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Sethna J, Wong K, Meyers K. Cardiometabolic Health in Asian American Children. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01896-9. [PMID: 38147200 DOI: 10.1007/s40615-023-01896-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND The aim was to compare cardiometabolic health between Asian American children and Non-Hispanic White (NHW) children as well as to compare cardiometabolic health among Asian American children by birthplace. METHODS Children aged 6-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 who self-identified as non-Hispanic Asian and NHW were included. Among Asian Americans, place of birth was defined as foreign born vs United States (US) born. Regression models were adjusted for age, sex, household income, food insecurity, passive smoke exposure, and body mass index (BMI) z-score. RESULTS Among 3369 children, 8.4% identified as Asian American (age 11.7 years) and 91.6% identified as NHW (age 11.7 years). Compared to NHW children, Asian American children had significantly lower BMI z-scores and odds of obesity. Asian American children had higher HOMA-IR, and greater odds of dyslipidemia and microalbuminuria compared to NHW children. Among Asian Americans, 30.5% were foreign born. Compared to foreign-born Asian American children, US-born Asian American children had significantly higher non-HDL, triglycerides, and uric acid, lower HDL, and lower odds of hyperfiltration. There were no differences in blood pressure by racial group or place of birth. CONCLUSIONS Although Asian American children have lower odds of obesity, they have significantly worse glucose intolerance, more dyslipidemia, and more microalbuminuria compared to NHW children. US-born Asian American children have worse cardiometabolic health profiles compared to foreign-born Asian Americans.
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Affiliation(s)
- Julian Sethna
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA
| | - Kristal Wong
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA.
| | - Kevin Meyers
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA.
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Sethna J, Wong K, Meyers K. Cardiometabolic Health in Asian American Children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.11.23298417. [PMID: 37986922 PMCID: PMC10659473 DOI: 10.1101/2023.11.11.23298417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background The aim was to compare cardiometabolic health between Asian American children and Non-Hispanic White (NHW) children as well as to compare cardiometabolic health among Asian American children by birthplace. Methods Children aged 6-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011-2018 who self-identified as non-Hispanic Asian and NHW were included. Among Asian Americans, place of birth was defined as foreign-born vs United States (US)-born. Regression models were adjusted for age, sex, household income, food insecurity, passive smoke exposure, and body mass index (BMI) z-score. Results Among 3369 children, 8.4% identified as Asian American (age 11.7 years) and 91.6% identified as NHW (age 11.7 years). Compared to NHW children, Asian American children had significantly lower BMI z-scores and odds of obesity. Asian American children had higher HOMA-IR and uric acid, and greater odds of dyslipidemia, microalbuminuria and glomerular hyperfiltration compared to NHW children. Among Asian Americans, 30.5% were foreign-born. Compared to foreign-born Asian American children, US-born Asian American children had significantly higher non-HDL, triglycerides, HOMA-IR and uric acid, lower HDL, and lower odds of hyperfiltration. There were no differences in blood pressure by racial group or place of birth. Conclusions Although Asian American children have lower odds of obesity, they have significantly worse glucose intolerance, higher serum uric acid levels, more dyslipidemia and more microalbuminuria compared to NHW children. US-born Asian American children have worse cardiometabolic health profiles compared to foreign-born Asian Americans.
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Affiliation(s)
- Julian Sethna
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
| | - Kristal Wong
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
| | - Kevin Meyers
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
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Sámano R, Martínez-Rojano H, Ortiz-Hernández L, Nájera-Medina O, Chico-Barba G, Gamboa R, Mendoza-Flores ME. Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review. Nutrients 2023; 15:nu15061530. [PMID: 36986260 PMCID: PMC10058126 DOI: 10.3390/nu15061530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.
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Affiliation(s)
- Reyna Sámano
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación de la Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Luis Ortiz-Hernández
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Oralia Nájera-Medina
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Gabriela Chico-Barba
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Ricardo Gamboa
- Departamento de Fisiología, Instituto Nacional de Cardiología, Mexico City 14080, Mexico
| | - María Eugenia Mendoza-Flores
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
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Methods, Ethics, and Cross-Language Considerations in Research With Ethnic Minority Children. Nurs Res 2021; 70:383-390. [PMID: 34225322 DOI: 10.1097/nnr.0000000000000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Qualitative research seeking the perspectives of minority children on child health issues such as childhood obesity and healthy weight care is limited, especially in nursing research. OBJECTIVE Our objective is to share methodological, ethical, and cross-language knowledge gained from conducting an ethnonursing research study. This study focused on providing a voice for ethnic minority children in childhood obesity literature. METHODS The purpose of the study was to discover cultural influences on healthy weight care in children of Burmese refugees of Karen ethnicity. Researchers may exclude children of ethnic minorities from studies because of the distinct challenges in conducting cross-language research and research with children. We critically examine these challenges. The challenge of being a stranger was addressed by a period of immersion in the children's activities prior to data collection, in addition to volunteering as an English teacher with Karen adults. The immersion period was crucial for developing the trust needed in child-inclusive research and research in ethnic minority communities. The challenge of designing an inclusive study with families who experience language barriers was addressed with an interpreter who not only spoke Karen but was also a part of the Karen community. The interpreter provided the authentic sociocultural language equivalence needed for the study's rigor. Ensuring the child's voice was clearly heard was addressed with member checking. Methodological changes necessitated by a pandemic were a distinct challenge discussed in detail. RESULTS We described methods useful for nurse researchers seeking transformative knowledge to reduce health disparities in childhood obesity. Nurse researchers may use these methods related to cross-language research and child research for designing research inclusive of minorities with language barriers. DISCUSSION The perspectives of children from ethnic minorities are needed to inform culturally congruent healthy weight care for their communities. The goal in providing transparency of the difficulties, successes, and recommendations for methods in research with children of Burmese refugees is to encourage more nurse researchers to work with marginalized groups. Nurse researchers can inform evidence-based, culturally appropriate interventions to address health inequities of minority communities by including the voice of children from these communities.
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Li X, Zhang Q, Zhou X, Guo S, Jiang S, Zhang Y, Zhang R, Dong J, Liao L. The different hypoglycemic effects between East Asian and non-Asian type 2 diabetes patients when treated with SGLT-2 inhibitors as an add-on treatment for metformin: a systematic review and meta-analysis of randomized controlled trials. Aging (Albany NY) 2021; 13:12748-12765. [PMID: 33973870 PMCID: PMC8148508 DOI: 10.18632/aging.202945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/27/2021] [Indexed: 12/19/2022]
Abstract
Aims: To investigate the efficacy and safety of SGLT-2 inhibitors as an add-on treatment for metformin between Asian and non-Asian T2DM. Methods: A systematic literature search of PubMed, EMBASE, and the Cochrane Library was performed through August 2020 with the following keywords: Sodium-Glucose Transporter 2 Inhibitors, Sodium Glucose Transporter 2 Inhibitors, SGLT2 inhibitor, SGLT-2 inhibitors, type 2 diabetes, and randomized controlled trials. Double-blinded RCTs comparing SGLT-2 inhibitors as an add-on treatment for metformin and metformin monotherapy in adults with type 2 diabetes were included. A random effects model was used to calculate overall effect sizes. Results: 5 RCTs with 1193 Asian patients and 7 RCTs with 2098 non-Asian patients were investigated. The improvement in HbA1c and fasting blood glucose in the Asian patients (WMD, −0.73%; 95% CI, −1.01% to −0.46%, p < 0.01; WMD, −1.51; 95% CI, −1.81 to −1.21, p < 0.01, respectively) were both significantly better than in the non-Asians (WMD, −0.45%; 95% CI, −0.62% to −0.29%, p < 0.01; WMD, −1.03; 95% CI, −1.27 to −0.78, p < 0.01, respectively). The effect of weight loss was similar in the non-Asian patients and Asian patients. There was little difference in the improvement of systolic blood pressure between them. The risk of serious adverse events was not significantly increased between the Asian and non-Asian patients. Conclusion: SGLT-2 inhibitors as an add-on treatment for metformin are more efficacious in East Asian T2DM patients than in non-Asian T2DM patients without an additional risk of severe adverse events.
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Affiliation(s)
- Xianzhi Li
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China.,Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China
| | - Qianping Zhang
- Division of Endocrinology, Department of Internal Medicine, Dezhou Municipal Hospital, Dezhou, Shandong 253000, China
| | - Xiaojun Zhou
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China.,Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China
| | - Siyi Guo
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji-nan, Shandong 250012, China
| | - Shan Jiang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji-nan, Shandong 250012, China
| | - Yuhan Zhang
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China
| | - Ruzhen Zhang
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China
| | - Jianjun Dong
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji-nan, Shandong 250012, China
| | - Lin Liao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China.,Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Ji-nan, Shandong 250014, China
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Kim Y, Je Y, Giovannucci E. Coffee consumption and all-cause and cause-specific mortality: a meta-analysis by potential modifiers. Eur J Epidemiol 2019; 34:731-752. [PMID: 31055709 DOI: 10.1007/s10654-019-00524-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/24/2019] [Indexed: 01/07/2023]
Abstract
Coffee consumption has been associated with decreased mortality in previous studies. As aging, obesity, and lifestyle factors affect the risk of mortality, the association between coffee and mortality needs to be examined in various subpopulations by characteristics of subjects. To quantitatively assess this association, we conducted an updated meta-analysis including stratified analyses by potential modifiers. We searched in the PubMed and Web of Science databases through March 8, 2019, and conducted meta-analysis including linear and non-linear dose-response analyses. We identified 40 studies including 3,852,651 subjects and 450,256 all-cause and cause-specific deaths. Non-linear inverse associations between coffee consumption and mortality from all-causes, cardiovascular disease (CVD), and cancers were found. The lowest relative risk (RR) was at intakes of 3.5 cups/day for all-cause mortality (RR = 0.85, 95% CI 0.82-0.89), 2.5 cups/day for CVD mortality (RR = 0.83, 95% CI 0.80-0.87), and 2 cups/day for cancer mortality (RR = 0.96, 95% CI 0.94-0.99), while additional intakes were not associated with further lower mortality. An inverse association between coffee consumption and all-cause mortality was maintained irrespective of age, overweight status, alcohol drinking, smoking status, and caffeine content of coffee. By region, Europe and Asia showed stronger inverse associations than US. A non-linear inverse association was found for mortality from respiratory disease and diabetes, while linear inverse association was found for mortality from non-CVD, non-cancer causes. Moderate coffee consumption (e.g. 2-4 cups/day) was associated with reduced all-cause and cause-specific mortality, compared to no coffee consumption. The inverse association between coffee and all-cause mortality was consistent by potential modifiers except region.
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Affiliation(s)
- Youngyo Kim
- Department of Food and Nutrition, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Youjin Je
- Department of Food and Nutrition, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Quader ZS, Gazmararian JA, McCullough LE. Obesity and understudied minority children: existing challenges and opportunities in epidemiology. BMC Pediatr 2019; 19:103. [PMID: 30971202 PMCID: PMC6458765 DOI: 10.1186/s12887-019-1484-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 04/02/2019] [Indexed: 12/30/2022] Open
Abstract
Background Obesity is a major public health concern in the United States and should be addressed as early as possible, in childhood. Disparities exist in obesity prevalence and its associated comorbidities by racial/ethnic group, however less is known about the smaller racial/ethnic subclasses that are often aggregated and assumed to be homogeneously at risk. As the racial and ethnic composition of the US shifts towards greater diversity, it is important that epidemiologic research addresses these new challenges. Main body In this short communication, we focus on Asian American children given that subgroups are historically understudied and emerging evidence among adults suggest heterogeneous associations for both obesity and cardio-metabolic outcomes. Existing limitations in this research area include: (1) identifying the appropriate measurement of adiposity in Asian American children; (2) determining high-risk cutoffs for intervention; and (3) developing strategies to ensure study robustness. Conclusion Data disaggregation is a necessary approach to understand potentially heterogeneous associations in childhood obesity and cardio-metabolic risk, but epidemiologic investigators must address these challenges. Ultimately, successful strategies could help better identify high risk subgroups, target interventions, and effectively reduce the burden of obesity among American youth.
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Affiliation(s)
- Zerleen S Quader
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
| | - Julie A Gazmararian
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Lauren E McCullough
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
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