Although obesity with its comorbidities is linked with higher cancer risk, the data on genome stability in the obese/severely obese are scarce. This is the first study with three DNA damage ...assessment assays (Fpg-modified and alkaline comet assays and micronucleus
assay) performed on a severely obese population (n = 53) where the results were compared with daily intake of food groups, nutrient intake, dietary inflammatory index (DII), and anthropometric and biochemical parameters usually measured in obese individuals. Results demonstrated the association between DNA damage levels and a decrease in cell proliferation with anthropometric measurements and the severity of obese status, together with elevated levels of urates, inorganic phosphates, chlorides, and hs troponin I levels. DII was connected with oxidative DNA damage, while BMI and basal metabolic rate (BMR) were associated with a decrease in cell proliferation and DNA damage creation. Measured daily BMR and calculated daily energy intake from the food frequency questionnaire (FFQ) demonstrated no significant difference (1792.80 vs. 1869.86 kcal day
mean values). Groups with higher DNA damage than expected (tail intensity in comet assay >9% and >12.4%, micronucleus frequency >13), consumed daily, weekly, and monthly more often some type of food groups, but differences did not show a clear influence on the elevated DNA damage levels. Combination of all three DNA damage assays demonstrated that some type of damage can start earlier in the obese individual lifespan, such as nuclear buds and nucleoplasmic bridges, then comes decrease in cell proliferation and then elevated micronucleus frequencies, and that primary DNA damage is not maybe crucial in the overweight, but in severely obese. Biochemically changed parameters pointed out that obesity can have an impact on changes in blood cell counts and division and also on genomic instability. Assays were able to demonstrate groups of sensitive individuals that should be further monitored for genomic instability and cancer prevention, especially when obesity is already connected with comorbidities, 13 different cancers, and a higher mortality risk with 7-10 disease-free years loss. In the future, both DNA damage and biochemical parameters should be combined with anthropometric ones for further obese monitoring, better insight into biological changes in the severely obese, and a more individual approach in therapy and treatment. Patients should also get a proper education about the foodstuff with pro- and anti-inflammatory effect.
Although obesity with its comorbidities is linked with higher cancer risk, the data on genome stability in the obese/severely obese are scarce. This is the first study with three DNA damage ...assessment assays (Fpg-modified and alkaline comet assays and micronucleus cytome assay) performed on a severely obese population (n = 53) where the results were compared with daily intake of food groups, nutrient intake, dietary inflammatory index (DII), and anthropometric and biochemical parameters usually measured in obese individuals. Results demonstrated the association between DNA damage levels and a decrease in cell proliferation with anthropometric measurements and the severity of obese status, together with elevated levels of urates, inorganic phosphates, chlorides, and hs troponin I levels. DII was connected with oxidative DNA damage, while BMI and basal metabolic rate (BMR) were associated with a decrease in cell proliferation and DNA damage creation. Measured daily BMR and calculated daily energy intake from the food frequency questionnaire (FFQ) demonstrated no significant difference (1792.80 vs. 1869.86 kcal daysup.−1 mean values). Groups with higher DNA damage than expected (tail intensity in comet assay >9% and >12.4%, micronucleus frequency >13), consumed daily, weekly, and monthly more often some type of food groups, but differences did not show a clear influence on the elevated DNA damage levels. Combination of all three DNA damage assays demonstrated that some type of damage can start earlier in the obese individual lifespan, such as nuclear buds and nucleoplasmic bridges, then comes decrease in cell proliferation and then elevated micronucleus frequencies, and that primary DNA damage is not maybe crucial in the overweight, but in severely obese. Biochemically changed parameters pointed out that obesity can have an impact on changes in blood cell counts and division and also on genomic instability. Assays were able to demonstrate groups of sensitive individuals that should be further monitored for genomic instability and cancer prevention, especially when obesity is already connected with comorbidities, 13 different cancers, and a higher mortality risk with 7–10 disease-free years loss. In the future, both DNA damage and biochemical parameters should be combined with anthropometric ones for further obese monitoring, better insight into biological changes in the severely obese, and a more individual approach in therapy and treatment. Patients should also get a proper education about the foodstuff with pro- and anti-inflammatory effect.
The previous review of physical activity (PA) among Croatian children and adolescents was conducted a decade ago. Therefore, the aim of this study was to summarize recent evidence on PA of Croatian ...children and adolescents and associated personal, social, environmental, and policy factors.
Eighteen experts reviewed the available evidence and provided ratings (from the lowest grade "F" to the highest grade "A+") for the 10 Global Matrix indicators. A systematic search with 100 keywords was conducted in Hrčak, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science for documents published from January 01, 2012, to April 15, 2022. We also conducted internet searches and secondary analyses of data (relative frequencies) from 6 studies.
After assessing 7562 references, we included 90 publications in the review and 18 studies (83.3% of medium-to-good quality) in evidence synthesis. We found a high prevalence of insufficient PA (especially among girls) and excessive screen time (especially among boys). PA participation of children and adolescents in Croatia has declined over time. The following grades were assigned to the indicators for Croatia: B- for overall PA, C- for organized sport and PA, C for active play, C- for active transportation, D+ for sedentary behavior, inconclusive for physical fitness, D+ for family and peers, B- for school, B- for community and environment, and D+ for government.
Coordinated actions are needed across sectors to improve PA promotion, with a focus on increasing PA among girls, reducing sedentary screen time among boys, improving parental support for PA, and further development of national PA policies.
The World Health Organization recommends adults to engage in muscle-strengthening activity (MSA) at least two times per week. The aim of this study was to determine the prevalence and correlates of ...MSA in Croatian adults. We analysed self-reported data collected among 4561 Croatians aged ≥18 years within the European Health Interview Survey (EHIS wave 2). We calculated the weighted prevalence of meeting the MSA guidelines, and odds ratios for different population groups, adjusted for a range of sociodemographic and lifestyle variables in a multivariable logistic regression analysis. The prevalence of meeting the MSA guidelines was 8.0% (95% CI: 7.2, 8.8) in the overall sample, 5.4% (95% CI: 4.5, 6.4) among females, and 10.9% (95% CI: 9.6, 12.3) among males. We found significantly lower odds of meeting the MSA guidelines for females, older age groups, inhabitants of sparsely populated areas, those with a low education level, obese individuals, and those who did not rate their health as “very good” (p < 0.05 for all). The vast majority of Croatian adults do not meet the MSA guidelines. Public health initiatives to promote MSA in Croatia should focus on females, seniors, sparsely populated areas, people with low education, obese individuals, and those with impaired health.
Svaki dvanaesti čovjek, stariji od 65 godina oboli
od Alzheimerove bolesti, a 24% starijih od 75 godina ima neki
oblik ove bolesti. U razvijenim zemljama svijeta, odnosno svim
zemljama “starog ...stanovništva” (u koje se ubraja i Hrvatska),
oko 50% starijih od 85 godina boluje od Alzheimera. Upravo ta
dobna skupina najbrže je rastuća populacijska skupina! Sam
po sebi nameće se zaključak koliki problem će uskoro biti ova
bolest koja se s pravom nosi epitete “tinjajuće bombe” i “tihe
epidemije”. Alzheimerova bolest progresivna je, neizlječiva i
može dovesti do potpune ovisnosti o drugima. Radi propadanja
moždanih stanica, oboljele osobe gube psihičke, fi zičke i
mentalne funkcije. Naglašen je gubitak pamćenja, gubitak
orijentacije u vremenu i prostoru, nemogućnost izvođenja
svakodnevnih aktivnosti i radnji. Oboljele osobe se osjećaju
bespomoćno i izgubljeno. U vrlo teškom položaju je i obitelj,
odnosno skrbnici oboljelog. Briga o bolesniku zahtijeva potpunu
posvećenost i radikalno mijenja život čitave obitelji. Obzirom
da nije izlječiva, naglasak treba dati usporavanju bolesti, što
duljem zadržavanju bolesnika u početnim stadijima bolesti,
sprečavanju preuranjenog institucionaliziranja bolesnika te
pomoći obiteljima u skrbi. Kako bi se to postiglo, potrebna je
kvalitetna i kontinuirana edukacija o bolesti, sustavna skrb te
primjerena, sustavna evidencija. U ovom trenutku, u Hrvatskoj
ne postoji primjerena registracija dijagnosticiranih bolesnika.
Samim time ne postoji niti motivacija stručnjaka za precizno
evidentiranje ove dijagnoze. Iz ovih razloga, Alzheimerova bolest
(G30) vrlo često se krije pod drugim dijagnozama, najčešće
demencijama. Često ostaje i nedijagnosticirana, a simptomi se
pogrešno interpretiraju kao normalan proces starenja što je vrlo
štetno za oboljelu osobu, obitelj i društvo. Osim toga, ne postoji
sustavno riješena skrb, posebno za oboljele u ranom i srednjem
stadiju bolesti, a koja bi se kvalitetno mogla riješiti kroz dnevni
boravak u gerontološkim centrima. Kao što je već naglašeno,
nužno je sustavno praćenje kroz registar, ali i evaluacija
utvrđivanja Alzheimerove bolesti.
Republika Hrvatska nalazi se u skupini zemalja
koje se suočavaju sa značajnim porastom broja starijih osoba.
Hrvatska gerontološka istraživanja ukazuju na izrazitu pojavnost
četiri glavna ...gerontološka javnozdravstvena problema u
starijih ljudi: nepokretnost koja se pojavljuje kao gerijatrijsko-
-imobilizacijski sindrom u starijih osoba, slijedi nestabilnost, zbog
velikog udjela ozljeda i padova u starijih, zatim nesamostalnost
sa sve većim udjelom demencija i Alzheimerove bolesti u
najstarijih starijih osoba te visoki udio prisutnoga nekontroliranog
mokrenja, odnosno inkontinencije u gerijatrijskih bolesnika.
Primjenom primjerenoga Programa primarne, sekundarne i
tercijarne prevencije fokusiranog na čimbenike koji dovode do
bolesnoga starenja, moguće je u značajnoj mjeri prevenirati
vodeće gerontološke javnozdravstvene probleme. Ovo dokazuje
i činjenica kako se u razvijenim zemljama svijeta, gdje se
posljednjih desetljeća djelovalo na čimbenike bolesnog starenja,
implikacijski unaprijedilo zdravlje i očuvala funkcionalna
sposobnost i u dubokoj starosti.
Gerontehnologija u Europi i u Hrvatskoj Kaliterna-Lipovčan, Ljiljana; Tomek-Roksandić, Spomenka; Perko, Goran ...
Medicus (Zagreb, Croatia : 1992),
10/2005, Letnik:
14, Številka:
2_Gerijatrija
Journal Article
Recenzirano
Odprti dostop
Zahvaljujući porastu općega životnog standarda
i unapređenju zdravstvene zaštite te kao posljedica smanjenja
prirodnog priraštaja, prvenstveno u ekonomski razvijenim
zemljama, udio starijega ...pučanstva neprekidno i ubrzano raste.
Upravo s ciljem unapređenja zdravlja i smanjenja funkcionalne
onesposobljenosti starijih ljudi, došlo je i do razvoja novih
tehnoloških rješenja zasnovanih na gerontološkim znanstvenim
spoznajama o procesu starenja. Znanje prikupljeno u okviru
gerontoloških istraživanja pruža osnovicu za prilagodbu
postojećih i za razvoj novih gerontehnoloških rješenja, kao što
su primjerice hodalice, medicinska oprema za kućnu uporabu,
higijenski ulošci za inkontinenciju, ulošci za cipele i sl., a koja
imaju za cilj zadovoljiti potrebe i omogućiti kvalitetnije življenje
individualnoga starijega korisnika. Najveći dometi upotrebe
gerontehnologije sa svrhom poboljšanja životnih uvjeta starijeg
stanovništva mogu se očekivati u području osobnih računala
i korištenja komunikacijskih elektronskih mreža. Medicinske
znanosti su uz pomoć tehnologije i najzaslužnije za činjenicu
da se životni vijek produžava te da stariji ljudi postaju sve
važniji segment društva. Procjenjuje se kako su ovome najviše
pridonijele gerontehnološke inovacije na području primarne,
sekundarne i tercijarne prevencije te ranog otkrivanja i
liječenja srčano-žilnih i neuroloških bolesti u starijih. Primjenom
gerontehnoloških rješenja u sklopu sustavne provedbe
Programa osnovnih preventivnih zdravstvenih mjera za starije
ljude, osigurat će se kvalitetnije, neovisnije življenje i u dubokoj
starosti uz racionalniju zdravstvenu gerijatrijsku potrošnju.
Praćenje utvrđenih i evaluiranih zdravstvenih
potreba starijih osoba prioritetni je gerontološki javnozdravstveni
program, čija primjena je indikator napretka ili
propusta u zaštiti zdravlja ...cjelokupnog pučanstva. Stoga
vođenje Registra utvrđenih i evaluiranih zdravstvenih potreba
starijih osoba za svoje područje djelovanja osiguravaju centri
za gerontologiju Zavoda za javno zdravstvo. Svrha je izrada
primjerenih normi i Programa zdravstvenih postupaka i mjera
te primarne, sekundarne i tercijarne prevencije u zaštiti zdravlja
starijih osoba. Za individualnu stariju osobu, zdravstvene se
potrebe zadovoljavaju s udjelom od 68% u gerontološkim
centrima izvaninstitucijske skrbi za starije u lokalnoj zajednici
gdje žive jer, svaka peta starija osoba u Hrvatskoj ovisna je o
tuđoj pomoći, odnosno socijalno-medicinskoj skrbi.
Centri za gerontologiju ZZJZ-a i gerontološki centri po županijama
Hrvatske omogućuju reduciranje razlike između utvrđenih i
zadovoljenih zdravstvenih potreba starijih osoba. Pritom je nužna
trajna edukacija iz gerontologije i gerijatrije u dodiplomskoj
i poslijediplomskoj izobrazbi stručnjaka različitog profi la koji
se skrbe za zaštitu zdravlja starijih osoba, a poglavito kao
subspecijalizacija gerontologija iz javnog zdravstva i gerijatrija
iz interne medicine.
Ubrzanim starenjem pučanstva Hrvatske mijenja
se struktura mortaliteta, morbiditeta i struktura korištenja
zdravstvene zaštite cjelokupnog stanovništva, iz čega proizlazi
sve veće isticanje ...javnozdravstvenog interesa o povezanosti
životne dobi populacije s objektivnim zadovoljenjem zdravstvenih
potreba starijih ljudi. Gerontološka javnozdravstvena analiza
udjela umrlih osoba starih 65 i više godina, kojih je u
promatranom razdoblju (2000. - 2004.) umrlo ukupno 193.717
u odnosu na ukupan broj umrlih osoba, ukazuje na njegov
konstantni porast: 75,1% u 2000., 75,5% u 2001., 76,8% u
2002., 77,9% u 2003. i 78,0% u 2004. godini. Opća stopa
mortaliteta bila je najveća u 2003. godini: 11,8‰. Također je i
specifi čna stopa mortaliteta, odnosno broj umrlih osoba starih
65 i više godina na 1.000 stanovnika jednake dobi, bila najveća
u 2003. godini: 56,2‰. Gerontološka analiza udjela umrlih u
dobi od 65 i više godina unutar pojedinačnih vodećih skupina
bolesti kao uzroka smrti u 2004. godini ukazuje na njihov visoki
udio od 87,4% u ukupno 24.959 umrlih od bolesti cirkulacijskog
sustava (I00-I99) u Hrvatskoj i udjelu od 86,7% umrlih od 65 i
više godina u Gradu Zagrebu. U Hrvatskoj 2004. godine umrli u
dobi od 65 i više godina čine izrazito visokih 89,3% u ukupno
2.895 umrlih od skupine bolesti dišnog sustava (J00-J99), 68,0%
u ukupno 12.408 umrlih u skupini novotvorina (C00-D48),
63,7% u ukupno 2.370 umrlih od skupine bolesti probavnog
sustava (K00-K93) te 45,1% od ukupno 2.870 umrlih u skupini
ozljeda, otrovanja i nekih drugih posljedica vanjskog uzroka
(S00-T98). Fokusirani gerontološki javnozdravstveni pokazatelji
o morbiditetu, funkcionalnoj onesposobljenosti i smrtnosti u
starijih ljudi osnova su za izradu primjerenoga i učinkovitog
Programa zdravstvenih mjera i postupaka u zaštiti zdravlja
starijih ljudi, a koji uključuje i primjenu s evaluacijom Programa
primarne, sekundarne i tercijarne prevencije za starije ljude. Cilj
je sprečavanje njihove prerane smrtnosti, kao i unapređivanje
zaštite zdravlja i funkcionalne sposobnosti hrvatske staračke
populacije i u dubokoj starosti.
The growth in the prevalence of chronic diseases of civilization is of concern. In Croatia, diseases of the circulatory system are the main cause of hospitalization amongst people aged >65 and the ...main cause of death for two thirds of those aged >65. Continuous physical activity in older people stands out as an important factor in the prevention of chronic diseases of civilization, particularly diseases of the circulatory system, but also for other health problems. A survey on the extent of physical activity amongst older people aged >65 carried out in Zagreb (N=449, Croatian Health Survey/2003; CROCAN Project) has shown that 42.8% were physically inactive, whilst only 19.1% were physically active on a daily basis. Physical activity, two to three times per week, which is recommended by WHO, was undertaken by 11.6% of those aged >65. These gerontologic health indicators show that the Programme of preventative measures is insufficiently applied amongst the elderly. This Programme includes primarily kinesiologic measures adapted for the elderly as developed in the study. It is important to ensure that the Programme of continuous physical activity is applied amonst the elderly to promote active healthy ageing. The type of physical activity, its intensity and frequency should be adapted to each individual's health status, their interests, physical condition and the extent of any previous experiences of physical activity.Thus, professional guidance, consultation with kinesiologists for the elderly and general practitioners as well as the collaboration with other medical specialists are necessary.
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