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Heinonen I, Helajärvi H, Pahkala K, Heinonen OJ, Hirvensalo M, Pälve K, Tammelin T, Yang X, Juonala M, Mikkilä V, Kähönen M, Lehtimäki T, Viikari J, Raitakari OT. Sedentary behaviours and obesity in adults: the Cardiovascular Risk in Young Finns Study. BMJ Open 2013; 3:bmjopen-2013-002901. [PMID: 23794543 PMCID: PMC3669715 DOI: 10.1136/bmjopen-2013-002901] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Sedentary behaviour may contribute to the development of obesity. We investigated the relations between different types of sedentary behaviour and adiposity markers in a well-characterised adult population after controlling for a wide range of potential confounders. DESIGN Cross-sectional study. SETTING The Cardiovascular Risk in Young Finns Multicenter Study. Participants Sedentary time (TV viewing, computer time, reading, music/radio listening and other relaxation) was assessed with a questionnaire for 1084 women and 909 men aged 30-45 years. Other study variables included occupational and leisure-time physical activity, sleep duration, socioeconomic status, smoking, alcohol consumption, energy intake, adherence to the recommended diet, multiple individual food items, age and genetic variants associated with body mass index (BMI). Primary outcome measures BMI in kg/m(2) and waist circumference (WC in cm). RESULTS Of the different sedentary behaviour types, TV viewing was most consistently related to higher BMI and WC, both in men and women. One additional daily TV hour was associated with a 1.81±0.44 cm larger WC in women and 2 cm±0.44 cm in men (both p<0.0001). The association with TV was diluted, but remained highly significant after adjustments with all measured covariates, including several potentially obesogenic food items associated with TV viewing. The intakes of food items such as sausage, beer and soft drinks were directly associated with TV viewing, while the intakes of oat and barley, fish, and fruits and berries were associated indirectly. After these adjustments, non-TV sedentary behaviour remained associated with adiposity indices only in women. CONCLUSIONS Out of the different types of sedentary behaviour, TV viewing was most consistently associated with adiposity markers in adults. Partial dilution of these associations after adjustments for covariates suggests that the obesogenic effects of TV viewing are partly mediated by other lifestyle factors.
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Affiliation(s)
- I Heinonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Pahkala K, Hietalampi H, Laitinen TT, Viikari JSA, Rönnemaa T, Niinikoski H, Lagström H, Talvia S, Jula A, Heinonen OJ, Juonala M, Simell O, Raitakari OT. Ideal cardiovascular health in adolescence: effect of lifestyle intervention and association with vascular intima-media thickness and elasticity (the Special Turku Coronary Risk Factor Intervention Project for Children [STRIP] study). Circulation 2013; 127:2088-96. [PMID: 23613255 DOI: 10.1161/circulationaha.112.000761] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND In the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study, repeated dietary counseling introduced in infancy and maintained until 20 years of age has led to lower intakes of saturated fat and serum low-density lipoprotein cholesterol. In this study, we examined prospectively the intervention effects on the ideal cardiovascular health concept recently described by the American Heart Association. Additionally, we investigated the association between the concept and vascular intima-media thickness and elasticity in adolescence. METHODS AND RESULTS In adolescents participating in the longitudinal, randomized, atherosclerosis-prevention STRIP study, complete data on ideal cardiovascular health metrics were available at 15 (n=394), 17 (n=376), and 19 (n=298) years of age. Aortic intima-media thickness and elasticity were measured with ultrasonography at the same ages. None of the adolescents had all 7 ideal cardiovascular health metrics. At least 5 ideal metrics was found in 60.2%, 45.5%, and 34.2% of the adolescents at 15, 17, and 19 years of age, respectively. Adolescents in the control group had an increased risk of low ideal cardiovascular health (≤3 metrics) compared with the intervention adolescents (risk ratio=1.35; 95% confidence interval=1.04-1.77). The number of ideal cardiovascular health metrics was inversely associated with aortic intima-media thickness (P<0.0001) and directly associated with elasticity (P=0.045). The risk of having high intima-media thickness (>85th percentile) was nearly 2-fold in adolescents with a low number of metrics (≤3) compared with those with a higher score (risk ratio=1.78; 95% confidence interval=1.31-2.43). CONCLUSIONS Ideal cardiovascular health as determined by the AHA can be promoted in adolescents. The ideal cardiovascular health concept is beneficially associated with vascular health already in adolescence, supporting the relevance of targeting these metrics as part of primordial prevention. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00223600.
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Affiliation(s)
- Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Turku, Finland.
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Jääskeläinen P, Magnussen CG, Pahkala K, Mikkilä V, Kähönen M, Sabin MA, Fogelholm M, Hutri-Kähönen N, Taittonen L, Telama R, Laitinen T, Jokinen E, Lehtimäki T, Viikari JSA, Raitakari OT, Juonala M. Childhood nutrition in predicting metabolic syndrome in adults: the cardiovascular risk in Young Finns Study. Diabetes Care 2012; 35:1937-43. [PMID: 22815293 PMCID: PMC3425009 DOI: 10.2337/dc12-0019] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our aim was to study the associations of childhood lifestyle factors (the frequency of consumption of vegetables, fruit, fish, and meat, butter use on bread, and physical activity) with the metabolic syndrome (MetS) in adulthood. RESEARCH DESIGN AND METHODS The study cohort consisted of 2,128 individuals, 3-18 years of age at the baseline, with a follow-up time of 27 years. We used the average of lifestyle factor measurements taken in 1980, 1983, and 1986 in the analyses. Childhood dietary factors and physical activity were assessed by self-reported questionnaires, and a harmonized definition of MetS was used as the adult outcome. RESULTS Childhood vegetable consumption frequency was inversely associated with adult MetS (odds ratio [OR] 0.86 [95% CI 0.77-0.97], P = 0.02) in a multivariable analysis adjusted with age, sex, childhood metabolic risk factors (lipids, systolic blood pressure, insulin, BMI, and C-reactive protein), family history of type 2 diabetes and hypertension, and socioeconomic status. The association remained even after adjustment for adulthood vegetable consumption. Associations with the other childhood lifestyle factors were not found. Of the individual components of MetS, decreased frequency of childhood vegetable consumption predicted high blood pressure (0.88 [0.80-0.98], P = 0.01) and a high triglyceride value (0.88 [0.79-0.99], P = 0.03) after adjustment for the above-mentioned risk factors. CONCLUSIONS Childhood vegetable consumption frequency is inversely associated with MetS in adulthood. Our findings suggest that a higher intake of vegetables in childhood may have a protective effect on MetS in adulthood.
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Würtz P, Mäkinen VP, Soininen P, Kangas AJ, Tukiainen T, Kettunen J, Savolainen MJ, Tammelin T, Viikari JS, Rönnemaa T, Kähönen M, Lehtimäki T, Ripatti S, Raitakari OT, Järvelin MR, Ala-Korpela M. Metabolic signatures of insulin resistance in 7,098 young adults. Diabetes 2012; 61:1372-80. [PMID: 22511205 PMCID: PMC3357275 DOI: 10.2337/db11-1355] [Citation(s) in RCA: 233] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 01/26/2012] [Indexed: 12/14/2022]
Abstract
Metabolite associations with insulin resistance were studied in 7,098 young Finns (age 31 ± 3 years; 52% women) to elucidate underlying metabolic pathways. Insulin resistance was assessed by the homeostasis model (HOMA-IR) and circulating metabolites quantified by high-throughput nuclear magnetic resonance spectroscopy in two population-based cohorts. Associations were analyzed using regression models adjusted for age, waist, and standard lipids. Branched-chain and aromatic amino acids, gluconeogenesis intermediates, ketone bodies, and fatty acid composition and saturation were associated with HOMA-IR (P < 0.0005 for 20 metabolite measures). Leu, Ile, Val, and Tyr displayed sex- and obesity-dependent interactions, with associations being significant for women only if they were abdominally obese. Origins of fasting metabolite levels were studied with dietary and physical activity data. Here, protein energy intake was associated with Val, Phe, Tyr, and Gln but not insulin resistance index. We further tested if 12 genetic variants regulating the metabolites also contributed to insulin resistance. The genetic determinants of metabolite levels were not associated with HOMA-IR, with the exception of a variant in GCKR associated with 12 metabolites, including amino acids (P < 0.0005). Nonetheless, metabolic signatures extending beyond obesity and lipid abnormalities reflected the degree of insulin resistance evidenced in young, normoglycemic adults with sex-specific fingerprints.
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Affiliation(s)
- Peter Würtz
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Biostatistics, Imperial College London, London, U.K
| | - Ville-Petteri Mäkinen
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- Folkhälsan Research Center, University of Helsinki, Helsinki, Finland
- Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Pasi Soininen
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- NMR Metabonomics Laboratory, Department of Biosciences, University of Eastern Finland, Kuopio, Finland
| | - Antti J. Kangas
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Taru Tukiainen
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Johannes Kettunen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Markku J. Savolainen
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Internal Medicine, Clinical Research Center, Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - Jorma S. Viikari
- Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Tapani Rönnemaa
- Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Wellcome Trust Sanger Institute, Hinxton, U.K
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, Imperial College London, London, U.K
- Department of Children, Young People, and Families, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Health Sciences, Biocenter Oulu, University of Oulu, Oulu, Finland
- Medical Research Council Health Protection Agency, Centre for Environment and Health, Imperial College London, London, U.K
| | - Mika Ala-Korpela
- Computational Medicine Research Group, Institute of Clinical Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
- NMR Metabonomics Laboratory, Department of Biosciences, University of Eastern Finland, Kuopio, Finland
- Department of Internal Medicine, Clinical Research Center, Biocenter Oulu, University of Oulu, Oulu, Finland
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