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Papassotiriou I, Riza E, Benetou V, Orfanos P. Mediterranean diet and a health behavior index in relation to cardiovascular biomarkers: Data from the Health and Retirement Study. Nutr Metab Cardiovasc Dis 2024; 34:925-934. [PMID: 38355386 DOI: 10.1016/j.numecd.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND AND AIM Although lifestyle factors have been repeatedly examined for their role on cardiovascular diseases, their composite effect has not been frequently explored. We aimed to investigate the relation of dietary patterns (DPs) and a health behavior index (HBI) with cardiovascular biomarkers. METHODS AND RESULTS A cross-sectional analysis with data from 3461 US residents, participants in the Health and Retirement Study (HRS), was performed. Nutritional data were obtained with a food frequency questionnaire, while adherence to Mediterranean Diet (MD) was determined by the Mediterranean Diet Score. A posteriori DPs were estimated using principal component analysis and the HBI was constructed combining adherence to MD, smoking status, physical activity levels, alcohol consumption and body mass index. Multiple linear regression models were performed to examine the relation between DPs or HBI and levels of C-reactive protein (CRP), glycosylated hemoglobin (HbA1C), cystatin C (Cys C), total cholesterol (TC), high density lipoprotein (HDL) and TC:HDL in blood. Multiple linear regression showed that the "healthy" DP and the MD had a significant negative association with CRP and Cys C (p < 0.05), while the "Western-type" DP had a significant positive association with TC:HDL ratio, CRP and Cys C. Moreover, the HBI was positively associated with HDL (p < 0.05) and negatively associated with TC:HDL ratio, CRP and Cys C (p < 0.05). CONCLUSIONS Adherence to MD and to a healthy dietary pattern was negatively associated with biomarkers of inflammation, while the HBI was associated with a better cardiometabolic profile, assessed with blood biomarkers.
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Affiliation(s)
- Ionas Papassotiriou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Harrison F, Mortby ME, Mather KA, Sachdev PS, Brodaty H. Apathy as a determinant of health behaviors in older adults: Implications for dementia risk reduction. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12505. [PMID: 38026759 PMCID: PMC10668002 DOI: 10.1002/dad2.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 08/04/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Long-term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differentially associated with multiple health behaviors. METHODS In 1037 community-dwelling older adults without dementia (aged 70-90, 55% women), regression analyses examined apathy, depression, and fatigue as predictors of health behaviors (physical activity, diet, alcohol, smoking) and a behavioral risk index. RESULTS Apathy was associated with reduced physical activity and alcohol use, and one or multiple behavioral risk factors. No or inconsistent relations were found between depression or fatigue and health behaviors. DISCUSSION Apathy is relevant to multiple health behaviors and should be considered when designing health promotion for older adults, including interventions for dementia risk reduction. Findings highlight the importance of distinguishing apathy from comorbid symptoms. Highlights Novel theory-based perspective on behavioural risk factors for dementia.Higher apathy predicted less physical activity and alcohol use, and increased odds of lifestyle risk factors.Depressive symptoms were not associated with any health behavior.Apathy may be a determinant of multiple health behaviors in older adults, distinct from depression and fatigue.Considering apathy in precision prevention of dementia appears warranted.
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Affiliation(s)
- Fleur Harrison
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
| | - Moyra E. Mortby
- School of Psychology, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures Institute, UNSW SydneySydneyNew South WalesAustralia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- NeuroPsychiatric InstitutePrince of Wales HospitalRandwickNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Older People's Mental Health ServicePrince of Wales HospitalRandwickNew South WalesAustralia
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Kamimura A, Higham R, Panahi S, Lee E, Griffin RJ, Sundrud J, Lucero M. How Food Insecurity and Financial Difficulty Relate to Emotional Well-Being and Social Functioning. South Med J 2021; 115:1-7. [PMID: 34964052 DOI: 10.14423/smj.0000000000001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Medically uninsured individuals living in poverty experience poor health and face social barriers that negatively affect their health. The purpose of this study was to examine the association between social barriers, particularly healthy food availability and financial difficulty, and well-being among uninsured free clinic patients in the United States. METHODS Data were collected using a self-administered paper survey at a free clinic from adult patients who spoke and read English or Spanish (N = 666) from January to April 2019. RESULTS Better neighborhood healthy food availability is associated with better self-reported general health. Food security is related to better emotional well-being and social functioning. Having difficulty paying rent or a mortgage is linked to worse emotional well-being and social functioning. CONCLUSIONS Providing health education programs may not be sufficient to promote healthy eating among underserved populations because of the social barriers that they experience, such as food insecurity and financial difficulty. Future research could be performed to determine how these social factors influence those of different social and cultural backgrounds than the participants in this study.
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Affiliation(s)
- Akiko Kamimura
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Rebecca Higham
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Samin Panahi
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Edward Lee
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Rachel J Griffin
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Justine Sundrud
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
| | - Mary Lucero
- From the Department of Sociology, the Division of Public Health, the School of Medicine, and the Maliheh Free Clinic, University of Utah, Salt Lake City, and the Keck School of Medicine, University of Southern California, Los Angeles
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Livingstone KM, Abbott G, Ward J, Bowe SJ. Unhealthy Lifestyle, Genetics and Risk of Cardiovascular Disease and Mortality in 76,958 Individuals from the UK Biobank Cohort Study. Nutrients 2021; 13:4283. [PMID: 34959842 PMCID: PMC8707428 DOI: 10.3390/nu13124283] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 11/24/2022] Open
Abstract
To examine associations of unhealthy lifestyle and genetics with risk of all-cause mortality, cardiovascular disease (CVD) mortality, myocardial infarction (MI) and stroke. We used data on 76,958 adults from the UK Biobank prospective cohort study. Favourable lifestyle included no overweight/obesity, not smoking, physical activity, not sedentary, healthy diet and adequate sleep. A Polygenic Risk Score (PRS) was derived using 300 CVD-related single nucleotide polymorphisms. Cox proportional hazard ratios (HR) were used to model effects of lifestyle and PRS on risk of CVD and all-cause mortality, stroke and MI. New CVD (n = 364) and all-cause (n = 2408) deaths, and stroke (n = 748) and MI (n = 1140) events were observed during a 7.8 year mean follow-up. An unfavourable lifestyle (0-1 healthy behaviours) was associated with higher risk of all-cause mortality (HR: 2.06; 95% CI: 1.73, 2.45), CVD mortality (HR: 2.48; 95% CI: 1.64, 3.76), MI (HR: 2.12; 95% CI: 1.65, 2.72) and stroke (HR:1.74; 95% CI: 1.25, 2.43) compared to a favourable lifestyle (≥4 healthy behaviours). PRS was associated with MI (HR: 1.35; 95% CI: 1.27, 1.43). There was evidence of a lifestyle-genetics interaction for stroke (p = 0.017). Unfavourable lifestyle behaviours predicted higher risk of all-cause mortality, CVD mortality, MI and stroke, independent of genetic risk.
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Affiliation(s)
- Katherine M. Livingstone
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia;
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia;
| | - Joey Ward
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK;
| | - Steven J. Bowe
- Deakin Biostatistics Unit, Deakin University, Geelong, VIC 3220, Australia;
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Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910148. [PMID: 34639449 PMCID: PMC8507630 DOI: 10.3390/ijerph181910148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/24/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022]
Abstract
There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000-2002) of 40-60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11-1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32-1.89; occupational class: 1.31, 1.08-1.59) and lipid medication (education: 1.34, 1.12-1.61; occupational class: 1.38, 1.13-1.67). Rented housing (1.35, 1.18-1.54 for hypertension medication; 1.21, 1.05-1.38 for lipid medication) and current economic difficulties (1.59, 1.28-1.98 for hypertension medication; 1.35, 1.07-1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.
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Tanaka S, Muraki S, Inoue Y, Miura K, Imai E. The association between subjective health perception and lifestyle factors in Shiga prefecture, Japan: a cross-sectional study. BMC Public Health 2020; 20:1786. [PMID: 33238945 PMCID: PMC7690120 DOI: 10.1186/s12889-020-09911-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 11/17/2020] [Indexed: 11/11/2022] Open
Abstract
Background The Ministry of Health has reported that in Japan, the Shiga prefecture has the highest life expectancy. Subjective health perception is a predictive indicator of mortality. For this study, we examined the association between subjective health perception and multiple lifestyle factors. Methods Data were obtained from the 2015 Health and Nutrition Survey in Shiga prefecture. The analytic sample comprised 6057 adults aged 20 or older. Information on subjective health perception and lifestyle behaviors was obtained from a self-administered questionnaire. As for subjective health perception, participants were divided into 2 groups: (1) Excellent or Good and (2) Average, Poor, or Very Poor. A 1-day dietary survey was also administered. The health behaviors score (HBS) was calculated based on 5 factors: consuming a healthy diet, never smoking, low-risk alcohol drinking, regular exercise, and moderate sleep duration. HBS scores ranged from 0 to 5. Multiple logistic regression was used to calculate the sex-, age- BMI- and energy intake-adjusted odds ratios (ORs) of poor subjective health across HBS, with 0 points as the reference. Results Among all participants, 2397 (39.6%) individuals were classified into the good subjective health group. Participants with an HBS of 3 (OR 0.59, 95% CI 0.37–0.96), 4 (OR 0.40, 95% CI 0.24–0.65) or 5 (OR 0.33, 95% CI 0.19–0.59) had a lower OR of rating themselves as being average/poor health compared with those having zero. The association with a higher HBS was remarkable (p for trend: < 0.001). Additional analyses revealed that the combinations including regular exercise were particularly associated with a lower risk of subjective average/poor health. Conclusions This study showed that the higher the number of healthy lifestyle factors, the lower risk of subjective average/poor health. Combinations of healthy lifestyle factors, especially those involving exercise, suggest good subjective health for individuals living in the Shiga prefecture.
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Borillo CJ, Tamanal JM, Kim CH. Determining the Cut Off Score of the Healthy Lifestyle Screening Tool among High School Students. J Lifestyle Med 2020; 10:92-101. [PMID: 32995336 PMCID: PMC7502896 DOI: 10.15280/jlm.2020.10.2.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022] Open
Abstract
Background Several lifestyle factors such as not smoking, drinking alcohol in moderation, eating healthily, regular exercise, and maintaining a normal weight have been known to play an important role in optimal health. A screening tool that has a standardized score that indicates healthy or risky lifestyle behaviors is needed for health promotion. However, such a tool that focuses on lifestyle behaviors have not incorporated scores to summarize the results. The purpose of this study is to develop the cut-off points of the Healthy Lifestyle Screening tool. Methods Data collection in this study was done from 198 Filipino high school students utilizing the Healthy Lifestyle Screening Tool. Results Receiver Operating Curve (ROC) results indicated cut-off score of 98 to separate into low and high score groups. The mean scores for all subcomponents were significantly different in between two groups. The general population fell in the high score category with a mean total score of 105.61 in which 81.31% were categorized in the high score group and 18.61% in the low score group. Subjects in general obtained low mean scores in specific subscale components such as rest (2.46) water (2.66) and exercise (2.78). Conclusion Increasing the total score by working on low scoring components will be beneficial in achieving a healthy lifestyle. This study reinforced the importance of holistic approach regarding health and well-being among high school students.
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Affiliation(s)
- Carmela Jeanette Borillo
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
| | - Jerre Mae Tamanal
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
| | - Cheong Hoon Kim
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
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McNaughton SA, Pendergast FJ, Worsley A, Leech RM. Eating occasion situational factors and sugar-sweetened beverage consumption in young adults. Int J Behav Nutr Phys Act 2020; 17:71. [PMID: 32493366 PMCID: PMC7271392 DOI: 10.1186/s12966-020-00975-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/19/2020] [Indexed: 02/04/2023] Open
Abstract
Background Young adulthood represents an influential transitional period marked by poor dietary habits and excess weight gain. Sugar-sweetened beverages (SSB) are a major source of excess caloric intake among young adults, yet little is known about the correlates of SSB consumption. This study examines the individual and situational correlates of SSB consumption, using real-time assessment of Australian young adults’ eating occasions. Methods Dietary, sociodemographic and health behaviour data were collected during the Measuring EAting in Everyday Life (MEALS) study (n = 675 adults, 18–30 y). Participants reported all foods and beverages consumed over 3–4 non-consecutive days using a real-time Smartphone food diary application (“FoodNow”). For every eating occasion, food and beverage intake was recorded along with situational characteristics (eating location, purchase location, presence of others and activities while eating). A beverage occasion was defined as any eating occasion where a beverage was consumed and a SSB occasion was defined as any eating occasion where a SSB was consumed. Multilevel logistic regression was used to examine individual and situational characteristics with SSB intake at beverage occasions (i.e. factors associated with choosing a SSB over other non-alcoholic beverages) and to examine factors associated with consuming a SSB at any occasion where food and/or beverages were consumed. Results Thirty-five percent of participants consumed SSBs during the recording period (n = 237). Of the 2185 beverage eating occasions reported by SSB consumers, 481 (20%) contained a SSB. SSB were rarely consumed on their own (i.e. other foods were present). Having a lower than tertiary education (odds ratio [95% confidence interval]: 1.53 [1.16, 2.01]; p < 0.01); eating in a café/restaurant, compared to at home (3.02 [1.58, 5.78]; p < 0.001), and purchasing beverages from a convenience outlet, compared to a supermarket/grocery store (4.58 [2.85, 7.38]; p < 0.001) were associated with SSB intake at beverage eating occasions. Similar associations were also found when all food and/or beverage eating occasions were examined. Conclusion In this study, SSB were often consumed with other foods and intake was associated with individual and situational factors. Further studies are needed to confirm these findings and explore how SSB are consumed in relation to their accompanying foods.
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Affiliation(s)
- Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Felicity J Pendergast
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Woo J, Lehrer HM, Whyne E, Steinhardt M. The longitudinal association of psychological resources with chronic conditions and the mediating roles of health behaviours and allostatic load. Psychol Health 2020; 35:629-643. [PMID: 31549526 PMCID: PMC7769193 DOI: 10.1080/08870446.2019.1656205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/22/2019] [Accepted: 08/09/2019] [Indexed: 01/19/2023]
Abstract
Objective: To investigate the association of psychological resources with the prevalence of chronic conditions up to 10 years later, and the mediating roles of health behaviours and allostatic load. Design: Participants from the Midlife in the United States study (N = 850) completed surveys and biomarker assessments over the course of 10 years. Main Outcome Measures: Primary outcome was the prevalence of chronic conditions later in life, controlling for baseline chronic conditions. Secondary outcomes were health behaviours and allostatic load. Direct and indirect associations between psychological resources and chronic conditions were examined. Results: Psychological resources were negatively associated with chronic conditions directly (ƅ = -.177, p < .05) and indirectly through health behaviours (ƅ = -.026, p < .05), but not through allostatic load (ƅ = -.000, p > .05). Psychological resources were positively associated with health behaviours (ƅ = .130, p < .01), but no association was found between psychological resources and allostatic load (ƅ = -.002, p > .05). Health behaviours were negatively associated with chronic conditions (ƅ = -.201, p < .01), and allostatic load was positively associated with chronic conditions (ƅ = .197, p < .05). Conclusion: Findings highlight the beneficial influence of psychological resources on chronic conditions, and the mediating role of health behaviours.
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Affiliation(s)
- Jihun Woo
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - H Matthew Lehrer
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - Erum Whyne
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - Mary Steinhardt
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
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Fukunaga A, Inoue Y, Chandraratne N, Yamaguchi M, Kuwahara K, Indrawansa S, Gunawardena N, Mizoue T, Samarasinghe D. Healthy lifestyle index and its association with hypertension among community adults in Sri Lanka: A cross-sectional study. PLoS One 2020; 15:e0226773. [PMID: 31923198 PMCID: PMC6953878 DOI: 10.1371/journal.pone.0226773] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 12/03/2019] [Indexed: 02/05/2023] Open
Abstract
Objectives To investigate the association between a healthy lifestyle index (HLI) (i.e., a composite score comprising multiple lifestyle factors) and hypertension among community adults living in Sri Lanka. Methods The present study used baseline information of a cluster randomized controlled trial among 456 adults aged 27–65 years in a semi-urban community in Colombo, Sri Lanka. The HLI was constructed by summing a number of low-risk lifestyle factors: low body mass index, sufficient physical activity, non-smoking, low alcohol consumption, and sufficient fruit and vegetable consumption. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of antihypertensive medication. A logistic regression model was used to investigate the association between the HLI (low: 0–2; middle: 3; high: 4–5) and hypertension. Results A total of 178 (39%) participants were hypertensive. Compared with the low HLI group, multivariate-adjusted odds ratios (95% confidence intervals) of hypertension were 0.72 (0.44–1.19) and 0.28 (0.15–0.54) for the middle and high HLI groups, respectively (p-trend <0.001). Conclusions The present study provides essential evidence on an inverse association between adherence to healthy lifestyles and hypertension.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Miwa Yamaguchi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | | | - Nalika Gunawardena
- Office for Sri Lanka, World Health Organization Country, Colombo, Sri Lanka
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Propionate suppresses hepatic gluconeogenesis via GPR43/AMPK signaling pathway. Arch Biochem Biophys 2019; 672:108057. [PMID: 31356781 DOI: 10.1016/j.abb.2019.07.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
Abstract
Short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate are generated by gut microbial fermentation of dietary fiber. SCFAs may exert multiple beneficial effects on human lipid and glucose metabolism. However, their actions and underlying mechanisms are not fully elucidated. In this study, we examined the direct effects of propionate on hepatic glucose and lipid metabolism using human HepG2 hepatocytes. Here, we demonstrate that propionate at a physiologically-relevant concentration effectively suppresses palmitate-enhanced glucose production in HepG2 cells but does not affect intracellular neutral lipid levels. Our results indicated that propionate can decline in gluconeogenesis by down-regulation of glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PEPCK) through activation of AMP-activated protein kinase (AMPK), which is a major regulator of the hepatic glucose metabolism. Mechanistic studies also revealed that propionate-stimulated AMPK phosphorylation can be ascribed to Ca2+/calmodulin-dependent protein kinase kinase β (CaMKKβ) activation in response to an increase in intracellular Ca2+ concentration. Moreover, siRNA-mediated knockdown of the propionate receptor GPR43 prevented propionate-inducible activation of AMPK and abrogates the gluconeogenesis-inhibitory action. Thus, our data indicate that the binding of propionate to hepatic GPR43 elicits CaMKKβ-dependent activation of AMPK through intracellular Ca2+ increase, leading to suppression of gluconeogenesis. The present study suggests the potential efficacy of propionate in preventive and therapeutic management of diabetes.
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Zhang Y, Tan X. Compliance with care and poor sleep quality among hypertensive adults in a mountainous area of Hubei Province, People's Republic of China. Patient Prefer Adherence 2019; 13:1221-1227. [PMID: 31413550 PMCID: PMC6662512 DOI: 10.2147/ppa.s212241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/07/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little information is available concerning the relationship between compliance with hypertensive care and poor quality of sleep among Chinese adults in rural areas. This study aimed to evaluate the association between the compliance with hypertensive care and sleep quality for hypertension of adults in a mountainous area in People's Republic of China. METHODS A total of 551 hypertensive patients (30-96 years of age) living in a remote mountainous area were recruited. Poor sleep quality was assessed using the standard Pittsburgh Sleep Quality Index (PSQI), and compliance with care was measured based on the Compliance of Hypertensive Patients Scale (CHPS). Hypertension was defined as blood pressure ≥140/90 mmHg or treated with antihypertensive medication. The associations between sleep quality and compliance variables were examined using Pearson's correlation. Multiple linear regressions were established to verify significant variables associated with respondents' compliance with care and poor sleep quality. RESULTS The average age of the sample was 67.15 years (SD=10.20), and 56.44% of the participants were female. The mean CHPS total score was 41.97 (SD=5.91), and the PSQI total score was 7.91 on average (SD=4.10). Correlation analysis revealed that patients with higher intention, healthier lifestyle, positive attitude and total compliance were more likely to have an increased risk of poor sleep quality. According to the results of multiple linear regression analyses, hypertension compliance was significantly associated with being female, married, non-rural residence and years of hypertension, while poor sleep quality had a significant association with living in rural areas, having concomitant disease and poor hypertension compliance. CONCLUSIONS There is a significant association between hypertension compliance and poor sleep quality. Future intervention programs should focus on improving compliance behavior as a modifiable background factor for sleep quality.
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Affiliation(s)
- Yuting Zhang
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
| | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
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