people of (a) East Asian and (b) European ancestry in the China Kadoorie Biobank (CKB) and UK Biobank (UKB), respectively. Mendelian randomisation (MR) methods were used to test the relationship between BMI with (a) health satisfaction and (b) life satisfaction. One-sample MR enabled us to test effects in men and women separately and to test the role of cultural contexts by stratifying our analyses by urban and rural home location in both China and the UK. Further, we implemented a control function method to test the linearity of the BMI-well-being relationship. We found evidence of different associations between BMI and well-being in individuals of East Asian versus European ancestry. For example, a genetically instrumented higher BMI tentatively associated with higher health satisfaction in people of East Asian ancestry, especially in females (ß: 0.041, 95% CI: 0.002, 0.081). In contrast, there was a robust inverse association between higher genetically instrumented BMI and health satisfaction in all European ancestry UKB participants (ß: −0.183, 95% CI: −0.200, −0.165, Pdifference < 1.00E−15). We also showed the importance of considering non-linear relationships in the MR framework by providing evidence of non-linear relationships between BMI and health and life satisfaction. Overall, our study suggests potential setting-specific causality in the relationship between BMI and subjective well-being, with robust differences observed between East Asians and Europeans when considering very similar outcomes. We highlight the importance of (a) considering potential non-linear relationships in causal analyses and (b) testing causal relationships in different populations, as the casual nature of relationships, especially relationships influenced by social processes, may be setting-specific.

Automatic International Hidradenitis Suppurativa Severity Score System (AIHS4): A novel tool to assess the severity of hidradenitis suppurativa using artificial intelligence.

Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that affects up to 4% of the European adult population. International Hidradenitis Suppurativa Severity Score System (IHS4) is a dynamic scoring tool that was developed to be incorporated into the doctor's daily clinical practice and clinical studies. This helps measure disease severity and guides the therapeutic strategy. However, IHS4 assessment is a time-consuming and manual process, with high inter-observer variability and high dependence on the observer's expertise. We introduce the Automatic International Hidradenitis Suppurativa Severity Score System (AIHS4), an automatic equivalent of IHS4 that deploys a deep learning model for lesion detection, called Legit.Health-IHS4net, based on the YOLOv5 architecture. AIHS4 was trained on Legit.Health-HS-IHS4, a collection of HS images manually annotated by six specialists and processed by a novel knowledge unification algorithm. Our results show that, with the current dataset size, our tool assesses the severity of HS cases with a performance comparable to that of the most expert physician. Furthermore, the model can be implemented into CADx systems to support doctors in their clinical practice and act as a new endpoint in clinical trials. Our work proves the potential usefulness of artificial intelligence in the practice of evidence-based dermatology: models trained on the consensus of large clinical boards have the potential to empower dermatologists in their daily practice and replace current standard clinical endpoints.

Transcriptomic Study on Human Skin Samples: Identification of Two Subclasses of Actinic Keratoses.

Actinic keratoses (AKs) are sun-damaged skin areas that affect 20% of the European adult population and more than 50% of people aged 70 years and over. There are currently no clinical or histological features allowing us to identify to which clinical class (i.e., regression or progression) an AK belongs. A transcriptomic approach seems to be a robust tool for AK characterization, but there is a need for additional studies, including more patients and elucidating the molecular signature of an AK. In this context, the present study, including the largest number of patients to date, is the first aiming at identifying biological features to objectively distinguish different AK signatures. We highlight two distinct molecular profiles: AKs featuring a molecular profile similar to squamous cell carcinomas (SCCs), which are called "lesional AKs" (AK_Ls), and AKs featuring a molecular profile similar to normal skin tissue, which are called "non-lesional AKs" (AK_NLs). The molecular profiles of both AK subclasses were studied, and 316 differentially expressed genes (DEGs) were identified between the two classes. The 103 upregulated genes in AK_L were related to the inflammatory response. Interestingly, downregulated genes were associated with keratinization. Finally, based on a connectivity map approach, our data highlight that the VEGF pathway could be a promising therapeutic target for high-risk lesions.

Using LC-MS/MS to Determine Salivary Steroid Reference Intervals in a European Older Adult Population.

A number of steroids, including glucocorticoids and sex hormones, have been associated with neurodegenerative and cardiovascular conditions common in aging populations. The application of liquid chromatography tandem mass spectrometry (LC-MS/MS) steroid analysis offers an opportunity to conduct simultaneous multiplex steroid analysis within a given sample. In this paper, we describe the application of an LC-MS/MS steroid analysis method for the assessment of reference ranges of steroids in human saliva samples (200 µL) collected from older adults (age 50 years and above) enrolled in a European cohort investigating the risk for Alzheimer's dementia. Saliva samples were prepared using supported liquid extraction (SLE) along with a calibration curve and analysed using a Waters I-Class UPLC (Ultra Performance Liquid Chromatography) and a Sciex QTrap 6500+ mass spectrometer. Mass spectrometry parameters of steroids were optimised for each steroid and a method for the chromatographic separation of 19 steroids was developed. Lower limits of quantitation (LLOQs), linearity and other method criteria were assessed. In total, data from 125 participants (500 samples) were analysed and assessed for reference ranges (64 male, 61 female). A total of 19 steroids were detected in saliva within the range of the method. There were clear diurnal patterns in most of the steroid hormones detected. Sex differences were observed for androstenedione (A4), testosterone (T), cortisone (E) and aldosterone (Aldo). In the first sample of the day, dehydroepiandrosterone (DHEA) was significantly higher in healthy volunteers compared to those with Alzheimer's disease biomarkers. This LC-MS/MS method is suitable for the analysis of 19 steroids in saliva in adults.

Clinical Validation of GenBody COVID-19 Ag, Nasal and Nasopharyngeal Rapid Antigen Tests for Detection of SARS-CoV-2 in European Adult Population.

Accurate and rapid identification of COVID-19 is critical for effective patient treatment and disease outcomes, as well as the prevention of SARS-CoV-2 transmission. Rapid antigen tests (RATs) for identifying SARS-CoV-2 are simpler, faster and less expensive than molecular assays. Any new product to be considered a medical device is subject to evaluation and data analysis to verify the in vitro diagnostic ability to achieve its intended purpose. Clinical validation of such a test is a prerequisite before clinical application. This study was a clinical validation on adult Europeans of GenBody COVID-19 Ag, nasal and nasopharyngeal RATs. A set of 103 positive and 301 negative from nose and nasopharynx samples confirmed by RT-qPCR were examined. The tests were safe to use and showed 100% specificity in both specimens, and high sensitivity of 94.17% (95%CI 87.75% to 97.83%) and 97.09% (95%CI 91.72% to 99.4%), respectively. The parameters were significantly better for samples with higher virus loads (the highest for CT ≤ 25). The GenBody COVID-19 Ag RATs are inexpensive (compared to RT-qPCR), reliable and rapid with high sensitivity and specificity, making them suitable for diagnosis and timely isolation and treatment of COVID-19 patients, contributing to the better control of virus spread.

Prevalence and Characteristics of Accessory Mandibular Canals: A Cone-Beam Computed Tomography Study in a European Adult Population.

The purpose of this observational study is to evaluate the prevalence and main characteristics of bifid canals within a European adult population, analyzing cone-beam-computed tomography (CBCT). The population study examined 300 subjects. The CBCTs were performed between 2012 and 2019, using PaX-Zenith3D with a standard protocol of acquisition. The parameters analyzed were the presence and lengths of the bifid mandibular canals. The sample included 49% male and 51% female participants. The mean age of the patients was 47.07 ± 17.7 years. Anatomical variants of the mandibular canal were identified in 28.8% of the sides and 50.3% of the patients. In 7.3% of the subjects, the anatomical variants were present bilaterally. The most frequently encountered bifid canal was Type 3 (40.5%), followed by the Type 1 canal (39.3%), the Type 2 canal (14.5%), and the Type 4 canal (5.9%), 40% on the right side and 60% on the left side. The average length of the bifid canals located on the right side of the mandible was 11.96 ± 5.57 mm, compared to 11.38 ± 4.89 mm for those measured on the left side. The bifid mandibular canal is a common anatomical variation of the mandibular canal. It is fundamental to performing an accurate preoperative evaluation using CBCT analysis to avoid and/or reduce intraoperative and postoperative complications.

Inflammatory potential of the diet and association with risk of differentiated thyroid cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Chronic inflammation is thought to initiate or promote differentiated thyroid cancer (DTC) and previous studies have shown that diet can modulate this inflammatory process. We aimed to evaluate the association of several dietary scores reflecting the inflammatory potential of the diet with DTC risk. Within the EPIC cohort, 450,063 participants were followed during a mean period of 14years, and 712 newly incident DTC cases were identified. Associations between four dietary inflammatory scores [the dietary inflammatory index (DII®) and two energy-adjusted derivatives (the E-DIIr and the E-DIId), and the Inflammatory Score of the Diet (ISD)] and DTC risk were evaluated in the EPIC cohort using multivariable Cox regression models. Positive associations were observed between DTC risk and the DIIs (HR for 1 SD increase in DII: 1.11, 95%CI: 1.01, 1.23, similar results for its derivatives), but not with the ISD (HR for 1 SD increase: 1.04, 95% CI 0.93, 1.16). Diet-associated inflammation, as estimated by the DII and its derivatives, was weakly positively associated with DTC risk in a European adult population. These results suggesting that diet-associated inflammation acts in the etiology of DTC need to be validated in independent studies.

Biomonitoring of ochratoxin A, 2\u2032R-ochratoxin A and citrinin in human blood serum from Switzerland

Biomonitoring of mycotoxins and their metabolites in biological fluids is increasingly used to assess human exposure. In this study, biomarkers of ochratoxin A (OTA) and citrinin (CIT) exposure were determined in a large number of serum samples from healthy blood donors in Switzerland. In 2019, 700 samples from different regions were obtained. From 240 donors, a second sample (taken 2–9 months later) was available for analysis. Moreover, 355 blood donor samples from 2005 from all regions in Switzerland and 151 additional samples from the southern Swiss region of Ticino from 2005 could be analysed.OTA, 2′R-ochratoxin A (2′R-OTA), ochratoxin alpha (OTα), CIT and dihydrocitrinone (DH-CIT) were analysed using validated targeted methods including precipitation and online SPE clean-up.OTA and 2′R-OTA were frequently detected (OTA in 99%; 2′R-OTA in 51% of the tested samples). The mean concentration in all positive samples was 0.4 ng/mL for OTA and 0.2 ng/mL for 2′R-OTA. OTα was not detected in any sample above the limit of quantification (LOQ). In contrast to OTA, CIT and DH-CIT were only quantifiable in 2% and 0.1% of the samples, respectively. No significant trend was observed between the samples from 2005 and the more recent samples, but OTA concentrations were usually higher in serum samples from the southern Swiss region of Ticino and in males compared to females.Our extensive data fit well within the framework of previously published values for the healthy adult European population.

Utility of Diabetes Type-Specific Genetic Risk Scores for the Classification of Diabetes Type Among Multiethnic Youth.

Genetic risk scores (GRS) aid classification of diabetes type in White European adult populations. We aimed to assess the utility of GRS in the classification of diabetes type among racially/ethnically diverse youth in the U.S. We generated type 1 diabetes (T1D)- and type 2 diabetes (T2D)-specific GRS in 2,045 individuals from the SEARCH for Diabetes in Youth study. We assessed the distribution of genetic risk stratified by diabetes autoantibody positive or negative (DAA+/-) and insulin sensitivity (IS) or insulin resistance (IR) and self-reported race/ethnicity (White, Black, Hispanic, and other). T1D and T2D GRS were strong independent predictors of etiologic type. The T1D GRS was highest in the DAA+/IS group and lowest in the DAA-/IR group, with the inverse relationship observed with the T2D GRS. Discrimination was similar across all racial/ethnic groups but showed differences in score distribution. Clustering by combined genetic risk showed DAA+/IR and DAA-/IS individuals had a greater probability of T1D than T2D. In DAA- individuals, genetic probability of T1D identified individuals most likely to progress to absolute insulin deficiency. Diabetes type-specific GRS are consistent predictors of diabetes type across racial/ethnic groups in a U.S. youth cohort, but future work needs to account for differences in GRS distribution by ancestry. T1D and T2D GRS may have particular utility for classification of DAA- children.

Metabolomics and Microbiomics: New Potential Strategies in Chronic Pain Syndrome.

Chronic pain affects almost 20% of the European adult population and it significantly reduces patients’ quality of life. Chronic pain is considered a multidimensional experience determined by the interaction of several genetic and environmental factors. The effect of specific genetic contributions is often unclear, and the interpretation of the results from studies focused on genetic influences on pain has been complicated by the existence of multiple pain phenotypes. A step forward from genetics could be given by the application of metabolomics and microbiomics tools. Metabolomics is a powerful approach for hypothesis generation in biology, and it aims to analyze low molecular weight compounds, either metabolic intermediates or metabolic end-products, resulting from human or microbial metabolism. Microbiomics is a fast-growing field in which all the microbes are examined together, and as a result, its perturbation may indicate the development of chronic diseases. By applying these methodologies for the study of chronic pain, several differences have been identified. The alteration of the choline-PAF pathway is an intriguing finding recognized by several groups. In our opinion, metabolomics and microbiomics techniques will allow significant progress into the medical field. Patients may benefit from the possibility of being stratified and classified based on their metabolic and microbial profile, which, in the next future, may lead to personalized therapy.

Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain.

Medical psychotropics are widely used and prescribed in developed countries. These medications may have an impairing effect on mood or perception and may induce harmful behaviors. Nevertheless, in Europe, studies on their importance from a medico-legal perspective are scarce. To fill this gap, we evaluate the determinants of these drugs in a retrospective study based on data obtained from forensic autopsies. Toxicological analyses were performed on 394 blood samples from compulsory autopsies at the Institute of Legal Medicine of Las Palmas. Of the samples, 41% (159) were positive for at least one psychotropic, with benzodiazepines being the most frequently detected (24.1%), followed by opiates and antidepressants. Benzodiazepines, opiates, and antidepressants were detected more frequently in men who suffered a violent death. More than 30% of the positive samples showed two or more drugs, suggesting a prevalence of polypharmacy among forensic autopsy subjects, with the most frequently combination found being benzodiazepines plus opiates (28.3% of positive samples). A combination of opiates plus antidepressants was also found in subjects involved in violent deaths. Our results suggest that more than 40% of the adult European population involved in medico-legal issues may be under the influence of legal psychotropics. The link between violent deaths and the use of medical psychotropics is particularly worrisome and indicates that these drugs should be carefully monitored in developed countries, in all forensic autopsies, in a similar way to illegal psychotropics.

The Combined Effects of Television Viewing and Physical Activity on Cardiometabolic Risk Factors: The Kardiovize Study.

The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2155 subjects (25–64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (<2 h/day), moderate (2–4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: High TVV/insufficient PA with body mass index (BMI) (β = 2.61, SE = 0.63), waist circumference (WC) (β = 7.52, SE = 1.58), body fat percent (%BF) (β = 6.24, SE = 1.02), glucose (β = 0.25, SE = 0.12), triglycerides (β = 0.18, SE = 0.05), and high density lipoprotein (HDL-c) (β = −0.10, SE = 0.04); high TVV/moderate PA with BMI (β = 1.98, SE = 0.45), WC (β = 5.43, SE = 1.12), %BF (β = 5.15, SE = 0.72), triglycerides (β = 0.08, SE = 0.04), total cholesterol (β = 0.21, SE = 0.10), low density protein (LDL-c) (β = 0.19, SE = 0.08), and HDL-c (β = −0.07, SE = 0.03); and moderate TVV/insufficient PA with WC (β = 2.68, SE = 1.25), %BF (β = 3.80, SE = 0.81), LDL-c (β = 0.18, SE = 0.09), and HDL-c (β = −0.07, SE = 0.03). Independent of PA levels, a higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.

Psychological impact of the quarantine during the COVID-19 pandemic on the general European adult population: a systematic review of the evidence.

Due to the coronavirus disease 2019 (COVID-19) different countries implemented quarantine measures to limit the spread of the virus. Many studies analysed the mental health consequences of restrictive confinement, some of which focused their attention on specific populations. The general public's mental health also requires significant attention, however. This study aimed to evaluate the effects of the COVID-19 quarantine on the general population's mental health in different European countries. Risk and protective factors associated with the psychological symptoms were analysed. A systematic search was conducted on four electronic databases (PubMed, PsycINFO, Scopus and Google Scholar). Studies published up until 20th April 2021, and following eligibility criteria were selected for this review. One thousand three hundred thirty-five (1335) studies were screened, 105 of which were included. Via network analysis, the current study investigated the pathways that underlie possible risk factors for mental health outcomes. Anxiety, depression, distress and post-traumatic symptoms are frequently experienced during the COVID-19 quarantine and are often associated with changes in sleeping and eating habits. Some socio-demographic and COVID-19-related variables were found to be risk factors for an individual's wellbeing. In particular, being female, young, having a low income, being unemployed and having COVID-19-like symptoms or chronic disorders, were found to be the most common risk factors for mental health symptoms. The COVID-19 pandemic represented an unprecedented threat to mental health globally. In order to prevent psychological morbidity and offer support tailored to short-, medium- and long-term negative outcomes, it is essential to identify the direct and indirect psychosocial effects of the lockdown and quarantine measures, especially in certain vulnerable groups. In addition to measures to reduce the curve of viral transmission, policy makers should urgently take into consideration provisions to alleviate hazards to mental health.