1
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Buckland G, Northstone K, Emmett PM, Taylor CM. Associations of childhood diet quality scores with arterial stiffness and carotid artery intima-media thickness in adolescence/early adulthood: findings from the ALSPAC cohort. Br J Nutr 2024; 131:720-735. [PMID: 38178807 PMCID: PMC10803818 DOI: 10.1017/s0007114523002763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/08/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024]
Abstract
This study examined the relationship between childhood diet quality and arterial stiffness and thickness during adolescence/early adulthood. Participants were from the Avon Longitudinal Study of Parents and Children (ALSPAC) with dietary data at ages 7, 10 and 13 years and pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) at ages 17 and/or 24 years. Diet quality (DQ) was assessed using five scores: a children's Mediterranean-style diet (C-rMED) Z-score, a children's Dietary Inflammatory Z-score (C-DIS), a DASH diet Z-score, a children's Eatwell Guide (C-EWG) Z-score reflecting UK dietary guidelines and a data-driven obesogenic Z-score. Adjusted regression models examined the associations between DQ scores at 7-13 years and PWV and cIMT at 17 and 24 years. In adjusted models, a high v. low Obesogenic Z-score at 7 and 10 years was associated with higher PWV at 17: β 0.07 (95 % CI 0.01, 0.13) and β 0.10 (95 % CI 0.04, 0.16), respectively. A high v. low C-rMED Z-score at 7 years was associated with lower PWV at 17 (β -0.07; 95 % CI -0.14, -0.01). A high (more anti-inflammatory) vs low C-DIS Z-score at 10 years was associated with a lower PWV at 17 years: β -0.06 (95 % CI -0.12, -0.01). No other associations were observed. In conclusion, an Obesogenic dietary pattern in childhood (7-10 years) was related to increased arterial stiffness, while Mediterranean-style and anti-inflammatory diets were related to decreased arterial stiffness in adolescence. This highlights the importance of establishing healthy dietary habits early in life to protect against vascular damage.
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Affiliation(s)
- Genevieve Buckland
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Pauline M. Emmett
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Caroline M. Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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2
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Abstract
Poor nutrition is the leading cause of poor health, health care spending, and lost productivity in the United States and globally, which acts through cardiometabolic diseases as precursors to cardiovascular disease, cancer, and other conditions. There is great interest in how the social determinants of health (the conditions in which people are born, live, work, develop, and age) impact cardiometabolic disease. Food insecurity is an example of a powerful social determinant of health that impacts health outcomes. Nutrition insecurity, a distinct but related concept to food insecurity, is a direct determinant of health. In this article, we provide an overview of how diet in early life relates to cardiometabolic disease and then continue to focus on the concepts of food insecurity and nutrition insecurity. In the discussions herein we make important distinctions between the concepts of food insecurity and nutrition insecurity and provide a review of their concepts, histories, measurement and assessment devices, trends and prevalence, and links to health and health disparities. The discussions here set the stage for future research and practice to directly address the negative consequences of food and nutrition insecurity.
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Affiliation(s)
- Eric J Brandt
- Division of Cardiovascular Medicine, Department of Internal Medicine (E.J.B., V.L.M.), University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation (E.J.B.), University of Michigan, Ann Arbor, MI
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.)
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W.L.)
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine (S.A.B.)
| | - Venkatesh L Murthy
- Division of Cardiovascular Medicine, Department of Internal Medicine (E.J.B., V.L.M.), University of Michigan, Ann Arbor, MI
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3
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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4
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Primordial Prevention of Atherosclerotic Cardiovascular Disease. J Cardiopulm Rehabil Prev 2022; 42:389-396. [DOI: 10.1097/hcr.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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5
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Xiao J, You Y, Chen X, Tang Y, Chen Y, Liu Q, Liu Z, Ling W. Higher S-adenosylhomocysteine and lower ratio of S-adenosylmethionine to S-adenosylhomocysteine were more closely associated with increased risk of subclinical atherosclerosis than homocysteine. Front Nutr 2022; 9:918698. [PMID: 36034911 PMCID: PMC9399787 DOI: 10.3389/fnut.2022.918698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/11/2022] [Indexed: 12/20/2022] Open
Abstract
Aim To examine the relationship of C1 metabolites of the methionine cycle with the risk of subclinical atherosclerosis (SA) in the Chinese population. Methods A total of 2,991 participants aged 45–75 years old were included for data analyses based on the baseline data of the Guangzhou Nutrition and Health Cohort. Three core serum methionine metabolites including serum S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), and homocysteine (Hcy) were measured by UPLC-MS/MS. SA was determined by B-mode ultrasound measured carotid intima-media thickness (CIMT) at the common artery and bifurcation segments. Multivariable logistic and linear regression models were performed to estimate the associations of C1 metabolites of the methionine cycle with SA risk or CIMT. Results After controlling for potential cofounders and other C1 metabolites, in comparison with the lowest quartile, participants in the highest quartile had lower risk of SA by 27.6% (OR = 0.724; 95% CI:0.563–0.93, Ptrend = 0.007) for SAM and 32.2% (OR = 0.678; 95% CI:0.538–0.855, Ptrend < 0.001) for SAM/SAH, while increased SA risk by 27.9% (OR = 1.279; 95% CI: 1.065–1.535, Ptrend < 0.001) for SAH. No significant association was observed for Hcy with SA after further adjustment of SAH and SAM. The results of multivariable linear regression showed similar findings. The highest two standardized coefficients were observed for SAH (β = 0.104 for CCA and 0.121 for BIF, P< 0.001) and SAM/SAH (β = −0.071 for CCA and −0.084 for BIF, P< 0.001). Subgroup analyses suggested more evident associations of SAH with SA were observed in participants of higher cardiovascular risk profiles. Conclusion Our cross-sectional data showed higher serum SAH, but lower SAM/SAH were independently associated with increased risk of SA among the Chinese middle-aged and elderly population.
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Affiliation(s)
- Jinghe Xiao
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yiran You
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xu Chen
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yi Tang
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yuming Chen
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Guangzhou, China
| | - Qiannan Liu
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Zhaomin Liu
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Guangzhou, China
| | - Wenhua Ling
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Guangzhou, China
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6
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Associations between intakes of foods and their relations to overweight/obesity in 16-year-old adolescents. J Nutr Sci 2022; 11:e26. [PMID: 35462882 PMCID: PMC9003630 DOI: 10.1017/jns.2022.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
There is limited knowledge about the associations between intakes of different foods and inconsistency in the literature of the relation between the quality of food intake and bodyweight in adolescents. The aim of this study is to explore how healthy self-reported food intakes are associated with each other and with overweight/obesity in adolescents. This is a cross-sectional study of seven cohorts of adolescents (n 13 451) who turned sixteen from 2009/2010 up to 2015/2016 and responded to a health questionnaire used by the School Health Services in southeast Sweden. Associations between intakes of ten self-reported foods as well as between food intakes and weight groups based on the International Obesity Task Force standards (isoBMI) were explored by multivariable logistic regression. Healthy intakes of different foods were mostly associated with each other with the strongest association between a high intake of fruit and a high intake of vegetables (odds ratio (OR) = 25 (95 % confidence interval (CI) 20⋅0–33⋅1)). A low-frequency intake of sweets/snacks (OR = 2⋅35 (95 % CI 1⋅84–3⋅00)) was associated with overweight/obesity as well as a healthy choice of butter/margarine (≤40 % fat) (OR = 1⋅82 (95 % CI 1⋅39 to 2⋅41)), but a high-frequency intake of vegetables was negatively associated with overweight/obesity 0⋅77 (0⋅62–0⋅95). To promote health and achieve a healthy weight among adolescents, it is important to take both diet quality and total food amount into consideration.
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7
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Angoff R, Mosarla RC, Tsao CW. Aortic Stiffness: Epidemiology, Risk Factors, and Relevant Biomarkers. Front Cardiovasc Med 2021; 8:709396. [PMID: 34820427 PMCID: PMC8606645 DOI: 10.3389/fcvm.2021.709396] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022] Open
Abstract
Aortic stiffness (AoS) is a maladaptive response to hemodynamic stress and both modifiable and non-modifiable risk factors, and elevated AoS increases afterload for the heart. AoS is a non-invasive marker of cardiovascular health and metabolic dysfunction. Implementing AoS as a diagnostic tool is challenging as it increases with age and varies amongst races. AoS is associated with lifestyle factors such as alcohol and smoking, as well as hypertension and comorbid conditions including metabolic syndrome and its components. Multiple studies have investigated various biomarkers associated with increased AoS, and this area is of particular interest given that these markers can highlight pathophysiologic pathways and specific therapeutic targets in the future. These biomarkers include those involved in the inflammatory cascade, anti-aging genes, and the renin-angiotensin aldosterone system. In the future, targeting AoS rather than blood pressure itself may be the key to improving vascular health and outcomes. In this review, we will discuss the current understanding of AoS, measurement of AoS and the challenges in interpretation, associated biomarkers, and possible therapeutic avenues for modulation of AoS.
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Affiliation(s)
- Rebecca Angoff
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ramya C Mosarla
- Division of Cardiology, Department of Medicine, New York University Langone Health, New York, NY, United States
| | - Connie W Tsao
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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8
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Mori S, Asakura K, Sasaki S, Nishiwaki Y. Relationship between maternal employment status and children's food intake in Japan. Environ Health Prev Med 2021; 26:106. [PMID: 34711169 PMCID: PMC8555293 DOI: 10.1186/s12199-021-01026-z] [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: 07/08/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
Background Although long maternal working hours are reported to have a negative effect on children’s dietary habits, few studies have investigated this issue in Japan. Healthy dietary habits in childhood are important because they may reduce the risk of future disease. Here, we examined the relationship between maternal employment status and children’s dietary intake in 1693 pairs of Japanese primary school 5th and 6th graders and their mothers. Methods The survey was conducted using two questionnaires, a brief-type self-administered diet history questionnaire and a lifestyle questionnaire. The analysis also considered mothers’ and children’s nutrition knowledge, attitudes toward diet, and some aspects of family environment. Results Longer maternal working hours were associated with children’s higher intake of white rice (g/1000kcal) (β 11.4, 95%CI [1.0, 21.9]; working ≥8h vs. not working), lower intake of confectioneries (g/1000kcal) (β −4.0 [−7.6, −0.4]), and higher body mass index (BMI) (kg/m2) (β 0.62 [0.2, 1.0]). Although maternal employment status was not significantly associated with lower intake of healthy food (e.g., vegetables) or higher intake of unhealthy food (e.g., sweetened beverages) in the children, in contrast with previous studies, it may have affected children’s energy intake through their higher intake of white rice. Further, children’s nutrition knowledge and attitudes toward diet, mothers’ food intake, and some family environment factors were significantly associated with intakes of vegetables and sweetened beverages in the children. Conclusions Longer maternal working hours were significantly associated with higher intake of white rice and lower intake of confectioneries, as well as higher BMI among children. Even when a mother works, however, it may be possible to improve her child’s dietary intake by other means such as nutrition education for children or enhancement of food environment.
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Affiliation(s)
- Sachie Mori
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan
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9
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Kähönen E, Aatola H, Lehtimäki T, Haarala A, Sipilä K, Juonala M, Raitakari OT, Kähönen M, Hutri-Kähönen N. Influence of early life risk factors and lifestyle on systemic vascular resistance in later adulthood: the cardiovascular risk in young Finns study. Blood Press 2021; 30:367-375. [PMID: 34605743 DOI: 10.1080/08037051.2021.1980372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE There are limited data available concerning the effects of lifetime risk factors and lifestyle on systemic hemodynamics, especially on systemic vascular resistance. The purpose of the study was to evaluate how lifetime cardiovascular risk factors (body mass index (BMI), high-density lipoprotein, low-density lipoprotein, triglycerides, systolic blood pressure, blood glucose) and lifestyle factors (vegetable consumption, fruit consumption, smoking and physical activity) predict systemic vascular resistance index (SVRI) and cardiac index (CI) assessed in adulthood. MATERIALS AND METHODS Our study cohort comprised 1635 subjects of the Cardiovascular Risk in Young Finns Study followed up for 27 years since baseline (1980; aged 3-18 years, females 54.3%) who had risk factor and lifestyle data available since childhood. Systemic hemodynamics were measured in 2007 (aged 30-45 years) by whole-body impedance cardiography. RESULTS In the multivariable regression analysis, independent predictors of the adulthood SVRI were childhood BMI, blood glucose, vegetable consumption, smoking, and physical activity (p ≤ .046 for all). Vegetable consumption, smoking, and physical activity remained significant when adjusted for corresponding adult data (p ≤ .036 for all). For the CI, independent predictors in childhood were BMI, systolic blood pressure, vegetable consumption, and physical activity (p ≤ .044 for all), and the findings remained significant after adjusting for corresponding adult data (p ≤ .046 for all). The number of childhood and adulthood risk factors and unfavourable lifestyle factors was directly associated with the SVRI (p < .001) in adulthood. A reduction in the number of risk factors and unfavourable lifestyle factors or a favourable change in BMI status from childhood to adulthood was associated with a lower SVRI in adulthood (p < .001). CONCLUSION Childhood BMI, blood glucose, vegetable consumption, smoking and physical activity independently predict systemic vascular resistance in adulthood. A favourable change in the number of risk factors or BMI from childhood to adulthood was associated with lower vascular resistance in adulthood.
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Affiliation(s)
- Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Atte Haarala
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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10
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Sang Y, Mao K, Cao M, Wu X, Ruan L, Zhang C. Longitudinal association between cardiovascular health and arterial stiffness in the Chinese adult population. J Int Med Res 2021; 49:300060521998889. [PMID: 33787372 PMCID: PMC8020111 DOI: 10.1177/0300060521998889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Arterial stiffness may be an intermediary biological pathway involved in the
association between cardiovascular health (CVH) and cardiovascular disease.
We aimed to evaluate the effect of CVH on progression of brachial–ankle
pulse wave velocity (baPWV) over approximately 4 years. Methods We included 1315 cardiovascular disease-free adults (49±12 years) who had two
checkups from 2010 to 2019. CVH metrics (current smoking, body mass index,
total cholesterol, blood pressure, and fasting plasma glucose) were assessed
at baseline, and the number of ideal CVH metrics and CVH score were
calculated. Additionally, baPWV was examined at baseline and follow-up. Results Median baPWV increased from 1340 cm/s to 1400 cm/s, with an average annual
change in baPWV of 15 cm/s. More ideal CVH metrics and a higher CVH score
were associated with lower baseline and follow-up baPWV, and the annual
change in baPWV, even after adjustment for confounding variables.
Associations between CVH parameters and baseline and follow-up baPWV
remained robust in different sex and age subgroups, but they were only able
to predict the annual change in baPWV in men and individuals older than 50
years. Conclusions Our findings highlight the benefit of a better baseline CVH profile for
progression of arterial stiffness.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kaimin Mao
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
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11
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Pool LR, Aguayo L, Brzezinski M, Perak AM, Davis MM, Greenland P, Hou L, Marino BS, Van Horn L, Wakschlag L, Labarthe D, Lloyd-Jones D, Allen NB. Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review. J Pediatr 2021; 232:118-126.e23. [PMID: 33516680 DOI: 10.1016/j.jpeds.2021.01.053] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). STUDY DESIGN A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. RESULTS There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. CONCLUSIONS Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Liliana Aguayo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Michal Brzezinski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew M Davis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley S Marino
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Wakschlag
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Darwin Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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12
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Lukomskyj N, Allman-Farinelli M, Shi Y, Rangan A. Dietary exposures in childhood and adulthood and cardiometabolic outcomes: a systematic scoping review. J Hum Nutr Diet 2021; 34:511-523. [PMID: 33406314 DOI: 10.1111/jhn.12841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/30/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Associations between diet and cardiometabolic outcomes are often based on a single measurement of diet in adulthood. Dietary exposures in childhood are thought to influence cardiometabolic disease development and individuals' diets can change over time, therefore dietary exposure in childhood and over long periods are both important to consider. This scoping review aimed to identify and characterise the literature on associations between diet measured in both childhood and adulthood and cardiometabolic outcomes. Seven databases were searched; eligible evidence sources were original analyses published as a journal article in English. Exposures included measures of dietary intake, diet quality and eating behaviours measured in both childhood and adulthood with at least five years between first and last measurements. Cardiometabolic outcomes included measures of anthropometry, biochemistry, vascular structure/function and disease states/scores. We identified 37 eligible articles from nine cohort studies. Dietary exposures were measured between two and eight times and most often assessed by food frequency questionnaire or diet history. The dietary exposures most frequently examined were protein, fat, carbohydrate, fruit, vegetables, sugar-sweetened beverages and breakfast. Cardiometabolic outcomes were predominantly based on risk markers. Authors utilised a variety of analytical approaches to transform and analyse repeated measures of diet, providing insights relevant to different lifespan nutrition concepts. The literature on associations between diet in childhood and adulthood and cardiometabolic outcomes is limited, but such studies have great potential to extend our knowledge in ways only possible with repeated measures of diet over time. Further research is needed to develop the evidence base for diet-disease relationships from a life course perspective, accounting for diet in both childhood and adulthood.
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Affiliation(s)
- Natalya Lukomskyj
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | | | - Yumeng Shi
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anna Rangan
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
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13
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Kähönen E, Aatola H, Pälve K, Hulkkonen J, Haarala A, Sipilä K, Juonala M, Lehtimäki T, Raitakari OT, Kähönen M, Hutri-Kähönen N. Association of lifetime blood pressure with adulthood exercise blood pressure response: the cardiovascular risk in young Finns study. Blood Press 2021; 30:126-132. [PMID: 33399019 DOI: 10.1080/08037051.2020.1868287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Elevated blood pressure (BP) in childhood has been associated with increased adulthood BP. However, BP and its change from childhood to adulthood and the risk of exaggerated adulthood exercise BP response are largely unknown. Therefore, we studied the association of childhood and adulthood BP with adulthood exercise BP response. MATERIALS AND METHODS This investigation consisted of 406 individuals participating in the ongoing Cardiovascular Risk in Young Finns Study (baseline in 1980, at age of 6-18 years; follow-up in adulthood in 27-29 years since baseline). In childhood BP was classified as elevated according to the tables from the International Child Blood Pressure References Establishment Consortium, while in adulthood BP was considered elevated if systolic BP was ≥120 mmHg or diastolic BP was ≥80 mmHg or if use of antihypertensive medications was self-reported. A maximal cardiopulmonary exercise test with BP measurements was performed by participants in 2008-2009, and exercise BP was considered exaggerated (EEBP) if peak systolic blood pressure exceeded 210 mmHg in men and 190 mmHg in women. RESULTS Participants with consistently high BP from childhood to adulthood and individuals with normal childhood but high adulthood BP had an increased risk of EEBP response in adulthood (relative risk [95% confidence interval], 3.32 [2.05-5.40] and 3.03 [1.77-5.17], respectively) in comparison with individuals with normal BP both in childhood and adulthood. Interestingly, individuals with elevated BP in childhood but not in adulthood also had an increased risk of EEBP [relative risk [95% confidence interval], 2.17 [1.35-3.50]). CONCLUSIONS These findings reinforce the importance of achieving and sustaining normal blood pressure from childhood through adulthood.
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Affiliation(s)
- Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kristiina Pälve
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, Turku, Finland
| | | | - Atte Haarala
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,The Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Clinical Chemistry, Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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14
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Liese AD, Couch SC, The NS, Crandell JL, Lawrence JM, Crume TL, Mayer-Davis EJ, Zhong VW, Urbina EM. Association between diet quality indices and arterial stiffness in youth with type 1 diabetes: SEARCH for Diabetes in Youth Nutrition Ancillary Study. J Diabetes Complications 2020; 34:107709. [PMID: 32888787 PMCID: PMC7673264 DOI: 10.1016/j.jdiacomp.2020.107709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
AIMS We studied the association of three distinct diet quality indices and two measures of arterial stiffness in youth and young adults (YYA) aged 10 to 30 with T1D. METHODS Cross-sectional (n = 1421) and longitudinal (n = 520) analyses were conducted in T1D YYA participating in the SEARCH for Diabetes in Youth Study. The diet quality indices included the Dietary Approaches to Stop Hypertension (DASH) index, the Healthy Eating Index 2015 (HEI-2015), and a modified Mediterranean Diet Quality Index (mKIDMED). Arterial stiffness was measured with pulse wave velocity (PWV) and augmentation index (AIx) obtained using a SphygmoCor-Vx device and tonometer. RESULTS Average diet quality was moderate to poor, with mean scores of 41 (DASH, range 0-80), 55 (HEI-2015, range 0-100), 3.7 (mKIDMED, range - 3-12). None of the diet quality scores was associated with the central PWV or Aix, independent of demographic, clinical and lifestyle factors, body mass index and HbA1c. Longitudinal data yielded consistent findings with cross-sectional results. CONCLUSIONS This study suggests that diet quality may not function as an independent risk factor for arterial stiffening in YYA with T1D. These findings do not diminish the importance of consuming a quality diet for the management of diabetes, as demonstrated in previous work.
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Affiliation(s)
- Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America.
| | - Sarah C Couch
- Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati Medical Center, Cincinnati, OH, United States of America.
| | - Natalie S The
- Department of Health Sciences, Furman University, Greenville, SC, United States of America.
| | - Jamie L Crandell
- Department of Biostatistics, Gillings School of Global Public Health, School of Nursing, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Jean M Lawrence
- Department of Research & Evaluation, Division of Epidemiologic Research Kaiser Permanente Research, Pasadena, CA, United States of America.
| | - Tessa L Crume
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Victor W Zhong
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States of America.
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States of America.
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15
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Metabolically Healthy Obesity: Presence of Arterial Stiffness in the Prepubescent Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196995. [PMID: 32987856 PMCID: PMC7579096 DOI: 10.3390/ijerph17196995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
Aim: Arteriosclerotic cardiovascular disease, one of the world’s leading causes of death, first manifests itself at an early age. The identification of children who may have increased cardiovascular risk in the future could be an important prevention strategy. Our aim was to assess the clinical, analytical, and dietary variables associated with arterial stiffness (AS), measured by carotid-femoral pulse wave velocity (cfPWV) in a prepubescent population with metabolically healthy obesity (MHO). Subjects and Methods: A cross-sectional study in prepubescent subjects with obesity who had ≤1 metabolic syndrome criteria (abdominal perimeter and blood pressure ≥90th percentile, triglycerides >150 mg/dL, HDL-cholesterol <40 mg/dL, fasting plasma glucose ≥100 mg/dL) was conducted. Adherence to Mediterranean Diet, blood pressure, BMI, waist/height ratio (WHtR), glycemic status, lipid profile, and cfPWV were analyzed. 75 MHO children (boys: 43; girls: 32; p = 0.20) (age = 10.05 ± 1.29 years; BMI = 25.29 ± 3.5 kg/m2) were included. Results: We found a positive correlation between cfPWV and weight (r = 0.51; p < 0.0001), BMI (r = 0.44; p < 0.0001), WHtR (r = 0.26; p = 0.02), fasting insulin levels (r = 0.28; p = 0.02), and insulin resistance (Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index) (r = 0.25; p = 0.04). Multiple linear regression analysis identified BMI and HOMA-IR as independent parameters associated with cfPWV. Conclusions: Prepubescent children with obesity who were shown to be metabolically healthy presented with arterial stiffness, which is closely related to BMI and the state of insulin resistance.
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16
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Fysekidis M, Kesse-Guyot E, Valensi P, Arnault N, Galan P, Hercberg S, Cosson E. Association Between Adherence To The French Dietary Guidelines And Lower Resting Heart Rate, Longer Diastole Duration, And Lower Myocardial Oxygen Consumption. The NUTRIVASC Study. Vasc Health Risk Manag 2019; 15:463-475. [PMID: 31802880 PMCID: PMC6826965 DOI: 10.2147/vhrm.s215795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/28/2019] [Indexed: 12/31/2022] Open
Abstract
Background To investigate whether chronic adherence to the French Nutrition and Health Program (PNNS) guidelines was associated with better cardiovascular health. Methods A study nested within the SU.VI.MAX2 cohort was conducted on participants without cardiovascular risk factors. Long-term adherence to the PNNS guidelines was estimated using validated dietary scores from 2007 and 2012. Individuals who did (PNNS+) and did not (PNNS−) continuously adhere to the PNNS guidelines were included. Applanation tonometry, impedance cardiography, laser doppler flowmetry, heart rate, heart rate variability, endothelial function was used for the assessment of cardiovascular health. Results A total of 49 subjects (mean age 65.4 ± 5.6 years, 75.5% women) had been included. Those in the PNNS+ group (n=26) were older, had a higher BMI and fat mass than those in the PNNS− group, both groups had similar metabolic parameters. After adjusting for sex, age, and BMI, PNNS+ subjects were found to have a lower heart rate (60.2 ± 8.0 vs 64.3 ± 8.4 beats/min, p=0.042), a lower heart rate × systolic blood pressure product (7166 ± 1323 vs 7788 ± 1680 beats× mmHg/min, p = 0.009), a longer diastole duration (66.7 ± 3.1% vs 64.6 ± 4.1% of the cardiac cycle duration, p=0.049), and a shorter tension–time index (2145 ± 489 vs 2307 ± 428 ms * mmHg, p=0.018) compared to the PNNS− group. Conclusion Long-term adherence to the PNNS guidelines had a favorable impact on heart rate, diastole duration, and myocardial oxygen consumption. Clinical Trial Registration number NCT01579409.
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Affiliation(s)
- Marinos Fysekidis
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-Idf, CINFO, Paris 13 University, Hôpital Jean Verdier, Bondy, France.,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
| | - Paul Valensi
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-Idf, CINFO, Paris 13 University, Hôpital Jean Verdier, Bondy, France
| | - Nathalie Arnault
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
| | - Emmanuel Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-Idf, CINFO, Paris 13 University, Hôpital Jean Verdier, Bondy, France.,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Inserm (U1153), Inra (U1125), Centre d'Epidémiologie et Statistiques Paris Cité, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny F-93017, France
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17
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Giontella A, Bonafini S, Tagetti A, Bresadola I, Minuz P, Gaudino R, Cavarzere P, Ramaroli DA, Marcon D, Branz L, Nicolussi Principe L, Antoniazzi F, Maffeis C, Fava C. Relation between Dietary Habits, Physical Activity, and Anthropometric and Vascular Parameters in Children Attending the Primary School in the Verona South District. Nutrients 2019; 11:E1070. [PMID: 31091731 PMCID: PMC6566536 DOI: 10.3390/nu11051070] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/30/2019] [Accepted: 05/10/2019] [Indexed: 12/18/2022] Open
Abstract
The aim of this school-based study was to identify the possible association between diet and physical activity, as well as the anthropometric, vascular, and gluco-lipid parameters. We administered two validated questionnaires for diet and physical activity (Food Frequency questionnaire (FFQ), Children-Physical Activity Questionnaire (PAQ-C)) to children at four primary schools in Verona South (Verona, Italy). Specific food intake, dietary pattern, and physical activity level expressed in Metabolic Equivalent of Task (MET) and PAQ-C score were inserted in multivariate linear regression models to assess the association with anthropometric, hemodynamic, and gluco-lipid measures. Out of 309 children included in the study, 300 (age: 8.6 ± 0.7 years, male: 50%; Obese (OB): 13.6%; High blood pressure (HBP): 21.6%) compiled to the FFQ. From this, two dietary patterns were identified: "healthy" and "unhealthy". Direct associations were found between (i) "fast food" intake, Pulse Wave Velocity (PWV), and (ii) animal-derived fat and capillary cholesterol, while inverse associations were found between vegetable, fruit, and nut intake and capillary glucose. The high prevalence of OB and HBP and the significant correlations between some categories of food and metabolic and vascular parameters suggest the importance of life-style modification politics at an early age to prevent the onset of overt cardiovascular risk factors in childhood.
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Affiliation(s)
- Alice Giontella
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | - Sara Bonafini
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | - Angela Tagetti
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | - Irene Bresadola
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Pietro Minuz
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | - Rossella Gaudino
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Paolo Cavarzere
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Diego Alberto Ramaroli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Denise Marcon
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | - Lorella Branz
- Department of Medicine, University of Verona, 37129 Verona, Italy.
| | | | - Franco Antoniazzi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy.
| | - Cristiano Fava
- Department of Medicine, University of Verona, 37129 Verona, Italy.
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18
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Komulainen K, Mittleman MA, Jokela M, Laitinen TT, Pahkala K, Elovainio M, Juonala M, Tammelin T, Kähönen M, Raitakari O, Keltikangas-Järvinen L, Pulkki-Råback L. Socioeconomic position and intergenerational associations of ideal health behaviors. Eur J Prev Cardiol 2019; 26:1605-1612. [DOI: 10.1177/2047487319850959] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Promoting ideal cardiovascular health behaviors is an objective of the American Heart Association 2020 goals. We hypothesized that ideal health behaviors of parents are associated with health behaviors of their adult offspring, and that higher socioeconomic position in either generation enhances intergenerational associations of ideal health behaviors. Design Prospective cohort study. Methods We included 1856 Young Finns Study participants who had repeated measurements of socioeconomic position (education, income, occupation), smoking status, body mass index, physical activity and diet from 2001, 2007 and 2011, and data on parental socioeconomic position and health behaviors from 1980. We calculated the total number of ideal behaviors in both generations using American Heart Association definitions. Intergenerational associations were examined using ordinal and linear multilevel regression with random intercepts, in which each participant contributed one, two or three measurements of adult health behaviors (2001, 2007, 2011). All analyses were adjusted for offspring sex, birth year, age, parental education and single parenthood. Results Overall, parental ideal health behaviors were associated with ideal behaviors among offspring (odds ratio (OR) 1.28, 95% confidence interval 1.17, 1.39). Furthermore, ORs for these intergenerational associations were greater among offspring whose parents or who themselves had higher educational attainment (OR 1.56 for high vs. OR 1.19 for low parental education; P = 0.01 for interaction, OR 1.32 for high vs. OR 1.04 for low offspring education; P = 0.02 for interaction). Similar trends were seen with parental income and offspring occupation. Results from linear regression analyses were similar. Conclusions These prospective data suggest higher socioeconomic position in parents or in their adult offspring strengthens the intergenerational continuum of ideal cardiovascular health behaviors.
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Affiliation(s)
- Kaisla Komulainen
- Department of Psychology and Logopedics, University of Helsinki, Finland
- Department of Epidemiology, Harvard TH Chan School of Public Health, USA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard TH Chan School of Public Health, USA
- Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, USA
| | - Markus Jokela
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Department of Physical Activity and Health, Sports & Exercise Medicine Unit, Paavo Nurmi Centre, University of Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Department of Physical Activity and Health, Sports & Exercise Medicine Unit, Paavo Nurmi Centre, University of Turku, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Finland
- Department of Health Services Research, National Institute for Health and Welfare, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Finland
- Division of Medicine, Turku University Hospital, Finland
- Murdoch Children's Research Institute, Australia
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Finland
- Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland
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19
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Higher dietary and serum carotenoid levels are associated with lower carotid intima-media thickness in middle-aged and elderly people. Br J Nutr 2019; 119:590-598. [PMID: 29508696 DOI: 10.1017/s0007114517003932] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Several studies have suggested that higher carotenoid levels may be beneficial for atherosclerosis patients, but few studies have examined this relationship in the Chinese population. This cross-sectional study examined the association between the levels of carotenoids in diet and serum and carotid intima-media thickness (IMT) in Chinese adults aged 50-75 years in Guangzhou, China. Dietary intake was assessed using a FFQ. HPLC was used to assay the serum concentrations of α-carotene, β-carotene, lutein+zeaxanthin, β-cryptoxanthin and lycopene. The IMT at the common carotid artery (CCA) and bifurcation of the carotid artery was measured by B-mode ultrasound. A total of 3707 and 2947 participants were included in the analyses of dietary and serum carotenoids. After adjustment for demographic, socio-economic and lifestyle factors, all the serum carotenoids levels except lycopene were found to be inversely associated with the IMT at the CCA and bifurcation (P trend<0·001 to 0·013) in both men and women. The absolute mean differences in the IMT between the subjects in the extreme quartiles of serum carotenoid levels were 0·034 mm (α-carotene), 0·037 mm (β-carotene), 0·032 mm (lutein+zeaxanthin), 0·030 mm (β-cryptoxanthin), 0·015 mm (lycopene) and 0·035 mm (total carotenoids) at the CCA; the corresponding values were 0·025, 0·053 0·043, 0·050, 0·011 and 0·042 mm at the bifurcation. The favourable associations were also observed between dietary carotenoids (except lycopene) and the CCA IMT. In conclusion, elevated carotenoid levels in diet and serum are associated with lower carotid IMT values (particular at the CCA) in Chinese adults.
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20
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Ahola AJ, Gordin D, Forsblom C, Groop PH. Association between diet and measures of arterial stiffness in type 1 diabetes - Focus on dietary patterns and macronutrient substitutions. Nutr Metab Cardiovasc Dis 2018; 28:1166-1172. [PMID: 30292475 DOI: 10.1016/j.numecd.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/13/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Increased arterial stiffness contributes to diabetic vascular complications. We identified dietary factors related to arterial stiffness in individuals with type 1 diabetes, a population with high risk of cardiovascular disease. METHODS AND RESULTS Altogether, 612 participants (40% men, mean ± standard deviation age 45 ± 13 years) completed a validated diet questionnaire and underwent measurements of arterial stiffness. Of these, 470 additionally completed a food record. Exploratory factor analysis was applied to identify dietary patterns from the diet questionnaires, and nutrient intakes were calculated from food record entries. Arterial stiffness was measured by applanation tonometry. Of the seven dietary factors formed, the factor scores of "Full-fat cheese and eggs" and "Sweet" patterns were negatively associated with measures of arterial stiffness. In the multivariable macronutrient substitution models, favouring carbohydrates over fats was associated with higher aortic mean arterial pressure and aortic pulse wave velocity. When carbohydrates were consumed in place of proteins, higher aortic pulse pressure, aortic mean arterial pressure, and augmentation index were recorded. Replacing energy from alcohol with proteins, was associated with lower aortic pulse pressure, aortic mean arterial pressure, and augmentation index. Relative distributions of dietary fatty acids were neutral with respect to the measures of arterial stiffness. CONCLUSION The macronutrient distribution of the diet is likely to affect the resilience of the arteries. Our observations suggest that reducing energy intake from carbohydrates and alcohol may be beneficial. These observations, especially those dealing with dietary patterns, need to be confirmed in a longitudinal study.
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Affiliation(s)
- A J Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Finland
| | - D Gordin
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Finland; Dianne Nunnally Hoppes Laboratory Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, USA
| | - C Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Finland
| | - P-H Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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Petersen KS, Keogh JB, Lister NB, Clifton PM. Dietary quality and carotid intima media thickness in type 1 and type 2 diabetes: Follow-up of a randomised controlled trial. Nutr Metab Cardiovasc Dis 2018; 28:830-838. [PMID: 29853429 DOI: 10.1016/j.numecd.2018.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS The relationship between dietary intake and carotid intima media thickness (IMT) and pulse wave velocity (PWV) in individuals with type 1 and type 2 diabetes has not been well studied. We investigated the association between dietary intake and common carotid artery intima media thickness (CCA IMT) and PWV in a cohort with type 1 and type 2 diabetes. METHODS AND RESULTS A one-year randomised controlled trial was conducted to investigate the effect of improving dietary quality on CCA IMT. These subjects were followed up again approximately 12 months after the completion of the trial (i.e. approximately 24 month since baseline). The study cohort included 87 subjects that had dietary intake and CCA IMT measured at baseline and after a mean of 2.3 years' follow-up. PWV was measured in a subsample of this cohort. Age and baseline mean CCA IMT were strongly associated with mean CCA IMT at 24 months. After adjustment for age and baseline mean CCA IMT, baseline consumption of carbohydrate (r = -0.28; p = 0.01), sugars (r = -0.27; p = 0.01), fibre (r = -0.26; p = 0.02), magnesium (r = -0.25; p = 0.02) and the Alternate Health Eating Index (AHEI) score (r = -0.23; p = 0.03) were inversely associated with mean CCA IMT at 24 months. Mixed linear modelling showed an interaction between mean CCA IMT and AHEI at baseline (p = 0.024). Those who were in the highest AHEI tertile at baseline had greater CCA IMT regression at 24 months compared to those in the lowest tertile, after adjustment for baseline age, BMI, smoking pack years, time since diabetes diagnosis, and mean arterial pressure at baseline (mean -0.043 mm; 95% CI -0.084, -0.003; p = 0.029). CONCLUSIONS In this prospective analysis greater diet quality at baseline, as measured by the AHEI, was associated with greater CCA IMT regression after approximately two years. This suggests that greater diet quality is associated with better longer term vascular health in individuals with type 1 and type 2 diabetes.
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Affiliation(s)
- K S Petersen
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide SA, Australia
| | - J B Keogh
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide SA, Australia
| | - N B Lister
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide SA, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide SA, Australia.
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Neighbourhood socioeconomic disadvantage, risk factors, and diabetes from childhood to middle age in the Young Finns Study: a cohort study. LANCET PUBLIC HEALTH 2018; 3:e365-e373. [PMID: 30030110 PMCID: PMC6079015 DOI: 10.1016/s2468-2667(18)30111-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/23/2018] [Accepted: 05/29/2018] [Indexed: 01/25/2023]
Abstract
Background Neighbourhood socioeconomic disadvantage has been linked to increased diabetes risk, but little is known about differences in risk factors in childhood and adulthood in those with high and low neighbourhood socioeconomic disadvantage, or about the association between long-term neighbourhood socioeconomic disadvantage and incidence of diabetes in adulthood. We used data from the prospective, population-based Young Finns Study to address these questions. Methods We did a nationwide population-based cohort study in Finland using data from The Young Finns Study, which included 3467 participants aged 6–18 years followed up for over 30 years via eight repeated biomedical examinations and linkage to electronic health records. Participants were also linked to national grid data on neighbourhood disadvantage via their residential address from age 6–48 years. We used these data to examine differences in ten risk factors (dietary habits, physical activity, daily smoking, body-mass index, systolic blood pressure, fasting HDL cholesterol, fasting triglycerides, fasting plasma glucose, fasting serum insulin, and homoeostasis model assessment insulin sensitivity) from childhood (6–21 years) to adulthood (22–48 years) among individuals with high (>0·5 SD above the national mean) and low (≥0·5 SD below the national mean) neighbourhood socioeconomic disadvantage, and the association of cumulative neighbourhood socioeconomic disadvantage with six cardiometabolic risk factors (obesity, high waist circumference, fatty liver, hypertension, carotid plaque, and left ventricle mass index) and diabetes by middle age (22–48 years). We used logistic and linear regression analyses to assess the effects of neighbourhood disadvantage on cardiometabolic and diabetes risk, controlling for potential confounders (age, sex, and individual socioeconomic disadvantage). Findings We included data for 3002 individuals with risk factor assessment in childhood and adulthood. Of whom, 2048 underwent a clinical examination during the last follow-up at age 33–48 years. Differences in risk factors by neighbourhood socioeconomic disadvantage at the beginning of follow-up were small, but large differences emerged over the follow-up. High neighbourhood socioeconomic disadvantage was characterised by decreased fruit and vegetable intake as early as age 6 years, decreased physical activity, and increased prevalence of daily smoking from adolescence (12 years) onwards, and decreased homoeostasis model assessment insulin sensitivity and increased fasting glucose and insulin concentration from early adulthood (27 years; all p<0·03). Individuals consistently exposed to high neighbourhood socioeconomic disadvantage were more likely to be obese (odds ratio [OR] 1·44, 95% CI 1·01–2·06), hypertensive (1·83, 1·14–2·93), have a fatty liver (1·73, 1·11–2·71), and diabetes (3·71, 1·77–7·75), compared with those who were consistently exposed to low neighbourhood socioeconomic disadvantage. Interpretation Living in socioeconomically disadvantaged areas can shape health in childhood and adulthood. Neighbourhood socioeconomic disadvantage is associated with differences in health risks across the life course, including detrimental lifestyle factors from childhood and adolescence onwards and worse glucose metabolism from early adulthood. By middle age, cumulative neighbourhood socioeconomic disadvantage is associated with increased cardiometabolic risk factors and increased incidence of diabetes. Funding Academy of Finland, NordForsk, UK Medical Research Council, European Commission, and European Research Council.
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23
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Rosettie KL, Micha R, Cudhea F, Peñalvo JL, O’Flaherty M, Pearson-Stuttard J, Economos CD, Whitsel LP, Mozaffarian D. Comparative risk assessment of school food environment policies and childhood diets, childhood obesity, and future cardiometabolic mortality in the United States. PLoS One 2018; 13:e0200378. [PMID: 29979761 PMCID: PMC6034872 DOI: 10.1371/journal.pone.0200378] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/24/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Promising school policies to improve children's diets include providing fresh fruits and vegetables (F&V) and competitive food restrictions on sugar-sweetened beverages (SSBs), yet the impact of national implementation of these policies in US schools on cardiometabolic disease (CMD) risk factors and outcomes is not known. Our objective was to estimate the impact of national implementation of F&V provision and SSB restriction in US elementary, middle, and high schools on dietary intake and body mass index (BMI) in children and future CMD mortality. METHODS We used comparative risk assessment (CRA) frameworks to model the impacts of these policies with input parameters from nationally representative surveys, randomized-controlled trials, and systematic reviews and meta-analyses. For children ages 5-18 years, this incorporated national data on current dietary intakes and BMI, impacts of these policies on diet, and estimated effects of dietary changes on BMI. In adults ages 25 and older, we further incorporated the sustainability of dietary changes to adulthood, effects of dietary changes on CMD, and national CMD death statistics, modeling effects if these policies had been in place when current US adults were children. Uncertainty across inputs was incorporated using 1000 Monte Carlo simulations. RESULTS National F&V provision would increase daily fruit intake in children by as much as 25.0% (95% uncertainty interval (UI): 15.4, 37.7%), and would have small effects on vegetable intake. SSB restriction would decrease daily SSB intake by as much as 26.5% (95% UI: 6.4, 46.4%), and reduce BMI by as much as 0.7% (95% UI: 0.2, 1.2%). If F&V provision and SSB restriction were nationally implemented, an estimated 22,383 CMD deaths/year (95% UI: 18735, 25930) would be averted. CONCLUSION National school F&V provision and SSB restriction policies implemented in elementary, middle, and high schools could improve diet and BMI in children and reduce CMD mortality later in life.
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Affiliation(s)
- Katherine L. Rosettie
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Renata Micha
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Frederick Cudhea
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Jose L. Peñalvo
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Martin O’Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan Pearson-Stuttard
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
- School of Public Health, Imperial College London, London, United Kingdom
| | - Christina D. Economos
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Laurie P. Whitsel
- American Heart Association, Arlington, Virginia, United States of America
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
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24
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Childhood dietary trajectories and adolescent cardiovascular phenotypes: Australian community-based longitudinal study. Public Health Nutr 2018; 21:2642-2653. [PMID: 29947308 DOI: 10.1017/s1368980018001398] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE With the intention to inform future public health initiatives, we aimed to determine the extent to which typical childhood dietary trajectories predict adolescent cardiovascular phenotypes. DESIGN Longitudinal study. Exposure was determined by a 4 d food diary repeated over eight waves (ages 4-15 years), coded by Australian Dietary Guidelines and summed into a continuous diet score (0-14). Outcomes were adolescent (Wave 8, age 15 years) blood pressure, resting heart rate, pulse wave velocity, carotid intima-media thickness, retinal arteriole-to-venule ratio. Latent class analysis identified 'typical' dietary trajectories from childhood to adolescence. Adjusted linear regression models assessed relationships between trajectories and cardiovascular outcomes, adjusted for a priori potential confounders. SETTING Community sample, Melbourne, Australia. SUBJECTS Children (n 188) followed from age 4 to 15 years. RESULTS Four dietary trajectories were identified: unhealthy (8 %); moderately unhealthy (25 %); moderately healthy (46 %); healthy (21 %). There was little evidence that vascular phenotypes associated with the trajectories. However, resting heart rate (beats/min) increased (β; 95 % CI) across the healthy (reference), moderately healthy (4·1; -0·6, 8·9; P=0·08), moderately unhealthy (4·5; -0·7, 9·7; P=0·09) and unhealthy (10·5; 2·9, 18·0; P=0·01) trajectories. CONCLUSIONS Decade-long dietary trajectories did not appear to influence macro- or microvascular structure or stiffness by mid-adolescence, but were associated with resting heart rate, suggesting an early-life window for prevention. Larger studies are needed to confirm these findings, the threshold of diet quality associated with these physiological changes and whether functional changes in heart rate are followed by phenotypic change.
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25
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Khoury M, Urbina EM. Cardiac and Vascular Target Organ Damage in Pediatric Hypertension. Front Pediatr 2018; 6:148. [PMID: 29881718 PMCID: PMC5976785 DOI: 10.3389/fped.2018.00148] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/03/2018] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis begins in youth and is associated with the presence of numerous modifiable cardiovascular (CV) risk factors, including hypertension. Pediatric hypertension has increased in prevalence since the 1980s but has plateaued in recent years. Elevated blood pressure levels are associated with impairments to cardiac and vascular structure and both systolic and diastolic function. Blood pressure-related increases in left ventricular mass (LVM) and abnormalities in cardiac function are associated with hard CV events in adulthood. In addition to cardiac changes, key vascular changes occur in hypertensive youth and adults. These include thickening of the arteries, increased arterial stiffness, and decreased endothelial function. This review summarizes the epidemiologic burden of pediatric hypertension, its associations with target organ damage (TOD) of the cardiac and vascular systems, and the impact of these adverse CV changes on morbidity and mortality in adulthood.
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Affiliation(s)
| | - Elaine M. Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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26
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Blekkenhorst LC, Bondonno NP, Liu AH, Ward NC, Prince RL, Lewis JR, Devine A, Croft KD, Hodgson JM, Bondonno CP. Nitrate, the oral microbiome, and cardiovascular health: a systematic literature review of human and animal studies. Am J Clin Nutr 2018; 107:504-522. [PMID: 29635489 DOI: 10.1093/ajcn/nqx046] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/21/2017] [Indexed: 12/25/2022] Open
Abstract
Background Dietary nitrate is an important source of nitric oxide (NO), a molecule critical for cardiovascular health. Nitrate is sequentially reduced to NO through an enterosalivary nitrate-nitrite-NO pathway that involves the oral microbiome. This pathway is considered an important adjunct pathway to the classical l-arginine-NO synthase pathway. Objective The objective of this study was to systematically assess the evidence for dietary nitrate intake and improved cardiovascular health from both human and animal studies. Design A systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by using key search terms in Medline and EMBASE databases and defined inclusion and exclusion criteria. Results Thirty-seven articles on humans and 14 articles on animals were included from 12,541 screened references. Data on the effects of dietary nitrate on blood pressure, endothelial function, ischemic reperfusion injury, arterial stiffness, platelet function, and cerebral blood flow in both human and animal models were identified. Beneficial effects of nitrate on vascular health have predominantly been observed in healthy human populations, whereas effects in populations at risk of cardiovascular disease are less clear. Few studies have investigated the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. In animal studies, there is evidence that nitrate improves blood pressure and endothelial function, particularly in animal models with reduced NO bioavailability. Nitrate dose seems to be a critical factor because there is evidence of cross-talk between the 2 pathways of NO production. Conclusions Evidence for a beneficial effect in humans at risk of cardiovascular disease is limited. Furthermore, there is a need to investigate the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. Further animal studies are required to elucidate the mechanisms behind the observed effects.
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Affiliation(s)
- Lauren C Blekkenhorst
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Alex H Liu
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Natalie C Ward
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Joshua R Lewis
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kevin D Croft
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan M Hodgson
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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27
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Affiliation(s)
- Kristen L Nowak
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.).
| | - Matthew J Rossman
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
| | - Michel Chonchol
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
| | - Douglas R Seals
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
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28
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Childhood socioeconomic status and lifetime health behaviors: The Young Finns Study. Int J Cardiol 2018; 258:289-294. [PMID: 29428239 DOI: 10.1016/j.ijcard.2018.01.088] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/19/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Differences in health behaviors partly explain the socioeconomic gap in cardiovascular health. We prospectively examined the association between childhood socioeconomic status (SES) and lifestyle factors in adulthood, and the difference of lifestyle factors according to childhood SES in multiple time points from childhood to adulthood. METHODS AND RESULTS The sample comprised 3453 participants aged 3-18 years at baseline (1980) from the longitudinal Young Finns Study. The participants were followed up for 31 years (N = 1675-1930). SES in childhood was characterized as reported annual family income and classified on an 8-point scale. Diet, smoking, alcohol intake and physical activity were used as adult and life course lifestyle factors. Higher childhood SES predicted a healthier diet in adulthood in terms of lower consumption of meat (β ± SE -3.6 ± 0.99,p < 0.001), higher consumption of fish (1.1 ± 0.5, p = 0.04) and higher diet score (0.14 ± 0.044, p = 0.01). Childhood SES was also directly associated with physical activity index (0.059 ± 0.023, p = 0.009) and inversely with the risk of being a smoker (RR 0.90 95%CI 0.85-0.95, p < 0.001) and the amount of pack years (-0.47 ± 0.18, p = 0.01). Life course level of smoking was significantly higher and physical activity index lower among those below the median childhood SES when compared with those above the median SES. CONCLUSIONS These results show that childhood SES associates with several lifestyle factors 31 years later in adulthood. Therefore, attention could be paid to lifestyle behaviors of children of low SES families to promote cardiovascular health.
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29
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Puolakka E, Pahkala K, Laitinen TT, Magnussen CG, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Tossavainen P, Jokinen E, Sabin MA, Laitinen T, Elovainio M, Pulkki-Råback L, Viikari JSA, Raitakari OT, Juonala M. Childhood Socioeconomic Status and Arterial Stiffness in Adulthood: The Cardiovascular Risk in Young Finns Study. Hypertension 2017; 70:729-735. [PMID: 28808067 DOI: 10.1161/hypertensionaha.117.09718] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 05/28/2017] [Accepted: 07/24/2017] [Indexed: 12/27/2022]
Abstract
Increasing evidence supports the importance of socioeconomic factors in the development of atherosclerotic cardiovascular disease. However, the association of childhood socioeconomic status (SES) with arterial stiffness in adulthood has not been reported. Our aim was to determine whether higher childhood family-level SES is associated with lower arterial stiffness in adulthood. The analyses were performed using data gathered within the longitudinal Young Finns Study. The sample comprised 2566 participants who had data concerning family SES at ages 3 to 18 years in 1980 and arterial pulse wave velocity and carotid artery distensibility measured 21 or 27 years later in adulthood. Higher family SES in childhood was associated with lower arterial stiffness in adulthood; carotid artery distensibility being higher (β value±SE, 0.029±0.0089%/10 mm Hg; P=0.001) and pulse wave velocity lower (β value±SE, -0.062±0.022 m/s; P=0.006) among those with higher family SES in a multivariable analysis adjusted with age, sex, and conventional childhood cardiometabolic risk factors. The association remained significant after further adjustment for participant's SES in adulthood (β value±SE, 0.026±0.010%/10 mm Hg; P=0.01 for carotid artery distensibility and β value±SE, -0.048±0.023 m/s; P=0.04 for pulse wave velocity) but attenuated after adjustment for adulthood cardiometabolic risk factors (β value±SE, 0.015±0.008%/10 mm Hg; P=0.08 for carotid artery distensibility and β value±SE, -0.019±0.02 m/s; P=0.38 for pulse wave velocity). In conclusion, we observed an association between higher family SES in childhood and lower arterial stiffness in adulthood. Our findings suggest that special attention could be paid to children from low SES families to prevent cardiometabolic diseases primordially.
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Affiliation(s)
- Elina Puolakka
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.).
| | - Katja Pahkala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Tomi T Laitinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Costan G Magnussen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Nina Hutri-Kähönen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Mika Kähönen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Terho Lehtimäki
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Päivi Tossavainen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Eero Jokinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Matthew A Sabin
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Tomi Laitinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Marko Elovainio
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Laura Pulkki-Råback
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Jorma S A Viikari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Olli T Raitakari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
| | - Markus Juonala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (E.P., K.P., T.T.L., C.G.M., O.T.R., M.J.), Department of Physical Activity and Health, Sports and Exercise Medicine Unit, Paavo Nurmi Centre (K.P., T.T.L.), and Department of Medicine (J.S.A.V., M.J.), University of Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.); Department of Pediatrics (N.H.-K.) and Department of Clinical Physiology (M.K.), Tampere University Hospital and University of Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland (T. Lehtimäki); Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Finland (P.T.); Department of Pediatric Cardiology, Hospital for Children and Adolescents (E.J.), Unit of Personality, Work, and Health, Institute of Behavioural Sciences (M.E., L.P.-R.), and Helsinki Collegium for Advanced Studies, University of Helsinki, Finland (L.P.-R.); Murdoch Childrens Research Institute, Royal Children's Hospital, Australia (M.A.S.); Department of Pediatrics, University of Melbourne, Victoria, Australia (M.A.S.); Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland (T. Laitinen); Division of Medicine, Turku University Hospital, Finland (J.S.A.V., M.J.); and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Finland (O.T.R.)
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Aatola H, Koivistoinen T, Tuominen H, Juonala M, Lehtimäki T, Viikari JSA, Raitakari OT, Kähönen M, Hutri-Kähönen N. Influence of Child and Adult Elevated Blood Pressure on Adult Arterial Stiffness: The Cardiovascular Risk in Young Finns Study. Hypertension 2017; 70:531-536. [PMID: 28674036 DOI: 10.1161/hypertensionaha.117.09444] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/05/2017] [Accepted: 05/01/2017] [Indexed: 01/26/2023]
Abstract
Elevated blood pressure (BP) in childhood has been associated with increased adult arterial stiffness, the independent predictor of cardiovascular and all-cause mortality. The favorable BP change from childhood to adulthood and the risk of high adult arterial stiffness has not been reported. We examined the effect of child and adult BP on pulse wave velocity (PWV) assessed in adulthood among 1540 white adults followed-up for 27 years since baseline (1980, aged 6-18 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood, BP was classified as elevated if systolic BP ≥120 mm Hg, diastolic BP ≥80 mm Hg, or self-reported use of antihypertensive medications. PWV was measured in 2007 by whole-body impedance cardiography, and high PWV was defined as values at or above the age-, sex-, and heart rate-specific 80th percentile. Individuals with persistently elevated BP and individuals with normal child but elevated adult BP had increased risk of high adult PWV (relative risk [95% confidence interval], 3.18 [2.22-4.55] and 2.64 [1.79-3.88], respectively) in comparison with individuals with normal (both child and adult) BP. In contrast, individuals with elevated BP in childhood but not in adulthood did not have significantly increased risk of high PWV (relative risk [95% confidence interval], 1.26[0.80-1.99]). The results were consistent when different definitions for child and adult elevated BP were applied. These findings highlight the importance of BP control in the primary prevention of cardiovascular diseases.
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Affiliation(s)
- Heikki Aatola
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland.
| | - Teemu Koivistoinen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Heikki Tuominen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Markus Juonala
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Terho Lehtimäki
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Jorma S A Viikari
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Olli T Raitakari
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Mika Kähönen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Nina Hutri-Kähönen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
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Chahal N, Rush J, Manlhiot C, Boydell KM, Jelen A, McCrindle BW. Dyslipidemia management in overweight or obese adolescents: A mixed-methods clinical trial of motivational interviewing. SAGE Open Med 2017; 5:2050312117707152. [PMID: 28567283 PMCID: PMC5438108 DOI: 10.1177/2050312117707152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 03/29/2017] [Indexed: 11/23/2022] Open
Abstract
Background: Lifestyle management for dyslipidemic adolescents often occurs in the context of family-centered care, which necessitates adaptation of counseling strategies. Objective: To determine the effectiveness of motivational interviewing for lifestyle behavior change for dyslipidemic adolescents in a dyad with a parent versus alone. Methods: A total number of 32 adolescents were randomized 1:1 to receive a series of motivational interviewing sessions either together with a parent or alone for a 6-month intervention, with both quantitative and qualitative assessment of outcomes. Results: Both groups were similar at baseline. Following the intervention, there were no significant differences between groups in physical, laboratory, lifestyle or psychosocial measures, except for a reduction in dietary fats/sugars (p = 0.02) and in screen time (p = 0.02) in the alone group. When both groups were combined, significant reductions at 6 months were noted for body mass index (p < 0.001), waist circumference (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein cholesterol (p < 0.001), triglycerides (p = 0.01), non–high-density lipoprotein cholesterol (p < 0.001), fasting insulin (p = 0.01), and homeostatic model (p = 0.02). Reduced screen time and increased fruit and vegetable intake were also noted for both groups combined. These changes were also reflected in self-efficacy (p = 0.004), self-esteem (p = 0.03), and improvement in quality of life measures. Interview data provided insights into the utility and acceptability of the motivational interviewing intervention. Conclusion: Motivational interviewing was an efficient strategy for inspiring healthy lifestyle and physiological changes among adolescents in both groups. Family centered pediatric approaches should consider the autonomy and individual preferences of the adolescent prior to counseling.
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Affiliation(s)
- Nita Chahal
- Labatt Family Heart Centre, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - Janet Rush
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Cedric Manlhiot
- Labatt Family Heart Centre, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - Katherine M Boydell
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Ahlexxi Jelen
- Labatt Family Heart Centre, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
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Rodríguez-Martin C, Alonso-Domínguez R, Patino-Alonso MC, Gómez-Marcos MA, Maderuelo-Fernández JA, Martin-Cantera C, García-Ortiz L, Recio-Rodríguez JI. The EVIDENT diet quality index is associated with cardiovascular risk and arterial stiffness in adults. BMC Public Health 2017; 17:305. [PMID: 28390406 PMCID: PMC5385012 DOI: 10.1186/s12889-017-4194-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 03/21/2017] [Indexed: 02/07/2023] Open
Abstract
Background We aimed to simplify information from food frequency questionnaires (FFQs) in a single parameter that allows for rapid identification of quality of patient diet and its relationship to cardiovascular risk and pulse wave velocity (PWV). Methods The sample from the EVIDENT study, consisting of 1553 subjects (aged 20–80 years) with no cardiovascular disease selected by random sampling among those attending primary care clinics, was used. The EVIDENT diet index (range 0–100) was calculated based on the results of a FFQ. Evaluation of dietary habits also included adherence to the Mediterranean diet (MD). Cardiovascular risk was estimated, and carotid-femoral pulse wave velocity was measured. Results Mean subject age was 54.9 ± 13.8 years, and 60.3% of subjects were female. The mean value of the EVIDENT diet index was 52.1 ± 3.2 points. Subjects in the third tertile (the highest score) had the greatest adherence to MD and the highest energy intake, with greater amounts of carbohydrates, protein, and fiber. The best cut-off point of the EVIDENT diet index for predicting good adherence to the MD is 52.3 (0.71 sensitivity, 0.61 specificity). In a multiple regression analysis, after a complete adjustment, it was estimated that for each one-point increase in the EVIDENT diet index, cardiovascular risk (CVR), blood-pressure, waist circumference, and PWV decreased by 0.14, 0.43, 0.24, and 0.09 respectively (p < 0.05, all). Conclusions The diet quality index developed is associated to CVR and its components, and also with arterial stiffness, as measured with PWV. This index is also a good predictor of adherence to MD.
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Affiliation(s)
- Carmela Rodríguez-Martin
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - María C Patino-Alonso
- Department of statistics, University of Salamanca, Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Department of medicine, University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - José A Maderuelo-Fernández
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - Carlos Martin-Cantera
- Passeig de Sant Joan Health Center, Catalan Health Service, Spanish Network for Preventive Activities and Health Promotion (redIAPP), Barcelona, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Department of biomedical and diagnostic sciences, University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - José I Recio-Rodríguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), Department of Nursing and Physiotherapy, University of Salamanca, Avda. Comuneros N° 27, 37003, Salamanca, Spain.
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Racial Differences in Aortic Stiffness in Children. J Pediatr 2017; 180:62-67. [PMID: 27817877 PMCID: PMC5183467 DOI: 10.1016/j.jpeds.2016.09.071] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/06/2016] [Accepted: 09/29/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate racial differences in central blood pressure and vascular structure/function as subclinical markers of atherosclerotic cardiovascular disease in children. STUDY DESIGN This cross-sectional study recruited 54 African American children (18 female, 36 male; age 10.5 ± 0.9 years) and 54 white children (27 female, 26 male; age 10.8 ± 0.9 years) from the Syracuse City community as part of the Environmental Exposures and Child Health Outcomes study. Participants underwent blood lipid and vascular testing on 2 separate days. Carotid artery intima-media thickness and aortic stiffness were measured by ultrasonography and carotid-femoral pulse wave velocity, respectively. Blood pressure was assessed at the brachial artery and estimated in the carotid artery using applanation tonometry. RESULTS African American children had significantly higher pulse wave velocity (4.8 ± 0.8 m/s) compared with white children (4.2 ± 0.7 m/s; P < .05), which remained significant after adjustment for confounding variables including socioeconomic status. African American children had significantly higher intima-media thickness (African American 0.41 ± 0.06, white 0.39 ± 0.05 mm), and carotid systolic blood pressure (African American 106 ± 11, white 102 ± 8 mm Hg; P < .05) compared with white children, although these racial differences were no longer present after covariate adjustments for height. CONCLUSIONS Racial differences in aortic stiffness are present in childhood. Our findings suggest that racial differences in subclinical cardiovascular disease occur earlier than previously recognized.
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Effects of combined healthy lifestyle factors on functional vascular aging: the Rotterdam Study. J Hypertens 2016; 34:853-9. [PMID: 26882039 DOI: 10.1097/hjh.0000000000000861] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate whether components of a healthy lifestyle, combined and individually, are associated with arterial stiffness as a marker of functional vascular aging. METHODS We included 3235 participants aged 61-96 years from the Rotterdam Study. Measures of arterial stiffness included: aortic pulse wave velocity and carotid distensibility coefficient. Participants were scored one point for each of healthy lifestyle factors: consumption of five or more of fruits and/or vegetables per day, 75 min or more vigorous physical activity per week, 18.5 ≤ BMI ≤ 24. 9, never smoked and light-to-moderate alcohol intake (maximum seven glasses for women and 14 glasses for men) per week. Also a combined score (0-5) was computed by adding the five factors. Linear regression analysis was used to evaluate the association of healthy lifestyle and measures of arterial stiffness adjusting for confounders. RESULTS Participants had -0.113 [95% confidence interval (CI): -0.196, -0.029] difference in mean aortic pulse wave velocity m/s per unit increment of the lifestyle factors score, independent of cardiovascular risk factors. Higher fruit and vegetable consumption -0.221 (95% CI: -0.409, -0.034) and physical activity -0.239 (95% CI: -0.433, -0.044) were also significantly associated with reduced aortic pulse wave velocity. The corresponding estimates in carotid distensibility coefficient lacked statistical significance when we adjusted for cardiovascular risk factors. CONCLUSION Combining multiple healthy lifestyle factors is associated with reduced aortic stiffness, a measure of functional vascular aging and independent of cardiovascular risk factors.
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Jarpe-Ratner E, Folkens S, Sharma S, Daro D, Edens NK. An Experiential Cooking and Nutrition Education Program Increases Cooking Self-Efficacy and Vegetable Consumption in Children in Grades 3-8. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:697-705.e1. [PMID: 27575849 DOI: 10.1016/j.jneb.2016.07.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/21/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Evaluate the effect of a community-based, experiential cooking and nutrition education program on consumption of fruits and vegetables and associated intermediate outcomes in students from low-income families. DESIGN Quasi-experimental program evaluation by pre-post survey of participating students and their parents. SETTING Underserved elementary and middle schools in Chicago. PARTICIPANTS Students (n = 271; 65% girls, 44% Hispanic, 32% African American; 94% eligible for free/reduced price lunch) in grades 3-8 selected by school staff to participate by variable inclusion criteria. 59% of students who applied returned both pre- and post-surveys. INTERVENTION(S) Ten-week (2 h/wk) chef-instructor-led program held in cafeteria kitchens after school. MAIN OUTCOME MEASURE(S) Changes in student nutrition knowledge, cooking self-efficacy, fruit and vegetable liking and consumption, and communication to family about healthy eating. ANALYSIS Changes from beginning to end of program were analyzed with paired t test. Results were considered significant at P < .05. RESULTS Increased nutrition knowledge score from 0.6 to 0.8, cooking self-efficacy score from 3.2 to 3.6, and vegetable consumption score from 2.2 to 2.4 (all P < .05). Increased score for communication about healthy eating (4.1 to 4.4; P < .05) 6 months after the end of the course. CONCLUSIONS AND IMPLICATIONS Experiential cooking and nutrition education programs led by chef-instructors may be effective ways to improve nutrition in low-income communities.
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Abnormalities of vascular structure and function in pediatric hypertension. Pediatr Nephrol 2016; 31:1061-70. [PMID: 26275663 PMCID: PMC4754169 DOI: 10.1007/s00467-015-3188-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/01/2015] [Accepted: 07/27/2015] [Indexed: 12/17/2022]
Abstract
Hypertension is associated with adverse cardiovascular (CV) events in adults. Measures of vascular structure and function, including increased carotid intima-media thickness (cIMT) and elevated arterial stiffness predict hard CV events in adulthood. Newer data suggest that abnormalities in target organ damage are occurring in adolescents and young adults with high blood pressure. In this review, we discuss the techniques for measuring vascular dysfunction in young people and the evidence linking blood pressure levels to this type of target organ damage.
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Petersen KS, Clifton PM, Lister N, Keogh JB. Effect of Improving Dietary Quality on Arterial Stiffness in Subjects with Type 1 and Type 2 Diabetes: A 12 Months Randomised Controlled Trial. Nutrients 2016; 8:nu8060382. [PMID: 27338467 PMCID: PMC4924222 DOI: 10.3390/nu8060382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/30/2016] [Accepted: 06/15/2016] [Indexed: 01/17/2023] Open
Abstract
People with diabetes have accelerated arterial stiffening. The aim of this study was to determine the effect of increasing fruit, vegetable and dairy intake for 12 months on carotid femoral pulse wave velocity (cfPWV), augmentation index (AIx), and central blood pressure (cBP), compared to a usual diet control, in people with type 1 and type 2 diabetes. In a 12 months randomised controlled trial, cfPWV, AIx and cBP were measured every 3 months. The intervention group received dietary counselling to increase consumption of fruit (+1 serving/day; 150 g/day), vegetables (+2 servings/day; 150 g/day) and dairy (+1 serving/day; 200–250 g/day) at baseline, 1, 3, 6 and 9 months. The control group continued on their usual diet. One hundred and nine participants were randomised and 92 (intervention n = 45; control n = 47) completed. At 3 months, fruit (184 g/day; p = 0.001) and dairy (83 g/day; p = 0.037) intake increased in the intervention group compared with the control group but this increase was not maintained at 12 months. After adjustment for baseline measurements there was no time by treatment effect for central systolic or diastolic BP, AIx or cfPWV. A time effect existed for AIx which modestly increased over time. Peripheral diastolic BP and central pulse pressure were improved in the intervention group compared with the control group at 12 months. In the cohort with type 1 and type 2 diabetes, improving dietary quality by increasing consumption of fruit, vegetables and dairy did not improve cBP, AIx or cfPWV, compared with a control group continuing on their usual diet, after 12 months.
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Affiliation(s)
- Kristina S Petersen
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australia.
| | - Peter M Clifton
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australia.
| | - Natalie Lister
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australia.
| | - Jennifer B Keogh
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australia.
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Petersen K, Blanch N, Keogh J, Clifton P. Weight Loss, Dietary Intake and Pulse Wave Velocity. Pulse (Basel) 2015; 3:134-40. [PMID: 26587462 DOI: 10.1159/000435792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.
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Affiliation(s)
- Kristina Petersen
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Natalie Blanch
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Jennifer Keogh
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Peter Clifton
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
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Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, Heffernan KS, Lakatta EG, McEniery CM, Mitchell GF, Najjar SS, Nichols WW, Urbina EM, Weber T. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension 2015; 66:698-722. [PMID: 26160955 DOI: 10.1161/hyp.0000000000000033] [Citation(s) in RCA: 969] [Impact Index Per Article: 107.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Kavey REW. Combined dyslipidemia in childhood. J Clin Lipidol 2015; 9:S41-56. [PMID: 26343211 DOI: 10.1016/j.jacl.2015.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/21/2015] [Accepted: 06/05/2015] [Indexed: 01/19/2023]
Abstract
Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed.
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Affiliation(s)
- Rae-Ellen W Kavey
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
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Endothelial function, arterial stiffness and adherence to the 2010 Dietary Guidelines for Americans: a cross-sectional analysis. Br J Nutr 2015; 113:1773-81. [PMID: 25885520 DOI: 10.1017/s0007114515000859] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Endothelial dysfunction and arterial stiffness are early predictors of CVD. Intervention studies have suggested that diet is related to vascular health, but most prior studies have tested individual foods or nutrients and relied on small samples of younger adults. The purpose of the present study was to examine the relationships between adherence to the 2010 Dietary Guidelines for Americans and vascular health in a large cross-sectional analysis. In 5887 adults in the Framingham Heart Study Offspring and Third Generation cohorts, diet quality was quantified with the 2010 Dietary Guidelines Adherence Index (DGAI-2010). Endothelial function was assessed via brachial artery ultrasound and arterial stiffness via arterial tonometry. In age-, sex- and cohort-adjusted analyses, a higher DGAI-2010 score (greater adherence) was modestly associated with a lower resting flow velocity, hyperaemic response, mean arterial pressure, carotid-femoral pulse wave velocity (PWV), and augmentation index, but not associated with resting arterial diameter or flow-mediated dilation (FMD). In multivariable models adjusting for cardiovascular risk factors, only the association of a higher DGAI-2010 score with a lower baseline flow velocity and augmentation index persisted (β = - 0·002, P= 0·003 and β = - 0·05 ± 0·02, P< 0·001, respectively). Age-stratified multivariate-adjusted analyses suggested that the relationship of higher DGAI-2010 scores with lower mean arterial pressure, PWV and augmentation index was more pronounced among adults younger than 50 years. Better adherence to the 2010 Dietary Guidelines for Americans, particularly in younger adults, is associated with a lower peripheral blood flow velocity and arterial wave reflection, but not FMD. The present results suggest a link between adherence to the Dietary Guidelines and favourable vascular health.
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Cayres SU, de Lira FS, Machado-Rodrigues AM, Freitas Júnior IF, Barbosa MF, Fernandes RA. The mediating role of physical inactivity on the relationship between inflammation and artery thickness in prepubertal adolescents. J Pediatr 2015; 166:924-9. [PMID: 25661410 DOI: 10.1016/j.jpeds.2014.12.057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/12/2014] [Accepted: 12/18/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice. STUDY DESIGN The sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 ± 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity. RESULTS In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipoprotein-cholesterol (β = -5.797 [-11.500 to -0.093]), femoral IMT (β = 0.062 [0.008-0.116]), and the sum of femoral and carotid IMT (β = 1.107 [0.223-1.919]), but only in the group without sports participation. Slopes of the crude linear regression were greater in the group without sports participation for femoral IMT (t = 2.621; P = .009) and the sum of femoral and carotid IMT (t = 2.876; P = .004) when compared with the group with sports participation. CONCLUSION Independent of body fatness and biological maturation, inflammatory status was related to artery IMT and dyslipidemia in prepubertal adolescents, modulated by sport participation.
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Affiliation(s)
- Suziane Ungari Cayres
- Post-Graduate Program in Movement Sciences, São Paulo State University-UNESP, Rio Claro, Brazil; Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, São Paulo State University-UNESP, Presidente Prudente, São Paulo, Brazil.
| | - Fábio Santos de Lira
- Post-Graduate Program in Movement Sciences, São Paulo State University-UNESP, Rio Claro, Brazil; Immunometabolism Research Group, Department of Physical Education, São Paulo State University-UNESP, Presidente Prudente, São Paulo, Brazil
| | | | - Ismael Forte Freitas Júnior
- Post-Graduate Program in Movement Sciences, São Paulo State University-UNESP, Rio Claro, Brazil; Immunometabolism Research Group, Department of Physical Education, São Paulo State University-UNESP, Presidente Prudente, São Paulo, Brazil
| | | | - Rômulo Araújo Fernandes
- Post-Graduate Program in Movement Sciences, São Paulo State University-UNESP, Rio Claro, Brazil; Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, São Paulo State University-UNESP, Presidente Prudente, São Paulo, Brazil
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Blanch N, Clifton PM, Keogh JB. A systematic review of vascular and endothelial function: effects of fruit, vegetable and potassium intake. Nutr Metab Cardiovasc Dis 2015; 25:253-266. [PMID: 25456155 DOI: 10.1016/j.numecd.2014.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 01/16/2023]
Abstract
AIM To review the relationships between: 1) Potassium and endothelial function; 2) Fruits and vegetables and endothelial function; 3) Potassium and other measures of vascular function; 4) Fruits and vegetables and other measures of vascular function. DATA SYNTHESIS An electronic search for intervention trials investigating the effect of potassium, fruits and vegetables on vascular function was performed in MEDLINE, EMBASE and the Cochrane Library. Potassium appears to improve endothelial function with a dose of >40 mmol/d, however the mechanisms for this effect remain unclear. Potassium may improve measures of vascular function however this effect may be dependent on the effect of potassium on blood pressure. The effect of fruit and vegetables on endothelial function independent of confounding variables is less clear. Increased fruit and vegetable intake may improve vascular function only in high risk populations. CONCLUSION Increasing dietary potassium appears to improve vascular function but the effect of increasing fruit and vegetable intake per se on vascular function is less clear.
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Affiliation(s)
- N Blanch
- School of Pharmacy and Medical Science, University of South Australia, Australia
| | - P M Clifton
- School of Pharmacy and Medical Science, University of South Australia, Australia
| | - J B Keogh
- School of Pharmacy and Medical Science, University of South Australia, Australia.
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Vigorous physical activity and carotid distensibility in young and mid-aged adults. Hypertens Res 2015; 38:355-60. [PMID: 25693850 DOI: 10.1038/hr.2015.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 12/09/2014] [Accepted: 12/12/2014] [Indexed: 11/09/2022]
Abstract
Although physical activity (PA) improves arterial distensibility, it is unclear which type of activity is most beneficial. We aimed to examine the association of different types of PA with carotid distensibility (CD) and the mechanisms involved. Data included 4503 Australians and Finns aged 26-45 years. Physical activity was measured by pedometers and was self-reported. CD was measured using ultrasound. Other measurements included resting heart rate (RHR), cardiorespiratory fitness (CRF), blood pressure, biomarkers and anthropometry. Steps/day were correlated with RHR (Australian men r = -0.10, women r = - 0.14; Finnish men r = -0.15, women r = -0.11; P<0.01), CRF and biochemical markers, but not with CD. Self-reported vigorous leisure-time activity was more strongly correlated with RHR (Australian men r = -0.23, women r = -0.19; Finnish men r = -0.20, women r = -0.13; P < 0.001) and CRF, and was correlated with CD (Australian men r = 0.07; Finnish men r = 0.07, women r = 0.08; P < 0.05). This relationship of vigorous leisure-time activity with CD was mediated by RHR independently of potential confounders. In summary, vigorous leisure-time PA but not total or less intensive PA was associated with arterial distensibility in young to mid-aged adults. Promotion of vigorous PA is therefore recommended among this population. RHR was a key intermediary factor explaining the relationship between vigorous PA and arterial distensibility.
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Kaikkonen JE, Mikkilä V, Juonala M, Keltikangas-Järvinen L, Hintsanen M, Pulkki-Råback L, Viikari JSA, Kähönen M, Lehtimäki T, Telama R, Raitakari OT. Factors associated with six-year weight change in young and middle-aged adults in the Young Finns Study. Scandinavian Journal of Clinical and Laboratory Investigation 2015; 75:133-44. [PMID: 25600675 DOI: 10.3109/00365513.2014.992945] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine factors associated with weight change and obesity risk in young and middle-aged adults. SUBJECTS/METHODS The Young Finns Study with its 923 women and 792 men aged 24-39 years at baseline were followed for six years. Variables associated with the weight change were investigated with regression models. RESULTS The average weight change was 0.45 kg/year in women and 0.58 kg/year in men. In women, weight change was steady across all ages. In men, weight changes were more pronounced in younger age groups. In women (weight gain > 2 kg, n = 490), medication for anxiety, low occupational status, high baseline BMI (body mass index), high intake of sweet beverages, high childhood BMI, high salt (NaCl and/or KCl) use, low number of children, low childhood family income, high stature and low level of dependence (a temperament subscale) were associated with increased weight gain (in the order of importance). In men (weight gain > 2 kg, n = 455), high stature, high intake of french fries, low intake of sweet cookies, young age, recent divorce, low intake of cereals, high intake of milk, depressive symptoms, rural childhood origin, high baseline BMI and unemployment were associated with more pronounced weight gain. Sedentarity (screen-time) was associated with weight gain only in young men. Physical activity and genetic risk for high BMI (score of 31 known variants) were not consistently associated with weight change. CONCLUSIONS Socio-economic factors, temperamental and physical characteristics, and some dietary factors are related with weight change in young/middle-aged adults. The weight change occurring in adulthood is also determined by childhood factors, such as high BMI and low family income.
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Affiliation(s)
- Jari E Kaikkonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku , Turku , Finland
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Petersen KS, Keogh JB, Meikle PJ, Garg ML, Clifton PM. Dietary predictors of arterial stiffness in a cohort with type 1 and type 2 diabetes. Atherosclerosis 2014; 238:175-81. [PMID: 25528424 DOI: 10.1016/j.atherosclerosis.2014.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/02/2014] [Accepted: 12/06/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the dietary predictors of central blood pressure, augmentation index and pulse wave velocity (PWV) in subjects with type 1 and type 2 diabetes. METHODS Participants were diagnosed with type 1 or type 2 diabetes and had PWV and/or pulse wave analysis performed. Dietary intake was measured using the Dietary Questionnaire for Epidemiological Studies Version 2 Food Frequency Questionnaire. Serum lipid species and carotenoids were measured, using liquid chromatography electrospray ionization-tandem mass spectrometry and high performance liquid chromatography, as biomarkers of dairy and vegetable intake, respectively. Associations were determined using linear regression adjusted for potential confounders. RESULTS PWV (n = 95) was inversely associated with reduced fat dairy intake (β = -0.01; 95% CI -0.02, -0.01; p = 0 < 0.05) in particular yoghurt consumption (β = -0.04; 95% CI -0.09, -0.01; p = 0 < 0.05) after multivariate adjustment. Total vegetable consumption was negatively associated with PWV in the whole cohort after full adjustment (β = -0.04; 95% CI -0.07, -0.01; p < 0.05). Individual lipid species, particularly those containing 14:0, 15:0, 16:0, 17:0 and 17:1 fatty acids, known to be of ruminant origin, in lysophosphatidylcholine, cholesterol ester, diacylglycerol, phosphatidylcholine, sphingomyelin and triacylglycerol classes were positively associated with intake of full fat dairy, after adjustment for multiple comparisons. However, there was no association between serum lipid species and PWV. There were no dietary predictors of central blood pressure or augmentation index after multivariate adjustment. CONCLUSION In this cohort of subjects with diabetes reduced fat dairy intake and vegetable consumption were inversely associated with PWV. The lack of a relationship between serum lipid species and PWV suggests that the fatty acid composition of dairy may not explain the beneficial effect.
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Affiliation(s)
- K S Petersen
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia.
| | - P J Meikle
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.
| | - M L Garg
- Nutraceuticals Research Group, 305C Medical Science Building, University of Newcastle, Callaghan, Australia.
| | - P M Clifton
- School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia.
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Hjelt S, Aatola H, Kähönen M, Juonala M, Koivistoinen T, Lehtimäki T, Viikari JSA, Raitakari OT, Laitinen T, Hutri-Kähönen N. Association of thyrotropin with arterial pulse wave velocity in young adults: The Cardiovascular Risk in Young Finns Study. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:716-21. [DOI: 10.3109/00365513.2014.953994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Siiri Hjelt
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital,
Tampere
| | - Heikki Aatola
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital,
Tampere
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital,
Tampere
| | - Markus Juonala
- Department of Medicine, Turku University Hospital and University of Turku,
Turku
- the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku,
Turku
| | - Teemu Koivistoinen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital,
Tampere
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital, and School of Medicine, University of Tampere,
Tampere
| | - Jorma S. A. Viikari
- Department of Medicine, Turku University Hospital and University of Turku,
Turku
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital and University of Turku,
Turku
- the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku,
Turku
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, and Kuopio University Hospital,
Kuopio, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital,
Tampere
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When to prevent cardiovascular disease? As early as possible: lessons from prospective cohorts beginning in childhood. Curr Opin Cardiol 2014; 28:561-8. [PMID: 23928921 DOI: 10.1097/hco.0b013e32836428f4] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW To detail recent developments linking modifiable youth risk factors with preclinical markers of cardiovascular disease such as carotid artery intima-media thickness, pulse-wave velocity (PVW) and large artery stiffness, brachial artery flow-mediated dilatation, left ventricular geometry, and coronary artery calcification in adulthood. RECENT FINDINGS Population-based data from prospective cohort studies beginning in youth with follow-up into adulthood have shown that the modifiable youth risk factors of elevated blood lipids, blood pressure, and adiposity, smoking (active and passive), metabolic disorders, physical inactivity, low cardiorespiratory fitness, and diet associate with preclinical markers of cardiovascular disease in adulthood. The data suggest that, in some instances, those who amend their trajectory by not maintaining these risk factors into adulthood experience reductions in preclinical markers to levels associated with never having had the risk factor. SUMMARY Though avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. Health-enhancing changes in the rates of active and passive smoking, adiposity, increased physical activity, accentuated fitness, modified diet, and socioeconomic position in the transition from youth to adulthood might be important in modifying an individual's trajectory from high risk in youth to low risk in adulthood.
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Aatola H, Hutri‐Kähönen N, Juonala M, Laitinen TT, Pahkala K, Mikkilä V, Telama R, Koivistoinen T, Lehtimäki T, Viikari JSA, Raitakari OT, Kähönen M. Prospective relationship of change in ideal cardiovascular health status and arterial stiffness: the Cardiovascular Risk in Young Finns Study. J Am Heart Assoc 2014; 3:e000532. [PMID: 24614756 PMCID: PMC4187504 DOI: 10.1161/jaha.113.000532] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/28/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND In 2010, the American Heart Association defined ideal cardiovascular health as the simultaneous presence of 4 favorable health behaviors (nonsmoking, ideal body mass index, physical activity at goal, and dietary pattern that promotes cardiovascular health) and 3 favorable health factors (ideal levels of total cholesterol, blood pressure, and fasting glucose). The association between a change in ideal cardiovascular health status and pulse wave velocity, a surrogate marker of cardiovascular disease, has not been reported. METHODS AND RESULTS The study cohort consisted of 1143 white adults from the Cardiovascular Risk in Young Finns Study who were followed for 21 years since baseline (1986). This cohort was divided in 2 subgroups: 803 participants (aged 9 to 18 years at baseline) to study the health status change from childhood to adulthood and 340 participants (aged 21 to 24 years at baseline) to study health status change from young adulthood to middle age. The change in the ideal cardiovascular health index was inversely associated with pulse wave velocity (adjusted for age, sex, and heart rate), every 1-point increase corresponded to a 0.09-m/s (P<0.001) decrease in pulse wave velocity in both groups. This association remained significant in subgroups based on the ideal cardiovascular health index at baseline. CONCLUSIONS The change in ideal cardiovascular health status, both from childhood to adulthood and from young adulthood to middle age, was an independent predictor of adult pulse wave velocity. Our results support the concept of ideal cardiovascular health as a useful tool for primordial prevention of cardiovascular disease.
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Affiliation(s)
- Heikki Aatola
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland (H.A., T.K., M.)
| | - Nina Hutri‐Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.)
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland (M.J., J.A.V.)
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.J., T.T.L., K.P., O.T.R.)
| | - Tomi T. Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.J., T.T.L., K.P., O.T.R.)
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.J., T.T.L., K.P., O.T.R.)
- Paavo Nurmi Center, Sports and Exercise Medicine Unit, University of Turku, Turku, Finland (K.P.)
| | - Vera Mikkilä
- Division of Nutrition, University of Helsinki, Helsinki, Finland (V.M.)
| | - Risto Telama
- Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland (R.T.)
| | - Teemu Koivistoinen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland (H.A., T.K., M.)
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere and Tampere University Hospital, Tampere, Finland (T.L.)
- School of Medicine, University of Tampere, Tampere, Finland (T.L., M.)
| | | | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland (O.T.R.)
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.J., T.T.L., K.P., O.T.R.)
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland (H.A., T.K., M.)
- School of Medicine, University of Tampere, Tampere, Finland (T.L., M.)
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