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Zhang Z, Lv D, You Y, Zhao Z, Hu W, Xie F, Lin Y, Xie W, Wu X. Assessing the importance of risk factors for diabetic retinopathy in patients with type 2 diabetes mellitus: Results from the classification and regression tree models. J Family Community Med 2024; 31:197-205. [PMID: 39176009 PMCID: PMC11338385 DOI: 10.4103/jfcm.jfcm_354_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/11/2024] [Accepted: 05/30/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the serious complications of diabetes mellitus (DM). Many studies have identified the risk factors associated with DR, but there is not much evidence on the importance of these factors for DR. This study aimed to investigate the associated factors for patients with type 2 DM (T2DM) and calculate the importance of the identified factors. MATERIALS AND METHODS Using probability proportionate to size sampling method in this community-based cross-sectional study, 22 community health service centers were selected from 10 administrative districts in Shenzhen, China. Approximately 60 T2DM patients were recruited from each center. The participants completed a structural questionnaire, had their venous blood collected, and underwent medical examinations and fundus photography. Logistic regression models were used to identify the risk factors of DR. The classification and regression tree (CART) model was used to calculate the importance of the identified risk factors. RESULTS This study recruited 1097 T2DM patients, 266 of whom were identified as having DR, yielding a prevalence rate of 24.3% (95% confidence interval [CI]: 21.7%-26.9%). Results showed that a longer duration of DM, indoor-type lifestyle, and higher levels of hemoglobin A1c (HbA1c) or urea increased the risk of DR. Patients with HbA1c values ≥7% were about 2.45 times (odds ratio: 2.45; 95% CI: 1.83-3.29) more likely to have DR than their counterparts. The CART model found that the values of variable importance for HbA1c, DM duration, lifestyle (i.e., indoor type), and urea were 48%, 37%, 10%, and 4%, respectively. CONCLUSION The prevalence of DR is high for T2DM patients who receive DM health management services from the primary healthcare system. HbA1c is the most important risk factor for DR. Integration of DR screening and HbA1c testing into the healthcare services for T2DM to reduce vision impairment and blindness is urgently warranted.
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Affiliation(s)
- Ziyang Zhang
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Deliang Lv
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Yueyue You
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Zhiguang Zhao
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Wei Hu
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Fengzhu Xie
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Yali Lin
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Wei Xie
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Xiaobing Wu
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
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Cheung CY, Zhang XJ, Chan HN, Zhang Y, Yuen VL, Hsu W, Lee ML, Xu D, Wong J, Tang FY, Kam KW, Young A, Ng MP, Ip P, Chen LJ, Wong TY, Pang CP, Tham CC, Yam JC. Influence of secondhand smoke exposure on the retinal vasculature of children in Hong Kong. COMMUNICATIONS MEDICINE 2023; 3:155. [PMID: 37884789 PMCID: PMC10603154 DOI: 10.1038/s43856-023-00389-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND A recent prospective demonstrated that cardiovascular risk factors in early childhood were associated with later cardiovascular events. However, the impact of secondhand smoke (SHS) on children is unclear. The aims of this study is to determine the effects of SHS exposure on the retinal vasculature of children. METHODS This is a population-based cross-sectional study of children aged 6 to 8 years. All participants received comprehensive ophthalmic examinations and retinal photography. Data on SHS exposure was derived from a validated questionnaire. A validated deep-learning system was used to automatically estimate retinal arteriolar and venular calibers from retinal photographs. Associations of quantitative retinal vessel caliber values with SHS exposure, number of smokers in the household, and total number of cigarettes smoked were determined by analyses of covariance (ANCOVA) after adjusting for potential confounders. Test of trend was determined by treating categorical risk factors as continuous ordinal variables. RESULTS Here we show children exposed to SHS have wider retinal arteriolar (CRAE 152.1 µm vs. 151.3 µm, p < 0.001) and venular (CRVE 216.7 µm vs. 215.5 µm, p < 0.001) calibers compared to those in smoke-free homes, after adjustment for different factors. Wider arteriolar and venular calibers are also associated with increasing number of smokers in the family (p trend < 0.001) and more cigarettes smoked among family smokers (p trend<0.001). CONCLUSIONS Exposure to SHS at home is associated with changes in retinal vasculature among children. This reinforces the adverse effect of secondhand smoking around children though further research incorporating comprehensive assessment of potential confounders is necessary.
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Affiliation(s)
- Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hei-Nga Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Vincent L Yuen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wynne Hsu
- School of Computing, National University of, Singapore, Singapore
| | - Mong Li Lee
- School of Computing, National University of, Singapore, Singapore
| | - Dejiang Xu
- School of Computing, National University of, Singapore, Singapore
| | - Jason Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kai Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Alvin Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Mandy P Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
- Tsinghua Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China.
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China.
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Harrington S, O'Dwyer V. The association between time spent on screens and reading with myopia, premyopia and ocular biometric and anthropometric measures in 6- to 7-year-old schoolchildren in Ireland. Ophthalmic Physiol Opt 2023; 43:505-516. [PMID: 36843144 DOI: 10.1111/opo.13116] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE More time spent on near tasks has consistently been associated with the promotion of myopia. The World Health Organization advises limiting daily screentime to less than 2 h for children aged five and over. This study explored the relationship between time spent on screens and reading/writing with refractive status, ocular biometric and anthropometric factors in 6- to 7-year-olds in Ireland. METHODS Participants were 723 schoolchildren (377 boys [51.8%]), mean age 7.08 (0.45) years. The examination included cycloplegic autorefraction (1% cyclopentolate hydrochloride), ocular biometry (Zeiss IOLMaster), height (cm) and weight (kg). Screentime and reading/writing time were reported by parents/legal guardians by questionnaire. Myopia (≤-0.50D) and premyopia (>-0.50D ≤ 0.75D) risk assessments were performed using logistic regression, and multivariate linear regression was used to analyse continuous variables. RESULTS Reported daily screentimes were 31% <1 h, 49.5% 1-2 h, 15.6% 2-4 h and 3.9% >4 h. Reading/writing times were 42.2% frequently, 48.0% infrequently and 9.8% seldom/never. Linear regression, controlling for age and ethnicity, revealed >2 h/day on screens was associated with a more myopic spherical equivalent [β = -1.15 (95% confidence intervals {CIs}: 1.62-0.69, p < 0.001)], increased refractive astigmatism (β = 0.29, CI: 0.06-0.51, p = 0.01), shorter corneal radius (β = 0.12, CI: 0.02-0.22, p = 0.02), higher axial length/corneal radius (β = 0.06, CI: 0.03-0.09, p < 0.001), heavier weight (β = 1.60, CI: 0.76-2.45, p < 0.001) and higher body mass index (BMI) (β = 1.10, CI: 0.28-1.12, p < 0.001). Logistic regression, controlling for age and ethnicity, revealed daily screentime >2 h was associated with myopia (OR = 10.9, CI: 4.4-27.2, p = 0.01) and premyopia (OR = 2.4, CI: 1.5-3.7, p < 0.001). Frequent reading/writing was associated with screentime ≤2 h/day (OR = 3.2, CI: 1.8-5.8, p < 0.001). CONCLUSION Increased screentime was associated with a more myopic refraction, higher axial length/corneal radius ratio, increased odds of myopia, premyopia, higher degrees of astigmatism, increased weight, BMI and decreased reading/writing time. Dedicated education programmes promoting decreased screentime in children are vital to prevent myopia and support eye and general health.
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Affiliation(s)
- Síofra Harrington
- School of Physics, Clinical, and Optometric Sciences, and Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Veronica O'Dwyer
- School of Physics, Clinical, and Optometric Sciences, and Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
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Liu G, Jiang A, Cao L, Ling S, Wang X, Bu S, Lu F. Optic disc and retinal vascular features in first 6 years of Chinese children. Front Pediatr 2023; 11:1101768. [PMID: 37033190 PMCID: PMC10077150 DOI: 10.3389/fped.2023.1101768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/23/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose Retinal microvasculature plays an important role in children's fundus lesions and even in their later life. However, little was known on the features of normal retina in early life. The purpose of this study was to explore the normal retinal features in the first 6 years of life and provide information for future research. Methods Children, aged from birth to 6 years old and diagnosed with various unilateral ocular diseases were included. Venous phase fundus fluorescein angiography images with the optic disc at the center were collected. Based on the ResUNet convolutional neural network, optic disc and retinal vascular features in the posterior retina were computed automatically. Results A total of 146 normal eyes of 146 children were included. Among different age groups, no changes were shown in the optic disc diameter (y = -0.00002x + 1.362, R2 = 0.025, p = 0.058). Retinal vessel density and fractal dimension are linearly and strongly correlated (r = 0.979, p < 0.001). Older children had smaller value of fractal dimension (y = -0.000026x + 1.549, R2 = 0.075, p = 0.001) and narrower vascular caliber if they were less than 3 years old (y = -0.008x + 84.861, R2 = 0.205, p < 0.001). No differences were in the density (y = -0.000007x + 0.134, R2 = 0.023, p = 0.067) and the curvature of retinal vessels (lnC = -0.00001x - 4.657, R2 = 0.001, p = 0.667). Conclusions Age and gender did not impact the optic disc diameter, vessel density, and vessel curvature significantly in this group of children. Trends of decreased vessel caliber in the first 3 years of life and decreased vessel complexity with age were observed. The structural characteristics provide information for future research to better understand the developmental origin of the healthy and diseased retina.
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Affiliation(s)
- Guina Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Anna Jiang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Le Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Saiguang Ling
- EVision Technology (Beijing) Co. LTD, Beijing, China
| | - Xi Wang
- EVision Technology (Beijing) Co. LTD, Beijing, China
| | - Shaochong Bu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- Correspondence: Shaochong Bu Fang Lu
| | - Fang Lu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Correspondence: Shaochong Bu Fang Lu
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Li DL, Zhou M, Pan CW, Chen DD, Liu MJ. Unhealthy Lifestyles and Retinal Vessel Calibers among Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2022; 15:nu15010150. [PMID: 36615807 PMCID: PMC9824413 DOI: 10.3390/nu15010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
The retinal vessel caliber (RVC) is an important biomarker of cardiovascular diseases, which can be semi-automatically measured by fundus photography. This review investigated the associations between the RVCs and the life styles of early life, such as physical activity (PA), sedentary behavior (SB), dietary and sleep, by summarizing the findings from studies on children and adolescents. Two databases (Medline and Embase) were searched from their inception to 30 June 2022. The selected studies were literatures on observational designs, fundus photographs, retinal vessels and lifestyles of children or adolescents. Correlation coefficients of unhealthy life styles and RVCs were transformed to Fisher's z-scores, and the random-effects model was applied to pool data. A total of 18 observational studies were selected; the lifestyles accessed include 9 studies for PA and SB, 8 studies for dietary and 1 study for sleep. The meta-analysis on the correlation coefficients of regression models found the high level of SB (qualified by screen time, ST) was associated the narrower central retinal arteriolar equivalent (CRAE) among children (r = -0.043, 95% confidence intervals [CI] -0.078 to -0.009). By comparing the first and fourth quartiles of PA, the meta-analysis showed that more indoor PA was associated with smaller venular calibers and more outdoor PA was associated with wider CRAE (r = 0.88, 95%CI -3.33 to 0). Unhealthy lifestyles might be harmful on the retinal microcirculation among children and adolescents but their health effect seems not to be as significant as those in adults.
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Affiliation(s)
- Dan-Lin Li
- School of Public Health, Medical of Soochow University, Suzhou 215123, China
| | - Miao Zhou
- Department of Ophthalmology, Peking University People’s Hospital, Beijing 100034, China
| | - Chen-Wei Pan
- School of Public Health, Medical of Soochow University, Suzhou 215123, China
| | - Dan-Dan Chen
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
- Correspondence: (D.-D.C.); (M.-J.L.); Tel.: +86-187-0250-5070 (M.-J.L.)
| | - Meng-Jiao Liu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China
- Correspondence: (D.-D.C.); (M.-J.L.); Tel.: +86-187-0250-5070 (M.-J.L.)
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Hanssen H. Vascular biomarkers in the prevention of childhood cardiovascular risk: From concept to clinical implementation. Front Cardiovasc Med 2022; 9:935810. [PMID: 36072878 PMCID: PMC9441864 DOI: 10.3389/fcvm.2022.935810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/02/2022] [Indexed: 02/01/2023] Open
Abstract
Vascular biomarkers allow for non-invasive assessment of vascular structure and function and have been shown to be surrogates for cardiovascular (CV) outcome in adults. They reflect the cumulative risk of a plethora of single CV risk factors, such as obesity and hypertension, on the arterial wall. The process of atherosclerosis oftentimes has its origin in childhood and tracks into adulthood. Obesity-related CV risk in childhood is a main determinant of manifest CV disease and adverse outcome in adulthood. To date, prevention strategies are directed toward the detection and reduction of CV disease in adulthood. This review updates and puts into perspective the potential use of vascular biomarkers in children. With reference to the concept of early vascular aging in adults, it elaborates on the role of vascular biomarkers for CV risk stratification in children. The concept of primordial vascular aging implies that young children be screened for vascular health, in an attempt to timely detect subclinical atherosclerosis and initiate treatment strategies to reverse vascular damage in a period of life with high probability for risk regression. The evidence for the validity of macro- and microvascular candidate biomarkers as screening tools of CV risk in children is reviewed, and limitations as well as remaining research gaps are highlighted. Furthermore, an overview on the effects of exercise treatment on vascular biomarkers is given. Vascular biomarkers susceptible to lifestyle or drug treatment have the potential to qualify as monitoring tools to guide clinicians. This review discusses evidence for vascular biomarkers to optimize screening of childhood CV risk from initial concepts to potential future clinical implementation in cardiovascular prevention.
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Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res 2022; 91:101095. [PMID: 35760749 DOI: 10.1016/j.preteyeres.2022.101095] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022]
Abstract
In the last two decades evidence has gradually accumulated suggesting that the eye may be a unique window for cardiovascular risk stratification based on the assessment of subclinical damage of retinal microvascular structure and function. This can be facilitated by non-invasive analysis of static retinal vessel diameters and dynamic recording of flicker light-induced and endothelial function-related dilation of both retinal arterioles and venules. Recent new findings have made retinal microvascular biomarkers strong candidates for clinical implementation as reliable risk predictors. Beyond a review of the current evidence and state of research, the article aims to discuss the methodological benefits and pitfalls and to identify research gaps and future directions. Above all, the potential use for screening and treatment monitoring of cardiovascular disease risk are highlighted. The article provides fundamental comprehension of retinal vessel imaging by explaining anatomical and physiological essentials of the retinal microcirculation leading to a detailed description of the methodological approach. This allows for better understanding of the underlying retinal microvascular pathology associated with the prevalence and development of cardiovascular disease. A body of new evidence is presented on the clinical validity and predictive value of retinal vessel diameters and function for incidence cardiovascular disease and outcome. Findings in children indicate the potential for utility in childhood cardiovascular disease prevention, and the efficacy of exercise interventions highlight the treatment sensitivity of retinal microvascular biomarkers. Finally, coming from the availability of normative data, solutions for diagnostic challenges are discussed and conceptual steps towards clinical implementation are put into perspective.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland.
| | - Lukas Streese
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland
| | - Walthard Vilser
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany; Neonatology and Pediatric Intensive Care Unit, Department of Pediatrics, Jena University Hospital, Jena, Germany
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Houben AJ, Stehouwer CD. Microvascular dysfunction: Determinants and treatment, with a focus on hyperglycemia. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2020.100073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Streese L, Guerini C, Bühlmayer L, Lona G, Hauser C, Bade S, Deiseroth A, Hanssen H. Physical activity and exercise improve retinal microvascular health as a biomarker of cardiovascular risk: A systematic review. Atherosclerosis 2020; 315:33-42. [DOI: 10.1016/j.atherosclerosis.2020.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023]
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Sousa‐Sá E, Zhang Z, Pereira JR, Wright IM, Okely AD, Santos R. Systematic review on retinal microvasculature, physical activity, sedentary behaviour and adiposity in children and adolescents. Acta Paediatr 2020; 109:1956-1973. [PMID: 31998981 DOI: 10.1111/apa.15204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/16/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
AIM As retinal microvasculature (RMV) can be assessed non-invasively, it presents an opportunity to examine the health and disease of the human microcirculation, as RMV alterations have been recognised as one of the earliest signs of cardiovascular risk. This review summarises current literature on the associations between physical activity (PA), sedentary behaviour (SB) and/or adiposity and RMV in children and adolescents aged 0-18 years. METHODS Six databases were searched (MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO and CINAHL), through to December 11, 2019. English, Portuguese, French, Spanish or Dutch were the languages searched. Meta-analyses were performed using the meta-analyst software. RESULTS A total of 6796 studies were screened, and 26 studies were included, representing 24 448 participants, from 12 different countries. Studies reporting results on weight status were twenty-three, PA was assessed in six studies, and SB was assessed in three studies. Four studies examined weight status and PA/SB. Meta-analysis was performed for two studies and showed that children with obesity have smaller retinal arterioles (-2.38 µm difference, 95% CI 0.62, 4.15 µm) and larger retinal venules (2.74 µm difference, 95% CI -4.78, -0.72 µm) than children without obesity. CONCLUSION Results showed that adiposity was associated with microvascular alterations in children and adolescents. Increased adiposity, lack of PA and high levels of SB were negatively correlated with vessel width parameters.
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Affiliation(s)
- Eduarda Sousa‐Sá
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Zhiguang Zhang
- Early Start University of Wollongong Wollongong NSW Australia
| | - João R. Pereira
- Early Start University of Wollongong Wollongong NSW Australia
- Research Unit for Sport and Physical Activity University of Coimbra Coimbra Portugal
| | - Ian M. Wright
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Anthony D. Okely
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Rute Santos
- Early Start University of Wollongong Wollongong NSW Australia
- Research Centre in Physical Activity, Health and Leisure University of Porto Porto Portugal
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Gall S, Walter C, du Randt R, Adams L, Joubert N, Müller I, Nqweniso S, Pühse U, Seelig H, Smith D, Steinmann P, Utzinger J, Gerber M. Changes in Self-Reported Physical Activity Predict Health-Related Quality of Life Among South African Schoolchildren: Findings From the DASH Intervention Trial. Front Public Health 2020; 8:492618. [PMID: 33102419 PMCID: PMC7555690 DOI: 10.3389/fpubh.2020.492618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/28/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: Regular physical activity is associated with multiple health benefits for children. Evidence from cross-sectional studies suggests that physical activity is positively associated with health-related quality of life (HRQoL). The promotion of physical activity, and hence HRQoL, through a school-based intervention is therefore an important endeavor, particularly in disadvantaged areas of low- and middle-income countries, including South Africa. Methods: We designed a multicomponent physical activity intervention that was implemented over a 20-week period in 2015 in eight disadvantaged primary schools of Port Elizabeth, South Africa. Overall, 758 children aged 8–13 years participated. HRQoL was measured with the 27-item KIDSCREEN questionnaire. Self-reported physical activity was assessed with a single item of the Health-Behavior of School-Aged Children test, and cardiorespiratory fitness with the 20-m shuttle run test. Post-intervention scores were predicted with mixed linear regression models, taking into consideration the clustered nature of the data. Results: Higher baseline levels as well as increasing levels of self-reported physical activity predicted all dimensions of children's HRQoL. Baseline levels and increases in cardiorespiratory fitness predicted children's self-perceived physical well-being (one of the HRQoL subscales). Participation in the multicomponent physical activity intervention did not affect children's HRQoL. Conclusion: Higher and increasing self-reported physical activity predict all assessed HRQoL dimensions, which underlines that the promotion of regular physical activity among children living in disadvantaged settings is an important public health measure. Policy makers should encourage schools to create physical activity friendly environments, while schools should implement regular physical education as proposed by the school curriculum.
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Affiliation(s)
- Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Nandi Joubert
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Danielle Smith
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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12
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Ma C, Zhou L, Xu W, Ma S, Wang Y. Associations of physical activity and screen time with suboptimal health status and sleep quality among Chinese college freshmen: A cross-sectional study. PLoS One 2020; 15:e0239429. [PMID: 32946516 PMCID: PMC7500622 DOI: 10.1371/journal.pone.0239429] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 09/07/2020] [Indexed: 01/12/2023] Open
Abstract
This study aimed to investigate the associations of physical activity (PA) and screen time (ST) with physiological, psychological, and social health-particularly regarding effects on sleep quality-among Chinese college freshmen. A cross-sectional survey was conducted at Renmin University of China, in Beijing. A total of 5,233 students were surveyed in September 2015. Participants completed a self-report questionnaire on their demographic characteristics, tobacco and alcohol use, PA, ST, sleep quality, and health status. Multivariate logistic regression was performed to examine the independent and interactive associations between PA and ST with sleep quality and suboptimal health status. In total, 10.43%, 13.18%, and 13.26% of the 5,233 students had physiological, psychological, and social suboptimal health status, respectively. The prevalence of poor sleep quality was 37.94%. High ST and high PA were significantly associated with physiological suboptimal health status (aOR = 1.39, 95% CI: 1.16-1.68, and aOR = 0.55, 95% CI: 0.45-0.71), psychological suboptimal health status (aOR = 1.43, 95% CI: 1.21-1.69, and aOR = 0.57, 95% CI: 0.47-0.69), social suboptimal health status (aOR = 1.27, 95% CI: 1.08-1.50, and aOR = 0.63, 95% CI: 0.52-0.77), and poor sleep quality (aOR = 1.20, 95% CI: 1.03-1.39, and aOR = 0.64, 95% CI: 0.55-0.76). Additionally, low ST and high PA were interactively negatively associated with poor sleep quality (aOR = 0.56, 95% CI: 0.45-0.70), physiological suboptimal health status (aOR = 0.49, 95% CI: 0.40-0.59), psychological suboptimal health status (aOR = 0.48, 95% CI: 0.39-0.58), and social suboptimal health status (aOR = 0.49, 95% CI: 0.40-0.59). These findings suggested there are independent and interactive associations of low ST and high PA with poor sleep quality and suboptimal health status among Chinese college freshmen.
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Affiliation(s)
- Chenjin Ma
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Long Zhou
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Wangli Xu
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Shuangge Ma
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Yu Wang
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
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13
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Delgado-Ron JA. Overview of studies linking time spent on smartphones with blood pressure. Hypertens Res 2020; 44:259-261. [PMID: 32884124 DOI: 10.1038/s41440-020-00540-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Jorge Andrés Delgado-Ron
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
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14
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D’Ascenzi F, Sciaccaluga C, Cameli M, Cecere A, Ciccone MM, Di Francesco S, Ganau A, Imbalzano E, Liga R, Palermo P, Palmiero P, Parati G, Pedrinelli R, Scicchitano P, Zito A, Mattioli AV. When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention. Eur J Prev Cardiol 2019; 28:361-369. [PMID: 33611390 DOI: 10.1177/2047487319893832] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022]
Abstract
Abstract
Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
- Department of Medicine, University of Pittsburgh, USA
| | - Carlotta Sciaccaluga
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Annagrazia Cecere
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Marco M Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D’Annunzio University of Chieti-Pescara, Italy
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, Italy
| | - Antonello Ganau
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Riccardo Liga
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | | | | | - Gianfranco Parati
- Department of Cardiovascular, Neural, and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Italy
- School of Medicine and Surgery, University Milano-Bicocca, Italy
| | - Roberto Pedrinelli
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | - Piero Scicchitano
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Annapaola Zito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
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15
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Delcourt C. Early Exposure to Secondhand Smoking and Ocular Health—Insights From Latest-Generation Optical Coherence Tomographic Imaging. JAMA Ophthalmol 2019; 137:1414-1415. [DOI: 10.1001/jamaophthalmol.2019.4185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Cécile Delcourt
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, Team Lifelong Exposures, Health, and Aging (LEHA), Unite Mixte de Recherche 1219, Bordeaux, France
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16
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Mnich C, Weyland S, Jekauc D, Schipperijn J. Psychosocial and Physiological Health Outcomes of Green Exercise in Children and Adolescents-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4266. [PMID: 31684109 PMCID: PMC6862643 DOI: 10.3390/ijerph16214266] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/19/2019] [Accepted: 10/31/2019] [Indexed: 11/16/2022]
Abstract
Both physical activity (PA) and nature exposure are associated with several youth health benefits. However, the health outcomes when being physically active in nature, called Green Exercise (GE), are less clear. Thus, the purpose of this systematic review was to provide an overview of the psychosocial and physiological outcomes of GE in children and adolescents and to outline future GE research directions. The PRISMA statement guided the review. Web of Science, PubMed, ERIC, and APA PsychNET were systematically searched in February 2019, including studies between 2000 and 2019. Fourteen of 1175 identified publications were included, which reported 15 different psychosocial and six different physiological outcomes, with some studies reporting more than one outcome. For 16 outcomes, studies reported either similar or no effects for both GE and comparison groups. For six outcomes, studies reported stronger effects for GE, for three outcomes, studies reported stronger effects in the comparison group. Evidence was rated as weak, using the EPHPP tool. Thus, GE does not have deleterious effects for children and adolescents compared to PA in other settings. GE might be beneficial; however, due to the study's heterogeneity and quality, it is premature to make definite conclusions. Future research should build the quality of evidence for GE, use more rigorous research designs, and investigate the underlying effects and mechanisms of GE.
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Affiliation(s)
- Carina Mnich
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe 76149, Germany.
| | - Susanne Weyland
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe 76149, Germany.
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe 76149, Germany.
| | - Jasper Schipperijn
- Department of Sport Science and Clinical Biomechanics, University of Southern, Odense 5230, Denmark.
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17
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Ludyga S, Köchli S, Pühse U, Gerber M, Hanssen H. Effects of a school-based physical activity program on retinal microcirculation and cognitive function in adolescents. J Sci Med Sport 2019; 22:672-676. [DOI: 10.1016/j.jsams.2018.11.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/01/2018] [Accepted: 11/29/2018] [Indexed: 12/14/2022]
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18
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Kandasamy Y, Rudd D, Smith R, Hartley L, De Boever P. Retinal microvascular development in the first two years. Microvasc Res 2019; 125:103875. [PMID: 30981745 DOI: 10.1016/j.mvr.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/18/2022]
Abstract
The link between in utero and early life insults and the development of chronic illness remains to be fully understood, but there is increasing data to indicate that microvasculature pathology plays an important mechanistic role. Currently available data indicate that retinal microvasculature changes are detectable in children as young as six years of age, however, there are no data for younger children. We present retinal microvasculature measurement from the first two years of life. Retinal images suitable for analysis were available from 18 infants in our proof-of-concept study. The mean and standard deviation (SD) for birth weight and gestation was 3410 (384) g and 39.1(1.4) weeks, respectively. Retinal vessel calibres were summarized as the mean(SD) central retinal arteriolar equivalent (CRAE) at six months of age was 156 (32) μm, increased to 175 (75) μm by 12 months and a slightly declined by 24 months of age to 168 (50) μm. In a similar pattern, mean(SD) central retinal venular equivalent (CRVE) at six months was 211 (19) μm, increased to 238 (25) μm by 12 months of age followed by a slight decline at 24 months of age to 222 (36) μm. The arterio-venous ratio and tortuosity index remained the same at 6, 12 and 24 months. Findings from this study could help future investigators better understand early microvasculature changes and adaptation that occur early in life.
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Affiliation(s)
- Yogavijayan Kandasamy
- Department of Neonatology, The Townsville Hospital, Queensland 4814, Australia; Mothers and Babies Research Centre, Hunter Medical Research Institute, HMRI, The University of Newcastle, NSW 2310, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, QLD 4814, Australia.
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Sciences, James Cook University, QLD 4814, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, HMRI, The University of Newcastle, NSW 2310, Australia
| | - Leo Hartley
- Department of Optometry and Vision Science, University of Melbourne, Victoria, Australia
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium
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19
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Endes K, Köchli S, Zahner L, Hanssen H. Exercise and Arterial Modulation in Children: The EXAMIN YOUTH Study. Front Physiol 2019; 10:43. [PMID: 30774601 PMCID: PMC6367232 DOI: 10.3389/fphys.2019.00043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Cardiovascular disease (CVD) remains to be one of the most frequent causes of death worldwide. Cardiovascular (CV) risk factors such as hypertension and obesity often manifest in childhood. The study examines the associations of blood pressure, body mass index and physical activity with cardiopulmonary, metabolic, and psychosocial health of children in a systems physiology approach. Methods/Design: This cross-sectional study will be performed in a cohort of 6 to 8 year old school children (n = 1000). As a measure of vascular health, retinal microvascular diameters and large artery pulse wave velocity will be examined. Anthropometric parameters, such as weight, height, body mass index, and blood pressure will be assessed according to standardized protocols for children. Physical fitness and activity will be measured by a 20 m shuttle run, a 20 m sprint and a proxy-reported questionnaire on lifestyle behavior. Spirometry, assessment of heart rate variability and skin advanced glycation end products as well as a flanker test will be performed to determine systemic end organ alterations. Discussion: The study offers a unique integrative primary prevention concept that aims to set the grounds for a healthy and active lifestyle approach during childhood. It will help optimize CV risk stratification to identify children at risk of disease progression later in life. The study will demonstrate the importance of specific CV screening programs in children to reduce the growing burden of CV disease in adulthood. Prospective follow-up studies will have to prove the efficacy of primary prevention programs in children to achieve healthier aging as a long-term goal.
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Affiliation(s)
| | | | | | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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20
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Ahmed SF, McDermott KC, Burge WK, Ahmed IIK, Varma DK, Liao YJ, Crandall AS, Khaderi SKR. Visual function, digital behavior and the vision performance index. Clin Ophthalmol 2018; 12:2553-2561. [PMID: 30573945 PMCID: PMC6292403 DOI: 10.2147/opth.s187131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Historically, visual acuity has been the benchmark for visual function. It is used to measure therapeutic outcomes for vision-related services, products and interventions. Quantitative measurement of suboptimal visual acuity can potentially be corrected optically with proper refraction in some cases, but in many cases of reduced vision there is something else more serious that can potentially impact other aspects of visual function such as contrast sensitivity, color discrimination, peripheral field of view and higher-order visual processing. The measurement of visual acuity typically requires stimuli subject to some degree of standardization or calibration and has thus often been limited to clinical settings. However, we are spending increasing amounts of time interacting with devices that present high-resolution, full color images and video (hereafter, digital media) and can record our responses. Most of these devices can be used to measure visual acuity and other aspects of visual function, not just with targeted testing experiences but from typical device interactions. There is growing evidence that prolonged exposure to digital media can lead to various vision-related issues (eg, computer vision syndrome, dry eye, etc.). Our regular, daily interactions (digital behavior) can also be used to assess our visual function, passively and continuously. This allows us to expand vision health assessment beyond the clinic, to collect vision-related data in the whole range of settings for typical digital behavior from practically any population(s) of interest and to further explore just how our increasingly virtual interactions are affecting our vision. We present a tool that can be easily integrated into digital media to provide insights into our digital behavior.
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Affiliation(s)
- Sarah Farukhi Ahmed
- Shiley Eye Institute of Ophthalmology, University of California, San Diego, CA, USA
| | | | | | - I Ike K Ahmed
- Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Devesh K Varma
- Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Y Joyce Liao
- Ophthalmology and Neurology, Stanford University Medical Center, Stanford, CA, USA
| | - Alan S Crandall
- Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - S Khizer R Khaderi
- Vizzario, Inc., Venice, CA, USA, .,Ophthalmology, Stanford University Medical Center, Stanford, CA, USA,
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21
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Solianik R, Streckis V, Imbrasiene D, Paunksnis A. Acute and chronic effects of soccer game on the retinal vessel diameters in middle-aged adults. J Sports Med Phys Fitness 2018; 59:1085-1092. [PMID: 30317840 DOI: 10.23736/s0022-4707.18.09164-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although changes in retinal vessel diameter is a new biomarker for the evaluation of cardiovascular risk factors, limited information is available regarding the effects of endurance exercises on retinal microcirculation. Thus, we aimed to evaluate both chronic and acute effects of soccer game on the diameters of retinal vessels in middle-aged players. METHODS Retinal vessel diameters were measured in 12 middle-aged amateur players (44.4±7.0 years of age) with more than four years of soccer playing experience and 12 age-matched sedentary adults (49.7±7.1 years of age). In soccer players, diameters were also measured immediately after the soccer game. Cardiovascular risk profiles (anthropometry and body composition and blood pressure [BP]) and physical activity levels were also measured. RESULTS Soccer players had wider retinal vessels than controls (P<0.05), resulting in greater arteriolar-to-venular diameter ratio (AVR) (P<0.05). Greater sports-related physical activity, lower body mass index (BMI) and fat mass were observed for soccer players compared to the controls (P<0.05), whereas BP did not differ. Physical activity level correlated positively with temporal retinal arteriolar (TRA) diameter and with AVR (P<0.05), whereas TRA diameter correlated negatively with BMI and fat mass (P<0.05). A significant correlation between temporal retinal venule (TRV) diameter and TRA diameter (P<0.05) was observed. The acute soccer game increased BP (P<0.05) and induced TRV dilatation (P<0.05). CONCLUSIONS In middle-aged amateur soccer players, improvement of the retinal microcirculation was observed. Cardiovascular risk factors and physical inactivity were associated with adverse retinal microvascular alterations. In terms of acute effects, soccer play causes venular, but not arteriolar dilatation for middle-aged adults.
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Affiliation(s)
- Rima Solianik
- Institute of Sports Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania - .,Department of Applied Biology and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania -
| | - Vytautas Streckis
- Institute of Sports Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.,Department of Trainings Systems, Lithuanian Sports University, Kaunas, Lithuania
| | - Daiva Imbrasiene
- Department of Applied Biology and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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22
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Siegrist M, Hanssen H, Lammel C, Haller B, Koch AM, Stemp P, Dandl E, Liestak R, Parhofer KG, Vogeser M, Halle M. Effects of a cluster-randomized school-based prevention program on physical activity and microvascular function (JuvenTUM 3). Atherosclerosis 2018; 278:73-81. [PMID: 30261471 DOI: 10.1016/j.atherosclerosis.2018.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 07/30/2018] [Accepted: 09/07/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS It is unknown whether a school-based prevention program has the potential to improve microvascular health in children. This study investigates the impact of the school-based lifestyle intervention program JuvenTUM 3 on physical activity, physical fitness, serum biomarkers and microvascular function. METHODS We studied 434 children (10-11 years) in a cluster-randomized setting (8 intervention schools, IG; 7 control schools, CG) over 18 months. The school-based prevention program included weekly lifestyle lessons for children with the aim to increase physical activity in and outside of school, physical fitness as well as health behavior. Anthropometric measurements and blood sampling were conducted using standard protocols, physical activity by use of a questionnaire and physical fitness by a 6-item-test battery. Central retinal arteriolar (CRAE) and venular (CRVE) vessel diameters as early marker of vascular dysfunction, as well as the arteriolar-to-venular diameter ratio (AVR), were investigated with a non-mydriatic vessel analyser. RESULTS School-based physical activity increased in 41% of children in IG (19% in CG, p = 0.038). Improvements in vascular parameters were observed for AVR (increase in 83% of children in IG versus 50% in CG; p < 0.001) and for CRVE (43% of children with retinal venular widening in IG versus 58% in CG, p = 0.019). These vascular improvements were also seen in overweight children for CRAE (p = 0.021) and AVR (p < 0.001). CONCLUSIONS The school-based prevention program JuvenTUM 3 increased physical activity at school inducing favourable effects on retinal microvasculature function. These findings underline the importance of early lifestyle interventions in children for primary prevention of cardiovascular disease.
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Affiliation(s)
- Monika Siegrist
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany.
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Division of Sports and Exercise Medicine, University of Basel, Switzerland
| | - Christoph Lammel
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Bernhard Haller
- Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Anna-Maria Koch
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Pia Stemp
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Elke Dandl
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Roberta Liestak
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Klaus G Parhofer
- Department of Internal Medicine II, University of Munich, Großhadern Campus, Munich, Germany
| | - Michael Vogeser
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany; DZHK (German Center for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
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23
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Shearer DM, Thomson WM, Cameron CM, Ramrakha S, Wilson G, Wong TY, Williams MJA, McLean R, Theodore R, Poulton R. Periodontitis and multiple markers of cardiometabolic risk in the fourth decade: A cohort study. Community Dent Oral Epidemiol 2018; 46:615-623. [PMID: 30160305 DOI: 10.1111/cdoe.12414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/11/2018] [Accepted: 07/18/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine associations between periodontitis at ages 32 and 38 and a range of early cardiometabolic risk biomarkers at age 38. METHODS Periodontal probing depth and bleeding on probing data collected during the age-32 and age-38 assessments in the Dunedin Multidisciplinary Health and Development Study were used to quantify periodontal inflammatory load. Retinal microvascular abnormalities, endothelial dysfunction, and metabolic syndrome data were collected during the age-38 assessment. Regression models were used to examine associations between these cardiometabolic risk markers and (1) the inflammatory load at age 38 and (2) the change in inflammatory load between ages 32 and 38. RESULTS Periodontal inflammatory load was recorded for 890 Study members at age 32, 891 at age 38, and 856 at both ages. Retinal vessel data were available for 922, endothelial dysfunction data for 909 and metabolic syndrome data for 905 at age 38. Neither the inflammatory load of periodontitis at 38 nor the changes in inflammatory load 32-38 were found to be associated with any of the three cardiometabolic risk markers. CONCLUSIONS Periodontitis was not associated with markers of cardiometabolic risk at this relatively early stage in the life course. It is possible that any influence of periodontitis on cardiometabolic health develops later in life, or periodontitis is not involved in the putative causal chain comprising systemic inflammation, cardiometabolic risk markers, and subsequent cardiovascular risk.
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Affiliation(s)
- Dara M Shearer
- Department of Oral Sciences, Faculty of Dentistry, Dunedin, New Zealand
| | - W Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, Dunedin, New Zealand
| | - Claire M Cameron
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Graham Wilson
- Department of Ophthalmology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Michael J A Williams
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael McLean
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Reremoana Theodore
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. ENVIRONMENTAL RESEARCH 2018; 164:149-157. [PMID: 29499467 DOI: 10.1016/j.envres.2018.01.015] [Citation(s) in RCA: 321] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/16/2018] [Indexed: 05/03/2023]
Abstract
UNLABELLED A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior. CONCLUSIONS Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents appears as a major factor which may hamper the formation of sound psychophysiological resilience.
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Affiliation(s)
- Gadi Lissak
- Meuhedet Health Services, Jerusalem, Israel.
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Köchli S, Endes K, Infanger D, Zahner L, Hanssen H. Obesity, Blood Pressure, and Retinal Vessels: A Meta-analysis. Pediatrics 2018; 141:peds.2017-4090. [PMID: 29743194 DOI: 10.1542/peds.2017-4090] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 01/30/2023] Open
Abstract
CONTEXT Retinal vessel imaging is a noninvasive diagnostic tool used to evaluate cardiovascular risk. Childhood obesity and elevated blood pressure (BP) are associated with retinal microvascular alterations. OBJECTIVE To systematically review and meta-analyze associations between obesity, BP, and physical activity with retinal vessel diameters in children. DATA SOURCES We conducted a literature search through the databases of PubMed, Embase, Ovid, Web of Science, and the Cochrane Register of Controlled Trials. STUDY SELECTION School- and population-based cross-sectional data. DATA EXTRACTION General information, study design, participants, exposure, and outcomes. RESULTS A total of 1751 studies were found, and 30 full-text articles were analyzed for eligibility. Twenty-two articles (18 865 children and adolescents) were used for further assessment and reflection. Eleven articles were finally included in the meta-analysis. We found that a higher BMI is associated with narrower retinal arteriolar (pooled estimate effect size -0.37 [95% confidence interval (CI): -0.50 to -0.24]) and wider venular diameters (0.35 [95% CI: 0.07 to 0.63]). Systolic and diastolic BP are associated with retinal arteriolar narrowing (systolic BP: -0.63 [95% CI: -0.92 to -0.34]; diastolic BP: -0.60 [95% CI -0.95 to -0.25]). Increased physical activity and fitness are associated with favorable retinal vessel diameters. LIMITATIONS Long-term studies are needed to substantiate the prognostic relevance of retinal vessel diameters for cardiovascular risk in children. CONCLUSIONS Our results indicate that childhood obesity, BP, and physical inactivity are associated with retinal microvascular abnormalities. Retinal vessel diameters seem to be sensitive microvascular biomarkers for cardiovascular risk stratification in children.
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Affiliation(s)
- Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
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Lundberg K, Tarp J, Vestergaard AH, Jacobsen N, Thykjaer AS, Rønne MS, Bugge A, Goldschmidt E, Peto T, Wedderkopp N, Grauslund J. Retinal vascular diameters in relation to physical activity in Danish children - The CHAMPS Eye Study. Scand J Med Sci Sports 2018; 28:1897-1907. [PMID: 29701884 DOI: 10.1111/sms.13204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 01/17/2023]
Abstract
Our objective was to determine associations between retinal vascular caliber and physical activity (PA) in a school-based child cohort. In a prospective study, we created a childhood cumulative average PA-index using objectively measured PA (accelerometry) assessed at four periods between 2009 and 2015. Cumulative exposure to PA intensities was estimated. Cross-sectional examinations on biomarkers, anthropometry, and ophthalmological data including retinal fundus photographs were performed in 2015. Semi-automated measurements of retinal vascular diameters were performed and summarized into central retinal arteriolar and venular equivalents (CRAE, CRVE). We included 307 participants. Mean age in 2015 was 15.4 years (0.7). The mean CRAE and CRVE were 156.5 μm (2.8) and 217.6 μm (7.7), respectively. After adjusting for age, gender, and axial length, more time in PA was independently related to thinner retinal venules (β-coefficient = -1.25 μm/%, 95% confidence interval = -2.20, -0.30, P < .01). Sedentary time was associated with wider venules (P < .01). Furthermore, birthweight (β-coefficient = 0.56 μm/%, 95% confidence interval = 0.18, 0.95, P < .01) was associated with CRVE. Blood pressure was associated with thinner retinal arterioles (β-coefficient = -0.19 μm/mmHg, 95% confidence interval = -0.36, -0.01, P = .04). We concluded that children with higher PA in childhood had thinner retinal venular caliber. Our results suggest that PA during childhood positively impacts the retinal microcirculation and that retinal vascular analysis may be a possible assessment to detect microvascular impairments in children with an increased risk of future cardiovascular disease.
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Affiliation(s)
- K Lundberg
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - J Tarp
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - A H Vestergaard
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - N Jacobsen
- Department of Ophthalmology, Rigshospitalet-Glostrup University Hospital, Copenhagen, Denmark
| | - A S Thykjaer
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - M S Rønne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - A Bugge
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - E Goldschmidt
- Danish Institute for Myopia Research, Vedbaek, Denmark
| | - T Peto
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - N Wedderkopp
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark.,The Orthopedic Department, Institute of Regional Health Services Research, Sport Medicine Clinic, University of Southern Denmark, Middelfart, Denmark
| | - J Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Luo H, Shrestha S, Zhang X, Saaddine J, Zeng X, Reeder T. Trends in Eye Injuries and Associated Medical Costs among Children in the United States, 2002-2014. Ophthalmic Epidemiol 2018; 25:280-287. [PMID: 29473762 DOI: 10.1080/09286586.2018.1441425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To describe the trends in eye injuries and associated medical costs among children in the United States. METHODS Data were from the 2002-2014 Medical Expenditure Panel Survey (MEPS). Eye injuries in children aged <18 years were identified by the International Classification of Diseases-9 (ICD-9) codes. The trends of cumulative incidence of eye injury, total costs, and average costs were estimated from 2002-2014 MEPS data. All costs were adjusted to 2014 US dollars. Analyses accounted for the complex stratified multistage survey design of the MEPS. We used MarketScan data (2010-2013) to validate outpatient cost estimates. RESULTS The 3-year average cumulative incidence of eye injuries declined from 0.56% in 2002-2004 to 0.31% in 2012-2014 (Trend p < 0.001). The average annual total costs decreased from $193 million during 2002-2004 to $66 million during 2012-2014 (p < 0.001). CONCLUSION The MEPS data showed that among children aged <18 years, the incidence of eye injuries and associated financial burden substantially declined during 2002-2014, highlighting the progress in preventing children eye injuries. Continuing efforts are needed to further reduce the burden in this population.
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Affiliation(s)
- Huabin Luo
- a Department of Public Health, East Carolina University, Greenville , NC , USA
| | - Sundar Shrestha
- b Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention (CDC) , Atlanta , GA , USA
| | - Xinzhi Zhang
- c Department of Health Services Administration , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jinan Saaddine
- b Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention (CDC) , Atlanta , GA , USA
| | - Xiaoming Zeng
- d Department of Health Services and Information Management , East Carolina University , Greenville , NC , USA
| | - Timothy Reeder
- e Department of Emergency Medicine, East Carolina University , Greenville , NC , USA
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28
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Cliff DP, McNeill J, Vella S, Howard SJ, Kelly MA, Angus DJ, Wright IM, Santos R, Batterham M, Melhuish E, Okely AD, de Rosnay M. The Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) cohort study: rationale and design. BMC Pediatr 2017; 17:95. [PMID: 28376910 PMCID: PMC5379769 DOI: 10.1186/s12887-017-0846-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prevalence estimates internationally suggest that many preschool-aged children (3-5 years) are insufficiently physically active and engage in high levels of screen-based entertainment. Early childhood is the developmental period for which we know the least about the effects of physical activity on development and health. Likewise, rapid technological advancements in mobile electronic media have made screen-based forms of entertainment for young children ubiquitous, and research demonstrating the impacts on cognition, psychosocial well-being, and health has lagged behind the rate of adoption of these technologies. The purpose of the Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) study is to investigate if physical activity and screen-based entertainment are independently associated with cognitive and psychosocial development, and health outcomes in young children, and if so, how much and which types of these behaviours might be most influential. METHODS The PATH-ABC study is a prospective cohort, aiming to recruit 430 3-5 year-old children. Children are recruited through and complete initial assessments at their Early Childhood Education and Care (ECEC) centre, and then 12-months later at their centre or school. Direct assessments are made of children's habitual physical activity using accelerometry, cognitive (executive function) and language development (expressive vocabulary), psychosocial development (emotional understanding, Theory of Mind, empathy, and heart rate variability), adiposity (body mass index and waist circumference), and cardiovascular health (blood pressure and retinal micro- vasculature). Educators report on children's psychological strengths and difficulties and self-regulation. Parents report on children's habitual use of electronic media and other child, parent and household characteristics. DISCUSSION The PATH-ABC study aims to provide evidence to enhance understanding of how much and which types of physical activity and screen-based media influence development and health in preschool-aged children. This information would benefit parents, educators, health professionals and governments seeking to develop strategies and policies to give young children the best start in life by promoting healthy levels of physical activity and electronic media use.
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Affiliation(s)
- Dylan P Cliff
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.
| | - Jade McNeill
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Stewart Vella
- Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Steven J Howard
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Megan A Kelly
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Douglas J Angus
- School of Psychology University of New South Wales, Kensington, Australia
| | - Ian M Wright
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Research Centre in Physical Activity, Health and leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Marijka Batterham
- Statistical Consulting Centre, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Edward Melhuish
- Early Start Research Institute, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
- Department of Education, University of Oxford, Oxford, UK
- Psychological Sciences, Birkbeck, University of London, London, UK
| | - Anthony D Okely
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Marc de Rosnay
- Early Start Research Institute, School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
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29
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Gopinath B, Moshtaghian H, Flood VM, Louie JCY, Liew G, Burlutsky G, Mitchell P. Pattern of omega-3 polyunsaturated fatty acid intake and fish consumption and retinal vascular caliber in children and adolescents: A cohort study. PLoS One 2017; 12:e0172109. [PMID: 28192538 PMCID: PMC5305252 DOI: 10.1371/journal.pone.0172109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 01/31/2017] [Indexed: 11/18/2022] Open
Abstract
We aimed to investigate whether fish and long chain omega-3 polyunsaturated fatty acid (LCn-3 PUFA) consumption changed appreciably during adolescence. We also assessed whether these dietary variables are associated with retinal microvascular signs (possible markers of future cardiovascular disease risk). 633 children had dietary data at ages 12 and 17. Fish and LCn-3 PUFA [eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] intake was assessed by a food frequency questionnaire. Retinal vessel caliber was quantified from digital photographs using computer software. Mean energy-adjusted intakes (mg/day) of total LCn-3 PUFA, EPA, and DHA at age 12 were 297.1±261.1; 102.5±106.9; and 129.7±137.7, respectively; and this increased significantly at age 17 to: 347.0±324.0 (p<0.0001); 122.5±132.7 (p = 0.0001); and 160.3±171.4 (p <0.0001), respectively. Increasing quartiles of LCn-3PUFA intake were associated with widening of mean retinal arteriolar caliber among 17-year old girls ~3.9 μm (multivariable-adjusted P-trend = 0.001). Girls who consumed ≥2 serves of fish/week versus those who did not had ~2.1 μm wider retinal arterioles (p = 0.03). No associations were observed among boys or with retinal venules. Mean dietary intakes of LCn-3 PUFA increased during adolescence, but are still below recommended levels of consumption. These results suggest that LCn-3 PUFA and fish intake might have a beneficial influence.
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Affiliation(s)
- Bamini Gopinath
- Center for Vision Research, Department of Ophthalmology and The Westmead Institute, University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Hanieh Moshtaghian
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Victoria M. Flood
- St Vincent’s Hospital, Sydney, NSW, Australia
- Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Jimmy C. Y. Louie
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - Gerald Liew
- Center for Vision Research, Department of Ophthalmology and The Westmead Institute, University of Sydney, Sydney, NSW, Australia
| | - George Burlutsky
- Center for Vision Research, Department of Ophthalmology and The Westmead Institute, University of Sydney, Sydney, NSW, Australia
| | - Paul Mitchell
- Center for Vision Research, Department of Ophthalmology and The Westmead Institute, University of Sydney, Sydney, NSW, Australia
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30
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Does Physical Fitness Buffer the Relationship between Psychosocial Stress, Retinal Vessel Diameters, and Blood Pressure among Primary Schoolchildren? BIOMED RESEARCH INTERNATIONAL 2016; 2016:6340431. [PMID: 27795958 PMCID: PMC5067327 DOI: 10.1155/2016/6340431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/24/2016] [Accepted: 09/07/2016] [Indexed: 11/18/2022]
Abstract
Background. Strong evidence exists showing that psychosocial stress plays an important part in the development of cardiovascular diseases. Because physical inactivity is associated with less favourable retinal vessel diameter and blood pressure profiles, this study explores whether physical fitness is able to buffer the negative effects of psychosocial stress on retinal vessel diameters and blood pressure in young children. Methods. 325 primary schoolchildren (51% girls, Mage = 7.28 years) took part in this cross-sectional research project. Retinal arteriolar diameters, retinal venular diameters, arteriolar to venular ratio, and systolic and diastolic blood pressure were assessed in all children. Interactions terms between physical fitness (performance in the 20 m shuttle run test) and four indicators of psychosocial stress (parental reports of critical life events, family, peer and school stress) were tested in a series of hierarchical regression analyses. Results. Critical life events and family, peer, and school-related stress were only weakly associated with retinal vessel diameters and blood pressure. No support was found for a stress-buffering effect of physical fitness. Conclusion. More research is needed with different age groups to find out if and from what age physical fitness can protect against arteriolar vessel narrowing and the occurrence of other cardiovascular disease risk factors.
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Gopinath B, Flood VM, Burlutsky G, Louie JCY, Baur LA, Mitchell P. Dairy Food Consumption and Health-Related Quality of Life in Boys: Preliminary Findings from a 5-Year Cohort Study. J Am Coll Nutr 2016; 35:522-558. [DOI: 10.1080/07315724.2015.1075444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Newman AR, Andrew NH, Casson RJ. Review of paediatric retinal microvascular changes as a predictor of cardiovascular disease. Clin Exp Ophthalmol 2016; 45:33-44. [DOI: 10.1111/ceo.12773] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 01/02/2023]
Affiliation(s)
- Alexander R Newman
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital; Adelaide South Australia Australia
| | - Nicholas H Andrew
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital; Adelaide South Australia Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital; Adelaide South Australia Australia
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Keel S, Itsiopoulos C, Koklanis K, Vukicevic M, Cameron F, Brazionis L. Physical Activity, Sedentary Behaviors, and Retinal Vascular Caliber in Children and Adolescents With Type 1 Diabetes. Asia Pac J Ophthalmol (Phila) 2016; 5:180-4. [PMID: 27003733 DOI: 10.1097/apo.0000000000000186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of this study was to investigate associations of physical activity and sedentary behaviors with retinal vascular caliber in children and adolescents with type 1 diabetes. DESIGN This was a hospital-based cross-sectional study. METHODS A study of 122 children and adolescents with type 1 diabetes was conducted over an 8-month period. Self-reported physical activity time and time spent watching TV or playing computer or video games were obtained using interviewer-administered questionnaires. Retinal vascular caliber was measured by a trained grader using a standardized protocol and later summarized as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) using a semiautomated computer program. RESULTS After adjusting for confounders (age, sex, ethnicity, body mass index, systolic blood pressure, HbA1c, maternal smoking status, age at which cow's milk was introduced, and CRVE/CRAE, respectively), narrower CRAE was independently related to more time spent playing computer/video games [ExpB = -3.85; 95% confidence interval (CI), -6.41 to -1.29; P = 0.004], whereas wider CRVE was independently related to lower physical activity level (ExpB = -1.08; 95% CI, -2.01 to -0.15; P = 0.03) and more time spent playing computer/video games (ExpB = 4.72; 95% CI, 0.52-8.92; P = 0.02). Television viewing time was not associated with retinal vascular caliber after adjustment. CONCLUSIONS The results of this study suggest that physical activity and sedentary behaviors in the form of "screen viewing time" are associated with retinal vessel caliber early in life. These results suggest that retinal vascular caliber may provide prognostic information beyond current traditional cardiovascular risk factors. Future longitudinal and interventional studies are warranted to evaluate the relevance of these observations.
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Affiliation(s)
- Stuart Keel
- From the Departments of *Clinical Vision Sciences and †Dietetics, Latrobe University; ‡Department of Endocrinology and Diabetes, Royal Children's Hospital; and §Department of Medicine, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
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Imhof K, Zahner L, Schmidt-Trucksäss A, Hanssen H. Association of body composition and blood pressure categories with retinal vessel diameters in primary school children. Hypertens Res 2016; 39:423-9. [PMID: 26763853 DOI: 10.1038/hr.2015.159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 11/02/2015] [Accepted: 11/26/2015] [Indexed: 12/12/2022]
Abstract
Alterations in retinal vessel diameters have been shown to be predictive of cardiovascular risk in adults and children. The aim of our study was to examine the association of body composition and blood pressure (BP) categories with retinal vessel diameters in school children. We examined anthropometric parameters, BP and retinal arteriolar (CRAE) and venular (CRVE) diameters as well as the arteriolar-to-venular diameter ratio (AVR) in 391 children (age: 7.3, s.d. 0.4). Differences between the lowest and highest BP quartiles indicated that higher systolic and diastolic BP were associated with narrower CRAE (P<0.001 for both). Children in the highest weight quartile had narrower CRAE compared with the lowest quartile (P=0.05). In the regression analysis, systolic and diastolic BP were associated with arteriolar narrowing (-0.4 measuring units (mu) per mm Hg, 95% confidence interval: [-0.6; -0.3] and -0.6 mu per mm Hg [-0.7; -0.4], respectively; P<0.001 for both). An independent association was found for diastolic BP only. Compared with normotensives (NT; 74.4% of cohort), arteriolar narrowing was already seen in children categorized as pre-hypertensive (PHT) (11.5% of cohort), which was similar to HT children (14.1% of cohort) (NT: mean 207.2 [205.6; 208.7] mu; PHT: 201.7 [197.8; 205.7] mu; HT: 199.7 [196.2; 203.3] mu; P=0.01 for PHT vs. NT and P<0.001 for HT vs. NT in systolic BP). Our results suggest that systolic and diastolic BP are main determinants of retinal arteriolar diameters; and therefore, microvascular health in young children. Pre-hypertension seems to be associated with retinal microvascular alterations early in life.
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Affiliation(s)
- Katharina Imhof
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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Li LJ, Ikram MK, Wong TY. Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease. J Physiol 2015; 594:2175-203. [PMID: 26435039 DOI: 10.1113/jp270947] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/28/2015] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non-invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low-fibre and high-sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre-clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Mohammad Kamran Ikram
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
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Imhof K, Faude O, Donath L, Bean-Eisenhut S, Hanssen H, Zahner L. The association of socio-economic factors with physical fitness and activity behaviours, spinal posture and retinal vessel parameters in first graders in urban Switzerland. J Sports Sci 2015; 34:1271-80. [PMID: 26548899 DOI: 10.1080/02640414.2015.1109703] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Socio-economic status during childhood has been shown to be a strong predictor of adult health outcome. Therefore, we examined associations of parental educational level, household income and migrant background with physical fitness, spinal flexibility, spinal posture as well as retinal vessel diameters in children of an urban Swiss region. A total of 358 first graders of the Swiss canton Basel-Stadt (age: 7.3, SD: 0.4) were examined. Physical fitness (20 m shuttle run test, 20 m sprint, jumping sidewards and balancing backwards), spinal flexibility and spinal posture (MediMouse®, Idiag, Fehraltdorf, Switzerland) and retinal microcirculation (Static Retinal Vessel Analyzer, Imedos Systems UG, Jena, Germany) were assessed. Parental education, household income, migrant background and activity behaviour were evaluated with a questionnaire. Parental education was associated with child aerobic fitness (P = 0.03) and screen time (P < 0.001). Household income was associated with jumping sidewards (P = 0.009), balancing backwards (P = 0.03) and sports club participation (P = 0.02). Migrant background was associated with BMI (P = 0.001), body fat (P = 0.03), aerobic fitness (P = 0.007), time spent playing outdoors (P < 0.001) and screen time (P < 0.001). For spinal flexibility and retinal vessel diameter, no associations were found (0.06 < P < 0.8). Low parental education, low household income and a migrant background are associated with poor physical fitness, higher BMI and body fat percentage and low-activity behaviour.
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Affiliation(s)
- Katharina Imhof
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
| | - Oliver Faude
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
| | - Lars Donath
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
| | - Salome Bean-Eisenhut
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
| | - Henner Hanssen
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
| | - Lukas Zahner
- a Department of Sport, Exercise and Health, Medical Faculty , University of Basel , Basel-Stadt , Switzerland
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Imhof K, Zahner L, Schmidt-Trucksäss A, Faude O, Hanssen H. Influence of physical fitness and activity behavior on retinal vessel diameters in primary schoolchildren. Scand J Med Sci Sports 2015; 26:731-8. [PMID: 26105148 DOI: 10.1111/sms.12499] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 01/25/2023]
Abstract
Retinal vessel alterations have been shown to be associated with cardiovascular risk factors and physical inactivity as early as childhood. In this context, the analysis of physical activity in children has solely been based on questionnaire assessments. The study aimed to examine the association of physical fitness performance and self-reported physical activity with retinal vessel diameters in young children. Three hundred ninety-one primary schoolchildren [7.3 years (SD 0.4)] were examined in this cross-sectional study. The primary outcome was endurance performance measured with the 20-m shuttle run. The additional tests consisted of a 20-m sprint, jumping sidewards and balancing backwards. Retinal microcirculation was assessed using a static retinal vessel analyzer. Parents completed questionnaires about physical and sedentary activities. Endurance performance was associated with narrower retinal venular diameters [-0.9 (95%CI: -1.8; -0.1) measuring units (mu)/ unit shuttle run, P = 0.04] and a higher arteriolar to venular ratio [0.003 (-0.001; 0.006)/unit shuttle run, P = 0.06]. The sprint performance was associated with narrower retinal arterioles [4.7 (0.8; 8.6) mu/unit sprint, P = 0.02]. Indoor playing activity correlated with narrower retinal venules [-0.04 (-0.07; -0.01) mu/per unit, P = 0.02]. Our data suggest that objectively measured endurance performance relates with better retinal vessel health in early childhood.
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Affiliation(s)
- K Imhof
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - L Zahner
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - A Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - O Faude
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - H Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
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Meyer U, Schindler C, Bloesch T, Schmocker E, Zahner L, Puder JJ, Kriemler S. Combined impact of negative lifestyle factors on cardiovascular risk in children: a randomized prospective study. J Adolesc Health 2014; 55:790-5. [PMID: 25249036 DOI: 10.1016/j.jadohealth.2014.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 05/19/2014] [Accepted: 07/03/2014] [Indexed: 01/09/2023]
Abstract
PURPOSE Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. METHODS Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and 64% were assessed again after 4 years. Measures included anthropometry, fasting blood samples, and a health assessment questionnaire. Participants scored one point for each negative lifestyle factor at baseline: overweight; physical inactivity; high media consumption; little outdoor time; skipping breakfast; and having a parent who has ever smoked, is inactive, or overweight. A CVR score at follow-up was constructed by averaging sex- and age-related z-scores of waist circumference, blood pressure, glucose, inverted high-density lipoprotein, and triglycerides. RESULTS The age-, sex-, pubertal stage-, and social class-adjusted probabilities (95% confidence interval) for being in the highest CVR score tertile at follow-up for children who had at most one (n = 48), two (n = 64), three (n = 56), four (n = 41), or five or more (n = 14) risky lifestyle factors were 15.4% (8.9-25.3), 24.3% (17.4-32.8), 36.0% (28.6-44.2), 49.8% (38.6-61.0), and 63.5% (47.2-77.2), respectively. CONCLUSIONS Even in childhood, an accumulation of negative lifestyle factors is associated with higher CVR scores after 4 years. These negative lifestyle factors are easy to assess in clinical practice and allow early detection and prevention of CVR in childhood.
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Affiliation(s)
- Ursina Meyer
- Centre on Aging and Mobility, University of Zürich, Zürich, Switzerland; Department of Human Movement Science, Maastricht University, Maastricht, The Netherlands; Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tamara Bloesch
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Eliane Schmocker
- Department of Sports Science, University of Konstanz, Konstanz, Germany
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jardena J Puder
- Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudoise, University of Lausanne, Lausanne, Switzerland
| | - Susi Kriemler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland.
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Gopinath B, Flood VM, Burlutsky G, Louie JCY, Baur LA, Mitchell P. Dairy food consumption, blood pressure and retinal microcirculation in adolescents. Nutr Metab Cardiovasc Dis 2014; 24:1221-1227. [PMID: 24996501 DOI: 10.1016/j.numecd.2014.05.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/25/2014] [Accepted: 05/28/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The relationship between dairy food consumption and dietary calcium intake, and vascular risk factors during adolescence remains unclear. We aimed to prospectively assess whether dairy food consumption (milk, cheese, yoghurt) is associated with blood pressure (BP) and retinal microvascular signs among adolescents. METHODS AND RESULTS As many as 2353 and 1216 participants aged 12 and 17, respectively, were examined. Longitudinal analyses involved 888 subjects with complete baseline and follow-up data. Dairy consumption was assessed from validated semi-quantitative food frequency questionnaires. BP information was collected and retinal vessel caliber was quantified from digital photographs using computer software. In girls, after multivariable adjustment, each serve/day increase in total dairy intake was concurrently associated with 1.04 (p = 0.03) and 1.10 mm Hg (p = 0.02) decreases in mean diastolic and arterial BP, respectively. Also in girls, each serve/day increase in cheese intake over 5 years was concurrently related to 7.18 (p = 0.001), 5.28 (p = 0.002) and 5.79 mm Hg (p = 0.001) decrease in mean systolic, diastolic and arterial BP, respectively. Among girls, each 100 mg/day increase in dietary calcium intake was associated with a concurrent 0.5 (p = 0.01) and 0.3 mm Hg (p = 0.02) decrease in mean systolic and arterial BP, respectively. Cross-sectionally, adolescents in the highest versus lowest tertile of yoghurt intake had ∼ 1.3 μm wider retinal arterioles (p = 0.05) and ∼ 2.0 μm narrower venules (p = 0.04). CONCLUSIONS Consumption of dairy products, particularly cheese, could have a beneficial effect on BP, particularly among girls.
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Affiliation(s)
- B Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Australia.
| | - V M Flood
- Faculty of Health Sciences, University of Sydney and St Vincent's Hospital, Australia
| | - G Burlutsky
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Australia
| | - J C Y Louie
- Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | - L A Baur
- University of Sydney Clinical School, The Children's Hospital at Westmead, Australia; School of Public Health, University of Sydney, Australia
| | - P Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Australia
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Gopinath B, Flood VM, Wang JJ, Burlutsky G, Mitchell P. Lower dairy products and calcium intake is associated with adverse retinal vascular changes in older adults. Nutr Metab Cardiovasc Dis 2014; 24:155-161. [PMID: 24418384 DOI: 10.1016/j.numecd.2013.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/16/2013] [Accepted: 06/17/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Higher consumption of dairy products and calcium is likely to play a role in maintaining optimal vascular health. In this study, we aimed to explore the associations between consumption of total-, regular- and low-fat dairy foods, and total calcium intake with retinal vascular caliber. METHODS AND RESULTS 2813 Blue Mountains Eye Study participants aged 50+ years had dietary data collected using a semi-quantitative food frequency questionnaire, and serves of dairy consumption were calculated. Fundus photographs were taken and retinal vascular caliber measured using computer-assisted techniques and summarized. After adjusting for age, sex, body mass index, smoking, mean arterial blood pressure, serum glucose, white cell count, history of diagnosed hypertension, stroke and coronary heart disease, plus retinal arteriolar caliber, participants in the lowest quintile of total dairy consumption compared to those in the remaining highest 4 quintiles had significantly wider retinal venular caliber, 227.2 versus 224.7 μm, respectively (multivariable-adjusted p = 0.002). Also, subjects in the lowest quintile of low-fat dairy product consumption versus those in the remaining quintiles of low-fat dairy intake had wider retinal venules (∼ 1.7 μm, p = 0.03) and narrower retinal arterioles (∼ 1.4 μm, p = 0.04). Participants in the lowest quintile versus highest quintile of total dietary calcium intake had ∼ 2.3 μm wider retinal venules (multivariable-adjusted p-trend = 0.02). CONCLUSIONS A significant association was observed between lower intake of dairy products or calcium and adverse retinal vascular signs. We cannot discount the possibility of confounding from unmeasured risk factors; hence, further studies are warranted to confirm these findings.
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Affiliation(s)
- B Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, NSW, Australia
| | - V M Flood
- Faculty of Health and Behavioural Sciences, University of Wollongong, Sydney, NSW, Australia
| | - J J Wang
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, NSW, Australia; Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Australia
| | - G Burlutsky
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, NSW, Australia
| | - P Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, NSW, Australia.
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Siegrist M, Hanssen H, Neidig M, Fuchs M, Lechner F, Stetten M, Blume K, Lammel C, Haller B, Vogeser M, Parhofer KG, Halle M. Association of leptin and insulin with childhood obesity and retinal vessel diameters. Int J Obes (Lond) 2013; 38:1241-7. [PMID: 24301134 DOI: 10.1038/ijo.2013.226] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 11/16/2013] [Accepted: 11/26/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Childhood obesity is associated with an impaired retinal microcirculation. The aim of the study was to investigate the association between specific obesity-related biomarkers, physical fitness and retinal vessel diameters in school children. DESIGN AND SUBJECTS We studied 381 children aged 10-11 years (body mass index (BMI): 19.3±3.7 kg m(-2)) in a school-based setting. MEASUREMENTS Anthropometric measurements and blood sampling were conducted using standard protocols for children. The serum biomarkers leptin, adiponectin, insulin as well as interleukin-6 (IL-6) were analyzed. Physical fitness was determined by a six-item-test battery and physical activity by use of a questionnaire. Central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and the arteriolar-to-venular diameter ratio (AVR) were assessed with a non-mydriatic vessel analyzer (SVA-T) using a computer-based program. RESULTS Compared with normal weight children (n=254), obese children (n=39) showed higher leptin (P<0.001), higher insulin (P<0.001), higher IL-6 (P<0.001) and lower adiponectin levels (P=0.013). Obese children demonstrated wider CRVE (P=0.041) and lower AVR (P<0.001). Higher leptin levels were associated with wider CRVE (P=0.032) and lower AVR (P=0.010), that was BMI dependent. Insulin levels were associated with arteriolar (P=0.045) and venular dilatation (P=0.034) after adjustment for BMI. No significant associations between adiponectin levels, IL-6 levels, physical fitness or physical activity and retinal vessel diameter were observed. Lower leptin levels were independently correlated with higher physical fitness (r=-0.33; P<0.001). CONCLUSION Leptin and insulin levels are associated with changes of the retinal microcirculation. Especially insulin seems to be a good target marker for the cardiometabolic risk assessment in children since elevated insulin levels are independently associated with microvascular end-organ alterations at an early stage. Lifestyle intervention studies are warranted to examine whether improvement of physical fitness or weight reduction can affect cardiometabolic risk markers and reverse alterations of the retinal microcirculation.
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Affiliation(s)
- M Siegrist
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - H Hanssen
- 1] Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany [2] Division of Sports Medicine, Institute of Exercise and Health Sciences, University of Basel, Basel, Switzerland
| | - M Neidig
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Fuchs
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - F Lechner
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Stetten
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - K Blume
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - C Lammel
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - B Haller
- Institute of Medical Statistics and Epidemiology, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Vogeser
- Department of Clinical Chemistry, University of Munich, Grosshadern Campus, Munich, Germany
| | - K G Parhofer
- Department of Internal Medicine II, University of Munich, Grosshadern Campus, Munich, Germany
| | - M Halle
- 1] Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany [2] DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany [3] Else Kröner-Fresenius-Zentrum am Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Li LJ, Lee YS, Wong TY, Cheung CYL. Can the retinal microvasculature offer clues to cardiovascular risk factors in early life? Acta Paediatr 2013; 102:941-6. [PMID: 23682621 DOI: 10.1111/apa.12294] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 05/15/2013] [Indexed: 11/29/2022]
Abstract
UNLABELLED Adulthood cardiovascular diseases (CVD) burdening in adulthood have been suggested to have possible predisposition early in life. We aimed to systematically review the literatures on retinal microvasculature among paediatric population in relation to a range of environmental and systemic changes. Papers with quantitative retinal vascular assessment and epidemiological design were reviewed. CONCLUSION This review supports the theory that major vascular diseases have pathological predisposition early in life by providing morphological evidence on retinal microcirculation in vivo.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Center; Singapore; Singapore
| | - Yung-Seng Lee
- Department of Paediatrics; National University of Singapore; Singapore; Singapore
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Gopinath B, Hardy LL, Baur LA, Burlutsky G, Mitchell P. Birth weight and time spent in outdoor physical activity during adolescence. Med Sci Sports Exerc 2013; 45:475-80. [PMID: 23059858 DOI: 10.1249/mss.0b013e3182752b95] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE We investigated the association between birth parameters (weight, length, and head circumference) and time spent in physical activity (outdoor and indoor) and screen time (TV viewing, computer, and videogame usage) among adolescents. METHODS A longitudinal cohort study surveyed 1794 children in 2004-2005 (median age = 12.7 yr), and 752 were resurveyed 5 yr later in 2009-2010 (age = 17-18 yr). Adolescents completed detailed activity questionnaires. Parents extracted birth parameter data from their child's health record booklet. RESULTS After adjusting for age, sex, ethnicity, gestational age, parental education, home ownership, exposure to passive smoking, and body mass index, 12-yr-old children in the highest compared with the lowest quartile of birth weight spent on average approximately 56 and 62 min more in total (Ptrend = 0.02) and outdoor physical activity (Ptrend = 0.02) per week, respectively. Similarly, 12-yr-old children in the high (>4000 g) versus very low (<2000 g) birth weight group spent approximately 1.3 h·wk more in outdoor activity (Ptrend = 0.02). Among those age 17-18 yr, increasing birth weight (lowest to highest quartile) was associated with greater time spent in outdoor physical activity (∼1 h·wk-1, Ptrend = 0.04). Significant associations were not observed between all birth parameters and recreational screen time. Also, no associations were observed between head circumference or birth length with physical activity and screen time. CONCLUSIONS Birth weight could be a potential determinant of physical activity, but not of screen time during adolescence. Hence, this could be part of the underlying mechanism between prenatal influences and future disease risk and could have possible clinical implications.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, NSW, Australia.
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Mitchell JA, Byun W. Sedentary Behavior and Health Outcomes in Children and Adolescents. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613498700] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The purpose of this review was to summarize findings from epidemiological studies that determined if sedentary behavior was associated with obesity, metabolic risk factors, and cardiorespiratory fitness in children and adolescents. We noted if studies adjusted for moderate-to-vigorous physical activity (MVPA), dietary intakes, and/or sleep duration. Articles were identified through PubMed using the search terms: (sedentary OR sitting OR television) AND (adiposity OR blood pressure OR body mass index OR cardiometabolic OR metabolic risk OR waist circumference). The search was limited to ages 6 to 18 years, humans, and published between January 1, 2008 and September 26, 2012. Cross-sectional and longitudinal studies observed associations between more sedentary behavior, especially screen-based sedentary behavior, and measures of obesity; and most associations were independent of MVPA and dietary intake. Cross-sectional and longitudinal studies reported associations between screen-based sedentary behavior and lower cardiorespiratory fitness, and most associations were independent of MVPA and obesity. Cross-sectional studies observed associations between more screen-based and objectively measured sedentary behavior and lower insulin sensitivity; and most associations were independent of MVPA and obesity. There was little-to-no evidence that sedentary behavior was associated with increased blood pressure and increased blood lipids.
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Affiliation(s)
- Jonathan A. Mitchell
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (JAM)
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, Indiana (WB)
| | - Wonwoo Byun
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (JAM)
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, Indiana (WB)
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45
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Recio-Rodriguez JI, Gomez-Marcos MA, Patino-Alonso MC, Romaguera-Bosch M, Grandes G, Menendez-Suarez M, Lema-Bartolome J, Gonzalez-Viejo N, Agudo-Conde C, Garcia-Ortiz L. Association of television viewing time with central hemodynamic parameters and the radial augmentation index in adults. Am J Hypertens 2013; 26:488-94. [PMID: 23467204 DOI: 10.1093/ajh/hps071] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We conducted a study to explore the relationship between television viewing time and central hemodynamic parameters and the radial augmentation index (AIx) in adults. METHODS Random sampling was used to select 732 individuals who attended primary-care centers as subjects for the study. The self-reported time that these individuals spent in viewing television was elicited with a questionnaire and included the number of hours that they spent watching television while sitting or lying down. The subjects' physical activity was estimated through accelerometers attached to their waists. Central hemodynamic parameters and the peripheral augmentation index adjusted for a heart rate of 75 bpm (PAIx75) were measured with pulse-wave application software (A-Pulse CASP). RESULTS The subjects' systolic blood pressure (SBP) (central and peripheral), pulse pressure, and radial AIx showed significant differences between tertiles of television viewing time, with the lowest values in the first tertile (P < 0.01). After adjustment for age and sex, a multiple linear regression analysis showed an association of television viewing time with office SBP. Although the association of television viewing time with central SBP followed the same trend as for office BP, it did not reach statistical significance. After adjustment for age, sex, waist-to-height ratio, physical activity reflected by accelerometer data (counts/min), high-density lipoprotein cholesterol, smoking, antihypertensive and antidiabetic medication, and the use of lipid-lowering drugs, an increase in PAIx75 of 0.22 was estimated for each hour of increase in television viewing time (P < 0.01). CONCLUSIONS Television viewing time was directly correlated with PAIx75 in an adult population. This correlation was maintained even after adjustment for physical activity, age, sex, and other cardiovascular risk factors.
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Affiliation(s)
- Jose I. Recio-Rodriguez
- La Alamedilla Health Centre, Castilla y León Health Service–SACYL , redIAPP, IBSAL, Salamanca, Spain
| | - Manuel A. Gomez-Marcos
- La Alamedilla Health Centre, Castilla y León Health Service–SACYL , redIAPP, IBSAL, Salamanca, Spain
| | - Maria C. Patino-Alonso
- La Alamedilla Health Centre, Castilla y León Health Service–SACYL , redIAPP, IBSAL, Salamanca, Spain
| | | | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Bilbao, Spain
| | | | - Jorge Lema-Bartolome
- Cuenca III Health Centre, Castilla La Mancha Health Service–SESCAM, Cuenca, Spain
| | | | - Cristina Agudo-Conde
- La Alamedilla Health Centre, Castilla y León Health Service–SACYL , redIAPP, IBSAL, Salamanca, Spain
| | - Luis Garcia-Ortiz
- La Alamedilla Health Centre, Castilla y León Health Service–SACYL , redIAPP, IBSAL, Salamanca, Spain
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Gopinath B, Hardy LL, Baur LA, Burlutsky G, Mitchell P. Physical activity and sedentary behaviors and health-related quality of life in adolescents. Pediatrics 2012; 130:e167-74. [PMID: 22689863 DOI: 10.1542/peds.2011-3637] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Our goal was to assess cross-sectional and longitudinal associations between physical activity and sedentary behaviors (television viewing, computer and video-game usage, and reading) with health-related QoL. METHODS Of 2353 children surveyed (median age: 12.7 years), 1216 were resurveyed 5 years later, and 475 were newly recruited into the study (N = 1691). Children completed detailed activity questionnaires. Health-related QoL was assessed by using the Pediatric Quality of Life Inventory (PedsQL). RESULTS Cross-sectionally, after multivariable adjustment, adolescents in the highest versus lowest tertile of time spent in outdoor physical activity and television viewing had a higher (P(trend) = .001) and lower (P(trend) = .0003) total PedsQL score, respectively. Adolescents who remained in the highest tertiles compared with those in the lowest tertiles of total physical activity over the 5 years had significantly higher scores in the following areas: total (P(trend) = .04), physical summary (P(trend) = .0001), and social (P(trend) = .02) domains. Conversely, those in the highest versus lowest tertile of screen-viewing time during follow-up reported significantly lower values in the following areas: total score (6.34-unit difference), physical summary (4.86-unit difference), psychosocial summary (7.09-unit difference), and emotional (8.33-unit difference) and school (9.78-unit difference) domains. CONCLUSIONS Regular physical activity over the long-term was associated with higher perceived health-related QoL among adolescents. Conversely, lower PedsQL scores were observed among those who spent the most time in screen-viewing activities. Improved understanding of these relationships could help in developing interventions to promote general well-being among adolescents.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
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Gopinath B, Flood VM, Wang JJ, Smith W, Rochtchina E, Louie JCY, Wong TY, Brand-Miller J, Mitchell P. Carbohydrate nutrition is associated with changes in the retinal vascular structure and branching pattern in children. Am J Clin Nutr 2012; 95:1215-22. [PMID: 22456656 DOI: 10.3945/ajcn.111.031641] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Higher intake of carbohydrates and high-glycemic index (high-GI) diets could lead to small vessel dysfunction. OBJECTIVES We aimed to assess the associations between intakes of high-GI and high-glycemic load (high-GL) diets, carbohydrate, and the main carbohydrate-containing food groups and retinal microvascular changes in preadolescents. DESIGN Students aged 12 y (n = 2353) from a random cluster sample of 21 schools underwent detailed eye examinations. Retinal vessel caliber and fractal dimension were measured from digital retinal images. A validated semiquantitative food-frequency questionnaire was administered. RESULTS After multivariable adjustment, children who consumed soft drinks once or more per day had significantly narrower mean retinal arterioles (∼1.9 μm) than did those who never or rarely consumed soft drinks (P-trend = 0.03). When the highest to lowest tertiles of carbohydrate consumption were compared, girls had significantly narrower retinal arterioles (∼1.4 μm; P-trend = 0.03) and boys had wider venules (∼2.3 μm; P-trend = 0.02). In girls only, a higher-GI diet was associated with narrower retinal arterioles (0.98-μm narrowing of retinal arteriolar caliber per SD increase in GI, P = 0.01). Carbohydrate intake and a high-GL diet were associated with greater retinal fractal dimension in girls (highest compared with lowest tertiles: P-trend = 0.003 and 0.01, respectively). CONCLUSIONS Greater consumption of carbohydrates and soft drinks was associated with retinal arteriolar narrowing and venular widening. Because these microvascular signs have been shown to be markers of future cardiovascular disease risk, the presence of this risk factor in children could support the need for healthy dietary patterns that include lower consumption of high-GI foods and soft drinks.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
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SERRE KEVIN, SASONGKO MUHAMMADBAYU. Modifiable Lifestyle and Environmental Risk Factors Affecting the Retinal Microcirculation. Microcirculation 2011; 19:29-36. [DOI: 10.1111/j.1549-8719.2011.00121.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Influence of parental history of hypertension on screen time and physical activity in young offspring. J Hypertens 2011; 30:336-41. [PMID: 22179085 DOI: 10.1097/hjh.0b013e32834ea436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Epidemiological data on the relationship between parental hypertension and lifestyle factors among children are limited. We assessed the associations between positive parental history of hypertension with a range of indicators of sedentariness (television viewing, computer and videogame usage) and physical activity (outdoor and indoor activity) among prepubertal children. METHODS Six-year-old (1765 of 2238 eligible) students from a random cluster sample of 34 Sydney schools were examined. Parents completed questionnaires about their medical conditions and the child's activities. If the biological mother and/or father had hypertension, then this was classified as positive parental history of hypertension. RESULTS Parents of 160 (9.2%) children gave a positive family history of hypertension. After adjusting for age, sex, ethnicity, parental education and employment and exposure to passive smoking, children with, compared with those without, a family history of hypertension were more likely to spend above the median time (hours/day) watching television and playing videogames [odds ratio (OR) 1.41, 95% confidence interval (CI) 1.02-1.96; OR 1.52, CI 1.12-2.06, respectively]. The offspring of hypertensive parents were more likely to spend above the median time in total physical activity (OR 1.67, 95% CI 1.23-2.27). Maternal (but not paternal) hypertension was associated with increased time spent watching television (P = 0.03) and in outdoor activity (P = 0.01). CONCLUSION Parental hypertension influences the time that prepubertal offspring spend in both active and sedentary pursuits. These findings highlight potential factors that could be addressed in the development of cardiovascular disease-preventive measures starting early in life among the offspring of hypertensive parents.
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Gopinath B, Baur LA, Hardy LL, Wang JJ, Teber E, Wong TY, Mitchell P. Parental history of hypertension is associated with narrower retinal arteriolar caliber in young girls. Hypertension 2011; 58:425-30. [PMID: 21768527 DOI: 10.1161/hypertensionaha.111.177022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We aimed to assess the associations between parental history of hypertension and indicators of cardiovascular risk (retinal vessel diameter, presence of obesity, and elevated blood pressure) in prepubertal children. There were 1739 (77.7% of those eligible) 6-year-old students (863 girls and 876 boys) who were examined from a random cluster sample of 34 Sydney schools. Parents completed questionnaires about their medical conditions, including whether they have/had hypertension. Retinal images were taken with a digital fundus camera, and retinal vessel caliber was quantified using computer software. Anthropometric (height, weight, percentage of body fat, and body mass index) and blood pressure measures were collected. There were 160 children (9.2%) with a positive parental history of hypertension (either biological mother and/or father). Children with a positive versus negative parental history of hypertension had significantly higher body mass index (16.8 versus 16.5 kg/m(2); P=0.04) and systolic blood pressure (101.3 versus 99.8 mm Hg; P=0.01). Girls with positive versus negative parental history of hypertension had significantly higher diastolic blood pressure (≈3.1 mm Hg; P=0.01) and narrower retinal arteriolar caliber (≈4.3 μm; P=0.0004). Positive parental history of hypertension was not associated with mean retinal vascular caliber among boys. We show that a positive parental history of hypertension in healthy prepubertal girls, but not boys, is associated with narrower retinal arteriolar vessels, likely conveying a predisposition to develop hypertension later in life. These findings may indicate the need for cardiovascular disease prevention measures starting early in life among offspring of hypertensive parents.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia
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