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Mina T, Xie W, Low DY, Wang X, Lam BCC, Sadhu N, Ng HK, Aziz NA, Tong TYY, Kerk SK, Choo WL, Low GL, Ibrahim H, Lim L, Tai ES, Wansaicheong G, Dalan R, Yew YW, Elliott P, Riboli E, Loh M, Ngeow J, Lee ES, Lee J, Best J, Chambers J. Adiposity and metabolic health in Asian populations: an epidemiological study using dual-energy x-ray absorptiometry in Singapore. Lancet Diabetes Endocrinol 2024; 12:704-715. [PMID: 39217997 DOI: 10.1016/s2213-8587(24)00195-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Type 2 diabetes, cardiovascular disease, and related cardiometabolic disturbances are increasing rapidly in the Asia-Pacific region. We investigated the contribution of excess adiposity, a key determinant of type 2 diabetes and cardiovascular risk, to unfavourable cardiometabolic profiles among Asian ethnic subgroups. METHODS The Health for Life in Singapore (HELIOS) Study is a population-based cohort comprising multiethnic Asian men and women living in Singapore, aged 30-84 years. We performed a cross-sectional analysis of data from individuals who had assessment of body composition by dual-energy x-ray absorptiometry and metabolic characterisation. In a subset of participants on no medication for type 2 diabetes, hypertension, and hypercholesterolaemia, we tested the relationship of BMI and visceral fat mass index (vFMI) with cardiometabolic phenotypes (glycaemic indices, lipid levels, and blood pressure), disease outcomes (type 2 diabetes, hypercholesterolaemia, and hypertension), and metabolic syndrome score with multivariable regression analyses. FINDINGS Between April 2, 2018, and Jan 28, 2022, 10 004 individuals consented to be part of the HELIOS cohort, of whom 9067 were included in the study (5404 [59·6%] female, 3663 [40·4%] male; 6224 [68·6%] Chinese, 1169 [12·9%] Malay, 1674 [18·5%] Indian; mean age 52·8 years [SD 11·8]). The prevalence of type 2 diabetes, hypercholesterolaemia, and hypertension was 8·2% (n=744), 27·2% (n=2469), and 18·0% (n=1630), respectively. Malay and Indian participants had 3-4-times higher odds of obesity and type 2 diabetes, and showed adverse metabolic and adiposity profiles, compared with Chinese participants. Excess adiposity was associated with adverse cardiometabolic health indices including type 2 diabetes (p<0·0001). However, while vFMI explained the differences in triglycerides and blood pressure between the Asian ethnic groups, increased vFMI did not explain higher glucose levels, reduced insulin sensitivity, and increased risk of type 2 diabetes among Indian participants. INTERPRETATION Visceral adiposity is an independent risk factor for metabolic disease in Asian populations, and accounts for a large fraction of type 2 diabetes cases in each of the ethnic groups studied. However, the variation in insulin resistance and type 2 diabetes risk between Asian subgroups is not consistently explained by adiposity, indicating an important role for additional mechanisms underlying the susceptibility to cardiometabolic disease in Asian populations. FUNDING Nanyang Technological University-the Lee Kong Chian School of Medicine, National Healthcare Group, and National Medical Research Council, Singapore.
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Affiliation(s)
- Theresia Mina
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Wubin Xie
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Dorrain Yanwen Low
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Xiaoyan Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Benjamin Chih Chiang Lam
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Integrated Care for Obesity & Diabetes, Khoo Teck Puat Hospital, Singapore
| | - Nilanjana Sadhu
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Hong Kiat Ng
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Nur-Azizah Aziz
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Terry Yoke Yin Tong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Swat Kim Kerk
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Wee Lin Choo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Guo Liang Low
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Halimah Ibrahim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Liming Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Gervais Wansaicheong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Rinkoo Dalan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Yik Weng Yew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Research Division, National Skin Centre, Singapore
| | - Paul Elliott
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elio Riboli
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marie Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Joanne Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Division of Medical Oncology, National Cancer Centre, Singapore
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; National Healthcare Group Polyclinic, Singapore
| | - Jimmy Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; North Region, Institute of Mental Health, Singapore
| | - James Best
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
| | - John Chambers
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
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Katangwe-Chigamba T, Kantilal K, Hartley-Palmer J, Salisu-Olatunji SO, Seeley C, Naughton F, Chester R. Diet and Physical Activity Interventions for People from Minority Ethnic Backgrounds in the UK: A Scoping Review Exploring Barriers, Enablers and Cultural Adaptations. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02112-y. [PMID: 39145834 DOI: 10.1007/s40615-024-02112-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 06/24/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Type 2 diabetes (T2D) and cardiovascular disease (CVD) are a global pandemic, driven by obesity, poor diet and physical inactivity. In the UK, the prevalence of T2D and CVD is higher in minority ethnic groups. Lifestyle prevention interventions can be effective but uptake amongst minority ethnic groups in the UK is low and the extent of cultural adaptations to increase engagement unknown. AIM To explore barriers, enablers and culturally adapted lifestyle interventions in UK minority ethnic groups. METHODS Four electronic databases were searched from to January 2013-2023. Two independent reviewers carried out manuscript selection and data extraction. Barriers and enablers were mapped to the Capability + Opportunity + Motivation = Behaviour (COM-B) theoretical model. Intervention adaptations were linked to behaviour change strategies and reported within a Cultural Adaptation framework. RESULTS Twenty-three studies were included, reporting barriers/enablers, culturally adapted interventions or both. Barriers and enablers mostly mapped to social and physical opportunity, and reflective motivation. Common adaptation strategies considered behavioural influences related to culture, values, religious beliefs and/or traditions. Most impactful strategies were associated with using credible sources of information and reorganising social and environmental contexts. DISCUSSION AND CONCLUSIONS The current umbrella approach to preventative intervention delivery is unlikely to promote sustained participation in behaviour change amongst UK ethnic minorities. Engagement strategies for this population should consider key determinants such as social contexts, beliefs and cultural norms. Important research gaps include interventions investigating tailored interventions for Black populations, and the impact of negative social experiences (e.g., racism) on engagement.
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Affiliation(s)
- Thando Katangwe-Chigamba
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Kumud Kantilal
- Research Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - Joseph Hartley-Palmer
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
| | | | - Carys Seeley
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Felix Naughton
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
| | - Rachel Chester
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
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Adjei NK, Samkange-Zeeb F, Boakye D, Saleem M, Christianson L, Kebede MM, Heise TL, Brand T, Esan OB, Taylor-Robinson DC, Agyemang C, Zeeb H. Ethnic differences in metabolic syndrome in high-income countries: A systematic review and meta-analysis. Rev Endocr Metab Disord 2024; 25:727-750. [PMID: 38598068 PMCID: PMC11294386 DOI: 10.1007/s11154-024-09879-9] [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] [Accepted: 03/23/2024] [Indexed: 04/11/2024]
Abstract
This review aimed to systematically quantify the differences in Metabolic Syndrome (MetS) prevalence across various ethnic groups in high-income countries by sex, and to evaluate the overall prevalence trends from 1996 to 2022. We conducted a systematic literature review using MEDLINE, Web of Science Core Collection, CINAHL, and the Cochrane Library, focusing on studies about MetS prevalence among ethnic groups in high-income countries. We pooled 23 studies that used NCEP-ATP III criteria and included 147,756 healthy participants aged 18 and above. We calculated pooled prevalence estimates and 95% confidence intervals (CI) using both fixed-effect and random-effect intercept logistic regression models. Data were analysed for 3 periods: 1996-2005, 2006-2009, and 2010-2021. The pooled prevalence of MetS in high-income countries, based on the NCEP-ATP III criteria, was 27.4% over the studied period, showing an increase from 24.2% in 1996-2005 to 31.9% in 2010-2021, with men and women having similar rates. When stratified by ethnicity and sex, ethnic minority women experienced the highest prevalence at 31.7%, while ethnic majority women had the lowest at 22.7%. Notably, MetS was more prevalent in ethnic minority women than men. Among ethnic minorities, women had a higher prevalence of MetS than men, and the difference was highest in Asians (about 15 percentage points). Among women, the prevalence of MetS was highest in Asians (41.2%) and lowest in Blacks/Africans (26.7%). Among men, it was highest in indigenous minority groups (34.3%) and lowest among in Blacks/Africans (19.8%). MetS is increasing at an alarming rate in high-income countries, particularly among ethnic minority women. The burden of MetS could be effectively reduced by tailoring interventions according to ethnic variations and risk profiles.
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Affiliation(s)
- Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Waterhouse Building 2nd Floor Block F, Liverpool, L69 3GL, UK.
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | | | - Daniel Boakye
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Maham Saleem
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lara Christianson
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | | | - Thomas L Heise
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tilman Brand
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Oluwaseun B Esan
- Department of Public Health, Policy and Systems, University of Liverpool, Waterhouse Building 2nd Floor Block F, Liverpool, L69 3GL, UK
| | - David C Taylor-Robinson
- Department of Public Health, Policy and Systems, University of Liverpool, Waterhouse Building 2nd Floor Block F, Liverpool, L69 3GL, UK
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Ye X, Zhang G, Han C, Wang P, Lu J, Zhang M. The association between Chinese visceral adiposity index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national cohort study. Front Endocrinol (Lausanne) 2024; 15:1381949. [PMID: 38601202 PMCID: PMC11004471 DOI: 10.3389/fendo.2024.1381949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Objective This study aimed to explore the association between the Chinese visceral adiposity index (CVAI) and cardiometabolic multimorbidity in middle-aged and older Chinese adults. Methods The data used in this study were obtained from a national cohort, the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018 wave). The CVAI was measured using previously validated biomarker estimation formulas, which included sex, age, body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol. The presence of two or more of these cardiometabolic diseases (diabetes, heart disease, and stroke) is considered as cardiometabolic multimorbidity. We used Cox proportional hazard regression models to examine the association between CVAI and cardiometabolic multimorbidity, adjusting for a set of covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to show the strength of the associations. We also conducted a subgroup analysis between age and sex, as well as two sensitivity analyses. Receiver operator characteristic curves (ROC) were used to test the predictive capabilities and cutoff value of the CVAI for cardiometabolic multimorbidity. Results A total of 9028 participants were included in the final analysis, with a mean age of 59.3 years (standard deviation: 9.3) and women accounting for 53.7% of the sample population. In the fully-adjusted model, compared with participants in the Q1 of CVAI, the Q3 (HR = 2.203, 95% CI = 1.039 - 3.774) and Q4 of CVAI (HR = 3.547, 95% CI = 2.100 - 5.992) were associated with an increased risk of cardiometabolic multimorbidity. There was no evidence of an interaction between the CVAI quartiles and sex or age in association with cardiometabolic multimorbidity (P >0.05). The results of both sensitivity analyses suggested that the association between CVAI and cardiometabolic multimorbidity was robust. In addition, the area under ROC and ideal cutoff value for CVAI prediction of cardiometabolic multimorbidity were 0.685 (95% CI = 0.649-0.722) and 121.388. Conclusion The CVAI is a valid biomarker with good predictive capability for cardiometabolic multimorbidity and can be used by primary healthcare organizations in the future for early warning, prevention, and intervention with regard to cardiometabolic multimorbidity.
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Affiliation(s)
- Xiaomei Ye
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Guangru Zhang
- Department of General Practice, Community Health Service Center Xiayang Street, Shanghai, China
| | - Chenyu Han
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Ping Wang
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiaping Lu
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Min Zhang
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
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Flores-Guillén E, Castro-Quezada I, Irecta-Nájera CA, Núñez-Ortega PE, Solís-Hernández R, García-Miranda R, Cruz-Cruz P, Medina-Gómez C, Sánchez-Chino XM, Olivo-Vidal ZE, Cruz M, Ochoa-Díaz-López H. Sociodemographic inequalities in cardiovascular risk factors among adolescents from indigenous areas in Chiapas, Mexico. CAD SAUDE PUBLICA 2023; 39:e00024623. [PMID: 37970940 PMCID: PMC10644975 DOI: 10.1590/0102-311xen024623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/24/2023] [Accepted: 08/17/2023] [Indexed: 11/19/2023] Open
Abstract
This study was aimed to determine the prevalence of cardiovascular risk factors among different sociodemographic groups of adolescents from indigenous communities in Chiapas, Mexico. A cross-sectional prevalence study was performed in urban and rural communities in the Tzotzil-Tzeltal and Selva regions of Chiapas. A sample of 253 adolescents was studied, of whom 48% were girls and 52% were boys. A descriptive analysis of quantitative variables was performed using measures of central tendency and dispersion. The prevalence of cardiovascular risk factors stratified by sex, geographical area, years of schooling, and ethnicity of the mothers was estimated. The prevalence of cardiovascular risk factors was analyzed in relation to the sociodemographic characteristics of the study population. Low HDL-c (51%) was the predominant cardiovascular risk factor. Girls had a higher prevalence of abdominal obesity, hypertriglyceridemia, and borderline total cholesterol than boys. High diastolic blood pressure was more prevalent in boys. Adolescents from urban areas had a higher prevalence of overweight/obesity and insulin resistance than adolescents from rural areas. The prevalence of overweight/obesity and abdominal obesity was higher in adolescents whose mothers had ≥ 7 years of schooling compared with adolescents with less educated mothers. Differences by maternal ethnicity also influenced the prevalence of insulin resistance. Among the main findings, this study associated sociodemographic and geographical inequalities with cardiovascular risk factors. Promoting a healthy lifestyle for this young population is absolutely necessary to prevent cardiovascular diseases in adulthood.
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Affiliation(s)
- Elena Flores-Guillén
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
- Universidad de Ciencias y Artes de Chiapas, Tuxtla Gutiérrez, México
| | | | | | | | | | - Rosario García-Miranda
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
- Escuelas de Lenguas, Universidad Autónoma de Chiapas, San Cristóbal de Las Casas, México
| | - Paola Cruz-Cruz
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
| | | | | | | | - Miguel Cruz
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Ciudad de México, México
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Moncada-Jiménez J, Dicker EE, Chacón-Araya Y, Peralta-Brenes M, Briceño-Torres JM, Villarreal-Ángeles M, Salazar-Villanea M, Vidoni ED, Burns JM, Johnson DK. Exploring Handgrip Strength as a Cross-cultural Correlate of Body Composition and Upper Body Strength in Older Adults from Costa Rica and Kansas. J Cross Cult Gerontol 2023; 38:223-244. [PMID: 37410203 PMCID: PMC10447276 DOI: 10.1007/s10823-023-09481-7] [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] [Accepted: 04/27/2023] [Indexed: 07/07/2023]
Abstract
Sarcopenia and disability in older adults are often characterized by body composition measurements; however, the gold standard of body composition measurement, dual-energy X-ray absorptiometry (DEXA), is expensive to acquire and maintain, making its use in low and middle income countries (LMIC) it out-of-reach in developing nations. Because these LMIC will bear a disproportionate amount of chronic disease burden due to global aging trends, it is important that reliable, low-cost surrogates need to be developed. Handgrip strength (HGS) is a reliable measure of disability in older adults but has not been used widely in diverse populations. This study compared HGS to multiple measurements of body composition in older adults from the US (Kansas) and a middle-income country (Costa Rica) to test if HGS is a cross-culturally appropriate predictive measure that yields reliable estimates across developed and developing nations. Percent body fat (%BF), lean tissue mass index (LTMI), appendicular lean soft tissue index (ALSTI), body fat mass index (BFMI), bone mineral density (BMD), and HGS were measured in older Costa Ricans (n = 78) and Kansans (n = 100). HGS predicted lean arm mass with equal accuracy for both samples (p ≤ 0.05 for all groups), indicating that it is a reliable, low-cost and widely available estimate of upper body lean muscle mass. Older adults from Costa Rica showed different body composition overall and HGS than controls from Kansas. Handgrip operates equivalently in the US and Mesoamerica and is a valid estimate of lean arm muscle mass as derived by the more expensive DEXA.
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Affiliation(s)
- José Moncada-Jiménez
- Human Movement Sciences Research Center, University of Costa Rica, San Jose, Costa Rica
- School of Physical Education and Sports, University of Costa Rica, San Jose, Costa Rica
| | - Eva E Dicker
- Alzheimer's Disease Research Center-East Bay, University of California, Davis, 100 N. Wiget Lane, Suite 150, Walnut Creek, CA, 94598, USA
- Department of Psychological Sciences, Rice University, 6100 Main St, Houston, TX, 77005, USA
| | - Yamileth Chacón-Araya
- Human Movement Sciences Research Center, University of Costa Rica, San Jose, Costa Rica
- School of Physical Education and Sports, University of Costa Rica, San Jose, Costa Rica
| | | | - José M Briceño-Torres
- Human Movement Sciences Research Center, University of Costa Rica, San Jose, Costa Rica
| | | | | | - Eric D Vidoni
- KU Alzheimer's Disease Center, University of Kansas, 4350 Shawnee Mission Pkwy, Fairway, KS, 66205, USA
| | - Jeffery M Burns
- KU Alzheimer's Disease Center, University of Kansas, 4350 Shawnee Mission Pkwy, Fairway, KS, 66205, USA
| | - David K Johnson
- Alzheimer's Disease Research Center-East Bay, University of California, Davis, 100 N. Wiget Lane, Suite 150, Walnut Creek, CA, 94598, USA.
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Baas RE, Hutten BA, Henrichs J, Vrijkotte TGM. Associations Between Maternal Lipid Blood Levels at the 13th Week of Pregnancy and Offspring's Adiposity at Age 11-12 Years. J Clin Endocrinol Metab 2022; 107:e4048-e4057. [PMID: 35861593 PMCID: PMC9516046 DOI: 10.1210/clinem/dgac442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT There is increasing evidence that intrauterine lipid metabolism influences the adiposity of the newborn and the first years thereafter. It remains unclear if these effects persist when these children grow older. OBJECTIVE This study examined the associations between maternal lipid blood levels during the 13th week of pregnancy and an offspring's adiposity, measured at age 11-12, and if these associations were moderated by the child's sex. METHODS Data were obtained from a community-based birth cohort, the Amsterdam Born Children and their Development (ABCD) study. At a median of 13 weeks' gestation, nonfasting blood samples of triglycerides (TGs), total cholesterol (TC), free fatty acids (FFAs), and apolipoprotein B/apolipoprotein A1 ratio (ApoB/ApoA1) were measured. An offspring's body mass index (BMI), subcutaneous fat (SCF), waist-to-height-ratio (WHtR), and fat percentage (fat%) were measured at age 11-12. Mothers with at-term born children were included (n = 1853). Multivariable linear regression analyses were performed to assess the associations between maternal lipids and each offspring's adiposity outcome separately. Sex differences were additionally evaluated. RESULTS TGs, TC, ApoB/ApoA1, and FFAs were significantly positively associated with BMI, WHtR, and fat% (adjusted for gestational age at blood sampling, child's age, sex, and sexual maturation). After additional adjustments for potential confounders and covariates, only TGs remained significantly associated with WHtR (0.45, 95% CI -0.007; 0.91). There were no associations between maternal lipids and SCF and no clear sex-specific results were found. CONCLUSION Overall, our results do not strongly support that maternal lipid profile during the 13th week of pregnancy has programming effects on adiposity in preadolescence.
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Affiliation(s)
- Rosa E Baas
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Barbara A Hutten
- Department of Epidemiology and Data Science, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jens Henrichs
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Correspondence: Tanja G.M. Vrijkotte, Department of Public and Occupational Health, Amsterdam UMC location AMC, Postbox 22660, 1100 DD Amsterdam, The Netherlands,
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8
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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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9
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Thelwell M, Bullas A, Kühnapfel A, Hart J, Ahnert P, Wheat J, Loeffler M, Scholz M, Choppin S. Modelling of human torso shape variation inferred by geometric morphometrics. PLoS One 2022; 17:e0265255. [PMID: 35271672 PMCID: PMC8912174 DOI: 10.1371/journal.pone.0265255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 02/26/2022] [Indexed: 02/06/2023] Open
Abstract
Traditional body measurement techniques are commonly used to assess physical health; however, these approaches do not fully represent the complex shape of the human body. Three-dimensional (3D) imaging systems capture rich point cloud data that provides a representation of the surface of 3D objects and have been shown to be a potential anthropometric tool for use within health applications. Previous studies utilising 3D imaging have only assessed body shape based on combinations and relative proportions of traditional body measures, such as lengths, widths and girths. Geometric morphometrics (GM) is an established framework used for the statistical analysis of biological shape variation. These methods quantify biological shape variation after the effects of non-shape variation-location, rotation and scale-have been mathematically held constant, otherwise known as the Procrustes paradigm. The aim of this study was to determine whether shape measures, identified using geometric morphometrics, can provide additional information about the complexity of human morphology and underlying mass distribution compared to traditional body measures. Scale-invariant features of torso shape were extracted from 3D imaging data of 9,209 participants form the LIFE-Adult study. Partial least squares regression (PLSR) models were created to determine the extent to which variations in human torso shape are explained by existing techniques. The results of this investigation suggest that linear combinations of body measures can explain 49.92% and 47.46% of the total variation in male and female body shape features, respectively. However, there are also significant amounts of variation in human morphology which cannot be identified by current methods. These results indicate that Geometric morphometric methods can identify measures of human body shape which provide complementary information about the human body. The aim of future studies will be to investigate the utility of these measures in clinical epidemiology and the assessment of health risk.
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Affiliation(s)
- Michael Thelwell
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
- * E-mail:
| | - Alice Bullas
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Andreas Kühnapfel
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - John Hart
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Peter Ahnert
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Jon Wheat
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Markus Loeffler
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Markus Scholz
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
| | - Simon Choppin
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
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10
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Hanna L, Nguo K, Furness K, Porter J, Huggins CE. Association between skeletal muscle mass and quality of life in adults with cancer: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022; 13:839-857. [PMID: 35156342 PMCID: PMC8977976 DOI: 10.1002/jcsm.12928] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 11/11/2021] [Accepted: 01/10/2022] [Indexed: 01/06/2023] Open
Abstract
Low skeletal muscle mass is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health-related quality of life (HRQOL) is less established. This systematic review and meta-analysis was performed to investigate the relationship between skeletal muscle mass and HRQOL in adults with cancer. Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, and PsycInfo) were systematically searched from 1 January 2007 until 2 September 2020. Studies reporting on the association between measures of skeletal muscle (mass and/or radiodensity) derived from analysis of computed tomography imaging, and a validated measure of HRQOL in adults with cancer, were considered for inclusion. Studies classifying skeletal muscle mass as a categorical variable (low or normal) were combined in a meta-analysis to investigate cross-sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesized. A total of 14 studies involving 2776 participants were eligible for inclusion. Skeletal muscle mass classified as low or normal was used to dichotomize participants in 10 studies (n = 1375). Five different cut points were used for classification across the 10 studies, with low muscle mass attributed to 58% of participants. Low muscle mass was associated with poorer global HRQOL scores [n = 985 from seven studies, standardized mean difference -0.27, 95% confidence interval (CI) -0.40 to -0.14, P < 0.0001], and poorer physical functioning domain HRQOL scores (n = 507 from five studies, standardized mean difference -0.40, 95% CI -0.74 to -0.05, P = 0.02), but not social, role, emotional, or cognitive functioning domain scores (all P > 0.05). Five studies examined the cross-sectional relationship between HRQOL and skeletal muscle mass as a continuous variable and found little evidence of an association unless non-linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains. Low muscle mass may be associated with lower global and physical functioning HRQOL scores in adults with cancer. The interpretation of this relationship is limited by the varied classification of low muscle mass between studies. There is a need for prospective, longitudinal studies examining the interplay between skeletal muscle mass and HRQOL over time, and data should be made accessible to enable reanalysis according to different cut points. Further research is needed to elucidate the causal pathways between these outcomes.
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Affiliation(s)
- Lauren Hanna
- Department of Nutrition, Dietetics and FoodMonash UniversityClaytonVICAustralia
- Department of Nutrition and Dietetics, Monash Medical CentreMonash HealthClaytonVICAustralia
| | - Kay Nguo
- Department of Nutrition, Dietetics and FoodMonash UniversityClaytonVICAustralia
| | - Kate Furness
- Department of Nutrition and Dietetics, Monash Medical CentreMonash HealthClaytonVICAustralia
- Department of Physiotherapy, School of Primary and Allied Health CareMonash UniversityFrankstonVICAustralia
| | - Judi Porter
- Department of Nutrition, Dietetics and FoodMonash UniversityClaytonVICAustralia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityGeelongVICAustralia
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11
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Ezzatvar Y, Izquierdo M, Ramírez-Vélez R, Del Pozo Cruz B, García-Hermoso A. Accuracy of different cutoffs of the waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: A systematic review and meta-analysis of diagnostic test accuracy studies. Obes Rev 2022; 23:e13375. [PMID: 34751482 DOI: 10.1111/obr.13375] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
The present systematic review with meta-analysis sought to estimate the accuracy of different waist-to-height ratio (WHtR) cutoff ranges as risk indicators for cardiometabolic health in different populations of children and adolescents. Systematic searches were undertaken to identify studies in apparently healthy participants aged 3-18 years that conducted receiver operating characteristic curve analysis and reported area under the receiver operating characteristic curves for WHtR with any cardiometabolic biomarker. Forty-one cross-sectional studies were included in the meta-analysis, including 138,561 young individuals (50% girls). Higher area under summary receiver operating characteristic (AUSROC) values were observed in cutoffs between 0.46 and 0.50 (AUSROC = 0.83, 95%CI: 0.80-0.86) and ≥0.51 (AUSROC = 0.87, 95%CI: 0.84-0.90) (p < 0.001 in comparison with cutoffs 0.41 to 0.45), with similar results in both sexes. The AUSROC value increased in the East and Southeast Asian regions using a WHtR cutoff of ≥0.46 (AUSROC = 0.90, 95%CI: 0.87 to 0.92). A cutoff of ≥0.54 was optimal for the Latin American region (AUSROC = 0.96, 95%CI: 0.94-0.97). Our meta-analysis identified optimal cutoff values of WHtR for use in children and adolescents from different regions. Despite the widely accepted WHtR cutoff of 0.50, the present study indicated that a single cutoff value of WHtR may be inappropriate.
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Affiliation(s)
- Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Antonio García-Hermoso
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain.,Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
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12
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Abstract
PURPOSE OF REVIEW The obesity epidemic is on the rise, and while it is well known that obesity is associated with an increase in cardiovascular risk factors such as type 2 diabetes mellitus, hypertension, and obstructive sleep apnea, recent data has highlighted that the degree and type of fat distribution may play a bigger role in the pathogenesis of cardiovascular disease (CVD) than body mass index (BMI) alone. We aim to review updated data on adipose tissue inflammation and distribution and CVD. RECENT FINDINGS We review the pathophysiology of inflammation secondary to adipose tissue, the association of obesity-related adipokines and CVD, and the differences and significance of brown versus white adipose tissue. We delve into the clinical manifestations of obesity-related inflammation in CVD. We discuss the available data on heterogeneity of adipose tissue-related inflammation with a focus on subcutaneous versus visceral adipose tissue, the differential pathophysiology, and clinical CVD manifestations of adipose tissue across sex, race, and ethnicity. Finally, we present the available data on lifestyle modification, medical, and surgical therapeutics on reduction of obesity-related inflammation. Obesity leads to a state of chronic inflammation which significantly increases the risk for CVD. More research is needed to develop non-invasive VAT quantification indices such as risk calculators which include variables such as sex, age, race, ethnicity, and VAT concentration, along with other well-known CVD risk factors in order to comprehensively determine risk of CVD in obese patients. Finally, pre-clinical biomarkers such as pro-inflammatory adipokines should be validated to estimate risk of CVD in obese patients.
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Affiliation(s)
- Mariam N Rana
- Department of Medicine, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Ian J Neeland
- Department of Medicine, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
- Harrington Heart and Vascular Institute, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
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13
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Wakabayashi I, Daimon T. Associations of Blood Urate Level with Glycemic Status and Other Cardiometabolic Risk Factors in Middle-Aged Women. WOMEN'S HEALTH REPORTS 2021; 2:413-421. [PMID: 34671762 PMCID: PMC8524732 DOI: 10.1089/whr.2021.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/15/2022]
Abstract
Background: Hyperuricemia is a risk factor of cardiovascular disease. It remains to be elucidated how blood urate level is associated with hyperglycemia in women. Methods: The participants were 4612 middle-aged Japanese female workers. They were divided into four quartile groups by serum urate level, and cardiovascular risk factors were compared in the quartile groups. Results: With an increase of the quartile for urate, the means of waist-to-height ratio, systolic and diastolic blood pressure, log-transformed triglycerides, low-density lipoprotein (LDL) cholesterol, and cardiometabolic index (CMI) tended to be higher and high-density lipoprotein (HDL) cholesterol tended to be lower. Hemoglobin A1c was significantly higher in the 4th quartile for urate than in the 1st quartile, but this difference was not found when body mass index (BMI) was adjusted. The odds ratios versus the 1st quartile for high waist-to-height ratio, hypertension, hypertriglyceridemia, hypo-HDL cholesterolemia, hyper-LDL cholesterolemia, high CMI, and diabetes tended to be higher with an increase of the quartile. The odds ratios of the 4th versus 1st quartiles for these abnormalities except for high waist-to-height ratio and diabetes were significantly higher than the reference level even with adjustment for BMI. Hemoglobin A1c showed a weak but significant positive correlation with urate in analysis with adjustment for BMI. Conclusion: Blood urate was positively associated with adiposity, blood pressure, triglycerides, LDL cholesterol, and glycemic status and was inversely associated with HDL cholesterol in middle-aged women. The associations of urate with blood pressure, blood lipids, and glycemic status remained independent of adiposity, although being confounded by adiposity.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine and Hyogo College of Medicine, Nishinomiya, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Nishinomiya, Japan
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14
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Metabolic syndrome incidence in an aging workforce: Occupational differences and the role of health behaviors. SSM Popul Health 2021; 15:100881. [PMID: 34401460 PMCID: PMC8350497 DOI: 10.1016/j.ssmph.2021.100881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/15/2021] [Accepted: 07/25/2021] [Indexed: 12/25/2022] Open
Abstract
This study investigates whether the incidence of metabolic syndrome (MetS), and its components, differs by occupational group among older workers (45-65 years) and whether health behaviors (smoking, leisure-time physical activity, diet quality, and alcohol consumption) can explain these differences. A sample of older workers (N = 34,834) from the North of the Netherlands was investigated. We analyzed data from two comprehensive measurement waves of the Lifelines Cohort Study and Biobank. MetS components were determined by physical measurements, blood markers, medication use, and self-reports. Occupational group and health behaviors were assessed by questionnaires. The association between occupational groups and MetS incidence was examined using logistic regression analysis. Health behaviors were subsequently added to the model to examine whether they can explain differences in MetS incidence between occupational groups. Low skilled white-collar (OR: 1.24; 95 % CI: 1.12, 1.37) and low skilled blue-collar (OR: 1.37; 95 % CI: 1.18, 1.59) workers had a significantly higher MetS incidence risk than high skilled white-collar workers. Similar occupational differences were observed on MetS component level. Combinations of unhealthy behaviors were more prevalent among blue-collar workers. MetS incidence in older workers differs between occupational groups and health behaviors explain a substantial part of these differences. Health promotion tailored to occupational groups may be beneficial specifically among older low skilled blue-collar workers. Research into other factors that contribute to occupational differences is needed as well as studies spanning the entire working life course.
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15
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Mwene-Batu P, Lemogoum D, de le Hoye L, Bisimwa G, Hermans MP, Minani J, Amani G, Mateso GQ, Cikomola JC, Dramaix M, Donnen P. Association between severe acute malnutrition during childhood and blood pressure during adulthood in the eastern Democratic Republic of the Congo: the Lwiro cohort study. BMC Public Health 2021; 21:847. [PMID: 33933039 PMCID: PMC8088659 DOI: 10.1186/s12889-021-10908-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/23/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Little is known about the long-term outcomes of Severe Acute Malnutrition (SAM) during childhood. As such, this study aims to explore the association between childhood SAM and blood pressure (BP) in adulthood in a context without nutrition transition. METHODOLOGY We identified 524 adults (Median age: 22 years) who were treated for SAM during childhood in Eastern DRC between 1988 and 2007. They were compared with 407 age-and-sex matched subjects with no history of SAM in the community. The variables examined for this study were the systolic (SBP), diastolic (DBP), mean (MBP) blood pressure (BP) and pulse pressure (PP), as well as high blood pressure (HBP) defined as BP ≥ 140/90 mmHg and/or use of BP-lowering drug(s) in adulthood. For comparison, linear and logistic regression models were used for analysing continuous and dichotomous variables, respectively. RESULTS Of the 524 exposed located, 145 were selected according to age. A total of 97 unexposed were recruited. Compared to unexposed, exposed had slightly higher SBP and PP after adjusting for occupation, body mass index (BMI) and food consumption [SBP = 1.4 mmHg (- 2.2, 4.8) and PP = 2.6 mmHg (- 0.3, 6.0)]. However, their DBP was lower than that of the unexposed [- 1.6 mmHg (- 4.6, 1.5)]. MBP and creatinine levels were similar between the two groups. The prevalence of HBP adjusted for age was higher among exposed than unexposed (9.7% vs 5.3%). In addition, the odds of having HBP was higher among exposed than unexposed, however the observed difference was not statistically significant [Odds Ratio (OR) 1.9 (0.7, 5.6)]. Finally, using multiple regression analysis, although the effect was not significant, SAM was a major contributor to HBP [adjusted OR 3.1 (0.9,10.9), p = 0.064], while only male gender and higher BMI (overweight/obesity) emerged as independent predictors of HBP among this young study population. CONCLUSIONS This study suggests that an episode of SAM in childhood has a weak impact on BP variability in young Congolese adults (from DRC) living in an environment without nutrition transition. However, people who experienced a period of SAM tended to have a higher prevalence of HBP and a much higher risk of developing HBP than unexposed. Additional multicentre studies involving a larger cohort would provide greater understanding of the impact of SAM on the overall risk of BP disorders during adulthood.
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Affiliation(s)
- Pacifique Mwene-Batu
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.
- Nutritional department, Centre de Recherche en Sciences Naturelles, Lwiro, Democratic Republic of Congo.
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.
| | - Daniel Lemogoum
- Hôpital ULB-Erasme , Université Libre de Bruxelles, Brussels, Belgium
| | - Laurène de le Hoye
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Ghislain Bisimwa
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Nutritional department, Centre de Recherche en Sciences Naturelles, Lwiro, Democratic Republic of Congo
| | - Michel P Hermans
- Division of Endocrinology & Nutrition, Cliniques universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jimmy Minani
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Gaylord Amani
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Guy-Quesney Mateso
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Justin Cirhuza Cikomola
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Univeristé catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Michelle Dramaix
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Donnen
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
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16
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The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review. Br J Nutr 2021; 127:722-735. [PMID: 33910664 DOI: 10.1017/s0007114521001446] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Body composition measurement using diagnostic computed tomography (CT) scans has emerged as a method to assess sarcopenia (low muscle mass) in oncology patients. Assessment of skeletal muscle mass (SMM) using the cross-sectional area of a single vertebral slice (at lumbar L3) in a CT scan is correlated with whole-body skeletal muscle volume. This method is used to assess CT-defined sarcopenia in patients with cancer, with low SMM effecting outcomes. However, as diagnostic scans are based on tumour location, not all include L3. We evaluated the evidence for the use of alternate vertebral CT slices for SMM evaluation when L3 is not available. Five electronic databases were searched from January 1996 to April 2020 for studies using CT scan vertebral slices above L3 for SM measurement in adults with cancer (solid tumours). Validation with whole-body SMM, rationale for the chosen slice and sarcopenia cut-off values were investigated. Thirty-two studies were included, all retrospective and cross-sectional in design. Cervical, thoracic and lumbar slices were used (from C3 to L1), with no validation of whole-body SMM using CT scans. Alternate slices were used in lung, and head and neck cancer patients. Sarcopenia cut-off values were reported in 75 % of studies, with differing methods, with or without sex-specific values, and a lack of consensus. Current evidence is inadequate to provide definitive recommendations for alternate vertebral slice use for SMM evaluation in cancer patients. Variation in sarcopenia cut-offs warrants more robust investigation, in order for risk stratification to be applied to all patients with cancer.
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17
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Wang M, Ying J, Ugbolue UC, Buchan DS, Gu Y, Baker JS. Cardio-Metabolic Risk Factors in Scottish South Asian and Caucasian Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094667. [PMID: 33925726 PMCID: PMC8125757 DOI: 10.3390/ijerph18094667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/27/2022]
Abstract
(1) Background: Scotland has one of the highest rates of obesity in the Western World, it is well established that poor weight profiles, and particularly abdominal obesity, is strongly associated with Type II diabetes and cardiovascular diseases. Whether these associations are apparent in ethnic population groups in Scotland is unclear. The purpose of this study was to examine the associations between different measures of fatness with clustered cardio metabolic risk factors between Scottish South Asian adolescents and Scottish Caucasian adolescents; (2) Methods: A sample of 208 Caucasian adolescents and 52 South Asian adolescents participated in this study. Stature, waist circumference, body mass index, blood pressure, physical activity, and cardiovascular disease (CVD) risk were measured; (3) Results: Significant, partial correlations in the South Asian cohort between body mass index (BMI) and individual risk factors were generally moderate. However, correlations between Waist circumference (WC) and individual risk factors were significant and strong. In the Caucasian cohort, a significant yet weak correlation between WC and total cholesterol (TG) was noted although no other associations were evident for either WC or BMI. Multiple regression analysis revealed that both BMI and WC were positively associated with CCR (p < 0.01) in the South Asian group and with the additional adjustment of either WC or BMI, the independent associations with clustered cardio-metabolic risk (CCR) remained significant (p < 0.005); (4) Conclusions: No positive relationships were found between BMI, WC, and CCR in the Caucasian group. Strong and significant associations between measures of fatness and metabolic risk were evident in Scottish South Asian adolescents.
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Affiliation(s)
- Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
| | - Jianhua Ying
- College of Science Technology, Ningbo University, Ningbo 315211, China;
| | - Ukadike Chris Ugbolue
- Institute for Clinical Exercise and Health Sciences, School of Science, University of the West of Scotland, Hamilton, Scotland ML3 0JB, UK; (U.C.U.); (D.S.B.)
| | - Duncan S. Buchan
- Institute for Clinical Exercise and Health Sciences, School of Science, University of the West of Scotland, Hamilton, Scotland ML3 0JB, UK; (U.C.U.); (D.S.B.)
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
- Correspondence: (Y.G.); (J.S.B.); Tel.: +86-5748-7600-456 (Y.G.); +852-3411-8032 (J.S.B.)
| | - Julien S. Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong 999077, China
- Correspondence: (Y.G.); (J.S.B.); Tel.: +86-5748-7600-456 (Y.G.); +852-3411-8032 (J.S.B.)
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18
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Osteopontin's relationship with malnutrition and oxidative stress in adolescents. A pilot study. PLoS One 2021; 16:e0249057. [PMID: 33765028 PMCID: PMC7993823 DOI: 10.1371/journal.pone.0249057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/10/2021] [Indexed: 01/24/2023] Open
Abstract
Osteopontin (OPN) is a protein involved in inflammatory illnesses such as fibrosis and cancer; its overexpression in cardiovascular diseases promotes the biomineralization of blood vessels and other soft tissues. Moreover, there is an active component of oxidative stress related with those diseases. The present study relates serum OPN levels with nutritional condition and oxidative stress in a group of adolescents. Anthropometric measurements were performed, and fasting blood samples were analyzed to determine OPN concentrations, blood chemistry parameters (glucose, triglycerides, total cholesterol, urea, uric acid, and creatinine) and oxidative stress biomarkers (Paraoxonase-1, Glutathione S-Transferase, Catalase, NAD(P)H Quinone Oxidoreductase, free carbonyl groups and malondialdehyde). Adolescents were categorized according to body mass index (BMI) and metabolic syndrome (MetS) criteria. We found increased OPN serum concentrations in overweight and obese adolescents, as well as in adolescents with MetS. Rises in OPN correlated with arm circumference and biomarkers of lipid peroxidation; with regard to serum glucose there was a trend to positive correlation. Our results suggest that serum OPN is associated to nutritional status and could be considered as an early biomarker of low-grade inflammation and probably the early biomineralization of soft tissues in adolescence.
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19
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Duggan CP, Kurpad A, Stanford FC, Sunguya B, Wells JC. Race, ethnicity, and racism in the nutrition literature: an update for 2020. Am J Clin Nutr 2020; 112:1409-1414. [PMID: 33274358 PMCID: PMC7727473 DOI: 10.1093/ajcn/nqaa341] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 01/06/2023] Open
Abstract
Social disparities in the US and elsewhere have been terribly highlighted by the current COVID-19 pandemic but also an outbreak of state-sponsored violence. The field of nutrition, like other areas of science, has commonly used 'race' to describe research participants and populations, without the recognition that race is a social, not a biologic, construct. We review the limitations of classifying participants by race, and recommend a series of steps for authors, researchers and policymakers to consider when producing and reading the nutrition literature. We recommend that biomedical researchers, especially those in the field of nutrition, abandon the use of racial categories to explain biologic phenomena but instead rely on a more comprehensive framework of ethnicity; that authors consider not just race and ethnicity but many social determinants of health, including experienced racism; that race and ethnicity not be conflated; that dietary pattern descriptions inform ethnicity descriptions; and that depersonalizating language be avoided.
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Affiliation(s)
- Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Anura Kurpad
- Department of Nutrition, St. John’s Research Institute, St. John’s National Academy of Health Sciences, Bangalore, India
| | - Fatima C Stanford
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Bruno Sunguya
- Directorate of Research and Publications, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, University College London, London, United Kingdom
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20
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Validity assessment of the single-point insulin sensitivity estimator (spise) for diagnosis of cardiometabolic risk in post-pubertal hispanic adolescents. Sci Rep 2020; 10:14399. [PMID: 32873820 PMCID: PMC7462984 DOI: 10.1038/s41598-020-71074-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022] Open
Abstract
Insulin measurements are not advised for cardiometabolic risk screening in large groups. Here we assessed the accuracy of the single-point insulin sensitivity estimator (SPISE) to diagnose cardiometabolic risk in Chilean adolescents. In 678 post-pubertal adolescents (52% males, M(SD) age = 16.8 (0.2) years), height, weight, waist circumference, blood lipids, glucose, insulin, and blood pressure were measured. BMI, HOMA-IR, and SPISE were estimated; HOMA-IR values ≥ 2.6 were considered insulin resistance (IR). Metabolic syndrome (MetS) was defined with the joint IDF/AHA/NHBLI standard. Using receiver operating characteristic curves, we obtained optimal SPISE cutpoints for IR and MetS diagnosis. The prevalence of MetS and IR was 8.2% and 17.1%, respectively. In males, the optimal cutoff for MetS diagnosis was 5.0 (sensitivity: 97%; specificity: 82%), and the optimal cutoff for IR diagnosis was 5.9 (sensitivity: 71%; specificity: 83%). In females, a SPISE of 6.0 had the highest sensitivity (90%) and specificity (74%) for MetS diagnosis. A SPISE of 6.4 was the optimal cutoff for IR diagnosis; however, sensitivity and specificity were 61% and 75%. In males and female post-pubertal adolescents, SPISE had a very good and good diagnostic performance, respectively, in predicting MetS. It was an accurate diagnostic tool for IR prediction in males, but not necessarily in females.
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21
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Wells JCK. Promoting ethnic parity in health, leaving behind "race": a challenge for the global community in 2020. Am J Clin Nutr 2020; 112:505-506. [PMID: 32869066 DOI: 10.1093/ajcn/nqaa189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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22
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Sarkar S, Lipworth L, Kabagambe EK, Bian A, Stewart TG, Blot WJ, Ikizler TA, Hung AM. A Description of Risk Factors for Non-alcoholic Fatty Liver Disease in the Southern Community Cohort Study: A Nested Case-Control Study. Front Nutr 2020; 7:71. [PMID: 32671089 PMCID: PMC7326146 DOI: 10.3389/fnut.2020.00071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/24/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is associated with obesity and hypercholesterolemia. In addition, total fat and folate intake have been associated with NAFLD. Aims: We investigated risk factors for NAFLD among individuals of largely low socioeconomic status, and whether these associations differed by race. Methods: A nested case-control study was conducted within the Southern Community Cohort Study. Through linkage of the cohort with Centers for Medicare and Medicaid Services, International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify incident NAFLD cases. Controls were matched 4:1 to cases on enrollment age, sex, and race. A logistic regression was used to estimate odds ratios for the associations of NAFLD with covariates of interest. Results: Neither total fat nor folate intake was significantly associated with NAFLD. Hypercholesterolemia (odds ratio 1.21) and body mass index (75th vs. 25th percentile) for blacks (odds ratio 1.96) and whites (odds ratio 2.33) were associated with an increased risk of non-alcoholic fatty liver disease. No significant interaction with race for any of the studied variables was noted. Conclusions: Both hypercholesterolemia and increasing body mass index, but not total fat and folate intake, were risk factors for NAFLD in the Southern Community Cohort Study.
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Affiliation(s)
- Sudipa Sarkar
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Loren Lipworth
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, United States.,Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Edmond K Kabagambe
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, United States.,Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Aihua Bian
- Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Thomas G Stewart
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - William J Blot
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, United States.,International Epidemiology Institute, Rockville, MD, United States
| | - T Alp Ikizler
- Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, United States.,Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Adriana M Hung
- Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, United States.,Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
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23
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Predictive anthropometric models of total and truncal body fat in Chilean children. Nutrition 2020; 77:110803. [PMID: 32442830 DOI: 10.1016/j.nut.2020.110803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/13/2020] [Accepted: 02/15/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to develop predictive anthropometric models for total and truncal body fat in Chilean children using the following anthropometric measurements: weight, height, skinfold thickness, and circumference. METHODS This cross-sectional study included 669 Chilean children (12.0 y ± 1.3) in Tanner stage IV from the Growth and Obesity Chilean Cohort Study. Anthropometric measurements and dual-energy X-ray absorptiometry were determined to calculate total and truncal body fat. Prediction models were fitted by linear regression analysis. RESULTS The predictive equation for log total body fat (kg) was 0.449 + 0.049 (body mass index in kg/m2) + 0.018 (triceps skinfold in mm) + 0.012 (biceps skinfold in mm) + 0.019 (brachial circumference in cm) + 0.091 (sex: 1 = boy, 2 = girl) + 0.018 (age in y). The predictive equation for log truncal fat (kg) was -2.107 + 0.046 (waist circumference in cm) + 0.010 (subscapular skinfold in mm) + 0.259 (sex: 1 = boy, 2 = girl) + 0.006 (age in y). The test of concordance between the predictive equations of total and truncal body fat with gold standard was r = 0.85 and 0.91, respectively. CONCLUSIONS In Chilean children, the high correlation between observed and predicted values enabled us to develop predictive equations for total and truncal body fat for children.
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24
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Kyrou I, Tsigos C, Mavrogianni C, Cardon G, Van Stappen V, Latomme J, Kivelä J, Wikström K, Tsochev K, Nanasi A, Semanova C, Mateo-Gallego R, Lamiquiz-Moneo I, Dafoulas G, Timpel P, Schwarz PEH, Iotova V, Tankova T, Makrilakis K, Manios Y. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe. BMC Endocr Disord 2020; 20:134. [PMID: 32164656 PMCID: PMC7066728 DOI: 10.1186/s12902-019-0463-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 11/28/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in adults, with alarmingly increasing prevalence over the past few decades worldwide. A particularly heavy healthcare burden of diabetes is noted in Europe, where 8.8% of the population aged 20-79 years is estimated to have diabetes according to the International Diabetes Federation. Multiple risk factors are implicated in the pathogenesis of T2DM with complex underlying interplay and intricate gene-environment interactions. Thus, intense research has been focused on studying the role of T2DM risk factors and on identifying vulnerable groups for T2DM in the general population which can then be targeted for prevention interventions. METHODS For this narrative review, we conducted a comprehensive search of the existing literature on T2DM risk factors, focusing on studies in adult cohorts from European countries which were published in English after January 2000. RESULTS Multiple lifestyle-related and sociodemographic factors were identified as related to high T2DM risk, including age, ethnicity, family history, low socioeconomic status, obesity, metabolic syndrome and each of its components, as well as certain unhealthy lifestyle behaviors. As Europe has an increasingly aging population, multiple migrant and ethnic minority groups and significant socioeconomic diversity both within and across different countries, this review focuses not only on modifiable T2DM risk factors, but also on the impact of pertinent demographic and socioeconomic factors. CONCLUSION In addition to other T2DM risk factors, low socioeconomic status can significantly increase the risk for prediabetes and T2DM, but is often overlooked. In multinational and multicultural regions such as Europe, a holistic approach, which will take into account both traditional and socioeconomic/socioecological factors, is becoming increasingly crucial in order to implement multidimensional public health programs and integrated community-based interventions for effective T2DM prevention.
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Affiliation(s)
- Ioannis Kyrou
- Aston Medical Research Institute, Aston Medical School, Aston University, B4 7ET, Birmingham, UK.
- WISDEM, University Hospital Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
- Translational & Experimental Medicine, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Greece.
| | - Constantine Tsigos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Anna Nanasi
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Csilla Semanova
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Rocío Mateo-Gallego
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón) CIBERCV, Zaragoza, Spain
- Universidad de Zaragoza, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón) CIBERCV, Zaragoza, Spain
| | - George Dafoulas
- National and Kapodistrian University of Athens, 17 Ag. Thoma St, 11527, Athens, Greece
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Greece
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25
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Wells JC, Sawaya AL, Wibaek R, Mwangome M, Poullas MS, Yajnik CS, Demaio A. The double burden of malnutrition: aetiological pathways and consequences for health. Lancet 2020; 395:75-88. [PMID: 31852605 PMCID: PMC7613491 DOI: 10.1016/s0140-6736(19)32472-9] [Citation(s) in RCA: 399] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/24/2019] [Accepted: 08/07/2019] [Indexed: 12/29/2022]
Abstract
Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.
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Affiliation(s)
- Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.
| | - Ana Lydia Sawaya
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Rasmus Wibaek
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark; Clinical Epidemiology, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Martha Mwangome
- Kenya Medical Research Institute Wellcome Trust Research Program, Kilifi, Kenya
| | - Marios S Poullas
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Alessandro Demaio
- School of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; EAT Foundation, Oslo, Norway; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; VicHealth, Melbourne, VIC, Australia
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26
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Martos-Moreno GÁ, Martínez-Villanueva J, González-Leal R, Barrios V, Sirvent S, Hawkins F, Chowen JA, Argente J. Ethnicity Strongly Influences Body Fat Distribution Determining Serum Adipokine Profile and Metabolic Derangement in Childhood Obesity. Front Pediatr 2020; 8:551103. [PMID: 33163464 PMCID: PMC7581788 DOI: 10.3389/fped.2020.551103] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 09/07/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Body fat content and distribution in childhood is influenced by sex and puberty, but interethnic differences in the percentage and distribution of body fat also exist. The abdominal visceral/subcutaneous fat ratio has been the main feature of body fat distribution found to associate with the serum adipokine profile and metabolic derangement in adulthood obesity. This has also been assumed for childhood obesity despite the known singularities of this disease in the pediatric age in comparison to adults. Objective: We aimed to investigate the effect of ethnicity, together with sex and pubertal status, on body fat content and distribution, serum adipokine profile, metabolic impairment and liver steatosis in children and adolescents with obesity. Patients and Methods: One hundred and fifty children with obesity (50% Caucasians/50% Latinos; 50% males/50% females) were studied. Body fat content and distribution were studied by whole body DXA-scan and abdominal magnetic resonance, and their relationships with liver steatosis (as determined by ultrasonography), glycemia, insulinemia, lipid metabolism, uric acid, total and HMW-adiponectin, leptin, leptin-receptor, and sex steroid levels were explored. Results: Latino patients had more severe truncal obesity (higher trunk/lower limb fat ratio, odds ratio 10.00; p < 0.05) and higher prevalence of liver steatosis than Caucasians regardless of sex or pubertal status, but there were no difference in the visceral/subcutaneous abdominal fat ratio, except for pubertal females. A higher trunk/lower limb fat ratio, but not the visceral/subcutaneous abdominal fat ratio, was associated with adipokine profile impairment (higher free leptin index and lower adiponectin levels), insulin resistance and dyslipidemia, and was further enhanced when liver steatosis was present (p < 0.05). A higher abdominal visceral/subcutaneous fat ratio was observed in prepubertal children (p < 0.01), except for Latino females, whereas predominant subcutaneous fat deposition was observed in adolescents. Conclusion: Ethnicity is one of the main determinants of increased trunk body fat accumulation in Latino children with obesity, which is best estimated by the trunk/lower limb fat ratio and related to the development of metabolic derangement and liver steatosis.
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Affiliation(s)
- Gabriel Á Martos-Moreno
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Julián Martínez-Villanueva
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Rocío González-Leal
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Vicente Barrios
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Sirvent
- Department of Radiology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Federico Hawkins
- Department of Endocrinology, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Julie A Chowen
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Madrileño de Estudios Avanzados (IMDEA) Food Institute, Madrid, Spain
| | - Jesús Argente
- Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Madrileño de Estudios Avanzados (IMDEA) Food Institute, Madrid, Spain
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27
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Wells JCK. The diabesity epidemic in the light of evolution: insights from the capacity-load model. Diabetologia 2019; 62:1740-1750. [PMID: 31451870 PMCID: PMC6731192 DOI: 10.1007/s00125-019-4944-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 05/21/2019] [Indexed: 12/21/2022]
Abstract
The global nutrition transition, which embraces major changes in how food is produced, distributed and consumed, is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: 'metabolic capacity,' which promotes glucose homeostasis, and 'metabolic load', which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under selective pressure to maximise reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
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28
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Kim JY, Oh S, Park HY, Jun JH, Kim HJ. Comparisons of different indices of low muscle mass in relationship with cardiometabolic disorder. Sci Rep 2019; 9:609. [PMID: 30679721 PMCID: PMC6345970 DOI: 10.1038/s41598-018-37347-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022] Open
Abstract
This study aimed to evaluate the most valid index among various indices of low muscle mass in assessing cardiometabolic risks in a Korean population. Appendicular lean mass index (ALMI, kg/m2), fat mass index (FMI, kg/m2), FMI-adjusted ALMI (ALMfmi), ratio of ALM to weight index (ALMwt), ratio of ALM to body mass index (ALMbmi) and ratio of ALM to truncal fat index (ALMtrunkfat) were measured by dual energy X-ray absorptiometry in 17,870 participants from 2008 to 2011. We adopted all the aforementioned indices of low muscle mass expressed as sex- and age-specific standard deviation scores (Z-scores). Low muscle mass for age was defined as Z-score <-1. The prevalence of low muscle mass was approximately 16% across all indices. Low muscle mass defined by ALMI had low muscle mass and low fat mass, and ALMfmi had low muscle mass at the same FMI. However, low muscle mass defined by ALMwt, ALMbmi and ALMtrunkfat had similar muscle mass with high FMI. The receiver operating characteristic curve in metabolic syndrome showed that the ALMtrunkfat was 0.74 in male and 0.69 in female, indicating that ALMtrunkfat was the best discrimination index for metabolic syndrome. This study showed that ALMtrunkfat could be a useful indicator for screening cardiometabolic risk factors, particularly in normal or overweight Asian population.
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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.
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hwa Yeon Park
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hye Jun
- Deparment of Family Medicine, Chamjoeun Hospital, Gwangju, Korea
| | - Hwa Jung Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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29
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Hilmi M, Jouinot A, Burns R, Pigneur F, Mounier R, Gondin J, Neuzillet C, Goldwasser F. Body composition and sarcopenia: The next-generation of personalized oncology and pharmacology? Pharmacol Ther 2018; 196:135-159. [PMID: 30521882 DOI: 10.1016/j.pharmthera.2018.12.003] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Body composition has gained increasing attention in oncology in recent years due to fact that sarcopenia has been revealed to be a strong prognostic indicator for survival across multiple stages and cancer types and a predictive factor for toxicity and surgery complications. Accumulating evidence over the last decade has unraveled the "pharmacology" of sarcopenia. Lean body mass may be more relevant to define drug dosing than the "classical" body surface area or flat-fixed dosing in patients with cancer. Since sarcopenia has a major impact on patient survival and quality of life, therapeutic interventions aiming at reducing muscle loss have been developed and are being prospectively evaluated in randomized controlled trials. It is now acknowledged that this supportive care dimension of oncological management is essential to ensure the success of any anticancer treatment. The field of sarcopenia and body composition in cancer is developing quickly, with (i) the newly identified concept of sarcopenic obesity defined as a specific pathophysiological entity, (ii) unsolved issues regarding the best evaluation modalities and cut-off for definition of sarcopenia on imaging, (iii) first results from clinical trials evaluating physical activity, and (iv) emerging body-composition-tailored drug administration schemes. In this context, we propose a comprehensive review providing a panoramic approach of the clinical, pharmacological and therapeutic implications of sarcopenia and body composition in oncology.
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Affiliation(s)
- Marc Hilmi
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
| | - Anne Jouinot
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
| | - Robert Burns
- Department of Radiology, Henri Mondor University Hospital, Créteil, France
| | - Frédéric Pigneur
- Department of Radiology, Henri Mondor University Hospital, Créteil, France
| | - Rémi Mounier
- Institut NeuroMyoGène (INMG) CNRS 5310 - INSERM U1217 - UCBL, Lyon, France
| | - Julien Gondin
- Institut NeuroMyoGène (INMG) CNRS 5310 - INSERM U1217 - UCBL, Lyon, France
| | - Cindy Neuzillet
- Department of Medical Oncology, Curie Institute, Versailles Saint-Quentin University, Saint-Cloud, France, and GERCOR group, Paris, France.
| | - François Goldwasser
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
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30
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Hills AP, Arena R, Khunti K, Yajnik CS, Jayawardena R, Henry CJ, Street SJ, Soares MJ, Misra A. Epidemiology and determinants of type 2 diabetes in south Asia. Lancet Diabetes Endocrinol 2018; 6:966-978. [PMID: 30287102 DOI: 10.1016/s2213-8587(18)30204-3] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes has rapidly developed into a major public health problem in south Asia (defined here as Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka) in recent decades. During this period, major lifestyle changes associated with economic transition, industrialisation, urbanisation, and globalisation have been key determinants in the increasing burden of non-communicable diseases. A decline in nutrition quality, reduced physical activity, and increased sedentary behaviours are reflected in the increasing prevalence of type 2 diabetes and related risk factors in the region. The International Diabetes Federation 2017 estimates of the prevalence of diabetes in adults in the region range from 4·0% in Nepal to 8·8% in India. The prevalence of overweight ranges from 16·7% in Nepal to 26·1% in Sri Lanka, and the prevalence of obesity ranges from 2·9% in Nepal to 6·8% in Sri Lanka. An increasing proportion of children, adolescents, and women are overweight or obese, leading to a heightened risk of type 2 diabetes. Ethnic south Asians present with greater metabolic risk at lower levels of BMI compared with other ethnic groups (referred to as the south Asian phenotype), with type 2 diabetes often developing at a younger age, and with rapid progression of diabetic complications. Because of the presence of multiple risk factors and a body composition conducive to the development of type 2 diabetes, south Asians should be aggressively targeted for prevention. In this Series paper, we detail trends in the prevalence of diabetes in the region and address major determinants of the disease in the context of nutrition and physical activity transitions and the south Asian phenotype.
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Affiliation(s)
- Andrew P Hills
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois At Chicago, Chicago, IL, USA
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | | | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Christiani Jeyakumar Henry
- Singapore Institute for Clinical Sciences, Clinical Nutrition Research Centre, Brenner Centre for Molecular Medicine, Singapore
| | - Steven J Street
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Mario J Soares
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Anoop Misra
- Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India; National Diabetes, Obesity, and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Thornborrow T, Jucker JL, Boothroyd LG, Tovée MJ. Investigating the link between television viewing and men's preferences for female body size and shape in rural Nicaragua. EVOL HUM BEHAV 2018. [DOI: 10.1016/j.evolhumbehav.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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32
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Heymsfield SB, Peterson CM, Bourgeois B, Thomas DM, Gallagher D, Strauss B, Müller MJ, Bosy-Westphal A. Human energy expenditure: advances in organ-tissue prediction models. Obes Rev 2018; 19:1177-1188. [PMID: 30035381 PMCID: PMC6107421 DOI: 10.1111/obr.12718] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 01/02/2023]
Abstract
Humans expend energy at rest (REE), and this major energy exchange component is now usually estimated using statistical equations that include weight and other predictor variables. While these formulas are useful in evaluating an individual's or group's REE, an important gap remains: available statistical models are inadequate for explaining underlying organ-specific and tissue-specific mechanisms accounting for resting heat production. The lack of such systems level REE prediction models leaves many research questions unanswered. A potential approach that can fill this gap began with investigators who first showed in animals and later in humans that REE reflects the summated heat production rates of individual organs and tissues. Today, using advanced imaging technologies, REE can be accurately estimated from the measured in vivo mass of 10 organ-tissue mass components combined with their respective mass-specific metabolic rates. This review examines the next frontier of energy expenditure models and discusses how organ-tissue models have the potential not only to better predict REE but also to provide insights into how perturbations in organ mass lead to structure-function changes across other interacting organ systems. The introductory ideas advanced in this review provide a framework for future human energy expenditure modelling research.
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Affiliation(s)
| | | | | | - Diana M. Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, NY, USA
| | - Dympna Gallagher
- Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Boyd Strauss
- Dept. of Medicine, School of Clinical Sciences, Monash University, Australia and Institute of Inflammation and Repair, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - Manfred J. Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
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Veru-Lesmes F, Rho A, King S, Joober R, Pruessner M, Malla A, Iyer SN. Social Determinants of Health and Preclinical Glycemic Control in Newly Diagnosed First-Episode Psychosis Patients. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:547-556. [PMID: 29661027 PMCID: PMC6099748 DOI: 10.1177/0706743718762097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The abnormally high incidence of disorders of glucose metabolism (DGM) in psychotic-spectrum disorders (PSD) has often been attributed to the side effects of antipsychotics and unhealthy lifestyles. The influence of social determinants of health has been largely ignored, despite ample evidence linking social adversity with both PSD and DGM. The aim of this study is to examine the influence of well-established social determinants of health on preclinical levels of glycated hemoglobin (HbA1c) in a sample of first-episode psychosis (FEP) patients. METHODS In a sample of newly admitted FEP patients, univariate analyses were used to select the main predictors of HbA1c levels from the following social determinants of health: childhood trauma, immigrant background, visible minority status, and indices of social and material deprivation. The predictors identified in the univariate analyses were tested in multivariate linear regression models including age, sex, BMI, depression, and physical anergia (proxy of sedentary behaviour) as covariates. RESULTS Univariate analyses identified visible minority status and childhood physical abuse as predictors of HbA1c. After controlling for covariates, minority status significantly predicted higher levels of glycated hemoglobin (β = 0.23; P = 0.01), and physical abuse had a marginally significant effect (β = 0.23; P = 0.06). Other predictors were not significantly associated. CONCLUSION FEP patients from a visible minority or who were victims of childhood physical abuse have higher levels of HbA1c at admission compared with other patients. This might suggest an increase in risk for the development of future DGM. If confirmed, preventive strategies could be tailored for these groups.
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Affiliation(s)
- Franz Veru-Lesmes
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Aldanie Rho
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec
| | - Suzanne King
- 2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Ridha Joober
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Marita Pruessner
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec.,4 Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Ashok Malla
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec.,Authors contributed equally to the work
| | - Srividya N Iyer
- 1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.,2 Douglas Mental Health University Institute, Montreal, Quebec.,3 Department of Psychiatry, McGill University, Montreal, Quebec.,Authors contributed equally to the work
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You JY, Kim YJ, Shin WY, Kim NY, Cho SH, Kim JH. Heritability of muscle mass in Korean parent-offspring pairs in the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V). Maturitas 2018; 114:67-72. [PMID: 29907249 DOI: 10.1016/j.maturitas.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/26/2018] [Accepted: 06/03/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Decreased muscle mass is known to be associated with several serious medical conditions. We analyzed the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V, 2010-2011) to estimate the heritability of muscle mass in Korean parent-offspring pairs. STUDY DESIGN Cross-sectional. MAIN OUTCOME MEASURES A total of 1233 parents (average age 57.67 ± 8.50 years) and 917 offspring (average age 29.10 ± 7.57 years) from 743 families were included in the analysis. Muscle mass was estimated based on three different indices: appendicular skeletal muscle mass (ASM) measured with a dual-energy X-ray absorptiometry (DXA), weight-adjusted ASM (SMI), and height-adjusted ASM (RASM). The heritability was estimated by employing the maximum-likelihood variance components implemented in Sequential Oligogenic Linkage Analysis Routines (SOLAR). The best-fitting model was determined out of four polygenic models. Pearson's partial correlation coefficient was also calculated using the muscle mass indices to further study the association between father or mother and son or daughter pairs. RESULTS The heritability estimates of the muscle mass indices ranged from 55% to 80% (all p < 0.01). The correlation coefficient of father and offspring ranged from 0.11 to 0.40, while that of mother and offspring ranged from 0.23 to 0.43 (all p < 0.01). CONCLUSIONS The heritability estimates of muscle mass in Koreans are large and significant, suggesting that parental muscle mass is an important predictor of the offspring's muscle mass. The result implies that there may be a genetic factor partly determining muscle mass.
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Affiliation(s)
- Ju-Young You
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yun-Jee Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Woo-Young Shin
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Na-Yeon Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung-Ha Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
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Mathias MG, Coelho‐Landell CDA, Scott‐Boyer M, Lacroix S, Morine MJ, Salomão RG, Toffano RBD, Almada MORDV, Camarneiro JM, Hillesheim E, de Barros TT, Camelo‐Junior JS, Campos Giménez E, Redeuil K, Goyon A, Bertschy E, Lévêques A, Oberson J, Giménez C, Carayol J, Kussmann M, Descombes P, Métairon S, Draper CF, Conus N, Mottaz SC, Corsini GZ, Myoshi SKB, Muniz MM, Hernandes LC, Venâncio VP, Antunes LMG, da Silva RQ, Laurito TF, Rossi IR, Ricci R, Jorge JR, Fagá ML, Quinhoneiro DCG, Reche MC, Silva PVS, Falquetti LL, da Cunha THA, Deminice TMM, Tambellini TH, de Souza GCA, de Oliveira MM, Nogueira‐Pileggi V, Matsumoto MT, Priami C, Kaput J, Monteiro JP. Clinical and Vitamin Response to a Short-Term Multi-Micronutrient Intervention in Brazilian Children and Teens: From Population Data to Interindividual Responses. Mol Nutr Food Res 2018; 62:e1700613. [PMID: 29368422 PMCID: PMC6120145 DOI: 10.1002/mnfr.201700613] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/02/2017] [Indexed: 12/11/2022]
Abstract
SCOPE Micronutrients are in small amounts in foods, act in concert, and require variable amounts of time to see changes in health and risk for disease. These first principles are incorporated into an intervention study designed to develop new experimental strategies for setting target recommendations for food bioactives for populations and individuals. METHODS AND RESULTS A 6-week multivitamin/mineral intervention is conducted in 9-13 year olds. Participants (136) are (i) their own control (n-of-1); (ii) monitored for compliance; (iii) measured for 36 circulating vitamin forms, 30 clinical, anthropometric, and food intake parameters at baseline, post intervention, and following a 6-week washout; and (iv) had their ancestry accounted for as modifier of vitamin baseline or response. The same intervention is repeated the following year (135 participants). Most vitamins respond positively and many clinical parameters change in directions consistent with improved metabolic health to the intervention. Baseline levels of any metabolite predict its own response to the intervention. Elastic net penalized regression models are identified, and significantly predict response to intervention on the basis of multiple vitamin/clinical baseline measures. CONCLUSIONS The study design, computational methods, and results are a step toward developing recommendations for optimizing vitamin levels and health parameters for individuals.
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Affiliation(s)
| | | | - Marie‐Pier Scott‐Boyer
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
| | - Sébastien Lacroix
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
| | - Melissa J. Morine
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
- Department of MathematicsUniversity of TrentoTrentoItaly
| | - Roberta Garcia Salomão
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | - Elaine Hillesheim
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nelly Conus
- Nestlé Institute of Health SciencesLausanneSwitzerland
| | | | | | | | - Mariana Mendes Muniz
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | - Vinícius Paula Venâncio
- School of Pharmaceutical Science of Ribeirao PretoUniversity of São PauloRibeirao PretoBrazil
| | | | | | - Taís Fontellas Laurito
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Isabela Ribeiro Rossi
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Raquel Ricci
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Jéssica Ré Jorge
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Mayara Leite Fagá
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | - Letícia Lima Falquetti
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | | | | | - Vicky Nogueira‐Pileggi
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | - Corrado Priami
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
- Department of MathematicsUniversity of TrentoTrentoItaly
| | - Jim Kaput
- Nestlé Institute of Health SciencesLausanneSwitzerland
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Diversity and inclusion in genomic research: why the uneven progress? J Community Genet 2017; 8:255-266. [PMID: 28770442 PMCID: PMC5614884 DOI: 10.1007/s12687-017-0316-6] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/29/2017] [Indexed: 12/15/2022] Open
Abstract
Conducting genomic research in diverse populations has led to numerous advances in our understanding of human history, biology, and health disparities, in addition to discoveries of vital clinical significance. Conducting genomic research in diverse populations is also important in ensuring that the genomic revolution does not exacerbate health disparities by facilitating discoveries that will disproportionately benefit well-represented populations. Despite the general agreement on the need for genomic research in diverse populations in terms of equity and scientific progress, genomic research remains largely focused on populations of European descent. In this article, we describe the rationale for conducting genomic research in diverse populations by reviewing examples of advances facilitated by their inclusion. We also explore some of the factors that perpetuate the disproportionate attention on well-represented populations. Finally, we discuss ongoing efforts to ameliorate this continuing bias. Collaborative and intensive efforts at all levels of research, from the funding of studies to the publication of their findings, will be necessary to ensure that genomic research does not conserve historical inequalities or curtail the contribution that genomics could make to the health of all humanity.
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Wells JCK. Body composition and susceptibility to type 2 diabetes: an evolutionary perspective. Eur J Clin Nutr 2017; 71:881-889. [PMID: 28352118 DOI: 10.1038/ejcn.2017.31] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes is rapidly increasing in prevalence worldwide, in concert with epidemics of obesity and sedentary behavior that are themselves tracking economic development. Within this broad pattern, susceptibility to diabetes varies substantially in association with ethnicity and nutritional exposures through the life-course. An evolutionary perspective may help understand why humans are so prone to this condition in modern environments, and why this risk is unequally distributed. A simple conceptual model treats diabetes risk as the function of two interacting traits, namely 'metabolic capacity' which promotes glucose homeostasis, and 'metabolic load' which challenges glucose homoeostasis. This conceptual model helps understand how long-term and more recent trends in body composition can be considered to have shaped variability in diabetes risk. Hominin evolution appears to have continued a broader trend evident in primates, towards lower levels of muscularity. In addition, hominins developed higher levels of body fatness, especially in females in relative terms. These traits most likely evolved as part of a broader reorganization of human life history traits in response to growing levels of ecological instability, enabling both survival during tough periods and reproduction during bountiful periods. Since the emergence of Homo sapiens, populations have diverged in body composition in association with geographical setting and local ecological stresses. These long-term trends in both metabolic capacity and adiposity help explain the overall susceptibility of humans to diabetes in ways that are similar to, and exacerbated by, the effects of nutritional exposures during the life-course.
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Affiliation(s)
- J C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
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Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010-2014. Nutrients 2017; 9:nu9030256. [PMID: 28287410 PMCID: PMC5372919 DOI: 10.3390/nu9030256] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 01/22/2023] Open
Abstract
The aims of this study were to assess the diagnostic value of the weight-to-height ratio (WHtR) for the detection of obesity and metabolic syndrome (MS) in Korean children and adolescents, and to determine the advantages of WHtR as a population-based screening tool in comparison with other obesity indicators, such as body mass index (BMI) and waist circumference (WC). We performed a cross-sectional analysis of data from 3057 children and adolescents (1625 boys, 1332 girls) aged 10-19 years who were included in the fifth Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2012) up to the second year of the sixth KNHANES (2013-2014). Receiver operation characteristic (ROC) curves were generated to determine the optimal cutoff value and accuracy of WHtR for predicting individual obesity indicators or more than two non-WC components of MS. The area under the ROC curve (AUC) is a measure of the diagnostic power of a test. A perfect test will have an AUC of 1.0, and an AUC equal to 0.5 means that the test performs no better than chance. The optimal WHtR cutoff for the evaluation of general obesity and central obesity was 0.50 in boys and 0.47-0.48 in girls, and the AUC was 0.9. Regarding the assessment of each MS risk factor, the optimal WHtR cutoff was 0.43-0.50 in boys and 0.43-0.49 in girls, and these cutoffs were statistically significant only for the detection of high triglyceride and low High-density lipoprotein (HDL) cholesterol levels. When a pairwise comparison of the AUCs was conducted between WHtR and BMI/WC percentiles to quantify the differences in power for MS screening, the WHtR AUC values (boys, 0.691; girls, 0.684) were higher than those of other indices; however, these differences were not statistically significant (boys, p = 0.467; girls, p = 0.51). The WHtR cutoff value was 0.44 (sensitivity, 67.7%; specificity, 64.6%) for boys and 0.43 (sensitivity, 66.4%; specificity, 66.9%) for girls. There was no significant difference between the diagnostic power of WHtR and that of BMI/WC when screening for MS. Although the use of WHtR was not superior, WHtR is still useful as a screening tool for metabolic problems related to obesity because of its convenience.
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Cornick JE, Teter C, K.Thaw A. Variations in Weight Stigma Concerns. Health Psychol Res 2016; 4:6003. [PMID: 28058288 PMCID: PMC5178818 DOI: 10.4081/hpr.2016.6003] [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: 05/17/2016] [Revised: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 11/30/2022] Open
Abstract
Over the past 40 years, obesity rates in the United States have grown significantly; these rates have not grown uniformly across the United States (18 of the 20 counties with the highest obesity rates are located in the South). Obesity increases cardiovascular disease risk factors and new research has highlighted the negative psychological effects of obesity, known as weight stigma, including decreased selfcontrol resources, over eating, and exercise avoidance. The primary objective of this study was to determine if weight stigma concerns varied regionally and if social behaviors influenced this variation. In two studies, we collected cross-sectional data from participants in the United States including height and weight, weight stigma concerns, and perception of friends' preoccupation with weight and dieting. We also collected each participant's home zip code which was used to locate local obesity rate. We established differences in the relationship between body mass index and weight stigma concerns by local county obesity rate and showed that perceived friend preoccupation with weight and dieting mediated this relationship for individuals in low and medium obesity rate counties. For individuals living in United States counties with lower levels of obesity, increases in personal body mass index leads to increased weight stigma concerns due to an increase in perceived friend preoccupation with weight and dieting. These results indicate that relationships between body mass index, weight stigma concerns, and social networks vary significantly for subpopulations throughout the United States.
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40
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Hruschka DJ, Hadley C. How much do universal anthropometric standards bias the global monitoring of obesity and undernutrition? Obes Rev 2016; 17:1030-1039. [PMID: 27383689 DOI: 10.1111/obr.12449] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 12/15/2022]
Abstract
Each year, hundreds of articles in population health and nutrition, many in high-profile journals, use standard cutoffs based on weight and height as assessments of obesity and undernutrition. These global efforts to monitor overweight and underweight often rest on the assumption that ethnic differences in underlying body form are sufficiently small to permit universal anthropometric cutoffs for comparing excess and insufficient body fat across populations. However, a century of work in human biological variation suggests that human populations can vary dramatically in underlying body form in a way that may require population-sensitive cutoffs for monitoring. Here, we describe recently developed methods that can provide population-sensitive assessments of both excess and insufficient energy reserves in a wide range of countries. We use this approach to illustrate how worldwide variation in human body form is far more widespread than previously thought, and that it can occur at several geographic scales, including the level of world regions, countries and populations within countries. The findings also suggest that using standard cutoffs that ignore this variation can underestimate current obesity levels in adults by more than 400-500 million while also incorrectly prioritizing high-risk areas for undernutrition in children in key regions around the world.
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Affiliation(s)
- D J Hruschka
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
| | - C Hadley
- Anthropology Department, Emory University, Decatur, GA, USA
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Kazlauskaite R, Avery-Mamer EF, Li H, Chataut CP, Janssen I, Powell LH, Kravitz HM. Race/ethnic comparisons of waist-to-height ratio for cardiometabolic screening: The study of women's health across the nation. Am J Hum Biol 2016; 29. [PMID: 27801534 DOI: 10.1002/ajhb.22909] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/16/2016] [Accepted: 08/06/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To compare the performance of waist-to-height ratio as a screening tool for cardiometabolic conditions - hypertension, prediabetes/diabetes, dyslipidemia, and subclinical inflammation - in 5 race/ethnic groups of mid-life women. METHODS Waist-to-height ratio and 4 cardiometabolic conditions were assessed in 3033 premenopausal midlife women (249 Hispanic, 226 Chinese, 262 Japanese, 1435 European-American, and 861 African American). The areas under the receiver operating characteristic curve (AUROC) were compared across the five race/ethnic groups using waist-to-height ratio to determine the likelihood of the four cardiometabolic conditions. RESULTS The performance of waist-to-height ratio to detect one or more cardiometabolic conditions was comparable among all race/ethnic groups (AUROC > 0.60, p = 0.252), and was good/fair (AUROC > 0.60) when hypertension, prediabetes/diabetes, dyslipidemia, or subclinical inflammation were analyzed separately. The performance of waist-to-height ratio of 0.50 was skewed towards higher specificity among groups with low prevalence of cardiometabolic conditions and lower median waist-to-height ratio, and towards higher sensitivity among groups with high prevalence of cardiometabolic conditions and higher median waist-to-height ratio. CONCLUSIONS Waist-to-height ratio can be used for community-based screening of mid-life women who may need secondary prevention for cardiometabolic conditions. A simple public health message: "Keep your waist to less than half of your height" applies to midlife women.
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Affiliation(s)
- Rasa Kazlauskaite
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.,Department of Medicine, Rush University Medical Center, Chicago, IL
| | | | - Hong Li
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Chandra P Chataut
- Department of Medicine, Rush University Medical Center, Chicago, IL.,Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, IL
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Lynda H Powell
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.,Department of Psychiatry, Rush University Medical Center, Chicago, IL
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Body composition and the monitoring of non-communicable chronic disease risk. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2016; 1:e18. [PMID: 29868210 PMCID: PMC5870426 DOI: 10.1017/gheg.2016.9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/17/2022]
Abstract
There is a need for simple proxies of health status, in order to improve monitoring of chronic disease risk within and between populations, and to assess the efficacy of public health interventions as well as clinical management. This review discusses how, building on recent research findings, body composition outcomes may contribute to this effort. Traditionally, body mass index has been widely used as the primary index of nutritional status in children and adults, but it has several limitations. We propose that combining information on two generic traits, indexing both the ‘metabolic load’ that increases chronic non-communicable disease risk, and the homeostatic ‘metabolic capacity’ that protects against these diseases, offers a new opportunity to improve assessment of disease risk. Importantly, this approach may improve the ability to take into account ethnic variability in chronic disease risk. This approach could be applied using simple measurements readily carried out in the home or community, making it ideal for M-health and E-health monitoring strategies.
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Kramer CK, Hamilton JK, Ye C, Hanley AJ, Connelly PW, Sermer M, Zinman B, Retnakaran R. Differential impact of maternal and paternal ethnicity on the pattern of fat distribution in infants at age 3 months. Pediatr Obes 2016; 11:11-7. [PMID: 25676072 DOI: 10.1111/ijpo.12012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 11/24/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND As ethnicity is typically recorded as a single demographic variable in clinical studies, little is known about the relative impact of maternal vs. paternal ethnicity on fat distribution. OBJECTIVES The objective of this study was to determine whether there is a differential impact of maternal and paternal ethnicity on infant adiposity. METHODS Three hundred fifty-five infants underwent anthropometric assessment at age 3 months, including skin-fold thickness (SFT) measurement at subscapular, suprailiac and triceps. Maternal (M) and paternal (P) ethnicity were classified as white (M = 241, P = 252), Asian (M = 50, P = 42) or other (M = 64, P = 61). RESULTS Infants with either Asian mother (compared with white) or Asian father (compared with white) had increased subscapular, suprailiac and triceps SFT (all P < 0.05). On logistic regression analysis, however, only maternal Asian ethnicity (compared with white) independently predicted the likelihood of an infant being in the highest tertile for SFT at subscapular (odds ratio [OR] = 2.72, 95% confidence interval 1.17-6.34, P = 0.02), suprailiac (OR = 3.56, 1.51-8.42, P = 0.004) and triceps (OR = 3.26, 1.40-7.55, P = 0.005). In contrast, paternal Asian ethnicity was independently associated with sum of SFT only (OR = 2.46, 1.02-5.97, P = 0.04). CONCLUSION Maternal and paternal Asian ethnicity have differential effects on infant fat distribution. Future clinical studies on obesity and fat composition should consider the distinct contributions of both parents to the ethnic classification of participants.
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Affiliation(s)
- C K Kramer
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.,Division of Endocrinology, University of Toronto, Toronto, Canada
| | - J K Hamilton
- Hospital for Sick Children, Department of Pediatrics, Toronto, Canada
| | - C Ye
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
| | - A J Hanley
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.,Division of Endocrinology, University of Toronto, Toronto, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - P W Connelly
- Division of Endocrinology, University of Toronto, Toronto, Canada.,Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada
| | - M Sermer
- Division of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | - B Zinman
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.,Division of Endocrinology, University of Toronto, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - R Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.,Division of Endocrinology, University of Toronto, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
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Busetto L, Dixon J, De Luca M, Shikora S, Pories W, Angrisani L. Bariatric surgery in class I obesity : a Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg 2015; 24:487-519. [PMID: 24638958 DOI: 10.1007/s11695-014-1214-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Class I obesity conveys an increased risk of comorbidities, impairs physical and mental health-related quality of life, and it is associated to an increased psychosocial burden, particularly in women. The need for effective and safe therapies for class I obesity is great and not yet met by nonsurgical approaches. Eligibility to bariatric surgery has been largely based on body mass index (BMI) cut points and limited to patients with more severe obesity levels. However, obese patients belonging to the same BMI class may have very different levels of health, risk, and impact of obesity on quality of life. Individual patients in class I obesity may have a comorbidity burden similar to, or greater than, patients with more severe obesity. Therefore, the denial of bariatric surgery to a patient with class I obesity suffering from a significant obesity-related health burden and not achieving weight control with nonsurgical therapy simply on the basis of the BMI level does not appear to be clinically justified. A clinical decision should be based on a more comprehensive evaluation of the patient's current global health and on a more reliable prediction of future morbidity and mortality. After a careful review of available data about safety and efficacy of bariatric surgery in patients with class I obesity, this panel reached a consensus on ten clinical recommendations.
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Affiliation(s)
- Luca Busetto
- Department of Medicine, University of Padua, Padua, Italy,
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Shen T, Shu XO, Xiang YB, Li HL, Cai H, Gao YT, Zheng W, Lipworth L. Association of hypertension and obesity with renal cell carcinoma risk: a report from the Shanghai Men's and Women's Health Studies. Cancer Causes Control 2015; 26:1173-80. [PMID: 26081424 DOI: 10.1007/s10552-015-0611-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 06/02/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Consistently reported associations between hypertension and obesity and renal cell carcinoma (RCC) risk have largely come from studies in Western populations. These associations were examined in a case-control study nested in the Shanghai Women's Health Study (SWHS, 1996-2000) and Shanghai Men's Health Study (SMHS, 2001-2006). METHODS Overall, 271 incident RCC cases (124 women, 147 men) were identified through 31 December 2011, and 2,693 controls were individually matched by sex, age, and calendar time at cohort enrollment, and menopausal status (for women). Participants completed a structured questionnaire by in-person interview at baseline, and conditional logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS Self-reported hypertension was associated with a significant 40 % increased risk of RCC among women and men (95 % CI 1.1, 1.9). Body mass index (BMI), modeled continuously, was associated with an elevated risk of RCC among men, with an OR of 1.5 (95 % CI 1.1, 2.0) per 5 kg/m(2) increase in BMI, but not among women. CONCLUSIONS Hypertension is independently associated with risk of RCC among both women and men in Shanghai, while overweight and obesity appear to be associated with risk of RCC in Chinese men only.
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Affiliation(s)
- Tian Shen
- Division of Epidemiology, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 800, Nashville, TN, 37203-1738, USA
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Wells JCK, Stocks J, Bonner R, Raywood E, Legg S, Lee S, Treleaven P, Lum S. Acceptability, Precision and Accuracy of 3D Photonic Scanning for Measurement of Body Shape in a Multi-Ethnic Sample of Children Aged 5-11 Years: The SLIC Study. PLoS One 2015; 10:e0124193. [PMID: 25919034 PMCID: PMC4412635 DOI: 10.1371/journal.pone.0124193] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/29/2015] [Indexed: 11/18/2022] Open
Abstract
Background Information on body size and shape is used to interpret many aspects of physiology, including nutritional status, cardio-metabolic risk and lung function. Such data have traditionally been obtained through manual anthropometry, which becomes time-consuming when many measurements are required. 3D photonic scanning (3D-PS) of body surface topography represents an alternative digital technique, previously applied successfully in large studies of adults. The acceptability, precision and accuracy of 3D-PS in young children have not been assessed. Methods We attempted to obtain data on girth, width and depth of the chest and waist, and girth of the knee and calf, manually and by 3D-PS in a multi-ethnic sample of 1484 children aged 5–11 years. The rate of 3D-PS success, and reasons for failure, were documented. Precision and accuracy of 3D-PS were assessed relative to manual measurements using the methods of Bland and Altman. Results Manual measurements were successful in all cases. Although 97.4% of children agreed to undergo 3D-PS, successful scans were only obtained in 70.7% of these. Unsuccessful scans were primarily due to body movement, or inability of the software to extract shape outputs. The odds of scan failure, and the underlying reason, differed by age, size and ethnicity. 3D-PS measurements tended to be greater than those obtained manually (p<0.05), however ranking consistency was high (r2>0.90 for most outcomes). Conclusions 3D-PS is acceptable in children aged ≥5 years, though with current hardware/software, and body movement artefacts, approximately one third of scans may be unsuccessful. The technique had poorer technical success than manual measurements, and had poorer precision when the measurements were viable. Compared to manual measurements, 3D-PS showed modest average biases but acceptable limits of agreement for large surveys, and little evidence that bias varied substantially with size. Most of the issues we identified could be addressed through further technological development.
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Affiliation(s)
- Jonathan C. K. Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
- * E-mail:
| | - Janet Stocks
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
| | - Rachel Bonner
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
| | - Emma Raywood
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
| | - Sarah Legg
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
| | - Simon Lee
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
| | - Philip Treleaven
- UCL Department of Computer Science, Malet Place, London, United Kingdom
| | - Sooky Lum
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, United Kingdom
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Ethnic variability in body size, proportions and composition in children aged 5 to 11 years: is ethnic-specific calibration of bioelectrical impedance required? PLoS One 2014; 9:e113883. [PMID: 25478928 PMCID: PMC4257615 DOI: 10.1371/journal.pone.0113883] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/31/2014] [Indexed: 11/22/2022] Open
Abstract
Background Bioelectrical Impedance Analysis (BIA) has the potential to be used widely as a method of assessing body fatness and composition, both in clinical and community settings. BIA provides bioelectrical properties, such as whole-body impedance which ideally needs to be calibrated against a gold-standard method in order to provide accurate estimates of fat-free mass. UK studies in older children and adolescents have shown that, when used in multi-ethnic populations, calibration equations need to include ethnic-specific terms, but whether this holds true for younger children remains to be elucidated. The aims of this study were to examine ethnic differences in body size, proportions and composition in children aged 5 to 11 years, and to establish the extent to which such differences could influence BIA calibration. Methods In a multi-ethnic population of 2171 London primary school-children (47% boys; 34% White, 29% Black African/Caribbean, 25% South Asian, 12% Other) detailed anthropometric measurements were performed and ethnic differences in body size and proportion were assessed. Ethnic differences in fat-free mass, derived by deuterium dilution, were further evaluated in a subsample of the population (n = 698). Multiple linear regression models were used to calibrate BIA against deuterium dilution. Results In children <11 years of age, Black African/Caribbean children were significantly taller, heavier and had larger body size than children of other ethnicities. They also had larger waist and limb girths and relatively longer legs. Despite these differences, ethnic-specific terms did not contribute significantly to the BIA calibration equation (Fat-free mass = 1.12+0.71*(height2/impedance)+0.18*weight). Conclusion Although clear ethnic differences in body size, proportions and composition were evident in this population of young children aged 5 to 11 years, an ethnic-specific BIA calibration equation was not required.
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Rush EC, Obolonkin V, Battin M, Wouldes T, Rowan J. Body composition in offspring of New Zealand women: ethnic and gender differences at age 1-3 years in 2005-2009. Ann Hum Biol 2014; 42:498-503. [PMID: 25248609 DOI: 10.3109/03014460.2014.959999] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND In multi-ethnic New Zealand the prevalence of obesity and diabetes is increasing and varies by ethnic group. AIM This study explored ethnic and gender differences in body composition in offspring of women treated for gestational diabetes in the metformin in gestational diabetes (MiG) trial. SAMPLE AND METHODS Total and regional body composition measured by dual X-ray absorptiometry were investigated in European, Indian, Polynesian and "Other" children aged 2 years (48 boys; 56 girls). RESULTS By ethnicity, boys were not different by height or weight. Compared with European girls, Indian girls weighed less (2.3 ± 0.58 kg) and Polynesian (1.13 ± 0.53 kg) more, but percentage body fat was not different. Adjusted for age, height and weight boys had less total and appendicular fat and higher abdominal fat mass and total bone mineral density than girls (p < 0.001). Adjusted for age, weight and height Indian boys had more fat in the central and abdominal regions and less total lean mass than European boys (p < 0.05). CONCLUSION These measurements provide early evidence for gender and ethnic differences in the distribution of fat and might help identify who is most likely to benefit from intervention in the first few years of life to reduce risk of chronic disease including diabetes.
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Affiliation(s)
- Elaine C Rush
- a Centre for Child Health Research, Faculty of Health and Environmental Sciences, AUT University , Auckland , New Zealand
| | - Victor Obolonkin
- a Centre for Child Health Research, Faculty of Health and Environmental Sciences, AUT University , Auckland , New Zealand
| | - Malcolm Battin
- b Newborn Services, National Women's Health, Auckland City Hospital , Auckland , New Zealand
| | - Trecia Wouldes
- c Department of Psychological Medicine , University of Auckland , Auckland , New Zealand , and
| | - Janet Rowan
- d Department of Obstetrics , National Women's Health , Auckland , New Zealand
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Albrecht SS, Barquera S, Popkin BM. Exploring secular changes in the association between BMI and waist circumference in Mexican-origin and white women: a comparison of Mexico and the United States. Am J Hum Biol 2014; 26:627-34. [PMID: 24917415 PMCID: PMC4138229 DOI: 10.1002/ajhb.22573] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/29/2014] [Accepted: 05/28/2014] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES BMI and waist circumference (WC) tend to be highly correlated, but changes in lifestyle behaviors may promote greater accumulation of abdominal fat for the same BMI in recent years. We examined secular shifts in BMI and WC distributions, and investigated whether WC for a given BMI has changed over time among Mexican-origin women in Mexico and the US, and in US white women as a comparison. METHODS Nationally representative surveys for women aged 20-49 years from Mexico (1988, 1999, and 2012) (n = 37,116) and the US (1988-1994, 1999-2002, and 2007-2010) (n = 6,985) were used. Quantile regressions estimated age-adjusted changes in BMI and WC across years; linear regression tested changes in mean WC over time, adjusting for age and BMI. RESULTS In all women, BMI and WC at most centiles increased over time. WC was also significantly higher over time for the same BMI, though the increase was largest in Mexican women. For example, WC was 6.7 cm (standard error (SE): 0.17, P < 0.0001) higher in 2012 than in 1999 among Mexican women, holding age and BMI constant. Estimates were smaller in magnitude for Mexican-American and white women (∼3 cm, P < 0.01), even when comparing over a longer timeframe (1988-1994 to 2007-2010). In all groups, WC adjusted for BMI increased to a larger extent among younger cohorts. CONCLUSION WC for the same BMI has increased in Mexican-American, white, and Mexican women of reproductive age. These patterns may have implications for future cardio-metabolic burden in Mexico and the US.
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Affiliation(s)
- Sandra S. Albrecht
- 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
| | | | - Barry M. Popkin
- 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
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Ibáñez L, Ong KK, López-Bermejo A, Dunger DB, de Zegher F. Hyperinsulinaemic androgen excess in adolescent girls. Nat Rev Endocrinol 2014; 10:499-508. [PMID: 24776733 DOI: 10.1038/nrendo.2014.58] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Hyperinsulinaemic androgen excess is the most common cause of hirsutism, acne and menstrual irregularity in adolescent girls. Here, we propose that the disorder frequently originates from an absolute or relative excess of lipids in adipose tissue, and from associated changes in insulin sensitivity, gonadotropin secretion and ovarian androgen release. Girls from populations with genotypes attuned to nutritionally harsh conditions seem to be particularly vulnerable to the development of hyperinsulinaemic androgen excess in today's obesogenic environment. We propose that hirsutism, hyperandrogenaemia and menstrual irregularity (≥2 years after menarche) is used as a diagnostic triad for the disorder. No pharmacological therapy has been approved for girls with androgen excess; however, lifestyle intervention is essential to reduce adiposity. In girls without obesity who are not sexually active, insulin sensitization has more broadly normalizing effects than estradiol-progestogen combinations. The early recognition of girls at risk of developing hyperinsulinaemic androgen excess might enable prevention in childhood.
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Affiliation(s)
- Lourdes Ibáñez
- Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Ken K Ong
- MRC Epidemiology Unit, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Abel López-Bermejo
- Paediatric Endocrinology, Dr Josep Trueta Hospital and Girona Institute for Biomedical Research, Avenue de França s/n, 17007 Girona, Spain
| | - David B Dunger
- Department of Paediatrics, Box 116, Level 8, Addenbrooke's Hospital Hills Road, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Francis de Zegher
- Paediatric Endocrinology, University Hospital Gasthuisberg, University of Leuven, Herestraat 49, 3000 Leuven, Belgium
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