Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health

Abstract

In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health

“…This decrease in risk can be mediated by an improvement in the cardiometabolic profile especially in individuals with obesity or overweight, insulin resistance, and diabetes [ 50 ]. Physical activity is a modifiable behavior that positively influences CRF level and can be a mitigation strategy against COVID-19 [ 49 ], especially in Czechia, where, in contrast to the decreasing burden and mortality related to CVD and certain cardiometabolic outcomes, the prevalence of dysglycemia and abnormal adiposity are increasing [ 8 ]. However, primary prevention programs in Czechia still require improvement.…”

“…However, primary prevention programs in Czechia still require improvement. Concepts of health promotion and primary/primordial prevention only emerged in former Czechoslovakia after political change in 1990, and a system of public health control is still being established [ 8 ]. Therefore, the number of physically inactive adults has been increasing [ 51 ], and only recently have multi-morbidity care models [ 52 ] been applied [ 53 , 54 ].…”

“…Therefore, the number of physically inactive adults has been increasing [ 51 ], and only recently have multi-morbidity care models [ 52 ] been applied [ 53 , 54 ]. A diligent focus on risk factors, including physical activity and fitness, is needed to slow down, stop, or even reverse cardiometabolic-based chronic disease progression [ 8 , 53 ].…”

“…Improvement in CRF is associated with a lower risk of all-cause [ 6 ] and CVD mortality [ 7 ]. This improvement favorably influences the health by reducing cardiometabolic risk characterized by dysglycemia, abnormal adiposity, hypertension, and dyslipidemia [ 8 ]; reducing adiposity, platelets adhesion, and aggregation; increasing skeletal muscle mass, insulin sensitivity, glucose disposal, and lipoprotein lipase function; and improving lipid profile [ 9 ].…”

“…Two studies are noteworthy: the Czechoslovakian study of 1071 subjects aged between 12 and 55 years [ 11 ], and the Lithuanian study of 168 adults, aged between 20 and 60 years [ 12 ]. The first study [ 11 ] used the data collected more than 40 years ago, which limited the current applicability of results, especially since concepts of health promotion and primordial/primary prevention only emerged in the former Czechoslovakia after 1990 [ 8 ]. In the second study [ 12 ], the sample was not population representative.…”