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Ramírez-Luzuriaga MJ, Kobes S, Sinha M, Knowler WC, Hanson RL. Increased Adiposity and Low Height-for-Age in Early Childhood Are Associated With Later Metabolic Risks in American Indian Children and Adolescents. J Nutr 2022; 152:1872-1885. [PMID: 35147199 PMCID: PMC9554900 DOI: 10.1093/jn/nxac031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/22/2021] [Accepted: 02/07/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Growth abnormalities in childhood have been related to later cardiometabolic risks, but little is known about these associations in populations at high risk of type 2 diabetes. OBJECTIVES We examined the associations of patterns of growth, including weight and height at ages 1-59 months, with cardiometabolic risk factors at ages 5-16 years. METHODS We linked anthropometric data collected at ages 1-59 months to cardiometabolic data obtained from a longitudinal study in a southwestern American Indian population at high risk of diabetes. Analyses included 701 children with ≥1 follow-up examination at ages 5-16 years. We derived age- and sex-specific weight-for-height z-scores (WHZ) and height-for-age z-scores (HAZ) at ages 1-59 months. We selected the highest observed WHZ and the lowest observed HAZ at ages 1-59 months and analyzed associations of z-scores and categories of WHZ and HAZ with cardiometabolic outcomes at ages 5-16 years. We used linear mixed-effects models to account for repeated measures. RESULTS Overweight/obesity (WHZ >2) at ages 1-59 months was significantly associated with increased BMI, fasting and 2-hour postload plasma glucose, fasting and 2-hour insulin, triglycerides, systolic blood pressure, diastolic blood pressure, and decreased HDL cholesterol at ages 5-16 years relative to normal weight (WHZ ≤1). For example, at ages 5-9 years, 2-hour glucose was 10.4 mg/dL higher (95% CI: 5.6-15.3 mg/dL) and fasting insulin was 4.29 μU/mL higher (95% CI: 2.96-5.71 μU/mL) in those with overweight/obesity in early childhood. Associations were attenuated and no longer significant when adjusted for concurrent BMI. A low height-for-age (HAZ < -2) at ages 1-59 months was associated with 5.37 mg/dL lower HDL (95% CI: 2.57-8.17 mg/dL) and 27.5 μU/mL higher 2-hour insulin (95% CI: 3.41-57.6 μU/mL) at ages 10-16 years relative to an HAZ ≥0. CONCLUSIONS In this American Indian population, findings suggest a strong contribution of overweight/obesity in early childhood to cardiometabolic risks in later childhood and adolescence, mediated through persistent overweight/obesity into later ages. Findings also suggest potential adverse effects of low height-for-age, which require confirmation.
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Affiliation(s)
- María J Ramírez-Luzuriaga
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Sayuko Kobes
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Madhumita Sinha
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Robert L Hanson
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
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Borges LL, Gerage AM, Monteiro LZ, Ulbrich AZ, Silva DAS. Proposition of Cutoff Points for Anthropometric Indicators to Identify High Blood Pressure in Adolescents. Front Nutr 2022; 9:874047. [PMID: 35923197 PMCID: PMC9339713 DOI: 10.3389/fnut.2022.874047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To propose cutoff points for anthropometric indicators for high blood pressure (HBP) screening in adolescents and to identify, among these indicators, those more accurately for boys and girls. Methods This cross-sectional study was carried out in the city of São José, SC, Brazil with 634 adolescents aged 14 to 19 years. Blood pressure levels were measured using a digital oscillometric sphygmomanometer and adolescents were classified as having HBP or not. Anthropometric indicators were calculated based on anthropometric measurements such as body mass (BM), height, waist circumference (WC), hip circumference (HC) and triceps, subscapularis, suprailiac, and midcalf skinfold thickness (SF). The Receiver Operating Characteristic Curve (ROC) was used to analyze the predictive capacity of anthropometric indicators in the identification of HBP. Results Higher values of Area Under the Curve (AUC) were for the anthropometric indicators BM (0.67; 95%CI: 0.62-0.72), body mass index (BMI) (0.67; 95%CI: 0.62-0.72), and WC (0.67; 95%CI: 0.62-0.71) for males. For females, no anthropometric indicator had discriminatory power for HBP screening. The cutoff points for the anthropometric indicators with discriminatory power for HBP screening in males were BM > 64.80 Kg, BMI > 21.76 Kg/m2, fat percentage (FP) > 15.75, waist height to ratio (WHtR) > 0.41, WC > 73.00 cm, and HC > 92.25 cm. Conclusion Anthropometric indicators of body adiposity had greater discriminatory power of HBP screening in males. For females, caution is suggested because the anthropometric indicators showed AUC values (95%CI) below 0.60.
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The Mediation Role of Fatness in Associations between Cardiorespiratory Fitness and Blood Pressure after High-Intensity Interval Training in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031698. [PMID: 35162721 PMCID: PMC8834818 DOI: 10.3390/ijerph19031698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Low cardiorespiratory fitness (CRF), elevated blood pressure (BP), and high fatness are cardiovascular disease risk factors. It remains unknown how fatness affects the influence of CRF on BP. Therefore, the aim was to examine whether the associations between baseline CRF and HIIT-postintervention resting BP were mediated through fatness in adolescents. MATERIAL AND METHODS The sample (n = 64) comprised 28 boys 36 girls aged 16 years. The analysed factors were fitness index- reflecting CRF, body fat mass (BFM), fat mass index (FMI), and body mass index (BMI). Bootstrapped mediation procedures were performed. The mediation analysis was conducted concerning the sex moderation effect. RESULTS The mediation effect of sex was confirmed; therefore, mediations models were designed separately for boys and girls. The results showed a statistically significant inverse relationship between baseline CRF and post-intervention systolic blood pressure (SBP) in both sexes (boys: B = -0.603, p = 0.010; girls: B = -0.394, p = 0.037). The relations between CRF and SBP revealed the mediation effect of the BFM and the FMI only in boys. CONCLUSIONS Fatness mediated associations between CRF and SBP in boys. Therefore, both CRF and fatness are necessary to maintain positive results of the BP revealed in normal SBP ranges after HIIT.
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DUARTE JUNIOR MADS, GAYA ACA, LEMES VB, FOCHESATTO CF, BRAND C, GAYA AR. Association between eating habits, body mass index, cardiorespiratory fitness, and cardiometabolic risk factors in children. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To verify the multivariate relationships between eating habits, cardiorespiratory fitness, body mass index, and cardiometabolic risk factors in children. Methods This is a cross-sectional study developed in a public elementary school with 60 first- to sixth-graders. Their eating habits were assessed using the Food Frequency Survey, weight, height, and cardiorespiratory fitness, assessed according to the Projeto Esporte Brasil protocol. Moreover, the variables, high-density lipoprotein, low-density lipoprotein, glucose, insulin, C-reactive protein, adiponectin, leptin, diastolic and systolic blood pressure were evaluated. Descriptive statistics were used for data analysis and generalized estimation equations were used for the analysis of direct and indirect relations, in a multivariate analysis model with several simultaneous outcomes. Results It appears that the eating habits and cardiorespiratory fitness explain 20% of the body mass index. Cardiometabolic risk factors are explained by the relationship between eating habits, cardiorespiratory fitness, and body mass index, according to the following percentages: 29% (systolic blood pressure), 18% (diastolic blood pressure), 63% (leptin), 4% (adiponectin), 14% (C-reactive protein), 17% (insulin), 10% (high-density lipoprotein), 1% (low-density lipoprotein), 4% (glucose). It is also observed that the effects of the eating habits on cardiometabolic risk factors are indirect, that is, they are dependent on changes in the body mass index and cardiorespiratory fitness levels. Conclusions The relationship between eating habits and cardiometabolic risk factors in children is dependent on cardiorespiratory fitness and body mass index. Thus, our findings suggest a multivariate relationship between these factors.
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Fong TCT. Indirect Effects of Body Mass Index Growth on Glucose Dysregulation via Inflammation: Causal Moderated Mediation Analysis. Obes Facts 2019; 12:316-327. [PMID: 31132775 PMCID: PMC6696889 DOI: 10.1159/000500422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/14/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE No existing studies have examined the mediating role of chronic inflammation between obesity and dysregulated glucose homeostasis in adolescent samples. This study evaluated whether C-reactive protein (CRP), an inflammation biomarker, mediated the effects of growth (annual increase) in body mass index (BMI) on glycated hemoglobin (HbA1c). METHODS BMI and biomarker data were used from wave I to wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health study; 4,545 adolescents; mean age = 14.9 years; 55.7% female) with valid CRP data. A causal moderated mediation analysis evaluated the direct and indirect effects of BMI slope on HbA1c via CRP across gender, with demographic and clinical characteristics as model covariates. RESULTS The participants displayed a linear BMI growth of 0.53-0.58 kg/m2/year throughout adolescence, with substantial interindividual variation. The BMI slope showed positive direct and indirect effects on HbA1c via CRP across gender, and there was a significant exposure-mediator interaction effect. A standardized increase in the BMI slope raised the probability of an abnormal HbA1c value by 6.0-8.5% in participants with various profiles. The total natural indirect effect accounted for 13.3-15.9% of the total effect in males and 21.2-22.7% in females. CONCLUSIONS The findings provide support for the inflammation mechanism in the effects of adiposity on glucose homeostasis. In adolescents, excess BMI growth was linked with a higher risk of glucose dysregulation either directly or indirectly via chronic inflammation.
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Affiliation(s)
- Ted Chun Tat Fong
- Center for Behavioral Health, The University of Hong Kong, Hong Kong, Hong Kong,
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Brand C, Dias AF, Fochesatto CF, García-Hermoso A, Mota J, Gaya ACA, Gaya AR. The role of body fat in the relationship of cardiorespiratory fitness with cardiovascular risk factors in Brazilian children. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201800040015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Chu DT, Minh Nguyet NT, Dinh TC, Thai Lien NV, Nguyen KH, Nhu Ngoc VT, Tao Y, Son LH, Le DH, Nga VB, Jurgoński A, Tran QH, Van Tu P, Pham VH. An update on physical health and economic consequences of overweight and obesity. Diabetes Metab Syndr 2018; 12:1095-1100. [PMID: 29799416 DOI: 10.1016/j.dsx.2018.05.004] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/04/2018] [Indexed: 12/21/2022]
Abstract
Overweight and obesity (OW and OB) have been on the increase globally and posed health risks to the world's population of all ages, including pre-born babies, children, adolescents, adults and elderly people, via their comorbid conditions. Excellent examples of comorbidities associated with obesity include cancer, cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). In this article, we aimed to review and update scientific evidence regarding the relationships between obesity and its common physical health consequences, including CVD, T2DM, hypertension, ischemic stroke, cancer, dyslipidemia and reproductive disorders. In addition, the economic burden of OW and OB will be discussed. Abundant evidence is found to support the associations between obesity and other diseases. In general, the odd ratios, risk ratios or hazard ratios are often higher in OW and OB people than in the normal-weight ones. However, the molecular mechanism of how OW and OB induce the development of other diseases has not been fully understood. Figures also showed that obesity and its-related disorders exert enormous pressure on the economy which is projected to increase. This review highlights the fact that obesity can lead to numerous lethal health problems; therefore, it requires a lot of economic resources to fight against this epidemic.
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Affiliation(s)
- Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam; Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam.
| | - Nguyen Thi Minh Nguyet
- Center for Environment and Health Studies, Thai Binh Medical University, Thai Binh, Vietnam
| | - Thien Chu Dinh
- Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam
| | | | - Khanh-Hoang Nguyen
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | | | - Yang Tao
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing, 8 210095, China
| | - Le Hoang Son
- VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Duc-Hau Le
- VINMEC Research Institute of Stem Cell and Gene Technology, Hanoi, Vietnam
| | - Vu Bich Nga
- National Institute of Diabetes and Metabolic Disorders, Hanoi, Vietnam
| | - Adam Jurgoński
- Department of Biological Function of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Tuwima 10 Str., 10-748, Olsztyn, Poland
| | - Quoc-Hung Tran
- University of Economics and Business, Vietnam National University, Hanoi, Vietnam
| | - Pham Van Tu
- Faculty of Social Work, Hanoi National University of Education, Hanoi, Vietnam
| | - Van-Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
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Gaya AR, Brand C, Dias AF, Gaya ACA, Lemes VB, Mota J. Obesity anthropometric indicators associated with cardiometabolic risk in Portuguese children and adolescents. Prev Med Rep 2017; 8:158-162. [PMID: 29057209 PMCID: PMC5643080 DOI: 10.1016/j.pmedr.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to determine the association between cardiometabolic risk with body mass index and skinfold independently or in combination in youth. This cross-sectional study comprised a convenience sample of 450 children and adolescents (255 girls), aged 10 to 18 years old. Indicators of body composition were measured, and hemodynamic assessment completed. The association between body mass index and/or sum of skinfolds and cardiometabolic risk (z score of the sum of triglycerides/high density lipoprotein cholesterol, waist circumference, and mean blood pressure), was calculated using Generalized Linear Models Regression. The results showed that youngsters classified as overweight or obese with the highest skinfold measurements had the strongest association with cardiometabolic risk (< beta >: 2.60; IC 95%: 2.25–3.0) when compared with those exhibiting normal skinfold thickness (< beta >: 1.78; IC 95%: 1.30–2.20). Body mass index was most strongly associated with cardiometabolic risk (< beta >: 1.78; IC 95%: 1.3–2.2), in comparison to skinfold thickness, which was associated to a lesser extent (< beta >: 0.41; IC 95%: 0.34–0.49). Results of this cross-sectional study indicate that body mass index is more strongly associated with cardiometabolic risk than skinfold thickness. However when these two measures of overweight/obesity are combined, prediction of cardiometabolic risk is further improved. It is therefore important that public health professionals consider both body mass index and sum of skinfolds to better predict cardiometabolic risk in overweight and obese youth. Implications for future research include the use of longitudinal designs and inclusion of children from other racial/ethnic groups. Body mass index and skinfold improved the prediction of cardiometabolic risk. Body mass index seems to be the best indicator of cardiometabolic risk factors. Anthropometric indicators are cost-effective screening of overweight/obesity.
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Key Words
- BMI, body mass index
- Body mass index
- CM, cardiometabolic
- DBP, diastolic blood pressure
- ESKF, average of skinfolds
- HDL-C, high density lipoprotein cholesterol
- Health
- LDL-C, low density lipoprotein cholesterol
- MAP, mean arterial pressure
- OW/OB, overweight/obese
- SBP, systolic blood pressure
- SKF, skinfolds
- Skinfold
- TG, triglycerides
- WC, waist circumference
- WHtR, waist-to-height ratio
- Youngsters
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Affiliation(s)
- Anelise Reis Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Caroline Brand
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Arieli Fernandes Dias
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Adroaldo Cezar Araujo Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Vanilson Batista Lemes
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Dr. Plácido da Costa, 91, 4200-450 Porto, Portugal
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