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Marrero A, Haneuse S, Golden CD, Rodríguez-Orengo JF, Tucker KL, Mattei J. Neo-Traditional and Industrialized Dietary Patterns Coexist and Are Differentially Associated with Cardiometabolic Health among Adults in Puerto Rico. J Nutr 2023; 153:3259-3269. [PMID: 37689268 PMCID: PMC10687615 DOI: 10.1016/j.tjnut.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND An increasingly industrialized food system has marginalized local, traditional food cultures in Puerto Rico (PR). Recent efforts to decolonize diets have promoted local food intake; however, how resulting dietary patterns may influence cardiometabolic disease remains unknown. OBJECTIVES This study aimed to 1) identify dietary patterns in PR and 2) determine their associations with metabolic syndrome (MetS) and its components. METHODS Data were obtained from participants (30-75 y) in PROSPECT (PR Observational Study of Psychosocial, Environmental, and Chronic Disease Trends; n = 989). Dietary patterns were derived using partial least squares analysis with food frequency questionnaire data, using nutrients associated with local food purchasing (dietary fiber, magnesium, saturated fat) as response variables. MetS was classified using harmonized criteria from clinical and laboratory measures and medication use. Fully adjusted generalized linear models tested associations between tertiles of dietary patterns and MetS. RESULTS Approximately half (52%) of the participants were classified with MetS. Four dietary patterns were revealed: conventional (legumes, coffee, and dairy), industrialized starch and meat-centric (red/processed meats, pasta, and starchy roots), industrialized sugar-centric (rice, sugary beverages, and refined grains), and neo-traditional (local plants and seafood). Individuals in the highest (compared with lowest) tertile of the industrialized starch and meat-centric dietary pattern had higher mean waist circumference (102 compared with 99 cm) (P = 0.01), fasting glucose (106 compared with 98 mg/dL) (P = 0.019), and systolic blood pressure (123 compared with 119 mmHg) (P = 0.022). Individuals in the highest (compared with lowest) tertile of the neo-traditional diet were 0.69 (0.49, 0.97) times less likely to have MetS (P = 0.035) and had 4.1 cm lower mean waist circumference (P = 0.002). CONCLUSIONS Promoting a neo-traditional diet and curbing industrialized starch and meat-centric diets may improve cardiometabolic health in PR. Results can guide local food promotion as a healthful, decolonizing approach in island settings.
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Affiliation(s)
- Abrania Marrero
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Christopher D Golden
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - José F Rodríguez-Orengo
- FDI Clinical Research of Puerto Rico, San Juan, Puerto Rico; Department of Biochemistry, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts-Lowell, Lowell, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States.
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Igboanugo S, Mielke J. The allostatic load model: a framework to understand the cumulative multi-system impact of work-related psychosocial stress exposure among firefighters. Health Psychol Behav Med 2023; 11:2255026. [PMID: 37711429 PMCID: PMC10498803 DOI: 10.1080/21642850.2023.2255026] [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: 12/14/2022] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
Firefighting is recognised as a profession where health and well-being can be affected by a variety of occupational factors, such as physical, thermal, and chemical stressors. Along with the risks intuitively associated with the fire service, however, psychosocial stress has begun to attract attention as another variable deserving of consideration. Indeed, long-term exposure to work-related psychosocial stress has been linked with poor health outcomes in many workers; however, despite this association, very little has been done to examine how such stressors become biologically embedded in firefighters. To help facilitate research into how psychosocial stress can affect health-related outcomes in the fire service, we propose a framework centered on the notion of allostatic load. First, we reviewed the occupational characteristics that may generate psychosocial stress within firefighters before introducing allostatic load (that is, dysregulation across various physiological systems caused by the need to manage ongoing stressors). Next, we provided a summary of how allostatic load can be measured and touched on the framework's utility for studying the cumulative effects of work-related stress on firefighter health. After this, factors that may influence the steps leading from stress exposure to health outcomes were discussed; in particular, we commented upon how research in this area should consider specific non-modifiable (age, sex, and ethnicity) and modifiable (psychosocial resources and behavioural habits) factors. Finally, we presented methodological barriers and opportunities that may arise when using the allostatic load framework with this professional group. By introducing the framework, we hope to provide a tool that may be used by those interested in stress-health research in firefighters to build the evidence needed to inform primary prevention measures.
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Affiliation(s)
- Somkene Igboanugo
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Patient Education and Engagement, University Health Network, Toronto, Canada
| | - John Mielke
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
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Maldonado LE, Sotres-Alvarez D, Mattei J, Daviglus ML, Talavera GA, Perreira KM, Van Horn L, Mossavar-Rahmani Y, LeCroy MN, Gallo LC, Albrecht SS. A Posteriori dietary patterns, insulin resistance, and diabetes risk by Hispanic/Latino heritage in the HCHS/SOL cohort. Nutr Diabetes 2022; 12:44. [PMID: 36229451 PMCID: PMC9561638 DOI: 10.1038/s41387-022-00221-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
Objective We examined links among dietary patterns (DPs), insulin resistance (IR), and diabetes risk by heritage in the Hispanic Community Health Study/Study of Latinos. Methods Hispanics/Latinos of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American heritage aged 18–74 years and diabetes-free completed two 24 h dietary recalls at baseline (2008–2011) and provided 6-year follow-up data (2014–2017; n = 7774). We classified 6-year IR status [improved, unchanged (referent), worsened] using a 1-SD change in fasting insulin between visits and defined incident diabetes based on American Diabetes Association criteria. We derived heritage-specific DPs via principal factor analysis and estimated their associations with 6-year IR status (multinomial) and incident diabetes (binary) using complex survey-based logistic regression. Results Five overarching DPs based on high-loading foods were shared by two or more heritage groups: “Burger, Fries, & Soft Drinks”; “White Rice, Beans, & Red Meats”; “Fish & Whole Grains”; “Cheese & Sweets”; and “Stew & Corn”. Comparing highest-to-lowest DP quintiles, the Dominican “Burger, Fries, & Soft Drinks” and Cuban “White Rice, Beans, & Red Meats” DPs were associated with worsened 6-year IR status (log-odds: 2.35, 95% CI: 1.02, 3.68, Ptrend = 0.037 and log-odds: 1.27, 95% CI: 0.49, 2.06, Ptrend = 0.009, respectively). The Puerto Rican “Burger, Fries, & Soft Drinks” and the Central American “White Rice, Beans, & Red Meats” DPs were associated with greater diabetes incidence (OR: 3.00, 95% CI:1.50, 5.99 and OR: 2.41, 95% CI: 1.05, 5.50, respectively). Conclusions A diet characterized by higher intakes of burgers, fries, and soft drinks and another characterized by higher intakes of white rice, beans, and red meats may be adversely associated with IR and diabetes risk in some Hispanic/Latino heritage groups. Future work is needed to offer more heritage-specific dietary guidance for diabetes prevention in this population.
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Affiliation(s)
- Luis E Maldonado
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Krista M Perreira
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.,Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Madison N LeCroy
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Sandra S Albrecht
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Obomsawin A, D'Amico D, Fiocco AJ. The association between Mediterranean diet adherence and allostatic load in older adults. Psychoneuroendocrinology 2022; 143:105840. [PMID: 35752058 DOI: 10.1016/j.psyneuen.2022.105840] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/10/2022] [Accepted: 06/13/2022] [Indexed: 01/18/2023]
Abstract
Allostatic load (AL) is a multisystemic index of biological wear and tear which is associated with poor health outcomes. In recent years, researchers have examined the association between dietary pattern intake and AL; however, no studies to date have examined the relationship between AL and consumption of a Mediterranean diet. Blood and urine samples were collected from 201 community-dwelling older adults who completed a Food Frequency Questionnaire (FFQ). A Mediterranean Diet Score (MDS) was calculated based on previous recommendations and a sex-based AL index was calculated using a count-based approach for 16 biomarkers associated with neuroendocrine, immune, cardiovascular, or metabolic function. It was hypothesized that a higher MDS would be associated with lower AL, and that this association would be particularly robust for the immune and metabolic subcomponents of the AL index. In support of the primary study hypotheses, generalized linear models revealed a significant inverse relationship between MDS and AL (ß = -0.03, P = 0.037). However, subcomponents of the AL model were not significantly associated with MDS. Exploratory sub-group analyses by sex suggested that the association between AL and MDS was more robust in male than in female participants. The current findings are interpreted with caution given the study design and sample characteristics. Nonetheless, these findings contribute to the literature supporting the Mediterranean diet as an important lifestyle behavior that may minimize AL, and therefore support healthy aging.
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Affiliation(s)
- Anik Obomsawin
- Toronto Metropolitan University, Department of Psychology, Institute for Stress and Wellbeing Research, Canada
| | - Danielle D'Amico
- Toronto Metropolitan University, Department of Psychology, Institute for Stress and Wellbeing Research, Canada
| | - Alexandra J Fiocco
- Toronto Metropolitan University, Department of Psychology, Institute for Stress and Wellbeing Research, Canada.
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Zhou MS, Hasson RE, Baylin A, Leung CW. Associations between diet quality and allostatic load in US adults: findings from the National Health and Nutrition Examination Survey 2015-2018. J Acad Nutr Diet 2022; 122:2207-2217. [DOI: 10.1016/j.jand.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/03/2022] [Accepted: 05/02/2022] [Indexed: 11/24/2022]
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Laugero KD, Paul DR, Jahns L. Energy intake and season interact to influence physiological stress load among midlife women. Stress 2021; 24:849-856. [PMID: 34006172 DOI: 10.1080/10253890.2021.1931106] [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] [Indexed: 10/21/2022] Open
Abstract
Allostatic load (AL) is an index that measures physiologic stress associated with chronic disease risk. One factor that may influence overall physiologic stress load and AL is energy consumption, but whether this association differs across different seasons is unknown. We tested whether energy consumption interacted with the season to influence AL in 52 mid-life (40-60 years) women from the Life in All Seasons Study. Women completed an online 24-h recall every 10 days and had components of allostatic load measured seasonally. Women were from the greater Grand Forks, ND catchment area and were followed for one year between July 2012 and July 2014. We found a significant (p = 0.01) interaction between season and energy consumption on AL. Further inspection showed that, during the summer and winter seasons, the average allostatic load rose with relatively higher energy consumption. We also observed a linear and positive association between AL and energy intake in summer (β = 0.0013 ± 0.0004; p = 0.001; r2 = 0.14) and winter (β = 0.0011 ± 0.0004; p = 0.007; r2 = 0.10), but not in fall or spring. These results suggest that factors associated with distinct times of the year promote or prevent the effects of higher energy consumption on physiological stress load. Since allostatic load is linked to elevated disease risk, our results provide additional information that may help to explain seasonal differences in disease risk of some women.
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Affiliation(s)
- Kevin D Laugero
- Obesity and Metabolism Research Unit, USDA/ARS/Western Human Nutrition Research Center, Davis, CA, USA
- Department of Nutrition, University of California, Davis, CA, USA
| | - David R Paul
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Lisa Jahns
- USDA/ARS/Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
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Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 397] [Impact Index Per Article: 132.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
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Acculturation and biological stress markers: A systematic review. Psychoneuroendocrinology 2021; 132:105349. [PMID: 34246155 PMCID: PMC8527572 DOI: 10.1016/j.psyneuen.2021.105349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The association of acculturation with health among immigrant populations is believed to be mediated, in part, by acculturation-related stress and stress biology. OBJECTIVES To review and qualitatively synthesize empirical findings on the relationship of acculturation with stress-related inflammatory and endocrine biomarkers and composite allostatic load (AL) scores. METHODS A literature search was performed in the PubMed and PsycInfo databases. Article titles, abstracts or full-texts were screened and checked for match with the search criteria. Studies were eligible if they empirically tested the relationship between acculturation and inflammatory/endocrine stress biomarkers or composite AL scores, and were published in the English language. RESULTS Among the 41 articles identified as relevant and included in this review, the majority were published after 2010, included adult Hispanic U.S.-based populations, used cross-sectional study designs, operationalized acculturation as a unidimensional construct, and varied considerably in the selection of covariates in the analyses. Acculturation was significantly associated with stress biomarkers in 29 studies, but the direction of effects varied across studies. Specifically, acculturation, operationalized as a higher orientation towards the host culture, was associated with inflammatory biomarkers in 10 of 14 studies, with endocrine stress biomarkers in 12 of 20 studies, and with composite AL scores in 7 of 8 studies. Overall, language-based proxy measures of acculturation were related to higher levels of stress-related inflammatory and endocrine biomarkers and to lower levels of AL scores, whereas nativity-, generation status- and length of stay-based proxy measures of acculturation were related to higher levels of inflammatory biomarkers and AL score. DISCUSSION The majority of studies reported associations between measures of acculturation and stress biomarkers, however the directions of effects varied across studies. We suggest this heterogeneity may, in part, be a function of limitations imposed by cross-sectional research designs and unidimensional measures of acculturation measures, and we highlight the need for longitudinal studies and use of multidimensional measures of acculturation to better uncover the biobehavioral mechanisms and pathways linking acculturation with health outcomes.
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Association between physiological stress load and diet quality patterns differs between male and female adults. Physiol Behav 2021; 240:113538. [PMID: 34314759 DOI: 10.1016/j.physbeh.2021.113538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
A promising, yet relatively unexplored factor that may influence a person's stress response, is diet. Diet can affect the physiological response to stress, but relationships between diet quality and the chronic stress marker allostatic load (AL) are insufficiently studied. Furthermore, sex, age, and BMI may interact with diet quality to influence AL. 358 adults were recruited across predetermined sex, age, and BMI ranges. Cluster analysis of 13 Healthy Eating Index (HEI) sub-scores across all participants revealed six distinct diet quality patterns (HEI-P). We found sex and HEI-P interacted (PHEIxSex = 0.0232) to affect AL, reflecting a significantly different AL between women and men consuming a diet more closely aligned with the Dietary Guidelines for Americans for dairy, refined grains, and sodium consumption, but less aligned for added sugar, saturated fat, and fruits/vegetables intake. Sex and HEI-P also interacted to affect cholesterol (PHEIxSex = 0.0157), norepinephrine (PHEIxSex = 0.0315), epinephrine (PHEIxSex = 0.0204), and systolic blood pressure (PHEIxSex = 0.0457) but, compared to total allostatic load, no individual component of this biomarker explained the entire array of sex by HEI-P interactions. Our results suggest that differences in HEI-P and sex interact to influence physiological stress load which, in turn, may help resolve discrepancies in diet and sex-related disease risk.
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11
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Yu EYT, Yeung CHN, Wan EYF, Tang EHM, Wong CKH, Cheung BMY, Lam CLK. Association between health behaviours and cardiometabolic dysregulation: a population-based survey among healthy adults in Hong Kong. BMJ Open 2021; 11:e043503. [PMID: 34244247 PMCID: PMC8273464 DOI: 10.1136/bmjopen-2020-043503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore the association between cardiometabolic dysregulation, an integral component of allostatic load, and health risk behaviours (HRBs) of the Hong Kong healthy adult population. DESIGN Secondary analysis of cross-sectional anonymous data. SETTING Data on sociodemographics, self-reported health status, HRBs and biomarkers were extracted from the Hong Kong Population Health Survey 2014/2015. PARTICIPANTS One thousand five hundred and fifty-one participants aged 18-64 years without self-reported diagnoses of hypertension, diabetes mellitus, hyperlipidaemia, cardiovascular disease, cognitive impairment or cancer. PRIMARY OUTCOME MEASURES Cardiometabolic dysregulation index (CMDI), ranging from 0 to 6, was calculated by counting the number of biomarkers including systolic blood pressure, diastolic blood pressure, waist to hip ratio, glycated haemoglobin, total cholesterol to high-density lipoprotein cholesterol ratio, and triglycerides that were above the respective normal level suggested by international guidelines and literature. HRBs including smoking, dietary habits and sleeping hours were collected by self-report questionnaire. Alcohol consumption was assessed by the 10-item Alcohol Use Disorders Identification Test, while physical activity level was measured using the Global Physical Activity Questionnaire. A composite HRB score, ranging from 0 to 5, was calculated as the cumulative number of HRBs. The effect of HRB on CMDI was evaluated by negative binomial regression with adjustment for socioeconomic status, health awareness and comorbidities of the participants. RESULTS The mean CMDI of the studied population was 1.6; 29.5% had a CMDI of 0, whereas 1.5% had a CMDI of 6. Significant difference was observed in mean CMDI between gender and different age groups. Sleeping less than 6 hours (incidence rate ratio (IRR)=1.26, p<0.001), smoking (IRR=1.15, p=0.027), insufficient physical activity (IRR=1.12, p=0.007) and higher composite HRB score (IRR=1.12, 95% CI 1.06 to 1.18) were significantly associated with higher CMDI. CONCLUSION Smoking, physical inactivity and inadequate sleep-an essential yet often overlooked health behaviour-were associated with higher CMDI in the Hong Kong healthy adult population.
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Affiliation(s)
- Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | | | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Eric Ho Man Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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12
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Arias-Gastélum M, Lindberg NM, Leo MC, Bruening M, Whisner CM, Der Ananian C, Hooker SP, LeBlanc ES, Stevens VJ, Shuster E, Meenan RT, Gille S, Vaughn KA, Turner A, Vega-López S. Dietary Patterns with Healthy and Unhealthy Traits Among Overweight/Obese Hispanic Women with or at High Risk for Type 2 Diabetes. J Racial Ethn Health Disparities 2021; 8:293-303. [PMID: 32495304 PMCID: PMC10754237 DOI: 10.1007/s40615-020-00782-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/14/2020] [Accepted: 05/22/2020] [Indexed: 01/02/2023]
Abstract
Hispanic women are at high risk for type 2 diabetes (T2D), with obesity and unhealthy eating being important contributing factors. A cross-sectional design was used in this study to identify dietary patterns and their associations with diabetes risk factors. Participants completed a culturally adapted Food Frequency Questionnaire capturing intake over the prior 3 months. Overweight/obese Hispanic women (n = 191) with or at risk for T2D were recruited from a community clinic into a weight loss intervention. Only baseline data was used for this analysis. Dietary patterns and their association with diabetes risk factors (age, body mass index, abdominal obesity, elevated fasting blood glucose [FBG], and hemoglobin A1c). An exploratory factor analysis of dietary data adjusted for energy intake was used to identify eating patterns, and Pearson correlation coefficient (r) to assess the association of the eating patterns with the diabetes risk factors. Six meaningful patterns with healthful and unhealthful traits emerged: (1) sugar and fat-laden, (2) plant foods and fish, (3) soups and starchy dishes, (4) meats and snacks, (5) beans and grains, and (6) eggs and dairy. Scores for the "sugar and fat-laden" and "meats and snacks" patterns were negatively associated with age (r = - 0.230, p = 0.001 and r = - 0.298, p < 0.001, respectively). Scores for "plant foods and fish" were positively associated with FBG (r = 0.152, p = 0.037). Being younger may be an important risk factor for a diet rich in sugar and fat; this highlights the need to assess dietary patterns among younger Hispanic women to identify traits potentially detrimental for their health.
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Affiliation(s)
- Mayra Arias-Gastélum
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
- Escuela de Ciencias de la Nutrición y Gastronomía, Universidad Autónoma de Sinaloa, 80019, Culiacán, Sinaloa, Mexico
| | - Nangel M Lindberg
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Michael C Leo
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Meg Bruening
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Corrie M Whisner
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Cheryl Der Ananian
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA, 92182, USA
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Victor J Stevens
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Elizabeth Shuster
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Richard T Meenan
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Sara Gille
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | | | - Ann Turner
- Virginia Garcia Memoria Health Center, Hillsboro, OR, 97123, USA
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA.
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, 85004, USA.
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Lopez-Cepero A, Rosal MC, Frisard C, Person S, Ockene I, Tucker KL. Changes in Glycemic Load Are Positively Associated with Small Changes in Primary Stress Markers of Allostatic Load in Puerto Rican Women. J Nutr 2020; 150:554-559. [PMID: 31665370 PMCID: PMC7308622 DOI: 10.1093/jn/nxz260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/26/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Puerto Ricans experience a high prevalence of type 2 diabetes. Dietary glycemic load (GL) and allostatic load (AL) have been linked with diabetes. AL, the wear and tear on the body from chronic stress, starts with secretion of primary stress markers from activation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS), and immune system. GL can act as a physiological stressor, contributing to the primary AL response. OBJECTIVE We examined the relation between GL and a composite score of primary stress markers of AL in Puerto Rican adults. METHODS Data were from the Boston Puerto Rican Health Study, a cohort study of Puerto Ricans, aged 45-75 y, including 262 men and 697 women with complete data at baseline and 2-y follow-up. GL was calculated from dietary intake obtained with an FFQ. Sex-specific composite primary AL scores included markers of the HPA axis (cortisol and dehydroepiandrosterone sulfate), SNS (epinephrine and norepinephrine), and immune system (C-reactive protein). Linear regression models were stratified by sex and adjusted for covariates. RESULTS Mean ± SD baseline GL score was 155 ± 28 for men and 135 ± 34 for women. Mean primary stress AL score was 1.25 ± 1.14 for men and 1.25 ± 1.06 for women. GL was not associated with AL score in men. In women, increasing GL from baseline to 2 y was significantly associated with increasing AL, after adjusting for sociodemographics, physical activity, smoking, BMI, menopause, and baseline AL score (β = 0.03; P = 0.049). Results became marginally significant after further adjustment for chronic diseases (P = 0.06) and intake of fats (P values: saturated fats = 0.08; trans fats = 0.06; unsaturated fats = 0.07), but the magnitude of the association remained unchanged. CONCLUSIONS Increasing GL over 2 y was positively associated with increasing composite score of primary markers of AL in Puerto Rican women. More studies are needed to confirm our findings.
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Affiliation(s)
- Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sharina Person
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ira Ockene
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Health risk behaviours and allostatic load: A systematic review. Neurosci Biobehav Rev 2020; 108:694-711. [DOI: 10.1016/j.neubiorev.2019.12.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/05/2019] [Accepted: 12/11/2019] [Indexed: 12/26/2022]
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Evaluation of Nutritional Status and Allostatic Load in Adult Patients With Type 2 Diabetes. Can J Diabetes 2019; 44:156-161. [PMID: 31445959 DOI: 10.1016/j.jcjd.2019.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/09/2019] [Accepted: 05/24/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Diabetes is a chronic disease, affected by nutritional status, and characterized by dysregulations in several systems. Allostatic load is an index that evaluates the dysregulation of all physiological and metabolic systems. This study was conducted to determine the relationship between nutritional status and allostatic load in patients with type 2 diabetes mellitus (T2DM). METHODS The study sample consisted of 30 males and 73 females between 20 and 55 years of age. Individuals had T2DM for 7.9±6.17 (mean ± standard deviation) years. World Health Organization criteria cutoffs were used to calculate allostatic load scores. Twelve parameters were questioned and an allostatic load score between 0 and 12 was obtained; values above the cutoff levels were assigned a value of 1, and values in the normal range were assigned a value of 0. RESULTS Individuals with high allostatic load comprised a significant portion of the sample (79.6%) for both males and females (73.3% and 82.2%, respectively). Longer diabetes duration was associated with high allostatic load score (p<0.05). There was lower vegetable consumption and higher fruit consumption in the high-allostatic-load group compared with the low-allostatic-load group (p<0.05). However, fruit consumption was still lower than recommended levels in both groups. CONCLUSIONS A significant number of individuals had high allostatic load scores in our study. A healthy diet plan in line with the recommendations may help to decrease the allostatic load scores by reducing body weight, waist/hip ratio, blood pressure and fasting blood glucose, and may prevent the negative effects of stress on metabolic processes in the long-term malnutrition in T2DM.
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Calcaterra V, Vinci F, Casari G, Pelizzo G, de Silvestri A, De Amici M, Albertini R, Regalbuto C, Montalbano C, Larizza D, Cena H. Evaluation of Allostatic Load as a Marker of Chronic Stress in Children and the Importance of Excess Weight. Front Pediatr 2019; 7:335. [PMID: 31440490 PMCID: PMC6693076 DOI: 10.3389/fped.2019.00335] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/24/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Allostatic load (AL) refers to the physiological response associated with the burden of chronic stress. Excessive weight is an important source of physiological stress that promotes a detrimental chronic low-inflammation state. In order to define a correlation between cumulative biological dysregulation and excess weight, we measured AL scores in a pediatric population. Patients and Methods: We enrolled 164 children and adolescents (11.89 ± 3.89). According to their body mass index (BMI) threshold, subjects were classified as normal in the BMI < 75th percentile, overweight in the BMI 75-95th percentile or obese in the BMI >95th percentile. Data based on 16 biomarkers were used to create the AL score. A dichotomous outcome for high AL was defined in those who had more than four dysregulated components. Results: High AL was noted in 88/164 subjects (53.65%), without significant differences between genders (p = 0.07) or pubertal status (p = 0.10). Subjects with a high AL, in addition to a higher BMI (p < 0.001), showed higher WC and WC/HtR (p < 0.001), triglycerides (p = 0.002), fasting blood glucose (p = 0.03), insulin resistance (p < 0.001), systolic (p < 0.001) and diastolic blood pressure (p = 0.001), GGT (p = 0.01), PCR (p = 0.01), and calprotectin (p < 0.01) as well as lower HDL cholesterol (p = 0.002) than subjects with a low AL. The rate of the cumulative biological dysregulation increased progressively with increases in BMI (p < 0.001). Conclusions: A high AL was associated with excess weight. AL may be considered a significant factor correlated with increased morbidity in children who are overweight/obese.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Federica Vinci
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Giulia Casari
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Gloria Pelizzo
- Pediatric Surgery Department, Children's Hospital "G. di Cristina", ARNAS "Civico-Di Cristina-Benfratelli", Palermo, Italy
| | - Annalisa de Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mara De Amici
- Immuno-Allergy Laboratory, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Albertini
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Corrado Regalbuto
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Chiara Montalbano
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Daniela Larizza
- Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy
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17
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Diet Quality for Sodium and Vegetables Mediate Effects of Whole Food Diets on 8-Week Changes in Stress Load. Nutrients 2018; 10:nu10111606. [PMID: 30388762 PMCID: PMC6266876 DOI: 10.3390/nu10111606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/23/2018] [Accepted: 10/27/2018] [Indexed: 12/26/2022] Open
Abstract
Very little is known about how whole food diets, such as those based on the Dietary Guidelines for Americans (DGA), influence psychological stress and physiological stress load. To better understand the effects of whole food diets on stress, we examined in a randomized control trial the effects of a DGA-based diet on markers of psychological and physiological stress. A randomized, double-blind, controlled 8-week intervention was conducted in overweight and obese women randomly assigned to one of two diet groups: a diet based on the 2010 DGA or a diet based on a Typical American Diet (TAD). The Perceived Stress Scale and allostatic load were used to assess stress load. Eight-week change in perceived stress did not significantly (p = 0.45) differ between the DGA (+0.53 ± 0.99) and TAD (-0.57 ± 0.99) groups. Likewise, 8-week change in allostatic load did not significantly (p = 0.79) differ between the two diet intervention groups (DGA: +0.001 ± 0.26 vs. TAD: +0.105 ± 0.28). However, we did find strong inverse associations between 8-week change in stress and intervention-based improvements in diet quality (lower sodium and higher vegetable consumption). When statistically accounting for these inverse associations, we found that perceived stress and allostatic load were higher (p < 0.04) in the DGA group. These findings suggest that improvements in dietary vegetable and sodium intake mediated effects of the diet intervention on psychological and physiological stress load. That is, adopting and adhering to a diet of higher quality (DGA) for 8 weeks may have been generally more stressful in the absence of improvements in vegetable or sodium consumption. This study provides further evidence for the mental health benefits of maximizing vegetable and minimizing sodium consumption.
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Mattei J, McClain AC, Falcón LM, Noel SE, Tucker KL. Dietary Acculturation among Puerto Rican Adults Varies by Acculturation Construct and Dietary Measure. J Nutr 2018; 148:1804-1813. [PMID: 30383277 PMCID: PMC6669953 DOI: 10.1093/jn/nxy174] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 07/10/2018] [Indexed: 01/14/2023] Open
Abstract
Background The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics. Objective We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States. Methods We analyzed cross-sectional data with 1194-1380 Puerto Ricans, aged 45-75 y. Acculturation was measured with the use of a language-based scale (0-100; higher score denotes more English use), a psychological-based scale (0-50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status. Results Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (β ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score β ± SE: -0.160 ± 0.032; P < 0.0001) than the psychological-based scale (-0.097 ± 0.028; P = 0.001) or years living in the mainland United States (-0.058 ± 0.028; P = 0.041). No associations were observed for the Western or sweets/desserts patterns. Conclusions In Puerto Rican adults, stronger psychological US orientation was associated with higher diet quality, particularly with higher income. More Spanish use, stronger psychological Puerto Rican orientation, and shorter length of mainland-US residency were associated with traditional dietary patterns. Appropriate diet-related acculturation constructs should be carefully considered among Hispanics/Latinos. This trial was registered at clinicaltrials.gov as NCT01231958.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Address correspondence to JM (e-mail: )
| | - Amanda C McClain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Luis M Falcón
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts, Lowell, MA
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
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Food Insecurity and Odds of High Allostatic Load in Puerto Rican Adults: The Role of Participation in the Supplemental Nutrition Assistance Program During 5 Years of Follow-Up. Psychosom Med 2018; 80:733-741. [PMID: 30045347 PMCID: PMC6330211 DOI: 10.1097/psy.0000000000000628] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Limited evidence demonstrates pathways linking food insecurity (FI) to chronic disease. Allostatic load (AL) may elucidate potential pathways, capturing both primary (neuroendocrine, inflammation) and secondary (metabolic, cardiovascular) physiological disturbances. We examined the longitudinal association of FI with 5-year AL and primary and secondary subsystem dysregulation and tested moderation by Supplemental Nutrition Assistance Program (SNAP) participation. METHODS We analyzed data from the longitudinal Boston Puerto Rican Health Study among 733 adults aged 45 to 75 years. Participants categorized as food insecure (assessed by US survey module) experienced FI at baseline and/or year 5. AL score comprised 11 biological components (5 primary, 6 secondary). We classified participants as having high scores for AL (≥6 dysregulated components), primary system (≥3), and secondary system (≥4). Multivariate models estimated odds ratios (OR), adjusting for baseline AL, sociodemographic, cultural, and behavioral characteristics. RESULTS By study end, 33.8% had experienced FI, 65.5% had participated in SNAP, and 37.5% had high AL. In adjusted models, FI was not associated with AL (OR [95% confidence intervals] = 1.07 [0.70-1.64]) or secondary system (0.82 [0.48-1.40]) scores, but was associated with high primary system scores (1.71 [1.25-2.36]). SNAP participation seemed to moderate the FI-primary system relationship (p = .06); food-insecure participants never receiving SNAP (mean (SE) = 2.06 (0.14)) had higher scores than food-secure participants receiving (1.72 (0.06], p = .02) or never receiving SNAP (1.64 (0.10), p = .01) and food-insecure participants receiving SNAP (1.80 (0.07), p = .08). CONCLUSIONS FI is associated with dysregulated components of the primary AL system, and this relationship may be stronger for those not receiving SNAP. Research is needed in additional populations to test AL as a plausible pathway connecting FI to chronic disease and SNAP as a moderator.
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Colón-Ramos U, Rodríguez-Ayuso I, Gebrekristos HT, Roess A, Pérez CM, Simonsen L. Transnational Mortality Comparisons Between Archipelago and Mainland Puerto Ricans. J Immigr Minor Health 2018; 19:1009-1017. [PMID: 27334006 DOI: 10.1007/s10903-016-0448-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Puerto Ricans in the US experience higher deaths from diabetes and other causes compared to non-Hispanic Whites and other Hispanic groups. We compared mortality in Puerto Rico to that of Puerto Ricans in the US as a first step to investigate if similar or worse mortality patterns originate from the sending country (Puerto Rico). Age-adjusted death rates were generated using national vital statistics databases in the US and territories for all-cause and the top ten causes of death among Hispanics in 2009. Mortality ratios in the archipelago of Puerto Rico (APR) were compared to mainland US Puerto Ricans (MPR). Rates for other ethnic/racial groups (Mexican Americans, Cubans, and non-Hispanic Whites, Blacks, American Indians, and Asians) were calculated to provide a context. APR had significantly higher all-cause mortality and death rates for diabetes, nephritis, pneumonia/influenza, and homicide/assault compared to MPR (APR/MPR ratio for all-cause: 1.08, diabetes: 2.04, nephritis: 1.84, pneumonia/influenza: 1.33, homicide/assault: 3.15). Death rates for diabetes and homicide/assault (particularly among men) were higher among APR compared to any other racial/ethnic groups in the US. In contrast, deaths from heart disease, cancer, and chronic liver disease were significantly lower for APR compared to MPR (MPR/APR ratio 0.72, 0.91, 0.41, respectively). Among APR women, death rates for these causes were also lower compared to any other group in the US. Substantial mortality variability exists between Puerto Ricans in Puerto Rico and those in the US, re-emphasizing the need to study of how socio-environmental determinants of health differ in sending and receiving countries. Explanations for disparate rates include access to and availability of healthcare and unique factors related to the migration experience of this group.
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Affiliation(s)
- Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, 20037, USA.
| | | | - Hirut T Gebrekristos
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Amira Roess
- Department of Global Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, 20037, USA
| | - Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA
| | - Lone Simonsen
- Department of Global Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, 20037, USA
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Marques-Vidal P, Waeber G, Vollenweider P, Guessous I. Socio-demographic and lifestyle determinants of dietary patterns in French-speaking Switzerland, 2009-2012. BMC Public Health 2018; 18:131. [PMID: 29329572 PMCID: PMC5766995 DOI: 10.1186/s12889-018-5045-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/08/2018] [Indexed: 12/23/2022] Open
Abstract
Background Food intake is a complex behaviour which can be assessed using dietary patterns. Our aim was to characterize dietary patterns and associated factors in French-speaking Switzerland. Methods Cross-sectional study conducted between 2009 and 2012 in the city of Lausanne, Switzerland, including 4372 participants (54% women, 57.3 ± 10.3 years). Food consumption was assessed using a validated food frequency questionnaire. Dietary patterns were assessed by principal components analysis. Results Three patterns were identified: “Meat & fries”; “Fruits & Vegetables” and “Fatty & sugary”. The “Meat & fries” pattern showed the strongest correlations with total and animal protein and cholesterol carbohydrates, dietary fibre and calcium. The “Fruits & Vegetables” pattern showed the strongest correlations with dietary fibre, carotene and vitamin D. The “Fatty & sugary” pattern showed the strongest correlations with total energy and saturated fat. On multivariate analysis, male gender, low educational level and sedentary status were positively associated with the “Meat & fries” and the “Fatty & sugary” patterns, and negatively associated with the “Fruits & Vegetables” pattern. Increasing age was inversely associated with the “Meat & fries” pattern; smoking status was inversely associated with the “Fruits & Vegetables” pattern. Being born in Portugal or Spain was positively associated with the “Meat & fries” and the “Fruits & Vegetables” patterns. Increasing body mass index was positively associated with the “Meat & fries” pattern and inversely associated with the “Fatty & sugary” pattern. Conclusions Three dietary patterns, one healthy and two unhealthy, were identified in the Swiss population. Several associated modifiable behaviours were identified; the information on socio- demographic determinants allows targeting of the most vulnerable groups in the context of public health interventions. Electronic supplementary material The online version of this article (10.1186/s12889-018-5045-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Idris Guessous
- Unit of population epidemiology, Division of primary care medicine, Department of community medicine, primary care and emergency medicine, Geneva university hospitals, Geneva, Switzerland.,Department of ambulatory care and community medicine, University of Lausanne, Lausanne, Switzerland
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Consumption of fast food, sugar-sweetened beverages, artificially-sweetened beverages and allostatic load among young adults. Prev Med Rep 2017; 10:212-217. [PMID: 29868371 PMCID: PMC5984206 DOI: 10.1016/j.pmedr.2017.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 10/06/2017] [Accepted: 11/03/2017] [Indexed: 12/24/2022] Open
Abstract
This study investigates the associations between recent consumption of fast foods, sugar-sweetened beverages, and artificially-sweetened beverages on level of allostatic load, a measure of cumulative biological risk, in young adults in the US. Data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Negative binomial regression models were used to estimate the associations between consumption of fast foods, sugar-sweetened, and artificially-sweetened beverages and allostatic load. Poisson and logistic regression models were used to estimate the associations between these diet parameters and combined biomarkers of physiological subsystems that comprise our measure of allostatic load. All analyses were weighted and findings are representative of young adults in the US, ages 24–34 in 2008 (n = 11,562). Consumption of fast foods, sugar-sweetened, and artificially-sweetened beverages were associated with higher allostatic load at a bivariate level. Accounting for demographics and medication use, only artificially-sweetened beverages remained significantly associated with allostatic load. When all three dietary components were simultaneously included in a model, both sugar- and artificially-sweetened beverage consumption were associated with higher allostatic load. Differences in allostatic load emerge early in the life course and young adults consuming sugar- or artificially-sweetened beverages have higher allostatic load, net of demographics and medication use. Public health messages to young adults may need to include cautions about both sugar- and artificially-sweetened beverages. Eating fast food is associated with higher AL at a bivariate level. Sugar-sweetened drinks are associated with higher AL at a bivariate level. Artificially-sweetened drinks are associated with higher AL at a bivariate level. With all three dietary variables together, only drinks remain associated with AL. Differences in AL emerge early in the life course, associated with consumption.
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Ferreira MPDN, Previdelli ÁN, Freitas TID, Marques KM, Goulart RMM, Aquino RDCD. Dietary patterns and associated factors among the elderly. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.160115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Abstract The aim of the present study was to identify dietary patterns among the elderly, and associate the same with sociodemographic characteristics, health and lifestyle. A cross-sectional study was carried out with a non-probabilistic sample of 295 elderly residents of both genders of the city of São Caetano do Sul, São Paulo, Brazil, who were users of public health units. Dietary patterns were identified considering 44 food items identified through 24-hour dietary recall. Factor analysis by the principal components method was used, adopting loads greater than 0.25 as the cut-off point, followed by Varimax orthogonal rotation. The associations were analyzed by the linear regression method, with variables with p<0.20 in univariate regression selected, and those with p<0.05 maintained in the multivariate model. There was a greater percentage of elderly females (85.1%) and those aged 60-69 years (46.4%). Three dietary patterns were identified: the "traditional" pattern was associated with the male gender (β=0.59, p<0.001) and physically active individuals (β=0.39, p=0.020); the "Pastas, pork and sweets" pattern was associated with the male gender (β=0.38, p=0.025) and retired individuals (β=0.55, p=0.017); and the "Coffee with milk and bread and butter" pattern was associated with an age of 80 years or older (β=0.55, p=0.004) and elderly persons who had difficulty chewing (β=0.38, p=0.013). The dietary patterns identified show that the elderly tend to maintain similar eating habits to the Brazilian population in general, and that diet changes to a similar degree as health and life style conditions.
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Marques-Vidal P, Gaspoz JM, Theler JM, Guessous I. Twenty-year trends in dietary patterns in French-speaking Switzerland: toward healthier eating. Am J Clin Nutr 2017; 106:217-224. [PMID: 28592598 DOI: 10.3945/ajcn.116.144998] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 05/05/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population.Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation.Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses.Results: Among 18,763 adults, 1 healthy ("fish and vegetables") and 2 unhealthy ("meat and chips" and "chocolate and sweets") patterns were identified. Scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and "chocolate and sweets" pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables" pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: -0.56 ± 1.39 compared with -0.05 ± 1.58 in low- compared with highly educated groups, respectively; P < 0.001; scores in 2014: 0.28 ± 1.64 compared with 0.24 ± 1.83, respectively; P = 0.772). Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P < 0.001) for the 35- to 44-y cohort compared with -0.002 (95% CI: -0.009, 0.005; P = 0.546) for the 45- to 54-y cohort.Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and the "chocolate and sweets" pattern scores decreased. The stronger increases in the "fish and vegetables" pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels.
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Affiliation(s)
- Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Jean-Michel Gaspoz
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and
| | - Jean-Marc Theler
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and
| | - Idris Guessous
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and .,Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
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Vadiveloo M, Mattei J. Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults. Ann Behav Med 2017; 51:94-104. [PMID: 27553775 PMCID: PMC5253095 DOI: 10.1007/s12160-016-9831-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Discrimination promotes multisystem physiological dysregulation termed allostatic load, which predicts morbidity and mortality. It remains unclear whether weight-related discrimination influences allostatic load. PURPOSE The aim of this study was to prospectively examine 10-year associations between weight discrimination, allostatic load, and its components among adults 25-75 years in the Midlife Development in the US Biomarker Substudy. METHODS Participants with information on weight discrimination were analyzed (n=986). At both timepoints, participants self-reported the frequency of perceived weight discrimination across nine scenarios as "never/rarely" (scored as 0), "sometimes" (1), or "often" (2). The two scores were averaged and then dichotomized as "experienced" versus "not experienced" discrimination. High allostatic load was defined as having ≥3 out of 7 dysregulated systems (cardiovascular, sympathetic/parasympathetic nervous systems, hypothalamic pituitary axis, inflammatory, lipid/metabolic, and glucose metabolism), which collectively included 24 biomarkers. Relative risks (RR) were estimated from multivariate models adjusted for sociodemographic and health characteristics, other forms of discrimination, and BMI. RESULTS Over 41% of the sample had obesity, and 6% reported weight discrimination at follow-up. In multivariable-adjusted analyses, individuals who experienced (versus did not experience) weight discrimination had twice the risk of high allostatic load (RR, 2.07; 95 % CI, 1.21; 3.55 for baseline discrimination; 2.16, 95 % CI, 1.39; 3.36 for long-term discrimination). Weight discrimination was associated with lipid/metabolic dysregulation (1.56; 95 % CI 1.02, 2.40), glucose metabolism (1.99; 95 % CI 1.34, 2.95), and inflammation (1.76; 95 % CI 1.22, 2.54), but no other systems. CONCLUSIONS Perceived weight discrimination doubles the 10-year risk of high allostatic load. Eliminating weight stigma may reduce physiological dysregulation, improving obesity-related morbidity and mortality.
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Affiliation(s)
- Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, 02881, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.
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Golzarand M, Bahadoran Z, Mirmiran P, Azizi F. Protein Foods Group and 3-Year Incidence of Hypertension: A Prospective Study From Tehran Lipid and Glucose Study. J Ren Nutr 2016; 26:219-25. [PMID: 26908191 DOI: 10.1053/j.jrn.2016.01.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/18/2016] [Accepted: 01/18/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Dietary factors play an important role in the development of hypertension (HTN). In this study, we aimed to determine the possible effect of protein foods group and its subgroups on risk of HTN after 3-year follow-up in Iranian adults. DESIGN Prospective study in framework of the Tehran Lipid and Glucose Study. SUBJECTS A total of 1,152 healthy adults, aged 20 to 84 years participated and were followed-up for 3 years. MAIN OUTCOME MEASURE Usual dietary intake was assessed using a 168-item validate semiquantitative food frequency questionnaire at baseline and again after 3 years. Protein foods group was considered as the sum of meats, poultry, seafood, eggs, beans and peas, nuts, and seeds. Blood pressure was measured at baseline and after 3 years, and HTN was diagnosed by the seventh report of Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). To assess the odds ratio of HTN in each tertile of protein foods group and its subgroup, a multivariate logistic regression adjusted for potential confounding variables was used. RESULTS Mean age of participants was 36.0 ± 11.2 years, and mean intake of protein foods group was 855 ± 343 g/week (range 70.5-3,450 g/week). After 3 years of follow-up, the incidence of HTN was 12.5%. There was no significant association between dietary intakes of the protein foods group, meats, poultry, seafood, beans and peas, and nuts and seeds and the occurrence of HTN over 3 years. However, 3-year incidence of HTN was significantly decreased in the highest tertile of eggs in compared with the lowest (odds ratio: 0.54; 95% confidence interval: 0.32-0.91; P for trend = .02). CONCLUSION Our findings indicated that egg consumption could have favorable effect against development of HTN.
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Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kusano Y, Crews DE, Iwamoto A, Sone Y, Aoyagi K, Maeda T, Leahy R. Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands. Ann Hum Biol 2015; 43:34-41. [PMID: 26148058 DOI: 10.3109/03014460.2015.1013985] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health. AIM To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture. SUBJECTS AND METHODS In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities. RESULTS Average age was 67.9 years (range = 55-89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL. CONCLUSIONS Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.
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Affiliation(s)
- Yosuke Kusano
- a Department of Community Development , Nagasaki Wesleyan University , Isahaya , Japan
| | - Douglas E Crews
- b Department of Anthropology , Ohio State University , Columbus , OH , USA
| | - Aiko Iwamoto
- c Department of Food and Nutrition , Osaka City University , Osaka , Japan , and
| | - Yoshiaki Sone
- c Department of Food and Nutrition , Osaka City University , Osaka , Japan , and
| | - Kiyoshi Aoyagi
- d School of Medicine, Nagasaki University , Nagasaki , Japan
| | - Takahiro Maeda
- d School of Medicine, Nagasaki University , Nagasaki , Japan
| | - Rachael Leahy
- b Department of Anthropology , Ohio State University , Columbus , OH , USA
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Sotos-Prieto M, Bhupathiraju SN, Falcón LM, Gao X, Tucker KL, Mattei J. A Healthy Lifestyle Score Is Associated with Cardiometabolic and Neuroendocrine Risk Factors among Puerto Rican Adults. J Nutr 2015; 145:1531-40. [PMID: 25948783 PMCID: PMC4478944 DOI: 10.3945/jn.114.206391] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/06/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although individual healthy lifestyle behaviors may reduce cardiovascular disease risk, few studies have analyzed the combined effect of multiple lifestyle components as one all-inclusive measure on such outcomes, much less in minority populations. OBJECTIVE We aimed to develop a Healthy Lifestyle Score (HLS) that included several lifestyle recommendations and to test its association with metabolic syndrome (MetS) and allostatic load (AL) and their cardiometabolic and neuroendocrine factors in Puerto Ricans. METHODS In a cross-sectional study in 787 Puerto Ricans living in Boston (aged 45-75 y), we developed an HLS that ranged from 0 to 190 (higher score indicative of healthier lifestyle) and included 5 components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep). Multivariable-adjusted models were used to test associations between the HLS and biomarkers of dysregulation and odds of MetS and high AL (≥4 out of 10 components). RESULTS The HLS showed adequate internal consistency (ρ = 0.31-0.69) and was inversely associated with urinary cortisol (β ± SE = -0.22 ± 0.11; P = 0.042), epinephrine (-0.20 ± 0.09; P = 0.017), and norepinephrine (-0.26 ± 0.11; P = 0.016); waist circumference (-0.014 ± 0.004; P = 0.003); and serum insulin (-0.30 ± 0.13; P = 0.028) and positively associated with plasma HDL cholesterol (0.007 ± 0.003; P = 0.021) after adjustment for potential confounders. For each 20-unit increase in HLS, participants had 19% (95% CI: 2%, 33%) and 25% (11%, 36%) lower odds of MetS or AL, respectively. Healthier scores for social support and network and smoking components were associated with lower odds of high AL (P < 0.005). No significant associations were observed for other individual lifestyle components. CONCLUSIONS Following an overall healthy lifestyle that comprises a combination of multiple behaviors may provide stronger protection against MetS and AL in Puerto Rican adults than individual components. The HLS may be a useful tool for examining health-related outcomes. This trial was registered at clinicaltrials.gov as NCT01231958.
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Affiliation(s)
| | | | - Luis M Falcón
- Center for Population Health and Health Disparities,,College of Fine Arts, Humanities, and Social Sciences, and
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA
| | - Katherine L Tucker
- Center for Population Health and Health Disparities,,Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell, MA; and
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;
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Abstract
OBJECTIVE Studies investigating mood in vegetarian diets have yielded conflicting results, either demonstrating risk for mental disorders or mood protection. Our objective was to investigate mood, as well as factors that potentially impact mood in vegans (VG), vegetarians (VEG), and omnivores (OMN). METHODS We surveyed mood, diet, and lifestyle factors in a broad geographic online sample of adult VG (n = 283), VEG (n = 109), and OMN (n = 228) who were recruited via diet-related social networks. Mood was measured with the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS The sample was mostly female (78.5%), and age was inversely correlated with all DASS scores (p < 0.05). Mean DASS-A (anxiety) and DASS-S (stress) scores differed by group (F(2,616) = 4.73, p = 0.009, η(2) = 0.015, and F(2, 615) = 8.23, p < 0.001, η(2) = 0.026, respectively), with VG scores lower than OMN scores, indicating less mood disturbance. Analyses of covariance were conducted by gender, adjusting for age. Anxiety scores were different in males only (F(2,128) = 5.39, p = 0.006, η(p)(2) = 0.078) and lower anxiety in males was related to a vegan diet and daily fruit and vegetable intake. Mean stress scores were different in females only (F(2,476) = 3.82, p = 0.023, η(p)(2) = 0.016) and lower stress in females was related to a vegan diet and lower daily intake of sweets. DISCUSSION A strict plant-based diet does not appear to negatively impact mood, in fact, reduction of animal food intake may have mood benefits. The improved mood domains were not consistent with those found in other studies, which may be due to methodological differences.
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Associations of allostatic load with sleep apnea, insomnia, short sleep duration, and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008. Ann Epidemiol 2014; 24:612-9. [PMID: 24985316 DOI: 10.1016/j.annepidem.2014.05.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/27/2014] [Accepted: 05/30/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE To examine whether allostatic load (AL), a measure of cumulative physiologic dysregulation across biological systems, was associated with sleep apnea, insomnia, and other sleep disturbances. METHODS Data from the National Health and Nutrition Examination Survey 2005-2008 were used. AL was measured using nine biomarkers representing cardiovascular, inflammatory, and metabolic system functioning. A total of 3330 US adults aged 18 years and older were included in this study. RESULTS The prevalence of high AL (AL score ≥3) was the highest among African Americans (26.3%), followed by Hispanic Americans (20.3%), whites (17.7%), and other racial/ethnic group (13.8%). After adjustment for sociodemographic and lifestyle factors, high AL was significantly associated with sleep apnea (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.40-2.63), snoring (OR, 2.20; 95% CI, 1.79-2.69), snorting/stop breathing (OR, 2.16; 95% CI, 1.46-3.21), prolonged sleep latency (OR, 1.42; 95% CI, 1.08-1.88), short sleep duration (<6 hours) (OR, 1.35; 95% CI, 1.00-1.82), and diagnosed sleep disorder (OR, 2.26; 95% CI, 1.66-3.08). There was no clear evidence that observed associations varied by sociodemographic characteristics. CONCLUSIONS This study suggests significant associations of high AL with sleep apnea, sleep apnea symptoms, insomnia component, short sleep duration, and diagnosed sleep disorder among US adults.
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Moubarac JC, Parra DC, Cannon G, Monteiro CA. Food Classification Systems Based on Food Processing: Significance and Implications for Policies and Actions: A Systematic Literature Review and Assessment. Curr Obes Rep 2014; 3:256-72. [PMID: 26626606 DOI: 10.1007/s13679-014-0092-0] [Citation(s) in RCA: 265] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper is the first to make a systematic review and assessment of the literature that attempts methodically to incorporate food processing into classification of diets. The review identified 1276 papers, of which 110 were screened and 21 studied, derived from five classification systems. This paper analyses and assesses the five systems, one of which has been devised and developed by a research team that includes co-authors of this paper. The quality of the five systems is assessed and scored according to how specific, coherent, clear, comprehensive and workable they are. Their relevance to food, nutrition and health, and their use in various settings, is described. The paper shows that the significance of industrial food processing in shaping global food systems and supplies and thus dietary patterns worldwide, and its role in the pandemic of overweight and obesity, remains overlooked and underestimated. Once food processing is systematically incorporated into food classifications, they will be more useful in assessing and monitoring dietary patterns. Food classification systems that emphasize industrial food processing, and that define and distinguish relevant different types of processing, will improve understanding of how to prevent and control overweight, obesity and related chronic non-communicable diseases, and also malnutrition. They will also be a firmer basis for rational policies and effective actions designed to protect and improve public health at all levels from global to local.
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Affiliation(s)
- Jean-Claude Moubarac
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907.
| | - Diana C Parra
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey Cannon
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
| | - Carlos A Monteiro
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
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Relationship of serum carotenoid concentrations with allostatic load as a measure of chronic stress among middle-aged adults in the USA. Public Health Nutr 2014; 18:313-21. [PMID: 24513032 DOI: 10.1017/s1368980014000056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Chronic stress and repeated physiological attempts at stress adaptation may result in 'fatigue' and suboptimal performance of multiple physiological systems, i.e. allostatic load (AL). Although carotenoids have been linked with individual cardiovascular, metabolic and inflammatory biomarkers, little is known about the relationship of carotenoids with the multi-system biomarker measure of stress, AL. The present study examined the association of serum concentrations of carotenoids with AL among middle-aged adults. DESIGN Cross-sectional. AL score was calculated based on nine risk-rated indicators (systolic and diastolic blood pressure, pulse rate, total and HDL-cholesterol, glycosylated Hb, sex-specific waist-to-hip ratio, albumin and C-reactive protein). SUBJECTS Middle-aged (45-64 years, n 3387) men and women participants in the Third National Health and Nutrition Examination Survey, NHANES III (1988-1994). RESULTS Serum β-carotene concentration was inversely associated with high AL after adjusting for age, education, race/ethnicity, serum cotinine, alcohol consumption, physical activity and other carotenoids (α-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin). Females in the lowest β-carotene quartile were 2·94 (95 % CI 1·74, 4·94) times and males 2·90 (95 % CI 1·43, 5·89) times as likely to have high AL, compared with peers in the highest quartile (P for linear trend 0·001 and 0·018 for females and males, respectively). Mean serum β-carotene concentrations were also inversely associated with the number of 'high-risk' AL components (P for linear trend <0·001 and 0·004 for females and males, respectively). CONCLUSIONS Our study adds to evidence linking low β-carotene levels with unfavourable health outcomes.
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Mattei J, Bhupathiraju S, Tucker KL. Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults. J Nutr 2013; 143:1753-9. [PMID: 24005611 PMCID: PMC3796346 DOI: 10.3945/jn.113.180141] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A score based on diet and lifestyle recommendations from the AHA has been associated with cardiovascular risk factors. We aimed to assess whether the diet components alone were associated with metabolic syndrome (MetS) and allostatic load (AL; a composite measure of 10 physiologically dysregulated variables). The diet score ranged from 0 to 90 and included intake components for dietary fats, fruits and vegetables, whole grains, salt, added sugars, and alcohol and was tested in a cross-sectional analysis of 1318 Puerto Rican adults (aged 45-75 y; 72% women) living in Boston, MA. The mean ± SD diet score was 28.0 ± 9.9 for men and 30.0 ± 10.1 for women. Replicating findings from a previous study in this cohort that used both the diet and lifestyle components, we observed associations between the diet-only score and insulin, waist circumference, and HDL cholesterol. We found novel significant associations between the continuous diet score and AL components, namely an inverse association with urinary cortisol and a positive association with serum dehydroepiandrosterone sulfate in women as well as an inverse association with urinary norepinephrine in men (all P < 0.05). In multinomial logistic regression, every 10 AHA diet score units were associated with 22% (95% CI: 1, 38; P = 0.043) lower odds of having ≥6 (vs. ≤2) dysregulated AL components in women. In men, every 10 diet score units were associated with lower odds of MetS (OR: 0.69; 95% CI: 0.52, 0.93; P = 0.016). Following AHA recommendations for a healthy diet may protect against the development of components of MetS and AL in Puerto Rican adults.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | | | - Katherine L. Tucker
- Center for Population Health and Health Disparities, Northeastern University, Boston, MA; and,Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell, MA,To whom correspondence should be addressed: E-mail:
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Kim JY. Relationships between Dietary Habits and Allostatic Load Index in Metabolic Syndrome Patients. Korean J Fam Med 2013; 34:334-46. [PMID: 24106586 PMCID: PMC3791341 DOI: 10.4082/kjfm.2013.34.5.334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 09/03/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Allostatic load (AL) measures overall physiological wear and tear on one's body, as a preclinical marker of pathophysiologic processes that precede the onset of disease. We studied the association of dietary habits with AL. METHODS Consecutive patients visiting a tertiary hospital Health Promotion Center from September 2009 to February 2010, older than 20 years with metabolic syndrome were selected for study (n = 204). By multivariable linear regression analysis, we investigated the association of various dietary habits evaluated by questionnaires. RESULTS In male, multivariable linear regression showed a significant negative association between fat preference and AL with BMI ≥ 30 (1st quartile [Q] vs. 2Q: β = -3.71; 95% confidence interval [CI], -6.26 to -1.16), a significant negative association between salt preference and AL with BMI 25-30 (β = -1.36; 95% CI, -2.46 to -0.26), a negative association between appetite control and AL with BMI < 25 (1Q vs. 3Q: β = -1.54; 95% CI, -3.00 to -0.096), a significant positive association between appetite control and AL with BMI 25-30 (1Q vs. 3Q: β = 1.30; 95% CI, 0.12 to 2.48), and a significant positive association between eating in response to food cues and AL in males with BMI 25-30 (1Q vs. 4Q: β = 1.09; 95% CI, 0.020 to 2.15). CONCLUSION Our results suggest that metabolic syndrome patients should be discouraged from eating fat and eating in response to food cues, and should be educated about nutrition and balanced diet.
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Affiliation(s)
- Ju Young Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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